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1.
MMWR Morb Mortal Wkly Rep ; 70(14): 523-527, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33830982

RESUMEN

Approximately 375,000 deaths during 2020 were attributed to COVID-19 on death certificates reported to CDC (1). Concerns have been raised that some deaths are being improperly attributed to COVID-19 (2). Analysis of International Classification of Diseases, Tenth Revision (ICD-10) diagnoses on official death certificates might provide an expedient and efficient method to demonstrate whether reported COVID-19 deaths are being overestimated. CDC assessed documentation of diagnoses co-occurring with an ICD-10 code for COVID-19 (U07.1) on U.S. death certificates from 2020 that had been reported to CDC as of February 22, 2021. Among 378,048 death certificates listing U07.1, a total of 357,133 (94.5%) had at least one other ICD-10 code; 20,915 (5.5%) had only U07.1. Overall, 97.3% of 357,133 death certificates with at least one other diagnosis (91.9% of all 378,048 death certificates) were noted to have a co-occurring diagnosis that was a plausible chain-of-event condition (e.g., pneumonia or respiratory failure), a significant contributing condition (e.g., hypertension or diabetes), or both. Overall, 70%-80% of death certificates had both a chain-of-event condition and a significant contributing condition or a chain-of-event condition only; this was noted for adults aged 18-84 years, both males and females, persons of all races and ethnicities, those who died in inpatient and outpatient or emergency department settings, and those whose manner of death was listed as natural. These findings support the accuracy of COVID-19 mortality surveillance in the United States using official death certificates. High-quality documentation of co-occurring diagnoses on the death certificate is essential for a comprehensive and authoritative public record. Continued messaging and training (3) for professionals who complete death certificates remains important as the pandemic progresses. Accurate mortality surveillance is critical for understanding the impact of variants of SARS-CoV-2, the virus that causes COVID-19, and of COVID-19 vaccination and for guiding public health action.


Asunto(s)
/mortalidad , Certificado de Defunción , Clasificación Internacional de Enfermedades , Vigilancia en Salud Pública/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estados Unidos/epidemiología , Adulto Joven
2.
Rev Bras Epidemiol ; 24: e210016, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33852706

RESUMEN

OBJECTIVES: To propose a methodological path to investigate the coverage and information filling of maternal-infant deaths recorded in the Ministry of Health's Mortality Information System for regional spaces. METHODS: Four steps were proposed: 1) Assessment of the completeness of the maternal and child variables, which was measured using the deterministic linkage technique between the Mortality Information System (Sistema de Informações sobre Mortalidade - SIM) and the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos - SINASC); 2) Application of the multiple imputation technique to achieve the total filling of the missing information of the variables; 3) Estimation of death coverage; 4) The Unknown Variable Information Index (Índice de Informação Desconhecida da Variável - IIDV) was measured, which represents the combined effect of data completeness and coverage of deaths. The proposal of the methodological path was exemplified for neonatal deaths in the municipalities of Paraíba that are part of the new classification proposed by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE), as adjacent rural areas, in three triennium periods from 2009 to 2017. RESULTS: The percentage of matching records was 45%. Most of the variables had a percentage of non-completion below 10% and around 17% for the mother's education. Coverages ranged from 75 to 83%. The IIDV for all variables was between 21 and 36% after the linkage. CONCLUSION: The path of the methodological proposal proved to be effective, which can be replicated to other regions, and can be extended to other categories of deaths such as post-neonatal. The combination of the proposed procedures demands low operating costs and their uses are relatively simple to be applied by the managers and technicians of the vital statistics information systems.


Asunto(s)
Certificado de Defunción , Nacimiento Vivo , Brasil/epidemiología , Niño , Ciudades , Femenino , Humanos , Lactante , Sistemas de Información , Embarazo
3.
Rev Bras Epidemiol ; 24: e210011, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33825773

RESUMEN

OBJECTIVE: To develop a linkage algorithm to match anonymous death records of cancer of the larynx (ICD-10 C32X), retrieved from the Mortality Information System (SIM) and the Hospital Information System of the Brazilian Unified National Health System (SIH-SUS) in Brazil. METHODOLOGY: Death records containing ICD-10 C32X codes were retrieved from SIM and SIH-SUS, limited to individuals aged 30 years and over, between 2002 and 2012, in the state of São Paulo. The databases were linked using a unique key identifier developed with sociodemographic data shared by both systems. Linkage performance was ascertained by applying the same procedure to similar non-anonymous databases. True pairs were those having the same identification variables. RESULTS: A total of 14,311 eligible death records were found. Most records, 10,674 (74.6%), were exclusive to SIM. Only 1,853 (12.9%) deaths were registered in both systems, representing true pairs. A total of 1,784 (12.5%) cases of laryngeal cancer in the SIH-SUS database were tracked in SIM with different causes of death. The linkage failed to match 167 (9.4%) records due to inconsistencies in the key identifier. CONCLUSION: The authors found that linking anonymous data from mortality and hospital records is a feasible measure to track missing records and may improve cancer statistics.


Asunto(s)
Almacenamiento y Recuperación de la Información , Neoplasias Laríngeas , Adulto , Algoritmos , Brasil/epidemiología , Bases de Datos Factuales , Certificado de Defunción , Estudios de Factibilidad , Sistemas de Información en Hospital , Humanos , Almacenamiento y Recuperación de la Información/métodos , Sistemas de Información , Neoplasias Laríngeas/mortalidad
4.
BMJ Open ; 11(1): e045360, 2021 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-33518529

RESUMEN

OBJECTIVE: To investigate whether uncertainty surrounding the death is associated with the inaccurate reporting of intellectual disability as the underlying cause of death. DESIGN: National Vital Statistics System 2005-2017 US Multiple Cause-of-Death Mortality files. SETTING: USA. PARTICIPANTS: Adults with an intellectual disability reported on their death certificate, aged 18 and over at the time of death. The study population included 26 555 adults who died in their state of residence between 1 January 2005 and 31 December 2017. PRIMARY OUTCOME AND MEASURES: Decedents with intellectual disability reported on their death certificate were identified using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code for intellectual disability (F70-79). Bivariate analysis and multilevel logistic regression models were used to investigate whether individual-level and state-level characteristics indicative of increased uncertainty at the time of death were associated with the inaccurate reporting of intellectual disability as the underlying cause of death. RESULTS: Inaccurate reporting of intellectual disability as the underlying cause of death was associated with sociodemographic characteristics, death context characteristics and comorbidities indicative of an increased amount of uncertainty surrounding the death. Most striking were increased odds of having intellectual disability reported as the underlying cause of death for decedents who had a choking event (OR=14.7; 95% CI 12.9 to 16.6, p<0.001), an external cause of death associated with a high degree of uncertainty, reported on their death certificate. CONCLUSION: It is imperative that medical personnel not let increased uncertainty lead to the inaccurate reporting of intellectual disability as the underlying cause of death as this practice obscures cause of death trends for this population. Instead, even in instances when increased uncertainty surrounds the death, certifiers should strive to accurately identify the disease or injury causing death, and report the disability in Part II of the death certificate.


Asunto(s)
Causas de Muerte , Certificado de Defunción , Discapacidad Intelectual , Incertidumbre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
5.
Natl Vital Stat Rep ; 69(14): 1-25, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33541519

RESUMEN

Objectives-This report expands the measures used to evaluate cause-of-death data quality by presenting a novel list of unsuitable underlying causes of death (UCOD). This list is intended to facilitate the measurement of the quality of cause-of-death reporting by medical certifiers in terms of completeness, as assessed by a UCOD that is sufficiently specific. Methods-A list of codes from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision was developed to classify unsuitable UCODs defined according to three main subtypes: unknown and ill-defined causes, immediate and intermediate causes, and nonspecific UCODs. Unsuitable UCODs and the three subtypes were examined using 2018 death certificate data for both U.S. residents and nonresidents in the 50 states and the District of Columbia. Differences in the frequency of unsuitable UCODs and the subtypes were tested by age group, place of death, and state of occurrence. Trends in unsuitable UCODs and the three subtypes were also investigated by analyzing death certificate data from 2010 to 2018. Results-In 2018, 34.7% of all death records had an unsuitable UCOD: 2.2% had an unknown or ill-defined cause as the UCOD, 12.7% had an immediate or intermediate cause as the UCOD, and 19.8% had a nonspecific UCOD. Unsuitable UCODs and the subtypes varied by age group, place of death, state, and year. No trend in unsuitable UCODs from 2010 to 2013 was seen, but from 2013 to 2018, a decrease of 0.6% per year was observed, which is likely due to a similar decrease in nonspecific UCODs during the same time period. Conclusion-This novel list of unsuitable UCOD codes can be used to assess the quality of cause-of-death data over time and by other various characteristics, with further applications for efforts to improve mortality data quality.


Asunto(s)
Causas de Muerte , Exactitud de los Datos , Certificado de Defunción , Humanos , Estados Unidos/epidemiología , Estadísticas Vitales
6.
Int J Palliat Nurs ; 27(1): 58-63, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33629908

RESUMEN

BACKGROUND: Homecare nurses play an important role in end-of-life care. A protocol is needed for the remote verification of expected deaths using information and communication technologies (ICT), that is consistent with Japanese guidelines. AIM: To clarify the processes that nurses use to verify deaths and to develop a tentative nursing protocol for verifying expected deaths, using home-based ICT. METHODS: Using literature and semi-structured interviews, a tentative nursing protocol was developed for verifying expected deaths using home-based ICT. FINDINGS: To protect the dignity of patients and their families, it is important that their understanding and consent is provided for the remote verification of expected deaths. Furthermore, the up-to-date legal and ethical responsibilities of nurses should be discussed regarding the verification of a patient's death to provide the best care for the patients and families when implementing the Death Certification Using Information and Communication Technology (DCUICT). CONCLUSION: This suggested protocol offers a framework for a new delivery of nursing care. It provides guidance for homecare nurses organising the care processes and nursing roles of DCUICT. Further revisions to this protocol must incorporate the specific requirement for the verification of nurses.


Asunto(s)
Muerte , Servicios de Atención de Salud a Domicilio , Evaluación en Enfermería , Teleenfermería , Certificado de Defunción , Humanos , Japón
7.
Int J Epidemiol ; 49(6): 1951-1962, 2021 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-33349855

RESUMEN

BACKGROUND: We estimated population-level associations between ethnicity and coronavirus disease 2019 (COVID-19) mortality using a newly linked census-based data set and investigated how ethnicity-specific mortality risk evolved during the pandemic. METHODS: We conducted a retrospective cohort study of respondents to the 2011 Census of England and Wales in private households, linked to death registrations and adjusted for emigration (n = 47 872 412). The outcome of interest was death involving COVID-19 between 2 March 2020 and 15 May 2020. We estimated hazard ratios (HRs) for ethnic-minority groups compared with the White population, controlling for individual, household and area characteristics. HRs were estimated on the full outcome period and separately for pre- and post-lockdown periods. RESULTS: In age-adjusted models, people from all ethnic-minority groups were at elevated risk of COVID-19 mortality; the HRs for Black males and females were 3.13 (95% confidence interval: 2.93 to 3.34) and 2.40 (2.20 to 2.61), respectively. However, in fully adjusted models for females, the HRs were close to unity for all ethnic groups except Black [1.29 (1.18 to 1.42)]. For males, the mortality risk remained elevated for the Black [1.76 (1.63 to 1.90)], Bangladeshi/Pakistani [1.35 (1.21 to 1.49)] and Indian [1.30 (1.19 to 1.43)] groups. The HRs decreased after lockdown for all ethnic groups, particularly Black and Bangladeshi/Pakistani females. CONCLUSION: Differences in COVID-19 mortality between ethnic groups were largely attenuated by geographical and socio-demographic factors, though some residual differences remained. Lockdown was associated with reductions in excess mortality risk in ethnic-minority populations, which has implications for a second wave of infection.


Asunto(s)
/etnología , Censos , Certificado de Defunción , Grupos Étnicos/estadística & datos numéricos , Mortalidad/etnología , Determinantes Sociales de la Salud , Adolescente , Adulto , Afroamericanos , Factores de Edad , Grupo de Ascendencia Continental Asiática , Estudios de Cohortes , Inglaterra/epidemiología , Grupo de Ascendencia Continental Europea , Composición Familiar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Características de la Residencia/clasificación , Características de la Residencia/estadística & datos numéricos , Estudios Retrospectivos , Factores Sexuales , Factores Socioeconómicos , Gales/epidemiología , Adulto Joven
8.
Gac. sanit. (Barc., Ed. impr.) ; 34(6): 624-626, nov.-dic. 2020. tab
Artículo en Español | IBECS | ID: ibc-200256

RESUMEN

El objetivo de este trabajo es confirmar, a partir de las Defunciones con Intervención Judicial (DIJ), si la causa de defunción fue un suicidio, según la información de la familia e identificar el porcentaje de los casos señalados como suicidio en el Boletín Estadístico de Defunción Judicial (BEDJ). Para ello se seleccionaron las DIJ de la base de datos del Parque Cementerio de Málaga en el año 2017. Se recabó información de las familias de las personas fallecidas a través del Gabinete Psicológico del Cementerio para confirmar o descartar el suicidio, y posteriormente se consultó el BEDJ para comprobar si los casos estaban identificados como suicidios. A través de los familiares se confirmaron 65 suicidios, de los que solo un 27% están identificados así en la sección correspondiente del BEDJ, documento que sirve de fuente de información para las estadísticas oficiales de suicidios. Se concluye que la familia puede ofrecer información complementaria que ayudaría a mejorar las estadísticas de suicidios


The objective of this study is to confirm from Deaths with Judicial Intervention (DIJ), whether cause of death was suicide, through family information and to establish the percentage of those identified as such in the Statistical Death Bulletin of Judicial Court (BEDJ). For this purpose, the DIJ were selected from the database of the Cementary Park of Málaga in 2017. Information was collected from the family of the deceased, through the Cementary's Psychological Cabinet to confirm or rule out suicide and the BEDJ was subsequently consulted to confirm whether these cases were identified as such. Relatives confirmed 65 suicides, of which only 27% are identified as such in the relevant section of the BEDJ, a document that serves as a source of information for official suicide statistics. From this study we concluded that the family can offer complementary information that would help improve suicide statistics


Asunto(s)
Humanos , Suicidio/estadística & datos numéricos , Certificado de Defunción/legislación & jurisprudencia , Suicidio/legislación & jurisprudencia , España/epidemiología , Registros de Mortalidad/estadística & datos numéricos , Causas de Muerte/tendencias , Rol Judicial
9.
N Z Med J ; 133(1527): 26-38, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332326

RESUMEN

AIM: To describe the context surrounding the deaths of homeless people in New Zealand and to determine the proportion of deaths that could be considered amenable to healthcare. METHOD: We used coroners' findings related to 171 deaths of persons with "no fixed abode" at the time of death, from 2008 to 2019. Recent lists of amenable mortality from the New Zealand Ministry of Health and the Office of National Statistics in the UK were combined to determine the rate of amenable mortality. RESULTS: The life expectancy of homeless persons identified in this sample was 30 years shorter than in the housed population, with a mean age of death of 45.7 years. Deaths occurred mainly alone, in public spaces (56.1%) or in private vehicles (14%). Three-quarters (75.8%) of homeless persons died from conditions amenable to timely and effective healthcare interventions, mostly from natural causes (45.7%) and suicide (41.5%). CONCLUSION: Homeless people experience considerable challenges when accessing the healthcare system, as uncovered by the dramatic rate of amenable mortality. Our findings highlight the urgent need to implement specific models of care that are designed to meet the social and healthcare needs of homeless persons and address the significant health inequalities they experience.


Asunto(s)
Causas de Muerte , Certificado de Defunción , Personas sin Hogar/estadística & datos numéricos , Esperanza de Vida , Accidentes/mortalidad , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Trastornos Relacionados con Alcohol/mortalidad , Trastornos Relacionados con Alcohol/prevención & control , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/prevención & control , Niño , Etanol/envenenamiento , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad , Nueva Zelanda/epidemiología , Neumonía/mortalidad , Neumonía/prevención & control , Suicidio/prevención & control , Suicidio/estadística & datos numéricos , Adulto Joven
10.
J Forensic Leg Med ; 76: 102072, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33157341

RESUMEN

All Covid-19 deaths and all nursing home and residential home deaths in Ireland must by law be reported to the Coroner, the independent Judicial Officer of the State, in the District in which they occur. This enables accurate and early collation of these death reports. Between January 1, 2015 and June 30, 2020 3342 deaths were reported to the Coroner's District for Kildare. From March 11, 2020, when the first Covid-19 death occurred in Ireland in County Kildare, to June 30, 2020 there were 1738 Covid-19 deaths nationally of which 139 were reported in Kildare with 113 (81%) of these deaths in nursing and residential homes. The calculated excess number of deaths notified for January to June 2020 compared with 2015-2019 was 198 (41%) of the 484 total deaths reported with a 131 (45%) excess in the 293 deaths in nursing and residential homes. Covid-19 deaths accounted for 70% and 86% of these excess deaths respectively. Following subtraction of the 18 non-natural cause deaths and 139 Covid-19 deaths from the total excess there remained an unexplained excess of 60 deaths due to natural causes in March to June of 2020 compared with 2015-2019. The peak excess total death percentage was 359% in April 2020, commencing with a small excess in March (30%), continuing into May (63%) and falling again in June (37%). In the nursing and residential home setting those excess death percentages were most marked at 527% in April, with 27% in March, 54% in May and 17% in June. Underlying medical conditions were recorded in 99% of those dying from Covid-19 and the average age of the deceased was 82.5 years with median of 78 years and 55% of those dying were female and 45% male. The clinical epidemiology and documented excess mortality of the reported deaths are chronicled and analysed to learn also about the future challenges with the continuing Covid-19 infection. A centralized national mortality database providing near real-time death certification enhances infectious disease surveillance and prompt clinical epidemiology and mortality excess studies and reduces under-reporting of Covid-19 deaths.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Neumonía Viral/mortalidad , Sistema de Registros/estadística & datos numéricos , Adulto , Causas de Muerte , Médicos Forenses , Bases de Datos Factuales , Certificado de Defunción , Femenino , Humanos , Irlanda/epidemiología , Masculino , Pandemias
11.
Lima; Perú. Ministerio de Salud; 20201100. 79 p. graf, tab.
Monografía en Español | MINSAPERÚ | ID: biblio-1140218

RESUMEN

El documento contiene el resumen y análisis estadístico a nivel país de la situación actual de la COVID-19 hasta el 27 de noviembre del 2020.


Asunto(s)
Informes de Casos , Certificado de Defunción , Diagnóstico de la Situación de Salud , Análisis Estadístico , Infecciones por Coronavirus
14.
S Afr Med J ; 110(7): 607-609, 2020 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-32880331

RESUMEN

Tuberculosis (TB) is a curable disease, but continues to contribute to large numbers of deaths globally and remains among the leading causes of death in South Africa (SA). Evaluating trends in TB deaths and progress towards the End TB strategy target of zero deaths is particularly important to guide policy and practice in SA. TB deaths are complicated by its relationship with HIV, and SA's initial slow response to HIV compounded this. In considering the reported deaths in SA that identify TB as the underlying cause of death, it is important to be aware of potential limitations and sources of bias. We have examined the relationship between TB and HIV and the recording of underlying and contributing causes of death, and clarified the World Health Organization's methodology for estimating TB deaths.


Asunto(s)
Tuberculosis/mortalidad , Causas de Muerte , Certificado de Defunción , Documentación , Infecciones por VIH/mortalidad , Humanos , Sudáfrica/epidemiología , Estadísticas Vitales , Organización Mundial de la Salud
15.
Brasília, D.F.; OPAS; 2020-09-08. (OPAS-W/BRA/COVID-19/20-106).
No convencional en Portugués | PAHO-IRIS | ID: phr2-52641

RESUMEN

Este informe técnico descreve sobre a declaração de óbito e a classificação [codificação da mortalidade segundo a Classificação Internacional de Doenças (CID)] das mortes relacionadas à COVID-19. O objetivo principal é identificar todas as mortes por COVID-19 em todos os países, incluindo aqueles que ainda não seguem as normas e padrões internacionais da OMS para declarações de óbito e codificação da mortalidade segundo a CID. Também aborda a questão relacionada à estimativa de todas as mortes associadas à pandemia da COVID-19. O documento está dividido em três seções: identificação das mortes por COVID-19; codificação de mortes por COVID-19; e mensuração e notificação da mortalidade bruta no contexto da pandemia da COVID-19 (mortalidade excessiva).


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Pandemias , Certificado de Defunción , Clasificación Internacional de Enfermedades , Causas de Muerte , Betacoronavirus
17.
Rev. esp. med. legal ; 46(3): 101-108, jul.-sept. 2020. ilus, graf
Artículo en Español | IBECS | ID: ibc-192311

RESUMEN

La certificación de la defunción es un acto médico en el que el profesional debe poner el mismo esfuerzo y dedicación que en el resto de los informes elaborados en vida del paciente. Para su correcta cumplimentación el facultativo debe seguir las instrucciones básicas, poniendo especial cuidado en rellenar adecuadamente la secuencia de causas de muerte. En casos de pandemia, la cumplimentación del certificado de defunción corresponde a la medicina asistencial y para poder hacerlo, los organismos oficiales deben publicar instrucciones basadas en recomendaciones internacionales. Debe establecerse, cuanto antes, la posibilidad de comunicación telemática de las defunciones. Mientras eso no sea posible tienen que establecerse procedimientos que permitan en situación de pandemia, comunicar de forma inmediata la mortalidad a las autoridades sanitarias


Death certification requires the same effort and dedication as all reports by doctors during their patients' lifetimes. The physician must follow the basic instructions to complete a death certificate correctly, taking special care to fill in the sequence of causes of death. In the case of a pandemic, completion of the death certificate falls to the primary care physician and therefore the official bodies must publish instructions based on international recommendations. It should be established as soon as possible whether it is possible to report deaths telematically. While this is not possible, in a pandemic procedures should be put in place to enable the immediate reporting of deaths to the health authorities


Asunto(s)
Humanos , Infecciones por Coronavirus/mortalidad , Síndrome Respiratorio Agudo Grave/mortalidad , Neumonía Viral/mortalidad , Certificado de Defunción/legislación & jurisprudencia , Causas de Muerte , Pandemias/legislación & jurisprudencia , Precauciones Universales/legislación & jurisprudencia
18.
Rev. esp. med. legal ; 46(3): 127-138, jul.-sept. 2020. ilus, tab, mapas, graf
Artículo en Español | IBECS | ID: ibc-192314

RESUMEN

En este artículo se revisan los aspectos microbiológicos de la infección COVID-19 y se presentan las recomendaciones sobre los análisis que deben realizarse en casos forenses. En primer lugar se analizan las características taxonómicas del virus, su relación con la familia Coronaviridae y su estructura genética. Se presentan brevemente las características clínicas y patológicas de la infección COVID-19, así como las coinfecciones que pueden asociarse a este virus. En el diagnóstico de laboratorio se describen la PCR -técnica de elección en la fase aguda de la infección-, los estudios antigénicos y los estudios serológicos. Finalmente se detallan los principales objetivos para los estudios microbiológicos en fallecidos en relación con la pandemia COVID-19 y se describen los principales análisis microbiológicos post mortem a realizar en fallecidos en el ámbito forense. Los estudios microbiológicos deben estar dirigidos tanto a la detección del SARS-CoV-2 como a la de las coinfecciones, que también podrían contribuir a la causa de muerte


We review the microbiological aspects of COVID-19 infection and present the microbiological studies that should be performed in forensic cases. We describe the taxonomic characteristics of the virus, its relationship with the Coronaviridae family and its genetic structure. We briefly present the clinical and pathological characteristics of COVID-19 infection, as well as the co-infections that could be associated with this virus. In the laboratory, PCR is a first-choice technique in the acute phase of the infection, together with antigen and serological studies. Finally, we describe the main objectives of microbiological studies in the deceased in relation to the COVID-19 pandemic, as well as the main post-mortem microbiological analysis to be carried out in the medico-legal context. The microbiological analysis should aim to detect both SARS-CoV-2 and coinfections, which may also contribute to the cause of death


Asunto(s)
Humanos , Infecciones por Coronavirus/mortalidad , Síndrome Respiratorio Agudo Grave/mortalidad , Neumonía Viral/mortalidad , Certificado de Defunción/legislación & jurisprudencia , Causas de Muerte , Virus del SRAS/aislamiento & purificación , Genoma Viral , Infecciones por Coronavirus/diagnóstico , Ciencias Forenses/métodos , Técnicas Microbiológicas/métodos , Pandemias/legislación & jurisprudencia
19.
Rev. esp. med. legal ; 46(3): 153-158, jul.-sept. 2020.
Artículo en Español | IBECS | ID: ibc-192317

RESUMEN

La Comunidad de Madrid ha sido la Comunidad más castigada por la pandemia por la Covid-19. La reciente puesta en funcionamiento del Instituto de Medicina Legal y Ciencias Forenses de la Comunidad de Madrid ha obligado a que con su precaria estructura gestionara esta situación, mediante el establecimiento de acuerdos e instrucciones que han impedido que éste se colapsara. Especialmente las medidas adoptadas por el Servicio de Patología han impedido este colapso y disponer de personal necesario para hacer frente a las contingencias que pudieran producirse. Se ha tenido que adoptar medidas especiales para el tratamiento de cadáveres en la Comunidad de Madrid, con la apertura de depósitos temporales, que hicieran frente al elevado número de fallecidos. Se ha realizado un estudio comparativo del número de fallecidos, según etiología médico-legal entre los años 2019 y 2020 en el periodo comprendido entre 9 de marzo y 20 de abril


The Community of Madrid has been the hardest hit by the COVID-19 pandemic.The recent launch of Madrid's Institute of Legal Medicine and Forensic Sciences, has forced its precarious structure to manage this situation, through the establishment of agreements and operational guidelines, which have prevented it from collapsing.These measures, also promoted by the different Services, but in particular, those adopted by the Pathology Service, have helped to avoid this situation.Special measures had to be adopted for the management of corpses in the Community of Madrid, with the opening of temporary morgues to deal with the high number of deaths.A comparative study of the number of deaths, according to forensic medical aetiology, was carried out between 2019 and 2020, in the period between March 9 to April 20


Asunto(s)
Humanos , Infecciones por Coronavirus/mortalidad , Causas de Muerte , Virus del SRAS/aislamiento & purificación , Morgue/organización & administración , Patologia Forense/tendencias , Pandemias/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/tendencias , Certificado de Defunción/legislación & jurisprudencia
20.
J Vis Exp ; (162)2020 08 05.
Artículo en Inglés | MEDLINE | ID: mdl-32831312

RESUMEN

Death notification is an important and challenging aspect of Emergency Medicine. An Emergency Medicine physician must deliver bad news, often sudden and unexpected, to patients and family members without any previous relationship. Unskilled death notification after unexpected events can lead to the development of pathologic grief and posttraumatic stress disorder. It is paramount for Emergency Medicine physicians to be trained in and practice death notification techniques. The GRIEV_ING curriculum provides a conceptual framework for death notification. The curriculum has demonstrated improvement in learners' confidence and competence when delivering bad news. Rapid Cycle Deliberate Practice is a simulation-based medical education technique that uses within the scenario debriefing. This technique uses the concepts of mastery learning and deliberate practice. It allows educators to pause a scenario, provide directed feedback, and then let learners continue the simulation scenario the "right way." The purpose of this scholarly work is to describe how to apply the Rapid Cycle Deliberate Practice debriefing technique to the GRIEV_ING death notification curriculum to more effectively train learners in the delivery of bad news.


Asunto(s)
Certificado de Defunción/legislación & jurisprudencia , Curriculum , Humanos
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