改进传统的死后医疗——基于血液的生物标志物的横断面使用

IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Forensic Sciences Research Pub Date : 2023-07-10 DOI:10.3390/forensicsci3030028
I. Šoša
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引用次数: 0

摘要

许多临床医学工具,如临床化学和诊断成像,优先用于临床诊断而不是死后诊断。事实上,对病人功能状态的评估应优先于尸检、诊断测试和实验室设备的横断面使用,这是合理的。此外,这些工具有时很昂贵,而且它们的使用并不总是具有合理的成本效益比。然而,一些死后观察,如炎症、肺水肿或浸润和脑肿胀,如果不使用免疫组织化学标志物进行死后诊断,就无法解释。在尸检护理中引入基于血液的生物标志物可以显著降低尸检不确定的发生率,以及尸检结果和临床诊断的差异。考虑到血管疾病对总死亡率的重大负担,这与血管病理学尤其相关。利用基于血液(循环)的生物标记物来扩大传统的尸体解剖,以避免侵入性的死后检查,将具有文化、宗教和潜在的经济优势。所有的目标分子都是在它们上调或下调的过程背景下讨论的,这被证明是死亡的最终原因。最终,很明显,需要进一步的研究来提供具体的验证,以使用每种病例的标记组合来达到有或没有临床记录的死后诊断。
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Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers
Many tools of clinical medicine, such as clinical chemistry and diagnostic imaging, are prioritized for clinical diagnosis over post mortem diagnosis. Indeed, it is reasonable that the assessment of a patient’s functional status should take priority over the post mortem, cross-sectional use of diagnostic tests and laboratory equipment. In addition, these tools are sometimes expensive, and their use does not always have a reasonable cost–benefit ratio. However, some post mortem observations, such as inflammation, pulmonary edema, or infiltration and cerebral swelling, cannot be explained without using immunohistochemical markers for post mortem diagnosis. Introducing blood-based biomarkers into post mortem care could significantly reduce the rates of inconclusive post mortems and discrepancies in autopsy findings and clinical diagnoses. This is particularly relevant in relation to vascular pathology, considering the significant burden that vascular diseases represent for overall mortality. Expanding traditional autopsies with blood-based (circulating) biomarkers to avoid invasive post mortem examination would have cultural, religious, and potentially economic advantages. All of the target molecules were discussed in the context of the processes they up-regulate or down-regulate, which turned out to be the final cause of death. Ultimately, it is evident that further studies are needed to provide concrete validation for using a combination of markers for each case to reach a post mortem diagnosis with or without clinical records.
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来源期刊
Forensic Sciences Research
Forensic Sciences Research MEDICINE, LEGAL-
CiteScore
3.60
自引率
7.70%
发文量
158
审稿时长
26 weeks
期刊最新文献
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