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The objective of the present study was the definition of the basic professional competences of the graduates of the clinical residency and internship in the speciality 31.08.10 'forensic medical expertise'. The program for the acquirement of the basic knowledge, skills, and professional competences needed to be trained in the speciality 31.08.10 'forensic medical expertise' has been elaborated in the framework of the more extensive program for the clinical residency and internship intended for the training of the highly qualified specialists in this discipline. The preliminary list of basic professional competences of a graduate from the clinical residency and internship has been formulated in accordance with the program for the training of a competitive and highly qualified forensic medical experts. The practical professional activities are considered to be an indispensable component of the training and educational process for a future forensic medical expert. It is believed that the strengthening of this training component will greatly contribute to the improvement of the quality of training of such specialists.

The authors discuss the conceptual issues of the academic program designed to teach forensic medicine to the students of the stomatological faculties of educational medical institutions. The program has been elaborated in conformity with the federal state educational standard of higher professional education in the speciality stomatology'. It defines the goals and objectives of this discipline, the scope of its competences, the subject matter and the content, the requirements to the studies and educational work, control over the level of its success, academic progress, and other aspects of the training activities, with special emphasis being placed on the formation of the general professional competence of the students to enable them to work independently after they graduated from the institute. The program takes into consideration the latest achievements in forensic medical science and their practical applications. Much attention is given to the organizational and processual aspects of forensic medicine, thanatology, general and special traumatology, mechanical asphyxia, effects of the environmental factors, intoxication, forensic medical expertise of living subjects and material evidence.

This paper is concerned with the theoretical aspects and present-day practice of commissioning expert assessments and performance of forensic medical expertise. Special attention is given to the conceptual problem of the interaction between the organizations engaged in forensic medical examination and law-enforcement bodies. The authors outline the most promising directions for the improvement of cooperation between such agencies, preliminary investigation and criminal enquiry facilities.

The analysis of the unfavourable outcomes of dental care based on the materials of forensic medical examinations carried out by the Bureau of Forensic Medical Expertise, Moscow Department of Health.

Expert reports concerning subjects with zygomatic bone fractures were analysed and comprehensively evaluated using investigatory, clinical and anamnestic data. A total of 704 forensic medical reports were available for the purpose including 225 (32%) isolated and 479 (68%) combined fractures. It was shown that most complications of zygomatic fractures develop late in the post-traumatic period which requires repeated examination of the patients within at least one month after the injury. It is emphasized that such examination must involve neuropathologist, ophthalmologist, and maxillofacial surgeon to adequately evaluate harm to the health in patients with isolated zygomatic fractures. The main causes of discrepancy between results of estimation of harm to the health during primary and subsequent forensic medical examination of subjects with zygomatic fractures are considered.

The analysis of the 1989-2005 records of the Moscow Bureau of Forensic-Medical Examinations, statistics on lethal narcotic poisonings by gender, age, education, social and family status has revealed that the trend to reduction of the number of narcotic substances (NS) poisonings stopped in 2003. There was a 238.4% rise in the above poisonings in 2004. The highest rise was in the age group of 21-25-year-olds (35.7%; CI = 0.34-0.37; p = 0.05) and 26-30-year-olds (29.6%; CI = 0.28-0.31; p = 0.05). Among lethal cases one-third were unemployed (35.8%; CI = 0.34-0.37; p = 0.05) and one-forth were workers (22.2%; CI = 0.20-0.24; p = 0.05). By the family status, most of the dead were unmarried (57%; CI = 0.55-0.59; p = 0.05). This study gives a complete and accurate picture of the structure of narcotic drug poisonings. Relevant preventive measures are proposed.

The article presents toxicological characteristics of 198 cases of acute parenteral poisoning with morphine and heroin in the range of concentrations of their metabolites in the blood and urine which occur in practice. Risk of death is quantified in the range of possible morphine concentrations in the blood in acute opiates intoxication with reference to gender and age. Assessment of the criteria of quantitative opiates toxicity was made according to the method of logit regression and dose-effect curve suitable for analysis of correlations between probability of death and blood concentrations of opiates metabolites. Conditional lethal doses in respect to gender and age are calculated.

Facts of prehospital death of 109 heroin addicts are analysed and systematized. It is shown that examination of the corpse at the point of detection may provide information on the circumstances of death and its cause. Correlation between morphine concentration in the corpse tissues and circumstances of death is studied. It is found that information about the victim and facts of his/her death suggest cause of death and help in directions of post-mortem examination and choice of diagnostic procedures.

A total of 198 cases of acute parenteral poisoning with opiates are characterized. The range of concentrations of opiates metabolites in the blood and urine, main causes of death due to opiate poisoning in alcohol intoxication are analysed. Opiates toxicity was assessed with the logit-regression method and dose-effect curves valid for analysis of relationships between probability of death and opiate metabolites concentration in blood and urine. Correlation between probability of death and detection of morphine and ethanol in biological media of the victims is considered. Concentrations of morphine in blood and urine definitely indicating opiates poisoning in alcohol intoxication as a cause of death are determined.

Toxicological characteristics are presented for 198 cases of acute parenteral poisoning with morphine and heroin. The range of their metabolites concentration in the blood and urine encountered in practice are analysed. Principal causes of death due to opiate poisoning in inpatients are shown. Opiates toxicity was assessed by the method of logit-regression and dose-effect curves for analysis of probability of death depending on opiate metabolite concentration in blood and urine. Relations between probability of death and detection of morphine in biological media of the victims are considered. Morphine concentrations in the blood and urine undoubtedly indicating morphine poisoning are determined.

Abuse of drugs has been a topical issue up to the present-day. Opiates like morphine and heroin are still prevalent. The routine methods of determination of drugs in blood made within the forensic medical expertise are time-consuming and samples must be specially prepared for them. ELISA, when used for the determination of opiates in blood and urine, significantly cuts the test time. According to our research results, the diagnosis of opiates by ELISA is advisable at the preliminary stage of the forensic expertise of cadaver; the method is informative, which is of extra importance in cases of purulent transformation of cadaveric material.

With due regard for the economic situation in regions, differences in the material-technical and personnel provision of each forensic-medical bureau (FMB), paying capacity of local residents and for other factors, a method for estimating the cost of forensic medical services was elaborated and offered for use. The formula of cost estimation for rendered services allow for basic wages (BW) and bonuses, sick-list and vacation payments, overhead charges (including FMB wear-and-tear), and BW assignment to off-budget funds (which constitute, in total, the self-cost of services) as well as the planned profit and road taxes.

A total of 743 lethal outcomes of thromboembolytic complications of trauma, diseases and certain pathological conditions as observed in 1999-2001 and in the three quarters of 2002 were studied. The undertaken analysis confirmed two factors provoking the pathological thrombosis, i.e. 1. Pathological changes observed in the surface vascular wall preconditioned by mechanical damages, atherosclerotic process and aging; and 2. A slower blood flow due to an impaired blood circulation, a forced positioning and to hypodynamics. While deciding on a possibility of a direct cause-effect relation between past traumas, surgeries, poisonings and death of thromboembolism of the pulmonary arteries (TEPA), such relation can be mentioned only on rare occasions. It is more often the case that an indirect, mediated relationship is found, when TERA evolves due to an unfavorable combination of risk factors, i.e. a forced immobility, changing coagulated blood system, impaired blood vessels etc.

This paper presents the first experience gained in Russia in expert identification practice with complex utilization of technologies of molecular genetic individualization of biological objects for solving identification tasks requiring the maximum complete armory of mutually supplementing means. This is particularly important for forensic expert personality identification in cases with many deaths, when indirect identification has to be resorted to, consisting in the use of biological samples from relatives of the victims as the identifying objects. Methodological approaches and concepts of expert studies, used for identification of the remains of people who died in terroristic acts committed in Moscow in September, 1999, are discussed. The results of this study and methodological experience notably extend the potentialities of expert evaluation as regards forensic medical identification of victims of overall disasters, terroristic acts, and war conflicts.

Describes the rare cases of incarceration of a part of the heart between the edges of the pericardium in incisions made during cardiosurgery for cut wounds of the heart and in case of incarceration of the heart at the site of rupture of the pericardium during traumas in the car cabin as a result of car accidents. Incarceration of the heart has been never diagnosed during patient's life.

The rate of the spin probe reduction by tongue homogenates was measured on postmortem days 15, 30, 45, 60, 75, 105, 135, 150, 165, 180, 195, 210, 225, and 240 in order to evaluate the possibility of determining the time of death by this test. The constant of the rate of phenol probe reduction by tongue homogenates was used as the diagnostic sign of the time elapsed since death. The results indicate that using this parameter, the time of death may be determined within the period from 4 to 8 months postmortem.

The constant of spin probe recovery by the myocardium was assessed 1, 3, 6, 9, 12, 15, 18, and 21 days postmortem in order to identify the time of death of subjects of both sexes who died from craniocerebral injury. The constant of the rate of spin probe recovery by the myocardium did not change during the first six days postmortem. After 6 days certain changes of the myocardial EPR spectra were observed, which may be used in the diagnosis of the time of death up to day 21 postmortem.

Electron paramagnetic resonance (EPR) was used for assessing the time of death. The kinetics of the reaction of the rate of recovery of spin probes incubated with homogenized muscle tissue was studied by repeatedly recording the central component of the probe followed by measuring its amplitude. Muscle tissue of 35 corpses was studied 7 to 182 days postmortem with a one-week interval. The results indicate that EPR may help assess the time of death in corpses transformed by putrefaction. The amplitude of the central component of spin probe EPR spectrum is recommended as the criterion of assessing the length of postmortem period.

A medical statistical analysis of 512 lethal cases of occupational injuries that occurred in Moscow in 1988-1990 has been carried out. Such cases made up 2.4% of all cases of violent death. The structure of traumatism is shown, as is the ratios between certain types of injuries, age and sex characteristics of the victims, causes of death, etc. A trend to lowering of the incidence of occupational injuries could be traced.

Determination of postmortem interval according to the time course of cathepsins activity within 5 days since death was carried out using myocardium and skeletal muscles of white breedless rats and cadavers of people who died of craniocerebral trauma. Natural time course of changes in cathepsins activity was determined which makes it possible to use these values as one of criteria in determination of postmortem interval.