Vol 6, No 1 (2020)

PROFESSIONAL REVIEW
DEVELOPMENT PROSPECTS OF 3D MODELLING IN FORENSIC MEDICINE: BIM-TECHNOLOGY AND 4D MODELLING
Leonov S.V., Shakiryanova Y.P., Pinchuk P.V.
Abstract

The present article provides an overview of the main methods of three-dimensional modelling currently used in various fields of science and practice, including forensic medicine. The possibilities of used methods are described.

The authors introduce the concept of BIM-technology, which allows various methods working in 3D to be applied comprehensively: from photogrammetry and computed tomography to line-of-sight and CAD modelling. The article presents a case involving practical application of BIM-technology within the practical work of a forensic expert. The possibilities of supplementing and expanding the model over time within a single information field (4D modelling) are shown.

Using the example of a specific examination, it is shown for which studies the created BIM-model can be employed, as well as what issues can be solved with its help. To that end, CT data was studied with the subsequent reconstruction of the 3D model of the damaged skull; blood traces were analysed with the subsequent 3D modelling of circumstances at the scene. The following methods were used for the reconstruction: photogrammetry, the finite element method and line-of-sight modelling of gunshot trajectories.

Applied within a situational forensic medical examination, BIM-technologies successfully provided answers to the investigator’s questions: mechanism underlying the formation of blood traces; location of the bleeding source; trajectories of projectiles and their elements; circumstances of the occurrence; position of the shooter; prediction of glass breakage caused by a bullet.

Conclusion. New computer technologies (BIM-technology and 4D modelling) constitute the next step in the development of three-dimensional modelling. Their introduction into the practice of experts will help create a single information field for all objects under study, as well as consider all possible investigative leads as objectively as possible

Russian Journal of Forensic Medicine. 2020;6(1):4-13
views
ORIGINAL INVESTIGATIONS
BONE TISSUE DESTRUCTION AND REGENERATION: FORENSIC MEDICAL ASSESSMENT
Konev V.P., Moskovskiy S.N., Krivoshein A.E., Shishkina Y.O., Korshunov A.S., Goloshubina V.V., Sorokina V.V.
Abstract

Bone regeneration of patients with osteoporosis takes significantly longer than the rehabilitation period of individuals without bone pathology. This is due to the predominance of destructive processes in the setting of osteoblastic reaction weakened by osteoporosis, persistent inflammatory reactions, as well as proliferating connective tissue.

Aim. Тo study the nature and dynamics of processes involved in the destruction and regeneration of bone tissue under various conditions, taking forensic medical assessment into account.

Material and methods. We studied the autopsy and biopsy material of bone tissue using clinical-instrumental and histological research methods.

Results. Using atomic force microscopy, it was found that in individuals with osteoporosis the formation of endosteal callus exhibits features associated with the impaired interlacing of collagen fibres due to the expanded space between them, and, as a result, an impaired connection between osseous structures with a low level of mineralisation.

Conclusion. In accordance with paragraph 24 of Order 194n On the Approval of Medical Criteria for Determining the Severity of Harm to Human Health verified systemic osteoporosis that was the setting for the fracture, which in fact is a pathological fracture, should not be considered as damage to health.

Russian Journal of Forensic Medicine. 2020;6(1):14-20
views
ASSESSMENT OF THE PSYCHOLOGICAL AND EMOTIONAL STATE OF THE PATIENT FOR THE PREVENTION OF CONFLICT SITUATIONS ARISING FROM PROFESSIONAL ERRORS, INADEQUATE PROVISION OF DENTAL CARE AND PERSONAL RESPONSE TO THE DISEASE
Iordanishvili A.K., Barinov E.K., Tytyuk S.Y.
Abstract

Prevention of conflict situations is a relevant issue in clinical dentistry.

Aim. To prevent conflict situations that arise from professional errors and inadequate provision of dental care while considering the internal picture of the disease through the assessment of the psychological and emotional state of the patient.

Material and methods. We assessed the psychological and emotional state of 77 (36 men and 41 women) patients aged 52 to 67 years that had fixed (group 1), removable (group 2) dentures on dental implants (group 3) using the syndrome of psycho-sensory-anatomical and functional (PSAF) maladjustment, as well as considering their satisfaction with dental rehabilitation.

Results. The possibility of identifying clinical cases in which conflicts may arise due to professional errors, inadequate provision of dental care or due to the patient’s personal response to the disease is shown.

Conclusion. In order to prevent patients’ complaints in such clinical situations, it is necessary to ensure the quality dental care and (or) special mental preparation of such patients needs to be completed prior to denture treatment.

Russian Journal of Forensic Medicine. 2020;6(1):21-26
views
DETERMINATION OF INTRAVITAM BODY TYPE IN MEN DRAWING ON THE OSTEOMETRIC CHARACTERISTICS OF SKELETONISED CLAVICLES
Smirnov A.V., Sundukov D.V.
Abstract

One of the major challenges faced by a forensic medical expert when performing the examination of bone remains for the purposes of personal identification is the determination of group characteristics, which include the person’s body type. The present study focuses on a new method for determining the intravitam body type when considering skeletonised remains.

Aim. To develop diagnostic mathematico-statistical models that allow the intravitam body type in men to be determined, drawing on the osteometric characteristics of skeletonised clavicles.

Material and methods. We studied clavicles from the osteological collection held at the Department of Anthropology, Lomonosov Moscow State University (62 adult male skeletons) according to the expanded osteometric program (15 characteristics). The obtained data were processed by StatSoft STATISTICA 10 using multivariate stepwise discriminant analysis (MDA).

Results. We have developed diagnostic models allowing the intravitam body type (ectomorph, mesomorph and endomorph) to be determined on the basis of skeletonised clavicles with an accuracy of 62.9–79 %. Using the proposed models, a more accurate determination of ectomorphs and mesomorphs (90 %) than endomorphs (41–58.8 %) is observed. In order to increase the objectiveness of the expert’s conclusion, we used function Pl showing the probability of correct body type classification in every single case.
The diagnostic models were successfully verified using the skeletal samples held at the Peter the Great Museum of Anthropology and Ethnography, with the maximum accuracy level reaching 80 %.

Russian Journal of Forensic Medicine. 2020;6(1):27-32
views
PROCEDURE FOR SEX DETERMINATION OF HUMAN SCAPULA
Chertovskikh A.A.
Abstract

The determination of sex drawing on the differences in certain dimensions of skeletal bones constitutes one of the main tasks of forensic medicine and osteology.

Aim. To develop informative and reliable science-based diagnostic criteria for sex determination (as part of personal identification in forensic medicine) on the basis of a number of parameters associated with the scapula, drawing on statistically calculated formulae.

Material and methods. The study included 108 corpses of people, who died aged 19 to 99 years in the Central region of Russia in 2016 from cardiovascular diseases, acute poisoning with ethanol and/or drugs, as well as from concomitant mechanical injuries to the body. Morphometric, osteometric and statistical methods of research were employed, along with a mathematical one when using a software package for the statistical analysis of the material.

Results. New formulae have been obtained that allow sex to be determined on the basis of individual parameters associated with the scapula.

Conclusion. The obtained data will help reliably reduce the number of osteometric studies, shifting focus to the collection of specific material, which will decrease economic and time expenditures on conducting the morphometric studies of bones in general, as well as dramatically increase the evidentiary significance of the examination in criminal proceedings.

Russian Journal of Forensic Medicine. 2020;6(1):33-35
views
SPLEEN TOPOGRAPHY IN AN UPRIGHT BODY POSITION
Levandrovskaya I.A., Aseeva I.A., Pinchuk P.V.
Abstract

The article covers the issues associated with determining spleen topography in living individuals in an up- right body position, as well as assessing the organ displacement during a deep breath and a change in shoulder position. A review of scientific literature revealed that all previous studies on the mechanism underlying spleen injuries are based on the generally accepted topographic location of the organ, which was determined using cadaveric material.

Aim. To determine spleen topography (holotopy and skeletopy) in living individuals (both male and female) of different age groups, as well as to assess the organ displacement during a deep breath and when the shoulder position is changed.

Material and methods. We conducted spleen ultrasound in adults of various age groups (males and females), 30 of whom were also examined in terms of its displacement when the shoulder position was changed. The position of the organ was noted during quiet and deep breathing, as well as when the shoulder position was changed; distance between the reference points was measured with the subsequent statistical analysis of the results.

Results. It was found that the spleen of a quietly breathing person in an upright body position is projected from the lower edge of the 8th left rib to 10th left rib along axillary lines. During a deep breath, the organ is displaced downward, on average by 5.15 ± 1.48 cm (from 3 cm to 8 cm), and slightly, on average by 1.34 ± 1.25 cm, forward (from 1 cm to 4.5 cm). The longitudinal axis of the spleen is perpendicular to that of the rib. Changes in the position of the shoulder in the shoulder joint revealed no spleen displacement.

Conclusion. The obtained data on the topographic location of the spleen will allow forensic medical experts to establish as objectively as possible the mechanism underlying spleen damage in terms of locating injurious exposure.

Russian Journal of Forensic Medicine. 2020;6(1):36-40
views
EXPERT PRACTICE
VIRTOPSY FOR STUDYING THE SUDDEN DEATH OF AN ADOLESCENT
Klevno V.A., Chumakova Y.V., Korotenko O.A., Sandu D.I., Dubrova S.E.
Abstract

The article discusses the application of pre-autopsy computed tomography (Virtopsy) for studying the sudden death of an adolescent with undiagnosed Marfan syndrome.

Aim. To identify the capabilities of the pre-autopsy computed tomography (CT) in determining the cause of the sudden death of an adolescent, as well as the extent of injuries, if present.

Material and methods. A CT scan was obtained at the Department of Diagnostic Radiology of a district hospital using a modern multifunctional CT scanner Siemens SOMATOM Perspective (64-slice configuration, slice width of 1.5 mm).

Results. The forensic medical examination revealed the following information about the corpse: asthenic body type, a height of 178 cm, long extremities, thin and long spider-like fingers, pectus excavatum, little fat beneath the skin and poor muscle development; blood in the pericardium, rupture of the dissecting aneurysm of the ascending aorta. The histological examination of the aorta revealed its dramatic thinning, fragmentation of the elastic fibres along with the alteration of the elastic framework, fragmentation and poor development of muscle fibres in the media. A CT scan showed the rupture of the dissecting aneurysm of the ascending thoracic aorta with para-aortic haematoma and cardiac tamponade.

Conclusion. The analysis of obtained data allowed us to diagnose a multisystemic disorder of connective tissue (Marfan syndrome) undiagnosed intra vitam. The sudden death was caused by the rupture of the dissecting aneurysm of the ascending aorta which is a complication of the congenital genetic pathology.

Intravitam CT or MRI scans of children being at risk of the multisystemic disorder of connective tissue will help detect pathological changes in the aortic wall and perform cardiac surgery promptly which would significantly increase the length of life and improve its quality for such patients.

Russian Journal of Forensic Medicine. 2020;6(1):41-45
views
MANUAL FOR THE FORENSIC MEDICAL EXPERT
INTERNAL QUALITY CONTROL OF FORENSIC MEDICAL EXAMINATIONS IN CASES INVOLVING FAILURE TO PROVIDE MEDICAL CARE
Barinov E.K., Mikheeva N.A., Kalinin R.E., Tarasova N.V.
Abstract

The poor quality of expert reports prepared at the stage of preliminary investigation constitutes the main reason for summoning expert witnesses to testify before a court of law and posing numerous questions to them. The same applies to the examinations conducted on case materials, both in the course of criminal and civil proceedings. Тhe lack of internal quality control over forensic medical examinations in cases related to inadequate medical care may compromise the reliability and scientific validity of conclusions. Forensic medical examinations related to the cases of inadequate medical care constitute the primary source of evidence affecting the validity and legitimacy of decisions made by law enforcement agencies about the criminal liability of medical staff. In addition, scientifically unfounded expert conclusions may lead to investigative and judicial errors.

Conclusion. Strict internal control over the forensic medical examinations is necessary to ensure that state forensic medical institutions produce expert reports fully compliant with the requirements of Law No. 73-FZ, which naturally should begin with a self-check.

Russian Journal of Forensic Medicine. 2020;6(1):46-50
views
GUIDELINES FOR CONDUCTING FORENSIC MEDICAL EXAMINATION IN CASES OF ALCOHOL POISONING
Klevno V.A., Maksimov A.V., Kuchuk S.A., Grigorieva E.N., Zatorkina O.G., Kislov M.A., Krupina N.A., Lysenko O.V., Romanko N.A., Tarasova N.V., Plis S.S.
Abstract

The guidelines for carrying out a forensic medical examination in cases of alcohol poisoning are developed by the working group of the Association of Forensic Medical Experts and posted in the information system of the Ministry of Health of the Russian Federation (Electronic rubric of clinical recommendations, Guidelines section).

The presented guidelines contain structured information on the issues of forensic medical examination in cases of alcohol poisoning: terms and definitions; stages of ethanol biotransformation and variants of thanatogenesis; factors affecting the acceleration or deceleration of ethanol resorption and elimination; principles underlying the diagnosis and differential diagnosis of alcohol poisoning; rules regarding sampling, storage and transportation of biological objects intended for forensic chemical analysis; issues pertaining to the filling-in of a medical certificate of death and assigning a code to it; as well as making a forensic diagnosis.

Differential diagnosis of the cause of death using the procedures given in the guidelines can improve the comprehensiveness, completeness and validity of the forensic medical examination of a corpse in the event of death caused by alcohol poisoning.

Russian Journal of Forensic Medicine. 2020;6(1):51-59
views
INFORMATION
REGISTERED TRADEMARK OF FORENSIC MEDICINE
Klevno V.A., Tarasova N.V., Kononov E.V., Goryachev A.V.
Abstract
The Federal Service for Intellectual Property (Rospatent) registered a trademark of forensic medicine and issued a nationally recognised certificate to the Association of Forensic Medical Experts. The logo draws on the idea of combining continuity and the desire to develop on the modern frontiers of science and practice, in accordance with existing Requirements and Rules.
Russian Journal of Forensic Medicine. 2020;6(1):60-62
views
KLEVNO VLADIMIR ALEKSANDROVICH. TO THE 65th BIRTHDAY
 
Abstract
.
Russian Journal of Forensic Medicine. 2020;6(1):63-64
views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies