ABSTRACT
This article focuses on current concepts of ischemic heart disease, its interventional treatment, pathomorphology of early and late postoperative complications, and forensic aspects in evaluation of restenosis of a stented blood vessel.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Disease , Coronary Restenosis , Coronary Angiography , Humans , Postoperative Complications/etiology , StentsABSTRACT
The combination of inherited and acquired factors of increased thrombosis complicates establishing the cause-effect relationships between mechanical injury and death during forensic medical examination. Morphometric parameters of the lung tissue and pulmonary vessels in isolated mechanical trauma under conditions of moderate hyperhomocysteinemia were studied in an experiment on laboratory animals. A regularity in changes of the morphometry parameters of the pulmonary vessels was found. Morphometric changes in the wall of pulmonary parenchyma veins can be used as an additional marker to assess the causal relationship between isolated mechanical injury and fatal complication in the form of pulmonary embolism.
Subject(s)
Hyperhomocysteinemia/metabolism , Pulmonary Embolism/metabolism , Thrombophilia/metabolism , Animals , Forensic Medicine/methods , Lung/metabolism , MaleABSTRACT
A model of moderate hyperhomocysteinemia associated with mechanical injury of the musculoskeletal system was developed and experimentally substantiated. The adequacy of this model for studies of morphological and functional regularities is verified. This model can be used for the development of a new concept of evaluation of thrombotic complications of mechanical injury.
Subject(s)
Hyperhomocysteinemia/pathology , Hyperhomocysteinemia/physiopathology , Microcirculation/physiology , Animals , Disease Models, Animal , Genotype , Hyperhomocysteinemia/genetics , Male , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Methylenetetrahydrofolate Reductase (NADPH2)/metabolism , Polymorphism, Single Nucleotide/genetics , Rats , Thrombosis/genetics , Thrombosis/physiopathologyABSTRACT
The objective of the present work was to develop the forensic medical criteria for the assessment of the significance of hereditary predisposition to thrombophilia in the case of thrombotic complications of a mechanical injury. The results of analysis of the frequency of genes responsible for hereditary predisposition to thrombogenesis (FII, FV, MTHFR, FGB, PAL-1) among the victims of mechanical injuries are presented. A total of 251 subjects were available for the examination. They were divided into 4 groups as follows: the subjects presenting with deep venous thrombosis in the lower extremities (DVTLE) after the injury (group 1), subjects with DVTLE without the preceding trauma (group 2), those with an injury to the locomotor apparatus without a subsequent thrombotic complication (group 3), and practically healthy persons (group 4). It was shown that the subjects of group I had the highest frequency of mutations and polymorphisms of MTHFR and PAl-1 genes. It is concluded that genetic typing for the detection of mutations in these two genes is indispensable for the subjects presenting with thrombotic complications after mechanical injuries to the locomotor organs.
Subject(s)
Forensic Genetics , Genetic Predisposition to Disease , Leg Injuries/complications , Postoperative Complications/genetics , Pulmonary Embolism/genetics , Venous Thrombosis/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Female , Gene Frequency , Genetic Testing , Humans , Leg Injuries/surgery , Male , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Middle Aged , Plasminogen Activator Inhibitor 1/genetics , Polymorphism, Single Nucleotide , Postoperative Complications/etiology , Pulmonary Embolism/etiology , Venous Thrombosis/etiology , Young AdultABSTRACT
Statistical data on the incidence and spectrum of thrombotic complications presented in this paper are based on the materials collected by the Department of Expertise of Living Subjects, Rostov Regional Bureau of Forensic Medical Expertise, during 2004-2010. The cases of interest were analysed by age, sex, time of injury, character of traumatic impact, and time of surgical intervention. It is concluded that such cases require forensic medical expertise by standardized methods.
Subject(s)
Expert Testimony , Forensic Medicine/standards , Postoperative Complications , Thrombosis , Wounds and Injuries/complications , Adult , Expert Testimony/legislation & jurisprudence , Expert Testimony/methods , Expert Testimony/standards , Female , Forensic Medicine/methods , Humans , Incidence , Male , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Surgical Procedures, Operative/adverse effects , Surgical Procedures, Operative/methods , Thrombosis/diagnosis , Thrombosis/epidemiology , Thrombosis/etiology , Thrombosis/therapy , Time-to-Treatment/statistics & numerical data , Trauma Severity Indices , Wounds and Injuries/classification , Wounds and Injuries/surgeryABSTRACT
The authors report statistical data on the spectrum and frequency of fatal thrombotic complications based on the analysis of materials available from the regional bureau of forensic medical examination collected in the period from 2004 to 2007. All lethal cases are categorized in terms of the patients' age, gender, time and clinical characteristics of the injury, time of surgical intervention. Results of the analysis indicate the necessity of examination of fatal cases of thrombotic complications following a standardized protocol.
