post-mortem

验尸后
  • 文章类型: Systematic Review
    挥发性物质滥用由于其容易获得和消费方法而在青少年中普遍存在。吸入性滥用是当前一个有问题的问题,由于对几个靶器官的直接毒性和导致缺氧的气体置换,导致显著的发病率和死亡率。这篇综述旨在评估疑似丁烷中毒病例的尸检和毒理学调查。我们使用系统审查首选报告项目(PRISMA)标准进行了全面研究。40篇科学论文符合纳入标准。共发现58例与丁烷有关的死亡病例。其中,我们发现11例自杀(18%),1起杀人案(2%),44例意外中毒(76%),2例与工作有关的死亡(4%)。54例进行尸检和尸检,而毒理学分析则在56例病例中进行。在尸检中,肺水肿(51%)和内脏充血(59%)是最常见的发现。当假设吸入丁烷死亡时,尸检和组织学检查结果可能是非特异性的,因此,毒理学研究承担着至关重要的作用,同时注意用于收集生物样品的方法。
    Volatile substance abuse is widespread among adolescents due to its easy availability and methods of consumption. Inhalant abuse represents a current problematic issue, causing significant morbidity and mortality due to direct toxicity on several target organs and displacement of gas which results in a lack of oxygen. This review aims to evaluate post-mortem and toxicological investigations in cases of suspected butane intoxication. We performed comprehensive research using the Preferred Reporting Items for Systematic Review (PRISMA) standards. Forty scientific papers fulfilled the inclusion criteria. A total of 58 cases of butane-related deaths were found. Among these, we found 11 cases of suicide (18%), 1 case of homicide (2%), 44 cases of accidental poisoning (76%), and 2 cases of work-related deaths (4%). Autopsy and post-mortem examinations were performed in 54 cases, whereas toxicological analyses were presented in 56 cases. In autopsy, pulmonary edema (51%) and poli-visceral congestion (59%) were the most common findings. When death by butane inhalation is hypothesized, autopsy and histological findings may be nonspecific, therefore toxicological investigations assume a crucial role along with attention to the methods used to collect biological samples.
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  • 文章类型: Systematic Review
    背景:对大脑进行事后检查是增加我们对精神障碍神经生物学理解的关键策略。虽然已经对一些精神障碍进行了广泛的验尸研究,其他人似乎相对被忽视了。
    目的:本研究的目的是对强迫症(OCD)的验尸研究进行系统评价。
    方法:根据PRISMA指南进行了系统评价,以提供定量,定性,或混合方法对强迫症的初步研究。搜索平台包括NCBIPubmed,Scopus,和WebofScience。
    结果:共发现52篇出版物,拆除不符合纳入标准的工程后,六(6)份同行评审的出版物仍然存在。这些验尸研究提供了DNA甲基化的数据,细胞和分子改变,以及与强迫症相关的大脑区域的基因表达谱。
    结论:纳入的研究强调了特征明确的强迫症患者死后大脑的潜在价值,并建议在这方面需要额外的工作。
    BACKGROUND: Post-mortem examination of the brain is a key strategy to increase our understanding of the neurobiology of mental disorders. While extensive post-mortem research has been undertaken on some mental disorders, others appear to have been relatively neglected.
    OBJECTIVE: The objective of the study was to conduct a systematic review of post-mortem research on obsessive-compulsive disorder (OCD).
    METHODS: A systematic review was performed in accordance with PRISMA guidelines to provide an overview of quantitative, qualitative, or mixed methods primary research studies on OCD. Search platforms included NCBI Pubmed, SCOPUS, and Web of Science.
    RESULTS: A total of 52 publications were found, and after the removal of works not meeting the inclusion criteria, six (6) peer-reviewed publications remained. These post-mortem studies have provided data on DNA methylation, cellular and molecular alterations, and gene expression profiling in brain areas associated with OCD.
    CONCLUSIONS: Included studies highlight the potential value of post-mortem brains from well-characterized individuals with OCD and suggest the need for additional work in this area.
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  • 文章类型: Journal Article
    在世界范围内,阿片类药物意外过量死亡人数大幅增加。这次审查的目的,以及我们试点研究的初步结果,是强调使用药物遗传学作为工具来预测意外阿片类药物过量死亡的原因。对于这篇评论,在2000年1月至2023年3月期间,对PubMed®进行了系统的文献检索。我们纳入了研究队列,case-controls,或病例报告调查了与阿片类药物相关的死后样本中遗传变异的频率以及这些变异与阿片类药物血浆浓度之间的关联。共有18项研究纳入我们的系统评价。系统评价提供了CYP2D6使用的证据,并且在较低的程度上,CYP2B6和CYP3A4/5基因分型可从验尸样本中识别出出乎意料的高或低阿片类药物和代谢物血液浓度。与普通人群中的预期频率相比,我们自己的初步研究为我们的美沙酮过量样品(n=41)中CYP2B6*4等位基因的富集提供了支持。我们的系统评价和初步研究的结果强调了药物遗传学在确定阿片类药物过量易感性方面的潜力。
    There has been a worldwide substantial increase in accidental opioid-overdose deaths. The aim of this review, along with preliminary results from our pilot study, is to highlight the use of pharmacogenetics as a tool to predict causes of accidental opioid-overdose death. For this review, a systematic literature search of PubMed® between the time period of January 2000 to March 2023 was carried out. We included study cohorts, case-controls, or case reports that investigated the frequency of genetic variants in opioid-related post-mortem samples and the association between these variants and opioid plasma concentrations. A total of 18 studies were included in our systematic review. The systematic review provides evidence of the use of CYP2D6, and to a lower extent, CYP2B6 and CYP3A4/5 genotyping in identifying unexpectedly high or low opioid and metabolite blood concentrations from post-mortem samples. Our own pilot study provides support for an enrichment of the CYP2B6*4-allele in our methadone-overdose sample (n = 41) compared to the anticipated frequency in the general population. The results from our systematic review and the pilot study highlight the potential of pharmacogenetics in determining vulnerability to overdose of opioids.
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  • 文章类型: Journal Article
    肌原纤维蛋白降解是质量恶化的重要因素,内源性蛋白酶潜能的程序激活或抑制可调节自溶蛋白水解诱导的死后鱼肌肉软化。在简要介绍鱼类骨骼肌肌原纤维蛋白降解的基础上,提出了对主要肌原纤维降解特性和内源性蛋白酶发挥的独特作用的详细描述,这反映了当前基于不同环境条件的肌原纤维水解机制研究的局限性和挑战。此外,综述了肌原纤维蛋白降解评价方法的最新研究进展。无标记蛋白质组学与生物信息学结合的潜在用途也被强调,并已成为深入了解蛋白质降解机制的重要手段。
    Myofibril proteins degradation constitutes an important factor in quality deterioration, procedural activation or inhibition of endogenous protease potential regulates autolytic proteolysis-induced softening of post mortem fish muscle. Based on the brief introduction of myofibril proteins degradation in fish skeletal muscle, a detailed description of the main myofibril degradation properties and the distinct role played by endogenous proteases were proposed, which reflects the limitations and challenges of the current research on myofibril hydrolysis mechanisms based on the varied surrounding conditions. In addition, the latest researches on the evaluation method of myofibril proteins degradation were comprehensively reviewed. The potential use of label-free proteomics combined with bioinformatics was also emphasized and has become an important means to in-depth understand protein degradation mechanism.
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  • 文章类型: Journal Article
    目前,法医病理学家将心肌炎诊断为死后的死因。没有系统的诊断方法,因此该确定受到观察者之间的变异性影响,并且不可重复。验尸研究通常依赖于临床诊断方法,这是不准确的。此外,目前尚无区分心肌炎为死因的标准化方法,心肌炎症是死后偶然发现的。只有少数研究研究了使用诸如炎症细胞数量和肌细胞坏死的存在等变量来量化这种差异的方法。然而,有几个限制阻碍了这项研究的可重复性。这篇综述调查了尸检中与心肌炎诊断为死亡原因相关的当前实践和局限性。
    Diagnosis of myocarditis as the cause of death at post-mortem is currently determined by a forensic pathologist. There is no systematic method for diagnosis and thus the determination is subject to inter-observer variability and is non-reproducible. Postmortem studies often rely on the clinical method of diagnosis, which is inaccurate. Furthermore, there is no current standardized method of distinguishing between myocarditis as cause of death, and myocardial inflammation as an incidental finding post-mortem. Only a few studies have investigated a method of quantifying this difference using variables such as number of inflammatory cells and presence of myocyte necrosis, however, there are several limitations hindering the reproducibility of this research. This review investigates the current practices and limitations associated with the diagnosis of myocarditis as cause of death in the autopsy setting.
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  • 文章类型: Journal Article
    严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)是造成持续大流行的全球健康问题。关于COVID-19的组织病理学证据尚未得到充分研究。这篇综述旨在提供,通过显微镜调查,不同器官和组织中COVID-19结构和超微结构改变的组织病理学概述,不包括呼吸系统。作者系统回顾了2020年2月至2022年7月期间的文献。选定的数据库是PubMed,Scopus,谷歌学者。搜索策略包括以下术语:“COVID-19”或SARS-CoV-2和“组织病理学”或“病理学”;以及“显微镜”和“肝脏”,\"心肌\",\"脾脏\",“睾丸”,和“胎盘”。使用系统审查和荟萃分析(PRISMA)指南的首选报告项目。本系统综述中包含的31篇文章表明,在组织病理学层面,COVID-19对组织产生有害影响,经常促进退化过程。即使COVID-19显示出呼吸系统的组织病理学倾向,其他组织,从心血管到生殖,受到COVID-19的影响。因此,本文提供了与COVID-19相关的结构和超微结构改变的组织病理学观察的最新观点,可能有助于更好地了解这种疾病的病理生理学基础.
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health concern responsible for the ongoing pandemic. Histopathological pieces of evidence on COVID-19 are not fully investigated. This review aims to provide, through microscopy investigations, a histopathological overview of COVID-19 structural and ultrastructural alterations in different organs and tissues, excluding the respiratory system. The authors systematically reviewed the literature over the period February 2020-July 2022. Selected databases were PubMed, Scopus, and Google Scholar. The search strategy included the following terms: \"COVID-19\" or SARS-CoV-2 and \"histopathology\" or \"pathology\"; and \"microscopy\" and \"liver\", \"myocardium\",\" spleen\", \"testis\", and \"placenta\". Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Thirty-one articles included in this systematic review demonstrated, at a histopathological level, that COVID-19 exerts detrimental effects on tissues, often promoting degenerative processes. Even if COVID-19 shows a histopathological tropism for the respiratory system, other tissues, from cardiovascular to reproductive, are affected by COVID-19. Therefore, this paper provides an up-to-date view of histopathological observations of the structural and ultrastructural alterations associated with COVID-19 and may contribute to a better knowledge of the physiopathological bases of this disease.
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  • 文章类型: Journal Article
    人脑状态通常通过外周组织中的脑特异性物质来估计,但是,对于大多数分析物,它们在大脑和周围的内容之间的一致性尚不清楚。在这次系统审查中,我们总结了人类研究的相关性。截至2022年6月,PubMed进行了搜索。我们包括测量相同受试者的中枢神经系统和外周中相同内源性神经特异性分析物的研究。不合格的是脑脊液研究,严重的血脑屏障破坏,具有良好确定的血液-外周一致性或在脑肿瘤中测量的分子。有17项研究合格。四项研究没有报告相关性,四项研究没有显着相关性。对四个分子进行两次检查。对于BDNF,两项研究均无相关性.对于苯丙氨酸,谷氨酰胺,和谷氨酸,结果是矛盾的。发现游离色氨酸(r=0.97)和转运蛋白(r=0.90)具有很强的相关性。因此,只有三个分子才有一定的确定性。血浆或血清中的BDNF不能反映脑含量,而游离色氨酸(血浆中)和转运蛋白(血细胞中)可以作为外周生物标志物。我们期待在先进的体内代谢组学分析领域取得突破,神经成像技术,和血液检测大脑来源的外泌体。
    Human brain state is usually estimated by brain-specific substances in peripheral tissues, but, for most analytes, a concordance between their content in the brain and periphery is unclear. In this systematic review, we summarized the investigated correlations in humans. PubMed was searched up to June 2022. We included studies measuring the same endogenous neurospecific analytes in the central nervous system and periphery in the same subjects. Not eligible were studies of cerebrospinal fluid, with significant blood-brain barrier disruption, of molecules with well-established blood-periphery concordance or measured in brain tumors. Seventeen studies were eligible. Four studies did not report on correlation and four revealed no significant correlation. Four molecules were examined twice. For BDNF, there was no correlation in both studies. For phenylalanine, glutamine, and glutamate, results were contradictory. Strong correlations were found for free tryptophan (r = 0.97) and translocator protein (r = 0.90). Thus, only for three molecules was there some certainty. BDNF in plasma or serum does not reflect brain content, whereas free tryptophan (in plasma) and translocator protein (in blood cells) can serve as peripheral biomarkers. We expect a breakthrough in the field with advanced in vivo metabolomic analyses, neuroimaging techniques, and blood assays for exosomes of brain origin.
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  • 文章类型: Journal Article
    未经批准:冠状病毒-19病(COVID-19)已被世界卫生组织(WHO)于2020年3月宣布为大流行。截至2021年11月28日,COVID-19造成的病例超过2.6亿例,死亡近520万人。受COVID-19感染影响最大的系统是呼吸系统,尽管其他几项研究表明多器官参与病理生理学,但尚不清楚。尸检结果有利于研究人员确定这些器官衰竭背后的机制。本综述的目的是总结与COVID-19死亡相关的尸检结果。
    UNASSIGNED:通过在线数据库进行在线文献检索,例如Scopus,PubMed和谷歌学者。搜索过程中输入的关键词是“验尸”,标题中的“尸检”和“COVID-19”,抽象和关键字。纳入标准是与本综述标题相关的主题,于2020-2021年出版,全文可用,英文。任何不相关的文章,重复的研究,包括系统综述和荟萃分析以及其他语言的综述文章被排除.
    UNASSIGNED:本综述共包括20篇文章。审查的文章主要是病例报告和病例系列,而其他文章则是病例对照和队列研究,范围从1到348例。大多数起源于美利坚合众国(美国)。
    未经证实:在COVID-19死亡的尸检结果中描述的最常见的系统是呼吸系统,最常见的组织学发现是弥漫性肺泡损伤(DAD)。其他器官的大部分发现与慢性病有关。
    UNASSIGNED: Coronavirus-19 disease (COVID-19) has been declared as pandemic by the World Health Organization (WHO) in March 2020. As of 28 November 2021, there were more than 260 million cases and nearly 5.2 million deaths caused by COVID-19. The most affected system by COVID-19 infection was the respiratory system although several other studies suggested multi-organ involvement with pathophysiology that was not clearly understood. Autopsy findings were beneficial to researchers to determine the mechanism behind these organ failures. The objective of this review was to summarize the autopsy findings related to COVID-19 death.
    UNASSIGNED: Online literature search was conducted via online databases such as Scopus, PubMed and Google Scholar. The keywords inputted during the search were \"post-mortem\", \"autopsy\" and \"COVID-19\" in title, abstract and keywords. The inclusion criteria were the topic related with the title of this review, published in 2020-2021, have full text available and in English language. Any articles that were not related, duplicated studies, review articles including systematic review and meta-analysis and in other languages were excluded.
    UNASSIGNED: A total of 20 articles were included in this review. The articles reviewed were mostly case reports and case series while others were case-control and cohort study ranging from one to 348 cases. Majority were originated from the United States of America (USA).
    UNASSIGNED: The most frequent system described in autopsy findings in COVID-19 death was the respiratory system, with the most common histological finding of diffuse alveolar damage (DAD). Majority of the findings of other organs were related to chronic diseases.
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  • 文章类型: Case Reports
    Ogilvie综合征是指结肠的大量扩张而没有机械性阻塞。尽管这种综合征在临床文献中是众所周知的,有时可能是腹部并发症,骨盆,或者髋关节手术,仅在法医文献中零星报道。我们介绍了对一名患者进行法医尸检的案例,该患者的死亡与髋部手术后Ogilvie综合征引起的盲肠坏死和急性腹膜炎有关。这个诊断是基于临床数据,验尸后的图像,尸检结果,组织学分析,死后化学,和微生物分析。对该疾病的文献和可能的病理生理学进行了回顾,同时关注医学法律观点。
    Ogilvie\'s syndrome refers to a massive dilation of the colon without mechanical obstruction. Although this syndrome is well-known in the clinical literature and may sometimes be encountered as a complication of abdominal, pelvic, or hip surgery, it has only been reported sporadically in the forensic literature. We present the case of a forensic autopsy carried out on a patient whose death was related to cecal necrosis with acute peritonitis due to Ogilvie\'s syndrome following hip surgery. This diagnosis was based on clinical data, post-mortem imagery, autopsy findings, histological analysis, post-mortem chemistry, and microbiological analysis. A review of the literature and possible physiopathology of this disease are performed, while focusing on medico-legal perspectives.
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  • 文章类型: Journal Article
    人们对线粒体功能障碍在精神分裂症病理生理学中的作用越来越感兴趣。线粒体复合物一(MCI)功能障碍,已被视为一种潜在的病因机制,线粒体功能障碍可能与多巴胺信号的改变相互作用,谷氨酸能功能障碍,和氧化应激。新的证据线从新的方法使它及时审查证据的线粒体参与精神分裂症,特别关注MCI。与对照组相比,精神分裂症中最一致的发现是死后脑组织中MCI亚基的表达降低(Cohen'sd>0.8);死后脑中MCI功能降低(d>0.7);以及神经葡萄糖利用率降低(d=0.3-0.6)。抗精神病药物可能会影响葡萄糖的利用,and,至少在体外,影响MC1。这些发现总体上与精神分裂症的MCI功能障碍相一致,但也强调需要进行体内研究以确定MCI功能障碍与患者症状之间的联系。如果新的成像工具证实MCI在该疾病中功能障碍,这可能为针对这种酶的新疗法铺平道路。
    There has been increasing interest in the role of mitochondrial dysfunction in the pathophysiology of schizophrenia. Dysfunction of mitochondrial complex one (MCI), has been viewed as a potential aetiological mechanism by which mitochondrial dysfunction might interact with alterations in dopamine signalling, glutamatergic dysfunction, and oxidative stress. New lines of evidence from novel approaches make it timely to review evidence for mitochondrial involvement in schizophrenia, with a specific focus on MCI. The most consistent findings in schizophrenia relative to controls are reductions in expression of MCI subunits in post-mortem brain tissue (Cohen\'s d>0.8); reductions in MCI function in post-mortem brains (d>0.7); and reductions in neural glucose utilisation (d = 0.3-0.6). Antipsychotics may affect glucose utilisation, and, at least in vitro, affect MC1. The findings overall are consistent with MCI dysfunction in schizophrenia, but also highlight the need for in vivo studies to determine the link between MCI dysfunction and symptoms in patients. If new imaging tools confirm MCI dysfunction in the disease, this could pave the way for new treatments targeting this enzyme.
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