基于死后全血舍曲林水平的致命性血清素综合征假阳性诊断》(A False-positive Diagnosis of a Letthal Serotonin Syndrome Based on Postmortem Whole-blood Levels of Sertraline):法医侦探工作如何利用医学知识和临床药理学破案。

IF 1.3 4区 医学 Q3 PSYCHIATRY
Sheldon H Preskorn, David D Masolak
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引用次数: 0

摘要

本专栏是三篇系列文章中的第三篇,描述了一些案例,在这些案例中,医学常识(包括精神病学和临床药理学)在确定失职是否是渎职诉讼中损害的直接原因方面发挥了重要作用。该案例说明了不考虑以下变量会如何导致对致死性血清素综合征的错误阳性诊断:(a) 治疗的时间过程,(b) 症状的时间过程,(c) 死前血浆和死后全血中高蛋白结合药物和高亲脂药物水平的差异。该案例还说明了将这 3 个变量考虑在内如何得出结论,即在护理病人方面没有失职,这不是病人死亡的直接原因,因此不存在医疗事故。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A False-positive Diagnosis of a Lethal Serotonin Syndrome Based on Postmortem Whole-blood Levels of Sertraline: How Forensic Detective Work Uses Medical Knowledge and Clinical Pharmacology to Solve Cases.

This column is the third in a 3-part series describing cases in which general medical knowledge, including psychiatric and clinical pharmacology, was instrumental in determining whether dereliction was the direct cause of damages in a malpractice suit. This case illustrates how not taking into account the following variables can result in a false-positive diagnosis of a lethal serotonin syndrome: (a) the time course of treatment, (b) the time course of symptoms, (c) the difference between antemortem plasma and postmortem whole-blood levels of highly protein bound and highly lipophilic drugs. The case also illustrates how taking those 3 variables into account led to the conclusion that there was no dereliction in the care of the patient that was the direct cause of his death, and hence, there was no medical malpractice.

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来源期刊
CiteScore
2.30
自引率
10.50%
发文量
159
审稿时长
>12 weeks
期刊介绍: Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field. Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.
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