Background. Mechanical trauma occupies one of the leading places in forensic medical examination. The main task of the expert, when conducting this kind of examination, is to provide a scientifically based answer to the questions of the pre-trial investigation bodies or the court, which relate not only to the determination of the mechanism of the injury, but also to the time period of its occurrence. Traditional methods of morphological research and methods of laboratory analyzes cannot always provide comprehensive information, especially in cases of determining the age of mechanical trauma in the early Post-mortem period. Therefore, new methods of biochemical research are being actively introduced into forensic medical practice.
Aim: Analysis of the literature devoted to the application of various biochemical diagnostic methods in forensic medical practice to establish the antiquity of mechanical trauma.
Results. In pathological conditions, such as, for example, trauma, certain molecular changes occur in the human body, which are associated with a systemic reaction to a stress factor and are manifested before the appearance of morphological changes in tissues and organs. Therefore, the use of biochemical research methods will significantly expand the possibilities of forensic diagnostics. The publication shows promising directions for the application of the biochemical method for forensic trauma diagnosis. Issues of establishing the statute of limitations for mechanical injuries are considered. Today, scientific studies of the body's stress state in cases of fatal injuries are becoming more and more common. Which is of great importance for forensic medical expert practice. Therefore, the role of manifestations of the body's systemic response to trauma is described. The role of natriuretic peptides, creatine kinase and procalcitonin in diagnosing the duration of the traumatic process is also shown.
Conclusion. The relevance and practical significance of biochemical research for the forensic diagnosis of the time of occurrence of a mechanical injury, as well as the development of new diagnostic criteria for determining the body's systemic response to trauma, necessitated a deep and comprehensive study of the above problems.
Belsey SL, Flanagan RJ. Postmortem biochemistry: Current applications. J. Forensic Leg. Med. Epub. 2016; 41:49-57. DOI: 10.1016/j.jflm.2016.04.011.
Ramazan A, Burak T, Mahmut Serif Y, Halit Canberk A, Necdet S. Omics era in forensic medicine: Towards a new age. Turk. J. Med. Sci. 2020; 50:1480-1490. DOI: 10.3906/sag-1912-197
Tomita H, Vawter MP, Walsh DM, Evans SJ, Choudary PV, Li J, Overman KM, Atz ME, Myers RM, Jones EG. et al. Effect of Agonal and Postmortem Factors on Gene Expression Proﬁle: Quality Control in Microarray Analyses of Postmortem Human Brain. Biol. Psychiatry. 2004;55:346-352. DOI: 10.1016/j.biopsych.2003.10.013
Maeda H, Ishikawa T, Michiue T. Forensic biochemistry for functional investigation of death: Concept and practical application. Leg. Med. 2011;13:55-67. DOI: 10.1016/j.legalmed.2010.12.005
Madea B, Musshoff F. Post-mortem biochemistry. Forensic Sci. Int. 2007;165:165-171. DOI: 10.1016/j.forsciint.2006.05.023
Maeda H, Zhu B-L, Ishikawa T, Quan L, Michiue T. Signiﬁcance of postmortem biochemistry in determining the cause of death. Leg. Med. 2009;11:S46-S49. DOI: 10.1016/j.legalmed.2009.01.048
Ondruschka B, Woydt L, Bernhard M, Franke H, Kirsten H, Löfﬂer S, Pohlers D, Hammer N, Dreßler J. Post-mortem in situ stability of serum markers of cerebral damage and acute phase response. Int. J. Legal Med. 2019;133:871-881. DOI: 10.1007/s00414-018-1925-2
Palmiere C, Mangin P. Postmortem chemistry update part II. Int. J. Legal Med. 2012;126:199-215. DOI: 10.1007/s00414-011-0614-1
Friedman MJ. Overview of Posttraumatic Stress Disorder (PTSD). Posttraumatic and Acute Stress Disorders. 2015:1-8. DOI: 10.1007/978-3-319-15066-6_1.
Ondruschka B, Schuch S, Pohlers D, Franke H, Dreßler J. Acute phase response after fatal traumatic brain injury. Int. J. Legal Med. 2018;132:531-539. DOI: 10.1007/s00414-017-1768-214.
Carvajal-Zarrabal O, Hayward-Jones PM, Nolasco-Hipolito C. et. al. Use of cardiac injury markers in the postmortem diagnosis of sudden cardiac death. Journal Forensic Science, 2017;62:1332-1335. DOI: 10.1111/1556-4029.13397.
Mortensen RF. C-Reactive Protein, Inﬂammation, and Innate Immunity. Immunol. Res. 2001;24:163-176. DOI:10.1385/IR:24:2:163
Fujita MQ, Zhu B-L, Ishida K, Quan L, Oritami S, Maeda H. Serum C-reactive protein levels in postmortem blood-an analysis with special reference to the cause of death and survival time. Forensic Sci. Int. 2002;130:160-166. DOI: 10.1016/S0379-0738(02)00381-X
Astrup BS, Thomsen JL. The routine use of C-reactive protein in forensic investigations. Forensic Sci. Int. 2007;172:49-55. DOI: 10.
Uhlin-Hansen L. C-reactive protein (CRP): A comparison of pre- and postmortem blood levels. Forensic Sci. Int. 2001;124:32-35. DOI: 10.
Pelinka L, Toegel E, Mauritz W, Redl H. Serum S 100 B: A Marker of Brain Damage in Traumatic Brain Injury with and without Multiple Trauma. Shock. 2003;19(3):195-200. DOI: 10.1097/00024382-200303000-00001.
Erhard N, Biliakov A, Volobuiev O. [Establishment of lifetime and prescription of injury in forensic medical practice (literature review)]. Medychni perspektyvy. 2022;27(2): 34-38. DOI: 10.26641/2307-0404.2022.2.260063 [in Ukrainian].
Daniels LB, Maisel AS. Natriuretic peptides. J. Am Coll Cardiol. 2007;50(25):2357-68. DOI:10.1016/j.jacc.2007.09.021
Ergard NN. [Diagnostic Measurement of Brain Natriuretic Peptide (BNP) for Analyzing Antemortal Period in Trauma Treatment in Forensic Medical Practice]. Ukrainskyi zhurnal Medytsyny, Biolohii ta Sportu. 2018;4(13),3:25-26. DOI: 10.26693/jmbs03.04.025 [in Ukrainian].
Hirvonen J, Kortelainen, M-L, Huttunen P. Pulmonary and serum surfactant phospholipids and serum catecholamines in strangulation an experimental study on rats. Forensic Sci. Int. 1997;90:17-24. DOI: 10.1016/S0379-0738(97)00135-7
Woolf PD, McDonald JV, Feliciano DV, Kely MM, Nichols D, Cox C: The catecholamine response to multisystem trauma. Arch Surg. 1992;127:899-903. DOI: 10.1001/archsurg.1992.01420080033005
Davies CL, Newman RJ, Molyneux SG, Grahame-Smith DG: The relationship between plasma catecholamines and severity of injury in man. J Trauma. 1984;24:99-105. DOI:10.1097/00005373-198402000-00002).
Wilke N, Janßen H, Fahrenhorst C, Hecker H, Manns MP, Brabant E-G, Tröger HD, Breitmeier D. Postmortem determination of concentrations of stress hormones in various body fluids is there a dependency between adrenaline/ noradrenaline quotient, cause of death and agony time? Int. J. Legal. Med. 2007;121:385-394. DOI: 10.1007/s00414-006-0132-8
Bao-Li Zhu, Takaki Ishikawa, Tomomi Michiue, Dong-Ri Li, Dong Zhao, Li Quan, Shigeki Oritani, Yasumori Bessho, Hitoshi Maeda. Postmortem serum catecholamine levels in relation to the cause of death. Forensic Sci Int. 2007;173(2-3):122-9. DOI: 10.1016/j.forsciint.2007.02.013.
Hervet T, Grouzmann E, Grabherr S, Mangin P. Determination of urinary catecholamines and metanephrines in cardiac deaths. J Legal Med .2016;130(4):995-1001. DOI: 10.1007/s00414-015-1303-2.
Hervet T, Teresiński G, Hejna P. et al. Catecholamines and their O-methylated metabolites in vitreous humor in hypothermia cases. Forensic Sci Med Pathol. 2016;12:163-169 DOI: 10.1007/s12024-016-9764-2.
Rousseau G, Reynier P, Jousset N, Rouge-Maillart C, Palmiere C. Updated review of postmortem biochemical exploration of hypothermia with a presentation of standard strategy of sampling and analyses. Clin. Chem. Lab. Med. 2018;56:1819-1827. DOI: 10.1515/cclm-2018-0153
Bańka R, Teresiński G, Buszewicz G, Mądro R. Glucocorticosteroids as markers of death from hypothermia. Forensic Science International. 2013;229(1-3):60-65. DOI: 10.1016/j.forsciint.2013.03.003
D'Ovidio C, Bonelli M, Rosato E, Savini F, Carnevale A. Evaluation of urinary catecholamines to reconstruct the individual death process after the catastrophe of Rigopiano (Italy). The Journal of Forensic and Legal Medicine. 2020;70:101908. DOI: 10.1016/j.jflm.2020.101908.
Grace GT, Shin B, Levin P, Stone HH: Immediate post-traumatic hypokalemia. Curr Surg. 1988;45:463-464.
Kolloch RE, Druse HJ, Friedrich R, Ruppert M, Overlack A, Stumpe KO. Role of epinephrine-induced hypokalemia in the regulation of renin and aldosterone in humans. J Lab Clin Med. 1996;127:50-56. DOI: 10.1016/s0022-2143(96)90165-1
Moratinos J, Reverte M: Effects of catecholamines on plasma potassium: the role of alpha and beta adrenoceptors. Fundam Clin Pharmacol 1993;7:143-153 DOI: 10.1111/j.1472-8206.1993.tb00228.x
Brown MJ, Brown DC, Murphy MB: Hypokalemia from beta 2 receptor stimulation by circulating epinephrine. Am J Cardiol. 1985;56:3D-9D. DOI: 10.1016/0002-9149(85)91107-5
Rosa RM, Silva P, Young JB, Landsberg L, Brown RS, Rowe JW, Epstein FH: Adrenergic modulation of extrarenal potassium disposal. N Engl J Med. 1980;302:431-439. DOI: 10.1056/NEJM198002213020803
Hansen O, Johansson BW, Nilsson-Ehel P. Metabolic, electrocardiographic, and hemodynamic responses to increased circulating adrenaline: effects of selective and nonselective beta adrenoceptor blockade. Angiology. 1990;41:175-188 DOI: 10.1177/000331979004100302
Beal Alan L; Deuser William E; Beilman Greg J. A role for epinephrine in post-traumatic hypokalemia Shock. 2007;27(4):358-363. DOI: 10.1097/01.shk.0000245029.47106.db
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