Sudebno-Meditsinskaya Ekspertisa最新文献

{"title":"[Analysis of dissertations on forensic medicine devoted to medical errors in cases of improper healthcare delivery over a 15-year period (2009-2023)].","authors":"O D Yagmurov, V A Koryakina, V A Fetisov","doi":"10.17116/sudmed20256803157","DOIUrl":"https://doi.org/10.17116/sudmed20256803157","url":null,"abstract":"<p><p>Results of dissertational researches and scientific researches are traditionally referred to the main sources for improving the quality and level of forensic medical examinations.</p><p><strong>Objective: </strong>To analyze the results of dissertational researches, completed by degree candidates in the «Forensic Medicine» specialty over a 15-year period (2009-2023), devoted to the analysis of medical errors in cases of improper healthcare delivery.</p><p><strong>Material and methods: </strong>An analysis of 16 works (4 doctoral and 12 PhD dissertations), published on the official websites of medical universities and the Russian Center of Forensic Medical Expertise, was done. Sampling methods of bibliometric and scientometric analyses were used.</p><p><strong>Results: </strong>Over a 15-year period, all authors published 379 articles, of which 21 (5.5%) were published in the «Forensic Medical Expertise» journal, 27 (7.1%) - in the «Medical Expertise and Law» journal, the overwhelming majority of articles were published in various medical subject collections, materials of research and practice conferences, congresses, including in 49 peer-reviewed medical journals recommended by the State Commission for Academic Degrees and Titles of the Ministry of Education and Science of the Russian Federation.</p><p><strong>Conclusion: </strong>Expert panel evidences on the «medical» cases indicate the need to expand and further develop joint scientific studies in such clinical disciplines as: «obstetrics and gynecology», «anesthesiology and resuscitation», «pediatric surgery», «oncology», «neonatology», «cardiology», «dentistry», «maxillofacial surgery», etc.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 3","pages":"57-64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fatal non-thrombotic pulmonary embolism in penis enlargement with injections of hyaluronic acid-based drugs].","authors":"S V Shigeev, Yu E Morozov, D V Gornostaev, O A Uspekhova","doi":"10.17116/sudmed20256801159","DOIUrl":"10.17116/sudmed20256801159","url":null,"abstract":"<p><p>Hyaluronic acid is widely used as an injectable dermal filler in medicine, especially in plastic surgery and cosmetology, due to its biocompatibility and non-immunogenicity. However, these manipulations can cause complications, the most threatening of which is non-thrombotic pulmonary embolism. The article presents a not previously described case of this complication development in a 56-year-old man who underwent penis enlargement with unknown hyaluronic acid-based drug. He complained of general health problems, shortness of breath, sweating, weakness, nausea, tremor in the limbs, and had to seek medical attention on the day of intervention. The patient died next morning. A post-injection damage on the glans penis has been revealed in forensic autopsy, a large accumulation of foreign substance with jelly-like consistency has been found in the area of the root of penis, that was confirmed by histological study. The gel has been also found in the lumina of numerous vessels of the lung of different diameter. Spectrographic analysis established the uniformity of foreign substance from the soft tissues of the root of penis and lung vessels, and also allowed to identify it as hyaluronic acid or hyaluronic acid sodium salt. The objective of this article is to inform a wide forensic audience about the possibility of developing fatal non-thrombotic pulmonary embolism associated with hyaluronic acid injections.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 1","pages":"59-62"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Sudden infant death syndrome: diagnostic problems, study algorithm].","authors":"S N Moskovsky, E K Emelyanova, D V Listkova","doi":"10.17116/sudmed2025680215","DOIUrl":"https://doi.org/10.17116/sudmed2025680215","url":null,"abstract":"<p><p>«Sudden infant death syndrome» (SIDS) term unifies cases of non-violent, unexpectedly occurred death of a child under one year of age in the absence of objective data explaining the causes of death, history of disease and postmortem examination.</p><p><strong>Objective: </strong>To identify the diagnostic criteria allowing to determine the immediate cause of death in SIDS.</p><p><strong>Material and methods: </strong>We analyzed data on 64 cases of sudden deaths of infants under 1 year of age between 2016 and 2023. All cases of sudden death) were subjected to forensic medical examination arbitrarily for the purpose of excluding violent cause of death (trauma, poisoning). Judicial committee workers requested and preliminarily studied in detail the medical records. Standards of forensic medical examination, established by regulatory order (federal laws and orders) were applied in the corpse's examination. Exclusion group included cases with confirmed chronic or congenital diseases, as well as cases of violent deaths.</p><p><strong>Results: </strong>The use of an established postmortem examination algorithm and an international standardized autopsy protocol significantly increases the number of identified causes of death, while reducing the frequency of SIDS diagnoses, that in turn allows to improve the quality of health care system work worldwide.</p><p><strong>Conclusion: </strong>It is necessary to develop and implement analogue of used abroad algorithm in the practice of domestic forensic medical experts and pathologists, that will allow to reveal the most frequent causes of death of children, draw attention of medical staff to them and, as a consequence, improve the quality of life-time diagnosis and contribute to the reduction of infant mortality.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 2","pages":"5-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Determination of tissular and species membership of hyaline cartilage microparticles by forensic cytology and enzyme-linked immunosorbent assay methods].","authors":"A A Gusarov, V L Sidorov, N E Surikova, O D Yagmurov","doi":"10.17116/sudmed20256802121","DOIUrl":"https://doi.org/10.17116/sudmed20256802121","url":null,"abstract":"<p><p>The article presents the results of hyaline cartilage microparticles study by forensic cytology and quantitative enzyme-linked immunosorbent assay. Hyaline cartilage cells' polymorphism was demonstrated as a result of the performed forensic cytological study. The high sensitivity of method was confirmed, the indicators of optic density and total IgG concentration were determined, as well as the optimal values of minimal and maximal calibration samples were identified using enzyme-linked immunosorbent assay. The obtained data can be used by experts of forensic units when determining tissular and species membership of hyaline cartilage microparticles by forensic cytology and enzyme-linked immunosorbent assay methods.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 2","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Method of linear calibration function control according to GOST R ISO 11095-2007 for measuring the mass concentration of ethanol].","authors":"M S Zatyamina, L A Smirnova, O V Ostrovskij, D V Kuznetsov","doi":"10.17116/sudmed20256801143","DOIUrl":"10.17116/sudmed20256801143","url":null,"abstract":"<p><strong>Objective: </strong>Implementation of the control method to validate previously obtained calibration functions according to GOST R ISO 11095-2007 using Reference Materials (RM): standard RMs - aqueous solutions of ethanol, produced and certified by the organization, and internal RMs - aqueous solutions of ethanol in different concentrations, developed by the user for internal use.</p><p><strong>Material and methods: </strong>We applied the control method in accordance with the National Standard of the Russian Federation GOST R ISO 11095-2007 using the standard and internal RMs - aqueous ethanol solutions in different concentrations. Measurements were performed for two subranges of ethanol concentrations on standard and internal RMs in accordance with the certified method.</p><p><strong>Results and conclusion: </strong>Control charts based on experimental data confirmed that the system was in a controlled state, and the calibration function required no updates on Day 7. No studied values fell outside the upper and lower control limits on the control charts. The uncertainty of the transformed values was assessed during the calibration function validation.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 1","pages":"43-49"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Uncharacteristic soft tissue injuries detectable in cases of death from general accidental hypothermia].","authors":"A Yu Chudakov, I A Tolmachev, A A Kuznetsova","doi":"10.17116/sudmed20256803120","DOIUrl":"https://doi.org/10.17116/sudmed20256803120","url":null,"abstract":"<p><p>General accidental hypothermia, which leads to death, is a complex problem, the scale of which is significantly underestimated. Statistics on mortality from general deep hypothermia are underreported because the diagnosis is often established after the fact, especially if death occurs in conditions complicating the body discovery or the cause of death determination. Many cases of death, erroneously classified as cardiovascular diseases or other causes, may actually be the result of long-term exposure to cold. In such situations, especially in remote areas or in the absence of proper forensic examination, the true cause of death may remain unknown.</p><p><strong>Objective: </strong>To describe the local signs of human death from hypothermia.</p><p><strong>Material and methods: </strong>In order to establish additional local signs of death from hypothermia, the findings of forensic experts and personal observations on the corpses of people who died from hypothermia on land (150 observations) were analyzed, as well as the personal photo archives of A.Yu. Chudakov.</p><p><strong>Results: </strong>The article describes uncharacteristic but very common soft tissue injuries for death from general hypothermia, including bite wounds of the fingers, abrasions, minor wounds on the back of the hands and fingers, detached nails from terminal self-digging, linear stripe-like abrasions on the face, wounds and bruises on the face and head, areas of the elbow and knee joints, which may indicate events that occurred in the terminal phase and some other data.</p><p><strong>Conclusion: </strong>Diagnosis of death from hypothermia requires a comprehensive approach, including inspection of the accident site (place of the corpse's discovery), analysis of history, external examination, forensic investigation, histological examination, as well as toxicological and other laboratory tests. Only a comprehensive analysis of all the data allows to establish the exact cause of death and exclude other factors. The mechanisms of human behavior in cooling are complex and require further research, including the study of neurochemical processes occurring in the brain under critical hypothermia.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 3","pages":"20-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Features of chemical and toxicological study of 1,4-dihydropyridine derivatives].","authors":"L L Kvachakhiya, V K Shormanov, V V Karnaukhova","doi":"10.17116/sudmed20256802137","DOIUrl":"https://doi.org/10.17116/sudmed20256802137","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the features of 1.4-dihydropyridine derivatives' determination in biological material in chemical and toxicological studies.</p><p><strong>Material and methods: </strong>Liquid-liquid extraction, semi-preparative column chromatography, thin-layer chromatography (TLC) and gas chromatography with mass spectrometric detection (GC-MS) were used as analysis methods.</p><p><strong>Results: </strong>It has been established that extraction of 1.4-dihydropyridine derivatives from biomaterial is most appropriate to be carried out by consecutive (by 30 min) infusion with two portions of acetone-acetonitrile (7.5:2.5) mixture at a mass ratio of the extracting liquid and bioactive matrix equal 2:1. The optimum regimen of 1.4-dihydropyridine derivatives chromatography in C-18 «Silasorb» sorbent column using acetonitrile-aqua (7:3) eluant was determined, that was realized in combined purification including the extraction with ethyl acetate from aqua-acetonitrile medium and column chromatography of analytes. Butanol-acetone (5:5) eluant may be used to identify analytes by TLC method («Sorbfil» plates). Additionally, the identification of 1.4-dihydropyridine derivatives can be performed using GC-MS (HP-5 ms Ultra inert (30 000×0.25 mm) column, immobilized phase is 5% phenyl-95% dimethylpolysiloxane, mobile phase is helium by characteristic retention time and ion sets in the analytes' mass-spectra. The same method was used for quantitative determination of studied compounds. Methods for the determination of amlodipine, nifedipine, nimodipine and felodipine were developed by GC-MS method in biomatrix model (liver tissue), that showed suitability to validation requirements by a number of key criteria. The maximum detectable and quantitatively determinable content levels of studied substances in biomatrix did not exceed 0.04-0.14 and 0.08-0.24 mg/g, respectively.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 2","pages":"37-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Forensic medical characteristics of bullet injuries caused by shots from smoothbore 12-gauge firearms].","authors":"S V Leonov, A V Khodulapov, P V Pinchuk, E N Leonova","doi":"10.17116/sudmed20256801134","DOIUrl":"10.17116/sudmed20256801134","url":null,"abstract":"<p><p>The article presents the results of experimental study of the features of injuries of clothing imitators (coarse calico) and parts of the human body as a result of shots from smoothbore 12-gauge firearms (12×70) with cartridges, equipped with metal alloy and plastic bullets. The distinctive features of morphology of experimental gunshot injuries caused by bullets of different construction have been given.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 1","pages":"34-37"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[On the challenges and shortfalls of expert assessment of maxillofacial injuries with concussions according to medical documents only].","authors":"M O Yagmurov, I A Tolmachev, A P Bozhchenko, Yu A Khrustaleva","doi":"10.17116/sudmed20256801154","DOIUrl":"10.17116/sudmed20256801154","url":null,"abstract":"<p><strong>Objective: </strong>To determine the shortfalls of medical documents for victims with facial injuries and concussions and the related challenges during forensic medical expert assessment of the injury.</p><p><strong>Material and methods: </strong>The medical records of the victims and the reports of forensic examination of living persons were examined.</p><p><strong>Results and conclusion: </strong>Facial injuries with concussion account for about 20% of all examinations of living persons. The morphological essence of the described lesions differs significantly among forensic medical experts and clinical doctors. Clinicians provide an excessive or insufficiently validated diagnosis of concussion, which is not confirmed during forensic medical examination in nearly 40% of cases. Forensic medical experts could determine the nature of trauma based on the study of medical documents only in 68% of cases. The efficacy of in-person expert examinations of victims is low. Some ambiguous provisions of regulations and medical criteria for determining the severity of harm caused to human health allow for arbitrary interpretation.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 1","pages":"54-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Method of autopsy study of thalamus and basal nuclei].","authors":"A S Konakov, Yu S Brikova, E M Koludarova","doi":"10.17116/sudmed20256803143","DOIUrl":"https://doi.org/10.17116/sudmed20256803143","url":null,"abstract":"<p><p>Thalamus and basal nuclei are deep structures of the brain which play a crucial role in regulating consciousness level. Traumatic injuries in them occur in craniocerebral injury (CCI), post-traumatic alterations - at the 2nd stage of dislocation syndrome. Non-traumatic hemorrhages are most often located in these structures. The existing methods of the brain autopsy study have not been effective enough for their focused detailed examination.</p><p><strong>Objective: </strong>To develop the rational and effective method of thalamus and basal nuclei autopsy examination for identification of pathomorphological changes and their characteristics.</p><p><strong>Material and methods: </strong>The brain of 42 males and 31 females aged 18-65 years who died due to CCI at different times of post-traumatic period, as well as 22 males and 25 females aged 35-68 years who died due to various causes of non-violent death, was examined according to autopsy data. The cases were divided into 2 groups for study of the thalamus and basal nuclei: in the 1st group (69 observations) the brain was examined by traditional methods (Virchow, Pitre, Fisher), in the 2nd group (51 observations) - by own developed method.</p><p><strong>Results: </strong>In the 1st study group hemorrhages in thalamus were found in 15% of cases, in basal nuclei - in 12%, in the 2nd group -hemorrhages in thalamus were identified in 32%, in basal nuclei - in 21% of observations. The application of newly developed method of thalamus and basal nuclei autopsy examination has shown its advisability and efficacy.</p><p><strong>Conclusion: </strong>The method of autopsy study of the thalamus and basal nuclei has been developed and proposed for practice that will allow to increase the objectivity and evidence of forensic medical examination of the corpse.</p>","PeriodicalId":35704,"journal":{"name":"Sudebno-Meditsinskaya Ekspertisa","volume":"68 3","pages":"43-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}