Aim. In this article, the authors determine the severity (index) of histological activity (HAI) and fi brosis in various forms of alcoholic liver disease drawing on the autopsy material, as well as suggest a marker for detecting fi brosis.Materials and methods. The authors studied 110 autopsies and histopathological studies of people who died from ethanol poisoning in the setting of various forms of alcoholic liver damage (95) and traumatic brain injury – control (15). Alcohol dehydrogenase (ADH) activity was studied through histochemical methods; values were estimated through the quantitative morphometry of the histochemical reaction product using the MORFOLOG program developed at the Department for Forensic Medicine (V.A. Porodenko, 1996). Statistical analysis was performed using the STATISTICA 10 software package and a created Exсel database. In order to determine the signifi cance between two compared values, the Student’s t-test was employed. Correlations were estimated using the Spearman’s rank correlation coeffi cient (r).Results. The study revealed various degrees of histological activity and fi brosis in the setting of alcoholic steatosis, hepatitis and cirrhosis. The initial liver damage is characterised by minimal / weak activity and F0–F2 stage of fi brosis. With the progression of the pathological process in the liver, HAI is estimated as moderate and severe (F2–F4 stage of fi brosis). There is a correlation between the development of perisinusoidal and pericellular fi broses (r = –0.655), septae (r = –0.435), connective tissue in the portal tracts and around a vein (r = –0.517) and the number of medium caliber vessels in the liver, as well as between the portal vein diameter and the development of perisinusoidal and pericellular fi broses (r = 0.377). The authors noted high and moderate positive correlation between the ADH activity in zone 3 of the liver acini and the development of necroses and fi brosis, minor cholestases, expansion of the perisinusoidal spaces. The calculated index of fi brosis and ischemic liver damage correlates with its impaired morphofunctional state.Conclusion. The obtained data indicate that fi brosis develops in the early stages of alcoholic liver damage, whose severity can be assessed using the proposed method for determining the index of fi brosis and ischemic liver damage, given that it refl ects both the structural and functional state of the organ.
Background: For many years, road traffic injuries have occupied a leading position in the structure of mechanical grass in most of the leading countries of the world. Children are particularly vulnerable to road accidents due to their psychoemotional and anatomical and physiological characteristics. Aims: To study the epidemiological aspects and features of injuries with a forensic medical assessment of injuries in children in various types of road accidents in the city of Krasnodar. Material and methods: Archival medical documentation of the Department of forensic medical examination of victims, accused, and other persons of the State Budgetary Institution Bureau of SME of the Ministry of Health of the Krasnodar Territory in relation to 1,134 children under the age of 18 years who were injured in an accident on the territory of Krasnodar in 20152019; analytical, statistical, and retrospective research methods were used. Results: Children were most often injured in the summer, especially in the month of August, on the second day of the week and at night; 50% of the injured children were pedestrians; combined nature of the injury was in 38.9% of cases, and most common injuries were localized in the head (45.8%) and lower extremities (38%); the most frequent soft tissue damage in all young road users were bruises; injuries in the cabin were more common soft tissue injuries of the head; skull fractures prevailed in drivers; severe forms of traumatic brain injuries were most common in pedestrians; fractures of the limbs were detected only in older age groups, most often in pedestrians; drivers and pedestrians were more likely to have damaged shin bones, whereas passengers have it in the femur and forearm; serious health damage was detected in almost every seventh child (13.8%), most often in children under three years old and 1417 years old; and light damage in every fifth (22.1%) child and twice as often as moderate health damage (11.8%). Conclusion: The level of child road traffic injuries in the city of Krasnodar in recent years has not decreased and the negative trend of accidents related to an increased incidence of trauma in children, resulting in serious injury.
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