The nomogram technique for determining the prescription of death coming by the content of acid phosphatase in the muscle tissue.

Criminologists and medical examiners in practice are interested in the existence of reliable, stable criteria that would allow to unambiguously interpret certain post-mortem phenomena observed in the body, and which would allow to determine the age of death. AIM: The aim of the study was to study the postmortem patterns of acid phosphatase in muscle tissue (MT) of various types to improve the accuracy of determining the age of death. MATERIALS AND METHODS: Determination of acid phosphatase content is performed in homogenates of myocardial, esophageal, diaphragm and intercostal muscles in the early postmortem period (PMP) (3-13 hours after death) in 30 human corpses. MT sampling was performed in the conditions of sectional biopsy with the use of special tools, preparation of MT homogenates - according to the standard method with subsequent determination of MT phosphatase content in MT homogenates by kinetic method. RESULTS: Analysis of postmortem changes in the content of acid phosphatase in MT depending on the time periods of the determining the age of death revealed that after 3 hours from the moment of death its content was the highest in a myocardium, the smallest - in MT of intercostal muscles (accordingly - 3,475±0,057 units/g and 2,662±0,028 units/g, p <0,001). The general pattern of acid phosphatase content in MT of different types was characterized by an increase in the content with increasing the age of death terms. In addition, the time series of changes in the acid phosphatase content obtained by us became the basis for substantiating the quantitative time dependences and constructing appropriate nomograms for forensic diagnosis of determining the age of death by the acid phosphatase content in MT. CONCLUSIONS: It is proved that the content of acid phosphatase naturally (and nonlinearly) changed in all studied homogenates of MT, but the initial and final level of acid phosphatase, depending on the type of MT differs. In addition, the dynamics of changes in the content of acid phosphatase in the time period 3÷13 hours. from the moment of death, depending on the type of MT, also varies. The quantitative analytical and graphical dependences of the change in the content of acid phosphatase in MT in the early PMP revealed in the study allowed to substantiate the corresponding nomograms.

The role of growth differentiation factor 15 as a predictor of 5-year survival of patients after acute coronary syndrome.

One of the problems of modern cardiology in Ukraine and the world is acute coronary syndrome (ACS), which results in high mortality and invalidation of patients. Recently, much attention is drawn to the growth differentiation factor 15 (GDF-15). A lot of studies provided, in which the role of GDF-15 in cardiovascular pathology proved. AIM: The aim of the study was to determine the predictive possibility of the GDF-15 marker in the stratification of the ACS complications risk within 5 years after the event. MATERIALS AND METHODS: 70 patients with ACS were involved. The mean age was (61.8 +/- 1.3) years, the following diagnosis was established in the patients: 76 patients had acute myocardial infarction with Q (AMI with Q), 28 - acute myocardial infarction without Q (AMI without Q) and 36 patients were diagnosed unstable angina (UA). During the follow-up period the endpoint was reached by 28 patients. RESULTS: A statistical relationship between the elevated level of GDF - 15 and the 5-year survival of these patients (χ2 = 4.75, p = 0.03) has been found. It was established that the level of the GDF-15 biomarker > 2350 pg/ml independently predicted the onset of adverse events with the sensitivity of 80% and the specificity of 60% (p = 0.006). To investigate the influence of the GDF-15 levels on mortality in the remote period, the Cox regression analysis was performed. It was revealed that the level of GDF-15 significantly predicted the onset of the primary endpoint within 5 years after ACS (p = 0.004). CONCLUSIONS: The increased level of GDF-15, determined in the first 24 hours after development of ACS, is highly associated with the adverse outcome within 5 years after the event.

Lipofuscin content in the muscle tissue during the early postmortem period: improvement of forensic diagnosis of the prescription of death coming.

Forensic medicine is naturally supported by fundamental sciences, its integration with them contributing to its improvement on the whole, particularly in diagnosis of the prescription of death coming. Scientific achievements and foreign specialists in forensic medicine during recent years have made it possible to significantly deepen our sound knowledge of postmortem phenomena. AIM: The aim of the research consisted in study of postmortem regularities in the content of lipofuscin in different types of the muscle tissue (MT) for improving accuracy of determination of prescription of death coming. MATERIALS AND METHODS: The content of lipofuscin was determined in homogenates of the myocardial, oesophageal, diaphragm and intercostal muscles within the early postmortem period on 30 human corpses. MT was sampled in conditions of postmortem biopsy with use of special instruments; homogenates were prepared following the standard technique with subsequent determination of lipofuscin content in MT homogenates according. Presentation of revealed regularities in changes of lipofuscin content in each type of MT homogenates is provided by building dynamic lines with polynomials of different (2-5) stages and accuracy of reproduction R2>0.95. RESULTS: By results of biochemical examination of lipofuscin in different types of the MT within different terms of the early postmortem period (PMP) it was proved that its content regularly changed in all types of the above tissue. The analytical and graphical dependences of the change in the content of lipofuscin in muscle tissue within the early PMP made it possible to substantiate relevant nomograms. Limitations for using the nomogram technique are as follows: prescription of death coming more than 13 hours, unknown conditions of the stay of a corpse after the coming of death. Advantages of the technique consist in the integrity of biochemical examination of different types of MT and simplicity in interpretation of findings. CONCLUSIONS: The application of the nomogram technique for assessing PDC by lipofuscin content in MT makes it possible to improve the accuracy of diagnosis for terms of the coming of death up to 60 minutes.