Relevance. The analysis demonstrated that legislative documents in Ukraine were developed to prevent and combat domestic violence, protect and respect human rights. The basic standards of the regulatory framework of Ukraine are consistent with the Istanbul Convention. A positive moment in the modern legislation of Ukraine is the establishment of restrictive measures for people who have committed domestic violence in the form of a ban on staying in a place of joint residence with a person who has suffered from domestic violence. Some recommendations on conducting a forensic medical examination in cases of domestic violence are proposed. Displayed aspects of an ethical approach in the "Rules for the Examination of Victims, Accused, and Other Persons" in order to reduce psychological trauma during the examination. Objective: to analyze and summarize the legal and forensic aspects of providing legal assistance to victims of domestic violence in Ukraine and to offer recommendations for their improvement Material and methods. The materials are data from available Internet sources within the spring of 2020; 68 appeals to forensic medical institutions. The analysis was performed using a descriptive method; fixation methods, statistical processing of the results. Results. Ukraine is oriented towards European standards, including in the area of issues of prevention and counteraction to domestic violence and respect for human rights. Recommended using modern methods of fixation during data collection and further examination of the victim in order to be able to use the obtained data by the parties to criminal proceedings / Сourt. Conclusions. The issue of prevention and counteraction to domestic violence needs special attention and further resolution due to the increase in domestic violence cases, especially during quarantine caused by COVID-19.

The purpose of the study was to study a complex of changes in ultrasound parameters of injured tissues of the liver, spleen, pancreas in mechanical trauma and their dependence on the nature and duration of injury. Materials and methods. Ultrasound examinations were performed in 60 injured patients (41 males and 19 females) aged 20 to 60 years old in the dynamics as for the 1st, 2nd, 3rd, 4th and 5th days after injury. Puncture, transverse and oblique scans from all possible accesses were used. The conditions of the liver, pancreas, spleen, kidneys were studied. Results and discussion. In the course of the studies, a high number of injuries to the abdominal and retroperitoneal organs was demonstrated; it was proved that isolated liver injuries were observed in 32%, in 68% the liver injury was combined with injuries of other abdominal organs. We observed isolated damage to the pancreas in 10%, in the remaining 90%, the injury to the pancreas was combined with damage to the liver, gallbladder and extrahepatic bile ducts, spleen, and intestines. Isolated injuries of the spleen were observed in 31% of patients; in other cases, the injury to the spleen was combined with injuries of other organs of the abdominal cavity. We observed isolated kidney damage in almost 15%. In 85% of cases, kidney damage was observed in combination with injuries of other parenchymal organs. It has been demonstrated that in the area of injured tissues of the liver, pancreas, spleen, and kidneys with blunt trauma to the abdomen in persons with no signs of alcohol intoxication, regular ultrasound changes are observed, which are in direct proportion to the time elapsed since the injury was caused. The main ultrasound signs of liver damage were ruptures of the parenchyma with the formation of intra-parenchymal or subcapsular hematomas. In general, for almost all the injured people the following sings were characteristic as an increase in liver size (often due to increased part of damage), heterogeneity of structure, blurred contours and their discontinuity, presence of hypo- and anechoic areas (hematomas) on the background of intact parenchyma. Characteristic ultrasound criteria of pancreatic damage in the first day are the lack of clear contours of the gland, their discontinuity, increase in the size of the gland, the presence of hypoechoic areas of different sizes. At ultrasound examination of the spleen, the main signs of its damage are the heterogeneity of the parenchyma and the presence of anechoic structure and free fluid in the abdominal cavity. In 69% of cases, the main sings were blurred and uneven contours of the spleen, as well as an increase in its size. Characteristic features of renal hematoma are an increase in their size, heterogeneity of structure with increasing echogenicity of the parenchyma, blurred contours and their discontinuity. Conclusion. It has been proven that it is advisable to use in a complex of changes in the parenchymal organs revealed by ultrasound examinations, both in cases of isolated organ trauma, and in cases of combined trauma of the abdominal cavity and retroperitoneal organs, to determine the time of causing damage, since it makes it possible to increase the objectivity of the results of establishing the duration of the injury

The purpose of the study was to analyze and generalize recommendations regarding the actions of medical workers when documenting the facts of sexual violence and providing medical and psychological assistance to persons affected by sexual violence related to the armed conflict in Ukraine. Results and discussion. As a result of the international armed conflict on the territory of Ukraine, caused by the aggression of the Russian Federation, a large number of crimes against the civilian population were recorded. At the present time, one of the difficult challenges of society is sexual violence in the conditions of armed conflict. Sexual violence during an armed conflict is not only a criminal offense, but also a violation of international humanitarian law and human rights. According to the United Nations, the facts of sexual violence in wartime are difficult to detect and investigate. Responding to sexual violence in armed conflict requires coordination of international and national institutions and an interdisciplinary approach to providing legal and medical assistance, social and psychological support to victims of sexual violence during armed conflict. The modern tool for combating violence against women and preventing violence against women is the Istanbul Convention. An important aspect is that the right of victims of sexual violence during armed conflicts to appeal to state bodies, human rights organizations, medical workers, psychologists for help is a personal decision of each victim. A victim of sexual violence in the context of an armed conflict has the right to receive qualified free medical care. Medical assistance to persons affected by conflict-related sexual violence is provided in health care facilities as needed at all levels of medical care, both outpatient and inpatient. The purpose of providing medical assistance to the victim is to overcome the negative consequences and effects of conflict-related sexual violence on the physical and psychological health of the victim. The injured person has the right to freely choose a health care facility, a doctor, and a method of treatment in accordance with the doctor's recommendations. Medical assistance to persons affected (or likely to be affected) by conflict-related sexual violence is provided in accordance with the Protocols for the provision of medical assistance. When seeking medical help from victims or their legal representatives, medical workers must record their complaints (appeals), collect anamnesis, conduct a medical examination with an assessment of the condition of a victim of conflict-related sexual violence and, if necessary, additional instrumental and laboratory examination and measures to prevent the consequences of sexual violence. Conclusion. We recommend an algorithm of actions for medical professionals in cases of recording and documenting the fact of conflict-related sexual violence. In order to prevent psychological traumatization of the victim, it is recommended to use modern methods of recording (photographing, video recording) during the collection of anamnesis and subsequent examination of the victim in order to enable the parties to the criminal proceedings/court to use the obtained data. It is emphasized that the timely conduct of forensic medical examinations in order to detect the presence of injuries with the subsequent recording of the facts of the conflict-related sexual violence will help the side of the criminal proceedings/court to take effective measures of a criminal or other nature against the offender

The article indicates that Ukraine has significantly approached European standards in terms of preventing domestic violence and observing women's rights, legal assistance is provided at the legislative level. However, due to the increase in cases of domestic violence, especially sexual violence in emergency situations, including in quarantine conditions due to the COVID-19 pandemic, the issues of preventing and combating domestic violence require special attention and further solutions. The timely conduct of forensic medical examinations in order to identify the presence of injuries with the subsequent fixation of the facts of domestic violence, especially sexual violence, provides significant assistance to justice in the investigation of crimes. In cases of sexual violence against women, in addition to fixing external injuries, it is also necessary to pay attention to the study of objects of biological origin, identification by species, sex, regional, organ or cellular identity. Material and methods. The study material was dried on gauze menstrual blood, taken from practically healthy women and women who have inflammatory diseases of the external genital organs, aged 18 to 45 with a normal menstrual cycle. In forensic practice, this method is new. Results and discussion. The obtained results allowed recommending this method for the forensic medical determination of the regional origin of blood. As a result of our research, we found the dependence of PGF2α content, firstly, on the age of women, and secondly, on the regional origin of the fluid. It should be noted that the content of PGF2α in vaginal fluid, menstrual blood and capillary blood in women of reproductive age, has an age feature, its content is higher by 6-12% for women aged 30-45 years. Thus, in women 30-45 years the content of PGF2α was always, in all fluids, higher than in women 18-29 years (p <0.001): in vaginal fluid it increased by 11%; in menstrual blood it was by 6% higher; in capillary blood it increased by 3%. PGF2α was the highest in menstrual blood compared to vaginal fluid and capillary blood. Moreover, this trend was true for women of both ages: in women aged 30-45, the content of PGF2α was 2.6 times higher in menstrual blood than in capillary, and 1.4 times more than in vaginal fluid; in women aged 18-29, the content of PGF2α was 2.7 times higher in menstrual blood than in capillary, and 1.5 times higher than in vaginal fluid. Thus, we obtained statistically significant indicators that indicated the possibility of establishing the menstrual origin of the blood by the quantitative content of PG F2α. Conclusion. In our opinion, the content of PGF2α above 13.1 ng / mg of dry tissue was a reliable sign of menstrual blood, which was of great diagnostic value in the differential diagnosis of regional origin of objects of biological origin (blood) in cases of sexual violence / sexual crimes

ВИЗНАЧЕННЯ ДАВНОСТІ УШКОДЖЕНЬ СЕЛЕЗІНКИ ГІСТОЛОГІЧНИМ МЕТОДОМ ПРИ МЕХАНІЧНІЙ ТРАВМІ В СУДОВО-МЕДИЧНІЙ ПРАКТИЦІ ©Бабкіна О.П.Національний медичний університет імені О.О. Богомольця Резюме. В результаті проведеного огляду літературних джерел і статистичного аналізу власних досліджень характе-ру, механізму і давності виникнення травми селезінки виявлена можливість встановлення давності ушкоджень селезінки при механічній травмі за динамікою змін її гістологічних показників, що має важливе значення для судово-медичної практиці.Ключові слова: Судово-медична експертиза, травма, давність, селезінка, гістологічні показники. ВСТУП.Травма селезінки за сучасних умов зустрічається досить часто та серед ушкоджень органів черевної порожнини займає одне з провідних місць. Частота ушкоджень селезінки за даними літератури складає від 15 до 33 % [1, 9, 17]. В літературних джерелах є велика кількість даних [5, 7, 12], що вказують на наявність особливостей ушкоджень селезінки залежно від виду травматичної дії, місця застосування зовнішньої сили, анатомічної будови даного органу, топографії, стану навколишніх органів, внаслідок чого можуть спостерігатися ушкодження у вигляді розривів капсули й тканини лінійної, зірчастої або зигзагоподібної форми, осередкових крововиливів під капсулою селезінки та в клітковині воріт, розривів тканини в зоні воріт і на задній поверхні селезінки, розділення на частини або розтрощування паренхіми або цілого органу, відриви від судинної ніжки, розриви зв'язок селезінки, частковий або повний її відрив в області воріт зі зсувом її в черевну або в плевральну порожнину. Основними механізмами утворення травм селезінки є удар, стиснення, струс тіла або їх комбінація. До теперішнього часу єдиної морфологічної класифікації ушкоджень селезінки не існує, не розроблено єдиного підходу до експертної оцінки травм селезінки, що включає характер ушкоджень, їх форму, орієнтацію, локалізацію, обсяг і морфологічні прояви травми. Деякі автори [13] виділяли субкапсулярні гематоми, розриви капсули, розриви паренхіми, центральні розриви, двомиттєві розриви. Інші науковці [15] пропонували розрізняти травми селезінки без ушкоджень капсули та утворення підкапсульної гематоми; травми селезінки без ушкоджень капсули з утворенням підкапсульної гематоми, виступаючої над поверхнею органу; удари та струси селезінки з центральною гематомою й ушкодженням паренхіми при неушкодженій капсулі; численні й глибокі розриви. Також досить часто постає питання про давність виникнення травми селезінки, яке, незважаючи на проведену велику кількість досліджень, остаточно до кінця не вирішено. Одним з методів встановлення давності заподіяння травми селезінки є гістологічний метод.Метою даної роботи було вивчення динаміки змін гістологічних показників травмованих тканин селезінки при механічній травмі залежно від давності заподіяння ушкоджень.Матеріал та методи дослідження. Матеріалом дослідження є тканини селезінки 78 осіб чоловічої та жіночої статі, віком від 20 до 60 років, що загинули при відомому та невідомому часі травми при наявності та відсутно...