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.     

Forensic medical diagnostics of chronic alcoholic intoxication based on histological changes in the soft tissues of oral cavity and salivary glands

Histological studies of oral cavity mucosa and salivary glands in subjects with chronic alcoholic intoxication revealed changes at the surface of the tongue and in the glandular tissues. Specific features of chronic alcoholic intoxication include acinar and ductal hyperplasia, reduction of the adipose tissue mass in salivary gland stroma, predominance of T-lymphocytes in hard palate minor salivary glands and B-lymphocytes in the stroma of labial minor salivary gland, the absence of plasma cells in the stroma of hard palate minor salivary glands and labial mucosa. Leukoplakia, dysplasia, and hyperplasia of the basal epithelial layer of oral cavity mucosa are considered to be the signs of long-term (over 12 months) alcohol consumption.     

The analysis of the unfavourable outcomes of dental care based on the materials of forensic medical examinations carried out by the Bureau of Forensic Medical Expertise, Moscow Department of Health

The analysis of the unfavourable outcomes of dental care based on the materials of forensic medical examinations carried out by the Bureau of Forensic Medical Expertise, Moscow Department of Health.     

Studies of dentition abnormalities in children of the Republic of Armenia for the purpose of personality identification

This paper reports the results of investigations carried out to elucidate the frequency and the structure of various forms of abnormalities of dentition among the children of the preschool and school age in the Republic of Armenia. These data may be of help for the forensic medical personality identification especially for the expertise of unrecognized corpses. Moreover, these data provide an indirect picture of the prevalence of abnormalities of dentition among the adult population of the country. Specifically they may sometimes be used to identify the ethnic and/or racial background of a person.     

On the stability of the irritant dibenz-[b,f]-[1,4]-oxazepine (substance CR)

The objective of the present study was to determine the duration and conditions of persistence of the irritant dibenz-[b,f]-[1,4]-oxazepine (substance CR) on the environmental objects. The quantitative analysis of the substance on cotton fabric specimens was carried out using the approved method of high performance liquid chromatography (HPLC) with UV detection at different time periods and envirobmental conditions. It was shown that the main factor determining the lifetime of dibenz-[b,f]-[1,4]-oxazepine on the cotton fabric is the ambient conditions. By way of example, the "open" and "closed", storage of such specimens during 300 days resulted in the decrease of the amount of substance CR to 22.5 and 79% of the initial level respectively. By the end experiment (day 600) these values lowered to 3 and 52.5% respectively. Taken together, the results of the study indicate that dibenz-[b,f]-[1,4]-oxazepine can be described as a substance resistant to environmental impacts. It is comparable in terms of stability with such known irritants as capsicum oleoresin and pelargonic acid morpholide.     

Forensic medical expertise of delayed consequences of traffic accidents included in article 6.11 of the Medical Criteria

The medical documentation pertaining to 767 victims of traffic accidents was revised. These subjects were classified in the acute post-traumatic period as experiencing serious harm to health in terms of the qualifying sign "substantial persistent loss of at least of one third of general working ability" (SPLGWA) based on the results of primary examination. It was shown that in the course of therapeutic and rehabilitative treatment of the subjects with bone fractures listed in articles 6.11.1, 6.11.2, 6.11.4 to 6.11.10 of the Medical Criteria most of the patients have their compromised functions repaired up to complete recovery of the working ability. According to the repeated evaluation the substantial (35%) loss of the working ability persisted only in 25.8% of the victims. 56.7% of the victims were estimated to have lost 10-30% of their working ability; SPLGWA was absent in 17.5% of the examined subjects.