Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach

Detalhes bibliográficos
Autor(a) principal: Castillo, Paola
Data de Publicação: 2017
Outros Autores: Ussene, Esperança, Palhares, Antônio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da Universidade do Estado do Amazonas (UEA)
Texto Completo: https://ri.uea.edu.br/handle/riuea/3106
Resumo: Background and Aims Complete diagnostic autopsies (CDA) remain the gold standard in the determination of cause of death (CoD). However, performing CDAs in developing countries is challenging due to limited facilities and human resources, and poor acceptability. We aimed to develop and test a simplified minimally invasive autopsy (MIA) procedure involving organ-directed sampling with microbiology and pathology analyses implementable by trained technicians in low- income settings. Methods A standardized scheme for the MIA has been developed and tested in a series of 30 autopsies performed at the Maputo Central Hospital, Mozambique. The procedure involves the collection of 20 mL of blood and cerebrospinal fluid (CSF) and puncture of liver, lungs, heart, spleen, kidneys, bone marrow and brain in all cases plus uterus in women of childbearing age, using biopsy needles. Results The sampling success ranged from 67% for the kidney to 100% for blood, CSF, lung, liver and brain. The amount of tissue obtained in the procedure varied from less than 10 mm2 for the lung, spleen and kidney, to over 35 mm2 for the liver and brain. A CoD was identified in the histological and/or the microbiological analysis in 83% of the MIAs. Conclusions A simplified MIA technique allows obtaining adequate material from body fluids and major organs leading to accurate diagnoses. This procedure could improve the determination of CoD in developing countries.
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spelling Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy ApproachMétodos patológicos aplicados ao Investigação de Causas de Morte em Países em desenvolvimento: mínimamente invasivo Abordagem de autópsiaAutopsiesCause of deathMinimally invasive autopsyPathologyLow- income settingsBackground and Aims Complete diagnostic autopsies (CDA) remain the gold standard in the determination of cause of death (CoD). However, performing CDAs in developing countries is challenging due to limited facilities and human resources, and poor acceptability. We aimed to develop and test a simplified minimally invasive autopsy (MIA) procedure involving organ-directed sampling with microbiology and pathology analyses implementable by trained technicians in low- income settings. Methods A standardized scheme for the MIA has been developed and tested in a series of 30 autopsies performed at the Maputo Central Hospital, Mozambique. The procedure involves the collection of 20 mL of blood and cerebrospinal fluid (CSF) and puncture of liver, lungs, heart, spleen, kidneys, bone marrow and brain in all cases plus uterus in women of childbearing age, using biopsy needles. Results The sampling success ranged from 67% for the kidney to 100% for blood, CSF, lung, liver and brain. The amount of tissue obtained in the procedure varied from less than 10 mm2 for the lung, spleen and kidney, to over 35 mm2 for the liver and brain. A CoD was identified in the histological and/or the microbiological analysis in 83% of the MIAs. Conclusions A simplified MIA technique allows obtaining adequate material from body fluids and major organs leading to accurate diagnoses. This procedure could improve the determination of CoD in developing countries.PLOS one2024-09-06T19:54:27Z2017-08-18T14:18:39Z2017-08-172017-08-18T14:18:39Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://ri.uea.edu.br/handle/riuea/3106Attribution-NonCommercial-NoDerivs 3.0 Brazilinfo:eu-repo/semantics/openAccessCastillo, PaolaUssene, EsperançaPalhares, Antônioengreponame:Repositório Institucional da Universidade do Estado do Amazonas (UEA)instname:Universidade do Estado do Amazonas (UEA)instacron:UEA2024-09-06T19:54:27Zoai:ri.uea.edu.br:riuea/3106Repositório InstitucionalPUBhttps://ri.uea.edu.br/server/oai/requestbibliotecacentral@uea.edu.bropendoar:2024-09-06T19:54:27Repositório Institucional da Universidade do Estado do Amazonas (UEA) - Universidade do Estado do Amazonas (UEA)false
dc.title.none.fl_str_mv Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
Métodos patológicos aplicados ao Investigação de Causas de Morte em Países em desenvolvimento: mínimamente invasivo Abordagem de autópsia
title Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
spellingShingle Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
Castillo, Paola
Autopsies
Cause of death
Minimally invasive autopsy
Pathology
Low- income settings
title_short Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
title_full Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
title_fullStr Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
title_full_unstemmed Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
title_sort Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
author Castillo, Paola
author_facet Castillo, Paola
Ussene, Esperança
Palhares, Antônio
author_role author
author2 Ussene, Esperança
Palhares, Antônio
author2_role author
author
dc.contributor.author.fl_str_mv Castillo, Paola
Ussene, Esperança
Palhares, Antônio
dc.subject.por.fl_str_mv Autopsies
Cause of death
Minimally invasive autopsy
Pathology
Low- income settings
topic Autopsies
Cause of death
Minimally invasive autopsy
Pathology
Low- income settings
description Background and Aims Complete diagnostic autopsies (CDA) remain the gold standard in the determination of cause of death (CoD). However, performing CDAs in developing countries is challenging due to limited facilities and human resources, and poor acceptability. We aimed to develop and test a simplified minimally invasive autopsy (MIA) procedure involving organ-directed sampling with microbiology and pathology analyses implementable by trained technicians in low- income settings. Methods A standardized scheme for the MIA has been developed and tested in a series of 30 autopsies performed at the Maputo Central Hospital, Mozambique. The procedure involves the collection of 20 mL of blood and cerebrospinal fluid (CSF) and puncture of liver, lungs, heart, spleen, kidneys, bone marrow and brain in all cases plus uterus in women of childbearing age, using biopsy needles. Results The sampling success ranged from 67% for the kidney to 100% for blood, CSF, lung, liver and brain. The amount of tissue obtained in the procedure varied from less than 10 mm2 for the lung, spleen and kidney, to over 35 mm2 for the liver and brain. A CoD was identified in the histological and/or the microbiological analysis in 83% of the MIAs. Conclusions A simplified MIA technique allows obtaining adequate material from body fluids and major organs leading to accurate diagnoses. This procedure could improve the determination of CoD in developing countries.
publishDate 2017
dc.date.none.fl_str_mv 2017-08-18T14:18:39Z
2017-08-17
2017-08-18T14:18:39Z
2024-09-06T19:54:27Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv https://ri.uea.edu.br/handle/riuea/3106
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dc.language.iso.fl_str_mv eng
language eng
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eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv PLOS one
publisher.none.fl_str_mv PLOS one
dc.source.none.fl_str_mv reponame:Repositório Institucional da Universidade do Estado do Amazonas (UEA)
instname:Universidade do Estado do Amazonas (UEA)
instacron:UEA
instname_str Universidade do Estado do Amazonas (UEA)
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reponame_str Repositório Institucional da Universidade do Estado do Amazonas (UEA)
collection Repositório Institucional da Universidade do Estado do Amazonas (UEA)
repository.name.fl_str_mv Repositório Institucional da Universidade do Estado do Amazonas (UEA) - Universidade do Estado do Amazonas (UEA)
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