Vol 5, No 2 (2019)

LEADING ARTICLE
CLINICAL AND ANATOMICAL COMPARISONS IN ASSESSING THE QUALITY OF MEDICAL CARE
Kakturskiy L.V., Zayratyants O.V.
Abstract

Purpose of research: To study methodological, organizational and normative problems of comparison of final clinical and pathological-anatomical diagnoses in the Russian Federation on the basis of a review of domestic and foreign publications.

Abstract: Clinical and anatomical comparisons remain the most important function of quality control of medical and diagnostic work. Cases of divergence of diagnoses should be the subject of professional discussion in the medical community with the adoption of appropriate administrative measures to address deficiencies in the provision of medical care. Currently, there is no adequate regulatory regulation of the issue of comparison of clinical and pathological-anatomical diagnoses. This gives rise to many problems, including the subjectivism of the pathologist in the interpretation of the actions of the clinician, the permanent threat of criminal liability of medical workers for misdiagnosis. Penalties for discrepancies in diagnoses imposed by the Сompulsory Health Insurance Fund lead to an artificial underestimation of the divergence of diagnoses in medical organizations and to incorrect statistical accounting. The underestimation of the role of comorbid diseases and the lack of clear norms of their use in the diagnosis create difficulties in the correct assessment of the disease tanatogenesis, limits the analysis of morbidity and mortality for multiple reasons and entails the loss of some of the available information. 

Russian Journal of Forensic Medicine. 2019;5(2):4-10
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ORIGINAL INVESTIGATIONS
THE ANALYSIS OF INDICATORS OF FINAL DISCREPANCIES AND FORENSIC DIAGNOSES IN CASES OF DEATH FROM DISEASES
Maksimov A.V., Kuchuk S.A.
Abstract
The article presents the results of the analysis of the dynamics of the discrepancy between the final and forensic diagnoses in the Moscow region in cases of death from diseases for the period 2014–2018. The scope of the study was 3114 cases of deaths in hospitals of medical organizations and aimed at forensic research to determine the cause of death. The study found that in the Moscow region over the past five years there has been an improvement in the diagnosis of diseases of the circulatory system, respiration, digestion, tumors and tuberculosis. In the analyzed period of time there was a decrease in the specific weight of the discrepancy of diagnoses in cases of death from diseases from 63.7 % to 48.4 %.
Russian Journal of Forensic Medicine. 2019;5(2):11-15
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FIREARMS OF LESION DESTRUCTION: THE ASPECTS OF PSYCHOLOGICAL IMPACT, THE CONCEPT OF RELATIVE PSYCHOLOGICAL STOPPING ACTION
Klevno V.A., Rasnyuk S.V., Vladimirov V.Y.
Abstract
The article presents a comparative assessment of the relative stopping effect of firearms of limited lesion, psychological aspects of the use of non-lethal traumatic weapons. The concept of relative psychological stopping action as one of the characteristics of traumatic weapon and the method of its calculation is offered to application.
Russian Journal of Forensic Medicine. 2019;5(2):16-20
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PATHOMORPHOLOGICAL CHANGES IN THE LIVER IN CASE OF POISONING WITH ETHANOL
Travenko E.N., Porodenko V.A.
Abstract
The article analyzes the data of autopsy and pathohistological examination of persons who died from ethanol poisoning against the background of various forms of alcoholic liver damage – adaptive hepatopathy (AGP), steatosis (AS), hepatitis (AG), cirrhosis (AC); assesses the morphological changes of the liver. New data on localization, character, degree of steatosis and fibrosis in liver acinuses were obtained. The results of the study can be used as additional criteria for the diagnosis of acute and chronic ethanol intoxication, which allows to objectify the expert conclusions in the production of forensic medical examination (research) of the corpse.
Russian Journal of Forensic Medicine. 2019;5(2):21-26
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VIRTOPSY
VIRTOPSY – NEW METHOD OF RESEARCH IN NATIONAL PRACTICE OF FORENSIC MEDICINE
Klevno V.A., Chumakova Y.V.
Abstract
The article presents the first national experience of using pre-sectional CT-research in forensic medical expert practice. The first results of implementation of virtopsy in thanatological practice of the Bureau of Forensic Medical Expertise of Moscow Region are presented.
Russian Journal of Forensic Medicine. 2019;5(2):27-31
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VIRTOPSY AFTER FATAL INJURY BY LANDING GEAR OF AN AIRCRAFT BOEING 737
Klevno V.A., Tarkhnishvili G.S., Spitsyna L.I., Mirzonov V.A., Balanyuk E.A.
Abstract
The article presents a rare case of virtopsy of a mortally injured person on the runway by the landing gear of the overclocking Boeing 737 aircraft. A case from the expert practice of the Khimki forensic medical department with preliminary pre-sectional MDCT examination of the corpse (virtual autopsy) and subsequent MDCT anatomical comparison of the results.
Russian Journal of Forensic Medicine. 2019;5(2):32-36
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EXPERT PRACTICE
DEATH FROM INGESTION OF POINTED METAL OBJECTS WITH PERFORATION OF THE STOMACH WALL AND HEART DAMAGE
Nikiforova S.A., Petrova N.E.
Abstract
The article is devoted to the rare occasion of death from ingestion of pointed metallic objects damaged internal organs. Highlight clinical and pathological feature of manifestation of injury of stomach, liver, pancreas, heart, with the development of inflammatory complications.
Russian Journal of Forensic Medicine. 2019;5(2):37-41
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INFRARED SPEСTROMETRY APPLICATION IN PRODUCTION OF MEDICO-CRIMINALISTIC EXAMINATIONS DURING THE PROCESS OF SOLVING FORENSIC MEDICAL EXAMINATION BUREAU TASKS
Zorin Y.V., Luzanova I.S., Svetlolobov D.Y., Shigeev S.V.
Abstract
Material is devoted to the question of infrared spectrometry practical application when conducting diagnostic and identification testings. The method is used to research material evidences in combination with traditional medico-criminalistic methods. Cases from practice are given as examples.
Russian Journal of Forensic Medicine. 2019;5(2):42-48
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DETERMINATION OF ROCURONIUM IN BIOLOGICAL OBJECTS BY HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY / MASS SPECTROMETRY
Matveeva A.A., Fedorova K.V., Lopushanskaya E.M., Kireeva A.V.
Abstract
The article deals with the issue of detection of rocuronium in biological objects. The analysis was performed by high-performance liquid chromatography / mass-spectrometry with “electrospray” ionization. We have a case of forensic practice.
Russian Journal of Forensic Medicine. 2019;5(2):49-51
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EDUCATION
SOME ASPECTS OF IMPROVEMENT OF QUALITY OF OUT-OF-CLASS AND CLASSROOM WORK OF STUDENTS ON OCCUPATION “THE MEDICOLEGAL RESEARCH OF THE CORPSE”
Nedelko N.F., Barinov E.K., Mikheeva N.A.
Abstract
Article is devoted to questions of the organization of the training process and the analysis of efficiency and quality of training of students depending on various ways of the organization and management of process of educational cognitive activity on classes in the subject “Medicolegal Research of a Corpse”.
Russian Journal of Forensic Medicine. 2019;5(2):52-58
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EDITORIAL
THE RESULTS OF THE INTERNATIONAL CONGRESS “TOPICAL ISSUES OF FORENSIC MEDICINE AND EXPERT PRACTICE – 2019”
Yolkina O.E.
Abstract
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Russian Journal of Forensic Medicine. 2019;5(2):59-64
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VLADIMIR VASILIEVICH KHOKHLOV. To the 70th Birthday
Editorial a.
Abstract
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Russian Journal of Forensic Medicine. 2019;5(2):65-66
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