[On the need to develop medical criteria of cause and effect relationship in cases related to improper provision of medical care].

Objective: Ensuring uniformity of forensic medical expertise in cases related to the improper provision of medical care; reducing the load on public forensic expert institutions by reducing the number of repeated examinations; raising the authority of forensic medical expertise service via introducing a unified approach to assessing the presence and nature of cause and effect relationship.

Material And Methods: The authors provide expert and court practice examples to show fundamental differences in forensic medical assessment of causal relations of improper provision of medical care with an adverse outcome. A focus is given to the court's assessment of expert opinions in a criminal process.

[Features of lung damage in baclofen poisoning].

Objective: To reveal pathological lung changes in baclofen poisoning and to assess their dynamics.

Material And Methods: The experiment included 20 mature (at age 20 weeks) male rats of Wistar line weighing 290-350 gr. The animals were divided into 3 study groups (5 rats in each) depending on experiment's duration after 85 mg/kg baclofen administration: 3, 4.

[Role and importance of forensic medical re-examination of defects in health care delivery].

Article is devoted to the problem of production and legal evaluation of repeated commission (complex) forensic medical examinations based on materials of «medical» practices, related to facts of health care delivery adverse outcomes, in criminal and civil proceedings. Reasons of re-examination assignment, theoretical and applied aspects of this procedural institute in evidence in cases of iatrogenic crimes and unqualified health care delivery were considered. The authors pay particular attention to deficiency of legal base and practical approaches to the re-examination assignment and its results' evaluation, and suggest ways to improve the forensic medical and law enforcement activity in this category of cases.

[Risk factors and mechanisms of acute pyelonephritis development after contact ureterolithotripsy].

Aim: of the study is to identify risk factors for the development of acute pyelonephritis after contact urethrolithotripsy (URLLT) and to establish the mechanisms for maintaining inflammation after the withdrawal of NSAIDs.

Material And Methods: The study included 21 patients who underwent contact ureterolithotripsy (URLT). The severity of leukocyturia was assessed 1 day after URLT, 2 days (the last appointment of NSAIDs, the total duration of the drug was 9 days) and 3 days (24 hours after NSAID discontinuation).

[Extracellular matrix remodeling as a risk factor for the progression of cerebrovascular pathology].

In recent years, attention of experts has been attracted to remodeling of the brains' extracellular matrix in connection with analysis of alterations' causes of the blood-brain barrier (BBB), development of neuroinflammation and neovasculogenesis, as well as the possibility of regeneration of nervous tissue in cerebrovascular pathology. The review discusses the molecular mechanisms of increasing BBB permeability in stroke associated with the interaction of structural elements of the capillary wall (endothelium and pericytes), glial cells and perivascular leukocytes. The role of brain extracellular matrix remodeling in the pathogenesis of neuroinflammation and participation of pericytes in this process are discussed.

[Risks of progression of cerebrovascular pathology associated with the activity of the brain purinergic system].

Until now, there is no understanding of the relationship between risk factors and the progression of cerebrovascular pathology. The review presents facts that confirm the involvement of various subtypes of purine P2 receptors in neuron activation, growth and myelination of axons, migration and microglia phagocytosis, astrogliosis, regulation of vascular tone, thrombosis and angiogenesis, neuroinflammation and immune responses. The data suggest the possibility of the activation of purinergic system of the brain during the development of main risk factors for cerebrovascular pathology (age, arterial hypertension, diabetes), as a stereotypical mechanism that can affect the homeostasis of the ensemble "neuron-glia-capillary".

[Subclavian artery aneurysms: pathogenesis, diagnosis, and therapeutic decision-making].

The article deals with the relevant literature data concerning diagnosis and treatment of subclavian artery aneurysms. This nosological entity is relatively uncommon, however its importance for modern medicine should not be underestimated. Despite a low incidence of the pathology, it should be understood that the disease's course for the patient is associated with the development of severe complications which may lead to disability or even death.

[The order of the investigators as an object of study in conducting forensic medical examinations according to «medical» cases].

The article is devoted to the problem of studying the orders of investigators on the appointment of forensic examinations in «medical» cases. The results of own research of the content of orders in the aspect of their filling with the circumstances of the case and the data necessary for the rational interaction of experts with the investigation team at the organizational stage of the examination are presented. The ways of improving the methods of carrying out examinations of this type in order to reduce the number of repeated and additional examinations, as well as interrogations of experts, and reduce the burden on state forensic institutions are proposed.

[The psychological recommendations on the organization of the self-directed learning among the students based at a department of forensic medicine].

The authors propose the recommendations for the organization of the self-directed learning among the students who study forensic medicine. These recommendations can be of help for the forensic medical experts involved in the continuous medical education programs.

[Activity of α2-adrenergic and PAF receptors of platelets as risk factor of acute pyelonephritis during urolithiasis in eldery women.].

The aim of the study is to identify possible mechanisms that could provoke a recurrence of chronic obstructive pyelonephritis (COP) in eldery women, thus to find out - why age and sex can be risk factors for acute pyelonephritis in urolithiasis. The results of 43 women over 65 years of age (mean age 71±1,5 years) are presented in study. The 26 patients were examined in remission phase of COP; 17 patients were examined in recurrence phase.

[Contrast-enhanced ultrasonography as the most perspective diagnostic method for unstable atherosclerotic plaque of carotid artery].

Problem of internal carotid artery disease diagnosis appears to be crucial today. Complications of this pathology are strokes and transient ischemic attacks. There is no technology for their prediction or at least stratifying risks.

[The history of collaboration between the Bureau of Forensic Medical Expertise of the Moscow Health Department and the Department of Forensic Medicine of the Sechenovsky University].

This article presents the materials devoted to the long-term history of collaboration between the Bureau of Forensic Medical Expertise of the Moscow Health Department and the Department of Forensic Medicine of the Sechenovsky University. Special attention is given to the contribution made by the Department of Forensic Medicine to the scientific and practical activities, methodological and staffing support first of the Moscow forensic medical services and thereafter of the Bureau of Forensic Medical Expertise operating under the auspices of the Moscow Health Department. Simultaneously, the influence of the work of the Moscow Bureau of Forensic Medical Expertise on the development and improvement of the scientific, methodological, and pedagogical activities of the Russia's oldest Department of Forensic Medicine is overviewed.

[Imaging of neoangiogenesis of internal carotid artery's atherosclerotic plaque by contrast-enhanced sonography and histological examination].

Previously, atherosclerosis was considered a disease accompanied exclusively by lipids accumulation. At present time success of fundamental and experimental science confirmed that atherosclerotic process is also associated with neovascularization and prolonged inflammatory response at all stages of atherogenesis from initial manifestations to thrombotic complications. The cause of atherosclerotic plaque instability is neovascularization, which is accompanied by intra-plaque hemorrhage and damage.

[Interaction of epinephrine and ADP in regulation of platelet function in chronic cerebral ischemia ].

The purpose is devoted to test of hypothesis that patients with chronic cerebral ischemia (CCI) have decreased secretion of platelet ADP as the reason of platelet aggregation restriction in response to stimulation of adrenaline. Methods. We used platelet-rich plasma which was separated by centrifugation from peripheral blood of 55 patients with a diagnosis of CCI of stage 1-2.

[The academic discipline 'forensic medicine' as an important component of the training of dental practitioners].

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.

[Thromboxane A2: Mechanisms of Synthesis and Intracellular Signaling System of Realization].

One of major complications of ischemic heart disease is myocardial infarction, which develops as a result of thrombosis at the site of ruptured atherosclerotic plaque. Platelets activation and aggregation are the key events of this process. The efficiency of aspirin and/or clopidogrel use is limited by residual platelet reactivity what indicates the need to explore its mechanisms.

[Possibilities to Control Early Stages of Inflammation in and of Thrombus Formation in Cardiovascular Pathology].

Circulating platelet-leukocyte aggregates (PLA) are present in patients with various diseases of the cardiovascular system and are considered as sensitive markers of platelet activation. At the same time characteristics of PLA in the circulating blood continue to be discussed in the context of the search for early markers of inflammation, which would bring us close to ability to limit the development of inflammatory response at the earliest stage. This review is devoted to analysis of studies of LA in the context of assessment of functional activity of platelets and possibilities of cooperation of blood cells during activation of leukocytes at early stage of realization of inflammation process.

[Molecular mechanisms of individual platelet reactivity in hematuria secondary to lithotripsy].

Aim: To investigate the mechanisms of individual platelet reactivity to ADP and adrenaline associated with the variability of hematuria after lithotripsy in patients with chronic obstructive pyelonephritis (COPN).

Materials And Methods: The study included 41 COPN patients admitted to the Department of Urology for lithotripsy (LT). The contact ultrasonic LT was performed using the Karl Storz Calcuson Ultrasonic Lithotripsy System.

[ROLE α2-ADRENERGIC RECEPTORS IN REGULATION PLATELET REACTIVITY IN THE ELDERLY AT CHRONIC OBSTRUCTIVE PYELONEPHRITIS].

Objective of the research was to determine involvement of platelets and the role of adrenaline in chronic inflammation maintaining and the initiation of acute inflammatory response in elderly patients with chronic obstructive pyelonephritis against this background. The study includes 60 patients with chronic obstructive pyelonephritis (COPN), which are distributed into two groups: basic - 22 elderly patients (age 73±1,5 years) and the comparison group - 38 middle-aged patients (52,5±2,4 years). The study excluded patients who took antiplatelet drugs and non-selective blockers of α adrenergic receptors at least 1 week before the study.

[The recovery of the function of hyporesponsive platelets during the antiplatelet therapy in patients with chronic cerebral ischemia].

Aim: To establish the ability of recovery of platelet proagregation status in patients with chronic cerebral ischemia receiving standard medical therapy.

Material And Methods: Thirty patients were studied. Platelets were isolated from peripheral blood by centrifugation.

[Interaction of the Humoral Agonist During the Platelets Activation in Patients with Chronic Cerebral Ischemia].

Objective: The aim of the study was to determine the effect of the standard drug therapy of 95 patients with chronic cerebral ischemia (CCI) on the functional status of platelets as possible participants of microcirculation of the brain.

Methods: Platelets were isolated from peripheral blood by centrifugation and examined at 24 hours after initiation of standard medical therapy including aspirin (100 mg). The cells were stimulated in vitro using adenosine diphosphate (ADP), epinephrine, platelet activating factor (PAF) and serotonin in an effective concentration (EC50) inducing in healthy individuals platelet aggregation in the range of 50 ± 5%.