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2.
Autops. Case Rep ; 11: e2021291, 2021. graf
Article in English | LILACS | ID: biblio-1249010

ABSTRACT

Microscopic findings in key tissues are often critical to determine the cause of death in medical autopsies. The overall quality of histologic sections depends on numerous pre-analytic factors, among which are tissue section size and thickness. We designed a prospective quality improvement study to determine whether a simple intervention of formalin pre-fixation of myocardium, liver, and kidney tissues could improve the ease of cutting and quality of autopsy histologic sections as assessed by histotechnicians and pathologists. Of 46 autopsies included in the study, 21 were randomly assigned to formalin pre-fixation, and 25 underwent routine sectioning without formalin pre-fixation. A significant improvement in overall quality score by histotechnicians was detected in the sections from pre-fixed autopsy tissues compared to the control group (p=0.0327). There was no significant difference in quality score between the two groups as assessed by pathologists. Our autopsy quality improvement study demonstrates that a simple, low-cost intervention of formalin pre-fixation of fresh autopsy tissues for 90 minutes could significantly improve the overall quality of sections submitted for histologic processing.


Subject(s)
Humans , Male , Female , Autopsy/methods , Histological Techniques/methods , Tissue Fixation/methods , Quality Improvement
3.
Rev. cuba. med. mil ; 49(4): e629, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156527

ABSTRACT

Diagnosticar correctamente las causas de muerte ayuda a salvar vidas, se realiza este trabajo con el objetivo de mostrar cómo debe ser estudiado el proceso que lleva a un paciente a la muerte y precisar con la mayor exactitud sus causas, basado en la experiencia cubana. Se enfatiza en la importancia de la exactitud y relación de los diagnósticos clínico y morfológico. A la necesidad de realizar autopsias con la mayor calidad y aprovechar al máximo sus beneficios. Se explican las reuniones relacionadas con la autopsia. La experiencia cubana con el sistema automatizado de registro y control de anatomía patológica y los principales resultados. En conclusión, se muestra cómo debe ser estudiado el proceso que lleva a un paciente a la muerte y cómo precisar con la mayor exactitud sus causas, la experiencia cubana y el importante papel de la autopsia en salvar vidas(AU)


Correctly diagnosing the causes of death helps save lives, this work is carried out with the aim of showing how the process that leads a patient to death should be studied and its causes should be specified with greater accuracy, based on the Cuban experience. The importance of the accuracy and relationship of clinical and morphological diagnoses is emphasized. The need to perform autopsies with the highest quality and make the most of its benefits. Autopsy-related meetings are explained. The Cuban experience with the automated system of registration and control of pathological anatomy and the main results obtained. In conclusion, it is shown how the process that leads a patient to death should be studied and how to pinpoint its causes, the Cuban experience and the important role of autopsy in saving lives(AU)


Subject(s)
Humans , Autopsy/methods , Cause of Death
4.
Rev. cuba. med. mil ; 49(4): e850, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156510

ABSTRACT

Introducción: La autopsia es una fortaleza del sistema de salud cubano. Su realización con la metodología adecuada a fallecidos confirmados a la COVID-19 en el Hospital Militar Central Dr. Luis Díaz Soto, permitió su estudio más adecuado. Objetivo: Identificar las características demográficas, enfermedades concomitantes y alteraciones morfológicas encontradas en las autopsias de fallecidos confirmados a la COVID-19. Métodos: Se realizó un estudio descriptivo de las 10 autopsias parciales realizadas a fallecidos confirmados de la COVID-19 entre el mes de marzo y junio del 2020, de acuerdo a la metodología en la realización de estas autopsias en el proceso de enfrentamiento a esta enfermedad. Resultados: Al sexo masculino y al grupo de edades de 70 - 79 años correspondió el 60 por ciento de los casos estudiados. En las causas directas de muerte predominó la bronconeumonía bacteriana, como complicación del proceso producido por la COVID-19 y en relación con otras causas básicas. Los fallecidos presentaron entre 3 a 6 comorbilidades asociadas. Conclusiones: Los grupos de edades más afectados estuvieron entre 70 y 79 años con equivalencia en ambos sexos. Las comorbilidades contribuyen a empeorar el pronóstico de estos fallecidos, con predominio de la hipertensión arterial y la diabetes mellitus. Las manifestaciones de la respuesta inflamatoria sistémica se presentan como complicaciones en ellos. La mortalidad por la COVID-19 como causa de muerte afectó a menos de la mitad de los casos estudiados, con expresión respiratoria y cardiaca por la acción del virus(AU)


Introduction: The autopsy is a strength of the Cuban health system. Its implementation with the appropriate methodology to deceased confirmed to COVID-19 at the Central Military Hospital "Dr. Luis Díaz Soto", allowed their more adequate study. Objective: To identify the demographic characteristics, concomitant diseases and morphological alterations found in the autopsies of deceased confirmed to COVID-19. Methods: A descriptive study of the 10 partial autopsies performed on confirmed deaths of COVID-19 between March and June 2020 was carried out, according to the methodology used to carry out these autopsies in the process of coping with this disease. Results: The male sex and the age group 70 - 79 years corresponded to 60 percent of the cases studied. Bacterial bronchopneumonia predominated in direct causes of death, as a complication of the process produced by COVID-19 and in relation to other basic causes. The deceased had between 3 to 6 associated comorbidities. Conclusions: The age groups most affected were between 70 and 79 years old with equivalence in both sexes. Comorbidities contribute to worsening the prognosis of these deceased, with a predominance of arterial hypertension and diabetes mellitus. The manifestations of the systemic inflammatory response present as complications in them. Mortality from COVID-19 as a cause of death affected less than half of the cases studied, with respiratory and cardiac expression due to the action of the virus(AU)


Subject(s)
Humans , Autopsy/methods , Coronavirus Infections/mortality , Epidemiology, Descriptive , Cuba
5.
Rev. cuba. med. mil ; 49(4): e719, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156505

ABSTRACT

Introducción: La aterosclerosis es una enfermedad que está entre las tres primeras causas básicas de muerte a nivel mundial. En la actualidad se relaciona con múltiples factores de riesgo, entre ellos el tabaquismo, que a su vez es un factor contribuyente al desarrollo de la cardiopatía isquémica. Objetivo: Caracterizar patomorfológicamente la lesión aterosclérótica de aorta y coronarias y su relación con el tabaquismo en fallecidos necropsiados. Métodos: Se realizó un estudio observacional, descriptivo y transversal; se estudiaron 431 fallecidos con autopsias clínicas, de ellos se analizaron cualitativa y cuantitativamente sus arterias coronarias y aorta mediante el sistema aterométrico. Resultados: Se presentaron mayores valores de lesiones ateroscleróticas en el grupo de fumadores con infarto de miocardio, por tanto los índices de obstrucción (Ω) y estenosis (P) tuvieron también valores más elevados. Tuvieron una superficie endarterial más afectada por placas fibrosas y graves, la arteria descendente anterior y la aorta abdominal. Conclusiones: El tabaquismo tuvo una asociación directa con el proceso aterosclerótico, se expresa por mayores valores de las lesiones en los fumadores identificados, tanto en el sector aórtico como en el coronario, además se identificó mayor susceptibilidad de la descendente y de aorta abdominal al daño aterosclerótico(AU)


Introduction: Atherosclerosis is a disease that is among the top three basic causes of death worldwide. It is currently associated with multiple risk factors, including smoking, which in turn is a contributing factor to the development of ischemic heart disease. Objective: To characterize pathomorphologically the atherosclerotic lesion of the aorta and coronary arteries and its relationship with smoking in autopsied deceased. Methods: An observational, descriptive and cross-sectional study was carried out; 431 deceased patients with clinical autopsies were studied, of which their coronary arteries and aorta were qualitatively and quantitatively analyzed using the atherometric system. Results: There were higher values ​​of atherosclerotic lesions in the group of smokers with myocardial infarction, therefore the obstruction (Ω) and stenosis (P) indices also had higher values. They had an endarterial surface more affected by fibrous and severe plaques, the anterior descending artery and the abdominal aorta. Conclusions: Smoking has a direct association with the atherosclerotic process, it is expressed by higher values ​​of the lesions in identified smokers, both in the aortic and coronary sectors, in addition, greater susceptibility of the descending and abdominal aorta to damage is identified atherosclerotic(AU)


Subject(s)
Humans , Male , Female , Autopsy/methods , Tobacco Use Disorder , Risk Factors , Atherosclerosis/mortality , Epidemiology, Descriptive , Cross-Sectional Studies
6.
Arq. bras. cardiol ; 115(6): 1178-1179, dez. 2020.
Article in English, Portuguese | LILACS | ID: biblio-1152949

ABSTRACT

O manejo de dispositivos cardíacos eletrônicos implantáveis de pacientes que evoluem a óbito tem sido motivo de controvérsia. Em nosso meio, não há recomendações uniformes, estando baseadas exclusivamente em protocolos institucionais e em costumes regionais. Quando o cadáver é submetido para cremação, além de outros cuidados, recomenda-se a retirada do dispositivo devido ao risco de explosão e dano do equipamento crematório. Principalmente no contexto da pandemia causada pelo SARS-Cov-2, a orientação e organização de unidades hospitalares e serviços funerários é imprescindível para minimizar o fluxo de pessoas em contato com fluidos corporais de indivíduos falecidos por COVID-19. Nesse sentido, a Sociedade Brasileira de Arritmias Cardíacas elaborou este documento com orientações práticas, tendo como base publicações internacionais e recomendação emitida pelo Conselho Federal de Medicina do Brasil.


The management of cardiac implantable electronic devices after death has become a source of controversy. There are no uniform recommendations for such management in Brazil; practices rely exclusively on institutional protocols and regional custom. When the cadaver is sent for cremation, it is recommended to remove the device due to the risk of explosion and damage to crematorium equipment, in addition to other precautions. Especially in the context of the SARS-CoV-2 pandemic, proper guidance and organization of hospital mortuary facilities and funeral services is essential to minimize the flow of people in contact with bodily fluids from individuals who have died with COVID-19. In this context, the Brazilian Society of Cardiac Arrhythmias has prepared this document with practical guidelines, based on international publications and a recommendation issued by the Brazilian Federal Medical Council.


Subject(s)
Humans , Pacemaker, Artificial , Autopsy/methods , Defibrillators, Implantable , Cardiac Resynchronization Therapy Devices , COVID-19
7.
Int. j. morphol ; 38(2): 241-246, abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1056429

ABSTRACT

El intervalo postmortem (IPM) es un importante desafío a resolver en patología forense, y consiste en poder determinar el tiempo transcurrido desde la muerte hasta el momento de la autopsia. Dada la poca confiablidad de algunos métodos por la gran influencia de factores externos, la Histoquímica (HQ) y la Inmunohistoquímica (IHQ), entre otros, han recibido considerable atención por sus niveles de objetividad en la investigación forense. Se presenta una revisión con búsqueda sistemática de estudios experimentales que apliquen métodos HQs e IHQs para la estimación del IPM sobre material cadavérico humano. Se identificaron 1053 artículos de los cuales 12 cumplieron con los criterios, a los que se agregaron 4 mediante una búsqueda manual (n=16 artículos). Alemania fue el país con más publicaciones destacando con 8 artículos. Las técnicas HQs de AgNORs, TRAP y PAS fueron utilizadas en 5 estudios (glándulas sudoríparas, piel, hígado, médula ósea y mucosa labial), mientras que las IHQs fueron empleadas con diferentes grupos antigénicos en 12 estudios (páncreas, cerebro, pulmón, tiroides, hígado, glándulas pituitarias, glándulas sudoríparas y mucosa gingival). Las estimaciones del IPM fueron posibles con márgenes entre 2-3 h. hasta los 20 días dependiendo de la técnica. El análisis de tejidos provenientes de cavidad oral asegura una vía no invasiva, de fácil acceso y bajo resguardo natural a la influencia de factores ambientales. Si bien no existe un método único que permita de manera confiable estas estimaciones, la introducción de nuevas técnicas permitiría evitar la producción de errores.


The postmortem interval (IPM) is an important challenge to be solved in forensic pathology, and it consists in determine the time elapsed since death until the autopsy. Given the low reliability of some methods due to the great influence of external factors, Histochemistry (HQ) and Immunohistochemistry (IHQ), among others, have received considerable attention for their levels of objectivity in forensic investigation. A scoping review of experimental studies that apply HQs and IHQs methods to estimate the MPI on human cadaveric material is presented. We identified 1053 articles, of which 12 met the criteria; we added 4 articles through a manual search (n = 16 articles). Germany was the most productive country, with 8 articles. HQ techniques of AgNORs, TRAP and PAS were used in 5 studies (on sweat glands, skin, liver, bone marrow and labial mucosa), while IHQs techniques were used with different antigenic groups in 12 studies (on pancreas, brain, lung, thyroid, liver, pituitary glands, sweat glands and gingival mucosa). IPM estimates were possible with margins between 2-3 hours up to 20 days depending on the technique. The analysis of oral tissues ensures a non-invasive route, easily accessible and under natural protection to the influence of environmental factors. Although there is no single method that reliably allows these estimates, the introduction of new techniques would prevent the production of errors.


Subject(s)
Humans , Postmortem Changes , Autopsy/methods , Immunohistochemistry/methods , Time Factors , Cadaver , Forensic Medicine
8.
Palmas; [Secretaria de Estado da Saúde]; 26 mar. 2020. 5 p.
Non-conventional in Portuguese | LILACS, ColecionaSUS, CONASS, SES-TO | ID: biblio-1120879

ABSTRACT

Promove esclarecimentos acerca dos novos procedimentos para o SVO-TO durante a pandemia de COVID-19 com a orientação para a redução de risco de contágio entre profissionais de saúde que lidam com atividades insalubres em salas de necropsias, profissionais administrativos e demais colaboradores nas sedes do Serviço de Verificação de Óbitos (SVO) em todo o Estado do Tocantins.


Promotes clarification about the new procedures for the SVO-TO during the COVID-19 pandemic with the orientation to reduce the risk of contagion among health professionals who deal with unhealthy activities in autopsy rooms, administrative professionals and other employees at the headquarters of the Death Verification Service (SVO) throughout the State of Tocantins.


Promueve el esclarecimiento sobre los nuevos procedimientos para el SVO-TO durante la pandemia COVID-19 con la orientación a reducir el riesgo de contagio entre los profesionales de la salud que se ocupan de actividades insalubres en las salas de autopsias, los profesionales administrativos y otros empleados en la sede de la Servicio de verificación de defunción (SVO) en todo el estado de Tocantins.


Subject(s)
Humans , Pneumonia, Viral , Autopsy/methods , Autopsy/standards , Coronavirus Infections , Pandemics
10.
Article in Spanish | LILACS | ID: biblio-1146807

ABSTRACT

Introducción: El femicidio es todo homicidio intencional de una mujer por razones de su género. El término overkillse utiliza en los casos donde se observa gran cantidad de heridas, excediendo lo necesario para causar la muerte. Presentamos este caso médico-legal con el objetivode ejemplificar la relación entre el overkill y los femicidios. Resultados: Los hallazgos de autopsia revelaron lesiones compatibles con estrangulación manualeinstrumentalizada y heridas por arma blanca. Esto permitiócalificarla como overkill. Conclusión: Este tipo de caso llama a la reflexión sobre los factores de riesgo y formas de cómo prevenirlos...(AU)


Subject(s)
Humans , Female , Adult , Violence Against Women , Gender Equity , Autopsy/methods , Forensic Medicine
11.
Rev. cuba. salud pública ; 46(supl.1): e2520, 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1144558

ABSTRACT

Estimado Editor: Desde hace diez siglos se ha demostrado la importancia de la autopsia clínica en el diagnóstico de disimiles enfermedades. Los beneficios de la correlación clinicopatológica son bien conocidos y ampliamente divulgados en la literatura especializada. Desde el microorganismo que causa la enfermedad de Whipple, la forma de demencia senil descrita por Aloysius Alois Alzheimer, la enfermedad fibroquística hasta la miocarditis reumática, fueron definidos a través de esta herramienta diagnóstica.1,2 Más recientemente, en 1984, Goldman3 publicó un trabajo en el que comparó tres épocas médicas coincidentes con la introducción de nuevas tecnologías en el hospital donde se realizó el estudio. Al correlacionar los diagnósticos pre mortem con los obtenidos de las autopsias, en las distintas épocas, comprobó que, a pesar de los avances tecnológicos, los índices de discrepancias se mantuvieron similares. Por tanto, sigue vigente la importancia y la necesidad de la autopsia como método para controlar y garantizar la calidad del trabajo médico. Por tales motivos, se considera la prueba de oro de la medicina clínica. La historia del desarrollo de las ciencias de la salud...(AU)


Subject(s)
Humans , Autopsy/methods , Coronavirus Infections/mortality
14.
Rev. cuba. inform. méd ; 11(2)jul.-dic. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093319

ABSTRACT

Cuba posee uno de los índices de autopsia más elevados del mundo, sin embargo, la información generada durante este proceso no se aprovecha al máximo, debido al crecimiento acelerado de los datos. El análisis de los resultados de la autopsia genera múltiples beneficios mayormente orientados a mejorar la calidad del diagnóstico médico. En este contexto el mayor desafío es la obtención del conocimiento implícito en los datos; factible con la incorporación de las nuevas Tecnologías de la Información y las Comunicaciones. En este trabajo se presenta el sistema informático SIRCAP el cual fue desarrollado con el objetivo de gestionar el conocimiento generado en los departamentos de Anatomía Patológica pertenecientes a la red hospitalaria cubana. El sistema obtenido garantiza con su generalización, el estudio de un mayor número de casos en apoyo a la toma de decisiones. Al mismo tiempo promueve la codificación de los diagnósticos según los más recientes estándares de terminología impulsados por la Organización Mundial de la Salud. La solución desarrollada, facilita el proceso de evaluación de la calidad en la atención médica, a partir del análisis y clasificación de la correlación clinicopatológica. Posibilita la configuración y aplicación reglas de control interno sobre los diagnósticos contribuyendo a elevar la calidad de los datos almacenados. Permite la creación de un amplio conjunto de reportes estadísticos sobre los datos, los cuales podrán ser empleados como soporte para la toma de decisiones, además de contribuir con el descubrimiento y explicación de nuevas enfermedades, manifestaciones inusuales de enfermedades conocidas y complicaciones terapéuticas(AU)


Cuba has one of the highest autopsy rates in the world, however, the information generated during this process is not used to the maximum, due to the accelerated growth of the data. The analysis of the results of the autopsy generates multiple benefits mainly aimed at improving the quality of medical diagnosis. In this context, the greatest challenge is obtaining the knowledge implicit in the data; feasible with the incorporation of the new Information and Communications Technologies. This work presents the SIRCAP computer system, which was developed with the aim of managing the knowledge generated in the departments of Pathological Anatomy belonging to the Cuban hospital network. The system obtained guarantees with its generalization, the study of a greater number of cases in support of decision making. At the same time, it promotes the coding of diagnoses according to the most recent terminology standards promoted by the World Health Organization. The developed solution facilitates the process of quality assessment in medical care, based on the analysis and classification of the clinic-pathological correlation. It allows the configuration and application of internal control rules over the diagnostics contributing to raise the quality of the stored data. It allows the creation of a wide set of statistical reports on data, which can be used as support for decision making, in addition to contributing to the discovery and explanation of new diseases, unusual manifestations of known diseases and therapeutic complications(AU)


Subject(s)
Autopsy/methods , Decision Making, Computer-Assisted , Medical Informatics , Knowledge Management , Information Technology Management , Cuba
15.
Rev. cuba. pediatr ; 91(3): e486, jul.-set. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093718

ABSTRACT

Introducción: La autopsia es un método que garantiza el estudio más completo del enfermo y la enfermedad y brinda información útil para salvar vidas humanas. Objetivo: Mostrar los principales datos demográficos y administrativos, las causas más frecuentes de muerte y la evaluación de los diagnósticos clínicos en fallecidos en un hospital pediátrico. Métodos: Con la ayuda de un Sistema Automatizado de Registro y Control de Anatomía Patológica, se registraron los datos necesarios de 994 autopsias clínicas pediátricas de 1 830 fallecidos en el Hospital Pediátrico Universitario Juan Manuel Márquez entre 1990 y 2015. Resultados: El índice de autopsias fue 71,0 por ciento, predominó el sexo masculino y el grupo de menores de un año. Las principales causas básicas de muerte fueron los tumores malignos de encéfalo, las leucemias linfoides y sus complicaciones fueron las principales causas directas e intermedias de muerte. La discrepancia diagnóstica pre- y posmortem entre causas básica de muerte fue de 19,1 por ciento y entre causa directa y causa intermedia, de 29,6 por ciento. La infección, cáncer y daño multiorgánico constituyeron los grupos de trastorno de mayor trascendencia que influyeron en la causa básica y directa de muerte. Conclusiones: Los resultados obtenidos demuestran la importancia de la autopsia para confirmar diagnósticos, evaluar la calidad del trabajo médico, entender mejor las causas de muerte y la existencia de una buena comunicación entre médico y patólogo. Una vez más se documenta la utilidad del sistema automatizado utilizado, que permite obtener toda la información computarizada y analizar con precisión las discrepancias diagnósticas(AU)


Introduction: Autopsy is a method that guarantees the most complete study of the patient and the disease, and provides useful information to save human lives. Objective: To show the main demographic and administrative data, the most frequent causes of death and the assessment to clinical diagnoses of deceased in a pediatric hospital. Methods: With the help of an Automated System for the Registration and Control of Pathological Anatomy (SARCAP, by its acronym in Spanish), the main demographic and administrative data in 994 pediatric clinical autopsies of 1 830 patients who died between 1990 and 2015 at Juan Manuel Márquez Pediatric Hospital were recorded. Results: The autopsies rate was 71.0 percent, the male sex prevailed and the group of children under one year. The main causes of death were malignant encephalon tumors, and lymphoid leukemias with complications were the main direct and intermediate causes of death. The pre-and post-mortem diagnostic discrepancy in basic causes of death was of 19.1 percent, and between direct cause of death and intermediate cause of death it was of 29.6 percent. Infection, cancer and multiple organ damage constituted the most important disorder's groups that influenced the basic cause of death and direct cause of death. Conclusions: Autopsy is useful to confirm diagnosis, evaluate the quality of medical work, better understand the causes of death in children, and the existence of a good communication among the physician and the pathologist. It is demonstrated one more time the usefulness of SARCAP, which allows to collect all the computerized data information and to analyze with precision the diagnostic discrepancies(AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Autopsy/methods , Autopsy/standards , Fatal Outcome
16.
Autops. Case Rep ; 9(3): e2019103, July-Sept. 2019. ilus, tab
Article in English | LILACS | ID: biblio-1016864

ABSTRACT

The effective value of microbiological post-mortem examinations stands as fundamental in forensic cases involving microbiology. We ran these analyses on five victims, who suddenly died after showing persistent fever. The examinations were conducted between 48 hours and 10 days after death, and adrenal gland apoplexy was detected in all the cases. Microbiological examinations identified Neisseria meningitidis, which was accountable for Waterhouse­Friderichsen syndrome. Diplococci were isolated from three cadavers that underwent forensic dissection between 2 and 3 days after death. The remaining two cadavers showed polymicrobial contamination, and a polymerase chain reaction technique was necessary to identify the pathogen. We assumed that the microbial overlap could lead to diagnostic mistakes and conceal the identification of the lethal pathogen. Therefore, we suggest using molecular techniques for a postmortem interval (PMI) longer than 72 hours. Classical microbiological examination should be performed for PMI within 72 hours.


Subject(s)
Humans , Autopsy/methods , Waterhouse-Friderichsen Syndrome/pathology , Microbiological Techniques , Fatal Outcome , Neisseria meningitidis
17.
Rev. cuba. obstet. ginecol ; 45(2): e451, abr.-jun. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093638

ABSTRACT

Introducción: La incidencia de muerte materna es un ítem indispensable para la medición de la calidad y cobertura en salud. Objetivo: Describir los hallazgos anatomopatológicos de 31 casos de muerte materna ocurridos en el área metropolitana de una ciudad intermedia de Colombia entre 2005-2018, así como establecer sus características sociodemográficas. Métodos: Se realiza estudio retrospectivo descriptivo de corte transversal basado en la revisión de 3 500 protocolos de autopsias efectuadas por el Departamento de Patología de la Universidad Industrial de Santander adscrito al Hospital Universitario de Santander, Colombia, entre enero 2005 y marzo 2018, se extractan aquellos en los cuales el diagnóstico relacionado sea de muerte materna y muerte materna tardía, tomando como referencia la definición dictada por la Organización Mundial de la Salud. Resultados: El rango de edad estuvo comprendido entre 14 y 40 años, promedio 26,7 años y mediana de 26 años. En 9 casos (29 por ciento) se reportó un nivel educativo básico primario y en los restantes (71 por ciento), básico secundario. No existieron casos con estudios universitarios. El rango de edad gestacional estuvo entre 11 y 39 semanas (promedio 31,4 semanas), y 8 casos correspondieron a primigestas (25,8 por ciento) Existieron 29 casos de muerte materna temprana y dos de muerte materna tardía; se detectaron 10 casos con causas obstétricas directas y 21 causas indirectas, de los cuales, 14 fueron de origen infeccioso, siendo el dengue la causa más frecuente. Conclusiones: En nuestro medio, los procesos infecciosos no ginecobstétricos ocasionan la mayor cantidad de casos de muerte materna, siendo el dengue la principal de estas causas(AU)


Introduction: The incidence of maternal death is an essential item for assessing quality and coverage in health. Objective: To describe the histological findings of 31 cases of maternal death that occurred in the metropolitan area of an intermediate city of Colombia from 2005-2018, as well as to establish their sociodemographic characteristics. Methods: A retrospective cross-sectional descriptive study was carried out based on the review of 3 500-autopsy protocols carried out by the Department of Pathology of Santander Industrial University, which were assigned to Santander University Hospital in Colombia, between January 2005 and March 2018. We mined those in which the related diagnosis is maternal death and late maternal death, taking as reference the definition stablished by the World Health Organization. Results: The age ranged 14 to 40 years, average 26.7 years and media 26 years. Nine cases (29 percent), reported primary basic education level and the remaining (71 percent), reported secondary basic education. There were no cases reported to have university studies. The gestational age ranged 11 to 39 weeks (average 31.4 weeks), and eight cases corresponded to primigravida (25.8 percent). There were 29 cases of early maternal death and two of late maternal death; 10 cases were detected to have direct obstetric causes and 21 indirect causes, 14 out of which had infectious causes. dengue was the most frequent cause. Conclusions: In our environment, infectious non-gynecological processes cause the highest number of maternal deaths. Dengue is the main cause(AU)


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Autopsy/methods , Maternal Death/prevention & control , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies
18.
Rev. inf. cient ; 98(4): 501-514, 2019. tabs
Article in Spanish | LILACS, CUMED | ID: biblio-1023971

ABSTRACT

Introducción: la calidad de la formación de los recursos humanos para la salud es una exigencia de la educación médica de postgrado. Objetivo: diseñar una modelación didáctica de la formación del residente de Anatomía Patológica para realizar la autopsia perinatal. Método: se realizó un estudio observacional y de corte pedagógico durante el periodo de 2016-2018. Se satisfizo el objetivo y se validó la modelación que se hizo con la participación de 7 profesores y mediante un pre-experimento con 6 residentes. Resultados: el 100 por ciento de los residentes mostraron insuficiencias para la realización de la autopsia perinatal, pero estas se corrigieron ostensiblemente después de la aplicación de un sistema de tareas docentes para este fin. El 100 por ciento de los profesores mostraron conformidad con la modelación propuesta. Conclusiones: la modelación didáctica de la preparación del residente de Anatomía Patológica para realizar la autopsia perinatal contribuye a un cambio didáctico-metodológico cualitativamente superior en el proceso de formación de estos residentes(AU)


Introduction: the quality of human resources training for health is a requirement of postgraduate medical education. Objective: to design a didactic modeling of the pathological Anatomy resident's training to perform the perinatal autopsy. Method: an observational and pedagogical study was carried out during the 2016-2018 period. The objective was met and the modeling that was done with the participation of 7 teachers and through a pre-experiment with 6 residents was validated. Results: 100 per cent of the residents showed inadequacies in performing the perinatal autopsy, but these were corrected ostensibly after the application of a system of teaching tasks for this purpose. 100per cent of teachers showed conformity with the proposed modeling. Conclusions: the didactic modeling of the pathological anatomy resident's preparation to perform the perinatal autopsy contributes to a qualitatively superior didactic-methodological change in the training process of these residents(AU)


Introdução: a qualidade da formação de recursos humanos em saúde é um requisito da educação médica de pós-graduação. Objetivo: projetar uma modelagem didática do treinamento do residente em Anatomia Patológica para realização da autópsia perinatal. Método: foi realizado um estudo observacional e pedagógico no período 2016-2018. O objetivo foi alcançado e a modelagem realizada com a participação de 7 professores e validada por meio de um pré-experimento com 6 residentes. Resultados: 100per cent dos residentes apresentaram inadequações na realização da autópsia perinatal, mas estas foram corrigidas ostensivamente após a aplicação de um sistema de tarefas de ensino para esse fim. 100 por cento dos professores mostraram conformidade com a modelagem proposta. Conclusões: a modelagem didática da preparação do residente em anatomia patológica para realização da autópsia perinatal contribui para uma mudança didático-metodológica qualitativamente superior no processo de treinamento desses residentes(AU)


Subject(s)
Humans , Pathology/education , Autopsy/methods , Education, Graduate , Professional Competence , Health Knowledge, Attitudes, Practice , Observational Studies as Topic
19.
Rev. Hosp. Clin. Univ. Chile ; 30(3): 199-205, 2019.
Article in Spanish | LILACS | ID: biblio-1051380

ABSTRACT

Most of today ́s medical knowledge of current advances in medicine are based on autopsy findings and patological studies conducted during the 19th century. At the end of the 60s, autopsies began to decline in many countries, for multivariate reasons. Nowadays, autopsies are almost no longer performed unless legal reasons are present. The so important and didactic Pathological Anatomy Meetings are not being held anymore either. These instances played a particularly important role, bringing together and gathering experts and apprentices from different medical areas and disciplines. Unfortunately they have been disappearing from hospitals. However, physicians still seem to need them, as many times there is urgent need to get reliable information about the etiology of thepatients' symptoms and the ultimate causes that led him or her to death. The relevance of this information for generating new knowledge and proposing new diagnostic or therapeutic tools for continuous improvement, both in the field of healthcare and training is indisputable. Unfortunately, we still face situations in which a patient dies in the midst of many doubts regarding the ultimate cause of death. At the University of Chile Clinical Hospital, a so-called Adverse Event Meetings have been held every Thursday for several years. A lot of time is spent trying to elucidate what could have happened, in an attempt to detect errors that could have been corrected A team of doctors, midwives and nurses, analyze all the adverse events reported, step by step. In spite of this, there are situations where doubts still persist, once the meeting is over. Currents advances in imaging, immune-histochemistry, molecular and genetic study techniques can make possible today to obtain most important information without the need for a traditional autopsy. These technologies, appear then as a substitute for traditional autopsies, since the realization of some of these post-mortem studies would allow to elucidate many diagnostic doubts, improving diagnostic and / or therapeutic procedures in case we are faced to similar cases in the future. The idea of performing the so called "virtual autopsies" in the University of Chile Clinical Hospital, is not very original, as others have been performing this procedure, in other hospital around the world. They already exist in several countries under the name of virtual autopsies or "virtuopsias". It is not an innovation of ours. This Virtual Autopsy Program does not imply to discard the classic autopsy, which probably should still be the first option for legal or very difficult cases, without a clear cause of death. The indication of performing virtual autopsies should be considered in all those circumstances where there is an important clinical doubt and when a classic autopsy is difficult to perform, whatever the reason for this is. (AU)


Subject(s)
Humans , Male , Female , Autopsy/methods , Autopsy/trends , Cause of Death
20.
Pan Afr. med. j ; 33(318)2019.
Article in English | AIM | ID: biblio-1268594

ABSTRACT

Reliable data on the cause of child death is the cornerstone for evidence-informed health policy making towards improving child health outcomes. Unfortunately, accurate data on cause of death is essentially lacking in most countries of sub-Saharan Africa due to the widespread absence of functional Civil Registration and Vital Statistics (CRVS) systems. To address this problem, verbal autopsy (VA) has gained prominence as a strategy for obtaining Cause of Death (COD) information in populations where CRVS are absent. This study reviewed publications that investigated the validation of VA methods for assessment of COD. A MEDLINE PubMed search was undertaken in June 2018 for studies published in English that investigated the validation of VA methods in sub-Saharan Africa from 1990-2018. Of the 17 studies identified, 9 fulfilled the study inclusion criteria from which additional five relevant studies were found by reviewing their references. The result showed that Physician-Certified Verbal Autopsy (PCVA) was the most widely used VA method. Validation studies comparing PCVA to hospital records, expert algorithm and Inter VA demonstrated mixed and highly varied outcomes. The accuracy and reliability of the VA methods depended on level of healthcare the respondents have access to and the knowledge of the physicians on the local disease aetiology and epidemiology. As the countries in sub-Saharan Africa continue to battle with dysfunctional CRVS system, VA will remain the only viable option for the supply of child mortality data necessary for policy making


Subject(s)
Africa South of the Sahara , Autopsy/methods , Autopsy/standards , Cause of Death , Child Mortality , Nigeria , Vital Statistics
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