Startseite Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
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Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective

  • Francesco De Micco , Gianmarco Di Palma , Flavia Giacomobono , Anna De Benedictis , Mariano Cingolani , Vittoradolfo Tambone , Luca Tomassini und Roberto Scendoni EMAIL logo
Veröffentlicht/Copyright: 29. Mai 2025
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Open Medicine
Aus der Zeitschrift Open Medicine Band 20 Heft 1

Abstract

Introduction

The evolution of Laboratory Medicine (LM) has expanded diagnostic and therapeutic horizons, yet ethical concerns pervade its advancements. This article explores the ethical challenges inherent in LM and advocates for a personalist bioethical framework as a guiding principle. It addresses issues such as patient data privacy, healthcare equity, communication of complex analysis results, genetic information management, and conflicts of interest.

Objectives

The proposed framework emphasizes principles such as the defense of life, freedom, responsibility, totality in therapy, and sociality and subsidiarity, with a focus on human dignity.

Results

Various bioethical theories address complex ethical issues in medicine and health sciences, often combined to guide clinical practice. This study focuses on personalist bioethics, prioritizing human dignity and intrinsic value, advocating for principles like defense of physical life, freedom, totality in therapy, and sociality. In LM, ethical analysis involves patient care, genetic testing, informed consent, and Artificial Intelligence integration, emphasizing transparency and patient autonomy.

Conclusion

LM plays a crucial role in healthcare, necessitating ethical considerations amidst technological progress. Upholding ethical frameworks, such as the ethics of good work, can ensure equitable and quality healthcare delivery.

Keywords: laboratory medicine; diagnostic and therapeutic evolution; ethical concerns; patient data privacy; healthcare equity; healthcare integration; personalist bioethics

1 Introduction

Laboratory medicine (LM) is a young science characterized by broad horizons and fascinating potential, synthesis between different branches such as Pathology, Clinical Biochemistry, Clinical Microbiology, and the contribution of new methodological perspectives appropriate to Medical Biotechnologies [1,2]. Its development has led to many significant innovations. New diagnostic technologies such as genomics, proteomics, and metabolomics have made a more precise and personalized diagnosis of diseases possible. These approaches allow the analysis of DNA, proteins, and metabolites to identify the causes and characteristics of diseases. Clinical analysis laboratories are becoming increasingly automated, reducing human errors, increasing efficiency, and allowing greater productivity. Robots are employed to perform repetitive and standardized analyses [3,4,5]. LM is moving toward more personalized approaches, taking into account the individual genetic and molecular characteristics of patients. This allows for the customization of treatments to maximize effectiveness and reduce side effects. Faster and portable diagnostic tests have been developed, allowing results to be obtained in minutes rather than hours or days. These tests are crucial for early diagnosis and disease control [6,7]. Information systems and big data play a crucial role in analyzing and interpreting laboratory results. The integration of this data allows for better management of patient information and contributes to evidence-based medicine [8,9]. Research continues to identify new biomarkers, which are biological indicators that can be measured and used to assess health status or the presence of diseases. These biomarkers often become targets for new therapies [10,11,12].

The evolution of LM has expanded diagnostic and therapeutic possibilities, enabling a better understanding of diseases and paving the way for more targeted and personalized treatments. However, it also presents some ethical issues that require attention.

With the increasingly widespread use of genomics and other advanced technologies, the collection and management of patient’s genetic and personal data become crucial. Ensuring data privacy and establishing secure protocols for handling sensitive information are important to prevent abuse or privacy violations [13,14]. New diagnostic technologies can be expensive and not always accessible to all patients, leading to disparities in access to healthcare. This raises ethical issues regarding fairness in the provision of healthcare services and ensuring that everyone can benefit from advances in LM [15]. The complexity of laboratory analysis results can make it difficult for patients to understand. Proper communication and interpretation of results are crucial to avoid misunderstandings or unnecessary anxieties. Genetic information can reveal predispositions to diseases or health conditions. For this reason, it would be advisable for the interpretation of the data and communication to the patient to be handled by Medical Laboratory Professionals (MLPs) with specific expertise in the field of genetics. This is to effectively convey to the patient the implications of the diagnosis in a clear and realistic manner while allowing the patient to actively participate in decisions regarding their health, respecting their dignity and autonomy. Furthermore, the use of such information raises ethical questions about genetic discrimination, stigmatization, and the management of information by insurance companies or employers [15,16,17].

Finally, in research laboratories and companies developing diagnostic technologies, conflicts of interest may arise between pursuing profit and the public interest in health. This could influence the presentation of data or the promotion of unnecessary tests or treatments [18,19].

The purpose of the article is to highlight the ethical issues related to the professional practice of LM and to propose an ethical framework as a reference to address these challenges and pursue safe and quality LM.

2 Bioethical framework

Multiple bioethical theories are available to reference, each offering a unique perspective in addressing complex ethical issues within medicine and health sciences, often used in combination to guide ethical decisions and clinical practice [20]. The bioethical framework referred to in this work is that of personalist bioethics [21,22]. It is an ethical approach that places human dignity and intrinsic value at its core. It focuses on the individual as a subject endowed with dignity and inalienable rights, aiming to protect and promote human well-being and dignity in every biomedical context. Conversely, the principialist and consequentialist models were not deemed suitable for the present analysis. While principlism offers a well-structured approach, it may not fully capture the relational aspects of patient care. On the other hand, consequentialism, with its outcome-oriented perspective, adopts a highly pragmatic approach but risks overlooking individual dignity [23]. This personalistic approach is based on several fundamental principles:

  1. The principle of defense of physical life. The principle of defense of physical life is one of the fundamental principles in bioethics, referring to the moral duty to protect and preserve human life. This principle underscores the intrinsic value of life and the ethical obligation to do everything possible to avoid physical harm or dangers that may compromise the health and physical well-being of individuals. From this principle arises the ethical imperative of respecting human life, wherein the defense and promotion of life have a limit in death, which is a part of life, and the promotion of health has a limit in illness, which should be healed and treated, and in any case considered with an active approach, even when it is incurable. In a laboratory context, this principle requires quality control measures to be taken in order to avoid errors in diagnostic results that could pose a danger to the patient. For example, ensuring analytical accuracy to prevent errors in diagnosis.

  2. The principle of freedom and responsibility. This principle refers to people’s capacity to act according to their own will and to take responsibility for their actions, decisions, and consequences. Freedom is closely linked to the concept of autonomy. It acknowledges the right and ability of individuals to make autonomous decisions regarding their own lives, health, and medical treatments. Freedom implies respect for individual rights, including rights such as privacy, freedom of expression, and the right to religious freedom. These rights can influence medical decisions, such as the choice of treatments based on personal or religious beliefs. However, the physician has the freedom to dissent from any requests that conflict with their conscience that are contrary to legal norms, professional ethics, or good clinical care practices. Freedom is reflected in the principle of informed consent, which ensures that patients are fully informed and free to accept or refuse medical treatment based on detailed information. In the laboratory setting, patients should be informed about how their genetic data might be used, with the option to withdraw their consent at any time.

  3. The principle of totality or therapeutic principle. Intervention in a person’s physical life is lawful where it is necessary for the safeguarding of the person’s own life. Therefore, it is necessary that when administering therapy, it is evaluated within the entirety of the person, demanding a certain proportion between the risks and damages it may entail and the benefits it provides. Administering disproportionate treatments without foreseeable results may demonstrate aggressiveness or therapeutic obstinacy. In such a case, within a laboratory, Artificial Intelligence (AI) systems could provide in-depth analyses of diagnostic results. However, the physician should always contextualize and validate this information, ensuring the comprehensive management of the data.

  4. The principle of sociality and subsidiarity. According to this principle, the common good is achievable through the good of the individual and solidarity toward those in greater need. Each citizen must consider not only their own life but also that of others as a personal and social good. The community, in turn, commits to promoting the life and health of everyone, ensuring that all have access to medical care and providing more assistance where the need is greatest [21,22]. In such a case, in keeping with the principle, it could be beneficial to introduce mobile laboratories or subsidies for screening in underserved areas.

Personalistic bioethics, thanks to its focus on the concept of human dignity and the recognition of the intrinsic value of the person, can find concrete applications in various areas of LM. In particular, in the delicate area of genetic testing, this perspective requires that the patient be informed about the potential results, often of a probabilistic nature, as well as about the possible impacts that such analyses may have on the life of the subject. In fact, by not providing unequivocally certain results regarding the materialization of a possible pathology, such analyses may influence a person’s life choices to a variable extent. This is essential to fully guarantee respect for the right to decisional autonomy. Similarly, in the use of laboratory diagnostic tools based on AI, personalist bioethics emphasizes the importance of a correct balance between technological efficiency and respect for the person. As is known, one of the major technical problems related to the use of AI is the lack of transparency in the algorithmic evaluation process. An inadequate understanding of the functioning of these systems represents a violation of the patient’s right to self-determination. In this sense, the personalist approach requires the implementation of approaches capable of increasing the explainability of AI systems, involving the patient in the understanding and management of the results.

3 Bioethical analysis

MLPs operate within three major areas: patients, medical colleagues, and other professional figures they engage with, as well as society itself [24,25]. It is precisely within this broad spectrum of work that ethical reflection becomes necessary. The urgent need to provide scientifically updated and clinically valid responses obliges MLPs to ensure that every phase of the processes they are responsible for maintains high standards in terms of quality, effectiveness, and safety. Only by doing so can patients be assured of receiving the best possible care, aligning with a modern and increasingly essential rationalization of resources.

3.1 The patient

As with any branch of medical science, the core of action in LM is centered around the patient. The current capability to perform and report laboratory tests in real-time, especially in urgent and emergency medicine, has altered the approach to patient care and its clinical management. The expertise within a medical laboratory holds direct responsibility for the quality and integrity of the service provided. This necessitates maintaining high standards of competence to safeguard patients from incompetent or even illegal practices.

A primary aspect concerns the vast amount of data a laboratory possesses to adequately identify patients. Laboratories must comply with data privacy laws and regulations, such as the General Data Protection Regulation (GDPR) in Europe or the Health Insurance Portability and Accountability Act (HIPAA) in the United States [26,27,28,29,30]. Therefore, ensuring patient information confidentiality and safeguarding personal data from unauthorized access and improper use is crucial. Rigorous cybersecurity standards are necessary to protect sensitive data, employing encryption, restricted access, firewalls, and other protective measures to prevent unauthorized access or intrusion [14,31,32].

Furthermore, patients should be properly informed about the type of information stored and the intended use (clinical, research, educational, etc.). Patients must provide informed consent for the collection and processing of data and should have some level of control over the use of their data, including the ability to revoke consent or limit access to specific information [33,34].

In this regard, it is worth highlighting the role of laboratories in biomedical research and the need for professionals involved to identify potential benefits and risks, informing patients about the procedures adopted, the risks, benefits, side effects, and possible alternative diagnostics [34,35,36,37]. Regarding procedures performed by MLPs, more invasive procedures necessitate adequate informed consent, whereas routine procedures like a venous blood draw can be implied when a patient spontaneously requests professional service. In this regard, two issues are particularly interesting for their ethical implications: Direct-to-Patient Report delivery and Direct-to-Consumer laboratory testing (DTC). In both cases, the interpretation of laboratory data may not be performed by a physician, with significant diagnostic and therapeutic consequences. Yet, the relational dimension and the need to inform the patient play a fundamental role in the field of medicine, given the specific contribution of medicine to the study of humans in a constitutive dimension, such as illness. An impersonal approach or even the absence of a relationship reduces, even nullifies, the space and time for care, limiting the autonomy of the patient as they are poorly informed or not informed at all. Therefore, laboratories should always provide assistance to their patients, even when tests are not directly under their responsibility, as in the case of DTC, also by establishing dedicated communication teams and developing, implementing, and verifying a communication plan [38]. In this way, the principles of defending physical life, freedom, and responsibility would be pursued, even for those segments of the population who are economically disadvantaged and can meet their health needs by accessing low-cost laboratory tests, without resulting in an informational deficit with consequences on their health status [39].

A separate consideration is warranted for genetic tests. Genetic information is highly sensitive and can reveal intimate health-related data and predisposition to certain diseases. For example, a patient’s genetic test results might be accidentally sent to an unauthorized recipient, exposing the patient to potential insurance discrimination. Genetic test results can have a strong emotional and psychological impact on the patient and their family. Discovering predispositions to serious illnesses can generate anxiety, stress, and concerns for the future, considering these data could be used for discrimination in various contexts, such as insurance, employment, or access to services [40,41,42,43,44]. Therefore, it is essential to ensure that patients are fully informed about the implications of genetic tests and provide their informed consent before undergoing such tests. Hence, a pre-test counseling session is mandatory to educate patients about the implications of these tests, assist them in understanding and managing the test results, and provide resources to address psychological implications [45,46,47]. For instance, a patient using a genetic testing kit without professional counseling might experience anxiety and misinterpretation of the results.

In assessing patient safety concerns related to digitization and automation, it is essential to consider the enhancement of LM through AI. AI will increasingly integrate with LM, enhancing diagnostic capabilities but also raising associated risks. It is conceivable that an AI system implemented for laboratory analysis could erroneously classify an autoimmune disease as a viral infection, leading to inappropriate treatments. This aspect underscores the principle of totality, which requires a balance between the use of technological tools and human critical intervention to ensure accurate clinical decisions [48]. The latest machine learning models act like “black boxes,” having a structure so complex that users cannot comprehend how an AI system converts data into decisions [49]. Uncontrolled and erroneous decision-making by an algorithm can cause severe and irreversible damage. The growing integration of AI in LM demands absolute transparency between doctors and patients, among doctors and healthcare organizations, and between healthcare organizations and the public, as it is essential for quality, safety, accountability, and informed decision-making [50]. The opacity of algorithmic decisions, autonomous behavior, and the complexity of AI systems make it extremely difficult for patients to prove liability in cases of harm resulting from medical errors. This can lead to prolonged timelines and, consequently, higher costs for legal proceedings. Furthermore, it should be noted that the unregulated use of AI could exacerbate inequalities in access to care, particularly if the system’s design fails to adequately consider the needs of the most vulnerable populations [51].

According to Pennestrì and Banfi, patients should explicitly consent to the use of their health data for purposes other than their health and be aware that medical decisions regarding their health are based on data processed by machines. Otherwise, there is a risk of breaking a fundamental element of the doctor-patient relationship, which is trust [52]. The concrete risk is the impoverishment of the perception of reality, which would be reduced to a formal datum, potentially leading to a crisis of identity and a loss of sense of one’s work activity. As Heidegger states, we need meditative thinking capable of confronting us with the complete dominion of technology [53].

The principle of defending physical life requires MLPs to be aware of the potential risks associated with the manipulation of biological samples when pervasive use of new technologies is employed. Therefore, it is necessary to ensure that all activities are conducted with utmost care and consideration for the health and physical well-being of patients, including fields such as patient privacy protection and data security, to prevent any unauthorized exposure or breach of confidentiality. The two main privacy regulatory models are the GDPR in Europe and the HIPAA in the United States. These regulatory frameworks are essential tools for protecting personal data, including health information, and are a cornerstone of privacy and security management in healthcare practices. They establish clear rules to ensure that data processing is lawful, transparent, and secure while safeguarding patient rights. The personalist approach aligns well with the principles established by the GDPR and HIPAA, as both models prioritize the protection of privacy and respect for individual rights. Like personalist ethics, these two regulatory frameworks place great emphasis on informed consent and patient autonomy. For example, in LM, this means that patients must be aware that their biological samples and related data are being used for diagnostic and therapeutic analysis. Another fundamental principle reflected in both regulatory frameworks is respect for dignity and privacy. In LM, it is essential to ensure that patient information, including genetic analyses and other sensitive data, is protected from any form of misuse or unauthorized disclosure. Furthermore, both models emphasize the concepts of personalization of treatment, transparency, and accountability. These aspects converge with the personalist model, which requires that data be processed for specific and targeted purposes while ensuring responsible use to promote trust in the health system. Therefore, it is evident that these regulations provide a solid basis for integrating personalist ethics, ensuring that each patient is treated with the utmost respect and that their information is used exclusively for their well-being [54,55,56].

The results of a laboratory test, like access to medical data, should be solely accessible to the clinician who requested the examination, the patient, or those the patient has authorized according to legal standards, the laboratory staff, or the healthcare facility if necessary within the patient’s diagnostic and treatment process. In any case, if data are shared with other healthcare providers or entities, it is important to do so securely and protected through secure networks and encrypted protocols [57,58,59].

It will also be necessary for patients to be properly and comprehensively informed that data concerning their health may be processed by machines without the interpretation of the data by a doctor. If this information is not provided, the principle of freedom and responsibility, which emphasizes the importance of balancing patients’ right to make autonomous decisions about their health with the responsibility of MLPs to provide them with informative and compassionate support during this process, would be violated.

AI being able to analyze huge amounts of clinical data allows the integration of information from different sources, helping to identify patterns and correlations that are difficult to detect manually [60]. A hybrid clinical methodology in which the human being’s critical thinking, i.e., the ability to analyze the available facts, evidence, observations, and arguments to form a judgment, is the apex of decision-making, is an extrusion of the principle of wholeness in that it emphasizes the importance of considering the whole individual, rather than treating only symptoms or illnesses in isolation, to provide effective and personalized treatment. Finally, it is imperative that, as in other fields of medicine, AI does not become a source of injustice and inequality. Indeed, AI can provide faster and more efficient diagnoses, but if these technologies are not distributed equitably or are not accessible to all socio-economic groups, it could increase inequalities in access to care precisely at the expense of those who need it most [61,62].

In such a scenario, while AI ensures improved efficiency and diagnostic precision, it remains essential to preserve the human element to guarantee patient-focused care. Automation can simplify diagnostic processes but cannot replace the professional in the empathetic communication of results. This aspect ensures respect for the principle of freedom and responsibility, enabling patients to make appropriately informed decisions about their health. AI algorithms should represent a supporting tool, not a substitute for the clinician’s judgment. A hybrid approach should be promoted, where AI provides in-depth analysis while the human operator contextualizes and validates the data. This approach embodies the principle of totality, emphasizing the consideration of the person as a whole rather than isolated technological data. Thus, in the context of technological advancements driven by AI, obtaining informed consent on how data are processed and interpreted becomes essential. Patients should be informed not only about the purpose and functioning of diagnostic tests but also about the specific role AI plays in the procedure, including its potential benefits, limitations, and possible biases. Communication should avoid technical jargon, and pre- and post-test counseling sessions should be provided. For example, explaining the difference between a probabilistic result generated by AI and a genetic predisposition is crucial, as this distinction could significantly influence the patient’s health decisions [63].

Enhancing patient autonomy and awareness could also be achieved through the implementation of dynamic consent models. These models allow patients to progressively update their consent preferences as personal data accumulates and algorithms evolve. Additionally, promoting educational campaigns – through brochures, online platforms, or television initiatives – could further enhance understanding and demystify AI-based diagnostics.

Moreover, the use of direct-to-consumer tests, as discussed, could undermine the relational dimension with the patient. To prevent this, laboratories could establish communication teams for patients using such tests. The issue of the gap between technological advancements and empathy could be addressed by ensuring enhanced ethical training for professionals and fostering relational skills. It is also crucial to focus on the digital divide. A potential solution could involve promoting mobile laboratory units or subsidies for screening tests in disadvantaged areas. Such an approach would ensure full compliance with the principle of subsidiarity [64,65].

As seen so far, the integration of AI in LM can represent a significant breakthrough, but it raises complex ethical issues. For example, the use of specific biomarkers can improve the accuracy of the diagnostic process, at the same time, if the algorithm’s training datasets are not representative of all populations, the system could autonomously perpetuate errors. An example could be a cardiovascular risk prediction algorithm, also based on laboratory variables, which, trained on a predominantly Caucasian population, could commit errors of underestimation or overestimation if applied to different ethnic groups. To mitigate these risks, as already analyzed, it is essential to implement technologies capable of ensuring transparency in decision-making models and developing human control mechanisms capable of balancing the reliability of technological tools and clinical judgment.

3.2 LM within the context of medicine

LM is a crucial pillar in modern medical practice, providing vital support for the diagnosis, treatment, and monitoring of health conditions. Collaboration between diagnostic laboratories and other sectors of medicine is essential to ensure comprehensive and high-quality care for patients.

Medical acts are integrated processes involving various actors with diverse skills, all focused on the patient’s well-being. The convergence of these actors toward a singular goal – the patient’s health – qualifies the medical act as genuinely integrated. Evaluating the integration of these actors’ partial objectives in their actions becomes crucial. The ethical goodness of a medical act is also judged by how well it is performed, objectively evaluating its execution. The necessary conditions for an ethically good medical act are its proper execution, adherence to the best evidence, compliance with the gold standard, and correct nosographic framing [66].

MLPs should uphold the dignity and respect of their profession as an integral part of the medical act. This can be achieved by significantly contributing to the advancement of their field, adhering to the ethical imperative of continuous professional development through a modern lifelong learning approach, promoting high standards of both theoretical and practical learning, and collaborating with other healthcare professionals.

This significantly impacts diagnosis and disease treatment, research and development, and prevention. LM, beyond providing tests for accurate diagnoses and aiding clinicians in determining the most suitable treatments, can identify specific biomarkers guiding personalized therapies, enabling doctors to tailor treatments based on individual patient characteristics [67]. In the latter case, laboratories can support the assessment of innovative therapies by monitoring patient responses to experimental treatments through data analysis [68,69].

Moreover, using laboratory tests for disease screening allows for early diagnosis, preventive interventions, monitoring of disease progression, and assessing the long-term effectiveness of treatments [70].

3.3 LM within the social context

LM, like other branches of Medical Services, offers a transparent, measurable, and robust cost analysis. This makes it particularly susceptible to external scrutiny through analysis methods and subsequent measures that mostly consider quantitative aspects.

The relationship between LM and business ethics is significant as clinical laboratories operate in a commercial context while providing essential services in the healthcare field.

It is crucial for laboratories to ensure cost transparency of tests and services to avoid financial surprises for patients. This guarantees fair access to laboratory services, reducing disparities in access to diagnostic tests and treatments [71]. It could be the case of an automated screening study that, when conducted in an underprivileged region, improves diagnostic accuracy. However, the lack of access to laboratories excludes low-income patients.

Furthermore, the corporate social responsibility of LMs is significant, involving participation in initiatives supporting public health and community well-being. This includes awareness programs, screenings, or support for local healthcare initiatives, as well as adopting sustainable and responsible practices to reduce the environmental impact of laboratory activities [71,72].

LMs can play a significant role in a health perspective based on a One Health approach. One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems [73]. The impact of LM can be decisive in identifying emerging and re-emerging infectious diseases, implementing more effective control measures to combat zoonotic diseases, and improving public health through food safety [74]. In this sense, LM could contribute to the recovery of a genuine conception of bioethics, namely a research tool that encompasses human life, animal life, and the environment in its scope of action in order to create a bridge between the human and biological sciences for human survival [75]. This perspective highlights the fundamental ethical value of the work of LMPs, which can be seen within the framework of moderate anthropocentrism, as expressed in the ethics of responsibility. This view is based on the rational principle of evaluating the negative consequences of every human action toward the environment and future generations [76].

In the changing landscape of healthcare, the shift to patient-centered care represents a profound transformation that places MLPs at the center of efforts to improve patient outcomes, requiring not only technical expertise but also a broad and adaptable skill set capable of addressing the complexities of modern medical practice. This change requires MLPs to maintain exceptional analytical accuracy in diverse laboratory settings, ensuring that the reliability of test results supports accurate clinical decisions while elevating the quality of laboratory services by optimizing processes in the pre-analytical and post-analytical phases to improve both efficiency and overall effectiveness [77].

In addition, the role of MLPs goes beyond traditional laboratory functions, as they are increasingly charged with leveraging laboratory data to influence diagnostic and therapeutic pathways, which requires a deep understanding of the impact of such data on clinical outcomes and a commitment to integrate cutting-edge technologies and methodologies into routine practice. By engaging in collaborative research with clinicians, MLPs bridge the gap between laboratory innovation and its application in patient care, contributing to a healthcare model that seamlessly integrates advanced diagnostics with treatment strategies.

In addition, successful engagement with a variety of stakeholders requires strong relationship management skills, coupled with the ability to communicate effectively and tailor messages to different audiences. This emphasis on refined interpersonal and communication skills underscores a critical dimension of their responsibilities [78].

Ultimately, the changing paradigm of healthcare requires MLPs to adapt in tandem, developing a multifaceted skill set that includes analytical skills, process improvement, strategic use of laboratory data, active participation in collaborative research, stakeholder engagement, and effective communication. Together, these competencies form the basis for advancing the transition to a more patient-centered model of care [79].

The evolution toward patient-centered care marks a critical juncture in the advancement of skills within the realm of MLPs. Their role demands a spectrum of specific proficiencies. These include upholding analytical precision across diverse testing environments, enhancing the overall quality of laboratory services, and ensuring streamlined efficacy in pre-analytical and post-analytical phases. MLPs are also tasked with optimizing the utilization of laboratory data within diagnostic and treatment pathways and evaluating its impact on patient outcomes. Collaboration with clinicians in applied research becomes essential for seamlessly integrating novel technologies and methodologies into clinical practice. Moreover, adept relationship management with all stakeholders and honed communication skills are pivotal facets of their evolving role. In essence, MLPs are pivotal agents in the shift toward patient-centric care, necessitating a multifaceted skill set encompassing analytical expertise, process refinement, data utilization, collaborative research, stakeholder engagement, and effective communication [71,80,81,82,83]. The aspect of communication skills merits reflection. It may seem superfluous for professionals in a field that historically doesn’t directly interact with patients. However, this is not the case. The remarkable development of predictive medicine will lead to increasingly personalized prevention, demanding an even greater communicative effort from every healthcare professional. They will have the task of clearly delineating the meaning of genetic predisposition and the potential risk of illness as physicians increasingly have healthy patients and help them better manage their health capital.

The role of LMPs can extend beyond the field of communication. The recent COVID-19 pandemic has shown how difficult it can be for people to find reliable sources and accurate information when they are inundated with an excessive amount of information, often unreliable or misleading [84]. Such a flow of “misinformed” information can hinder efforts to effectively address public health crises. What do the sensitivity and specificity of a test mean? What are the consequences of low specificity? How does the rapid antigen test work, and when is it indicated? Is the molecular test more reliable? And serological tests? These were some of the questions that many sought answers to, even just by consulting the web. LMPs are also called to be protagonists in the health literacy process by providing information based on scientific evidence, transparent, correct, coherent in argumentation, clear and adequate to the understanding of the recipient, inclusive and reliable [85]. It is not just one of the many options but an ethical duty substantiated by criteria oriented toward the good of the recipient.

Finally, transparent and honest communication also applies to errors made in healthcare provided within laboratory activities [86]. This specific aspect of communication is an ethical and deontological duty that presupposes an open and honest relationship with the patient and their family. If errors and adverse events are communicated promptly, then the patient will be able to make informed choices, undergo appropriate treatments, and mitigate damages. Above all, it will strengthen the patient’s trust in healthcare workers and healthcare institutions.

4 Conclusion

LM plays a fundamental role in the healthcare ecosystem, closely collaborating with other medical sectors to provide accurate diagnoses, patient monitoring, and support for clinical decisions.

As highlighted, there are multiple ethical challenges associated with the practice of this medical activity that require special attention, such as privacy and data management, fair access to diagnostic technologies, result interpretation and communication, ethical use of genetic information, and potential conflicts of interest between profit pursuit and public health interest.

Addressing these challenges requires a balance between technological innovation and safeguarding rights, privacy, and equitable access to medical care. Adequate regulations, ethical guidelines, and increased public awareness can help mitigate these issues and ensure that LM is practiced ethically and responsibly. An additional ethical challenge lies in ensuring a balance between profit needs and public health priorities. It is essential for laboratories to adopt policies that prioritize patient well-being over economic gain, avoiding conflicts of interest by promoting transparent practices, ethical guidelines, and auditing mechanisms.

We believe that a possible response lies in adopting a well-structured ethical framework, such as that of the ethics of good work, which emphasizes integrity and excellence in professional practices for the benefit of individuals and society [87,88]. According to this ethical framework, the activity carried out by professionals working in the field of LM should be characterized by (a) an interdisciplinary co-design related to complexity theory and systemic thinking; (b) realistic knowledge that always starts from experience and seeks scientific truth as the basis for choices; (c) a management model useful for motivational engagement of all involved components; (d) awareness that every medical act is a free and responsible human act with intrinsic ethical value; (e) the retrieval of the political dimension of good work, that is, professional excellence as a tool in service to society and the common good; (f) the capacity for radical procedural innovation; and (g) placing the individual at the center of work, improving effectiveness and efficiency while ensuring sustainability [87]. These characteristics align with the personalist bioethical framework: interdisciplinarity reflects sociality, realistic knowledge aligns with wholeness, motivational management supports subsidiarity, and ethical awareness links with freedom and responsibility, professional excellence and innovation emphasizes sociality and responsibility, while patient-centeredness emphasizes human dignity, operationalizing the framework in LM. In pragmatic terms, it seems crucial to promote policies that encourage the adoption of clear bioethical frameworks and regulations regarding the use of AI technology and genetic data. Healthcare personnel should take part in training programs on bioethics in order to improve communicative and interpersonal skills to be able to handle complex situations. Finally, the development of diagnostic technologies that respect ethical principles and are accessible even in low-income settings should be encouraged.

We believe that by following this path, respectful and dignified treatment for all individuals can be ensured, promoting fair and universal access to safe and quality healthcare services.

Acknowledgments

Gianmarco Di Palma is a Ph.D. student enrolled in the National Ph.D. in Artificial Intelligence, XL cycle, a course on Health and Life Sciences, organized by Università Campus Bio-Medico di Roma.

  1. Funding information: Authors state no funding involved, and no funds, grants, or other support were received.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and consented to its submission to the journal, reviewed all the results, and approved the final version of the manuscript. FDM and GDP conceptualized the study. FG and MC conducted the literature review and contributed to drafting the theoretical framework. ADB developed the bioethical framework and assisted in manuscript preparation. LT provided methodological expertise and supported the refinement of the study approach. VT supervised the research and provided critical revisions. RS prepared the manuscript with contributions from all co-authors.

  3. Conflict of interest: The authors have no relevant financial or non-financial interests to disclose.

  4. Data availability statement: Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

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Received: 2024-07-03
Revised: 2025-01-29
Accepted: 2025-02-06
Published Online: 2025-05-29

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Investigation of the pathogenic variants induced Sjogren’s syndrome in Turkish population
  128. Nucleotide metabolic abnormalities in post-COVID-19 condition and type 2 diabetes mellitus patients and their association with endocrine dysfunction
  129. TGF-β–Smad2/3 signaling in high-altitude pulmonary hypertension in rats: Role and mechanisms via macrophage M2 polarization
  130. Ultrasound-guided unilateral versus bilateral erector spinae plane block for postoperative analgesia of patients undergoing laparoscopic cholecystectomy
  131. Profiling gut microbiome dynamics in subacute thyroiditis: Implications for pathogenesis, diagnosis, and treatment
  132. Delta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?
  133. Anticancer activity mechanism of novelly synthesized and characterized benzofuran ring-linked 3-nitrophenyl chalcone derivative on colon cancer cells
  134. H2valdien3 arrests the cell cycle and induces apoptosis of gastric cancer
  135. Prognostic relevance of PRSS2 and its immune correlates in papillary thyroid carcinoma
  136. Association of SGLT2 inhibition with psychiatric disorders: A Mendelian randomization study
  137. Motivational interviewing for alcohol use reduction in Thai patients
  138. Luteolin alleviates oxygen-glucose deprivation/reoxygenation-induced neuron injury by regulating NLRP3/IL-1β signaling
  139. Polyphyllin II inhibits thyroid cancer cell growth by simultaneously inhibiting glycolysis and oxidative phosphorylation
  140. Relationship between the expression of copper death promoting factor SLC31A1 in papillary thyroid carcinoma and clinicopathological indicators and prognosis
  141. CSF2 polarized neutrophils and invaded renal cancer cells in vitro influence
  142. Proton pump inhibitors-induced thrombocytopenia: A systematic literature analysis of case reports
  143. The current status and influence factors of research ability among community nurses: A sequential qualitative–quantitative study
  144. OKAIN: A comprehensive oncology knowledge base for the interpretation of clinically actionable alterations
  145. The relationship between serum CA50, CA242, and SAA levels and clinical pathological characteristics and prognosis in patients with pancreatic cancer
  146. Identification and external validation of a prognostic signature based on hypoxia–glycolysis-related genes for kidney renal clear cell carcinoma
  147. Engineered RBC-derived nanovesicles functionalized with tumor-targeting ligands: A comparative study on breast cancer targeting efficiency and biocompatibility
  148. Relationship of resting echocardiography combined with serum micronutrients to the severity of low-gradient severe aortic stenosis
  149. Effect of vibration on pain during subcutaneous heparin injection: A randomized, single-blind, placebo-controlled trial
  150. The diagnostic performance of machine learning-based FFRCT for coronary artery disease: A meta-analysis
  151. Comparing biofeedback device vs diaphragmatic breathing for bloating relief: A randomized controlled trial
  152. Serum uric acid to albumin ratio and C-reactive protein as predictive biomarkers for chronic total occlusion and coronary collateral circulation quality
  153. Multiple organ scoring systems for predicting in-hospital mortality of sepsis patients in the intensive care unit
  154. Single-cell RNA sequencing data analysis of the inner ear in gentamicin-treated mice via intraperitoneal injection
  155. Suppression of cathepsin B attenuates myocardial injury via limiting cardiomyocyte apoptosis
  156. Review Articles
  157. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  158. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  159. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  160. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  161. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  162. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  163. The application of augmented reality in robotic general surgery: A mini-review
  164. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  165. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  166. Plant polyphenols, terpenes, and terpenoids in oral health
  167. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  168. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  169. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  170. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  171. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  172. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  173. Giant borderline ovarian tumours – review of the literature
  174. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  175. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  176. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  177. Supplement strategies for infertility in overweight women: Evidence and legal insights
  178. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  179. A meta-analysis of the effects of DBS on cognitive function in patients with advanced PD
  180. Protective role of selenium in sepsis: Mechanisms and potential therapeutic strategies
  181. Strategies for hyperkalemia management in dialysis patients: A systematic review
  182. C-reactive protein-to-albumin ratio in peripheral artery disease
  183. Case Reports
  184. Delayed graft function after renal transplantation
  185. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  186. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  187. Giant right atrial hemangioma presenting with ascites: A case report
  188. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  189. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  190. Molecular hydrogen-rhodiola as an adjuvant therapy for ischemic stroke in internal carotid artery occlusion: A case report
  191. Coronary artery anomalies: A case of the “malignant” left coronary artery and its surgical management
  192. Rapid Communication
  193. Biological properties of valve materials using RGD and EC
  194. A single oral administration of flavanols enhances short-term memory in mice along with increased brain-derived neurotrophic factor
  195. Letter to the Editor
  196. Role of enhanced external counterpulsation in long COVID
  197. Expression of Concern
  198. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  199. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  200. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  201. Corrigendum
  202. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  203. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  204. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  205. Retraction
  206. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  207. Retraction of: “LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through downregulating SP-A by sponging to miR-424”
  208. Retraction of: “SCARA5 inhibits oral squamous cell carcinoma via inactivating the STAT3 and PI3K/AKT signaling pathways”
  209. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  210. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  211. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  212. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  213. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  214. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  215. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  216. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  217. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  218. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  219. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  220. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  221. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  222. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  223. Red cell distribution width predicts early kidney injury: A NHANES cross-sectional study
  224. Special Issue Diabetes mellitus: pathophysiology, complications & treatment
  225. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  226. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  227. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  228. A review of brain research on T2DM-related cognitive dysfunction
  229. Metformin and estrogen modulation in LABC with T2DM: A 36-month randomized trial
  230. Special Issue Innovative Biomarker Discovery and Precision Medicine in Cancer Diagnostics
  231. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
https://doi.org/10.1515/med-2025-1153
Schlagwörter für diesen Artikel
laboratory medicine; diagnostic and therapeutic evolution; ethical concerns; patient data privacy; healthcare equity; healthcare integration; personalist bioethics
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Research Articles
  2. Network pharmacological analysis and in vitro testing of the rutin effects on triple-negative breast cancer
  3. Impact of diabetes on long-term survival in elderly liver cancer patients: A retrospective study
  4. Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
  5. Risk factors for severe adverse drug reactions in hospitalized patients
  6. Analysis of the effect of ALA-PDT on macrophages in footpad model of mice infected with Fonsecaea monophora based on single-cell sequencing
  7. Development and validation of headspace gas chromatography with a flame ionization detector method for the determination of ethanol in the vitreous humor
  8. CMSP exerts anti-tumor effects on small cell lung cancer cells by inducing mitochondrial dysfunction and ferroptosis
  9. Predictive value of plasma sB7-H3 and YKL-40 in pediatric refractory Mycoplasma pneumoniae pneumonia
  10. Antiangiogenic potential of Elaeagnus umbellata extracts and molecular docking study by targeting VEGFR-2 pathway
  11. Comparison of the effectiveness of nurse-led preoperative counseling and postoperative follow-up care vs standard care for patients with gastric cancer
  12. Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis
  13. Adhered macrophages as an additional marker of cardiomyocyte injury in biopsies of patients with dilated cardiomyopathy
  14. Association between statin administration and outcome in patients with sepsis: A retrospective study
  15. Exploration of the association between estimated glucose disposal rate and osteoarthritis in middle-aged and older adults: An analysis of NHANES data from 2011 to 2018
  16. A comparative analysis of the binary and multiclass classified chest X-ray images of pneumonia and COVID-19 with ML and DL models
  17. Lysophosphatidic acid 2 alleviates deep vein thrombosis via protective endothelial barrier function
  18. Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
  19. Serum PM20D1 levels are associated with nutritional status and inflammatory factors in gastric cancer patients undergoing early enteral nutrition
  20. Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study
  21. Vitamin D replacement therapy may regulate sleep habits in patients with restless leg syndrome
  22. The first-line antihypertensive nitrendipine potentiated the therapeutic effect of oxaliplatin by downregulating CACNA1D in colorectal cancer
  23. Health literacy and health-related quality of life: The mediating role of irrational happiness
  24. Modulatory effects of Lycium barbarum polysaccharide on bone cell dynamics in osteoporosis
  25. Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
  26. Examination of the causal role of immune cells in non-alcoholic fatty liver disease by a bidirectional Mendelian randomization study
  27. Clinical analysis of ten cases of HIV infection combined with acute leukemia
  28. Investigating the cardioprotective potential of quercetin against tacrolimus-induced cardiotoxicity in Wistar rats: A mechanistic insights
  29. Clinical observation of probiotics combined with mesalazine and Yiyi Baitouweng Decoction retention enema in treating mild-to-moderate ulcerative colitis
  30. Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection
  31. Sex-specific associations of sex hormone binding globulin and risk of bladder cancer
  32. Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women
  33. The ERAS nursing care strategy for patients undergoing transsphenoidal endoscopic pituitary tumor resection: A randomized blinded controlled trial
  34. The serum IL-17A levels in patients with traumatic bowel rupture post-surgery and its predictive value for patient prognosis
  35. Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients
  36. Analysis of serum NLR combined with intraoperative margin condition to predict the prognosis of cervical HSIL patients undergoing LEEP surgery
  37. Commiphora gileadensis ameliorate infertility and erectile dysfunction in diabetic male mice
  38. The correlation between epithelial–mesenchymal transition classification and MMP2 expression of circulating tumor cells and prognosis of advanced or metastatic nasopharyngeal carcinoma
  39. Tetrahydropalmatine improves mitochondrial function in vascular smooth muscle cells of atherosclerosis in vitro by inhibiting Ras homolog gene family A/Rho-associated protein kinase-1 signaling pathway
  40. A cross-sectional study: Relationship between serum oxidative stress levels and arteriovenous fistula maturation in maintenance dialysis patients
  41. A comparative analysis of the impact of repeated administration of flavan 3-ol on brown, subcutaneous, and visceral adipose tissue
  42. Identifying early screening factors for depression in middle-aged and older adults: A cohort study
  43. Perform tumor-specific survival analysis for Merkel cell carcinoma patients undergoing surgical resection based on the SEER database by constructing a nomogram chart
  44. Unveiling the role of CXCL10 in pancreatic cancer progression: A novel prognostic indicator
  45. High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries
  46. RAB39B: A novel biomarker for acute myeloid leukemia identified via multi-omics and functional validation
  47. Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
  48. Clinical efficacy of azacitidine in the treatment of middle- and high-risk myelodysplastic syndrome in middle-aged and elderly patients: A retrospective study
  49. The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients
  50. Expression and clinical significance of ITGA3 in breast cancer
  51. Single-nucleus RNA sequencing reveals ARHGAP28 expression of podocytes as a biomarker in human diabetic nephropathy
  52. rSIG combined with NLR in the prognostic assessment of patients with multiple injuries
  53. Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake
  54. Exploring causal relationship between 41 inflammatory cytokines and marginal zone lymphoma: A bidirectional Mendelian randomization study
  55. Gender beliefs and legitimization of dating violence in adolescents
  56. Effect of serum IL-6, CRP, and MMP-9 levels on the efficacy of modified preperitoneal Kugel repair in patients with inguinal hernia
  57. Effect of smoking and smoking cessation on hematological parameters in polycythemic patients
  58. Pathogen surveillance and risk factors for pulmonary infection in patients with lung cancer: A retrospective single-center study
  59. Necroptosis of hippocampal neurons in paclitaxel chemotherapy-induced cognitive impairment mediates microglial activation via TLR4/MyD88 signaling pathway
  60. Celastrol suppresses neovascularization in rat aortic vascular endothelial cells stimulated by inflammatory tenocytes via modulating the NLRP3 pathway
  61. Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
  62. GATA1: A key biomarker for predicting the prognosis of patients with diffuse large B-cell lymphoma
  63. Influencing factors of false lumen thrombosis in type B aortic dissection: A single-center retrospective study
  64. MZB1 regulates the immune microenvironment and inhibits ovarian cancer cell migration
  65. Integrating experimental and network pharmacology to explore the pharmacological mechanisms of Dioscin against glioblastoma
  66. Trends in research on preterm birth in twin pregnancy based on bibliometrics
  67. Four-week IgE/baseline IgE ratio combined with tryptase predicts clinical outcome in omalizumab-treated children with moderate-to-severe asthma
  68. Single-cell transcriptomic analysis identifies a stress response Schwann cell subtype
  69. Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus
  70. Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients
  71. Interleukin-37 mediates the anti-oral tumor activity in oral cancer through STAT3
  72. CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
  73. Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study
  74. Comprehensive biomedicine assessment of Apteranthes tuberculata extracts: Phytochemical analysis and multifaceted pharmacological evaluation in animal models
  75. Relation of time in range to severity of coronary artery disease in patients with type 2 diabetes: A cross-sectional study
  76. Dopamine attenuates ethanol-induced neuronal apoptosis by stimulating electrical activity in the developing rat retina
  77. Correlation between albumin levels during the third trimester and the risk of postpartum levator ani muscle rupture
  78. Factors associated with maternal attention and distraction during breastfeeding and childcare: A cross-sectional study in the west of Iran
  79. Mechanisms of hesperetin in treating metabolic dysfunction-associated steatosis liver disease via network pharmacology and in vitro experiments
  80. The law on oncological oblivion in the Italian and European context: How to best uphold the cancer patients’ rights to privacy and self-determination?
  81. The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer
  82. Factors affecting the measurements of peripheral oxygen saturation values in healthy young adults
  83. Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Investigation of the pathogenic variants induced Sjogren’s syndrome in Turkish population
  128. Nucleotide metabolic abnormalities in post-COVID-19 condition and type 2 diabetes mellitus patients and their association with endocrine dysfunction
  129. TGF-β–Smad2/3 signaling in high-altitude pulmonary hypertension in rats: Role and mechanisms via macrophage M2 polarization
  130. Ultrasound-guided unilateral versus bilateral erector spinae plane block for postoperative analgesia of patients undergoing laparoscopic cholecystectomy
  131. Profiling gut microbiome dynamics in subacute thyroiditis: Implications for pathogenesis, diagnosis, and treatment
  132. Delta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?
  133. Anticancer activity mechanism of novelly synthesized and characterized benzofuran ring-linked 3-nitrophenyl chalcone derivative on colon cancer cells
  134. H2valdien3 arrests the cell cycle and induces apoptosis of gastric cancer
  135. Prognostic relevance of PRSS2 and its immune correlates in papillary thyroid carcinoma
  136. Association of SGLT2 inhibition with psychiatric disorders: A Mendelian randomization study
  137. Motivational interviewing for alcohol use reduction in Thai patients
  138. Luteolin alleviates oxygen-glucose deprivation/reoxygenation-induced neuron injury by regulating NLRP3/IL-1β signaling
  139. Polyphyllin II inhibits thyroid cancer cell growth by simultaneously inhibiting glycolysis and oxidative phosphorylation
  140. Relationship between the expression of copper death promoting factor SLC31A1 in papillary thyroid carcinoma and clinicopathological indicators and prognosis
  141. CSF2 polarized neutrophils and invaded renal cancer cells in vitro influence
  142. Proton pump inhibitors-induced thrombocytopenia: A systematic literature analysis of case reports
  143. The current status and influence factors of research ability among community nurses: A sequential qualitative–quantitative study
  144. OKAIN: A comprehensive oncology knowledge base for the interpretation of clinically actionable alterations
  145. The relationship between serum CA50, CA242, and SAA levels and clinical pathological characteristics and prognosis in patients with pancreatic cancer
  146. Identification and external validation of a prognostic signature based on hypoxia–glycolysis-related genes for kidney renal clear cell carcinoma
  147. Engineered RBC-derived nanovesicles functionalized with tumor-targeting ligands: A comparative study on breast cancer targeting efficiency and biocompatibility
  148. Relationship of resting echocardiography combined with serum micronutrients to the severity of low-gradient severe aortic stenosis
  149. Effect of vibration on pain during subcutaneous heparin injection: A randomized, single-blind, placebo-controlled trial
  150. The diagnostic performance of machine learning-based FFRCT for coronary artery disease: A meta-analysis
  151. Comparing biofeedback device vs diaphragmatic breathing for bloating relief: A randomized controlled trial
  152. Serum uric acid to albumin ratio and C-reactive protein as predictive biomarkers for chronic total occlusion and coronary collateral circulation quality
  153. Multiple organ scoring systems for predicting in-hospital mortality of sepsis patients in the intensive care unit
  154. Single-cell RNA sequencing data analysis of the inner ear in gentamicin-treated mice via intraperitoneal injection
  155. Suppression of cathepsin B attenuates myocardial injury via limiting cardiomyocyte apoptosis
  156. Review Articles
  157. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  158. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  159. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  160. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  161. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  162. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  163. The application of augmented reality in robotic general surgery: A mini-review
  164. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  165. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  166. Plant polyphenols, terpenes, and terpenoids in oral health
  167. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  168. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  169. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  170. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  171. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  172. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  173. Giant borderline ovarian tumours – review of the literature
  174. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  175. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  176. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  177. Supplement strategies for infertility in overweight women: Evidence and legal insights
  178. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  179. A meta-analysis of the effects of DBS on cognitive function in patients with advanced PD
  180. Protective role of selenium in sepsis: Mechanisms and potential therapeutic strategies
  181. Strategies for hyperkalemia management in dialysis patients: A systematic review
  182. C-reactive protein-to-albumin ratio in peripheral artery disease
  183. Case Reports
  184. Delayed graft function after renal transplantation
  185. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  186. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  187. Giant right atrial hemangioma presenting with ascites: A case report
  188. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  189. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  190. Molecular hydrogen-rhodiola as an adjuvant therapy for ischemic stroke in internal carotid artery occlusion: A case report
  191. Coronary artery anomalies: A case of the “malignant” left coronary artery and its surgical management
  192. Rapid Communication
  193. Biological properties of valve materials using RGD and EC
  194. A single oral administration of flavanols enhances short-term memory in mice along with increased brain-derived neurotrophic factor
  195. Letter to the Editor
  196. Role of enhanced external counterpulsation in long COVID
  197. Expression of Concern
  198. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  199. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  200. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  201. Corrigendum
  202. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  203. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  204. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  205. Retraction
  206. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  207. Retraction of: “LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through downregulating SP-A by sponging to miR-424”
  208. Retraction of: “SCARA5 inhibits oral squamous cell carcinoma via inactivating the STAT3 and PI3K/AKT signaling pathways”
  209. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  210. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  211. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  212. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  213. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  214. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  215. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  216. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  217. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  218. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  219. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  220. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  221. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  222. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  223. Red cell distribution width predicts early kidney injury: A NHANES cross-sectional study
  224. Special Issue Diabetes mellitus: pathophysiology, complications & treatment
  225. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  226. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  227. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  228. A review of brain research on T2DM-related cognitive dysfunction
  229. Metformin and estrogen modulation in LABC with T2DM: A 36-month randomized trial
  230. Special Issue Innovative Biomarker Discovery and Precision Medicine in Cancer Diagnostics
  231. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
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Heruntergeladen am 27.11.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2025-1153/html?lang=de
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