Legal regulation and management of fee for services in the state expert institutions

With due regard for the economic situation in regions, differences in the material-technical and personnel provision of each forensic-medical bureau (FMB), paying capacity of local residents and for other factors, a method for estimating the cost of forensic medical services was elaborated and offered for use. The formula of cost estimation for rendered services allow for basic wages (BW) and bonuses, sick-list and vacation payments, overhead charges (including FMB wear-and-tear), and BW assignment to off-budget funds (which constitute, in total, the self-cost of services) as well as the planned profit and road taxes.     

Forensic and medical aspects of lethality from thromboembolytic complications of trauma,diseases and certain pathological conditions

A total of 743 lethal outcomes of thromboembolytic complications of trauma, diseases and certain pathological conditions as observed in 1999-2001 and in the three quarters of 2002 were studied. The undertaken analysis confirmed two factors provoking the pathological thrombosis, i.e. 1. Pathological changes observed in the surface vascular wall preconditioned by mechanical damages, atherosclerotic process and aging; and 2. A slower blood flow due to an impaired blood circulation, a forced positioning and to hypodynamics. While deciding on a possibility of a direct cause-effect relation between past traumas, surgeries, poisonings and death of thromboembolism of the pulmonary arteries (TEPA), such relation can be mentioned only on rare occasions. It is more often the case that an indirect, mediated relationship is found, when TERA evolves due to an unfavorable combination of risk factors, i.e. a forced immobility, changing coagulated blood system, impaired blood vessels etc.     

Dependence of acute opiate poisoning lethal outcome on the gender, age, and duration of addiction

The article presents toxicological characteristics of 198 cases of acute parenteral poisoning with morphine and heroin in the range of concentrations of their metabolites in the blood and urine which occur in practice. Risk of death is quantified in the range of possible morphine concentrations in the blood in acute opiates intoxication with reference to gender and age. Assessment of the criteria of quantitative opiates toxicity was made according to the method of logit regression and dose-effect curve suitable for analysis of correlations between probability of death and blood concentrations of opiates metabolites. Conditional lethal doses in respect to gender and age are calculated.     

Circumstances and toxicological characteristics of deadly opiates poisoning

Facts of prehospital death of 109 heroin addicts are analysed and systematized. It is shown that examination of the corpse at the point of detection may provide information on the circumstances of death and its cause. Correlation between morphine concentration in the corpse tissues and circumstances of death is studied. It is found that information about the victim and facts of his/her death suggest cause of death and help in directions of post-mortem examination and choice of diagnostic procedures.     

Utilization of complex technologies of molecular genetics for forensic expert identification of unidentified remains of victims of terrorist acts in Moscow in 1999

This paper presents the first experience gained in Russia in expert identification practice with complex utilization of technologies of molecular genetic individualization of biological objects for solving identification tasks requiring the maximum complete armory of mutually supplementing means. This is particularly important for forensic expert personality identification in cases with many deaths, when indirect identification has to be resorted to, consisting in the use of biological samples from relatives of the victims as the identifying objects. Methodological approaches and concepts of expert studies, used for identification of the remains of people who died in terroristic acts committed in Moscow in September, 1999, are discussed. The results of this study and methodological experience notably extend the potentialities of expert evaluation as regards forensic medical identification of victims of overall disasters, terroristic acts, and war conflicts.     

Forensic-medical diagnostic implication of morphine levels in the blood and urine

Toxicological characteristics are presented for 198 cases of acute parenteral poisoning with morphine and heroin. The range of their metabolites concentration in the blood and urine encountered in practice are analysed. Principal causes of death due to opiate poisoning in inpatients are shown. Opiates toxicity was assessed by the method of logit-regression and dose-effect curves for analysis of probability of death depending on opiate metabolite concentration in blood and urine. Relations between probability of death and detection of morphine in biological media of the victims are considered. Morphine concentrations in the blood and urine undoubtedly indicating morphine poisoning are determined.