Current trends in the dynamics of violent and nonviolent deaths and the problems in recording them

The number of forensic autopsies in cases with violent and spontaneous deaths increases from 1984 to 1996 by 11.1 and 25.8%, respectively. The rate of increase in the incidence of violent deaths outstripped 1.6 times the total mortality values. This resulted in an essential increase in the work loading of experts, with an increase in the number of complex expert evaluations. The system of registration of violent deaths is imperfect: it does not provide accurate data on the number of murders and suicides, which are overrated at regional statistical departments in comparison with the records of legal organs, while the values recorded at statistical departments are notably underrated in comparison with forensic medical records. The authors offer amendments and revisions for the current form of medical certificate of death and the order of its filling, granting, and storage.     

Morphologic changes in spinal cord of patients with spinal injuries who died in hospital

Morphologic changes in the spine have been investigated in patients with spinal injuries who died in hospital. The incidence of injuries has been evaluated as 9.3% of mechanical injuries. Purposeful search for possible injuries increased the rate of detection of injuries of the spine and the cord. Spinal cord can be impaired without involving the osseous formations and spinal ligaments. Edema of the cord tissue develops during the early period of injury and prevents the detection of injuries, persisting for a long time after the injury. Edemas are detected even in subjects who died at the site of accident.     

Establishing the personal identity of the victims in aviation catastrophes

Algorithm of organization measures and expert investigations is proposed, based on experience gained in expert studies during liquidation of aircraft catastrophes. It permits effective classification, differentiation, and identification of victims and is based on traditional and high technological methods of investigation.     

Investigation of osteoporotic changes of the long tubular leg bones for identification of human biological age

The authors propose to introduce into expert practice a number of methods estimating age-related osteoporosis by such quantitative characteristics as coefficient of optical transmission, optic density, porosity. The data confirm nonlinear dependence of age dynamics of osteoporotic changes which can be more effectively described by equations of polynomial regression.     

Forensic medical assessment of subendocardial hemorrhage in acute blood loss

A retrospective analysis of forensic autopsy protocols for 240 victims who died of acute blood loss aged 17-55 years (186 male and 56 female corpses--76.8 and 23.2%, respectively) has shown that appearance of Minakov's spots (MS) depends on duration of the terminal period. Subendocardial hemorrhages occurred most frequently (61.5%) in the terminal period up to one hour. The terminal period for several minutes was associated with MS appearance in 27.5% cases, for several hours--in 6.6%, for 24 hours and more--in 4.4%. MS incidence rate did not correlate with the group of the study, blood loss volume, severity of alcohol intoxication.     

Proposals on standardization of the terminology used in assessing quality of medical service

The terms and notions used in assessment of medical care quality are sometimes ambiguously interpreted. The authors propose a complex approach to standardization of terminology used for assessment of medical care quality.     

Defects in medical care delivery to patients with lung and breast cancer undergoing radiotherapy

Patients aged 55 and 63 years received extracorporeal 30 and 40 Gy gamma-therapy for lung cancer, respectively. Two and 60 days after irradiation, respectively, the patients developed arrosive pulmonary hemorrhage with lethal outcomes. Forensic medical examination in both cases has detected acute radiation pneumonitis with impairment of pulmonary artery endothelium that provoked hemorrhage. The literature review covers acute and chronic lesions of the lungs in radiotherapy of lung and breast tumors.