[The forensic chemical investigation of acetylsalicylic acid].

The objective of the present study was to develop the universal approach to the quantitative determination of acetylsalicylic acid in biological tissues and fluids to be applied in the practice of forensic chemical expertise with the use of thin-layer chromatography, gas chromatography and mass spectrometry, low-pressure column chromatography, and spectrophotometry. A system of solvents consisting of acetone and ethyl acetate (7:3) was proposed as a universal agent for extracting acetylsalicylic acid from the cadaveric tissues and blood. It was shown that acetylsalicylic acid and its principal metabolite, salicylic acid, can be purified from the endogenous admixtures present in the biological materials by column chromatography on silica gel L 40/100 mcm. Salicylic acid in extracts from biological materials was identified and quantified with the use of thin-layer chromatography, gas chromatography/mass spectrometry, and electronic spectrophotometry. The method for forensic chemical investigation of acetylsalicylic acid has been developed and applied in the analysis of the material provided for expertise.

[Determination of carbofuran in the biological material for the purpose of forensic medical examination].

It is proposed to use the mixture of acetone and ethylacetate (1:1) as an universal solvent for the extraction of carbofuran from cadaveric tissues and fluids. Extracted carbufuran can be purified from endogenous admixtures on KSS No 3 Silica Gel columns (80/120 mcm) and identified using TLC, electron spectrophotometrty, HPLC, and GC-MS. The proposed method of forensic chemical analysis of carbofuran was applied for the purpose of forensic medical expertise.

[The detection of beta-cypermethrin during forensic chemical expertise of biological materials].

The optimal conditions for the isolation of beta-cypermethrin from biological materials by means of dioxane extraction have been developed. The possibility to purify beta-cypermethrin from endogenous impurities is demonstrated by combination of liquid-liquid extraction and chromatography through a silica gel column (L 40/100 mcm). It is shown that identification and quantitative determination of beta-cypermethrin extracted from the cadaveric liver tissues are possible using such techniques as thin-layer chromatography, electron spectrometry, and chromato-mass spectrometry. A method for forensic chemical expertise of the presence of beta-cypermethrin in biological materials is described.

[Detection of bancol for the purpose of forensic chemical expertise].

Optimal conditions for the extraction of bancol from the biological material with toluene are described. The possibility of its purification and separation from co-extracted compounds on a silicagel L column, 40/100 mcm is illustrated. Identification and quantitative determination of bancol isolated from the cadaverous liver were performed by the electron spectrophotometry technique, thin-layer chromatography, and high performance liquid chromatography using normal-phase sorbents. A method of bancol detection was adapted for the purpose of forensic medical expertise and applied for the postmortem examination of the cadaverous tissues.

[Forensic chemical detection of furadan].

Isolation of furadan from biological material by ethyl acetate is considered. Column chromatography with silicone gel L 100/160micro was used to purify extractions from biological objects. A technique was elaborated for identification and quantitation of furadan in cadavers. It is possible to use this technique in forensic expert examination.

[Survival of patients with infectious endocarditis in various treatment methods]. / Vyzhivaemost' bol'nykh infektsionnym éndokarditom pri razlichnykh metodakh lecheniia.

The aim of the study was to compare survival of patients with infectious endocarditis (IE) by abuse of intravenous narcotic substances in conservative and combined treatment in acute IE phase. A total of 195 IE patients were examined. 121 of them was treated conservatively, 74 patients received a combined treatment including surgical one. A long-term prognosis was studied by the Kaplan-Meier method. Among drug addicts with IE, the number of survivors in the observation period in early operation in the active IE phase was significantly higher than in the conservative therapy. Long-term survival of drug addicts with IE in combined treatment was also higher: 1-2- and 3-year survival was 85.8, 76.3 and 61.0% against 64.8, 49.0 and 34.2% in conservative treatment, respectively. In non-addicts the differences were weaker: long-term survival in combined treatment was higher than in conservative one only in 5-year survival (74.1 and 41.6%, respectively).

[Echocardiography--prognosis of the course of infectious endocarditis and long-term survival in this disease]. / Ekhokardiografia - vozmozhnosti prognozirovaniia techeniia infektsionnogo éndokardita i dolgovremennoi vyzhivaemosti pri nem.

AIM: To determine prognostic opportunities of echocardiography (ECG) in infectious endocarditis (IE) basing on the assessment of microbial vegetations size and degree of valvular failure. MATERIAL AND METHODS: Of 114 patients with definite IE (72 male, 42 female), 90 ones had primary and 24 secondary endocarditis. The prospective study included all the survivors in the IE active stage--78 patients. RESULTS: Vegetations > 1 cm in size were detected in 50.8% patients, < 1 cm--in 49.2%. Hospital lethality in vegetations > 1 cm and < 1 cm was 25.8 and 16.1%, respectively. Thromboembolism rate was 81 and 64.2%, respectively. One-year survival was 78.7 and 71.4%, two-year survival 66.5 and 61.7%, three-year survival 66.5 and 49.4%, five-year survival--51.7 and 32.9% in vegetations < 1 cm and > 1 cm, respectively. Valvular regurgitation of the first degree was in 17.5%, of the second degree--in 41.9%, third-fourth degree--in 36.6% patients. Hospital lethality in mitral valve failure was 32.1%, in aortic and tricuspid failure--17.8 and 11.4%, respectively. CONCLUSION: EchoCG was most effective for predicting thromboembolism and cardiac failure. Valvular regurgitation of the third-fourth degree significantly correlates with severe cardiac failure. ECG is less informative for predicting hospital lethality.

[Right ventricular myocardial infarction in a patient with infectious endocarditis]. / Infarkt miokarda pravogo i levogo zheludochka serdtsa u bol'nogo infektsionnym éndokarditom.

A case of right and left ventricular myocardial infarction in infectious endocarditis of the aortic valve in an injected drug abuser is reported. The infarction was diagnosed only in autopsy. Diagnostic difficulties are discussed. The literature on the problem is listed.

[Infectious endocarditis of the left heart atrium in injection drug addicts]. / Infektsionnyi éndokardit klapanov levykh kamer serdtsa u in"ektsionnykh narkomanov.

AIM: To study etiology, clinical picture, course and prognosis of left heart infection endocarditis (LHIE) in drug addicts. MATERIAL AND METHODS: 61 drug addicts entered the study. 14 of them had lesions of the left heart valves (group 1), 11--of the right and left heart valves (group 2), 36--of the tricuspid valve (group 3), 39 control patients with LHIE had no addiction. Mean age in group 1 was 25.9 +/- 8.8 years, in group 4--48.3 +/- 12.6 years, p < 0.001. RESULTS: Females prevailed in group 3, males--in group 4. Splenomegaly was more frequent in the addicts. Lung lesions (abscesses and infarction) prevailed in groups 2 and 3. Cardiac failure was found more frequently in groups 1 and 4, edema--in group 3, brain affections--in groups 1 and 4. Renal damage was encountered with equal frequency in the addicts and non-addicts. The addicts had, largely, infarctions, non-addicts--glomerulonephritis. Viral hepatitis C was associated with drug addiction. Blood seedings were on the whole positive in 54%, in drug addicts--in 69%. St. aureus predominated (44%). In group 3 it was detected in 72%. It was higher than in groups 4 and 1 (p < 0.001, p < 0.01, respectively). Lethality in group 1 (57%) was higher than in group 3 (22%, p < 0.05) and group 2 (18%, p < 0.01). The leading cause of death in group 1 was cerebral thromboembolism with development of meningoencephalitis. Other causes--progressive cardiac and renal failure.