Vol 5, No 3 (2019)

PROFESSIONAL REVIEW
THE CHILD ABUSE IN BULGARIA
Kolev Y.G., Radoinova D.D.
Abstract

The problem with violence among children and adolescents is very popular today. The reason is that the cases of aggressive verbal and physical acts on and among children have become very frequent. The better recognition of child rights, problems and needs will contribute to the elaboration of effective policies and practices for improvement of the state of children in Bulgaria. The legislation, procedures and authorities related to child protection in Bulgaria are described. Data collected from different sources concerning child abuse, are presented. The use of forensic medicine in prevention of child abuse is still not fully implemented in government politics. Actual priorities are common with other countries of the region. Many aspects of violence against children remain hidden for the specialized institutions and for the society, because in most cases these acts are not reported or registered. Reasons for this to happen are the lack of social sensitivity and engagement for prevention of violence against children, the ignorance of child’s right to protection and of everyone’s obligation to inform agencies for child protection about children at risk as well. This is not specific for Bulgaria only, but applies to all the European countries.

Russian Journal of Forensic Medicine. 2019;5(3):4-10
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ORIGINAL INVESTIGATIONS
ASSESMENT OF THE RELIABILITY OF FEDERAL STATISTICAL MONITORING DATA ON THE NUMBER AND STRUCTURE OF DIVERGENCES IN THE FINAL CLINICAL AND MEDICO-LEGAL DIAGNOSES
Maksimov A.V., Kuchuk S.A.
Abstract

Objectives. To examine the objectivity and reliability of the branch statistical reporting on the number of deaths and divergences of the final clinical and medico-legal diagnoses in the hospitals of the Moscow region.

Material and methods. We have investigated materials of the Bureau of Forensic Medical Expertise of Moscow Region and data of the Federal statistical monitoring № 14 «Information on the activities of the inpatient care units’ in the Moscow region in 2018. It was the sampling inquiry. The causes of death were grouped by classes and nosologiсal entities of ICD‑10. Research methods: documentary, statistical and analytical. Descriptive statistics of the absolute and relative values.

Results. Significant differences between the data of Federal statistical monitoring No. 14 and the Bureau of Forensic Medical Expertise of Moscow Region were established both in the number of medico-legal examinations in relation to individual entities and in the number of established divergences of diagnoses.

Conclusion. The form of Federal statistical monitoring No. 14 provides biased information in the section of information on cases subjected to forensic autopsy: input errors are 90 %.

Russian Journal of Forensic Medicine. 2019;5(3):11-14
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СHARACTERISTICS OF FIREARM INJURIES OF NON-BIOLOGICAL SIMULATORS, CAUSED BY SHOTS FROM A TRAUMATIC GUN MR‑341 “HOWDAH”
Leonov S.V., Pinchuk P.V., Gonikshtein Y.G.
Abstract

Objectives. Investigation of the injuries on biological simulators and topography of the gunshot residue after shots from the traumatic weapon MR-341 «Howdah» (a sawn-off shotgun of the smooth barrel gun IZH-43КN) using cartridges of 12/35 caliber at different distances (contact shot, 5 cm, 10 cm, then with increments of 10 cm to 100 cm inclusive, 125 cm, 150 cm and 175 cm).

Material and methods. Blocks of biological simulator (fragments of the chests of pigs) were used as the targets. After shots the targets were examined visually, in visible infrared rays, under the stereomicroscope and metrically.

Results. Morphology of the injuries and topography of the residue deposition has features that allow to consider the range and distance of the shot. Action of the flame and powder gases is manifested at the distance up to 5 cm inclusive; the zone of predominant deposition of the soot has an external border corresponding to the distance of the shot up to 20 cm; the zone of predominant action of the gunpowder has an additional morphology in the form of deposition of multiple rubber particles and continues at the distance of up to 80 cm from the muzzle end of the weapon. Additional features that allow to specify the zone of close range and the distance of the shot are established: after the shots from the distance of 10 cm traces of wad of semicircular and circular shape and gray color were revealed separate from the main gunshot injury; rubber particles were revealed on the target surface after the shots from the distance of up to 80 cm. The results of the study can be used in medico-legal practice to address the issues of the fact and distance of the shot from the traumatic weapon MR-341 “Howdah”.

Russian Journal of Forensic Medicine. 2019;5(3):15-18
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EVALUATION OF THE MORPHOFUNCTIONAL STATE OF THE LIVER BY MORPHOMETRIC METHODS
Travenko E.N., Porodenko V.A.
Abstract

Objectives. Morphometry of the main vascular and parenchymal structures of the liver which reflect its morphofunctional state.

Material and methods. We examined the postmortem liver samples from 15 cases of rapid death of youth and adult men (26.6 % and 40 %, respectively) and women (13.4 % and 20 %, respectively). For histological studies we used archival paraffin-embedded tissue blocks of the liver. A series of 5 μm sections were made. Tissue sections were stained with hematoxylin-eosin. Random fields of view of histological slides were photographed with the OLYMPUS XC30 digital camera mounted on the OLYMPUS CX41 microscope (Japan) with SWH ocular magnification ×10 and UPLanFL aim magnifications ×10, ×20, ×40 (at least 10 fields of view of each slide). Morphometric data analysis was carried using Image Scope Color viewing program and Olympus cellSens imaging software (Japan). Statistical analysis was carried out using the software STATISTICA 10.

Results. The liver microvasculature vessels have different diameters: the largest one corresponds to the interlobular veins ((87.80 ± 1.84) μm), the smallest corresponds to the interlobular arteries ((25.62 ± 2.41) μm). The diameter of the central vein is (54.03 ± 0.86) μm. The diameter of sinusoids is (28.36 ± 0.93) μm, interlobular bile ducts – (13.86 ± 0.80) μm. The areas of hepatocytes and nuclei are of (486.14 ± 11.15) μm2 and (58.89 ± 1.86) μm2, respectively; the area of the cytoplasm is (427.25 ± 9.19) μm2. The nuclear cytoplasmic ratio is 0.137 ± 0.06.

Conclusion. The obtained morphometric data can be used for the comparison when studying the pathological features of the liver in other pathological conditions such as alcohol intoxication. Further development of this research area is required to select morphometric characteristics and map the relative morphometric norm of a “healthy” liver.

Russian Journal of Forensic Medicine. 2019;5(3):19-23
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PARAMETERS OF THE ACROMION PROCESS FOR HUMAN SEX IDENTIFICATION
Chertovskikh A.A., Tuchik E.S.
Abstract

The sex identification by the various parameters of the bones is one of the most important tasks of osteology and forensic science.

Objectives. To develope evidence-based diagnostic criteria for determining a person’s gender in the context of forensic identification of the person using some parameters of the scapula: the length and width of the acromion process.

Material and methods. The study material was 108 corpses aged 19 to 99 years old from the central region of Russia examined in 2016. The causes of death were diseases of the cardiovascular system, poisoning with ethanol and/or narcotics, complex mechanical trauma. Morphological, morphometric and osteometric methods were used as well as mathematical using statistical software.

Results. New criteria were obtained for the sex identification by certain parameters of the scapula. The use of the established data will make it possible to reasonably reduce the range of osteological examinations in favor of a targeted sampling of material which will reduce the time and economic costs of the morphometric bone examinations as well as increase the evidence-based value of expert’s report in criminal procedure.

Russian Journal of Forensic Medicine. 2019;5(3):24-27
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PROSPECTS FOR THE USE OF THE PARAMETERS OF OXIDATIVE MODIFICATION OF SERUM PROTEINS FOR ASSESSMENT OF THE AGONAL PERIOD DURATION
Edelev I.S., Obukhova L.M., Andriyanova N.A., Edelev N.S.
Abstract

In the article we present results of the studies in cases of death with a long agonal period to determine the length of the agony.

Objectives. The task was to examine the features of oxidative modification of serum proteins in cases of deaths with a long agonal period.

Material and methods. In all experiments we analyzed the liquid blood sampled from 54 corpses of persons of both sexes who died from the violent and natural death in age of 13 to 89 years. The assessment of the oxidative modification of proteins (OMP) was performed by the level of carbonyl derivatives detected in the reaction with 2,4-dinitrophenylhydrazine. The levels of absolute and relative (in terms of protein) total OMP in cases of long agonal period were compared with the counterpart levels in cases of the short agony. The duration of the agonу was determined using information about the circumstances of the case and investigative data with the permission of the authority ordered the forensic examination. The autopsy data also were taken into account.

Results. We revealed the dependence of the OMP level on the duration of the agonal period. The total OMP (in terms of protein) in cases of long agony have decreased by 45.46 %. The data obtained have showed that the parameters of the OMP, taking into account all the relevant factors, can be used to develop criteria for establishing the duration of the agonal period as well as to increase the evidence-based significance of medico-legal conclusions.

Russian Journal of Forensic Medicine. 2019;5(3):28-32
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VIRTOPSY
POTENTIAL OF THE VIRTUAL AUTOPSY IN CASE OF FIREARM INJURY
Klevno V.V., Chumakova Y.V., Pavlik D.P., Dubrova S.E.
Abstract

The article presents the cases observed in the practice of the Office of medico-legal examinations of the Moscow Region when computed tomography (CT) was used for the first time in Russia for pre-autopsy examination (virtual autopsy) of three corpses with gunshot wounds followed by imaging-anatomical comparison of the results.

Objectives. Determination of the injury volume, visualization of the wound tracts, localization of the bullets.

Material and methods. Computed tomography was performed in radiology department using CT Scanner Hitachi Eclos‑16 (16 slices per rotation, slice thickness 1.5 and 2.0 mm) followed by multi-planar reconstruction of the images.

Results. 3D reconstruction of the CT scans of the corpses has visualized the whole volume of the trauma. Firearm perforating skull fractures, crushing injuries of the brain, injuries of the thoracic and abdominal organs along the wound tracks, bullets at the ends of the blind wound tracks were revealed on CT-scans.

Conclusion. Pre-autopsy CT with 3D-reconstruction has allowed to determine localization of the bullets in the bodies accurately. This allowed to choose the optimal examination tactics in each particular case and provided invaluable assistance in the search for the bullets. Virtopsy in the cases of firearm injury has great diagnostic opportunities in visualization and 3D presentation of the wound tracks and their direction. 3D CT has recorded the original position and characteristics of the skull fractures under the undamaged tissues. The authors made the assumption that a virtual autopsy could be a reliable alternative to traditional autopsy in the foreseeable future in cases of firearm injuries.

Russian Journal of Forensic Medicine. 2019;5(3):33-38
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EXPERT PRACTICE
SUICIDAL INTOXICATION WITH TOILET BOWL CLEANER
Buschmann C., Hartwig S., Tsokos M.
Abstract

We describe and discuss the case of a 44-year old paranoid woman who committed suicide by ingestion of approximately 4 litres of toilet bowl cleaner. Autopsy findings consisted of central dysregulation and extensive mucosa ulcerations of oesophagus and stomach with fatal bleeding. Autopsy and toxicological results are presented in the light of the literature.

Russian Journal of Forensic Medicine. 2019;5(3):39-41
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MANUAL FOR THE FORENSIC MEDICAL EXPERT
FORENSIC DIAGNOSIS OF SUDDEN CARDIAC DEATH ON THE BACKGROUND OF ALCOHOLIC CARDIOMYOPATHY
Porsukov E.A.
Abstract

The criteria of differential diagnosis of death from alcoholic cardiomyopathy and acute alcohol poisoning are proposed on the basis of the characteristic pathogmonic histological changes revealed in authors in the kaordiomyocytes. An attempt was made to create recommendations on the differential diagnosis of death from alcoholic cardiomyopathy and some other causes of death (acute alcohol poisoning, sudden death from coronary heart disease).

Russian Journal of Forensic Medicine. 2019;5(3):42-44
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REVIEWS
REVIEW OF THE TEXTBOOK “FORENSIC MEDICINE”. EDITOR I. V. BUROMSKII
Klevno V.A.
Abstract

Doctor of Medical Sciences, Professor V. A. Klevno has reviewed the textbook “Forensic Medicine” for the medical students written by the team of authors edited by the Doctor of Medical Sciences I. V. Buromskiy and published by “NORMA” in 2019. The textbook is recommended for use in the educational process as a main course book in the discipline of “Forensic Medicine”.

Russian Journal of Forensic Medicine. 2019;5(3):45-47
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EDITORIAL
COMPARISON OF CLINICAL AND FORENSIC DIAGNOSES. OPINION OF FORENSIC EXPERTS
Yolkina O.E.
Abstract
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Russian Journal of Forensic Medicine. 2019;5(3):48-50
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