Наукові праці. Кафедра судової медицини, медичного правознавства імені заслуженого професора М.С. Бокаріуса
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Item Forensic medical aspects of the severity of chest injuries according to the results of the examination of patients in a specialized hospital(2024) Gubin, M.; Malykhina, O.; Voitov, E.; Serbinenko, I.; Gaynanova, V.Closed chest trauma can cause impaired functioning of the respiratory system. Victims with closed chest trauma may be subject to forensic medical examination. The purpose of the study is to determine the severity of closed blunt chest trauma from a forensic perspective based on the results of an examination of patients in a specialised hospital to identify additional diagnostic criteria. The material for the study was the medical records of 103 inpatients of the Zaycev V.T. Institute of General and Emergency Surgery. Considering the diagnostic examination of the victims in the observation groups, the severity of the injuries was determined. Severe bodily injuries were diagnosed in 19 (18.4%) cases of closed chest injuries with acute respiratory failure and loss of part or all of an organ (lung). Injuries of moderate severity were diagnosed in 70 (67.9%) cases of closed chest trauma, mostly with rib fractures, in the absence of life-threatening injuries. Minor injuries were diagnosed in 14 (13.6%) cases of chest trauma without rib fractures with intrapleural injuries and complications or without any complications. It has been established that in the forensic assessment of closed chest injuries, additional diagnostic criteria should be considered: the presence of acute respiratory failure, the dynamics and duration of recovery of post-traumatic morphological and functional changes in injured organs, and the loss of part or all of an organ (lung).Item Forensic medical determination of severity of chest injuries with thorax trauma(2022) Gubin, Mykola; Olkhovsky, Vasil; Grygorian, EdgarBackground. Closed chest trauma with rib fractures is a common injury to the external respiratory system. Victims with such an injury may be subject to forensic examination. The aim of the study was to determine the severity of injuries in patients with closed chest trauma with violation of the integrity of the costal skeleton, treated in a specialized surgical hospital, to establish additional criteria for forensic diagnosis of such trauma. Materials and Methods. 71 medical cards of inpatients, patients with chest injuries who were treated at Kharkiv Institute of General and Emergency Surgery named after V.T. Zaitsev were analyzed. A forensic medical evaluation of closed chest injuries with rib fractures was performed according to the severity of injuries according to clinical observations. Morphological and clinical approach was used to determine severity of injuries. Results. Severe injuries were found in 14 (19.7%) cases of injuries, mainly with the occurrence of a life-threatening phenomenon, namely acute respiratory failure. Moderate injuries were found in 57 (80.3%) cases of chest injuries with rib fractures in the absence of danger to life. Conclusions. It is established that in the available scientific and methodological literature there are no diagnostic morpho-clinical signs for qualitative forensic assessment and prediction of the final results of closed chest injuries, there are different views on forensic assessment. It is determined that when applying the morphological and clinical approach of forensic assessment, additional diagnostic criteria for closed chest injuries, should be considered when determining the severity of injuries: dynamics and duration of recovery of post-traumatic morphological and functional changes of injured organs. or the entire respiratory system (lungs), the occurrence of lifethreatening phenomena. The ways of further improvement of forensic diagnostics in the assessment of these injuries by the degree of their severity are identified.Item Forensic evaluation of clinical observations of injuries of some external respiratory organs(2022) Gubіn, Mykola; Malykhina, Olena; Voitov, Yevgen; Serbinenko, IgorIn the structure of injuries of the external respiratory system, closed chest injury occupies a leading place. Such injuries in victims may be a reason for forensic medical examinations. The aim of the work was to establish a forensic medical assessment of the severity of injuries of the respiratory system based on clinical observations of closed blunt trauma of the chest to determine additional diagnostic criteria for its seriousness. The material for the study was medical records of 126 patients of the Kharkiv Institute of General and Emergency Surgery, named after V.T. Zaitseva, who had chest injuries. According to the materials of clinical observations of closed chest injuries, the severity of injuries in the victims was assessed. In 24 (19%) cases of closed chest injuries, severe injuries were found mainly with acute respiratory failure as a life-threatening condition. In 72 (57.2%) cases of closed chest injuries, mainly with rib fractures, moderate injuries were found in the absence of danger to life. In 30 (23.8%) cases of chest injuries without rib fractures with intrapleural injuries and complications and mild chest injuries without any complications, assessed as minor injuries. It is established that in the forensic medical examination of closed chest injuries, it is necessary to consider additional diagnostic criteria: the presence of life-threatening phenomena, the dynamics and duration of recovery of post-traumatic morpho-functional changes of injured organs.