Minimally Invasive Postmortem Intestinal Tissue Sampling in Malnourished and Acutely Ill Children Is Feasible and Informative
Rattachement africain : us, Malawi, nl, Kenya, ca, gb. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Intestinal disorders such as environmental enteric dysfunction (EED) are prevalent in low- and middle-income countries (LMICs) and important contributors to childhood undernutrition and mortality. Autopsies are rarely performed in LMICs but minimally invasive tissue sampling is increasingly deployed as a more feasible and acceptable procedure, although protocols have been devoid of intestinal sampling to date. We sought to determine (1) the feasibility of postmortem intestinal sampling, (2) whether autolysis precludes enteric biopsies' utility, and (3) histopathologic features among children who died during hospitalization with acute illness or undernutrition. METHODS: Transabdominal needle and endoscopic forceps upper and lower intestinal sampling were conducted among children aged 1 week to 59 months who died while hospitalized in Blantyre, Malawi. Autolysis ratings were determined for each hematoxylin and eosin slide, and upper and lower intestinal scoring systems were adapted to assess histopathologic features and their severity. RESULTS: Endoscopic and transabdominal sampling procedures were attempted in 28 and 14 cases, respectively, with >90% success obtaining targeted tissue. Varying degrees of autolysis were present in all samples and precluded histopathologic scoring of 6% of 122 biopsies. Greater autolysis in duodenal samples was seen with longer postmortem interval (Beta = 0.06, 95% confidence interval, 0.02-0.11). Histopathologic features identified included duodenal Paneth and goblet cell depletion. Acute inflammation was absent but chronic inflammation was prevalent in both upper and lower enteric samples. Severe chronic rectal inflammation was identified in children as young as 5.5 weeks. CONCLUSIONS: Minimally invasive postmortem intestinal sampling is feasible and identifies histopathology that can inform mortality contributors.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Minimally Invasive Postmortem Intestinal Tissue Sampling in Malnourished and Acutely Ill Children Is Feasible and Informative
- Date Crossref
- 15/12/2021
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Washington Department of Global Health pays non établi dans la noticeUniversité ou école supérieure
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Kamuzu Central Hospital Malawi (code pays fourni par la source)Établissement de santé
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Emma Kinderziekenhuis pays non établi dans la noticeÉtablissement de santé
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Amsterdam Institute for Global Health and Development pays non établi dans la noticeStructure de recherche
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The Childhood Acute Illness and Nutrition Network Kenya (code pays fourni par la source)Institution
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Kamuzu University of Health Sciences Department of Paediatrics and Child Health Blantyre, Malawi (code pays fourni par la source)Université ou école supérieure
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Washington University in St. Louis pays non établi dans la noticeUniversité ou école supérieure
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Hospital for Sick Children pays non établi dans la noticeÉtablissement de santé
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University of Liverpool pays non établi dans la noticeUniversité ou école supérieure
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University of Malawi Malawi (code pays fourni par la source)Université ou école supérieure
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Malawi-Liverpool-Wellcome Trust Clinical Research Programme Malawi (code pays fourni par la source)Structure de recherche
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Wellcome Centre for Molecular Parasitology pays non établi dans la noticeStructure de recherche
Department of Global Health — University of Washington, Kamuzu Central Hospital (Malawi) et Emma Kinderziekenhuis, avec 9 autres affiliations. Pays d’affiliation : Malawi, Kenya.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.