On the interaction between State Forensic Medical Centers of the Russian Ministry of Defense and territorial organs of the Russian Federal Service on Surveillance for Consumer Rights (Roszdravnadzor): topical problems and possibilities for their solution

The present paper is focused on the consideration of topical problems pertaining to the interaction between state forensic medical centers of the Russian Ministry of Defense (SFMF MD RF) and territorial organs of the Russian Federal Service on Surveillance for Consumer Rights (Roszdravnadzor) in the framework of unscheduled inspections of the organization and conduction of forensic medical expertise. Such inspections not infrequently give rise to conflicts between the administration of SFMF ND RF and commissions of territorial organs of Roszdravnadzor. The principal source of such conflicts is the representatives of Roszdavnadzor frequently fail to observe the requirements envisaged by the normative legal acts of the Russian Federation regulating activities of this state agency and the laws of the Russian Federation governing action management in the field of forensic medical expertise. The main causes behind the conflicts and their consequences are discussed, recommendations are proposed to resolve them.     

The detection of nifedipine in biological materials

The objective of the present study was to find optimal conditions for the isolation of nifedipine from biological materials by ethylacetate. It was shown that nifedipine can be purified from co-extracted substances of the biological material on a Silasorb C-18 column with the size of the particles 30 microns. The authors propose to use thin-layer chromatography, IR spectrophotometry, and reverse-phase high performance liquid chromatography for the identification and quantitative determination of nifedipine extracted from cadaveric liver samples.     

Forensic medical examination of a medical malpractice case as a form of situational expertise

The authors propose to divide the process of forensic medical examination of a medical malpractice case into several stages and substantiate the possibility of their realization as a form of situational forensic medical expertise.     

Correction of the alkylnitrite method for the detection of ethanol in blood taking into account toxico-kinetic and anthropometric data

The correction coefficient for the systemic inaccuracy arising during determination of blood ethanol by alkylnitrite gas chromatography and concomitant calibration of aqueous solutions was estimated to equal 0.82; this finding was confirmed by the results of the toxico-kinetic assay for the measurement of total body water (TBW) from the kinetic curve characterizing the time dependence of ethanol concentration in the exhaled air, saliva, capillary and venous blood in combination with 4 anthropometric methods and (in several cases) direct physical detection of TBW. When detecting the blood ethanol level with a correction coefficient of 0.82, the mutual position of the kinetic curves for ethanol concentrations in the blood and the exhaled air (recalculated for the blood level with a coefficient of 2100) as well as in the blood and saliva agreed with that reported in the available literature; it significantly differed from the position of the curves obtained with a correction coefficient of 0.95. The causes accounting for the systematic inaccuracy and erroneous values of the correction coefficients in earlier studies are discussed.     

On the importance of a comprehensive study for diagnostics of death from acute ethanol poisoning and coronary heart disease

Over 30 000 cases of acute poisoning with ethyl alcohol and its surrogates are recorded annually in this country. Differential diagnostics between fatal poisoning and death from coronary heart disease encounters serious difficulties. The authors report a comprehensive forensic chemical, morphometric, and pathomorphological study of the activity of ethanol-oxidizing enzyme systems in the internal organs. The results of histochemical examination provide a basis for the extension of diagnostic potential of the available methods and the enhancement of the objective value of expert reports.     

Morphometric diagnostics of the age of encapsulated subdural hematomas

The present morphometric investigation was carried out using dura matter preparations, capsules, and contents of 94 encapsulated subdural hematomas obtained from the corpses of subjects with a non-penetrating craniocerebral injury and the duration of the post-traumatic period ranging from 8 days to 2.5 years. The correlation analysis confirmed the necessity of differentiation between resorbed and unresorbed encapsulated subdural hematomas. The data obtained were used to construct 5 regression models for the estimation of the age of unresorbed encapsulated subdural hematomas and 1 regression model for the identification of the age of resorbed encapsulated subdural hematomas. The regression models included different combinations of three morphometric characteristics of the hematoma capsule as the independent variables, viz. maximum thickness, relative extent of hemosiderosis, and relative amount of macrophages in the cellular infiltrate. The amount of variability in the age of encapsulated subdural hematomas accounted for by the regression models is 62%. It is concluded that the results of the study can be used in the practical work of forensic medical experts.     

The problems of differential diagnostics and forensic medical expertise of various forms of craniocerebral injuries

The problem of differential diagnostics and forensic medical expertise of various forms of craniocerebral injuries is discussed. It is concluded that clinical and laboratory studies are insufficient to objectively estimate the results of the examination. The authors emphasize the importance of searching for new and more informative diagnostic techniques.