Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , |
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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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 |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://ri.uea.edu.br/handle/riuea/3106 |
url |
https://ri.uea.edu.br/handle/riuea/3106 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivs 3.0 Brazil info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivs 3.0 Brazil |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
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) |
instacron_str |
UEA |
institution |
UEA |
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) |
repository.mail.fl_str_mv |
bibliotecacentral@uea.edu.br |
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1816701131916574720 |