Saratov JOURNAL of Medical and Scientific Research

Forensic medicine

Dynamics of frequency of alcohol-related fatal automobile trauma in the Saratov region from 2006 till 2017

Year: 2019, volume 15 Issue: №3 Pages: 701-706
Heading: Forensic medicine Article type: Original article
Authors: Savenkova E.N., Efimov А.А., Alekseev Yu.D., Raykova K.A., Avdeeva O.S., Gavrichenko E.P.
Organization: Saratov State Medical University
Summary:

Objective; to analyze of the dynamics of frequency of alcohol-related fatal automobile trauma in the Saratov region over the years 2006-2017. Material and Methods. The study was conducted on the basis of the results of forensic medical examinations of the corpses of persons dead in a car accident in the period from 2006 to 2017 Results. During the study period in the Saratov region slightly decreased the proportion of alcohol intoxication in traffic accidents from 35-40% (2012-2015) to 23.5% (2017). Until 2015, the frequency of alcohol intoxication with trauma in the cabin and pedestrian injury almost did not differ, making up 35-40%. By 2017, the proportion of injured pedestrians with ethanol in the blood more than twice exceeded those affected in the cabin, moreover, the structure of ethanol intoxication in pedestrians is dominated by a concentration of 2.5-3.5%o and more. Along with the decrease in the frequency of ethanol in the blood among drivers (from about 40% in 2012-2015 to 23.5% in 2017), the share of heavy ethanol intoxication decreased, which until 2012 ranged from 33 to 60%, in 2017 it decreased to 25%. The age structure of alcohol-associated automobile trauma has changed: the share of intoxication among persons of 17-30 years has decreased, has increased in age groups of 31-40 years and 41-50 years. Conclusion. During the twelve-year period in the Saratov region in the structure of alcohol- associated automobile trauma there have been positive trends, expressed in a decrease in the proportion of victims in the cabin with the presence of ethanol in the blood, among drivers, and also a decrease in alcohol intoxication among young people. Negative trends should be considered an increase in the proportion of pedestrians with the presence of alcohol in the blood with a predominance of concentration corresponding to a severe degree of ethanol intoxication, increase of the share of ethanol intoxication in older age groups.

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Clinical manifestations and forensic medical evaluation of hemothorax

Year: 2017, volume 13 Issue: №2 Pages: 221-224
Heading: Forensic medicine Article type: Original article
Authors: Kupryushin A.S., Efimov А.А., Loginov S.N., Vishnyakova Zh.S., Latynova I.V., Semina M.N., Godukhina E.M.
Organization: Penza State University, Saratov State Medical University
Summary:

Objtctive: to determine the degree of validity of the allocation of traumatic hemothorax as a medical criterion of a qualifying trait in respect of serious harm to health, which is life-threatening. Material and Methods. A retrospective analysis of 130 case histories of the patients of the Department of Thoracic Surgery was carried out at Penza Clinical Hospital n.a. N.N. Burdenko. The sex, age, severity of the patient's condition, the volume of blood in the pleural cavity, complications of hemothorax (GT), the time between trauma and seeking medical help, and other injuries were analyzed. Results. It was found out that among patients with HT men were 4,2 times more than women. HT developed after traumatic exposure to the thorax in patients of both gender groups. Conclusion. The severity of the condition of patients with HT is determined by the volume of blood in the pleural cavity, complications, the presence of concomitant damages, the number of days between receiving an injury and contacting a medical organization. In the formulation of p. 6.1.10 Order No. 194n of the Ministry of Health and Social Development of April 24, 2008, "On the Approval of Medical Criteria for Determining the Severity of Harm to Human Health" we should add the phrase: "...or a severe or medium hemothorax that causes a life threatening condition..." aiming at an objective forensic evaluation of traumatic h e moth о rax.

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Characteristics of cases with poor outcomes of rendering medical care to children in six regions of the Russian Federation

Year: 2017, volume 13 Issue: №1 Pages: 010-013
Heading: Forensic medicine Article type: Original article
Authors: Erofeev S.V., Kupryushin A.S., Efimov А.А., vishnyakova Zh.S., Semina M.N.
Organization: Bureau of Forensic Medical Examination of the Ivanovo Region, Ivanovo State Medical Academy, Penza State University, Saratov State Medical University
Summary:

Objective: to determine the characteristics of the outcome of the improper care for children, established during the commission of forensic examinations. Material and Methods. The material of this study was commission a forensic medical examination of the archives department of complex expertise of the Bureaus of Forensic Medicine of Moscow; the Moscow, Penza, Samara and Ulyanovsk regions, and the Republic of Mordovia, conducted from 1996 to 2006. The method of this study was a statistical database processing using Excel software application package. Results. The article presents the results of the analysis of 279 forensic medical examinations conducted by committees in the Bureaus of Forensic Medical Examination of Moscow; the Moscow, Penza, Samara and Ulyanovsk regions, and the Republic of Mordovia from 1996 to 2006. The examinations were conducted in connection with poor outcomes of rendering medical care to children. Conclusion. The number of conducted examinations correlates with the population of the region. The parents of the children affected by poor treatment mostly demand the medical staff to be prosecuted and more often make legal claims to the quality of emergency medical care; dissatisfaction with the quality of medical care is more often expressed by the parents of children under 3 years old. Legal claims are more often made against obstetricians-gynecologists, pediatricians, surgeons, infectious disease specialists and anesthesiologists-resuscitators. If the conclusion of the forensic medical examination committee on the nature of the pathological process coincides with the final clinical diagnosis, the provided medical care often turns out to be adequate; in cases of inadequate medical care the risks of moderate and grievous bodily harm as well as the patient's death are high.

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The analysis of the structure of causes of violent death in Saratov (from 2011 to 2015)

Year: 2016, volume 12 Issue: №1 Pages: 27-31
Heading: Forensic medicine Article type: Original article
Authors: Efimov А.А., Savenkova E.N., Alekseev Yu.D., Ivakhina S.A., Raykova K.A., Kalugina S.A.
Organization: Saratov State Medical University, Saratov Bureau of Forensic Medical Examination
Summary:

Objective: the establishment changes in the structure of the causes of violent death in Saratov from 2011 till 2015. Material and Methods. The examination was based on analysis of the results of the forensic medical expert researches of corpses in the Saratov city office of forensic medical examination of corpses in the period from 2011 to 2015. Results. The structure of the causes of violent death was identical in Saratov in the last five years. The mechanical trauma was a leader, in second place — poisonings, then — mechanical asphyxia and external factors. There were two trends in the dynamics of components of each type of violent death: positive and negative. Positive trends were expressed as a decrease in the proportion of deaths from poisoning by ethanol and reducing the number of deaths from alcohol intoxication from other causes. Negative trends were expressed as the increase in the number of forensic medical expert examinations in the last two years, an increasing share of violent death of children in 2015, maintaining the leading position of automotive trauma among deaths from injuries by blunt objects. Conclusion. The number of forensic medical examinations of corpses was increased in Saratov for the studied period, but the proportion of fatal poisoning with ethanol was decreased. In 2015, the share of violent death of children aged under 14 was increased.

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Forensic medical evaluation age-related changes aorta and pair large arteries

Year: 2015, volume 11 Issue: №2 Pages: 118-122
Heading: Forensic medicine Article type: Original article
Authors: Efimov А.А., Savenkova E.N.
Organization: Saratov State Medical University
Summary:

Objective: differentiation of age-dependence indices of aorta, carotid, brachial, femoral arteries and drawing the mathematical model for forensic age determinations on their basis. Material and methods. Objects were: aorta, fragments of right and left carotid, brachial and femoral arteries taken in a complex of 186 male and female corpses, died at the age of 17-94. Research methods consisted of organometrical, histological, micrometrical, correlative and regressive analysis. The Results. Correlative and regressive analysis of 35 indicators of aorta, carotid, brachial and femoral arteries was conducted. All material was divided into figures with a significant correlation with age and performance of age-independent. The mathematical model was composed for calculation of age. Conclusion. Indicated involution of arterial wall and compiled on the basis of a mathematical model for determination the age could be taken as the basis for forensic method of age determination.

Keywords: age, arteries, morphology
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