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1.
Sud Med Ekspert ; 67(3): 29-33, 2024.
Article in Russian | MEDLINE | ID: mdl-38887068

ABSTRACT

Death from general hypothermia is one of the leading causes in the structure of violent death in the Russian Federation. OBJECTIVE: To clarify and supplement the complex of differential diagnostic macro- and microscopic signs of a fatal acute general cold trauma received when person is in the air and water. MATERIAL AND METHODS: The conclusions of forensic medical experts on the bodies of people who died from hypothermia in the air and in water (by 150 observations) were analyzed. Methods of descriptive statistics, calculation of the frequency ratio of signs' occurrence were used. RESULTS: The article provides quantitative assessment of occurrence (detection) rate of diagnostically significant signs established with the help of traditional methods of expert examination. A new classification of diagnostic death signs from hypothermia taking into account their differential diagnostic significance and reflecting the conditions of a person's stay in the air and water in the pre-mortem and post-mortem periods, as well as terminal period mechanisms is proposed. CONCLUSION: The established complexes of signs provide an objective basis for determining death cause in non-obvious conditions when cold exposure is expected to be one of the most damaging factors.


Subject(s)
Hypothermia , Humans , Hypothermia/diagnosis , Hypothermia/mortality , Cause of Death , Russia/epidemiology , Forensic Pathology/methods , Expert Testimony/methods , Autopsy/methods , Cold Temperature , Diagnosis, Differential , Forensic Medicine/methods , Air/analysis , Water
2.
Sud Med Ekspert ; 67(3): 19-23, 2024.
Article in Russian | MEDLINE | ID: mdl-38887066

ABSTRACT

One of the main tasks in expertise of living persons is to determine the harm caused to human health. According to the regulations, only harm to human health caused by an injury and causally related with it is taken into account in the forensic examination of a living person. The establishment of a causal link allows to assess correctly the harm severity caused to human health. In this respect, the study of the effect of biological damaging factor on human body (cause) and the result of this interaction (effect) is a new step in modern science. The article presents the analysis of data from the reports of the Russian Reference Center on monitoring of enteric infection agents for 2016-2021; the results of examinations of subjects who suffered from acute enteric infections for 2018-2019 to study causal links in forensic medicine in cases of acute intestinal infections.


Subject(s)
Forensic Medicine , Humans , Forensic Medicine/methods , Acute Disease , Russia , Male , Female
3.
Nutrients ; 16(12)2024 Jun 18.
Article in English | MEDLINE | ID: mdl-38931269

ABSTRACT

Since the 1970s, the utility of nailfold capillaroscopy (NFC) in diagnosing rheumatological disorders such as systemic sclerosis has been well established. Further studies have also shown that NFC can detect non-rheumatic diseases such as diabetes, glaucoma, dermatitis, and Alzheimer disease. In the past decade, nailfold capillary morphological changes have also been reported as symptoms of unhealthy lifestyle habits such as poor diet, smoking, sleep deprivation, and even psychological stress, all of which contribute to slow blood flow. Therefore, studying the relationships between the morphology of nailfold capillaries and lifestyle habits has a high potential to indicate unhealthy states or even pre-disease conditions. Simple, inexpensive, and non-invasive methods such as NFC are important and useful for routine medical examinations. The present study began with a systematic literature search of the PubMed database followed by a summary of studies reporting the assessment of morphological changes detected by NFC, and a comprehensive review of NFC's utility in clinical diagnosis and improving unhealthy dietary lifestyles. It culminates in a summary of dietary and lifestyle health promotion strategy, assessed based on NFC and other related measurements that indicate healthy microvascular blood flow and endothelial function.


Subject(s)
Life Style , Microscopic Angioscopy , Nails , Humans , Microscopic Angioscopy/methods , Nails/blood supply , Diet , Capillaries/diagnostic imaging
4.
Ind Health ; 2024 May 28.
Article in English | MEDLINE | ID: mdl-38811195

ABSTRACT

This article aims to provide a historical overview of how workplace safety and health legislations in Singapore and Japan have evolved, and perform a comparative analysis of the occupational health systems where work-related medical examinations and health screening are concerned. The discourse is centered on three key themes - coverage, comprehensiveness, and continuity of care. The comparative analysis was performed based on secondary data obtained from open-source platforms. Singapore and Japan have robust workplace safety and health legislative frameworks and laws. However, their approaches diverge because of differing socioeconomic and political contexts. Japan's regulations are generally more comprehensive, require more frequent monitoring of workers' health status, and encompass both physical and mental health components. Singaporean companies focus primarily on the physical component of health, and statutory examinations are required only for exposure to specific occupational hazards. With increasing prominence of mental health issues and shift towards preventive care in Singapore, there will be greater emphasis on a holistic approach to each employee's overall health in future. For Japan, the challenge would be to strike a balance between long-term sustainability of current policies against the need for state and corporations to still retain an adequate stake in ensuring workers' overall health.

5.
Article in English | MEDLINE | ID: mdl-38684792

ABSTRACT

OBJECTIVES: Large Language Models (LLMs) such as ChatGPT and Med-PaLM have excelled in various medical question-answering tasks. However, these English-centric models encounter challenges in non-English clinical settings, primarily due to limited clinical knowledge in respective languages, a consequence of imbalanced training corpora. We systematically evaluate LLMs in the Chinese medical context and develop a novel in-context learning framework to enhance their performance. MATERIALS AND METHODS: The latest China National Medical Licensing Examination (CNMLE-2022) served as the benchmark. We collected 53 medical books and 381 149 medical questions to construct the medical knowledge base and question bank. The proposed Knowledge and Few-shot Enhancement In-context Learning (KFE) framework leverages the in-context learning ability of LLMs to integrate diverse external clinical knowledge sources. We evaluated KFE with ChatGPT (GPT-3.5), GPT-4, Baichuan2-7B, Baichuan2-13B, and QWEN-72B in CNMLE-2022 and further investigated the effectiveness of different pathways for incorporating LLMs with medical knowledge from 7 distinct perspectives. RESULTS: Directly applying ChatGPT failed to qualify for the CNMLE-2022 at a score of 51. Cooperated with the KFE framework, the LLMs with varying sizes yielded consistent and significant improvements. The ChatGPT's performance surged to 70.04 and GPT-4 achieved the highest score of 82.59. This surpasses the qualification threshold (60) and exceeds the average human score of 68.70, affirming the effectiveness and robustness of the framework. It also enabled a smaller Baichuan2-13B to pass the examination, showcasing the great potential in low-resource settings. DISCUSSION AND CONCLUSION: This study shed light on the optimal practices to enhance the capabilities of LLMs in non-English medical scenarios. By synergizing medical knowledge through in-context learning, LLMs can extend clinical insight beyond language barriers in healthcare, significantly reducing language-related disparities of LLM applications and ensuring global benefit in this field.

6.
Dent J (Basel) ; 12(4)2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38668001

ABSTRACT

The dental treatment of patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC) may be challenging for dentists. This study aimed to characterize systemic changes in patients with OOPSCC undergoing dental treatment prior to cancer therapy, with a specific focus on laboratory assessments. The primary objectives included identifying potential adverse events, such as infections or bleeding, resulting from dental procedures. Additionally, the study aimed to correlate baseline patient characteristics with treatment-related toxicities. This was a prospective cohort study that included 110 OOPSCC patients referred to the Dental Oncology Service at São Paulo State Cancer Institute, Brazil, between November/2019 and December/2020. Comorbidities, sociodemographic data, medication in use, cancer treatment-related toxicities, and altered laboratory tests results were correlated. The most common comorbidities and altered laboratory results were hypertension, dyslipidemia, diabetes, as well as elevated levels of C-reactive protein, hemoglobin, and hematocrit. Toxicities exhibited a progressive pattern over time, encompassing oral mucositis (OM), xerostomia, dysphagia, dysgeusia, trismus, and radiodermatitis. No correlation between comorbidities and cancer treatment-related toxicities, a positive correlation between medications in use and OM, and a negative correlation between medications and dysgeusia were found. OM was associated with altered thyroxine (T4) and free thyroxine (FT4), calcium, urea, creatinine, alkaline phosphatase, and syphilis. Family income and housing were OM predictors. Altered T4/FT4/urea/calcium/alkaline phosphatase/creatinine/syphilis may be useful clinical predictors of OM. Despite the elevated prevalence of comorbidities and abnormal laboratory findings, dental treatment prior to cancer treatment yielded no adverse events.

8.
BMC Med Educ ; 24(1): 354, 2024 Mar 29.
Article in English | MEDLINE | ID: mdl-38553693

ABSTRACT

BACKGROUND: Writing multiple choice questions (MCQs) for the purpose of medical exams is challenging. It requires extensive medical knowledge, time and effort from medical educators. This systematic review focuses on the application of large language models (LLMs) in generating medical MCQs. METHODS: The authors searched for studies published up to November 2023. Search terms focused on LLMs generated MCQs for medical examinations. Non-English, out of year range and studies not focusing on AI generated multiple-choice questions were excluded. MEDLINE was used as a search database. Risk of bias was evaluated using a tailored QUADAS-2 tool. RESULTS: Overall, eight studies published between April 2023 and October 2023 were included. Six studies used Chat-GPT 3.5, while two employed GPT 4. Five studies showed that LLMs can produce competent questions valid for medical exams. Three studies used LLMs to write medical questions but did not evaluate the validity of the questions. One study conducted a comparative analysis of different models. One other study compared LLM-generated questions with those written by humans. All studies presented faulty questions that were deemed inappropriate for medical exams. Some questions required additional modifications in order to qualify. CONCLUSIONS: LLMs can be used to write MCQs for medical examinations. However, their limitations cannot be ignored. Further study in this field is essential and more conclusive evidence is needed. Until then, LLMs may serve as a supplementary tool for writing medical examinations. 2 studies were at high risk of bias. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.


Subject(s)
Knowledge , Language , Humans , Databases, Factual , Writing
9.
Sud Med Ekspert ; 67(1): 62-66, 2024.
Article in Russian | MEDLINE | ID: mdl-38353017

ABSTRACT

The article is devoted to the current legal responsibility of medical staff. It is noted that this issue has not been sufficiently studied and requires further research. The article identifies an attempt to assess statistically significant correlation between defects of medical care provision and data of causal analysis as a research task. The practical experience on 215 conclusions of commission forensic medical examinations, in which doctors of surgical specialties were considered on «medical cases¼, has been summarized. A high statistically significant correlation between defects in treatment, diagnosis, organization of medical care, management of medical records and data of causal relationship has been established on the basis of performed scientific researches. The idea that, despite possible subjectivism, the causal relationship is confirmed by factual data on revealed defects in medical care obtained from the study, has been proven.


Subject(s)
Patient Care , Humans , Causality
10.
BMC Med Educ ; 24(1): 143, 2024 Feb 14.
Article in English | MEDLINE | ID: mdl-38355517

ABSTRACT

BACKGROUND: Large language models like ChatGPT have revolutionized the field of natural language processing with their capability to comprehend and generate textual content, showing great potential to play a role in medical education. This study aimed to quantitatively evaluate and comprehensively analysis the performance of ChatGPT on three types of national medical examinations in China, including National Medical Licensing Examination (NMLE), National Pharmacist Licensing Examination (NPLE), and National Nurse Licensing Examination (NNLE). METHODS: We collected questions from Chinese NMLE, NPLE and NNLE from year 2017 to 2021. In NMLE and NPLE, each exam consists of 4 units, while in NNLE, each exam consists of 2 units. The questions with figures, tables or chemical structure were manually identified and excluded by clinician. We applied direct instruction strategy via multiple prompts to force ChatGPT to generate the clear answer with the capability to distinguish between single-choice and multiple-choice questions. RESULTS: ChatGPT failed to pass the accuracy threshold of 0.6 in any of the three types of examinations over the five years. Specifically, in the NMLE, the highest recorded accuracy was 0.5467, which was attained in both 2018 and 2021. In the NPLE, the highest accuracy was 0.5599 in 2017. In the NNLE, the most impressive result was shown in 2017, with an accuracy of 0.5897, which is also the highest accuracy in our entire evaluation. ChatGPT's performance showed no significant difference in different units, but significant difference in different question types. ChatGPT performed well in a range of subject areas, including clinical epidemiology, human parasitology, and dermatology, as well as in various medical topics such as molecules, health management and prevention, diagnosis and screening. CONCLUSIONS: These results indicate ChatGPT failed the NMLE, NPLE and NNLE in China, spanning from year 2017 to 2021. but show great potential of large language models in medical education. In the future high-quality medical data will be required to improve the performance.


Subject(s)
Artificial Intelligence , Educational Measurement , Licensure , China , Data Accuracy , Education, Nursing , Education, Pharmacy , Education, Medical
11.
JMIR Med Educ ; 10: e49970, 2024 Jan 16.
Article in English | MEDLINE | ID: mdl-38227351

ABSTRACT

BACKGROUND: ChatGPT is among the most popular large language models (LLMs), exhibiting proficiency in various standardized tests, including multiple-choice medical board examinations. However, its performance on otolaryngology-head and neck surgery (OHNS) certification examinations and open-ended medical board certification examinations has not been reported. OBJECTIVE: We aimed to evaluate the performance of ChatGPT on OHNS board examinations and propose a novel method to assess an AI model's performance on open-ended medical board examination questions. METHODS: Twenty-one open-ended questions were adopted from the Royal College of Physicians and Surgeons of Canada's sample examination to query ChatGPT on April 11, 2023, with and without prompts. A new model, named Concordance, Validity, Safety, Competency (CVSC), was developed to evaluate its performance. RESULTS: In an open-ended question assessment, ChatGPT achieved a passing mark (an average of 75% across 3 trials) in the attempts and demonstrated higher accuracy with prompts. The model demonstrated high concordance (92.06%) and satisfactory validity. While demonstrating considerable consistency in regenerating answers, it often provided only partially correct responses. Notably, concerning features such as hallucinations and self-conflicting answers were observed. CONCLUSIONS: ChatGPT achieved a passing score in the sample examination and demonstrated the potential to pass the OHNS certification examination of the Royal College of Physicians and Surgeons of Canada. Some concerns remain due to its hallucinations, which could pose risks to patient safety. Further adjustments are necessary to yield safer and more accurate answers for clinical implementation.


Subject(s)
Otolaryngology , Surgeons , Humans , Canada , Certification , Hallucinations
12.
Prev Med ; 180: 107849, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38185224

ABSTRACT

BACKGROUND: Engagement in preventive healthcare services is crucial for preventing diseases. We explored how working hours are associated with engagement in preventive healthcare services, with a focus on gender differences. METHODS: This cross-sectional study used data from the 2007-2012 Korean National Health and Nutrition Examination Survey. The dependent variable was engagement in each of the five preventive healthcare services (health check-ups, influenza vaccination, and stomach, breast, and cervical cancer screenings). We estimated the prevalence ratios (PRs) and 95% confidence intervals (CIs) using robust Poisson regression. RESULTS: The study analyzed 19,819 workers (9119 women). The adjusted PRs (95% CI) of the association between working ≥55 h per week and engagement in preventive healthcare services among men were 0.95 (0.90-1.00) for health check-ups, 0.86 (0.77-0.96) for influenza vaccination, and 0.95 (0.87-1.03) for stomach cancer screening compared to working 35-40 h per week. Among women, the adjusted PRs (95% CI) of the association between working ≥55 h per week and engagement in preventive healthcare services were 0.84 (0.78-0.91) for health check-ups, 0.82 (0.73-0.92) for influenza vaccination, and 0.88 (0.80-0.97) for stomach, 0.85 (0.78-0.94) for breast, and 0.82 (0.74-0.91) for cervical cancer screenings. CONCLUSION: Long working hours were negatively associated with engagement in preventive healthcare services, and the association was pronounced among female workers. Efforts to promote preventive healthcare participation among individuals with long working hours are necessary, and it is essential to consider the unique vulnerabilities of women when developing such policies.


Subject(s)
Influenza, Human , Uterine Cervical Neoplasms , Male , Humans , Female , Nutrition Surveys , Cross-Sectional Studies , Uterine Cervical Neoplasms/prevention & control , Preventive Health Services , Delivery of Health Care , Republic of Korea/epidemiology
13.
J Forensic Sci ; 69(1): 252-263, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37792506

ABSTRACT

Evidence describing age-related differences among children with suspected physical and sexual child abuse is lacking. We describe findings in severe cases of suspected abuse. Cases with 756 children <15 years old were included during 2001-2013 at the Department of Forensic Medicine, Aarhus University, using forensic evaluation documents, medical records, and court proceedings. Eight percent of children <4 years old died from child abuse, 36% through violence resulting in death, and 64% by manslaughter, whereas 1% > 4 years old died, solely by manslaughter. External injuries were mainly located to head and torso in children <4 years old, changing to the upper and lower extremities in older children. Child sexual abuse was suspected in 52% of cases with living children <4 years old, 83% of children 4-7 years of age, 88% of children 8-11 years of age, and 93% of children >12 years old. Anogenital findings were mainly caused by other medical conditions in children <4 years old, hymenal clefts in the superior half of the hymenal rim were almost exclusively found in children between 8 and 11 years of age, whereas both superficial and complete hymenal clefts in the inferior half of the hymenal rim were found in children >12 years old. The present study describes age-related differences in victims of suspected child abuse. Fatal versus nonfatal child physical abuse and the significance of hymenal findings in child sexual abuse could be studied further.


Subject(s)
Child Abuse, Sexual , Child Abuse , Female , Child , Humans , Adolescent , Child, Preschool , Child Abuse, Sexual/diagnosis , Physical Examination/methods , Hymen/injuries , Forensic Medicine/methods , Child Abuse/diagnosis , Retrospective Studies
14.
Leg Med (Tokyo) ; 67: 102373, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38154311

ABSTRACT

The Russian invasion of Ukraine in 2022 caused a significant spike in the number of deaths from blast injury. The impossibility of evacuating the bodies of dead servicemen or civilians from the battlefield for a long time leads to the fact that forensic experts often have to deal with the examination of bodies in a state of decomposed changes. At the same time, the material and technical support of forensic medical institutions in different parts of Ukraine is heterogeneous: most experts do not have access to laboratory or instrumental research methods and can only rely on macroscopic research data. This article provides an overview of the cases of expert examination of cases of explosive trauma of decomposed bodies using macroscopic, microscopic, chemical and instrumental research, which indicates the high efficiency of their use for the purpose of solving expert questions of various nature. At the same time, the identified morphological characteristics of the damage are not purely specific and indicate the action of a blunt solid object with a limited contact surface, which had high kinetic energy and significant penetrating capacity.


Subject(s)
Blast Injuries , Wounds, Penetrating , Humans , Blast Injuries/diagnosis
15.
Sud Med Ekspert ; 66(6): 24-27, 2023.
Article in Russian | MEDLINE | ID: mdl-38093425

ABSTRACT

OBJECTIVE: To find a way and form of presenting impedance metrics data to clarify prescription of death coming in a comprehensive assessment. MATERIAL AND METHODS: The impedance of biological objects was measured depending on prescription of death coming in standardized conditions (air temperature +4 °C, humidity 45%). The main examined postmortem period was 1 months. Measurements were made on 3 diagnostic zones of biological object and for 5 current frequency of the study. A total of 2100 readings were taken. RESULTS AND CONCLUSION: The studies performed in standardized conditions have showed that using impedance metrics method to diagnose prescription of death coming is possible. The analysis of only absolute impedance values is not sufficient to clarify prescription of death coming due to its undulating changes. The additional use of relative coefficients, characterizing impedance dispersion, is suggested. The study of possible using the impedance indicators of corpse's tissues to determine prescription of death coming should be performed with consideration to pathomorphology of degradation. Further study of impedance dynamics when corpse is under different conditions is necessary for development of a working algorithm to determine prescription of death coming based on tissue impedance.


Subject(s)
Postmortem Changes , Humans , Electric Impedance , Cadaver , Temperature
16.
Sud Med Ekspert ; 66(6): 59-64, 2023.
Article in Russian | MEDLINE | ID: mdl-38093432

ABSTRACT

The article presents a part of historical path (1918-1991) of forensic medical examination in the Republic of Belarus, the history of origin, formation and development of forensic medical service and the academical departments of forensic medicine in the BSSR. The creation date of the state forensic medical service on the territory of Belarus can be considered as 3 of July 1918 yr. Since then, the service has passed from the judicial and administrative subdivision of the department of public healthcare of Executive Committee of Vitebsk Council of Workers, Peasant and Red Army Deputies (1918), the department of forensic medicine of the PCH of the BSSR (1919), forensic medical department at the Central Chemical and Biological Station of the PCH of the BSSR (1921) to the Institute of Scientific and Forensic Examination of the BSSR (1929), Central Forensic Medical Laboratory of the PCH of the BSSR (1931) and Republican Bureau of Forensic Medical Examination under the Ministry of Healthcare of the BSSR (1952). The historical stages of the existence of the forensic medical service and its state organizations in the BSSR were following: 1) stage of origin (1918-1922); 2) stage of formation (1921-1941, 1946-1952); 3) stage of development (1952). The main forensic medical experts, who made a significant contribution to the origin, formation and development of forensic medical examination in the territory of Belarus were V.F. Chervakov (1930-1939), S.A. Prilutskiy (1939-1941, 1946-1960), V.K. Steshits (1961-1977) and S.S. Maksimov (from 1977).


Subject(s)
Forensic Medicine , Humans , Republic of Belarus
17.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 31(Special Issue 2): 1171-1175, 2023 Oct.
Article in Russian | MEDLINE | ID: mdl-38069881

ABSTRACT

Screening or its synonym medical check-up is the result of a health indicator, representing results of a medical examination and an effective tool of disease prevention. The concept of the term screening in European countries implies active detection of a disease or a premorbidity in people who are considered or consider themselves healthy. Medical check-up is a set of measures that includes preventive medical examination and additional methods of examinations conducted in order to assess the state of health and carried out in relation to certain groups of the population. The study and analysis of the international screening model and experience of its implementation, its role in the system of primary health care, including rehabilitation, is very important in terms of shaping public health at the international level. The article discusses regional trends in screening (medical check-up) and issues related to the conceptual and methodological aspects of medical check-up organization in the context of public health and prevention of risk factors. The data were searched in Scopus Web of Science, MedLine, the Cochrane Library, PubMed.


Subject(s)
Public Health , Humans , Risk Factors , Russia , Europe/epidemiology
18.
JMIR Med Educ ; 9: e47191, 2023 Nov 07.
Article in English | MEDLINE | ID: mdl-37934568

ABSTRACT

BACKGROUND: ChatGPT has gained global attention recently owing to its high performance in generating a wide range of information and retrieving any kind of data instantaneously. ChatGPT has also been tested for the United States Medical Licensing Examination (USMLE) and has successfully cleared it. Thus, its usability in medical education is now one of the key discussions worldwide. OBJECTIVE: The objective of this study is to evaluate the performance of ChatGPT in medical biochemistry using clinical case vignettes. METHODS: The performance of ChatGPT was evaluated in medical biochemistry using 10 clinical case vignettes. Clinical case vignettes were randomly selected and inputted in ChatGPT along with the response options. We tested the responses for each clinical case twice. The answers generated by ChatGPT were saved and checked using our reference material. RESULTS: ChatGPT generated correct answers for 4 questions on the first attempt. For the other cases, there were differences in responses generated by ChatGPT in the first and second attempts. In the second attempt, ChatGPT provided correct answers for 6 questions and incorrect answers for 4 questions out of the 10 cases that were used. But, to our surprise, for case 3, different answers were obtained with multiple attempts. We believe this to have happened owing to the complexity of the case, which involved addressing various critical medical aspects related to amino acid metabolism in a balanced approach. CONCLUSIONS: According to the findings of our study, ChatGPT may not be considered an accurate information provider for application in medical education to improve learning and assessment. However, our study was limited by a small sample size (10 clinical case vignettes) and the use of the publicly available version of ChatGPT (version 3.5). Although artificial intelligence (AI) has the capability to transform medical education, we emphasize the validation of such data produced by such AI systems for correctness and dependability before it could be implemented in practice.

19.
Wiad Lek ; 76(9): 1978-1983, 2023.
Article in English | MEDLINE | ID: mdl-37898933

ABSTRACT

OBJECTIVE: The aim: To identify the main groups of expert defects that arise during the forensic assessment of changes detected during the examination of persons who died from a traumatic brain injury (TBI). PATIENTS AND METHODS: Materials and methods: A total of 102 repeated commission forensic medical examinations with changed conclusions in corpses with TBI were analyzed. Data processing and analysis were conducted using statistical methods. RESULTS: Results: The examined forensic medical assessments of TBI with changed conclusions in corpses were categorized into the following groups: defects in estab¬lishing the diagnosis of TBI - 17.65±7.4%; defects in establishing the mechanism of TBI - 35.3±9.3%; defects in establishing the duration of TBI - 39.22±9.5%: sober - 20±12.4%; with alcohol intoxication - 80±12.4%. A combination of defects was found in 7.83±5.2% of cases. Defects that directly affected the experts' incorrect establishment of the diagnosis, mechanism, and duration of TBI were also identified. CONCLUSION: Conclusions: The largest number of changed conclusions during the forensic medical examination of corpses in cases of TBI was due to the wrongly established duration of the trauma, accounting for 39.2±9.5%, with the vast majority of cases (80±12.4%) observed against the background of alcohol intoxication. The mechanism of trauma accounted for 35.3±9.3% of the changed conclusions. The main defects were incomplete collection of material for histological examination (90.2±5.8%) and incorrect interpretation of the results of histological examination (76.48±8.2%), along with the violation of the method of sectional examination (68.6±9.0%). Different groups of expert defects predominated in the cases with an incorrectly established diagnosis of TBI, duration of trauma, and mechanism.


Subject(s)
Alcoholic Intoxication , Brain Injuries, Traumatic , Humans , Brain Injuries, Traumatic/diagnosis , Cadaver , World Health Organization
20.
Sud Med Ekspert ; 66(5): 11-17, 2023.
Article in Russian | MEDLINE | ID: mdl-37796454

ABSTRACT

The article presents the results of the study of quantitative indicators and analytical compilation of forensic medical expert practice data in terms of the age of living persons in Russia examination as a whole and in individual federal districts and subjects of Russia in the period from 2003 to 2021. It has been established that against the background of the rather low number of expert examinations, performed to determine the living persons age, there has been an increase in this indicator since 2018, mainly due to the Central Federal District. Regional differences in the studied indicators were identified. A systematic survey study of literature (electronic search of publications in PubMed, Science Direct Scopus and eLIBRARY databases) was conducted on the issue of forensic medical assessment of living persons' age, including the methodical support of this examination type, to form an idea of existing scientific clusters. Search modes allowed to form an array of 184 publications indexed in the database Scopus, PubMed, and 8 publications presented in Russian Science Citation Index. The study results were used as a predictor of the efficacy of the package of measures to modernize this type of expert study. The proposed set of measures to improve the scientific and methodical support of forensic medical examination for age establishment will optimize practical activities and increase the evidential efficacy of expert opinions.


Subject(s)
Expert Testimony , Forensic Medicine , Humans , Forensic Medicine/methods , Russia , Surveys and Questionnaires
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