Evidence map›Paper›PMID 34910181›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021

Minimally Invasive Postmortem Intestinal Tissue Sampling in Malnourished and Acutely Ill Children Is Feasible and Informative.

Erika Feutz, Wieger Voskuijl, Peter J Finch, Ta-Chiang Liu, Robert H J Bandsma, Phillip I Tarr, Christopher Alan Moxon, Kelley VanBuskirk, Sarah Lawrence, Grace Umutesi and 5 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Minimally Invasive Tissue Sampling Surveillance Alliance-Facilitating the Expansion of Pathology-Based Mortality Surveillance.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 8 institutions in 6 countries.

Erika FeutzDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Wieger VoskuijlAmsterdam Centre for Global Child Health, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
Peter J FinchDepartment of Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi.
Ta-Chiang LiuDepartment of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA.
Robert H J BandsmaHospital for Sick Children, Translational Medicine Program and Centre for Global Child Health, Toronto, Canada.
Phillip I TarrDepartment of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.
Christopher Alan MoxonDepartment of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Kelley VanBuskirkDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Sarah LawrenceDepartment of Pediatrics, University of Washington, Seattle, Washington, USA.
Grace UmutesiDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Kirkby D TickellDepartment of Global Health, University of Washington, Seattle, Washington, USA.
James A BerkleyThe Childhood Acute Illness & Nutrition (CHAIN) Network, Nairobi, Kenya.
Judd L WalsonDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Steve KamizaDepartment of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi.
Donna M DennoDepartment of Global Health, University of Washington, Seattle, Washington, USA.
University of Washington · USThe Childhood Acute Illness and Nutrition Network · KEKamuzu Central Hospital · MWWashington University in St. Louis · USEmma Kinderziekenhuis · NLHospital for Sick Children · CAKenya Medical Research Institute · KEUniversity of Liverpool · GB

Funding

Washington University DDRCC Supplemental Equipment RequestP30DK052574 · NIDDK · WASHINGTON UNIVERSITY · PI Nicholas O. Davidson · 2000 to 2026
$30.8M
Medical Research Council MR/M007367/1NIDDK NIH HHS P30 DK052574
6 · The paper itself

Abstract

backgroundIntestinal 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.

methodsTransabdominal 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.

resultsEndoscopic 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.

conclusionsMinimally invasive postmortem intestinal sampling is feasible and identifies histopathology that can inform mortality contributors.

Indexed as

MalnutritionAutopsyBiopsyChildHumansInfantPovertySpecimen Handlingchild mortalityenvironmental enteric dysfunctionhistopathologyMinimally invasive tissue sampling

Identifiers

PMID34910181
PMCPMC8672761
OpenAlexW3205285925

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.