Vol 8, No 1 (2022)
- Year: 2022
- Published: 14.04.2022
- Articles: 10
- URL: https://for-medex.ru/jour/issue/view/33
- DOI: https://doi.org/10.17816/2411-8729-2022-1-1
Full Issue
Original study articles
Features of gunshot bullet injuries resulting from ricochet when firing from smooth-bore weapons, depending on pre-barrier distance
Abstract
BACKGROUND: According to the literature, the speed and kinetic energy of the bullet within 100 m of flight varies slightly, on the basis of which we put forward a scientific hypothesis that there were no significant changes in the picture of gunshot injuries formed when firing a hunting rifle and subsequent ricochet, when changing the values of pre-grade distance.
AIMS: Determining the effect of the pre-barrier distance on the characteristic of gunshot injuries resulting from a bullet ricochet when fired from a smooth-bore weapon.
MATERIAL AND METHODS: A ballistic experiment was conducted to model the ricochet of a bullet and the formation of gunshot damage to stray targets when fired from a 12-caliber “IZh-27 M” hunting rifle using 12/70 “Gold” hunting bullet cartridges with a 32 gr “Gualandi” bullet, at a barrier of steel brand St45, at a meeting angle of 30 degrees, from the pre-barrier distance values 1–2–3–4–6–8–10 m. The formed damage was subjected to visual examination, measurement, microscopic, photographic, research in ultraviolet and infrared rays, contact-diffusion, mathematical-statistical methods.
RESULTS: The study demonstrated that the change in the pre-barrier distance values within these limits does not lead to the formation of statistically significant differences in the main parameters characterizing gunshot injuries: shape, presence of a tissue defect, dimensions of injuries, coincidence of the orientation of the longitudinal axis of the damage with the longitudinal axis of the barrier, the presence and dimensions of additional damage, the dimensions of wiping areas in the area of additional damage, the sizes of products of the shot deposition areas on the target surface (p <0,050).
CONCLUSION: Established patterns can be used in conducting ballistic experiments to model a bullet ricochet, as well as for reconstructing the circumstances of the incident during a situational examination in cases of gunshot injuries formed as a result of a ricochet when firing from a smooth-bore weapon.
Сharacteristics of the projectile trajectory after breaking through obstacles (biological material and triplex) fired from the «Horhe» non-lethal pistol and «Saiga» rifle
Abstract
BACKGROUND: When conducting forensic and medico-criminalistic examinations in cases of gunshot injury, when establishing the possible relative position of the shooter and the victim, the direction of the release of fragments of the obstacle, its particles and the projectile is of great expert importance. The effect of projectile trajectory normalization by forensic experts has not been previously described - in the literature available to us there are only indications of changes in the projectile trajectory when breaking through an obstacle. Little knowledge of the topic, the lack of scientific developments on this study for more than 50 years prompted us to conduct an experimental study.
AIMS: Study of the deviation of the emission of particles of obstacles, represented by biological material (pig skin) and laminated glass (triplex).
MATERIAL AND METHODS: A series of experimental shots were carried out with projectiles fired from a traumatic pistol “Jorge” and a carbine “Saiga” (a semi-shell bimetallic bullet with a lead core of a 5.45×39 mm cartridge), it was noted that when breaking through both biological material and triplex glass located under angles of 40–60º with respect to the line of sight, with a pre-obstruction distance of 100–200–1000 cm. Shots were fired from a distance of 1–2 m into a biological barrier, from 10 m ― into a triplex. The resulting damage was studied using visual, measuring, macroscopic, photographic analysis.
RESULTS: The study showed that there is a discrepancy (change) in the trajectory of movement from the aiming line of secondary projectiles, which arose after the destruction of the barrier and the firearm, and its parts, formed as a result of the penetration of the barrier by a bullet. The deviation was fixed at a different value depending on the angle of inclination of the barrier.
CONCLUSION: The results obtained can be taken into account when setting up various ballistic experiments, as well as in reconstructing the circumstances of the incident during forensic, medical-forensic and forensic ballistic examinations.
Case reports
Forensic evaluation of ankle injury sustained as a result of a hoverboard impact: case from practice
Abstract
Currently, the so-called means of individual mobility are gaining high popularity. Their use naturally entailed an increase in the number of road “incidents”, as well as the number of examinations carried out. The question of the most “traumatic” parts of the human body, the type volume of injuries in this type of injury in the domestic forensic medical literature has not been studied to date.
A description of the case from practice is given: citizen A. received an isolated injury to the right ankle joint when a person driving a hoverboard hit her. Citizen A. was hospitalized in the surgical department of the district hospital, where she underwent inpatient treatment and was discharged on the 16th day after the grass. The patient was examined by doctors, she underwent radiography of the right tibia. During the commission forensic medical examination on the case file with the examination of the victim, with the involvement of a radiologist as an expert and a detailed description of the radiographs, conclusions were made about the localization, nature, amount of damage, as well as the severity of the harm caused to health.
Analysis of foreign studies suggests that injuries associated with the participation of gyroscooters occur mainly when falling with the formation of fractures of the bones of the upper limbs. However, some authors cite cases of lower limb injuries with ankle injury. This case confirms the research of some foreign authors. In addition, this case clearly illustrates the role and significance of an additional instrumental method of research (radiography) and objective examination of the injured of the expert commission.
To the problem of death of children from closure of respiratory tract by foreign object: expert observation
Abstract
In the special forensic literature, information on the deaths of children from mechanical asphyxiation as a result of closure of the airways by foreign objects is small and fragmentary, a small number of works are devoted to them, despite the fact that the social significance of this problem is great.
An expert observation of a case of asphyxia developed in a child as a result of closure of the upper respiratory tract by a foreign object is given. The child played for 1.5 years and suddenly began to choke. A forensic examination of the corpse revealed the presence of a foreign body (part of a child’s toy) in the area of the vocal cords, completely covering the lumen of the entrance to the larynx; acute pulmonary bloating, hemorrhages in soft tissues from the area of entrance to the larynx, foci of acute pulmonary alveoli emphysema, hemorrhages in pulmonary tissue, signs of rapid death.
Forensic medical diagnosis: mechanical asphyxia from closing the lumen of the respiratory tract with a foreign body (the presence of a foreign body in the vocal cords, completely blocking the lumen of the entrance to the larynx; acute swelling of the lungs, hemorrhages in the soft tissues from the entrance to the larynx, foci of acute emphysema of the pulmonary alveoli, hemorrhages in the lung tissue, signs of rapid death).
The work of a forensic medical expert is often hampered by the lack of clinical data and the circumstances of the incident, as well as difficulties in interpreting the results of the study. In cases where adults are present during the aspiration of a foreign body by a child, respiratory failure is recorded with cyanosis of the face, breath holding, followed by paroxysmal unproductive cough, which indicates an existing threat of asphyxia. In this expert observation, the detailed circumstances of the incident provided by law enforcement agencies and the “asphyxic” alertness of the expert helped to establish the cause of death and formulate a forensic diagnosis and conclusions. However, it is important to understand that cases of death of children from obstructive asphyxia are potentially preventable and require targeted preventive work.
Reviews
Problems of organizing the work of pathological and anatomical bureau (devices), forensic medical examination bureau in the conditions of COVID-19
Abstract
The work of medical professionals is always associated with a risk to life, but during the onset of the COVID-19 pandemic, forensic experts and pathologists were faced with the need to diagnose a new and highly contagious disease in the presence of inadequate specific methodological guidelines.
Optimization of work organization processes, analysis of risk factors for the spread of COVID-19 infection in pathological and anatomical bureaus (departments) and forensic medical examination bureaus is an urgent task of public health. Forensic pathologists and pathologists are among the most vulnerable groups of healthcare workers exposed to the risk of infection in the workplace during epidemics, pandemics, and in high-risk conditions when emerging infections such as COVID-19 coronavirus.
The purpose of the study was to analyze and identify the problems of organizing the work of persons involved in forensic medical examinations, post-mortem examinations in the context of the COVID-19 coronavirus.
The study showed that the existing regulatory organization of the work of persons involved in the conduct of forensic medical examinations, post-mortem examinations does not allow to fully ensure the structural and procedural factors that regulate the activities of the personnel of pathological bureaus (departments) and forensic medical examination bureaus under the risk of coronavirus infection COVID-19.
Pathology of COVID-19
Abstract
Coronavirus infection 2019 (COVID-19) has become a challenge for the health care system around the world due to the progressive increase in the number of cases with severe manifestations of the disease. Autopsy findings are fundamental and critical to better understanding how infection affects the human body. These data are needed to improve diagnostic and treatment methods, as well as to stratify risk groups.
The purpose of the review is to analyze and summarize the pathological data available to date related to COVID-19. In COVID-19, the lungs are usually severe and swollen. Histologically, the most frequent is the detection of both exudative and proliferative diffuse alveolar injury with the formation of hyaline membranes, inflammatory cell infiltration, and stagnant small vessels. There is also evidence that SARS-CoV-2 causes endothelial dysfunction. There is still insufficient data to reflect the complete pathophysiological picture of SARS-CoV-2 infection.
Almost all of the articles reviewed in this review focused on pulmonary macro- and microscopic changes; there is little data on the features of the virus affecting other organs and its systemic effect. Despite the tremendous attention and investment in the fight against the new coronavirus infection, diagnosis of most of the deaths associated with COVID-19 is difficult.
It is necessary to conduct further pathological studies, the purpose of which should be the development of a standardized diagnostic method, as well as the isolation of pathognomonic signs of the disease.
The problems of determining of the age of bruises by modern diagnostic methods. Literature review
Abstract
Determination of the age of bruises is an important task forensic medicine. The article provide a review of the literature concerning the state of the study of this problem.
Traumatic hemorrhages, the most frequent injuries encountered in practice by a forensic medical expert, are formed as a result of accumulation of blood in the lesion due to rupture of blood vessels. Traditionally, the leading methods for determining the age of traumatic effects are macroscopy, colorimetry, radiography, impedance measurement, ultrasonography, infrared thermometry, spectrophotometry, etc. The difficulties of using instrumental methods are associated with the operation of devices, the high cost of equipment, and often with the contradictory opinion of the authors, which does not allow choosing a certain method.
In various publications, the advantage is given to those methods that analyze color as the main characteristic of a bruise. In order to objectify this characteristic, is actively underway on the development of spectroscopy technologies capable of determining the spectrum of substances beyond the control of the human eye. A promising approach to establish the prescription of traumatic hemorrhages can be the method of hyperspectral spectroscopy by simultaneously capturing the image of a bruise and obtaining spectral, including spatial data of the studied skin area. The expediency of using hyperspectral technologies in forensic medical practice lies in the non-invasiveness of the study, harmlessness to living persons, compactness of the device, as well as the prospects of studying the lifetime of bruises in corpses.
The conducted analysis of the literature creates the need to explore the possibilities of this method.
Prospects for studying the thanatogenesis and morphological manifestations of alcoholic cardiomyopathy
Abstract
The purpose of the work was to analyze the current literature data on the morphology and thanatogenesis of alcoholic cardiomyopathy, as well as to determine further prospects for research on this issue. Domestic and foreign literary sources devoted to sudden death, pathomorphology of alcoholic cardiomyopathy, immunohistochemical and biochemical methods of its diagnosis were studied. As a result of the analysis, the essence of thanatogenesis in alcoholic cardiomyopathy is revealed, the prospect of immunohistochemical and morphometric methods is outlined.
According to the literature data, based on the results of the studies, an approximate scheme of thanatogenesis and subsequent scientific directions for the study of investigative deaths in alcoholic cardiomyopathy, in search of other diseases, can be built. In the Australian literature, the benefits of immunohistochemical are used to elucidate the antecedent pathochemical consequences. Also, in relation to the diagnosis of death from alcoholic cardiomyopathy, thanatogenetic analysis can be provided, since the sequence of development of fatally significant events in the form of various sudden deaths is not the same. In the interpretation of the processes occurring at the end of thanatogenesis in the myocardium, polarization microscopic examination is indispensable. I would like to note a number of biochemical changes in alcoholic cardiomyopathy, which demonstrate some features of the course of metabolic processes in this pathology, especially since this method and the immunohistochemical study are more in line with the modern requirements of evidence-based medicine.
As a result of the literature analysis, the essence of thanatogenesis in alcoholic cardiomyopathy was revealed, the prospect of immunohistochemical and morphometric methods was outlined.
Ways to improve the quality of training specialists in postgraduate studies
Abstract
The article is devoted to the analysis and generalization of the procedures for training postgraduate specialists. Particular attention is focused on the most important functions of postgraduate studies and ways to improve its effectiveness. The role and place of postgraduate studies in the system of higher education is characterized on the basis of a retrospective analysis of the development of the system in recent decades.
The study is based on the analysis of current legal acts that determine the procedures for the training of scientific and scientific-pedagogical personnel in graduate school. The main requirements for the preparation of postgraduate students are presented in accordance with the new legislation, which makes it possible to consider the pre-defense of a dissertation as the end of postgraduate studies. The concept of “institute of scientific postgraduate studies” is defined, the conditions for the formation, abolition and restoration of such a scientific phenomenon in the system of higher education are formulated. There are highlighted the key requirements for an organization that implements postgraduate programs in terms of its scientific and educational activities, as well as changes in the requirements for scientific supervisors of graduate students. There are presented the main indicators of the effectiveness of training in graduate school at the Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky.
It is concluded that the specification and increasing requirements for the organization and implementation of postgraduate programs within an educational institution are the determining factor in terms of increasing the efficiency of training specialists in postgraduate studies and mastering postgraduate programs.
Book reviews
Review of the collective monograph «Forensic medical expert service of the Moscow region: history and modernity» edited by V.A. Klevno, V.Yu. Nazarov
Abstract
The article analyzes the book “Forensic Medical Expert Service of the Moscow region: history and modernity” edited by Doctor of Medical Sciences, Professor Vladimir Alexandrovich Klevno and Doctor of Medical Sciences, Associate Professor Viktor Yurievich Nazarov, presents an objective assessment of the published data on the history and current state of the forensic medical expert service of the Moscow region and the development of Russia’s largest state forensic institution State Budgetary Healthcare Institution of the Moscow region “Bureau of Forensic Medical Examination”. The purpose of the review is to give an objective assessment of the information contained in the scientific publication and to determine their value for science and practice.
First of all, the author notes the uniqueness of the publication, in which for the first time the history of forensic medicine of the Moscow region is covered in detail and reliably, the main milestones of the history of the Bureau’s development are scrupulously and carefully outlined, an unprecedented number of little-known facts and reliably generalized information are included (archival data, accurate statistical reports, detailed biographies). The conclusion is substantiated that by its 100th anniversary, the state budgetary healthcare institution of the Moscow region “Bureau of Forensic Medical Examination”, under the leadership of Professor V.A. Klevno, has achieved leading positions in all indicators of forensic expert activity and has become the leading among state forensic expert institutions in the healthcare system of the Russian Federation. It is noted that the book “Forensic Medical Expert Service of the Moscow region: history and modernity”, written at the highest scientific level, includes an unprecedented amount of little-known and reliably generalized information.
The author noted that the book was written at the highest scientific level and, undoubtedly, is a significant contribution to the history of the national forensic medical service.
It can be argued that with the publication of the book “Forensic Medical Expert Service of the Moscow Region: History and Modernity”, a whole and reliable picture of the true history of the Moscow Regional forensic medicine is being created, covering the main significant time intervals.
Without a doubt, this work will serve for many years as a source of reliable information for forensic experts, historians and a wide range of people interested in the past, present and future of forensic medicine in Russia.