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Sample records for citrus sudden death

  1. Sudden Infant Death Syndrome

    Science.gov (United States)

    Sudden infant death syndrome (SIDS) is the sudden, unexplained death of an infant younger than one year old. Some people call ... boys, African Americans, and American Indian/Alaska Native infants have a higher risk of SIDS. Although health ...

  2. Genetic variation and recombination of RdRp and HSP 70h genes of Citrus tristeza virus isolates from orange trees showing symptoms of citrus sudden death disease

    Directory of Open Access Journals (Sweden)

    Pappas Georgios J

    2008-01-01

    Full Text Available Abstract Background Citrus sudden death (CSD, a disease that rapidly kills orange trees, is an emerging threat to the Brazilian citrus industry. Although the causal agent of CSD has not been definitively determined, based on the disease's distribution and symptomatology it is suspected that the agent may be a new strain of Citrus tristeza virus (CTV. CTV genetic variation was therefore assessed in two Brazilian orange trees displaying CSD symptoms and a third with more conventional CTV symptoms. Results A total of 286 RNA-dependent-RNA polymerase (RdRp and 284 heat shock protein 70 homolog (HSP70h gene fragments were determined for CTV variants infecting the three trees. It was discovered that, despite differences in symptomatology, the trees were all apparently coinfected with similar populations of divergent CTV variants. While mixed CTV infections are common, the genetic distance between the most divergent population members observed (24.1% for RdRp and 11.0% for HSP70h was far greater than that in previously described mixed infections. Recombinants of five distinct RdRp lineages and three distinct HSP70h lineages were easily detectable but respectively accounted for only 5.9 and 11.9% of the RdRp and HSP70h gene fragments analysed and there was no evidence of an association between particular recombinant mosaics and CSD. Also, comparisons of CTV population structures indicated that the two most similar CTV populations were those of one of the trees with CSD and the tree without CSD. Conclusion We suggest that if CTV is the causal agent of CSD, it is most likely a subtle feature of population structures within mixed infections and not merely the presence (or absence of a single CTV variant within these populations that triggers the disease.

  3. Etiology of three recent diseases of citrus in São Paulo State: sudden death, variegated chlorosis and huanglongbing.

    Science.gov (United States)

    Bové, Joseph Marie; Ayres, Antonio Juliano

    2007-01-01

    The state of São Paulo (SSP) is the first sweet orange growing region in the world. Yet, the SSP citrus industry has been, and still is, under constant attack from various diseases. In the 1940s, tristeza-quick decline (T-QD) was responsible for the death of 9 million trees in SSP. The causal agent was a new virus, citrus tristeza virus (CTV). The virus was efficiently spread by aphid vectors, and killed most of the trees grafted on sour orange rootstock. Control of the disease resided in replacing sour orange by alternative rootstocks giving tolerant combinations with scions such as sweet orange. Because of its drought resistance, Rangpur lime became the favourite alternative rootstock, and, by 1995, 85% of the SSP sweet orange trees were grafted on this rootstock. Therefore, when in 1999, many trees grafted on Rangpur lime started to decline and suddenly died, the spectre of T-QD seemed to hang over SSP again. By 2003, the total number of dead or affected trees was estimated to be over one million. The new disease, citrus sudden death (CSD), resembles T-QD in several aspects. The two diseases have almost the same symptoms, they spread in time and space in a manner strikingly similar, and the pathological anatomy of the bark at the bud union is alike. Transmission of the CSD agent by graft-inoculation has been obtained with budwood inoculum taken not only on CSD-affected trees (grafted on Rangpur lime), but also on symptomless trees (grafted on Cleopatra mandarin) from the same citrus block. This result shows that symptomless trees on Cleopatra mandarin are tolerant to the CSD agent. Trees on rootstocks such as Sunki mandarin or Swingle citrumelo are also tolerant. Thus, in the CSD-affected region, control consists in replacing Rangpur lime with compatible rootstocks, or in approach-grafting compatible rootstock seedlings to the scions of trees on Rangpur lime (inarching). More than 5 million trees have been inarched in this way. A new disease of sweet orange

  4. Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Yipsy María Gutiérrez Báez

    2015-09-01

    Full Text Available Since the second half of the twentieth century, dying suddenly due to heart-related problems has become the main health issue in all countries where infectious diseases are not prevalent. Sudden death from cardiac causes is an important global health problem. Major databases were searched for the leading causes of sudden cardiac death. It has been demonstrated that there is a group of hereditary diseases with structural alterations or without apparent organic cause that explains many cases of sudden death in young people, whether related or not to physical exertion. Certain population groups are at higher risk for this disease. They are relatively easy to identify and can be the target of primary prevention measures.

  5. Unnatural sudden infant death

    OpenAIRE

    Meadow, R

    1999-01-01

    AIM—To identify features to help paediatricians differentiate between natural and unnatural infant deaths.
METHOD—Clinical features of 81 children judged by criminal and family courts to have been killed by their parents were studied. Health and social service records, court documents, and records from meetings with parents, relatives, and social workers were studied.
RESULTS—Initially, 42 children had been certified as dying from sudden infant death syndrome (SIDS), and 29 wer...

  6. Sudden Death of Entanglement

    CERN Document Server

    Yu, Ting

    2009-01-01

    A new development in the dynamical behavior of elementary quantum systems is the surprising discovery that correlation between two quantum units of information called qubits can be degraded by environmental noise in a way not seen previously in studies of dissipation. This new route for dissipation attacks quantum entanglement, the essential resource for quantum information as well as the central feature in the Einstein-Podolsky-Rosen so-called paradox and in discussions of the fate of Schr\\"{o}inger's cat. The effect has been labeled ESD, which stands for early-stage disentanglement or, more frequently, entanglement sudden death. We review recent progress in studies focused on this phenomenon.

  7. Sudden death in eating disorders

    Directory of Open Access Journals (Sweden)

    Jáuregui-Garrido B

    2012-02-01

    Full Text Available Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.Keywords: sudden death, cardiovascular complications, refeeding syndrome, QT interval, hypokalemia

  8. Sudden infant death syndrome

    Science.gov (United States)

    ... than girls. Most SIDS deaths occur in the winter. The following may increase the risk for SIDS: ... BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; ...

  9. Sudden cardiac death

    DEFF Research Database (Denmark)

    Hougen, H P; Valenzuela, Antonio Jesus Sanchez; Lachica, E;

    1992-01-01

    53 and one case was inconclusive. After studying the circumstances of death, the number of discrepancies were reduced to 20, so that concordance was reached in 86% of all the cases. The results show that the combination of different methods leads to a diagnosis of myocardial infarction in far more...

  10. Sudden death during sports activities

    OpenAIRE

    STERGIOULAS APOSTOLOS; PRIFTAKIS ANASTASIOS G; VASILAKIS NIKOLAOS

    2016-01-01

    Sudden death during sports activities is a relatively rare, yet tragic event, with significant economic and social consequences. According to the existing studies, the annual incidence ranges from 3/100,000 to 1/250,000. The victims are mainly males with ratios varying from 18/1 to 9/1. The colored athletes are proportionally more susceptible and have a particular sensitivity to hypertrophic cardiomyopathy. Athletes have a 2.8/1 higher risk to have sudden death than non-athletes. But this is...

  11. Autologistic model with an application to the citrus "sudden death" disease Modelo autologístico com aplicação para a doença "morte súbita" dos citrus

    Directory of Open Access Journals (Sweden)

    Elias Teixeira Krainski

    2008-01-01

    Full Text Available The citrus sudden death (CSD disease affects dramatically citrus trees causing a progressive plant decline and death. The disease has been identified in the late 90's in the main citrus production area of Brazil and since then there are efforts to understand the etiology as well as the mechanisms its spreading. One relevant aspect of such studies is to investigate spatial patterns of the occurrence within a field. Methods for determining whether the spatial pattern is aggregated or not has been frequently used. However it is possible to further explore and describe the data by means of adopting an explicit model to discriminate and quantify effects by attaching parameters to covariates which represent aspects of interest to be investigated. One alternative involves autologistic models, which extend a usual logistic model in order to accommodate spatial effects. In order to implement such model it is necessary to take into account the reuse of data to built spatial covariates, which requires extensions in methodology and algorithms to assess the variance of the estimates. This work presents an application of the autologistic model to data collected at 11 time points from citrus fields affected by CSD. It is shown how the autologistic model is suitable to investigate diseases of this type, as well as a description of the model and the computational aspects necessary for model fitting.A morte súbita dos citros (MSC é uma doença com efeitos dramáticos em árvores de citros causando declínio progressivo e morte. Ela foi identificada no final da década de 90 em uma das principais áreas de produção no Brasil e desde então esforços são empregados para entender a sua etiologia e os seus mecanismos de dispersão. Um aspecto relevante para estudos é a investigação do padrão espacial da incidência dentro de um campo. Métodos para determinar se o padrão espacial é agregado ou não têm sido freqüentemente utilizados. Entretanto é poss

  12. Sudden death in eating disorders

    OpenAIRE

    Jáuregui-Garrido B; Jáuregui-Lobera I

    2012-01-01

    Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfact...

  13. Sudden Cardiac Death in Athletes.

    Science.gov (United States)

    Wasfy, Meagan M; Hutter, Adolph M; Weiner, Rory B

    2016-01-01

    There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience sudden cardiac death (SCD). This article reviews the epidemiology and common causes of SCD in specific athlete populations. There is ongoing debate about the optimal mechanism for SCD prevention, specifically regarding the inclusion of the ECG and/or cardiac imaging in routine preparticipation sports evaluation. This controversy and contemporary screening recommendations are also reviewed. PMID:27486488

  14. Hypokalemia and sudden cardiac death

    DEFF Research Database (Denmark)

    Kjeldsen, Keld

    2010-01-01

    Worldwide, approximately three million people suffer sudden cardiac death annually. These deaths often emerge from a complex interplay of substrates and triggers. Disturbed potassium homeostasis among heart cells is an example of such a trigger. Thus, hypokalemia and, also, more transient...... was found in 24% of hospitalized patients. Hypokalemia is associated with increased risk of arrhythmia in patients with cardiovascular disease, as well as increased all-cause mortality, cardiovascular mortality and heart failure mortality by up to 10-fold. Long-term potassium homeostasis depends on renal...... capacity for potassium exchange. In cardiovascular patients, hypokalemia is often caused by nonpotassium-sparing diuretics, insufficient potassium intake and a shift of potassium into stores by increased potassium uptake stimulated by catecholamines, beta-adrenoceptor agonists and insulin. Interestingly...

  15. Sudden unexpected death in infancy in Denmark

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Holst, Anders Gaarsdal; Theilade, Juliane;

    2011-01-01

    Abstract Background. Incidence of sudden unexpected death in infancy (SUDI) and sudden infant death syndrome (SIDS) differs among studies and non-autopsied cases are difficult to assess. Objectives. To investigate causes of sudden death in infancy in a nationwide setting. Validate the use of the ...... are SUDI, and the majority of these are caused by cardiac disease or SIDS. Autopsy is not always performed and valuable information is subsequently lost. Cause of Death registry data is not accurate in describing SIDS....

  16. Genetics of sudden cardiac death.

    Science.gov (United States)

    Refaat, Marwan M; Hotait, Mostafa; London, Barry

    2015-07-01

    Sudden cardiac death (SCD) is defined by the World Health Organization (WHO) as death within 1 h of symptom onset (witnessed) or within 24 h of being observed alive and symptom free (unwitnessed). It affects more than 3 million people annually worldwide and affects approximately 1/1000 people each year in the USA. Familial studies of syndromes with Mendelian inheritance, candidate genes analyses, and genome-wide association studies (GWAS) have helped our understanding of the genetics of SCD. We will review the genetics of arrhythmogenic hereditary syndromes with Mendelian inheritance from familial studies with structural heart disease (hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic cardiomyopathy) as well as primary electrical causes (long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, and short QT syndrome). In addition, we will review the genetics of intermediate phenotypes for SCD such as coronary artery disease and electrocardiographic variables (QT interval, QRS duration, and RR interval). Finally, we will review rare and common variants that are associated with SCD in the general population and were identified from candidate gene analyses and GWAS. Our understanding of the genetics of SCD will improve by the use of next-generation sequencing/whole-exome sequencing as well as whole-genome sequencing which have the potential to discover unsuspected common and rare genetic variants that might be associated with SCD. PMID:26026997

  17. Athletes at Risk for Sudden Cardiac Death

    Science.gov (United States)

    Subasic, Kim

    2010-01-01

    High school athletes represent the largest group of individuals affected by sudden cardiac death, with an estimated incidence of once or twice per week. Structural cardiovascular abnormalities are the most frequent cause of sudden cardiac death. Athletes participating in basketball, football, track, soccer, baseball, and swimming were found to…

  18. Drugs, QTc prolongation and sudden cardiac death

    NARCIS (Netherlands)

    S.M.J.M. Straus (Sabine)

    2005-01-01

    textabstract__Abstract__ The term sudden cardiac death pertains to an unexpected death from cardiac causes within a short time period and has been described throughout history. The ancient Egyptians inscribed on the tomb of a nobleman some 4500 years ago that he had died suddenly and without appare

  19. Sudden cardiac death risk stratification.

    Science.gov (United States)

    Deyell, Marc W; Krahn, Andrew D; Goldberger, Jeffrey J

    2015-06-01

    Arrhythmic sudden cardiac death (SCD) may be caused by ventricular tachycardia/fibrillation or pulseless electric activity/asystole. Effective risk stratification to identify patients at risk of arrhythmic SCD is essential for targeting our healthcare and research resources to tackle this important public health issue. Although our understanding of SCD because of pulseless electric activity/asystole is growing, the overwhelming majority of research in risk stratification has focused on SCD-ventricular tachycardia/ventricular fibrillation. This review focuses on existing and novel risk stratification tools for SCD-ventricular tachycardia/ventricular fibrillation. For patients with left ventricular dysfunction or myocardial infarction, advances in imaging, measures of cardiac autonomic function, and measures of repolarization have shown considerable promise in refining risk. Yet the majority of SCD-ventricular tachycardia/ventricular fibrillation occurs in patients without known cardiac disease. Biomarkers and novel imaging techniques may provide further risk stratification in the general population beyond traditional risk stratification for coronary artery disease alone. Despite these advances, significant challenges in risk stratification remain that must be overcome before a meaningful impact on SCD can be realized.

  20. Classification of sudden and arrhythmic death

    DEFF Research Database (Denmark)

    Torp-Pedersen, C; Køber, L; Elming, H;

    1997-01-01

    as being arrhythmic or sudden are all biased by the difficulty of having to decide on the degree of unexpectedness or the likelihood that life could continue without the arrhythmia. The uncertainties are enlarged by the fact that critical data (such as knowledge of arrhythmias at the time of death......Since all death is (eventually) sudden and associated with cardiac arrhythmias, the concept of sudden death is only meaningful if it is unexpected, while arrhythmic death is only meaningful if life could have continued had the arrhythmia been prevented or treated. Current classifications of death...... or autopsy) are available in only a few percent of cases. A main problem in using classifications is the lack of validation data. This situation has, with the MADIT trial, changed in the case of the Thaler and Hinkle classification of arrhythmic death. The MADIT trial demonstrated that arrhythmic death...

  1. Sudden cardiac death in 2 young siblings.

    Science.gov (United States)

    Kundu, Reetu; Punia, Rajpal Singh; Handa, Uma; Singh, Amandeep; Mohan, Harsh

    2014-12-01

    Hypertrophic cardiomyopathy is a disease known for exhibiting phenotypic and genetic heterogeneity. At times, sudden cardiac death may be the first and foremost manifestation of the disease. We report 2 cases of hypertrophic cardiomyopathy causing sudden death, which were diagnosed on autopsy with special emphasis on histopathological findings of this entity. The role of a pathologist cannot be undermined as the disease is a diagnostic challenge often overlooked by the neophytes in the field due to unawareness. PMID:25361060

  2. Sudden cardiac death in children and adolescents (excluding Sudden Infant Death Syndrome)

    International Nuclear Information System (INIS)

    Sudden death in the young is rare. About 25% of cases occur during sports. Most young people with sudden cardiac death (SCD) have underlying heart disease, with hypertrophic cardiomyopathy and coronary artery anomalies being commonest in most series. Arrhythmogenic right ventricular dysplasia and long QT syndrome are the most common primary arrhythmic causes of SCD. It is estimated that early cardiopulmonary resuscitation and widespread availability of automatic external defibrillators could prevent about a quarter of pediatric sudden deaths

  3. SOCCER RELATED SUDDEN DEATHS IN TURKEY

    Directory of Open Access Journals (Sweden)

    Çağlar Özdemir

    2008-06-01

    Full Text Available Regular physical exercise is recommended by the medical community, because it offers the potential to reduce the incidence of coronary events. On the other hand, vigorous exertion may act as a trigger of acute myocardial infarction and sudden cardiac death in susceptible individuals. Death during sports activities differs among sports disciplines and countries. In Turkey, soccer attracts more spectators than any other sports activity and the attention of the press and media, and is preferred over other sports by many young and middle-aged individuals. As autopsy-based studies are infrequent in literature and there is a lack of data detailing sudden death during physical activity in Turkey, we present a Turkish series of sudden deaths that occurred during soccer games based on data provided by the Morgue Specialization Department of the Council of Forensic Medicine. We identified 15 male cases of soccer-related sudden death aged from 10 to 48 years. Coronary artery disease was identified as the cause of sudden death in 11 cases

  4. Cardiac channelopathies and sudden infant death syndrome

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Jacob; Winkel, Bo Gregers; Grunnet, Morten;

    2011-01-01

    Sudden infant death syndrome (SIDS) is always a devastating and unexpected occurrence. SIDS is the leading cause of death in the first 6 months after birth in the industrialized world. Since the discovery in 1998 of long QT syndrome as an underlying substrate for SIDS, around 10-20% of SIDS cases...

  5. Sudden death in water: Diagnostic challenges

    Directory of Open Access Journals (Sweden)

    Elvira Ventura Spagnolo

    2016-03-01

    Full Text Available The authors report a case of sudden death in a breath-holding diver and highlight the forensic diagnostic difficulties in opining the cause of sudden death in water. The autopsy showed increased thickness of the left ventricular wall with a distinct pattern of concentric hypertrophy, evident particularly in the subaortic interventricular septum. Histological examination revealed diffuse interstitial fibrosis and associated findings of multifocal myocyte disarray especially evident in the subaortic interventricular septum. The analysis and discussion of this case made it possible to attribute sudden death to a lethal arrhythmia following myocyte disarray and hypoxia caused by breath-holding, the triggering factor of apnea. This case demonstrates the importance of a thorough forensic investigation, particularly in histological terms, in subjects found dead in water, in order to ascertain the real cause of death, which may not be always ascribable to drowning.

  6. Histological findings in unclassified sudden infant death, including sudden infant death syndrome

    NARCIS (Netherlands)

    G. Liebrechts-Akkerman (Germaine); J.V.M.G. Bovée (Judith V. M. G.); L.C.D. Wijnaendts (Liliane); A. Maes (Ann); P.G.J. Nikkels (Peter); R.R. de Krijger (Ronald)

    2013-01-01

    textabstractOur objective was to study histological variations and abnormalities in unclassified sudden infant death (USID), including sudden infant death syndrome (SIDS), in The Netherlands. Two hundred Dutch USID cases between 1984 and 2005 were identified. The histology slides and autopsy reports

  7. Histological Findings in Unclassified Sudden Infant Death, Including Sudden Infant Death Syndrome

    NARCIS (Netherlands)

    Liebrechts-Akkerman, Germaine; Bovee, Judith V. M. G.; Wijnaendts, Liliane C. D.; Maes, Ann; Nikkels, Peter G. J.; de Krijger, Ronald R.

    2013-01-01

    Our objective was to study histological variations and abnormalities in unclassified sudden infant death (USID), including sudden infant death syndrome (SIDS), in The Netherlands. Two hundred Dutch USID cases between 1984 and 2005 were identified. The histology slides and autopsy reports of 187 case

  8. Psychosocial Aspects of the Sudden Infant Death Syndrome ("Cot Death").

    Science.gov (United States)

    Bluglass, Kerry

    1981-01-01

    Reviews literature on reactions of parents and siblings to Sudden Infant Death Syndrome (SIDS). The prospects for prolonged, adverse reactions are considered, and professional concerns regarding abnormal adaptation are noted. (Author/DB)

  9. EFFORT ADAPTATION OR SUDDEN CARDIAC DEATH?

    Directory of Open Access Journals (Sweden)

    Musat Carmina Liana

    2009-12-01

    Full Text Available During training processes, the human body gradually adapts itself, yet it is hard to believe that it has beenconceived in such way that it could endure the conditions of winning a modern Olympic or world medal. Withrespect to the physical effort, there is the following paradox: if the physical effort is acknowledged as a protector of the heart on the long term, then what causes these sports-related conditions that may result in sudden death?Thus arises the necessity of tracking and evaluating the cardiovascular risk targeting the professional sportsmen, their EKG fluctuations, the cardiovascular causes of sudden death, the part played by the physician and the sportsman in preventing the sudden death, as well as numerous clinical cases of sports cardiology

  10. Sudden Infant Death Syndrome (SIDS)

    Science.gov (United States)

    ... that stays unexplained after a complete investigation. This investigation can include an autopsy, a review of the death scene, and complete family and medical histories. 1 A diagnosis of SIDS is made by collecting information, conducting scientific or forensic tests, and talking with parents, other ...

  11. Febrile convulsions and sudden infant death syndrome

    DEFF Research Database (Denmark)

    Vestergaard, Mogens; Basso, Olga; Henriksen, Tine Brink;

    2002-01-01

    It has been suggested that sudden infant death syndrome (SIDS) and febrile convulsions are related aetiologically. We compared the risk of SIDS in 9877 siblings of children who had had febrile convulsions with that of 20.177 siblings of children who had never had febrile convulsions. We found...

  12. Sudden cardiac death in young adults

    DEFF Research Database (Denmark)

    Larsen, Maiken K; Nissen, Peter H; Kristensen, Ingrid B;

    2012-01-01

    Familial hypercholesterolemia (FH) is a genetic disorder that may lead to premature coronary heart disease (CHD) and sudden cardiac death (SCD). Mutations in the LDLR or APOB genes cause FH. We have screened the LDLR and the ligand-binding region of APOB genes in 52 cases of SCD. Deceased patients...

  13. Endotoxemia in sudden infant death syndrome.

    Science.gov (United States)

    Platt, M S; Elin, R J; Hosseini, J M; Smialek, J E

    1994-09-01

    Endotoxemia has been proposed as a significant cause of Sudden Infant Death Syndrome (SIDS). We examined postmortem sera from left and right heart samples of 21 SIDS cases (1989 definition) and 23 controls. The controls were culture results did not materially affect endotoxin concentrations. Thus, we conclude that endotoxemia is not a substantial pathophysiologic event in SIDS. PMID:7825560

  14. Morte súbita dos citros: suscetibilidade de seleções de limão-cravo e uso de interenxertos Citrus sudden death: susceptibility of rangpur lime selections and the use of interstocks

    Directory of Open Access Journals (Sweden)

    Jorgino Pompeu Junior

    2008-12-01

    Full Text Available A morte súbita dos citros é uma doença que afeta cultivares de laranjas e tangerinas enxertadas nos limões-Cravo e Volkameriano. Ela foi observada em plantas com dois a seis anos de idade que, após mostrarem sintomas gerais de declínio, entraram em colapso e morreram. A retirada da casca dos porta-enxertos suscetíveis revela o amarelecimento na região cambial, sendo esse o sintoma-diagnóstico da doença e que precede os sintomas da copa. As plantas enxertadas nas tangerinas Cleópatra e Sunki, no trifoliata e no citrumelo Swingle, não mostram sintomas da doença. A transmissão por borbulha e a evolução espacial sugerem que a morte súbita dos citros seja causada por patógeno transmitido por vetor alado. Com o objetivo de selecionar porta-enxertos tolerantes à doença, laranjeiras Valência enxertadas em 254 porta-enxertos foram plantadas em maio de 2003 e 2004 em solos onde foram erradicados pomares afetados pela morte súbita dos citros e próximos a pomares afetados pela doença. Em novembro de 2006, o sintoma-diagnóstico da doença estava presente em dez seleções de limão-Cravo: Santa Barbara red lime, Borneo red lime, Limão-Cravo Taquaritinga, Rangpur India C-26-1, Rangpur rose lemon, Rangpur Kusaie lime, Rangpur red lime D-33-40, Rangpur Egyptian lime, Rangpur lemon India e Japanshe citroen. A presença de interenxerto de trifoliata ou de tangerina Cleópatra, entre o limão-Cravo e a laranja Valência, não impediu a manifestação da doença.Citrus sudden death (CSD or morte súbita dos citros affects sweet orange cultivars and some mandarin trees grafted on Rangpur lime and Volkamer lemon rootstocks. The disease was observed in trees with ages ranging from two to six years; after showing general decline symptoms, the affected trees suddenly collapse and die. Trees on Cleopatra and Sunki mandarins, 'Swingle' citrumelo and trifoliate orange showed no symptoms of CSD. Cambial yellowing in the rootstock can be observed

  15. [EPIDEMIOLOGY OF SUDDEN CARDIAC DEATH: DATA FROM THE PARIS SUDDEN DEATH EXPERTISE CENTER REGISTRY].

    Science.gov (United States)

    Jouven, Xavier; Bougouin, Wulfran; Karam, Nicole; Marijon, Eloi

    2015-09-01

    Sudden cardiac death is an unexpected cardiac arrest without obvious extra-cardiac cause. Epidemiology of sudden cardiac death has been poorly documented in France, mainly because of challenging requirement in order to capture all cases in a specific area. The Parisian registry (Sudden Death Expertise Center, European Georges Pompidou Hospital, Paris) was initiated in May 2011 and analyzed data of all sudden death in Paris and suburbs (6.6 millions inhabitants). Over 3 years, the annual incidence estimated to 50-70 per 100,000. Those occurred mainly in men (69%), with a mean age of 65 year, and at home (75%). The event was witnessed in 80% of cases, but bystander cardiopulmonary resuscitation was initiated in only half of cases. Initial cardiac rhythm was ventricular fibrillation in 25%. Survival to hospital discharge remains low (8%).

  16. Sudden cardiac death in children and adolescents (excluding Sudden Infant Death Syndrome)

    OpenAIRE

    Gajewski Kelly; Saul Philip

    2010-01-01

    Sudden death in the young is rare. About 25% of cases occur during sports. Most young people with sudden cardiac death (SCD) have underlying heart disease, with hypertrophic cardiomyopathy and coronary artery anomalies being commonest in most series. Arrhythmogenic right ventricular dysplasia and long QT syndrome are the most common primary arrhythmic causes of SCD. It is estimated that early cardiopulmonary resuscitation and widespread availability of automatic external defibrillators...

  17. Imaging spectrum of sudden athlete cardiac death.

    LENUS (Irish Health Repository)

    Arrigan, M T

    2012-02-01

    Sudden athlete death (SAD) is a widely publicized and increasingly reported phenomenon. For many, the athlete population epitomize human physical endeavour and achievement and their unexpected death comes with a significant emotional impact on the public. Sudden deaths within this group are often without prior warning. Preceding symptoms of exertional syncope and chest pain do, however, occur and warrant investigation. Similarly, a positive family history of sudden death in a young person or a known family history of a condition associated with SAD necessitates further tests. Screening programmes aimed at detecting those at risk individuals also exist with the aim of reducing fatalities. In this paper we review the topic of SAD and discuss the epidemiology, aetiology, and clinical presentations. We then proceed to discuss each underlying cause, in turn discussing the pathophysiology of each condition. This is followed by a discussion of useful imaging methods with an emphasis on cardiac magnetic resonance and cardiac computed tomography and how these address the various issues raised by the pathophysiology of each entity. We conclude by proposing imaging algorithms for the investigation of patients considered at risk for these conditions and discuss the various issues raised in screening.

  18. Rituals around Sudden Death in Recent Years

    OpenAIRE

    Anders Gustavsson

    2008-01-01

    Life is normally expected to proceed through childhood, youth, adulthood and old age. What happens then if death occurs at some earlier phase of life and not at a far distant time in people’s everyday lives? This will most often be a sudden and unexpected death. How do the nearest family, friends and acquaintances of the deceased cope with this? How and why are new rituals created, how are they spread, and what meaning do they have for the people who are thrust into difficult situations? Thes...

  19. The Debate in Cuba's Scientific Community on Sudden Cardiac Death.

    Science.gov (United States)

    Vilches, Ernesto; Ochoa, Luis A; Ramos, Lianne

    2015-10-01

    Sudden cardiac death poses a challenge to modern medicine because of its high incidence, the unexpected and dramatic nature of the event, and years of potential life lost. What's more, despite modest decreases in global mortality attributed to cardiovascular diseases, incidence of sudden cardiac death has not declined. Cuba, like most of the Americas, suffers from knowledge gaps that hamper adequate strategies to address sudden cardiac death as a population health problem. We suggest that a generally accepted operational definition of sudden cardiac death be agreed upon, and a national registry developed that recognizes this cause of death on death certificates. These two actions will enable Cuba's public health authorities to assess the extent of the problem and to design intervention strategies for the population with intermediate and lower cardiovascular risk, the group in which most cases occur. KEYWORDS Sudden cardiac death, cardiovascular disease, sudden death, sudden cardiac arrest, risk reduction, prevention and control, Cuba.

  20. Sudden cardiac death in young athletes

    Directory of Open Access Journals (Sweden)

    Östman-Smith I

    2011-07-01

    Full Text Available Ingegerd Östman-SmithDivision of Paediatric Cardiology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, SwedenAbstract: Athletic activity is associated with an increased risk of sudden death for individuals with some congenital or acquired heart disorders. This review considers in particular the causes of death affecting athletes below 35 years of age. In this age group the largest proportion of deaths are caused by diseases with autosomal dominant inheritance such as hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, long QT-syndrome, and Marfan’s syndrome. A policy of early cascade-screening of all first-degree relatives of patients with these disorders will therefore detect a substantial number of individuals at risk. A strictly regulated system with preparticipation screening of all athletes following a protocol pioneered in Italy, including school-age children, can also detect cases caused by sporadic new mutations and has been shown to reduce excess mortality among athletes substantially. Recommendations for screening procedure are reviewed. It is concluded that ECG screening ought to be part of preparticipation screening, but using criteria that do not cause too many false positives among athletes. One such suggested protocol will show positive in approximately 5% of screened individuals, among whom many will be screened for these diseases. On this point further research is needed to define what kind of false-positive and false-negative rate these new criteria result in. A less formal system based on cascade-screening of relatives, education of coaches about suspicious symptoms, and preparticipation questionnaires used by athletic clubs, has been associated over time with a sizeable reduction in sudden cardiac deaths among Swedish athletes, and thus appears to be worth implementing even for junior athletes not recommended for formal preparticipation screening. It is strongly argued

  1. Rituals around Sudden Death in Recent Years

    Directory of Open Access Journals (Sweden)

    Anders Gustavsson

    2008-04-01

    Full Text Available Life is normally expected to proceed through childhood, youth, adulthood and old age. What happens then if death occurs at some earlier phase of life and not at a far distant time in people’s everyday lives? This will most often be a sudden and unexpected death. How do the nearest family, friends and acquaintances of the deceased cope with this? How and why are new rituals created, how are they spread, and what meaning do they have for the people who are thrust into difficult situations? These are the questions that will be discussed in this paper. The emphasis is on the present day.The public marking of sudden death by means of collective actions has become far more prominent in recent years in comparison to the past times. This can be seen at sites where a traffic accident, a murder, or manslaughter has occurred, and in connection with memorials to fishermen who have lost their lives at sea.A behavioural pattern having mostly to do with young people who have perished or been killed has obviously been the subject of fairly rapid cultivation. A generational gap is obvious in such incidents. The youth thus become the centre of attention in that they are the most active and inventive.There is no doubt that newspapers have been instrumental in the spread of these new rituals that commemorate young victims of unexpected death, with their articles and, especially, their photographs from the scenes of traffic accidents or murders. The newspapers’ clearly increasing interest in life’s tragic occurrences has led to a noticeable change in attitude that indicates that such tragedy no longer must be kept secret. Instead, it can be commemorated more openly in public and within one’s social group. Solidarity and collectivism have become important key words in traumatic situations at the expense of individuality and privacy. This is a primary change in the study of rituals around sudden death in recent times.

  2. Prevention of sudden cardiac death by the implantable cardioverter defibrilator

    OpenAIRE

    Kovačević Dragan V.; Stojišić-Milosavljević Anastazija; Topalov Vasilije; Mihajlović Bogoljub; Sakač Dejan; Kozlovački Živa

    2011-01-01

    Introduction. Sudden cardiac death or, as it is also called, a modern man’s killer occurs a few hours after the beginning of the disease. Sudden death is the one that happens within an hour from the onset of the subjective discomforts regardless of the existence of any previous disease. According to modern statistics, 450.000 people die suddenly in the USA and 150,000 in Germany. Causes of sudden death. The most frequent causes of sudden death are cardiologic or, in other words, a heart...

  3. Sudden cardiac death in children (1-18 years)

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Risgaard, Bjarke; Sadjadieh, Golnaz;

    2014-01-01

    AIMS: Hitherto, sudden cardiac death in children (SCDc)-defined as sudden cardiac death (SCD) in the 1-18 years old-has been incompletely described in the general population. Knowledge on incidence rates, causes of death and symptoms prior to death is sparse and has been affected by reporting....... A cardiac disease was known prior to death in 18% of all sudden unexpected death cases. In two-thirds of all sudden unexpected death cases no previous medical history was registered. Causes of death in autopsied cases were cardiac or unknown in 70%. Unexplained deaths, presumed to be a primary cardiac...... and referral bias. METHODS AND RESULTS: In a nationwide setting all deaths in children aged 1-18 years in Denmark in 2000-06 were included. To chart causes of death and incidence rates, death certificates and autopsy reports were collected and read. By additional use of the extensive healthcare registries...

  4. Sudden unexpected death in epilepsy genetics: Molecular diagnostics and prevention.

    Science.gov (United States)

    Goldman, Alica M; Behr, Elijah R; Semsarian, Christopher; Bagnall, Richard D; Sisodiya, Sanjay; Cooper, Paul N

    2016-01-01

    Epidemiologic studies clearly document the public health burden of sudden unexpected death in epilepsy (SUDEP). Clinical and experimental studies have uncovered dynamic cardiorespiratory dysfunction, both interictally and at the time of sudden death due to epilepsy. Genetic analyses in humans and in model systems have facilitated our current molecular understanding of SUDEP. Many discoveries have been informed by progress in the field of sudden cardiac death and sudden infant death syndrome. It is becoming apparent that SUDEP genomic complexity parallels that of sudden cardiac death, and that there is a pauci1ty of analytically useful postmortem material. Because many challenges remain, future progress in SUDEP research, molecular diagnostics, and prevention rests in international, collaborative, and transdisciplinary dialogue in human and experimental translational research of sudden death.

  5. Risk stratification for sudden cardiac death.

    Science.gov (United States)

    Sabir, Ian N; Usher-Smith, Juliet A; Huang, Christopher L-H; Grace, Andrew A

    2008-01-01

    Recent advances in pharmacological and device-based therapies have provided a range of management options for patients at risk of sudden cardiac death (SCD). Since all such interventions come with their attendant risks, however, stratification procedures aimed at identifying those who stand to benefit overall have gained a new degree of importance. This review assesses the value of risk stratification measures currently available in clinical practice, as well as of others that may soon enter the market. Parameters that may be obtained only by performing invasive cardiac catheterisation procedures are considered separately from those that may be derived using more readily available non-invasive techniques. It is concluded that effective stratification is likely to require the use of composite parameters and that invasive procedures might only be justified in specific sub-groups of patients. PMID:19351522

  6. Sudden cardiac death and mitral and aortic valve disease

    Directory of Open Access Journals (Sweden)

    Bockeria O.L.

    2013-09-01

    Independent determinants of sudden death were left ventricular ejection fraction and atrial fibrillation. The main cause of death in patients with mitral valve stenosis is a thromboembolism from the left heart chambers to systemic circulation, and the risk of the latter increases with atrial fibrillation. There is no sudden cardiac death in mitral valve stenosis. The absence of left ventricular remodeling in mitral valve stenosis probably explains this finding. Onset of symptoms and signs of left ventricular dysfunction are the main predictors of sudden death and are indications for surgery. It should be emphasized that the database of sudden cardiac death in patients with valvular heart disease is very limited compared to patients with coronary heart disease and cardiomyopathies. Some issues related to predictors and mechanisms of SCD are currently poorly understood, therefore prevention of sudden cardiac death is difficult, especially in asymptomatic patients.

  7. Sudden cardiac death in adults: causes, incidence and interventions.

    Science.gov (United States)

    Walker, Wendy Marina

    Many nurses will be familiar with the unexpected death of an adult patient following a sudden, life-threatening cardiac event. It is a situation that demands sensitive nursing care and skilled interventions to provide a foundation for recovery and promote healthy bereavement. This article examines the causes and incidence of sudden cardiac death in adults. Possible reactions of those who are suddenly bereaved are described and immediate care interventions aimed at dealing with the grief process are discussed. The article concludes by identifying ways in which the incidence of sudden cardiac death may be reduced.

  8. Respiratory tract infections, reflex apnea and sudden infant death

    OpenAIRE

    Lindgren, Carl

    1996-01-01

    RESPIRATORY TRACT INFECTIONS, REFLEX APNEA AND SUDDEN INFANT DEATH. Experimental and epidemiological studies with special reference to Respiratory syncytial virus, Bordetella pertussis and sleep position. Carl Lindgren, Department of Women and Child Health, Karolinska Institute, Stockhohn, Sweden, and Department of Pediatrics, Division of Neonatology, Vanderbilt University, Nashville, Tennessee, USA. The seasonal distribution of Sudden infant death syndrome (SIDS) ...

  9. Risk factors and causes of sudden noncardiac death

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Lynge, Thomas Hadberg; Wissenberg, Mads;

    2015-01-01

    BACKGROUND: On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease. OBJECTIVE: The purpose of this study...... was to report the risk factors and causes of SNCD. METHODS: We conducted a retrospective, nationwide study including all deaths between 2000 and 2006 of individuals aged 1-35 years and all deaths between 2007 and 2009 of individuals aged 1-49 years. Two physicians identified all sudden death cases through....... The median age in the SNCD death population was 32 years. Increasing age was inversely associated with SNCD (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87-0.98). Female sex, in-hospital location, and the absence of cardiac comorbidities were positively associated with SNCD (OR 1.7, 95% CI 1...

  10. Predicting the risk of sudden cardiac death.

    Science.gov (United States)

    Lerma, Claudia; Glass, Leon

    2016-05-01

    Sudden cardiac death (SCD) is the result of a change of cardiac activity from normal (typically sinus) rhythm to a rhythm that does not pump adequate blood to the brain. The most common rhythms leading to SCD are ventricular tachycardia (VT) or ventricular fibrillation (VF). These result from an accelerated ventricular pacemaker or ventricular reentrant waves. Despite significant efforts to develop accurate predictors for the risk of SCD, current methods for risk stratification still need to be improved. In this article we briefly review current approaches to risk stratification. Then we discuss the mathematical basis for dynamical transitions (called bifurcations) that may lead to VT and VF. One mechanism for transition to VT or VF involves a perturbation by a premature ventricular complex (PVC) during sinus rhythm. We describe the main mechanisms of PVCs (reentry, independent pacemakers and abnormal depolarizations). An emerging approach to risk stratification for SCD involves the development of individualized dynamical models of a patient based on measured anatomy and physiology. Careful analysis and modelling of dynamics of ventricular arrhythmia on an individual basis will be essential in order to improve risk stratification for SCD and to lay a foundation for personalized (precision) medicine in cardiology. PMID:26660287

  11. Sudden Unexpected Death in Fetal Life Through Early Childhood.

    Science.gov (United States)

    Goldstein, Richard D; Kinney, Hannah C; Willinger, Marian

    2016-06-01

    In March 2015, the Eunice Kennedy Shriver National Institute of Child Health and Human Development held a workshop entitled "Sudden Unexpected Death in Fetal Life Through Early Childhood: New Opportunities." Its objective was to advance efforts to understand and ultimately prevent sudden deaths in early life, by considering their pathogenesis as a potential continuum with some commonalities in biological origins or pathways. A second objective of this meeting was to highlight current issues surrounding the classification of sudden infant death syndrome (SIDS), and the implications of variations in the use of the term "SIDS" in forensic practice, and pediatric care and research. The proceedings reflected the most current knowledge and understanding of the origins and biology of vulnerability to sudden unexpected death, and its environmental triggers. Participants were encouraged to consider the application of new technologies and "omics" approaches to accelerate research. The major advances in delineating the intrinsic vulnerabilities to sudden death in early life have come from epidemiologic, neural, cardiac, metabolic, genetic, and physiologic research, with some commonalities among cases of unexplained stillbirth, SIDS, and sudden unexplained death in childhood observed. It was emphasized that investigations of sudden unexpected death are inconsistent, varying by jurisdiction, as are the education, certification practices, and experience of death certifiers. In addition, there is no practical consensus on the use of "SIDS" as a determination in cause of death. Major clinical, forensic, and scientific areas are identified for future research. PMID:27230764

  12. Sudden infant death syndrome (SIDS)--standardised investigations and classification

    DEFF Research Database (Denmark)

    Bajanowski, Thomas; Vege, Ashild; Byard, Roger W;

    2007-01-01

    Sudden infant death syndrome (SIDS) still accounts for considerable numbers of unexpected infant deaths in many countries. While numerous theories have been advanced to explain these events, it is increasingly clear that this group of infant deaths results from the complex interaction of a variety...... criteria and inconsistent use of definitions. An approach to sudden infant death is outlined with discussion of appropriate tissue sampling, ancillary investigations and the use of controls in research projects. Standardisation of infant death investigations with the application of uniform definitions...

  13. Prevention of sudden cardiac death by the implantable cardioverter defibrilator

    Directory of Open Access Journals (Sweden)

    Kovačević Dragan V.

    2011-01-01

    Full Text Available Introduction. Sudden cardiac death or, as it is also called, a modern man’s killer occurs a few hours after the beginning of the disease. Sudden death is the one that happens within an hour from the onset of the subjective discomforts regardless of the existence of any previous disease. According to modern statistics, 450.000 people die suddenly in the USA and 150,000 in Germany. Causes of sudden death. The most frequent causes of sudden death are cardiologic or, in other words, a heart rhythm disorder such as ventricular tachycardia, ventricular fibrillation and bradycardiac rhythm disorder. All these reasons can be efficiently prevented by the implantation of the cardioverter defibrillators. Implantable cardioverter defibrillator. In comparison with the already known medications, the defibrillator seems to be the most efficient in prevention of sudden cardiac death. This fact has been confirmed by large multicentre studies. The implantation itself is a routine procedure. It lasts about an hour and it often passes without any complications. The patient leaves the hospital a few days after the procedure. About 150 of these procedures are performed per year at the Institute of Cardiovascular Diseases Vojvodina. The Social Insurance Fund bears medical costs and the patient only pays the participation fee, which is symbolical if compared to the value and use of the device. Owing to this fact, this device is available to every patient thus making the efficient sudden cardiac death prevention possible.

  14. Advanced Electrocardiographic Predictors of Sudden Death in Familial Dysautonomia

    Science.gov (United States)

    Solaimanzadeh, I.; Schlegel, T. T.; Greco, E. C.; DePalma, J. L.; Starc, V.; Marthol, H.; Tutaj, M.; Buechner, S.; Axelrod, F. B.; Hilz, M. J.

    2007-01-01

    To identify accurate predictors for the risk of sudden death in patients with familial dysautonomia (FD). Ten-minute resting high-fidelity 12-lead ECGs were obtained from 14 FD patients and 14 age/gender-matched healthy subjects. Multiple conventional and advanced ECG parameters were studied for their ability to predict sudden death in FD over a subsequent 4.5-year period, including multiple indices of linear and non-linear heart rate variability (HRV); QT variability; waveform complexity; high frequency QRS; and derived Frank-lead parameters. Four of the 14 FD patients died suddenly during the follow-up period, usually with concomitant pulmonary disorder. The presence of low vagally-mediated HRV was the ECG finding most predictive of sudden death. Concomitant left ventricular hypertrophy and other ECG abnormalities such as increased QTc and JTc intervals, spatial QRS-T angles, T-wave complexity, and QT variability were also present in FD patients, suggesting that structural heart disease is fairly common in FD. Although excessive or unopposed cardiac vagal (relative to sympathetic) activity has been postulated as a contributor to sudden death in FD, the presence of low vagally-mediated HRV was paradoxically the best predictor of sudden death. However, we suggest that low vagally-mediated HRV be construed not as a direct cause of sudden death in FD, but rather as an effect of concurrent pathological processes, especially hypoxia due to pulmonary disorders and sleep apnea, that themselves increase the risk of sudden death in FD and simultaneously diminish HRV. We speculate that adenosine may play a role in sudden death in FD, possibly independently of vagal activity, and that adenosine inhibitors such as theophylline might therefore be useful as prophylaxis in this disorder.

  15. Extreme sacrifice: sudden cardiac death in the US Fire Service

    OpenAIRE

    Smith, Denise L.; Barr, David A.; Kales, Stefanos N

    2013-01-01

    Firefighting is a hazardous profession which has claimed on average the lives of 105 US firefighters per year for the past decade. The leading cause of line-of-duty mortality is sudden cardiac death, which accounts for approximately 45% of all firefighter duty-related fatalities. Strenuous physical activity, emotional stress, and environmental pollutants all strain the cardiovascular system, and each can increase the risk of sudden cardiac events in susceptible individuals. Sudden cardiac dea...

  16. Sudden maternal deaths in Malaysia: a case report.

    Science.gov (United States)

    Jegasothy, Ravindran

    2002-08-01

    We report on a retrospective study of maternal deaths in Malaysia that occurred within 24 hours of delivery, abortion or operative termination of the pregnancy (defined as sudden deaths) in the years 1995-1996. There were 131 sudden maternal deaths (20.6% of all maternal deaths); postpartum hemorrhage, obstetric embolisms, trauma and hypertensive disorders of pregnancy were the main causes. There was a disproportionately increased risk of sudden maternal deaths in the Chinese and the 'other bumiputra' racial groups. The proportion of mothers who had no obstetric risk factors in the pregnancy that led to death was 16.8%. Fourteen mothers died in transit Twenty mothers died after a cesarean section. The findings of this review emphasize the fact that caregivers in obstetrics need to be forever vigilant. All maternity staff need to be well trained in emergency care and there needs to be quick referral to centers that can provide expertise in handling these emergencies. PMID:12452259

  17. Sudden death of entanglement of a quantum model

    Institute of Scientific and Technical Information of China (English)

    Zhang Guo-Feng

    2007-01-01

    In this paper the so-called sudden death effect of entanglement is investigated in a quantum model. The results show that one can expect the resurrection of the original entanglement to occur in a periodic way following each sudden death event. The length of the time interval for the zero entanglement depends not only on the degree of entanglement of the initial state but also on the initial state.

  18. Control of Sudden Death of Entanglement by Transient Effects

    Institute of Scientific and Technical Information of China (English)

    Hunkar Kayhan

    2011-01-01

    We investigate the properties of entanglement between an isolated atom and a Jaynes-Cummings atom in the presence of transient effects. These effects are due to the modulation of the atom-field coupling whose explicit time-dependence is considered for the case of the linear sweep. We show that the sudden death of entanglement can be controlled by the transient effects. These effects can suppress the sudden death of entanglement in time.

  19. The incidence of sudden cardiac death in athletes

    Directory of Open Access Journals (Sweden)

    Popović Dejana

    2006-01-01

    Full Text Available Introduction. Despite remarkable advances in medicine and sports, sudden cardiac death remains a significant problem. Incidence of sudden cardiac death. The incidence of sudden cardiac death varies in different studies and there are no systematic data about it. It varies in different types of sports, with age and sex. Sudden cardiac death and physical activity. Many changes in cardiac morphology and function represent an adaptive response to physical activity. As a result, the heart undergoes profound morphologic, functional and electro-physiological alterations. But as there are different kinds of physical activities, the degree of these morphological changes is highly variable. It is needless to say how important it is to know which changes in the heart due to physical activity are normal, and when they are pathological. Considering the results of many studies, the main cause of sudden cardiac death is hypertrophic cardiomiopathy. Conclusion. It is very important to distinguish physiological changes of the heart due to physical activity, and pathological changes due to some cardiac diseases. That is why, clear recommendations on intensity, type, duration and frequency of physical training in every sports discipline are necessary. That is the only way to decrease the incidence of sudden cardiac death in athletes. .

  20. Diabetes mellitus and sudden cardiac death: what are the data?

    Science.gov (United States)

    Bergner, Daniel W; Goldberger, Jeffrey J

    2010-01-01

    Diabetes mellitus has long been linked to an increased risk of sudden cardiac death. However, the magnitude of this association, and the mechanism accounting for this phenomenon, have not been precisely defined. In this review, we evaluate the epidemiological data pertaining to the association between diabetes mellitus and sudden cardiac death and discuss various proposed mechanisms that may account for this relationship. Potential factors contributing to the increased risk of sudden cardiac death observed in patients with diabetes mellitus include silent myocardial ischemia, autonomic nervous system dysfunction, abnormal cardiac repolarization, hypoglycemia, a hypercoaguable state secondary to diabetes mellitus, diabetic cardiomyopathy, and impaired respiratory response to hypoxia and hypercapnea. We conclude that diabetes mellitus does appear to be associated with an increased risk of sudden cardiac death. Although this increased risk is relatively modest, given the large number of diabetic patients worldwide, the absolute number of sudden cardiac deaths attributable to diabetes mellitus remains significant. Little evidence exists to support any specific mechanism(s) accounting for this association. Further investigation into the pathophysiology of sudden cardiac death in diabetes mellitus may yield improved risk stratification tools as well as identify novel therapeutic targets.

  1. [Sudden death in new-born babies (author's transl)].

    Science.gov (United States)

    Guilhaume, A

    This sudden death of a new-born baby, which had been thriving up to then, is a dramatic but not exceptional event. A systematic search for the etiology must be made, and this should include an autopsy in order that the diagnosis of "sudden and unexplained death" is confirmed only after eliminating all other possible causes. Knowledge of this syndrome has benefited from epidemiological surveys which have defined the previous clinical condition, but none of the many etiollotical hypotheses envisaged can take into account the total number of cases reported. One of the most recent cases developed apnoea during sleep, which could explain some unexpected deaths in new-born babies. This was discovered by polygraphic sleep recordings and confirmed by pathological examinations. These demonstrated indirect signs of chronic hypoxia which could have been related to the sudden death of the baby. Though there does not appear to be any relationship between the apnoea syndrome during sleep and these sudden and unexpected deaths, this hypothesis has opened up a new promising line of research which could help to identify new-born babies at risk from "sudden death", and to propose preventative measures. PMID:224505

  2. Sudden infant death in service families.

    Science.gov (United States)

    Miller, S A

    1987-02-01

    A study of all the cot deaths in infancy which occurred in Service families in British Forces Germany (BFG) from 1981-4 was undertaken in order to ascertain the frequency of these tragedies. The total number of deaths was ninety-seven and in sixty cases no cause of death was found at post mortem. The incidence in the Service community was calculated so that comparison could be made with the civilian population of England and Wales. The results of the study indicated that cot deaths occurred relatively more frequently in the Service population even allowing for socio-economic differences between the two groups. However, postneonatal deaths from causes other than cot death occurred less often in BFG. Cot deaths are therefore the cause of the higher postneonatal mortality rates in the Service community and they constitute an important target for preventive medicine. The measures which have been taken in BFG in recent years to reduce the number of cot deaths are discussed in this paper together with some further ideas which might help to solve this distressing problem.

  3. Symptoms Before Sudden Arrhythmic Death Syndrome

    DEFF Research Database (Denmark)

    Glinge, Charlotte; Jabbari, Reza; Risgaard, Bjarke;

    2015-01-01

    these, 30 (22%) had contacted the healthcare system. Antecedent symptoms (symptoms >24 hours before death) were present in 34 (25%) patients. Prodromal symptoms (symptoms ≤24 hours before death) were present in 23 (17%) patients. Cardiac symptoms included chest pain (n = 16, 12%), dyspnea (n = 18, 13...

  4. Sudden death due to inhalant abuse in youth: Case report

    Directory of Open Access Journals (Sweden)

    Ramazan Akcan

    2010-06-01

    Full Text Available Intentional inhalation or abuse of volatile substances is a common public health problem all over the world. As these substances generate euphoria frequency of use among adolescents and young adults is increasing steadily. In cases using inhalants to achieve a euphoric state -without knowing possible consequences- sudden death may occurdue to acute cardio-pulmonary dysfunction.Here we present a case of sudden death of a nineteen-year-old female due to inhalation of volatile from butane containing lighter gas tube, with the findings of autopsy and death scene investigation.In the context of this case; it was aimed to draw attention to the risk of sudden death and steady increase of frequencyof volatile substance abuse among adolescents and young adults due to various psycho-social factors.

  5. Supporting families after sudden infant death.

    Science.gov (United States)

    McClain, M E; Shaefer, S J

    1996-04-01

    Parents consistently report that supportive contacts with their health care providers make a difference in their overall adjustment to their baby's death. Parents require continuing validation that the baby's death is no one's fault, that it was not caused by anything they did or did not do. In supporting bereaved families, our goal is to assist parents to incorporate the baby's death into their lives in a way that allows them to continue to function and to recognize life as worth living and happiness as possible.

  6. Systemic Steroid Application Caused Sudden Death of a Patient with Sudden Deafness

    Directory of Open Access Journals (Sweden)

    Eriko Ogino-Nishimura

    2013-01-01

    Full Text Available A 63-year-old man, who was diagnosed with sudden sensorineural hearing loss (SSHL, showed severe hypertension 10 hours after prednisolone administration. Subsequently, the patient suddenly died due to pulmonary edema. The autopsy indicated a pheochromocytoma in the right adrenal gland, and the cause of death was determined to be a pheochromocytoma crisis induced by systemic administration of prednisolone. Pheochromocytoma crisis is a life-threatening condition and can result from the use of corticosteroids. Physicians should consider the risk of a pheochromocytoma crisis due to systemic corticosteroids in the treatment of patients with sudden sensorineural hearing loss.

  7. Sudden unexpected death associated with lymphocytic thyroiditis

    DEFF Research Database (Denmark)

    Vestergaard, Vibeke; Drostrup, Dorthe Høj; Thomsen, Jørgen L

    2007-01-01

    of their alcohol abuse, (iii) cases of fatal poisoning other than opiate addicts, (iv) unknown cause of death and (v) controls without prior disease. Tissue samples from the thyroid gland were cut and stained with haematoxylin and eosin and van Gieson. Histology examinations were subsequently performed blind......A forensic autopsy study comprising 125 cases was carried out retrospectively in order to evaluate pathological changes in the thyroid gland in different groups of death. The five groups selected consecutively were: (i) opiate addicts who died from an overdose, (ii) alcoholics who died as a result...

  8. 运动性猝死%Exercise-related sudden death

    Institute of Scientific and Technical Information of China (English)

    潘志军

    2006-01-01

    目的:探讨和分析运动性猝死的流行病学和病因学特征,为竞技体育和全民健身提供科学有效的预防措施.资料来源:应用计算机检索Medline 1982-01/2005-07关于运动性猝死的相关文献,检索词为"exercise/spot,sudden death".并限定文章的语种类为English.同时利用计算机检索同期维普中文科技期刊全文数据库关于运动性猝死的相关文献,检索词为"运动、猝死",限定文章语言种类为中文.资料选择:对资料进行初选,选择与运动有关的猝死文献,排除重复性研究文献以及个案.资料提炼:在63篇文献中,经分类整理,纳入14篇.资料综合:运动性猝死发生率低,进展迅速,与运动项目和运动强度之间没有明显相关,多发生在30~60岁,男性多于女性.病因多为心源性和脑源性猝死,冠状动脉粥样硬化是运动性猝死的一个主要原因.结论:运动性猝死发生率低,存在性别特征,冠状动脉粥样硬化是运动性猝死的一个重要因素.必须加强对运动性猝死流行病学和病因学以及预防措施的研究.%OBJECTIVE: To investigate and analyze the epidemiological and etiological characteristics of exercise-related sudden death, so as to provide scientific and effective preventive measures for competitive sports and the body building of the entire people.DATA SOURCES: A computer-based online search of Medline database was conducted to identify articles about exercise-related sudden death published in English between January 1982 and July 2005 by using the keywords of "exercise/sport, sudden death". Meanwhile, Chinese relevant articles at the same period were searched in VIP database with the same keywords in Chinese.STUDY SELECTION: The data were primarily checked, those about exercise-related sudden death were selected, and the repetitive studies and case report were deleted.DATA EXTRACTION: Fourteen of the 63 literatures were involved after classification.DATA SYNTHESIS: Exercise

  9. Epidemiology of Sudden Cardiac Death: Clinical and Research Implications

    OpenAIRE

    Chugh, Sumeet S.; Reinier, Kyndaron; Teodorescu, Carmen; Evanado, Audrey; Kehr, Elizabeth; Samara, Mershed Al; Mariani, Ronald; Gunson, Karen; Jui, Jonathan

    2008-01-01

    The current annual incidence of sudden cardiac death in the US is likely to be in the range of 180–250,000 per year. Coinciding with the decreased mortality from coronary artery disease, there is evidence pointing toward a significant decrease in rates of sudden cardiac death in the US during the second half of the twentieth century. However the alarming rise in prevalence of obesity and diabetes in the first decade of the new millennium both in the US and worldwide, would indicate that this ...

  10. Sudden cardiac death in 13 captive chimpanzees (Pan troglodytes).

    Science.gov (United States)

    Lammey, Michael L; Lee, D Rick; Ely, John J; Sleeper, Meg M

    2008-02-01

    Sudden cardiac death (SCD), presumed secondary to fatal arrhythmias, is a common cause of mortality in captive chimpanzees at the Alamogordo Primate Facility. Over the 6-year period at the Alamogordo Primate Facility between 2001 and 2006, 13 animals were defined as sudden cardiac death (11 male and 2 female) on the basis of clinical presentation which was 38% of all deaths. All animals had annual physical exams, including electrocardiograms and serial blood pressures. Six of the 13 animals underwent a complete cardiac evaluation by a veterinary cardiologist and all six of these animals were diagnosed with various degrees of cardiomyopathy. Systemic hypertension was noted in two of the 13 cases and antemortem cardiac arrhythmias were seen in all 13 animals. Histological examination of the hearts revealed myocardial fibrosis in 12 chimpanzees. Most of the animals (10/13) that died of sudden cardiac death had cardiomegaly (increased heart weight/body weight ratio) and some degree of myocardial fibrosis noted. Additional data as well as serial diagnostic evaluations will be needed to identify the possible causes of sudden cardiac death in captive chimpanzees. PMID:18269527

  11. Study on Pulmonary Surfactant of Sudden Death of Infant

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To find the pathogenesis of sudden infant death syndrome (S IDS) from changes of pulmonurry surfactant. Methods By means of thin-layer ckromatography technique, surfactant in whole lung specimens of 10 infants with SIDS and 10 control infants without SIDS (dead of nonrespiratory diseases ) were examined qualitatively and quantitatively. Results Eleven components in pulmonary surfactant were examined qualitatively, including lysophosphatidylcholine , sphingomyelin , phosphatidylcholine , phosphatidylserine , phosphatidylinositol , phos phatidylethanolamine , phosphatidylglycerol , diphosphatidylylycerol , phosphatidic acid, cholesterol and neutral lipids. Quantitative examination showed that the amount of surfactant of whole lung specimens in sudden death group [-(8.9±1.0) rng/g wet lung weight] was significantly less than that in control group [-(12. 6±1.4) mg/g uet lung weight, P<0. 01]. Qualitative variance showed that the percentages of phosphatidylcholine (49. 4 % ± 2. 0 % ) and phosphatidylylycerol ( 2. 6 % ± 0. 7 % ) decreased markedly in sudden death group compared with those in control group (61.5 % ± 3. 0 % and 4.3 % ±1. 5%, P < 0. 01 ). Conclusion Before death there is serions defect on metabolism of pulmonary surfactant in sudden death infants, with the amount decreasing and the ratio of its components being disturbed, which is one of the important pathogenies of SIDS.

  12. Study on Pulmonary Surfactant of Sudden Death of Infant

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To find the pathogenesis of sudden infant death syndrome (S IDS) from changes of pulmonurry surfactant. Methods By means of thin-layer ckromatography technique, surfactant in whole lung specimens of 10 infants with SIDS and 10 control infants without SIDS (dead of nonrespiratory diseases ) were examined qualitatively and quantitatively. Results Eleven components in pulmonary surfactant were examined qualitatively, including lysophosphatidylcholine , sphingomyelin , phosphatidylcholine , phosphatidylserine , phosphatidylinositol , phos phatidylethanolamine , phosphatidylglycerol , diphosphatidylylycerol , phosphatidic acid, cholesterol and neutral lipids. Quantitative examination showed that the amount of surfactant of whole lung specimens in sudden death group [-(8.9±1.0) rng/g wet lung weight] was significantly less than that in control group [-(12. 6±1.4) mg/g uet lung weight, P<0. 01]. Qualitative variance showed that the percentages of phosphatidylcholine (49. 4 % ± 2. 0 % ) and phosphatidylylycerol ( 2. 6 % ± 0. 7 % ) decreased markedly in sudden death group compared with those in control group (61.5 % ± 3. 0 % and 4.3 % ±1. 5%, P < 0. 01 ). Conclusion Before death there is serions defect on metabolism of pulmonary surfactant in sudden death infants, with the amount decreasing and the ratio of its components being disturbed, which is one of the important pathogenies of SIDS.

  13. Sudden infant death syndrome: an unrecognized killer in developing countries

    Directory of Open Access Journals (Sweden)

    Ndu IK

    2016-02-01

    Full Text Available Ikenna Kingsley Ndu Department of Paediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria Abstract: Sudden infant death syndrome (SIDS is defined as the sudden unexpected death of an infant <1 year of age, with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation including performance of a complete autopsy and review of the circumstances of death and the clinical history. SIDS contributes to infant mortality and resulted in ~15,000 deaths globally in 2013. Most of the risk factors of SIDS are common in developing countries; yet, there has been little interest in SIDS by researchers in Africa. This review looks at the extent of the attention given to SIDS in a developing country like Nigeria, and factors responsible for the scarce data concerning this significant cause of mortality. Keywords: SIDS, mortality, Nigeria

  14. [Sudden cardiac death in individuals with normal hearts: an update].

    Science.gov (United States)

    González-Melchor, Laila; Villarreal-Molina, Teresa; Iturralde-Torres, Pedro; Medeiros-Domingo, Argelia

    2014-01-01

    Sudden death (SD) is a tragic event and a world-wide health problem. Every year, near 4-5 million people experience SD. SD is defined as the death occurred in 1h after the onset of symptoms in a person without previous signs of fatality. It can be named "recovered SD" when the case received medical attention, cardiac reanimation effective defibrillation or both, surviving the fatal arrhythmia. Cardiac channelopathies are a group of diseases characterized by abnormal ion channel function due to genetic mutations in ion channel genes, providing increased susceptibility to develop cardiac arrhythmias and SD. Usually the death occurs before 40 years of age and in the autopsy the heart is normal. In this review we discuss the main cardiac channelopathies involved in sudden cardiac death along with current management of cases and family members that have experienced such tragic event.

  15. Tissue and Animal Models of Sudden Cardiac Death

    OpenAIRE

    Sallam, Karim; Li, Yingxin; Sager, Philip T.; Steven R. Houser; Wu, Joseph C.

    2015-01-01

    Sudden Cardiac Death (SCD) is a common cause of death in patients with structural heart disease, genetic mutations or acquired disorders affecting cardiac ion channels. A wide range of platforms exist to model and study disorders associated with SCD. Human clinical studies are cumbersome and are thwarted by the extent of investigation that can be performed on human subjects. Animal models are limited by their degree of homology to human cardiac electrophysiology including ion channel expressi...

  16. Preventing Sudden Death: Cardiovascular Screening of Young Athletes.

    Science.gov (United States)

    Ades, Philip A.

    1992-01-01

    Efficiently and inexpensively identifying athletes at risk for exercise-related sudden death is difficult. The article discusses types of cardiac disorders and outlines a practical screening method that features a cardiac history questionnaire designed to identify symptomatic athletes and those with a family history of congenital heart disease.…

  17. Sudden Cardiac Death : Epidemiology, Circadian Variation, and Triggers

    NARCIS (Netherlands)

    Mahmoud, Karim D.; de Smet, Bart J. G. L.; Zijlstra, Felix; Rihal, Charanjit S.; Holmes, David R.

    2011-01-01

    Sudden cardiac death (SCD) remains a major health issue accounting for over 5% of annual mortality in the Western world. There are several causes of SCD, most commonly, coronary artery disease. Although identifying the prodrome of SCD has attracted considerable interest, a large proportion of patien

  18. Relationship between coronary atherosclerosis and 'sudden cardiac death'

    International Nuclear Information System (INIS)

    Coronary arteriosclerosis in mini-pigs was produced by combination of hypercholesterolemia and twofold X irradiation of the cardiac region. 15-21 weeks following irradiation 40% of the adult animals and 58% of the juvenils died of 'sudden cardiac death'. The mortality rate decreased significantly after application of the calcium-channel blocking agent nifedipine

  19. Left ventricular cardiac myxoma and sudden death in a dog

    NARCIS (Netherlands)

    de Nijs, Maria Irene; Vink, Aryan; Bergmann, Wilhelmina; Szatmári, Viktor

    2016-01-01

    BACKGROUND: Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. CASE PRESENTATION: A previously healthy 12-year-old male West Highland white terrier was found dead

  20. Defining Sudden Infant Death and Sudden Intrauterine Unexpected Death Syndromes with Regard to Anatomo-Pathological Examination

    Science.gov (United States)

    Ottaviani, Giulia

    2016-01-01

    Crib death, or sudden infant death syndrome (SIDS), is the most frequent form of death in the first year of life, striking one baby in every 1,700–2,000. Yet, despite advances in maternal–infant care, sudden intrauterine unexplained/unexpected death syndrome (SIUDS) has a sixfold to eightfold greater incidence than that of SIDS. Frequent congenital abnormalities, likely morphological substrates for SIDS–SIUDS, were detected, mainly represented by alterations of the cardiac conduction system, such as accessory pathways and abnormal resorptive degeneration, and hypoplasia/agenesis of the vital brainstem structures. On the basis of these considerations, the new common definition of the SIDS–SIUDS complex is “The sudden death of a fetus after the 25th gestational week or infant under one year of age which is unexpected by history and remains unexplained after a thorough case investigation, including examination of the death scene, performance of a general autopsy and examination of the fetal adnexa”. Therefore, given that the general autopsy does not disclose any cause of death, a more in-depth histopathological analysis of the cardiac conduction system and autonomic nervous system by specialized pathologists is necessary.

  1. Sudden unexpected death in epilepsy: Identifying risk and preventing mortality.

    Science.gov (United States)

    Lhatoo, Samden; Noebels, Jeffrey; Whittemore, Vicky

    2015-11-01

    Premature death among individuals with epilepsy is higher than in the general population, and sudden unexpected death is the most common cause of this mortality. A new multisite collaborative research consortium, the Center for sudden unexpected death in epilepsy (SUDEP) Research (CSR), has received major funding from the National Institutes of Health (NIH) to examine the possible biologic mechanisms underlying this potentially preventable comorbidity and develop predictive biomarkers for interventions that could lower SUDEP incidence. This inaugural report describes the structure of the CSR, its priorities for human and experimental research, and the strategic collaborations and advanced tools under development to reduce this catastrophic outcome of epilepsy. The CSR Partners Program will work closely with committed volunteer agencies, industry, and academic institutions to accelerate and communicate these advances to the professional and lay community.

  2. Sudden unexpected death in epilepsy: Identifying risk and preventing mortality.

    Science.gov (United States)

    Lhatoo, Samden; Noebels, Jeffrey; Whittemore, Vicky

    2015-11-01

    Premature death among individuals with epilepsy is higher than in the general population, and sudden unexpected death is the most common cause of this mortality. A new multisite collaborative research consortium, the Center for sudden unexpected death in epilepsy (SUDEP) Research (CSR), has received major funding from the National Institutes of Health (NIH) to examine the possible biologic mechanisms underlying this potentially preventable comorbidity and develop predictive biomarkers for interventions that could lower SUDEP incidence. This inaugural report describes the structure of the CSR, its priorities for human and experimental research, and the strategic collaborations and advanced tools under development to reduce this catastrophic outcome of epilepsy. The CSR Partners Program will work closely with committed volunteer agencies, industry, and academic institutions to accelerate and communicate these advances to the professional and lay community. PMID:26494436

  3. Sudden death of a patient with pulmonary Langerhans cell histiocytosis.

    Science.gov (United States)

    Nakhla, Hassan; Jumbelic, Mary I

    2005-06-01

    We report a case of sudden death due to bilateral pneumothorax in a previously healthy 16-year-old adolescent white girl. She presented with sudden onset of shortness of breath followed by loss of consciousness. Postmortem chest radiograph showed bilateral pneumothoraces. Autopsy confirmed the bilateral pneumothorax and additionally showed emphysematous changes and bullae throughout the lung tissue. Microscopic sections of the lungs showed Langerhans cell histiocytosis. To the best of our knowledge, this is the first reported case of fatal presentation of pulmonary Langerhans cell histiocytosis. PMID:15913433

  4. Mutations in calmodulin cause ventricular tachycardia and sudden cardiac death

    DEFF Research Database (Denmark)

    Nyegaard, Mette; Overgaard, Michael Toft; Sondergaard, M.T.;

    2012-01-01

    Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a devastating inherited disorder characterized by episodic syncope and/or sudden cardiac arrest during exercise or acute emotion in individuals without structural cardiac abnormalities. Although rare, CPVT is suspected to cause...... a substantial part of sudden cardiac deaths in young individuals. Mutations in RYR2, encoding the cardiac sarcoplasmic calcium channel, have been identified as causative in approximately half of all dominantly inherited CPVT cases. Applying a genome-wide linkage analysis in a large Swedish family with a severe...... calmodulin-binding-domain peptide at low calcium concentrations. We conclude that calmodulin mutations can cause severe cardiac arrhythmia and that the calmodulin genes are candidates for genetic screening of individual cases and families with idiopathic ventricular tachycardia and unexplained sudden cardiac...

  5. Sudden unexpected death in epilepsy: Evaluation of forensic autopsy cases.

    Science.gov (United States)

    Zhuo, Luo; Zhang, Yang; Zielke, H Ronald; Levine, Barry; Zhang, Xiang; Chang, Lin; Fowler, David; Li, Ling

    2012-11-30

    Epilepsy is a common chronic neurological disorder characterized by seizures. Mortality is significantly increased in patients with epilepsy. Sudden unexpected death in epilepsy (SUDEP) is the most common seizure-related category of death. A retrospective study of forensic autopsy cases from 2007 to 2009 at the Office of the Chief Medical Examiner (OCME) yielded a total of 104 sudden unexpected deaths directly or indirectly caused by an epilepsy/seizure disorder in the State of Maryland. Of these deaths, 74 cases met a general accepted definition of SUDEP. The age of SUDEP individuals ranged from 14 to 63 with the majority of subjects in the ages between 21 and 50 years (58 cases, 78.4%). Males were slightly more likely than females to die of SUDEP (male:female=1.5:1 based on the rate). The onset age of epilepsy was documented in 47.3% of cases (35/74) based on investigation and medical records. Of the 35 cases, 12 subjects had early onset epilepsy (onset ages 1-15 years) and 20 subjects had duration of epilepsy for more than 10 years. The majority of deaths (61 of the 74 cases, 82.4%) were unwitnessed. Death scene investigation showed that 71 deaths (95.9%) occurred inside their residence with 50 subjects (70.4%) found either in bed or on the bedroom floor near the bed. Forty-three out of 74 cases (58.1%) showed neuropathological lesions. Per history, 50 subjects were reported as being on anti-epileptic drugs (AEDs). However, postmortem toxicological analysis revealed that only 26 subjects (35.1%) had detectable AEDs. Of the 74 cases, seizure disorder or epilepsy was listed as primary cause of death in 66 cases and the term of SUDEP as official cause of death in only 8 cases. This report focuses on the characteristics of death scene investigation and postmortem examination findings of SUDEP cases.

  6. Incidence of Sudden Cardiac Death in a Young Active Population

    OpenAIRE

    Farioli, Andrea; Christophi, Costas A; Quarta, Candida Cristina; Kales, Stefanos N

    2015-01-01

    Background: Little is known about the burden of sudden cardiac death (SCD) among active, presumably healthy persons. We investigated the incidence of SCD among US male career firefighters. Methods and Results: All on-duty SCDs among US male career firefighters between 1998 and 2012 were identified from the US Fire Administration and the US National Institute for Occupational Safety and Health databases. Age-specific incidence rates (IRs) of SCD with 95% CIs were computed. A joinpoint model wa...

  7. Incidence of Sudden Cardiac Death in a Young Active Population

    OpenAIRE

    Farioli, Andrea; Christophi, Costas A; Quarta, Candida Cristina; Kales, Stefanos N

    2015-01-01

    Background Little is known about the burden of sudden cardiac death (SCD) among active, presumably healthy persons. We investigated the incidence of SCD among US male career firefighters. Methods and Results All on-duty SCDs among US male career firefighters between 1998 and 2012 were identified from the US Fire Administration and the US National Institute for Occupational Safety and Health databases. Age-specific incidence rates (IRs) of SCD with 95% CIs were computed. A joinpoint model was ...

  8. Postmortem blood ferritin concentrations in sudden infant death syndrome.

    OpenAIRE

    Worwood, M.; Raha-Chowdhury, R.; Fagan, D G; Moore, C.A.

    1995-01-01

    AIMS--To confirm the observation of extremely high concentrations of ferritin in postmortem serum samples in sudden infant death syndrome (SIDS); to examine the factors influencing blood ferritin concentrations postmortem; to determine whether or not these high blood ferritin concentrations are characteristic of SIDS. METHODS--Postmortem samples of cardiac blood were obtained from 58 full term infants who died of SIDS and 14 full-term infants who died of a variety of other causes. Whole blood...

  9. Sudden death due to recreational exercise in physicians.

    Science.gov (United States)

    Duraković, Z; Misigoj-Duraković, M; Skavić, J

    2002-12-01

    In a period from 1982-2002 we noticed five dead among Croatian male physicians aged 34 to 67, during or after recreational physical exercise: swimming, soccer, tennis and jogging. Three of them who were autopsied, have been non-smokers and without previous symptoms. In all coronary heart disease was found. The left descending anterior artery was stenotic in one and occluded in two, with myocardial scars in one. An acute myocardial infarction was found in none of them, and in two-left ventricular hypertrophy 15 and 18 mm. We could not find a recent medical record in those physicians including a clinical finding and other findings. Two physicians who were not been autopsied, had possible an alcohol cardiomyopathy. Both of them were smokers. In Croatia about 7% of the whole population are engaged in recreational physical exercise. In a period of twenty years (1982-2002) we noticed 43 sudden and unexpected deaths during or immediately after physical exercise: it reached 43/6,300,000 sudden death in Croatia in twenty years or 2.15/315,000 yearly among persons engaged in physical exercise. In Croatia there are 4,957 male physicians-specialists, and a rate of sudden cardiac death during or immediately after physical exercise in this group reached 5/99,140 in 20 years or 1/19,828 every four years. A medical check up before recreational physical exercise is essential including a clinical examination, a serum concentration of risk factors and other risk factors, an electrocardiogram at rest, a stress test and echocardiography in clinical indication, as are medical controls over persons taking exercise. This study shows that medical evaluation is important because of the underlying problems such as sudden death during exercise. In non-trained persons and in the elderly a physical exercise should be recommended of a gradually intensity, which could not exceed 6 METs. PMID:12528274

  10. [Newborn sleep positioners and sudden infant death syndrome risk].

    Science.gov (United States)

    Rossato, Norma Elena

    2013-01-01

    The rate of sudden infant death decreased after the publication of the first guidelines regarding infant sleep position and safe environment in 1992. From 2005 onwards, infant deaths by suffocation, choking or entrapment have increased. Some of them were associated with wedges, positioning devices, and bumper pads. Media and manufacturers should follow safe sleep guidelines in their messaging and advertising, but there is a lack of control over this. We emphasize the important role of health professionals in disseminating the recommendation for a safe infant sleep environment. PMID:23381706

  11. Epilepsy and risk of death and sudden unexpected death in the young

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Winkel, Bo Gregers; Risgaard, Bjarke;

    2013-01-01

    Patients with epilepsy are at increased risk of premature death from all causes and likely also from sudden unexplained death (SUD). Many patients with epilepsy have significant comorbidity, and it is unclear how much of the increased risk can be explained by epilepsy itself. We aimed to chart th...

  12. Causes and prevention of sudden cardiac death in the elderly.

    Science.gov (United States)

    Tung, Patricia; Albert, Christine M

    2013-03-01

    Sudden cardiac death (SCD) is a major cause of mortality in elderly individuals owing to a high prevalence of coronary heart disease, systolic dysfunction, and congestive heart failure (CHF). Although the incidence of SCD increases with age, the proportion of cardiac deaths that are sudden decreases owing to high numbers of other cardiac causes of death in elderly individuals. Implantable cardioverter-defibrillator (ICD) therapy has been demonstrated to improve survival and prevent SCD in selected patients with systolic dysfunction and CHF. However, ICD therapy in elderly patients might not be effective because of a greater rate of pulseless electrical activity underlying SCD and other competing nonarrhythmic causes of death in this population. Although under-represented in randomized trials of ICD use, elderly patients comprise a substantial proportion of the population that qualifies for and receives an ICD for primary prevention under current guidelines. Cardiac resynchronization therapy (CRT), which has been demonstrated to reduce mortality in selected populations with heart failure, is also more commonly used in this group of patients than in younger individuals. In this Review, we examine the causes of SCD in elderly individuals, and discuss the existing evidence for effectiveness of ICD therapy and CRT in this growing population.

  13. The spectrum of epidemiology underlying sudden cardiac death.

    Science.gov (United States)

    Hayashi, Meiso; Shimizu, Wataru; Albert, Christine M

    2015-06-01

    Sudden cardiac death (SCD) from cardiac arrest is a major international public health problem accounting for an estimated 15%-20% of all deaths. Although resuscitation rates are generally improving throughout the world, the majority of individuals who experience a sudden cardiac arrest will not survive. SCD most often develops in older adults with acquired structural heart disease, but it also rarely occurs in the young, where it is more commonly because of inherited disorders. Coronary heart disease is known to be the most common pathology underlying SCD, followed by cardiomyopathies, inherited arrhythmia syndromes, and valvular heart disease. During the past 3 decades, declines in SCD rates have not been as steep as for other causes of coronary heart disease deaths, and there is a growing fraction of SCDs not due to coronary heart disease and ventricular arrhythmias, particularly among certain subsets of the population. The growing heterogeneity of the pathologies and mechanisms underlying SCD present major challenges for SCD prevention, which are magnified further by a frequent lack of recognition of the underlying cardiac condition before death. Multifaceted preventative approaches, which address risk factors in seemingly low-risk and known high-risk populations, will be required to decrease the burden of SCD. In this Compendium, we review the wide-ranging spectrum of epidemiology underlying SCD within both the general population and in high-risk subsets with established cardiac disease placing an emphasis on recent global trends, remaining uncertainties, and potential targeted preventive strategies.

  14. Sudden unexpected death in epilepsy: epidemiology, mechanisms, and prevention.

    Science.gov (United States)

    Devinsky, Orrin; Hesdorffer, Dale C; Thurman, David J; Lhatoo, Samden; Richerson, George

    2016-09-01

    Sudden unexpected death in epilepsy (SUDEP) can affect individuals of any age, but is most common in younger adults (aged 20-45 years). Generalised tonic-clonic seizures are the greatest risk factor for SUDEP; most often, SUDEP occurs after this type of seizure in bed during sleep hours and the person is found in a prone position. SUDEP excludes other forms of seizure-related sudden death that might be mechanistically related (eg, death after single febrile, unprovoked seizures, or status epilepticus). Typically, postictal apnoea and bradycardia progress to asystole and death. A crucial element of SUDEP is brainstem dysfunction, for which postictal generalised EEG suppression might be a biomarker. Dysfunction in serotonin and adenosine signalling systems, as well as genetic disorders affecting cardiac conduction and neuronal excitability, might also contribute. Because generalised tonic-clonic seizures precede most cases of SUDEP, patients must be better educated about prevention. The value of nocturnal monitoring to detect seizures and postictal stimulation is unproven but warrants further study. PMID:27571159

  15. [Sudden cardiac death during a city marathon run].

    Science.gov (United States)

    Beutler, J; Schmid, E; Fischer, S; Hürlimann, S; Konrad, C

    2015-06-01

    Sudden cardiac death (SCD) in young athletes during physical stress is a rare event with an incidence of 1-3 deaths per 100,000 athletes per year. A coronary anomaly is the second most common cause of death following hypertrophic cardiomyopathy. Symptomatic prodromes occur in 20% of cases prior to the SCD event. This case report describes a 35-year-old male who collapsed near the finishing line of a half marathon run. Despite immediate resuscitation attempts and initial return of spontaneous circulation (ROSC), a pulseless electrical activity (PEA) followed and the patient died 1 h after arrival in the resuscitation unit. The autopsy revealed an anomalous left coronary artery (ALCA), which can lead to ischemia of the respective heart muscles under severe stress.

  16. Risk Factors for Sudden Cardiac Death : Risk Factors for Sudden Cardiac Death

    NARCIS (Netherlands)

    M.N. Niemeijer (Maartje)

    2016-01-01

    markdownabstractSCD is a common cause of death, with around four to five million cases annually worldwide. Determining which persons are at high risk for SCD remains difficult, due to lack of knowledge on individual risk factors and because in the majority of cases, SCD is the first manifestation of

  17. Sudden death in infancy due to bicuspid aortic valve.

    Science.gov (United States)

    Karayel, Ferah; Ozaslan, Abdi; Turan, Arzu Akcay; Pakis, Isil; Ketenci, Cetin; Eroglu, Ayse Guler

    2006-09-01

    Symptoms of bicuspid aortic valve usually occur in the age group of 50-70 years, but rarely, it can also lead to sudden unexpected death in infancy and early childhood. The autopsy of a 2-month-old baby boy, found dead in his cot, revealed the heart weight as 25 g, and the macroscopic examination showed the circumference of the aortic valve consisting of two leaflets as 8 mm. The thickness of the left ventricle, right ventricle, and septum was measured as 8, 7, and 10 mm, respectively. Microscopically, the heart revealed hypertrophic changes of myocytes. Subendocardial areas displayed necrosis of myocytes, and severe and diffuse ischemic changes characterized by loss of myofibers and vacuolization. Interstitial pneumonia was identified in the lungs. Death occurred as a result of a congenital bicuspid aortic valve obstructing the left ventricular outflow tract complicated by lung infection. As there are only a few reported cases in infancy, and congenital bicuspid aortic valve can lead to sudden unexpected death, this case is presented to the forensic community.

  18. Coronary atherosclerosis in sudden cardiac death: An autopsy study

    Directory of Open Access Journals (Sweden)

    Sudha M

    2009-10-01

    Full Text Available Background: The incidence of ischemic heart disease (IHD has markedly increased in India over the past few years. Considering the variations in racial, dietary and lifestyle patterns in our population, it is essential to study the biology of coronary atherosclerosis in our patients. Vulnerable plaques have a large number of foam cells, extracellular lipid, thin fibrous caps and clusters of inflammatory cells and are more prone to rupture. These plaques are nourished by the microvessels arising from the vasa vasorum of the blood vessels and by lumen-derived microvessels through the fibrous cap. This autopsy study was designed to analyse the coronary arterial tree in cases of sudden cardiac death, classify coronary atherosclerotic plaques and to assess the factors contributing to vulnerability of the plaques including inflammation, calcification and microvascular density. Materials and Methods: Seven cases of sudden cardiac death were included in the study. The hearts were perfusion-fixed and the coronary arteries along with their main branches were dissected and studied. The location of the plaques, type of plaques, presence of inflammation and calcification were assessed. The cap thickness and microvessel density per 1000um 2 were assessed. The statistical significance was estimated. Results and Conclusions: Extensive high-grade coronary atherosclerotic disease was seen in all sudden cardiac death cases. Majority of the plaques were vulnerable. High-grade inflammation was seen in most of the vulnerable and ruptured plaques. All the ruptured plaques were uncalcified indicating that calcification probably stabilizes the plaques and protects against rupture. Increased microvessel density was noted in ruptured plaques compared to vulnerable plaques. However, it was not statistically significant.

  19. Sudden death of cardiac origin and psychotropic drugs

    Directory of Open Access Journals (Sweden)

    Quadiri eTimour

    2012-05-01

    Full Text Available Mortality rate is high in psychiatric patients versus general population. An important cause of this increased mortality is sudden cardiac death (SCD as a major side-effect of psychotropic drugs. These SCDs generally result from arrhythmias occurring when the posology is high and may attain a toxic threshold but also at dosages within therapeutic range, in the presence of risk factors. There are three kinds of risk factors: physiological (e.g.: low cardiac rate of sportsmen, physiopathological (e.g.: hepatic insufficiency, hypothyroidism and "therapeutic" (due to interactions between psychotropic drugs and other medicines. Association of pharmacological agents may increase the likelihood of SCDs either by i a pharmacokinetic mechanism (e.g.: increased torsadogenic potential of a psychotropic drug when its destruction and/or elimination are compromised or ii a pharmacodynamical mechanism (e.g.: mutual potentiation of proarrhythmic properties of two drugs. In addition, some psychotropic drugs may induce sudden death in cases of pre-existing congenital cardiopathies such as i congenital long QT syndrome, predisposing to torsade de pointes that eventually cause syncope and sudden death. ii a Brugada syndrome, that may directly cause ventricular fibrillation due to reduced sodium current through Nav1.5 channels. Moreover, psychotropic drugs may be a direct cause of cardiac lesions also leading to SCD. This is the case, for example, of phenothiazines responsible for ischemic coronaropathies and of clozapine that is involved in the occurrence of myocarditis. The aims of this work are to delineate: i the risk of SCD related to the use of psychotropic drugs; ii mechanisms involved in the occurrence of such SCD; iii preventive actions of psychotropic drugs side effects, on the basis of the knowledge of patient-specific risk factors, documented from clinical history, ionic balance and ECG investigation by the psychiatrist.

  20. Living after sudden death: A case report of Naxos disease

    Directory of Open Access Journals (Sweden)

    Jose Alberto Garcia Noain

    2012-01-01

    Full Text Available Naxos disease is a recessive inherited condition with arrhythmogenic right ventricular dysplasia (ARVD and a peculiar cutaneous phenotype (woolly hair and a palmoplantar keratoderma. Woolly hair appears from birth, palmoplantar keratoderma develops during childhood and cardiomyopathy is clinically manifested by adolescence. Patients present with syncope, sustained ventricular tachycardia or sudden death. We report a case of a 14 year old boy from Spain, who was admitted into our emergency room after being resuscitated from cardiac arrest, secondary to malignant ventricular tachycardia that developed while he was playing basketball.

  1. Ebstein's Anomaly, Left Ventricular Noncompaction, and Sudden Cardiac Death

    Science.gov (United States)

    McGee, Michael; Warner, Luke; Collins, Nicholas

    2015-01-01

    Ebstein's anomaly is a congenital disorder characterized by apical displacement of the septal leaflet of the tricuspid valve. Ebstein's anomaly may be seen in association with other cardiac conditions, including patent foramen ovale, atrial septal defect, and left ventricular noncompaction (LVNC). LVNC is characterized by increased trabeculation within the left ventricular apex. Echocardiography is often used to diagnose LVNC; however, magnetic resonance (MR) imaging offers superior characterization of the myocardium. We report a case of sudden cardiac death in a patient with Ebstein's anomaly with unrecognized LVNC noted on post mortem examination with screening documenting the presence of LVNC in one of the patient's twin sons. PMID:26240764

  2. Excess sudden cardiac deaths after short-term clarithromycin administration in the CLARICOR trial

    DEFF Research Database (Denmark)

    Winkel, Per; Hilden, J; Hansen, Jørgen Fischer;

    2011-01-01

    -hospital (nonsudden) death. Result: In 100 of 189 (53%) cardiovascular (CV) deaths in which it was possible to examine the question, there was a strong association between place of death and the classification of CV death as sudden or not-sudden. The excess mortality in the clarithromycin group was confined to sudden......Objectives: To elucidate potential mechanisms for the clarithromycin-induced excess mortality observed in the CLARICOR trial during 2.6 year follow-up of patients with stable coronary artery disease. Methods: Cox analyses using out-of-hospital death as a proxy for sudden death compared to in...... coronary heart disease patients not using statins....

  3. Profile of sudden death in an adult population (1999-2008).

    LENUS (Irish Health Repository)

    Downes, M R

    2010-06-01

    Sudden death is the sudden and unexpected death of an individual within 24 hours of symptom onset. The vast majority of these cases are found, at autopsy, to be due to underlying ischaemic cardiac disease. We retrospectively reviewed all adult post mortems performed at Beaumont Hospital over a decade (1999-2008). Our aim was to identify all sudden death cases (natural and accidental) and subclassify them according to age profile and organ system involved. We identified 1230 sudden death cases in the review period with 775 (63%) deaths attributable to ischaemic heart disease. The rate of sudden death remained constant over the decade with 663 (54%) deaths occurring in the first five years. Our negative autopsy rate was 2.8% corresponding to 35 cases. This is the first Irish study to retrospectively review all adult sudden deaths within a defined catchment area and analyse them as outlined above.

  4. A possible explanation of sudden infant death syndrome (SIDS).

    Science.gov (United States)

    Christos, G A; Christos, J A

    1993-09-01

    Research into (lucid) dreaming has shown that the images of a dream are supported by the corresponding body actions, utilizing those muscles which remain active during dreaming. We suggest that Sudden Infant Death Syndrome (SIDS) or Cot Death may be a result of an infant dreaming about its life as a fetus. In the course of that dream, since a fetus does not breathe in the usual sense, the infant may cease to breathe and die. Our hypothesis is consistent with the known facts about SIDS, including social factors such as sleeping position and climatic variation. We suggest that the risk of SIDS can be reduced by making the environment of the infant, as much as possible, unlike that of the womb.

  5. A possible explanation of sudden infant death syndrome (SIDS).

    Science.gov (United States)

    Christos, G A; Christos, J A

    1993-09-01

    Research into (lucid) dreaming has shown that the images of a dream are supported by the corresponding body actions, utilizing those muscles which remain active during dreaming. We suggest that Sudden Infant Death Syndrome (SIDS) or Cot Death may be a result of an infant dreaming about its life as a fetus. In the course of that dream, since a fetus does not breathe in the usual sense, the infant may cease to breathe and die. Our hypothesis is consistent with the known facts about SIDS, including social factors such as sleeping position and climatic variation. We suggest that the risk of SIDS can be reduced by making the environment of the infant, as much as possible, unlike that of the womb. PMID:8259083

  6. Muerte súbita y epilepsia Sudden death and epilepsy

    Directory of Open Access Journals (Sweden)

    I. Galtés

    2009-07-01

    Full Text Available La muerte súbita es una de las principales causas de mortalidad en pacientes epilépticos. Se define por su presentación repentina e inesperada, no traumática, con o sin evidencia de crisis, sin que el examen postmortem revele hallazgos anatómicos o toxicológicos como causa de la muerte. En este sentido, los hallazgos de autopsia suelen ser inespecíficos y por lo que respecta al examen neuropatológico, son raros los casos en los que se puede demostrar la presencia de lesiones encefálicas. En este trabajo, presentamos el caso de un varón de 29 años de edad, con antecedentes de enfermedad epiléptica, que falleció de forma súbita e inesperada mientras dormía. El estudio neuropatológico reveló la presencia de anomalías cerebrales en ambos hemisferios que consistían en trastornos de la sulcación y de la migración neuronal. Se realiza la descripción macroscópica de estas malformaciones congénitas, las cuales con frecuencia se manifiestan clínicamente en forma de crisis comiciales.Sudden unexpected death in epilepsy is one of the main causes of mortality in epileptic patients. It is defined as sudden, unexpected, non-traumatic death in an individual with epilepsy, witnessed or unwitnessed, in which postmortem examination fails to reveal an anatomical or toxicological cause of the death. In this sense, postmortem examination uses to be unspecific and neuropathological findings are unusual. In this paper, a case is presented of a 29-year old male, with a medical history of chronic epilepsy, who died suddenly and unexpectedly during sleep. Neuropathological study showed brain anomalies in both hemispheres related to sulcation and neuronal migration disorders. We report the macroscopical description of these congenital malformations, which have been widely associated with epilepsy.

  7. Pathomorphological cardial changes in the sudden infant death syndrome

    Directory of Open Access Journals (Sweden)

    Rozumny D.V.

    2014-03-01

    disturbances and may be important in the development of sudden death in children.

  8. Sudden infant death syndrome: a possible primary cause.

    Science.gov (United States)

    Richardson, B A

    1994-01-01

    The hypothesis that poisoning by phosphines, arsines and stibines might be the primary cause of sudden infant death syndrome (SIDS) was investigated. Most mattress materials contain phosphorus or antimony compounds as fire retardant additives. Mattress materials in areas affected by the warmth and perspiration of the sleeping infant were found to be naturally infected by the fungus Scopulariopsis brevicaulis which is thought to be capable of generating phosphines, arsines and stibines from materials containing phosphorus, arsenic or antimony compounds. These gases may cause anticholinesterase poisoning and cardiac failure in infants, but contributory factors include the prone sleeping position and overwrapping. In England and Wales, the progressive increase in SIDS between 1951 and 1988 seems to be related to increasing use of phosphorus and antimony compounds as fire retardents in cot mattresses.

  9. Endogenous alcohol production by intestinal fermentation in sudden infant death.

    Science.gov (United States)

    Geertinger, P; Bodenhoff, J; Helweg-Larsen, K; Lund, A

    1982-01-01

    In some cases of sudden infant death syndrome (SIDS) the intestinal flora was found to be dominated by Candida albicans. Microbiologic investigations of the various organs showed the occasional presence of different Candida species, but not in the form of massive growth as in sepsis. There is no basis to assume that the activity of yeasts, first of all of Candida albicans, is a contributory factor in the occurrence of SIDS. Candida albicans was shown to produce alcohol from glucose at a rate of maximally 1 mg of alcohol per gram of intestinal content per hour. It is concluded that the intestinal production of alcohol in vivo from cases showing a Candida albicans dominated intestinal flora will not be able to surpass the normal alcohol metabolizing capacity of the liver. Thus, measurable concentrations of alcohol in the blood from such cases cannot be expected.

  10. Sudden infant death syndrome, childhood thrombosis, and presence of genetic risk factors for thrombosis

    DEFF Research Database (Denmark)

    Larsen, T B; Nørgaard-Pedersen, B; Banner, Jytte;

    2000-01-01

    in the child. This prompted us to investigate these genetic markers of thromboembolic disease in 121 cases of sudden infant death syndrome and in relevant controls, in the expectation of a more frequent occurrence of these markers if thrombosis is an etiological factor in sudden infant death syndrome......Sudden infant death syndrome or "cot death" has until the late eighties been a significant cause of death in children between the ages of 1 month and 1 year. Approximately two per 1000 children born alive dies of sudden infant death syndrome each year in Western Europe, North America, and Australia....... The vulnerability of the infant brain stem to ischemia has been suggested to be a conceivable cause of sudden infant death syndrome. This is compatible with a hypothesis that genetic risk factors for cerebral thrombosis could cause microinfarction in the brain stem during the first month of life, affecting vital...

  11. Prevention of sudden cardiac death in hemodialysis patients.

    Science.gov (United States)

    O'Shaughnessy, Michelle M; O'Regan, John A; Lavin, Peter J

    2014-01-01

    One quarter of all hemodialysis patients will succumb to sudden cardiac death (SCD), a rate far exceeding that observed in the general population. A high prevalence of atherosclerotic coronary artery disease amongst patients with end-stage kidney disease (ESKD) partly explains this exaggerated risk. However, uremia and dialysis related factors are also of critical importance. Interventions aimed at preventing SCD have been inadequately studied in patients with ESKD. Data extrapolated from non-renal populations cannot necessarily be applied to hemodialysis patients, who possess relatively unique risk factors for SCD including "uremic cardiomyopathy", electrolyte shifts, fluctuations in intravascular volume and derangements of mineral and bone metabolism. Pending data derived from proposed randomized controlled clinical trials, critical appraisal of existing evidence and the selective application of guidelines developed for the general population to dialysis patients are required if therapeutic nihilism, or excessive intervention, are to be avoided. We discuss the evidence supporting a role for medical therapies, dialysis prescription refinements, revascularization procedures and electrical therapies as potential interventions to prevent SCD amongst hemodialysis patients. Based on current best available evidence, we present suggested strategies for the prevention of arrhythmia-mediated death in this highly vulnerable patient population. PMID:24720456

  12. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both

    DEFF Research Database (Denmark)

    Solomon, Scott D; Zelenkofske, Steve; McMurray, John J V;

    2005-01-01

    BACKGROUND: The risk of sudden death from cardiac causes is increased among survivors of acute myocardial infarction with reduced left ventricular systolic function. We assessed the risk and time course of sudden death in high-risk patients after myocardial infarction. METHODS: We studied 14,609 ...

  13. Sudden unexplained death: Heritability and diagnostic yield of cardiological and genetic examination in surviving relatives

    NARCIS (Netherlands)

    Tan, Hanno L.; Hofman, Nynke; Van Langen, Irene M.; Van Der Wal, Allard C.; Wilde, Arthur A. M.

    2005-01-01

    Background-Sudden death mostly follows from cardiac disorders that elicit lethal ventricular arrhythmias. In young individuals, it often remains unexplained because history and/or postmortem analysis are absent or provide no clue. Because such sudden unexplained deaths (SUDs) may have heritable caus

  14. Cardiac symptoms before sudden cardiac death caused by coronary artery disease

    DEFF Research Database (Denmark)

    Jabbari, Reza; Risgaard, Bjarke; Holst, Anders G;

    2013-01-01

    The aim of this nationwide case-control study was to identify and characterise symptoms before sudden death of young persons who had died due to coronary artery disease (CAD).......The aim of this nationwide case-control study was to identify and characterise symptoms before sudden death of young persons who had died due to coronary artery disease (CAD)....

  15. Nationwide study of sudden cardiac death in persons aged 1-35 years

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Holst, Anders Gaarsdal; Theilade, Juliane;

    2011-01-01

    % of all deaths), of which 156 (25%) were not autopsied. Of the 469 autopsied cases, 314 (67%) were SCD. The most common cardiac cause of death was ischaemic heart disease (13%); 29% of autopsied sudden unexpected death cases were unexplained. In 45% of SCD cases, the death was witnessed; 34% died during......Aims The aim of this investigation was to study the incidence of sudden cardiac death (SCD) in persons aged 1-35 years in a nationwide setting (5.38 million people) by systematic evaluation of all deaths. Methods and results All deaths in persons aged 1-35 years in Denmark in 2000-06 were included....... Death certificates were read independently by two physicians. The National Patient Registry was used to retrieve information on prior medical history. All autopsy reports were read and the cause of death was revised based on autopsy findings. We identified 625 cases of sudden unexpected death (10...

  16. Prolonged QTc interval and risk of sudden cardiac death in a population of older adults

    DEFF Research Database (Denmark)

    Straus, Sabine M J M; Kors, Jan A; De Bruin, Marie L;

    2006-01-01

    OBJECTIVES: This study sought to investigate whether prolongation of the heart rate-corrected QT (QTc) interval is a risk factor for sudden cardiac death in the general population. BACKGROUND: In developed countries, sudden cardiac death is a major cause of cardiovascular mortality. Prolongation...... of the QTc interval has been associated with ventricular arrhythmias, but in most population-based studies no consistent association was found between QTc prolongation and total or cardiovascular mortality. Only very few of these studies specifically addressed sudden cardiac death. METHODS: This study......). The association between a prolonged QTc interval and sudden cardiac death was estimated using Cox proportional hazards analysis. RESULTS: During an average follow-up period of 6.7 years (standard deviation, 2.3 years) 125 patients died of sudden cardiac death. An abnormally prolonged QTc interval (>450 ms in men...

  17. Sudden infant death syndrome and the genetics of inflammation

    Directory of Open Access Journals (Sweden)

    Linda eFerrante

    2015-02-01

    Full Text Available Several studies report signs of slight infection prior to death in cases of sudden infant death syndrome (SIDS. Based on this, a hypothesis of an altered immunological homeostasis has been postulated. The cytokines are important cellular mediators that are crucial for infant health by regulating cell activity during the inflammatory process. The pro-inflammatory cytokines favor inflammation; the most important of these are IL-1α, IL-1β, IL-6, IL-8, IL-12, IL-18, TNF-α and IFN-γ. These cytokines are controlled by the anti-inflammatory cytokines. This is accomplished by reducing the pro-inflammatory cytokine production, and thus counteracts their biological effect. The major anti-inflammatory cytokines are interleukin 1 receptor antagonist (IL-1ra, IL-4, IL-10, IL-11, and IL-13. The last decade there has been focus on genetic studies within genes that are important for the immune system, for SIDS with a special interest of the genes encoding the cytokines. This is because the cytokine genes are considered to be the genes most likely to explain the vulnerability to infection, and several studies have investigated these genes in an attempt to uncover associations between SIDS and different genetic variants. So far the genes encoding IL-1, IL-6, IL-10 and TNF-α are the most investigated within SIDS research, and several studies indicates associations between specific variants of these genes and SIDS. Taken together this may indicate that in at least a subset of SIDS predisposing genetic variants of the immune genes are involved. However, the immune system and the cytokine network are complex, and more studies are needed in order to better understand the interplay between different genetic variations and how this may contribute to an unfavorable immunological response.

  18. Sudden cardiac death in China: current status and future perspectives.

    Science.gov (United States)

    Zhang, Shu

    2015-10-01

    Sudden cardiac death (SCD) is a major cause of mortality worldwide. Similar to the number of SCDs in western countries including the USA, the number of SCDs in China is ∼544,000 annually. However, there are significant differences in patient characteristics between Chinese primary prevention population and U.S. primary prevention population. In contrast to western countries where implantable cardioverter-defibrillator (ICD) devices have been well adopted as a major effective method for both primary and secondary prevention of SCD, China has a low prevalence of ICD utilization (∼1.5 device per 1 million people). Socioeconomic and political factors, awareness and knowledge of SCD, and the difference in disease patterns have led to the underutilization of ICD in China. China, as the most populated and the second largest economic country in the world, has now taken variable approaches to address this pressing health problem and enhances the delivery of lifesaving therapies, including arrhythmia ablation and medical treatment besides ICD, to patients who are at risk of SCD.

  19. Early repolarization syndrome: A cause of sudden cardiac death

    Institute of Scientific and Technical Information of China (English)

    Abdi; Ali; Nida; Butt; Azeem; S; Sheikh

    2015-01-01

    Early repolarization syndrome(ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considerable risk of life- threatening arrhythmias and sudden cardiac death(SCD). Early repolarization characteristics associated with SCD include high-amplitude J-point elevation, horizontal and/or downslopping ST segments, and inferior and/or lateral leads location. The prevalence of ERS varies between 3% and 24%, depending on age, sex and J-point elevation(0.05 m V vs 0.1 m V) being the main determinants.ERS patients are sporadic and they are at a higher risk of having recurrent cardiac events. Implantable cardioverter-defibrillator implantation and isoproterenol are the suggested therapies in this set of patients. On the other hand, asymptomatic patients with ERS are common and have a better prognosis. The risk stratification in asymptomatic patients with ERS still remains a grey area. This review provides an outline of the up-to-date evidence associated with ERS and the risk of life- threatening arrhythmias. Further prospective studies are required to elucidate the mechanisms of ventricular arrhythmogenesis in patients with ERS.

  20. Avaliação genética de seleções e híbridos de limões cravo, volkameriano e rugoso como porta-enxertos para laranjeiras Valência na presença da morte súbita dos citros Genetic evaluation of selections and hybrids of rangpur lime, volkamer and rough lemons rootstocks for Valência orange trees in the presence of the citrus sudden death

    Directory of Open Access Journals (Sweden)

    Jorgino Pompeu Junior

    2013-03-01

    genótipos Rangpur- Lime x Trifoliata 3810 (1648, Rangpur- Lime x Trifoliata 5320 (1644, Limão- Cravo x Citrange- Carrizo (1524, Citrus pennivesiculata (880, Limão- Cravo x Trifoliata- Swingle A (1707, Rangpur- Rose- Lemon 124684 (864, Rangpur- Red -Lime D33.47 (867 e Limão- Cravo -Ipanema (1522. Dentre os 10 melhores genótipos para produção de frutos e para eficiência produtiva, apenas três são coincidentes: Rangpur- Rose -Lime (868, Citrus pennivesiculata (880 e Limão- Cravo-Ipanema (1522.This study aimed to perform the genetic evaluation of fruit production, productive efficiency and growth of Valência orange (Citrus sinensis trees scions grafted on selections and hybrids of Rangpur lime (C. limonia, Volkamer (C. volkameriana and Rough (C. jambhiri lemons rootstocks grown in the presence of the Citrus Sudden Death (CSD. In an affected endemic area for CSD 36 genotypes of these rootstocks were evaluated, represented by five plants each one, measured in five harvests from the third to seventh years after planting. Seven of them showed symptoms of CSD: Rangpur Otaheite orange 12901 (859, Rangpur Red Lime D.33.30 (866, Limão Cravo EEL (871, Rangpur Borneo red (874, Citrus kokhai (1649, Rough lemon 58329 (1655 and Limão Cravo x Swingle B (1695. For selection and breeding purposes, genetic and phenotypic parameters were estimated and individual genotypic values were predicted for all traits by the REML/BLUP (restricted maximum likelihood/best linear unbiased prediction procedure. The analysis of fruit production in five harvests showed selective accuracy of 84.59% revealing that a greater number of harvests is unnecessary. Selection of the best seven genotypes led to a genetic gain of 11.5% for fruit production while the selection of the very best genotype provided an estimated genetic gain of 16.3%. The higher predicted genetic means (>70.0 kg.pl-1 for fruit production were obtained for the genotypes Ipanema Rangpur Lime (1522, Santa Bárbara Red Lime (884

  1. Sudden cardiac death in patients with diabetes mellitus and chronic heart failure.

    Science.gov (United States)

    Walker, Andrew Mn; Cubbon, Richard M

    2015-07-01

    In patients with diabetes mellitus, around 50% of deaths due to cardiovascular causes are sudden cardiac deaths. The prevalence of diabetes in cohorts with chronic heart failure is increasing, and while sudden cardiac death is an increasingly rare mode of death in chronic heart failure patients as a whole, the risk of this outcome remains high in those with diabetes. This review summarises the current knowledge on the incidence of sudden cardiac death in patients with diabetes and chronic heart failure, before discussing the causes of the excess risk seen in those with these coexistent conditions. We then describe current strategies for risk stratification and prevention of sudden cardiac death in these patients before discussing the priorities for further study in this area.

  2. Preventing tomorrow's sudden cardiac death today: part I: Current data on risk stratification for sudden cardiac death.

    Science.gov (United States)

    Al-Khatib, Sana M; Sanders, Gillian D; Bigger, J Thomas; Buxton, Alfred E; Califf, Robert M; Carlson, Mark; Curtis, Anne; Curtis, Jeptha; Fain, Eric; Gersh, Bernard J; Gold, Michael R; Haghighi-Mood, Ali; Hammill, Stephen C; Healey, Jeff; Hlatky, Mark; Hohnloser, Stefan; Kim, Raymond J; Lee, Kerry; Mark, Daniel; Mianulli, Marcus; Mitchell, Brent; Prystowsky, Eric N; Smith, Joseph; Steinhaus, David; Zareba, Wojciech

    2007-06-01

    Accurate and timely prediction of sudden cardiac death (SCD) is a necessary prerequisite for effective prevention and therapy. Although the largest number of SCD events occurs in patients without overt heart disease, there are currently no tests that are of proven predictive value in this population. Efforts in risk stratification for SCD have focused primarily on predicting SCD in patients with known structural heart disease. Despite the ubiquity of tests that have been purported to predict SCD vulnerability in such patients, there is little consensus on which test, in addition to the left ventricular ejection fraction, should be used to determine which patients will benefit from an implantable cardioverter defibrillator. On July 20 and 21, 2006, a group of experts representing clinical cardiology, cardiac electrophysiology, biostatistics, economics, and health policy were joined by representatives of the US Food and Drug administration, Centers for Medicare Services, Agency for Health Research and Quality, the Heart Rhythm Society, and the device and pharmaceutical industry for a round table meeting to review current data on strategies of risk stratification for SCD, to explore methods to translate these strategies into practice and policy, and to identify areas that need to be addressed by future research studies. The meeting was organized by the Duke Center for the Prevention of SCD at the Duke Clinical Research Institute and was funded by industry participants. This article summarizes the presentations and discussions that occurred at that meeting.

  3. Early markers for myocardial ischemia and sudden cardiac death.

    Science.gov (United States)

    Sabatasso, Sara; Mangin, Patrice; Fracasso, Tony; Moretti, Milena; Docquier, Mylène; Djonov, Valentin

    2016-09-01

    The post-mortem diagnosis of acute myocardial ischemia remains a challenge for both clinical and forensic pathologists. We performed an experimental study (ligation of left anterior descending coronary artery in rats) in order to identify early markers of myocardial ischemia, to further apply to forensic and clinical pathology in cases of sudden cardiac death. Using immunohistochemistry, Western blots, and gene expression analyses, we investigated a number of markers, selected among those which are currently used in emergency departments to diagnose myocardial infarction and those which are under investigation in basic research and autopsy pathology studies on cardiovascular diseases. The study was performed on 44 adult male Lewis rats, assigned to three experimental groups: control, sham-operated, and operated. The durations of ischemia ranged between 5 min and 24 h. The investigated markers were troponins I and T, myoglobin, fibronectin, C5b-9, connexin 43 (dephosphorylated), JunB, cytochrome c, and TUNEL staining. The earliest expressions (≤30 min) were observed for connexin 43, JunB, and cytochrome c, followed by fibronectin (≤1 h), myoglobin (≤1 h), troponins I and T (≤1 h), TUNEL (≤1 h), and C5b-9 (≤2 h). By this investigation, we identified a panel of true early markers of myocardial ischemia and delineated their temporal evolution in expression by employing new technologies for gene expression analysis, in addition to traditional and routine methods (such as histology and immunohistochemistry). Moreover, for the first time in the autopsy pathology field, we identified, by immunohistochemistry, two very early markers of myocardial ischemia: dephosphorylated connexin 43 and JunB. PMID:27392959

  4. Distillability sudden death and sudden birth in a two-qutrit system under decoherence at finite temperature

    Science.gov (United States)

    Guo, You-neng; Fang, Mao-fa; Wang, Guo-you; Zeng, Ke

    2016-07-01

    Distillability sudden death and sudden birth in a two-qutrit system locally subject to amplitude damping channel at a finite temperature have been studied in detail. By using the negativity and the realignment criterion, the results show that certain initially prepared free entangled states under amplitude damping channel at a finite temperature may become bound entangled or separable states in a finite time. Moreover, we have also demonstrated initially prepared bound entangled or separable states may also become distillable entangled states in a finite time.

  5. Sudden unexplained death in childhood. An audit of the quality of Autopsy reporting

    LENUS (Irish Health Repository)

    Treacy, A

    2013-03-01

    Cases of sudden unexplained death in childhood (SUDC) in Ireland in children aged >1year and <5 years were examined in order to assess the quality of autopsy reporting. All SUDC cases are notified to and documented by the National Sudden Infant Death Register (NSIDR) in Ireland along with all cases of sudden infant death syndrome (SIDS) referring to sudden infant deaths less than one year of age. The database of the NSIDR in Ireland was interrogated and cases of SIDS and SUDC were compared over a fifteen-year period (1995-2009). SIDS cases whose autopsies were conducted in the same hospital in the same year as the index SUDC case were used for comparison. The autopsy report for each case was examined and modified Rushton(MR) scores 1\\r\

  6. Controlling entanglement sudden death in cavity QED by classical driving fields

    OpenAIRE

    Zhang, Jian-Song; Xu, Jing-Bo; Lin, Qiang

    2008-01-01

    We investigate the entanglement dynamics of a quantum system consisting of two-level atoms interacting with vacuum or thermal fields with classical driving fields. We find that the entanglement of the system can be improved by adjusting the classical driving field. The influence of the classical field and the purity of the initial state on the entanglement sudden death is also studied. It is shown that the time of entanglement sudden death can be controlled by the classical driving fields. Pa...

  7. Pressure volume characteristics of the lungs in sudden infant death syndrome.

    OpenAIRE

    Fagan, D. G.; Milner, A D

    1985-01-01

    Data on the pressure volume characteristics of left lungs obtained from 23 babies dying from sudden infant death syndrome were compared with results from 18 length-matched babies dying from established but primarily non-pulmonary causes. Volume distension at 30 cm of water and deflation flow volume characteristics were very similar in the two groups. These findings do not suggest that babies dying from sudden infant death syndrome have abnormally stiff lungs.

  8. Burden of sudden cardiac death in persons aged 1 to 49 years

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza;

    2014-01-01

    BACKGROUND: Knowledge of the burden and causes of sudden cardiac death (SCD) is sparse in persons aged... artery disease was the most common cause of death and was found in 158 (36%) autopsied cases, followed by 135 (31%) cases of sudden unexplained death. CONCLUSIONS: In a nationwide cohort of persons aged... in persons aged 1 to 35 years. Notably, coronary artery disease was the most common cause of SCD, followed by unexplained deaths. These findings may help in developing strategies to prevent SCD in the future....

  9. The Costs of Suicide and Sudden Death within an Organization

    Science.gov (United States)

    Kinder, Andrew; Cooper, Cary L.

    2009-01-01

    The effect of any death spreads out to many people. Deaths that occur in the workplace need to be handled with particular care given that the bereaved family as well as work colleagues will have been affected. Death by suicide or situations when an employee becomes suicidal can challenge even the most experienced manager. This article aims to…

  10. Analysis of the prodromal symptoms of unexplained sudden death in patients with or without underlying diseases

    Institute of Scientific and Technical Information of China (English)

    TIAN Zhao-xing; L(U) Yan-yu; YAN Wei; ZHAO Wen-kui; LI Xuan

    2012-01-01

    Background In recent years,the incidence of unexplained sudden death has risen significantly across the world.However,it occurred suddenly,often in young apparently healthy individuals and almost 50% of the patients did not have any warning signals or symptoms.Therefore,the prodromal symptoms before the incident are extremely important for early prediction of sudden death.In this article,we aimed to explore the value of prodromal symptoms for unexplained sudden death and whether the prodromal symptoms have a predictive function to unexplained sudden death (USD)without underlying diseases.Methods A total of 208 sudden death cases were selected for the survey in the Emergency Department of Peking University Third Hospital from January 2006 to December 2009 and their medical records were reviewed.The patients were divided into two groups,65 patients had underlying diseases while 143 had not underlying diseases.In the meantime,their prodromal symptoms were collected and compared,prodromal symptoms including chest distress,dyspnea,syncope,fever,headache,vomiting,etc.Results Patients with underlying diseases were compared to those without underlying diseases associated with sudden death; there was no significant difference in gender and age distribution.Among the 208 cases,39 cases (18.75%) had prodromal symptoms,patients with underlying diseases had prodromal symptoms in 12 cases (18.46%),while patients without underlying diseases had prodromal symptoms in 27 cases (18.88%).The difference between the two groups with prodromal symptoms was not statistically significant(P>0.05).Conclusions Prodromal symptoms are extremely important warning signals in the occurrence of USD.It has equally important predictive value for patients both with and without underlying diseases,especially in predicting sudden death caused by cardiopulmonary and neurological diseases.

  11. Sudden Death Caused by Anomalous Origin of the Coronary Artery During Exercise.

    Science.gov (United States)

    Kurosu, Akira; Kuroyanagi, Kazumi; Yamauchi, Shinobu; Omura, Kazunobu; Saito, Kazuyuki

    2016-03-01

    Anomalous origin of the coronary artery (AOCA) is a rare, but important cause of sudden cardiac death among young athletes. Nine autopsy cases (8 male, 1 female; mean age, 17.9 years; age range, 11-31 years) of sudden death during or just after exercise caused by AOCA were reviewed. The exercises performed at the time of death were running (4 cases), soccer (2 cases), and baseball, swimming and kendo (Japanese swordsmanship) (1 case each). In 6 cases, the left coronary artery arose from the right sinus of Valsalva, and in 3, the right coronary artery from the left sinus. The coronary arteries passed between the pulmonary artery and the aorta with an acute angle takeoff from the orifice. Three cases had cardiovascular manifestations prior to death. In cases with cardiovascular manifestations, novel imaging methods should be considered to prevent sudden death. PMID:27404630

  12. Characteristics of Sudden Unexpected Cancer Deaths Investigated by Medical Examiners in Tokyo, Japan (2009)

    OpenAIRE

    ,

    2014-01-01

    Background Annually, about 400 cases of sudden unexpected death are attributed to cancer in Tokyo, Japan. These individuals may have been undiagnosed, or their medical conditions may not have been carefully evaluated before death. We examined medical consultations, cancer diagnoses, and economic status of all cancer deaths investigated by medical examiners in 2009. Methods Among cases handled by the Tokyo Medical Examiner’s Office in 2009 (N = 12 493), records for all cases of cancer death (n...

  13. Subvalvular aortic stenosis as a cause of sudden death: two case reports.

    Science.gov (United States)

    Turan, Arzu Akcay; Guven, Taner; Karayel, Ferah; Pakis, Isil; Gurpinar, Kagan; Ozaslan, Abdi

    2006-03-01

    Sudden death is defined as a death that occurs suddenly, develops during an unpredictable course, and is due to natural or unnatural causes. Although there is no universally standardized definition on how "sudden" a sudden death is, WHO defines sudden death as a death that occurs within 24 hours after the onset of symptoms. The aim of this study is to present 2 rarely reported autopsy cases and to emphasize the importance of systemic autopsy at sudden death. On macroscopic examination, crescent-shaped, thick, fibrous membranes, located 5 mm and 3 mm away from the aortic valves, were detected. Fibrous membranes extended from the ventricular septum to the left ventricular outflow tract, thus apparently narrowing this region. Left ventricular wall and septum were slightly thickened, and there were scattered grayish-white areas of a small diameter. These became more intense in the septum and myocardium of the left ventricle on the anterior plane of the myocardial sections. In both cases, the aortic valves of were thickened and also markedly narrowed on one of them. In this case, the fibrous membrane adhered to the aortic valve and extended to the anterior leaflet of the mitral valve at one side. Both aortic valves comprised 3 leaflets. Other valves and coronary arteries showed no macroscopic pathologic findings. Microscopic examination of both cases demonstrated that the fibrous membrane comprising abundant collagen fibers was situated on the ventricular septum. Hypertrophy, moderate to severe interstitial fibrosis, and focal areas of scarring were observed in the specimens taken from the septal and ventricular myocardium. No abnormality was found on the conduction system examinations. Toxicologic analysis results in blood were negative. Based on the findings, membranous-type (discrete type) subvalvular aortic stenosis, diagnosed during the autopsy, was considered as the cause of sudden death in both cases.

  14. Sports and Marfan Syndrome: Awareness and Early Diagnosis Can Prevent Sudden Death.

    Science.gov (United States)

    Salim, Mubadda A.; Alpert, Bruce S.

    2001-01-01

    Physicians who work with athletes play an important role in preventing sudden death related to physical activity in people who have Marfan syndrome. Flagging those who have the physical stigmata and listening for certain cardiac auscultation sounds are early diagnostic keys that can help prevent deaths. People with Marfan syndrome should be…

  15. Validation of a computer case definition for sudden cardiac death in opioid users

    Directory of Open Access Journals (Sweden)

    Kawai Vivian K

    2012-08-01

    Full Text Available Abstract Background To facilitate the use of automated databases for studies of sudden cardiac death, we previously developed a computerized case definition that had a positive predictive value between 86% and 88%. However, the definition has not been specifically validated for prescription opioid users, for whom out-of-hospital overdose deaths may be difficult to distinguish from sudden cardiac death. Findings We assembled a cohort of persons 30-74 years of age prescribed propoxyphene or hydrocodone who had no life-threatening non-cardiovascular illness, diagnosed drug abuse, residence in a nursing home in the past year, or hospital stay within the past 30 days. Medical records were sought for a sample of 140 cohort deaths within 30 days of a prescription fill meeting the computer case definition. Of the 140 sampled deaths, 81 were adjudicated; 73 (90% were sudden cardiac deaths. Two deaths had possible opioid overdose; after removing these two the positive predictive value was 88%. Conclusions These findings are consistent with our previous validation studies and suggest the computer case definition of sudden cardiac death is a useful tool for pharmacoepidemiologic studies of opioid analgesics.

  16. Chlamydia and sudden infant death syndrome. A study of 166 SIDS and 30 control cases

    DEFF Research Database (Denmark)

    Banner, Jytte; Lundemose, A G; Gregersen, M;

    1990-01-01

    Chlamydia inclusions could be demonstrated by an immunofluorescence assay in formalin-fixed lung sections in 32 of 166 cases (19.4%) of Sudden Infant Death Syndrome (SIDS) and in the lungs of only 1 of 30 infants with a known cause of death (3.3%). The difference is statistically significant (P =...

  17. A comparison of genetic findings in sudden cardiac death victims and cardiac patients

    DEFF Research Database (Denmark)

    Hertz, Christin L; Ferrero-Miliani, Laura; Frank-Hansen, Rune;

    2015-01-01

    systematically identified and reviewed. The frequencies of disease-causing mutation were on average between 16 and 48% in the cardiac patient studies, compared with ∼10% in the post-mortem studies. The frequency of pathogenic mutations in heart genes in cardiac patients is up to four-fold higher than that in SCD......Sudden cardiac death (SCD) is responsible for a large proportion of non-traumatic, sudden and unexpected deaths in young individuals. Sudden cardiac death is a known manifestation of several inherited cardiac diseases. In post-mortem examinations, about two-thirds of the SCD cases show structural...... previously characterized as unexplained. Additionally, a genetic diagnose in a SCD victim with a structural disease may not only add to the differential diagnosis, but also be of importance for pre-symptomatic family screening. In the case of SCD, the optimal establishment of the cause of death...

  18. The factors contributing to the risk of sudden infant death syndrome.

    Science.gov (United States)

    Athanasakis, E; Karavasiliadou, S; Styliadis, I

    2011-04-01

    Sudden infant death syndrome (SIDS) is defined as the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history. SIDS is one of the leading causes of infant mortality and occurs from the first month, until the first year of life for newborns and infants.The aim of this review was to identify and examine risk factors responsible for causing the sudden infant death and to propose certain measures in order to protect newborns and infants from sudden death. The potential factors that contribute to the occurrence of SIDS include inadequate prenatal care, low birth weight (sleep environment such as the prone or side sleeping position and thick coverlet increase the risk of sudden death in infants. Also, the combination of risk factors such as that of prone sleeping position and soft bed mattress are linked to a 20-fold increased risk of death. Finally, polymorphisms in the serotonin transporter gene (5-HTT), viral respiratory infections, long Q-T (responsible for the presence of fatal arrhythmia) are related to the SIDS.Literature review indicates that each individual risk factor contributes to the appearance of SIDS and the establishment of certain protective measures for parents and health professionals has reduced its prevalence. But the precise identification of the SIDS causes and how these contribute to the occurrence of sudden death in neonates and infants, remains a challenge for health professionals. PMID:22110293

  19. Physical exertion as a trigger of myocardial infarction and sudden cardiac death.

    Science.gov (United States)

    Mittleman, M A; Siscovick, D S

    1996-05-01

    The data reviewed in this article indicate that physical exertion can trigger the onset of nonfatal myocardial infarction and sudden cardiac death. In addition, it is clear that although the relative risk associated with heavy exertion may be high, the absolute risk is actually quite small. It also is clear that regular exercise reduces the risk of triggering of myocardial infarction and sudden cardiac death by isolated bouts of exertion. Thus, these data provide further support for encouragement of regular exercise, as recommended by the American Heart Association. Such a program is likely to lower the overall risk of myocardial infarction and sudden cardiac death because it may lower the baseline risk and also decrease the relative risk that an episode of exertion will trigger a myocardial infarction or sudden cardiac death. Specific recommendations for patients with a history of myocardial infarction or angina are complex. Patients with coronary artery disease have the same relative risk of myocardial infarction and sudden cardiac death as those with no such history. Because of their elevated and variable baseline risk, however, specific recommendations regarding the risks and benefits of heavy physical exertion must be provided by their individual physicians, acting on recommended guidelines for exercise in such patients.

  20. Risk factor of sudden death in dilated cardiomyopathy patients: A retrospective follow-up study

    Institute of Scientific and Technical Information of China (English)

    LIU Ping; MA Ai-qun; LIU Yu; ZHANG Yan-hui

    2005-01-01

    Objective: To discuss the related risk factors of sudden death in dilated cardiomyopathy(DCM)patients. Methods: A retrospective survey of DCM patients was conducted, ail patients were chosen at random from Xi'an city and 8 adjacent counties. One hundred and fifty patients were reinvestigated after 3. 1 ± 1.5 years. Binary multivariate logistic regression analyses and one way analysis of variance(ANOVA) were used to identify risk factors of the sudden death in DCM patients. Results: Risk factors of sudden death in 150 DCM patients were frequently ventricular premature beats (OR=11. 617), paroxysmalventricular tachycardia (OR=6.305), hypertension (OR= 5.689), EF (OR=0.977). The serum sodium concentration (P= 0. 023) and left ventricular diastolic dimension (LVDD)(P= 0. 039) were significant difference between the sudden death group and the survival group in one way ANOVA, LVDD was not a risk factor in multivariate analysis controlling for possible confounding. Conclusion: The present study identified some risk factors of sudden death in DCM patients, including frequently ventricular premature beats, paroxysmal ventricular tachycardia, hypertension and low EF value.

  1. Rare Titin (TTN Variants in Diseases Associated with Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Oscar Campuzano

    2015-10-01

    Full Text Available A leading cause of death in western countries is sudden cardiac death, and can be associated with genetic disease. Next-generation sequencing has allowed thorough analysis of genes associated with this entity, including, most recently, titin. We aimed to identify potentially pathogenic genetic variants in titin. A total of 1126 samples were analyzed using a custom sequencing panel including major genes related to sudden cardiac death. Our cohort was divided into three groups: 432 cases from patients with cardiomyopathies, 130 cases from patients with channelopathies, and 564 post-mortem samples from individuals showing anatomical healthy hearts and non-conclusive causes of death after comprehensive autopsy. None of the patients included had definite pathogenic variants in the genes analyzed by our custom cardio-panel. Retrospective analysis comparing the in-house database and available public databases also was performed. We identified 554 rare variants in titin, 282 of which were novel. Seven were previously reported as pathogenic. Of these 554 variants, 493 were missense variants, 233 of which were novel. Of all variants identified, 399 were unique and 155 were identified at least twice. No definite pathogenic variants were identified in any of genes analyzed. We identified rare, mostly novel, titin variants that seem to play a potentially pathogenic role in sudden cardiac death. Additional studies should be performed to clarify the role of these variants in sudden cardiac death.

  2. Stratification of the Risk of Sudden Death in Nonischemic Heart Failure

    Directory of Open Access Journals (Sweden)

    Maurício Pimentel

    2014-10-01

    Full Text Available Despite significant therapeutic advancements, heart failure remains a highly prevalent clinical condition associated with significant morbidity and mortality. In 30%-40% patients, the etiology of heart failure is nonischemic. The implantable cardioverter-defibrillator (ICD is capable of preventing sudden death and decreasing total mortality in patients with nonischemic heart failure. However, a significant number of patients receiving ICD do not receive any kind of therapy during follow-up. Moreover, considering the situation in Brazil and several other countries, ICD cannot be implanted in all patients with nonischemic heart failure. Therefore, there is an urgent need to identify patients at an increased risk of sudden death because these would benefit more than patients at a lower risk, despite the presence of heart failure in both risk groups. In this study, the authors review the primary available methods for the stratification of the risk of sudden death in patients with nonischemic heart failure.

  3. Heart diseases play a vital role in sudden unexpected death in epilepsy

    Directory of Open Access Journals (Sweden)

    Ze-ning SHI

    2014-12-01

    Full Text Available Sudden unexpected death in epilepsy (SUDEP indicates sudden death without a definite cause in epileptics, especially during seizures or interictal phase. The risk of sudden death in epileptic patients is over 20 times higher than that in individuals without epilepsy. The explicit pathogenesis of SUDEP is not clear, while the heart disease is likely to play an important role in SUDEP. Cardiac dysfunction, which is caused by ion channel diseases, autonomic dysfunction, antiepileptic drugs (AEDs, is associated with SUDEP. Understanding of the mechanisms about cardiac factors is required to provide effective strategy for future control of SUDEP. doi: 10.3969/j.issn.1672-6731.2014.11.006

  4. Sudden infant death syndrome, childhood thrombosis, and presence of genetic risk factors for thrombosis

    DEFF Research Database (Denmark)

    Larsen, TB; Nørgaard-Pedersen, B; Lundemose, JB;

    2000-01-01

    . The vulnerability of the infant brain stem to ischemia has been suggested to be a conceivable cause of sudden infant death syndrome. This is compatible with a hypothesis that genetic risk factors for cerebral thrombosis could cause microinfarction in the brain stem during the first month of life, affecting vital...... centers or their blood supply. The presence of three common point mutations seen in families with thrombophilia (1691G-->A in the coagulation factor V gene, 677C-->T in the methylenetetrahydrofolate reductase gene, and the 20210G-->A mutation in the prothrombin gene) could increase the risk for thrombosis...... in the child. This prompted us to investigate these genetic markers of thromboembolic disease in 121 cases of sudden infant death syndrome and in relevant controls, in the expectation of a more frequent occurrence of these markers if thrombosis is an etiological factor in sudden infant death syndrome...

  5. Screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Lewalter, Thorsten; Bongiorni, Maria Grazia;

    2013-01-01

    The purpose of this EHRA survey was to examine the current clinical practice of screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy with a focus on selection of candidates for implantable cardioverter-defibrillator (ICD) therapy, timing of ICD...... implantation, and use of non-invasive and invasive diagnostic tests across Europe. A systematic screening programme for sudden cardiac death existed in 19 out of 31 centres (61.3%). Implantation of ICDs according to the inclusion criteria of MADIT-II and SCD-HeFT trials was reported in 30 and 29% of centres......, respectively, followed by MADIT-CRT (18%), COMPANION (16%), and combined MADIT and MUSTT (7%) indications. In patients with severe renal impairment, ICD implantation for primary prevention of sudden death was always avoided in 8 centres (33.3%), was not used only if creatinine level was >2.5 mg/dL in 10...

  6. Sudden death due to an unrecognized cardiac hydatid cyst: three medicolegal autopsy cases.

    Science.gov (United States)

    Pakis, Isil; Akyildiz, Elif Ulker; Karayel, Ferah; Turan, Arzu Akcay; Senel, Berna; Ozbay, Mehmet; Cetin, Gursel

    2006-03-01

    Echinococcosis is a human infection caused by the larval stage of Echinococcocus granulosus. The most common sites of infection are the liver and the lungs. Cardiac hydatid cysts are very rare, even in regions where hydatic cysts are endemic (the Mediterranean, South America, Africa, and Australia). It has been reported that cardiac involvement is seen in about 0.5-3% of human echinococcosis cases. Three cases of cardiac hydatid disease that caused sudden death and which were histopathologically diagnosed are reported. Cardiac echinococcosis is rare, but due to its insidious presentation and affinity to cause sudden death, it is important that it be identified in the histopathological examination.

  7. Physical and chemical injury as causes of sudden cardiac death: the forensic forum.

    Science.gov (United States)

    Riddick, L

    1994-01-01

    Physical and chemical injuries account for the largest number of sudden, unexpected cardiac deaths in persons between the ages of 1 and 44 years. Blunt-force injuries, lacerations, avulsions, and contusions of the heart and great vessels sustained during motor vehicle crashes constitute the most prevalent type of lethal physical trauma to the cardiovascular system. The second most prevalent type of trauma is from penetrating and perforating wounds inflicted by firearms. The mechanisms of these injuries are discussed, with emphasis placed on those factors contributing to lethality. The three most prevalent chemicals associated with sudden cardiac death-ethyl alcohol, cocaine, and tricylic antidepressants-are briefly mentioned.

  8. Factors related to the adjustment of siblings following sudden infant death

    OpenAIRE

    Coughlan, Barbara; Carr, Alan; Fitzgerald, Michael

    2001-01-01

    Participants in this study were 119 siblings of children who had died from sudden infant death and their parents. This non-representative self-selected group, were profiled as 11 year old boys or girls from middle or uppermiddle class intact families whose siblings had died a sudden death about 7 years before the study. The average age of mothers who participated were in their late 30s and the average age of fathers were in the early 50s, with a third of families being rural...

  9. Anti-HERG activity and the risk of drug-induced arrhythmias and sudden death

    DEFF Research Database (Denmark)

    De Bruin, M L; Pettersson, M; Meyboom, R H B;

    2005-01-01

    AIMS: Drug-induced QTc-prolongation, resulting from inhibition of HERG potassium channels may lead to serious ventricular arrhythmias and sudden death. We studied the quantitative anti-HERG activity of pro-arrhythmic drugs as a risk factor for this outcome in day-to-day practice. METHODS AND RESU...... with the risk of reports of serious ventricular arrhythmias and sudden death in the WHO-UMC database. These findings are in support of the value of pre-clinical HERG testing to predict pro-arrhythmic effects of medicines....

  10. Environmental air pollution is an aggravating event for sudden unexpected death in epilepsy

    Directory of Open Access Journals (Sweden)

    Carla A. Scorza

    2013-10-01

    Full Text Available It is extremely difficult to estimate the occurrence of sudden unexpected death in epilepsy (SUDEP. On the other hand, discovering and carefully evaluating new risk factors that may contribute to the onset of cardiovascular abnormalities in people with refractory epilepsy may prevent fatal events in these individuals. In this context, we should not ignore that urban air pollution is a leading problem for environmental health and is able to cause serious cardiovascular dysfunctions that culminate in sudden death. In this regard, we aimed to determine whether environmental exposure to air pollution is an aggravating event for SUDEP.

  11. Infant dreaming and fetal memory: a possible explanation of sudden infant death syndrome.

    Science.gov (United States)

    Christos, G A

    1995-04-01

    During rapid-eye-movement sleep, when we dream, the brain is thought to be processing stored memory. The memory of a newborn infant is dominated by its fetal experience, and the infant is likely to dream about its life in the womb. Research with lucid (or conscious) dreaming has shown that dream images are supported by the corresponding body actions, using those muscles which remain active during rapid-eye-movement sleep. We suggest that sudden infant death syndrome or cot death may be a result of an infant dreaming about its life (or memory) as a fetus. In the course of that dream, since a fetus does not breathe (in the usual sense) the infant may cease to breathe and may die. This simple hypothesis is consistent with all of the known facts about sudden infant death syndrome (pathological and epidemiological), such as the age at death curve (the observed exponential decay and possibly the peak at 2-3 months), the higher risk with the prone sleeping position (but not excluding the supine position), and the observed climatic variation (seasonal and regional) in the incidence of sudden infant death syndrome. Many of these well-established facts have no other known explanation and other theories can generally only account for a few of the known facts about sudden infant death syndrome. Our hypothesis is also supported by recent findings that, as a group, sudden infant death syndrome infants have a higher proportion of rapid-eye-movement sleep, and also that they have an average higher heart rate (corresponding to possible fetal dreams) but only during rapid-eye-movement sleep.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Infant dreaming and fetal memory: a possible explanation of sudden infant death syndrome.

    Science.gov (United States)

    Christos, G A

    1995-04-01

    During rapid-eye-movement sleep, when we dream, the brain is thought to be processing stored memory. The memory of a newborn infant is dominated by its fetal experience, and the infant is likely to dream about its life in the womb. Research with lucid (or conscious) dreaming has shown that dream images are supported by the corresponding body actions, using those muscles which remain active during rapid-eye-movement sleep. We suggest that sudden infant death syndrome or cot death may be a result of an infant dreaming about its life (or memory) as a fetus. In the course of that dream, since a fetus does not breathe (in the usual sense) the infant may cease to breathe and may die. This simple hypothesis is consistent with all of the known facts about sudden infant death syndrome (pathological and epidemiological), such as the age at death curve (the observed exponential decay and possibly the peak at 2-3 months), the higher risk with the prone sleeping position (but not excluding the supine position), and the observed climatic variation (seasonal and regional) in the incidence of sudden infant death syndrome. Many of these well-established facts have no other known explanation and other theories can generally only account for a few of the known facts about sudden infant death syndrome. Our hypothesis is also supported by recent findings that, as a group, sudden infant death syndrome infants have a higher proportion of rapid-eye-movement sleep, and also that they have an average higher heart rate (corresponding to possible fetal dreams) but only during rapid-eye-movement sleep.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7666822

  13. Arrhythmia Management in the Elderly-Implanted Cardioverter Defibrillators and Prevention of Sudden Death.

    Science.gov (United States)

    Manian, Usha; Gula, Lorne J

    2016-09-01

    We present an overview of arrhythmia management in elderly patients as it pertains to implantable cardioverter defibrillator (ICD) therapy and prevention of sudden death. Treatment of arrhythmia in elderly patients is fraught with challenges pertaining to goals of care and patient frailty. With an ever increasing amount of technology available, realistic expectations of therapy need to balance quality and quantity of life. The ICD is an important treatment option for selected patients at risk of ventricular arrhythmia and sudden cardiac death. However, the incidence of sudden death as a percentage of all-cause mortality decreases with age. Studies have reported that 20% of elderly patients might die within 1 year of an episode of life-threatening ventricular arrhythmia, but most because of nonarrhythmic causes. This illustrates the 'sudden cardiac death paradox,' with a great proportion of death in elderly patients, even those at risk for ventricular arrhythmias, attributable to medical conditions that cannot be addressed by an ICD. We discuss current practices in ICD therapy in elderly patients, existing evidence from registries and clinical trials, approaches to risk stratification, and important ethical considerations. Although the decision on whether ICD insertion is appropriate in the elderly population remains an area of uncertainty from an evidence-based and ethical perspective, we offer insight on potential clinical and research strategies for this growing population. PMID:27568872

  14. Nationwide (Denmark) Study of Symptoms Preceding Sudden Death due to Arrhythmogenic Right Ventricular Cardiomyopathy

    DEFF Research Database (Denmark)

    Sadjadieh, Golnaz; Jabbari, Reza; Risgaard, Bjarke;

    2014-01-01

    In this study, we investigated medical history and symptoms before death in all subjects aged 1 to 35 years who died a sudden cardiac death (SCD) from arrhythmogenic right ventricular cardiomyopathy (ARVC) in Denmark in the years 2000 to 2006. All deaths (n=6,629) in subjects aged 1 to 35 years in...... Denmark in the period 2000 to 2006 were included. A total of 16 cases of SCD due to ARVC were identified based on histopathologic examination. Information on medical history was retrieved from The National Patient Registry, general practitioners, and hospitals. Symptoms before death were compared with 2...

  15. Sudden death due to a cystic lesion in the cerebellum.

    Science.gov (United States)

    Igari, Yui; Hosoya, Tadashi; Hayashizaki, Yoshie; Usui, Akihito; Kawasumi, Yusuke; Usui, Kiyotaka; Funayama, Masato

    2014-12-01

    A middle-aged female patient with a depressive disorder presented to a mental hospital because of a 2-month worsening history of headache, dizziness, and nausea. The next morning, she was observed to be sleeping, but was then found dead 1h later. Postmortem computed tomography and autopsy revealed a large cyst in the right cerebellar hemisphere, hydrocephalus, and transforaminal herniation. Careful observation revealed an approximately 0.4cm×0.8cm slightly grayish discoloration in the cyst wall that was diagnosed as hemangioblastoma based on its histological features. Finally, we concluded that the cause of death in this case was attributable to the brain stem compression, which was caused by obstructive hydrocephalus secondary to the cystic hemangioblastoma in the cerebellum. The symptoms for 2 months before her death had most likely resulted from increased intracranial pressure. Hemangioblastomas usually appear as nodules in the wall of the cyst, but the tumor in our case looked like just a slightly grayish discoloration. Therefore, cystic lesions in the CNS need to be carefully examined. PMID:25459277

  16. Relation of Taser (electrical stun gun) deployment to increase in in-custody sudden deaths.

    Science.gov (United States)

    Lee, Byron K; Vittinghoff, Eric; Whiteman, Dean; Park, Minna; Lau, Linda L; Tseng, Zian H

    2009-03-15

    Despite controversy concerning their safety, use of electrical stun guns (Tasers) by law enforcement agencies is increasing. We examined the effect of Taser deployment on rates of (1) in-custody sudden deaths in the absence of lethal force, (2) lethal force (firearm) deaths, and (3) officer injuries (OIs) requiring emergency room visits. Under the Public Records Act and the Freedom of Information Act, 126 police and sheriff departments from California cities were mailed surveys requesting rates of each of the outcomes of interest for each of the 5 years preceding Taser deployment through the 5 years after deployment. To control for population size and crime rates, we used total annual arrests per city as reported to the Department of Justice. Fifty cities provided predeployment and postdeployment data on in-custody sudden death, 21 cities reported firearm deaths, and 4 cities reported OIs. The rate of in-custody sudden death increased 6.4-fold (95% confidence interval 3.2-12.8, p = 0.006) and the rate of firearm death increased 2.3-fold (95% confidence interval 1.3-4.0, p = 0.003) in the in the first full year after Taser deployment compared with the average rate in the 5 years before deployment. In years 2 to 5 after deployment, rates of the 2 events decreased to predeployment levels. We observed no significant change in the rate of serious OIs after Taser deployment. In conclusion, although considered by some a safer alternative to firearms, Taser deployment was associated with a substantial increase in in-custody sudden deaths in the early deployment period, with no decrease in firearm deaths or serious OIs. PMID:19268749

  17. Sudden death due to a glial cyst of the pineal gland.

    OpenAIRE

    Milroy, C M; Smith, C.L.

    1996-01-01

    Asymptomatic cysts of the pineal gland are found frequently by radiological examination of the brain or at postmortem examination. Symptomatic cysts are rare, and may require surgical intervention. Sudden death due to a cystic lesion of the pineal gland is very rare. A case of a 22 year old man who collapsed and died unexpectedly is reported. Postmortem examination revealed a glial cyst of the pineal gland and evidence of chronic obstructive hydrocephalus. Deaths from colloid cysts and pineal...

  18. Re-emerging issue of sudden death syndrome in stone fruit orchards

    NARCIS (Netherlands)

    Wenneker, M.; Janse, J.D.; Bruine, de J.A.

    2012-01-01

    In the Netherlands, bacterial canker in plum trees (Prunus domestica) is a serious and recent problem in plum production. It is caused by Pseudomonas syringae pathovars syringae and morsprunorum. The trunks of the affected plum trees are girdled by bacterial cankers resulting in sudden death of infe

  19. Risk stratification for sudden cardiac death : current status and challenges for the future

    NARCIS (Netherlands)

    Wellens, Hein J. J.; Schwartz, Peter J.; Lindemans, Fred W.; Buxton, Alfred E.; Goldberger, Jeffrey J.; Hohnloser, Stefan H.; Huikuri, Heikki V.; Kaeaeb, Stefan; La Rovere, Maria Teresa; Malik, Marek; Myerburg, Robert J.; Simoons, Maarten L.; Swedberg, Karl; Tijssen, Jan; Voors, Adriaan A.; Wilde, Arthur A.

    2014-01-01

    Sudden cardiac death (SCD) remains a daunting problem. It is a major public health issue for several reasons: from its prevalence (20% of total mortality in the industrialized world) to the devastating psycho-social impact on society and on the families of victims often still in their prime, and it

  20. Athletic Training Educators' Pedagogical Strategies for Preparing Students to Address Sudden Death in Sport

    Science.gov (United States)

    Mazerolle, Stephanie M.; Pagnotta, Kelly D.; Salvatore, Anthony C.; Casa, Douglas J.

    2013-01-01

    Context: Educational training programs both impart knowledge and allow students to practice skills to gain clinical competence. Objective: Understand the educational training provided to athletic training students regarding sudden death in sport beyond exertional heat stroke. Design: An exploratory, qualitative study using telephone interviews and…

  1. Non-potassium sparing diuretics and sudden cardiac death in hypertensive patients : a pharmacoepidemiologic approach

    NARCIS (Netherlands)

    A.W. Hoes (Arno)

    1992-01-01

    textabstractThe studies described in this thesis focus on the possible relationship between the use of non-potassium sparing diuretics and the occurrence of sudden cardiac death in hypertensive patients. To study this potential adverse drug reaction several methods were applied, including estimates

  2. Risk Factors of Sudden Infant Death Syndrome and Risk Factors for Sleep Disturbances

    Science.gov (United States)

    Kelmanson, Igor A.

    2011-01-01

    Relationship between major risk factors of sudden infant death syndrome (SIDS) and sleep disorders in the infants is the subject of review and discussion. Improper micro-environmental characteristics (especially poor environmental organisation and lack of developmental stimulation), pre-term delivery and/or infant low birth weight, prone sleep…

  3. Spatial and temporal analysis of populations of the Sudden Oak Death pathogen in Oregon forests

    Science.gov (United States)

    Sudden oak death caused by the oomycete Phytophthora ramorum was first discovered in California towards the end of the 20th century and subsequently emerged on tanoak forests in Oregon before its first detection in 2001 by aerial surveys. The Oregon Department of Forestry has since monitored the epi...

  4. Sudden death in young persons with uncontrolled asthma--a nationwide cohort study in Denmark

    DEFF Research Database (Denmark)

    Gullach, Anders Juul; Risgaard, Bjarke; Lynge, Thomas Hadberg;

    2015-01-01

    BACKGROUND: Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled ast...

  5. Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy : Systematic review of clinical risk markers

    NARCIS (Netherlands)

    Christiaans, Imke; Van Engelen, Klaartje; Van Langen, Irene M.; Birnie, Erwin; Bonsel, Gouke J.; Elliott, Perry M.; Wilde, Arthur A.M.

    2010-01-01

    We performed a systematic literature review of recommended 'major' and 'possible' clinical risk markers for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). We searched the Medline, Embase and Cochrane databases for articles published between 1971 and 2007. We included English langua

  6. Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy: systematic review of clinical risk markers

    NARCIS (Netherlands)

    I. Christiaans; K. van Engelen; I.M. van Langen; E. Birnie; G.J. Bonsel; P.M. Elliott; A.A.M. Wilde

    2010-01-01

    We performed a systematic literature review of recommended 'major' and 'possible' clinical risk markers for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). We searched the Medline, Embase and Cochrane databases for articles published between 1971 and 2007. We included English langua

  7. SUDDEN CARDIAC DEATH AND THE USE OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS IN PEDIATRIC-PATIENTS

    NARCIS (Netherlands)

    SILKA, MJ; KRON, J; DUNNIGAN, A; DICK, M; BINKBOELKENS, M; ERICKSON, CC; JEDEIKIN, R; WETZEL, GT; VANHARE, GF; CAMPBELL, R; WALSH, E; SAUL, JP; SCHAFFER, MS; KARPAWICH, P; VOGEL, RL; BENSON, DW; DEAL, B; SCAGLIOTTI, D; STERBA, R; HORDOF, AJ; KRONGRAD, E; KANTER, RJ; EPSTEIN, M; COHEN, M; BEDER, S; HAMILTON, R; FOURNIER, A; HUBBARD, J; CHRISTIANSEN, JL; JENNINGS, J; VILLAFANE, J; PORTER, CBJ; CASE, C; GILLETTE, PC; BELAND, M; KUGLER, JD; OCONNOR, BK; ALLENDER, H; HERNDON, SP; SMITH, RT; BURTON, D; KURER, CC; BYRUM, C; GUAM, WE; FRIEDMAN, R; PERRY, JC; SCOTT, W; MEHTA, AV; PICKHOFF, AS; FISH, F; YEAGER, S; KAWABORI, [No Value; TRIPPLE, M; ROSENFELD, LE

    1993-01-01

    Background. During the past decade. the implantable cardioverter-defibrillator (ICD) has emerged as the primary therapeutic option for survivors of sudden cardiac death (SCD). Investigation of the clinical efficacy of these devices has primarily assessed outcome in adults with coronary artery diseas

  8. Contribution of inherited heart disease to sudden cardiac death in childhood

    NARCIS (Netherlands)

    Hofman, Nynke; Tan, Hanno L.; Clur, Sally-Ann; Alders, Mariel; Van Langen, Irene M.; Wilde, Arthur A. M.

    2007-01-01

    BACKGROUND. In children aged 1 to 18 years, the causes of sudden cardiac death may remain unresolved when autopsy results are negative. Because inherited cardiac diseases are likely, cardiologic and genetic investigations of relatives may still yield the diagnosis in these cases. Moreover, these inv

  9. Monocyte chemotactic protein-1 expression in coronary atherosclerosis plaque of sudden coronary death patients

    Institute of Scientific and Technical Information of China (English)

    冯相平

    2006-01-01

    Objective To investigate the expression of monocyte chemotactic protein 1 (MCP-1) in coronary atherosclerosis plaque of sudden coronary death (SCD) patients and the relationship between MCP-1 expression and SCD. Methods Autopsy heart samples (n=90) collected during 2001 - 2003 were divided to SCD group (n=

  10. Risk stratification for sudden cardiac death: Current status and challenges for the future

    NARCIS (Netherlands)

    H.J.J. Wellens (Hein); P.J. Schwartz (Peter); F.W. Lindemans (Fred); A.E. Buxton (Alice); J.J. Goldberger (Jeffrey); S.H. Hohnloser (Stefan); H.V. Huikuri (Heikki); S. Kääb (Stefan); M.T. La Rovere (Maria Teresa); M. Malik (M.); R.J. Myerburg (Robert); M.L. Simoons (Maarten); K. Swedberg (Karl); J.G.P. Tijssen (Jan); A.A. Voors (Adriaan); A.A.M. Wilde (Arthur)

    2014-01-01

    textabstractSudden cardiac death (SCD) remains a daunting problem. It is a major public health issue for several reasons: from its prevalence (20% of total mortality in the industrialized world) to the devastating psycho-social impact on society and on the families of victims often still in their pr

  11. Non-cardiac QTc-prolonging drugs and the risk of sudden cardiac death

    NARCIS (Netherlands)

    Straus, SMJM; Sturkenboom, MCJM; Bleumink, GS; van der Lei, J; de Graeff, PA; Kingma, JH; Stricker, BHC

    2005-01-01

    Aims To assess the association between the use of non-cardiac QTc-prolonging drugs and the risk of sudden cardiac death. Methods and results A population-based case-control study was performed in the Integrated Primary Care Information (IPCI) project, a longitudinal observational database with compl

  12. Subtle killers and sudden death: Genetic variants modulating ventricular fibrillation in the setting of myocardial infarction

    NARCIS (Netherlands)

    R. Pazoki

    2015-01-01

    Sudden cardiac death (SCD) is a catastrophic cardiovascular event most commonly occurring as a consequence of ventricular fibrillation (VF) in adults suffering from acute myocardial infarction (MI) or its late consequences. Several studies have demonstrated the role of family history of SCD in the d

  13. Does electrophysiological testing have any role in risk stratification for sudden cardiac death?

    Institute of Scientific and Technical Information of China (English)

    Fei Lü; Wei Hua

    2010-01-01

    @@ Introduction Implantation of implantable cardioverter defibrillators (ICD) has widely been accepted for secondary prevention of sudden cardiac death (SCD) in cardiac arrest survivors.1 Currently there are increasing interests in primary prevention of SCD in selected high risk patients who have not experienced cardiac arrest.1

  14. Mechanisms of sudden unexpected death in epilepsy: the pathway to prevention.

    Science.gov (United States)

    Massey, Cory A; Sowers, Levi P; Dlouhy, Brian J; Richerson, George B

    2014-05-01

    Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in patients with refractory epilepsy, with an estimated 35% lifetime risk in this patient population. There is a surprising lack of awareness among patients and physicians of this increased risk of sudden death: in a recent survey, only 33% of Canadian paediatricians who treated patients with epilepsy knew the term SUDEP. Controversy prevails over whether cardiac arrhythmia or respiratory arrest is more important as the primary cause of death. Effective preventive strategies in high-risk patients will rely on definition of the mechanisms that lead from seizures to death. Here, we summarize evidence for the mechanisms that cause cardiac, respiratory and arousal abnormalities during the ictal and postictal period. We highlight potential cellular mechanisms underlying these abnormalities, such as a defect in the serotonergic system, ictal adenosine release, and changes in autonomic output. We discuss genetic mutations that cause Dravet and long QT syndromes, both of which are linked with increased risk of sudden death. We then highlight possible preventive interventions that are likely to decrease SUDEP incidence, including respiratory monitoring in epilepsy monitoring units and overnight supervision. Finally, we discuss treatments, such as selective serotonin reuptake inhibitors, that might be personalized to a specific genetic or pathological defect.

  15. Sudden unexpected death due to severe pulmonary and cardiac sarcoidosis.

    Science.gov (United States)

    Ginelliová, Alžbeta; Farkaš, Daniel; Farkašová Iannaccone, Silvia; Vyhnálková, Vlasta

    2016-09-01

    In this paper we report the autopsy findings of a 57 year old woman who died unexpectedly at home. She had been complaining of shortness of breath, episodes of dry coughing, and nausea. Her past medical and social history was unremarkable. She had no previous history of any viral or bacterial disease and no history of oncological disorders. Autopsy revealed multiple grayish-white nodular lesions in the pleura and epicardial fat and areas resembling fibrosis on the cut surface of the anterior and posterior wall of the left ventricle and interventricular septum. Histological examination of the lungs and heart revealed multiple well-formed noncaseating epithelioid cell granulomas with multinucleated giant cells. Death was attributed to myocardial ischemia due to vasculitis of intramural coronary artery branches associated with sarcoidosis. Sarcoidosis is a multisystemic disease of unknown etiology characterized by the formation of noncaseating epithelioid cell granulomas in the affected organs and tissues. The diagnosis of sarcoidosis in this case was established when other causes of granulomatous disease such as tuberculosis, berylliosis, hypersensitivity pneumonitis, and giant cell myocarditis had been reasonably excluded. PMID:27379608

  16. Fatty acid oxidation disorders as primary cause of sudden and unexpected death in infants and young children

    DEFF Research Database (Denmark)

    Banner, Jytte; Kølvraa, S; Gregersen, N;

    1997-01-01

    Disorders of fatty acid metabolism are known to be responsible for cases of sudden and unexpected death in infancy. At least 14 disorders are known at present. 120 cases of sudden infant death syndrome (SIDS) had been examined for a prevalent mutation (G985) causing medium chain acyl Co...

  17. Pattern of sudden death at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South West Nigeria

    Directory of Open Access Journals (Sweden)

    Akinwusi PO

    2013-06-01

    Full Text Available Patience Olayinka Akinwusi,1,2 Akinwumi Oluwole Komolafe,3 Olanrewaju Olayinka Olayemi,2 Adeleye Abiodun Adeomi41Department of Medicine, College of Health Sciences, Osun State University, 2Department of Medicine, LAUTECH Teaching Hospital, Osogbo, 3Department of Morbid Anatomy, Obafemi Awolowo University Teaching, Hospitals Complex, Ile-Ife, Osun State, 4Department of Community Medicine, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, NigeriaBackground: The purpose of this study was to determine the etiology and epidemiologic characteristics of sudden death at Ladoke Akintola University of Technology (LAUTECH Teaching Hospital, South West Nigeria.Methods: This was a retrospective descriptive study of all cases of natural unexpected death, either occurring out of hospital or less than 24 hours after admission to LAUTECH Teaching Hospital, over a nine-year period from January 2003 to December 2011. Data were generated from information in the case notes and autopsy reports for these cases.Results: Sudden death accounted for 29 (4.0% of 718 adult medical deaths and 1.0% of all adult medical admissions. Out-of-hospital deaths occurred in 72.4% of cases. The mean age of the patients was 46.8 ± 11.5 (range 25–74 years. The male to female ratio was 6.25:1. Cardiovascular disease were the most common cause of death (51.7%, followed by respiratory disease (20.7%, pulmonary thromboembolism (10.4%, central nervous system disease (13.8%, gastrointestinal disorders (13.8%, severe chemical/drug poisoning (13.8%, and combined cardiovascular and central nervous system disease (13.8%. Hypertension-related causes were responsible for 14/29 (48.3% of the sudden deaths. Hypertensive heart disease accounted for 86.7% of the cardiovascular deaths, hypertensive heart failure accounted for 73.3%, whilst all heart failure cases accounted for 80.0%. Left ventricular hypertrophy was present in 69.2% of the patients with hypertensive heart disease. Moderate to severe

  18. Congenital anomalies of coronary arteries: role in the pathogenesis of sudden cardiac death.

    Science.gov (United States)

    Cheitlin, Melvin D; MacGregor, John

    2009-06-01

    After hypertrophic cardiomyopathy, coronary artery anomalies of origin from the wrong sinus of Valsalva are the second most common cause of sudden death on the athletic field in the USA. Although the right coronary artery arising from the left coronary sinus (ARCA) is four times as common as the left coronary artery arising from the anterior sinus (ALCA), it is the latter that is by far the more common cause of sudden death with or shortly after vigorous physical activity. Of the four types of ALCA, the interarterial type, where the left coronary artery passes anteriorly between the aorta and the right ventricular outflow tract, is the only type that places the patient at risk of sudden death. Another feature of this syndrome is the fact that sudden death occurs associated with or shortly after vigorous exercise and is very unusual after the patient is > 35 years of age. The mechanism by which there is sudden occlusion of the interarterial coronary artery is at present unknown, although there are a number of hypotheses involving the oblique passage of the vessel as it leaves the aorta. Sudden death is probably rare considering the number of people who have these anomalies. Symptoms premonitory to a fatal event such as exertional syncope, chest pain, or palpitations are probably common in patients at risk, and surgical correction is indicated in symptomatic patients at any age. In older asymptomatic patients, surgery is not recommended, since the incidence of sudden death in this age group is extremely small. In asymptomatic young patients, a stress test, preferably with radioisotope myocardial perfusion imaging or stress echocardiogram, should be done and surgical correction performed in those with ischemia provoked in the appropriate myocardial region. Since there is evidence that in patients who have survived a potentially fatal event, it is rare to be able to provoke ischemia with equal or greater exercise than had precipitated the malignant arrhythmia, the

  19. Leaky RyR2 channels unleash a brainstem spreading depolarization mechanism of sudden cardiac death.

    Science.gov (United States)

    Aiba, Isamu; Wehrens, Xander H T; Noebels, Jeffrey L

    2016-08-16

    Cardiorespiratory failure is the most common cause of sudden unexplained death in epilepsy (SUDEP). Genetic autopsies have detected "leaky" gain-of-function mutations in the ryanodine receptor-2 (RyR2) gene in both SUDEP and sudden cardiac death cases linked to catecholaminergic polymorphic ventricular tachycardia that feature lethal cardiac arrhythmias without structural abnormality. Here we find that a human leaky RyR2 mutation, R176Q (RQ), alters neurotransmitter release probability in mice and significantly lowers the threshold for spreading depolarization (SD) in dorsal medulla, leading to cardiorespiratory collapse. Rare episodes of sinus bradycardia, spontaneous seizure, and sudden death were detected in RQ/+ mutant mice in vivo; however, when provoked, cortical seizures frequently led to apneas, brainstem SD, cardiorespiratory failure, and death. In vitro studies revealed that the RQ mutation selectively strengthened excitatory, but not inhibitory, synapses and facilitated SD in both the neocortex as well as brainstem dorsal medulla autonomic microcircuits. These data link defects in neuronal intracellular calcium homeostasis to the vulnerability of central autonomic brainstem pathways to hypoxic stress and implicate brainstem SD as a previously unrecognized site and mechanism contributing to premature death in individuals with leaky RYR2 mutations. PMID:27482086

  20. Idiopathic Infantile Arterial Calcification: A Rare Cause of Sudden Unexpected Death in Childhood

    Directory of Open Access Journals (Sweden)

    Susana Guimarães

    2010-01-01

    Full Text Available Unexpected child death investigation is a difficult area of forensic practice in view of the wide range of possible genetic, congenital, and acquired natural and nonnatural causes. Idiopathic infantile arterial calcification (IIAC is a rare autosomic recessive disease usually diagnosed postmortem. Inactivating mutations of the ENPP1 gene were described in 80% of the cases with IIAC. We report a case of a 5-year-old girl submitted to a forensic autopsy due to sudden death and possible medical negligence/parents child abuse. Major alterations found (intimal proliferation and deposition of calcium hydroxyapatite around the internal elastic lamina and media of arteries; acute myocardial infarct, stenotic and calcified coronary artery; perivascular and interstitial myocardial fibrosis; and subendocardial fibroelastosis were diagnostic of IIAC. We reviewed IIAC cases published in the English literature and highlight the importance of adequate autopsy evaluation in cases of sudden child death.

  1. Sudden Death in Sauna Due to Fatal Burns: A Case Report.

    Science.gov (United States)

    Lindroos, Katarina; Keltanen, Terhi

    2016-03-01

    Sudden death during or after sauna bathing is a rare event. When occurring accidentally, it is often caused or contributed by consumption of ethanol. To accidentally burn to death because of hot air is highly uncommon without some contributing factor that lowers the person's consciousness. Hot air burns have been reported to develop in 20 to 60 minutes. We present a case of sudden death of a healthy man with rare and extensive hot air burns that developed in less than 10 minutes in the sauna. Ethanol was not a contributing factor. Substantial injuries were found at the autopsy, both external and internal, for instance, small hemorrhages in the stomach mucosa, indicating a heavy antemortem stress reaction. The most probable reason for the extensive scalds was concluded to be, apart from the high temperature, the high degree of relative humidity in the sauna.

  2. Sudden unexpected nocturnal death in Chiari type 1 malformation and potential role of opioid analgesics

    Directory of Open Access Journals (Sweden)

    Fereydoon Roohi

    2014-01-01

    Full Text Available Background: Chiari malformation type 1 (CM1 is a common congenital anomaly of the craniocervical junction. CM1 is reported to run a usually benign course and patients typically experience no symptoms or chronic, slowly progressive symptoms. However, recent reports indicate that a subset of patients with CM1 may present with acute deterioration and sudden unexpected death (SUD. We report a case of SUD during sleep in a young man with CM1, which we believe was related to the administration of common and therapeutic doses of narcotic analgesics for the management of pain. We will clarify the pathophysiology of acute deterioration and SUD in CM1 and the possibility that the adverse effects of opiate analgesics likely were the leading cause of death in our patient. Case Description: In this review, we present a 29-year-old male with worsening headache secondary to previously diagnosed CM1. The patient died suddenly and unexpectedly after administration of common and therapeutic doses of narcotic analgesics for the management of pain. Conclusion: The mechanism(s of acute neurological deterioration and sudden death in patients with CM1 remains poorly understood. We believe the rapid fatal deterioration in our patient following administration of opioids suggests that this category of medication may cause sudden unexpected "neurogenic" cardiac death in CM1 patients by inducing sleep-related breathing difficulties and associated hypercapnia. Hypercapnia by further increasing intracranial pressure can result in a sudden pressure-induced decompensation of the cardiopulmonary control centers in the brain stem and cause instantaneous cardiorespiratory arrest.

  3. Sudden death related to advanced coronary atherosclerosis in mini-pigs

    International Nuclear Information System (INIS)

    Advanced coronary atherosclerosis was produced in 30 mini-pigs by a combination of a hypercholesterolaemic diet and X-irradiation to the precordial region. Within 11-25 weeks after the irradiation, 13 of the 30 animals died a sudden death probably caused by coronary atherosclerosis. The contents of free and ester-bound cholesterol in the right coronary artery were significantly higher in the animals which died spontaneously than in surviving animals. In an untreated group of 12 animals 7 died whereas in a group treated with β-pyridylcarbinol only 1 out of 5 died. In the coronary arteries, the contents of both free and ester-bound cholesterol were significantly lower in the β-pyridylcarbinol-treated animals. In a sulfinpyrazontreated group 3 out of 8, and in a metoprolol-treated group 2 out of 5 animals died. None of these drugs reduced the accumulation of cholesterol in the coronary arteries. The rate of sudden death was 26 +- 6% (P<0.05) lower in the combined group of treated animals than in the untreated ones. By regular ECG recordings, signs which could predict the fatal outcome of the experiment were looked for. Although depressed ST segments were present before death in a few animals, this was not a regular phenomenon. It is concluded that advanced coronary atherosclerosis in mini-pigs often leads to sudden death and that this animal model seems suitable for testing the potential therapeutic effects of drugs. (author)

  4. Common underlying diseases do not contribute in determining the causes of sudden unexplained death

    Institute of Scientific and Technical Information of China (English)

    TIAN Zhao-xing; L(U) Yan-yu; Chetan Rai Nugessur; YAN Wei; ZHAO Wen-kui; KONG Li-li; ZHENG Ya-an

    2013-01-01

    Background Underlying diseases have a statistically significant positive correlation to sudden death.However,sudden unexplained death (SUD) is different from sudden death,as there is no clinical evidence to support the sudden death due to the original underlying disease,nor a lethal pathological basis to be found during autopsy.In addition,SUD are more common in young,previously healthy individuals,usually without any signs of disease,with no positive lesions found after autopsy.Therefore,a causal relationship between SUD and the underlying disease needs to be further explored.This study aimed to explore the role that common underlying diseases play in patients with SUD and to reveal the correlation between them.Methods The medical records,history and case information of 208 patients with SUD were collected for the survey.All these SUD occurred in the emergency room of Peking University Third Hospital from January 2006 to December 2009.The patients were stratified by with and without common underlying diseases.To examine possible associations between the underlying diseases and the cause of unexplained sudden death,the chi-squared and Fisher's exact tests were used.Results Among the 208 patients,65 were diagnosed with common underlying diseases while 143 were not.Within these two groups,there were 45 patients for whom the clear cause of death was determined.However,there were no statistically significant differences or strong associations (x2=1.238,P >0.05) between the 11 patients with (16.90%) and 34 without (23.78%) common underlying disease among these 45 patients.We also found that occurrence of the common underlying diseases,such as neurological system,cardiovascular and pulmonary system diseases,are not statistically significant (P >0.05) in the diagnosis of the SUD.Conclusion Common underlying diseases make no obvious contributions to SUD and are not useful in diagnosing the underlying reasons for death.

  5. Vpliv telesne dejavnosti na zdravje in nenadno smrt: The influence of physical exercise on health and on sudden death:

    OpenAIRE

    Marušič, Dorjan; Starc, Radovan; Starc, Saša

    2005-01-01

    Sudden death occurring during or immediately after sports activity in recreative sportsmen is rare. The authors deal with death that occurs suddenlyand unexpectedly during or immediately after sports activities in apparently healthy, asymptomatic and well-trained persons. The vast majority of sudden deaths are due do coronary artery disease in persons older than 30-35 years. The paper analyses beneficial effects of regular physical exercise on the cardiovascular system, and its role in reduce...

  6. Effect of excess noise on continuous variable entanglement sudden death and Gaussian quantum discord

    Institute of Scientific and Technical Information of China (English)

    Su Xiao-Long

    2013-01-01

    A symmetric two-mode Gaussian entangled state is used to investigate the effect of excess noise on entanglement sudden death and Gaussian quantum discord with continuous variables.The results show that the excess noise in the channel can lead to entanglement sudden death of a symmetric two-mode Gaussian entangled state,while Gaussian quantum discord never vanishes.As a practical application,the security of a quantum key distribution (QKD) scheme based on a symmetric two-mode Gaussian entangled state against collective Gaussian attacks is analyzed.The calculation results show that the secret key cannot be distilled when entanglement vanishes and only quantum discord exists in such a QKD scheme.

  7. [Assessment of risk of sudden cardiac death in patients with hypertrophic cardiomyopathy].

    Science.gov (United States)

    Attanasio, Philipp; Blaschke, Florian; Pieske, Burkert; Tschöpe, Carsten; Haverkamp, Wilhelm

    2016-07-01

    Hypertrophic cardiomyopathy (HCM) is a hereditary disease characterized by left ventricular hypertrophy with or without concomitant outflow tract obstruction. Identification of patients with HCM who are at high risk of sudden cardiac death (SCD) is crucial as those patients are likely to benefit from an implantable cardioverter defibrillator (ICD). Based on the HCM Risk-SCD study published in 2013, that included 3675 HCM patients with 24 313 years of follow up, a new clinical risk prediction model for sudden cardiac death was developed. This model was included in the recently released 2014 ESC guidelines. This review summarizes the changes in the prediction model and the resulting recommendations and discusses potential risks and limitations of the new score. PMID:27404936

  8. 47. A cardiac center experience with Brugada syndrome who survived sudden cardiac death

    Directory of Open Access Journals (Sweden)

    I. Suliman

    2016-07-01

    Full Text Available Brugada syndrome is a heritable arrhythmia syndrome that is characterized by an electrocardiographic pattern consisting of coved-type ST-segment elevation (2 mm followed by a negative T wave in the right precordial leads, V1 through V3 (often referred to as type 1 Brugada electrocardiographic pattern, here we describe 3 cases of Brugada who survived sudden cardiac death (SCD cardiac center experience with survived Brugada syndrome patients – case series. First Case: The Father 45 years old male, presented in 2005 after involvement in unprovoked motor vehicle accident, the patient was the driver who lost consciousness and rushed to the hospital. On arrival to our ER and putting the patient on the bed, the ER doctor observed a brief episode of VF on the monitor. The patient was taken to the catheterization Lab , his coronaries were normal. The diagnosis of Brugada was established and the patient received a defibrillator. At That Time all family members were screened and were negative. Second Case: The Son of the first patient 5 years later his 23 years old male rushed to our ER after he lost consciousness, he was passenger in the car of his friend. Third Case: The pilot A military pilot aged a male 35 years old was in very good health when he lost consciousness and brought to the hospital after resuscitation in 2005. He had full invasive cardiac evaluation, subsequently he received a defibrillator in the same admission period, till 2015 he is doing fine. Brugada syndrome is associated with high tendency for sudden cardiac death. In our three cases the first clinical presentation was survived sudden cardiac death (SCD and all three male patients survived. We did not encounter a female patient who survived sudden cardiac death.

  9. Evaluation of HIV protease inhibitor use and the risk of sudden death or nonhemorrhagic stroke

    DEFF Research Database (Denmark)

    Worm, S W; Kamara, D A; Reiss, P;

    2012-01-01

    Concerns have arisen about possible effects of protease inhibitors (PIs) on cardiac conductivity. We found no significant association between current or recent PI exposure and sudden death or nonhemorrhagic stroke (adjusted rate ratio, 1.22; 95% confidence interval, .95-1.57), whereas cumulative...... exposure to PIs was associated with an increased risk (adjusted rate ratio, 1.06 per year of exposure; 95% confidence interval, 1.01-1.11)....

  10. Abbreviated report of the NIH/NINDS workshop on sudden unexpected death in epilepsy

    OpenAIRE

    Hirsch, L J; Donner, E.J.; So, E. L.; M. Jacobs; Nashef, L.; Noebels, J.L.; Buchhalter, J.R.

    2011-01-01

    Sudden unexpected death in epilepsy (SUDEP) is a devastating complication of epilepsy and is not rare. The NIH and National Institute of Neurological Disorders and Stroke sponsored a 3-day multidisciplinary workshop to advance research into SUDEP and its prevention. Parallel sessions were held: one with a focus on the science of SUDEP, and the other with a focus on issues related to the education of health care practitioners and people with epilepsy. This report summarizes the discussions and...

  11. Rationale and design of the Pan-African Sudden Cardiac Death survey

    DEFF Research Database (Denmark)

    Bonny, Aimé; Ngantcha, Marcus; Amougou, Sylvie Ndongo;

    2014-01-01

    of districts of interest will be checked for past medical history, circumstances of death, and autopsy report (if possible). We will also analyse the employment of resuscitation attempts during the time frame of sudden cardiac arrest (SCA) in various patient populations throughout African countries. CONCLUSION......: This study will provide comprehensive, contemporary data on the epidemiology of SCD in Africa and will help in the development of strategies to prevent and manage cardiac arrest in this region of the world....

  12. Entanglement sudden death in qubit-qutrit systems under depolarizing noise

    CERN Document Server

    Khan, Salman

    2010-01-01

    I study the effects of decoherence on some qubit-qutrit systems under the influence of global, collective, local and multilocal depolarizing noise. I show that the entanglement sudden death (ESD) can be avoided under particular situations. The conjecture that ESD occurs in all bipartite states is questioned. I show that a critical point exists at which all the states are equally entangled. Furthermore, no ESD occurs when only the qubit is coupled to its local environment.

  13. Aborted Sudden Cardiac Death and a Mother with Suspected Metabolic Myopathy

    OpenAIRE

    Josef Finsterer; Claudia Stöllberger; Hans Keller

    2014-01-01

    Aborted sudden cardiac death (SCD) has not been reported as initial manifestation of cardiac involvement in metabolic myopathy (MM). A 20-year-old female with a previous history of three syncopes, hyperhidrosis, and recurrent tick bites experienced aborted SCD. Her mother presented with MM, and a history of pituitary adenoma, nephroptosis, arterial hypertension, depression, migraine, goiter, pancreatitis, osteoporosis, hyperhidrosis, multiple muscle ruptures, and hyperlipidemia. After a few d...

  14. Excited Delirium and Sudden Death: A Syndromal Disorder at the Extreme End of the Neuropsychiatric Continuum

    Science.gov (United States)

    Mash, Deborah C.

    2016-01-01

    Over the past decade, the excited delirium syndrome (ExDS) has raised continued controversy regarding the cause and manner of death of some highly agitated persons held in police custody, restrained or incapacitated by electrical devices. At autopsy, medical examiners have difficulty in identifying an anatomic cause of death, but frequently cite psychostimulant intoxication as a contributing factor. The characteristic symptoms of ExDS include bizarre and aggressive behavior, shouting, paranoia, panic, violence toward others, unexpected physical strength, and hyperthermia. Throughout the United States and Canada, these cases are most frequently associated with cocaine, methamphetamine, and designer cathinone abuse. Acute exhaustive mania and sudden death presents with behavioral symptoms that are identical to what is described for ExDS in psychostimulant abusers. Bell's mania or acute exhaustive mania was first described in the 1850's by American psychiatrist Luther Bell in institutionalized psychiatric patients. This rare disorder of violent mania, elevated body temperature and autonomic collapse continued to be described by others in the psychiatric literature, but with different names until the first cases of ExDS were seen at the beginning of the cocaine epidemic by medical examiners. The neurochemical pathology examination of brain tissues after death revealed a loss of dopamine transporter regulation together with increases in heat shock protein 70 (hsp70) expression as a biomarker of hyperthermia. The similarity in the behavioral symptoms between extremely agitated psychostimulant abusers and unmedicated psychiatric patients suggests that a genetic disorder that leads to dysregulated central dopamine transporter function could be a precipitating cause of the acute delirium and sudden death. While the precise cause and mechanism of lethality remains controversial, the likely whys and wherefores of sudden death of ExDS victims are seen to be

  15. 运动性猝死的再分析%Reanalysis of Sports Sudden Death

    Institute of Scientific and Technical Information of China (English)

    徐杏玲

    2014-01-01

    In this paper, through consulting a large number of literature , such as newspapers and periodicals for defining the definition , pathogenesis of sports sudden death , through expert interviews and statistics on the distribution of sports sudden death (total distribution, incidence of a disease, gender, age, project) are detailed analyzed in this paper .Discussion on the frontier problems of sports sudden death , and comprehensive prevention measures are put forward .%本文通过查阅大量的文献资料、报纸书刊等对运动性猝死的定义、发病机制进行界定,通过专家访谈、数据统计等对运动性猝死的各项分布(总体分布、发病率、性别、年龄、项目)进行具体阐述。讨论了运动性猝死的前沿性问题,从而全面提出了预防措施。

  16. Cause of Sudden Cardiac Deaths on Autopsy Findings; a Four-Year Report

    Directory of Open Access Journals (Sweden)

    Dinesh Rao

    2014-03-01

    Full Text Available Introduction: Incidence of sudden cardiac death (SCD has been steadily increasing all over the world. While knowing the cause of SCD is one of the favorites of the physicians involved with these cases, it is very difficult and challenging task for the forensic physician. The present report is a prospective study regarding cause of SCDs on autopsy examination in four-year period, Bangalore, India. Methods: The present prospective study is based on autopsy observations, carried out for four-year period from 2008 to 2011, and analyzed for cause of SCDs. The cases were chosen as per the definition of sudden death and autopsied. The material was divided into natural and unnatural groups. Finally, on histopathology, gross examination, hospital details, circumstantial, and police reports the cause of death was inferred. Results: A total of 2449 autopsy was conducted of which 204 cases were due to SCD. The highest SCDs were reported in 50-60 years age group (62.24%; n-127, followed closely by the age group 60-69 (28.43%; n-58. Male to female ratio was around 10:1. The maximum number of deaths (n=78 was within few hours (6 hours after the onset of signs and symptoms. In 24 (11.8% cases major narrowing was noted in both the main coronaries, in 87 (42.6% cases in the left anterior descending coronary artery (LAD, and in 18 (51.5% cases in the right coronary artery (RCA. The major cardiac pathology resulting in sudden death was coronary artery disease (n-116; 56.86% and myocardial infarction (n-104; 50.9%. most of the SCDs occurred in the place of residence (n-80; 39.2% followed closely by death in hospital (n-49; 24.01%. Conclusion: Coronary occlusion was the major contributory cause of sudden death with cardiac origin and the highest number of deaths were reported in the age 50-59 years with male to female ratio of 10:1. 

  17. Impact of age and sex on sudden cardiovascular death following myocardial infarction

    DEFF Research Database (Denmark)

    Abildstrom, S Z; Rask-Madsen, C; Ottesen, M M;

    2002-01-01

    OBJECTIVE: To evaluate and compare the risk of sudden cardiovascular death (SCD) and non-SCD after myocardial infarction (MI) associated with age and sex. DESIGN: Cohort study of patients admitted with an enzyme verified acute MI and discharged alive. Patients were followed up for up to four years....... PATIENTS: 5983 consecutive hospital survivors of acute MI were enrolled in the TRACE (trandolapril cardiac evaluation) registry from 1990-92. Four age groups were prespecified: or = 76 years. MAIN OUTCOME MEASURES: SCD was defined as cardiovascular death within one hour of onset...... years). Age significantly increased both SCD and non-SCD risk (p women...

  18. Update: Causes and symptoms of sudden cardiac death in young athletes.

    Science.gov (United States)

    Asif, Irfan M; Yim, Eugene S; Hoffman, Jacob M; Froelicher, Vic

    2015-02-01

    Abstract Sudden cardiac death (SCD) is the leading cause of death during exercise. While initial reports suggested that the most common cause of SCD in young athletes was due to hypertrophic cardiomyopathy (HCM), a critical review of investigations in several populations (athletes, non-athletes, military, national, and international) supports that the most common finding at autopsy of young individuals with SCD is actually a structurally normal heart (SNH). This information is vital for sports medicine clinicians, especially with regard to the pre-participation evaluation (PPE) since cardiac death associated with a SNH is likely attributed to disorders such as arrhythmia or ion channel diseases. This comprehensive review explores the causes of SCD, along with the symptoms preceding death, which ultimately may help refine the PPE and maximize the ability to detect potentially lethal disease prior to competition.

  19. Muerte súbita en paciente con síndrome LEOPARD / Sudden death in patients with LEOPARD syndrome

    Directory of Open Access Journals (Sweden)

    Eliany Rodríguez Moreno

    2015-10-01

    Full Text Available LEOPARD or Moynahan syndrome, also called multiple lentigines, is a rare genetic disease which causes multiple visceral abnormalities, including heart abnormalities, and may trigger sudden death. The case of a 26-year-old woman with a history of hypertrophic cardiomyopathy since early childhood is reported. She was referred to consultation due to loss of consciousness, associated with moderate exertion, and a resuscitated sudden death episode. The study revealed the presence of LEOPARD syndrome with subvalvular pulmonary stenosis and left ventricular hypertrophic cardiomyopathy, both of which cause sudden cardiac death.

  20. Possibilities of post-mortem diagnostics, including immunodiagnostics, in cases of sudden death due to anaphylactic and anaphylactoid reactions

    Directory of Open Access Journals (Sweden)

    Mariusz Kobek

    2014-12-01

    Full Text Available Postmortem diagnostics of anaphylactic and anaphylactoid reaction as the cause of death in cases of sudden deaths without witnesses, as well as those in which circumstances of sudden disease and then death are known, seems to be very difficult. This is caused by the lack of characteristic macro- or microscopic changes to internal organs resulting from a short, or even very short time, that elapses from the action of the etiological factor till death. In the above mentioned cases it is often impossible to establish univocally the cause of death, despite considering information on the cause of disease and its clinical symptoms. On the basis of 2 cases of sudden deaths resulted from the intake of hazel nuts, and the administration of contrast agent before radiological examination, the authors discuss the usefulness of postmortem determinations of tryptase and IgE in blood for diagnostics of deaths resulting from anaphylactic and anaphylactoid reaction, respectively.

  1. Possibilities of post-mortem diagnostics, including immunodiagnostics, in cases of sudden death due to anaphylactic and anaphylactoid reactions.

    Science.gov (United States)

    Kobek, M; Jankowski, Z; Chowaniec, C; Chowaniec, M; Jabłoński, C; Skowronek, R

    2014-01-01

    Postmortem diagnostics of anaphylactic and anaphylactoid reaction as the cause of death in cases of sudden deaths without witnesses, as well as those in which circumstances of sudden disease and then death are known, seems to be very difficult. This is caused by the lack of characteristic macro- or microscopic changes to internal organs resulting from a short, or even very short time, that elapses from the action of the etiological factor till death. In the above mentioned cases it is often impossible to establish univocally the cause of death, despite considering information on the cause of disease and its clinical symptoms. On the basis of 2 cases of sudden deaths resulted from the intake of hazel nuts, and the administration of contrast agent before radiological examination, the authors discuss the usefulness of postmortem determinations of tryptase and IgE in blood for diagnostics of deaths resulting from anaphylactic and anaphylactoid reaction, respectively. PMID:25574942

  2. Sudden cardiovascular death following myocardial infarction: the importance of left ventricular systolic dysfunction and congestive heart failure

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Ottesen, Michael M; Rask-Madsen, Christian;

    2005-01-01

    BACKGROUND: To study the prognostic information of congestive heart failure (CHF) and left ventricular systolic dysfunction regarding sudden and non-sudden cardiovascular death (SCD and non-SCD) in patients with acute myocardial infarction (MI), as this may indicate the potential benefit...

  3. Involvement of neuroleptic drugs in selenium deficiency and sudden death of cardiac origin: study and human post-mortem examination.

    Science.gov (United States)

    Hamdan, Lamia; Bost, Muriel; Chazot, Guy; Bui-Xuan, Bernard; Vaillant, Fanny; Dehina, Leila; Descotes, Jacques; Tabib, Alain; Mamou, Zahida; Timour, Quadiri

    2012-06-01

    The involvement of psychotropic drugs in sudden deaths has been highlighted. The objective of this work was to establish a link between selenium levels in heart tissue, psychotropic treatment and sudden death. Selenium levels were measured by electrothermal atomic absorption spectroscopy post-mortem in heart, brain and liver. Histological examination evidenced dilated cardiomyopathy in 45% of cases, left ventricular hypertrophy in 36%, and ischemic coronaropathy in 18%. A significant reduction of myocardial selenium levels compared to controls was seen in patients treated with neuroleptic drugs or meprobamate. No changes in brain or liver selenium levels were seen. These results suggest that selenium deficiency can facilitate sudden death in patients on psychotropic drugs. The reduced activity of glutathione peroxidase due to selenium deficiency can result in augmented oxidative stress in myocardial cells and myocardiopathy leading to sudden death. PMID:22664334

  4. Strategy for clinical evaluation and screening of sudden cardiac death relatives

    DEFF Research Database (Denmark)

    Ferrero-Miliani, Laura; Holst, Anders Gaarsdal; Pehrson, Steen;

    2010-01-01

    Sudden cardiac death (SCD) may be the first and final manifestation of several heart diseases. In the young, SCD is often caused by a hereditary cardiac disease. As the most frequently seen inherited cardiac diseases have an autosomal-dominant pattern of inheritance, half of the first...... a limited number of inherited cardiac diseases associated with SCD are without any structural changes. In other cases, the autopsy may reveal noncardiac causes of death, which is also important for reassuring the relatives. However, in cases with no autopsy or negative findings, thorough clinical......-degree relatives are at risk of having or developing the same disease. Therefore, screening of these high-risk relatives is a rational approach to reduce the incidence of SCD. To offer family screening and counseling, the cause of death should be carefully established. Autopsy is only performed in a limited number...

  5. A common single nucleotide polymorphism can exacerbate long-QT type 2 syndrome leading to sudden infant death

    DEFF Research Database (Denmark)

    Nof, Eyal; Cordeiro, Jonathan M; Pérez, Guillermo J;

    2010-01-01

    BACKGROUND: Identification of infants at risk for sudden arrhythmic death remains one of the leading challenges of modern medicine. We present a family in which a common polymorphism (single nucleotide polymorphism) inherited from the father, combined with a stop codon mutation inherited from...... suggest that a common polymorphism (K897T) can markedly accentuate the loss of function of mildly defective HERG channels, leading to long-QT syndrome-mediated arrhythmias and sudden infant death....

  6. Sudden death in spondylo-meta-epiphyseal dysplasia, short limb-abnormal calcification type.

    Science.gov (United States)

    Dias, Cristina; Cairns, Robyn; Patel, Millan S

    2009-01-01

    The spondylo-meta-epiphyseal dysplasias are an expanding group of skeletal dysplasias with specific features differentiating each subtype. We review the precocious carpal mineralization, unique metacarpal shape, triangular distal phalanges and mushroom cloud-shaped proximal phalanges present at an early age in spondylo-meta-epiphyseal dysplasia, short limb-abnormal calcification type (SMED SL-AC) and report two patients with clinical and radiographic features consistent with SMED SL-AC, who died suddenly because of spinal cord compression. The patients presented are female siblings, providing further evidence for autosomal recessive inheritance. Cervical cord compression is found in half of reported patients and is the major cause of mortality. SMED SL-AC should be added to the list of genetic causes of sudden death. Radiological features in the hand may be used in the first few years of life to support an early diagnosis and thus allow for prevention of premature demise. PMID:19050401

  7. The Mikamo lecture. Role of higher nervous activity in sudden cardiac death.

    Science.gov (United States)

    Lown, B

    1990-06-01

    The brain receives and catalogues myriads of information from within and without the organism. These inputs promote neural integration of bodily function through a multiplicity of cybernetic feedback loops. Higher nervous activity shapes the contours of perceived well-being and determines the course and progress of disease. Behavioral and neural factors play an important role in cardiovascular function and are especially relevant to the problem of sudden cardiac death (SCD). Clinical data attesting to the role of biobehavioral factors in SCD derive from a diversity of sources. It has long been known that bereavement increases the prevalence of cardiac fatality. Business failure rates are strongly related to increased mortality among persons aged 55 and over. Recession in economic activity, with increasing unemployment, is associated with augmented death rates from ischemic heart disease. In extensive surveys conducted among London civil servants, Rose and Marmot found not only the level but the type of employment to be a factor determining coronary heart disease mortality. Blue collar workers had a 3.6 times greater chance of dying from heart disease than an age-matched population in the higher ranks of civil service. A man's employment status was a stronger predictor of risk for dying from coronary heart disease than any of the usual risk factors, such as smoking, blood pressure, height-weight ratio, leisure time activities, glucose tolerance, or plasma cholesterol. Operation of behavioral factors is also suggested by the time of occurrence of sudden death. Among 3,983 men followed for more than 30 years, Rabkin and co-workers observed an excess proportion of fatalities on Mondays. No such pattern was noted for cancer mortality. Not only the day of the week but the time of day appears to be a factor. Muller and co-workers found a significant preponderance in the occurrence of myocardial infarction and sudden death from 6:00 AM to noon. They could not implicate

  8. Possibilities of post-mortem diagnostics, including immunodiagnostics, in cases of sudden death due to anaphylactic and anaphylactoid reactions

    OpenAIRE

    Mariusz Kobek; Zbigniew Jankowski; Czesław Chowaniec; Małgorzata Chowaniec; Christian Jabłoński; Rafał Skowronek

    2014-01-01

    Postmortem diagnostics of anaphylactic and anaphylactoid reaction as the cause of death in cases of sudden deaths without witnesses, as well as those in which circumstances of sudden disease and then death are known, seems to be very difficult. This is caused by the lack of characteristic macro- or microscopic changes to internal organs resulting from a short, or even very short time, that elapses from the action of the etiological factor till death. In the above mentioned cases it is often i...

  9. Incidence and etiology of sports-related sudden cardiac death in Denmark - Implications for preparticipation screening

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Winkel, Bo Gregers; Theilade, Juliane;

    2010-01-01

    SCD were found, 8 of which had antecedent symptoms. The incidence rate was 1.21 (95% confidence inrterval (CI): 0.68 to 2.00) per 100,000 athlete person-years. The most common autopsy findings were arrhythmogenic right ventricular cardiomyopathy (n = 4), sudden unexplained death (n = 4) and coronary artery...... disease (n = 2). The incidence of SCD in the general population age 12- to 35 was 3.76 (95% CI: 3.42 to 4.14) per 100,000 person-years. Conclusion In Denmark, SrSCD is a rare occurrence and the incidence rate is lower than that of SCD in the general population. This may imply a low value...... this to the incidence of sudden cardiac death SCD in the background population. Methods Al 5,662 death certificates for decedents in the perio 2000 to 2006 in the age group 12 to 35 years in Denmark were read independently by 2 physicians to identify cases of SCD. Information from autopsy reports, selected hospital...

  10. Toxic gas generation from plastic mattresses and sudden infant death syndrome.

    Science.gov (United States)

    Warnock, D W; Delves, H T; Campell, C K; Croudace, I W; Davey, K G; Johnson, E M; Sieniawska, C

    1995-12-01

    Microbial generation of toxic gases from antimony, arsenic, or phosphorus in compounds used as fire retardants in cot mattresses has been proposed as a cause of sudden infant death. To test this hypothesis, 23 polyvinyl chloride mattress samples from cot death cases were incubated on malt agar plates until good microbial growth was obtained. Silver nitrate and mercuric chloride test papers were then inserted and the colour reactions recorded. The predominant organism, recovered from all mattresses tested, was not, as claimed in earlier work, the fungus Scopulariopsis brevicaulis, but a mix of common environmental Bacillus spp. Test paper colour changes occurred whenever bacterial growth was present, but these reactions also occurred in control tests in which no mattress material was present on the plates. Chemical and instrumental analyses of exposed test papers showed that the colour reactions were not due to deposits of antimony, arsenic, or phosphorus. Our findings do not support the hypothesis that toxic gases derived from antimony, arsenic, or phosphorus are a cause of sudden infant death. More sulphur was found in test papers exposed in plates containing bacterial growth than in those without such growth. This result suggests that the test paper reactions were due to the generation of sulphur-containing compounds during bacterial growth on the agar medium. PMID:7491046

  11. Cardiac asystole following cannabis (marijuana) usage--additional mechanism for sudden death?

    Science.gov (United States)

    Menahem, Samuel

    2013-12-10

    A 21 year old university student previously operated during infancy for an unobstructed total anomalous pulmonary venous drainage with an excellent result, was noted on a routine follow up 24 h Holter monitor to have multiple pauses related to cardiac asystole, the longest lasting 5.8 s and temporally related to marijuana inhalation. A repeat Holter was normal following a two week cessation of marijuana usage and again when carried out 3 months later. The documented periods of asystole may be a precursor of sudden death seen in addicts even without evidence of ischaemic heart disease. PMID:24200372

  12. Risk of cardiovascular disease in family members of young sudden cardiac death victims

    DEFF Research Database (Denmark)

    Ranthe, Mattis Flyvholm; Winkel, Bo Gregers; Andersen, Elisabeth Wreford;

    2012-01-01

    AimsDescriptive and genetic studies suggest that relatives of sudden cardiac death (SCD) victims have an increased risk of several cardiovascular diseases (CVDs). Given the severe consequences of undiagnosed CVD and the availability of effective treatment, the potential for prevention in this group...... = 470), along with their first- and second-degree relatives (n = 3073). We compared the incidence of CVD in those relatives with that in the background population using standardized incidence ratios (SIRs). The observed number of CVDs over 11 years of follow-up was 292, compared with 219 expected based...

  13. Changes in the epidemiology of sudden infant death syndrome in Sweden 1973-1996

    OpenAIRE

    Alm, B; Norvenius, S; Wennergren, G; Skjarven, R; Oyen, N; Milerad, J; Wennborg, M; Kjaerbeck, J; Helweg-Larsen, K.; Irgens, L.

    2001-01-01

    BACKGROUND—From the early 1970s to the early 1990s, there was a significant rise in the incidence of sudden infant death syndrome (SIDS) in Scandinavia. Following the risk reducing campaign, the incidence has fallen to about the same level as in 1973.
AIMS—To identify the changes that have occurred in the epidemiology of SIDS.
METHODS—We compared the Swedish part of the Nordic Epidemiological SIDS Study (NESS), covering the years 1992-1995, with two earlier, descriptive s...

  14. Influence of the Stark Shift on Entanglement Sudden Death and Birth in Cavity QED

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian-Song; CHEN Ai-Xi; WU Kun-Hua

    2011-01-01

    We investigate the entanglement dynamics of two two-level atoms interacting with two vacuum fields of two spatially separated cavities with the Stark effects by employing the concurrence. It is shown that the entanglement sudden death (ESD) and birth (ESB) could be controlled by adjusting the Stark-shift parameters. If the Stark-shift parameters are chosen appropriately, then ESD and ESB phenomena will appear. In addition, the appearance of ESD before or after ESB depends on the Stark-shift values.

  15. Cardiac MRI and CT features of inheritable and congenital conditions associated with sudden cardiac death

    Energy Technology Data Exchange (ETDEWEB)

    Sparrow, Patrick; Merchant, Naeem; Provost, Yves; Doyle, Deirdre; Nguyen, Elsie; Paul, Narinder [University Health Network and Mount Sinai Hospital, Division of Cardiothoracic Imaging, Department of Medical Imaging, Toronto, Ontario (Canada)

    2009-02-15

    Cardiac MRI (CMR) and electrocardiogram (ECG)-gated multi-detector computed tomography (MDCT) are increasingly important tools in the identification and assessment of cardiac-related disease processes, including those associated with sudden cardiac death (SCD). While the commonest cause of SCD is coronary artery disease (CAD), in patients under 35 years inheritable cardiomyopathies such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy are important aetiologies. CMR in particular offers both accurate delineation of the morphological abnormalities associated with these and other conditions and the possibility for risk stratification for development of ventricular arrhythmias with demonstration of macroscopic scar by delayed enhancement imaging with intravenous gadolinium. (orig.)

  16. A Case of Sudden Death in Decameron IV.6: Aortic Dissection or Atrial Myxoma?

    Science.gov (United States)

    Toscano, Fabrizio; Spani, Giovanni; Papio, Michael; Rühli, Frank J; Galassi, Francesco M

    2016-07-01

    Giovanni Boccaccio's Decameron contains a novella that details the sudden death of a young man called Gabriotto, including a portrayal of the discomfort that the protagonist experienced and a rudimentary autopsy performed by local physicians. The intriguing description of symptoms and pathologies has made it possible to read a 7-century-old case through the modern clinical lens. Thanks to the medical and philological analysis of the text-despite the vast difference between modern and medieval medicine-2 hypothetical diagnoses have emerged: either an aortic dissection or an atrial myxoma.

  17. Audit of practice in sudden unexpected death in epilepsy (SUDEP) post mortems and neuropathological findings

    Science.gov (United States)

    Michalak, Zuzanna; Wright, Gabriella; Dawson, Timothy; Hilton, David; Joshi, Abhijit; Diehl, Beate; Koepp, Matthias; Lhatoo, Samden; Sander, Josemir W.; Sisodiya, Sanjay M.

    2015-01-01

    Aims Sudden unexpected death in epilepsy (SUDEP) is one of the leading causes of death in people with epilepsy. For classification of definite SUDEP, a post mortem (PM), including anatomical and toxicological examination, is mandatory to exclude other causes of death. We audited PM practice as well as the value of brain examination in SUDEP. Methods We reviewed 145 PM reports in SUDEP cases from four UK neuropathology centres. Data were extracted for clinical epilepsy details, circumstances of death and neuropathological findings. Results Macroscopic brain abnormalities were identified in 52% of cases. Mild brain swelling was present in 28%, and microscopic pathologies relevant to cause or effect of seizures were seen in 89%. Examination based on whole fixed brains (76.6% of all PMs), and systematic regional sampling was associated with higher detection rates of underlying pathology (P < 0.01). Information was more frequently recorded regarding circumstances of death and body position/location than clinical epilepsy history and investigations. Conclusion Our findings support the contribution of examination of the whole fixed brain in SUDEP, with high rates of detection of relevant pathology. Availability of full clinical epilepsy‐related information at the time of PM could potentially further improve detection through targeted tissue sampling. Apart from confirmation of SUDEP, complete neuropathological examination contributes to evaluation of risk factors as well as helping to direct future research into underlying causes. PMID:26300477

  18. After sudden unexpected death in epilepsy: Lessons learned and the road forward.

    Science.gov (United States)

    Donner, Elizabeth J; Waddell, Briony; Osland, Karen; Leach, John P; Duncan, Susan; Nashef, Lina; Picot, Marie Christine

    2016-01-01

    The devastating effects of sudden unexpected death in epilepsy (SUDEP) can be difficult to navigate, even for experienced clinicians. Mounting evidence supports full disclosure of the risks of epilepsy to those affected and their caregivers, and recommendations from regulatory and professional groups encourage the same. Following a death, families are faced with tragedy, guilt, and sometimes anger. Clinicians are often called upon to provide information and support. The development of a comprehensive approach to SUDEP education requires careful consideration of the people living with epilepsy, facts about SUDEP and known risk factors, as well as experiences of families and care providers. In this article, we share the experiences of those working in SUDEP education and epilepsy care, including the voluntary sector. We explore the experience of bereaved families and clinicians, derive lessons from published research, highlight areas where more research is needed, and report on preliminary data from a nationwide study from France.

  19. Differences in investigations of sudden unexpected deaths in young people in a nationwide setting

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Holst, Anders Gaarsdal; Theilade, Juliane;

    2012-01-01

    differences exist in the investigation of young persons dying suddenly and unexpectedly. METHODS AND RESULTS: All deaths in persons aged 1-35 years in Denmark in 2000-2006 were included. Death certificates were read independently by two physicians. External examination as well as autopsy status was retrieved....... Significant regional differences were found regarding external examinations and autopsy frequencies. Ratios of conducted external examinations varied between 63% and 93% (p¿=¿0.004). Autopsy ratios varied between 60% and 88% (p¿=¿0.001). In urban areas, external examinations and autopsies were more often...... conducted than in rural areas. In East Denmark, there were more external examinations resulting in a forensic autopsy, and there was a higher overall autopsy rate compared to West Denmark. CONCLUSION: Despite operating under the same set of laws, we document significant regional differences in forensic...

  20. Sudden Cardiac Death in Young Athletes; a Literature Review and Special Considerations in Asia

    Directory of Open Access Journals (Sweden)

    Halabchi

    2011-03-01

    Full Text Available Sudden cardiac death (SCD in a young athlete is rare, but catastrophic. Exercise acts as a risk factor for SCD in people with cardiovascular disease. A diversity of cardiovascular disorders including hypertrophic cardiomyopathy, congenital coronary anomalies, arrhythmogenic right ventricular dysplasia, dilated cardiomyopathy, aortic rupture due to Marfan syndrome, myocarditis, valvular disease and electrical disorders (Wolff–Parkinson–White syndrome, long QT syndrome, Brugada syndrome, as well as commotio cordis represent the common causes of SCD in young athletes. As the outcome of lethal cardiovascular disorders is not reversible except in few cases, effective measures should be addressed to reduce the burden of sudden cardiac death in young athletes. Currently, two types of recommendations are proposed by American and European countries. It seems that there are some special considerations in Asia, entirely different from North America or Europe, which warrant more comprehensive research on epidemiology and etiology of SCD in young Asian athletes by country and evaluation of current national preventive strategies and their achievements in decreasing the risk. Using these data and considering regional restrictions, an expert group will be able to plan a practical and feasible preventive strategy.

  1. Electrophysiologic testing guided risk stratification approach for sudden cardiac death beyond the left ventricular ejection fraction.

    Science.gov (United States)

    Gatzoulis, Konstantinos A; Tsiachris, Dimitris; Arsenos, Petros; Tousoulis, Dimitris

    2016-01-26

    Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators (ICD), after an efficient risk stratification approach. The proposed risk stratifier of an impaired left ventricular ejection fraction has limited sensitivity meaning that a significant number of victims will remain undetectable by this risk stratification approach because they have a preserved left ventricular systolic function. Current risk stratification strategies focus on combinations of non invasive methods like T wave alternans, late potentials, heart rate turbulence, deceleration capacity and others, with invasive methods like the electrophysiologic study. In the presence of an electrically impaired substrate with formed post myocardial infarction fibrotic zones, programmed ventricular stimulation provides important prognostic information for the selection of the patients expected to benefit from an ICD implantation, while due to its high negative predictive value, patients at low risk level may also be detected. Clustering evidence from different research groups and electrophysiologic labs support an electrophysiologic testing guided risk stratification approach for sudden cardiac death.

  2. Cardiac Tropism of Borrelia burgdorferi: An Autopsy Study of Sudden Cardiac Death Associated with Lyme Carditis.

    Science.gov (United States)

    Muehlenbachs, Atis; Bollweg, Brigid C; Schulz, Thadeus J; Forrester, Joseph D; DeLeon Carnes, Marlene; Molins, Claudia; Ray, Gregory S; Cummings, Peter M; Ritter, Jana M; Blau, Dianna M; Andrew, Thomas A; Prial, Margaret; Ng, Dianna L; Prahlow, Joseph A; Sanders, Jeanine H; Shieh, Wun Ju; Paddock, Christopher D; Schriefer, Martin E; Mead, Paul; Zaki, Sherif R

    2016-05-01

    Fatal Lyme carditis caused by the spirochete Borrelia burgdorferi rarely is identified. Here, we describe the pathologic, immunohistochemical, and molecular findings of five case patients. These sudden cardiac deaths associated with Lyme carditis occurred from late summer to fall, ages ranged from young adult to late 40s, and four patients were men. Autopsy tissue samples were evaluated by light microscopy, Warthin-Starry stain, immunohistochemistry, and PCR for B. burgdorferi, and immunohistochemistry for complement components C4d and C9, CD3, CD79a, and decorin. Post-mortem blood was tested by serology. Interstitial lymphocytic pancarditis in a relatively characteristic road map distribution was present in all cases. Cardiomyocyte necrosis was minimal, T cells outnumbered B cells, plasma cells were prominent, and mild fibrosis was present. Spirochetes in the cardiac interstitium associated with collagen fibers and co-localized with decorin. Rare spirochetes were seen in the leptomeninges of two cases by immunohistochemistry. Spirochetes were not seen in other organs examined, and joint tissue was not available for evaluation. Although rare, sudden cardiac death caused by Lyme disease might be an under-recognized entity and is characterized by pancarditis and marked tropism of spirochetes for cardiac tissues. PMID:26968341

  3. Arrhythmogenic right ventricular cardiomyopathy as a cause of sudden death in young people: Literature review

    Directory of Open Access Journals (Sweden)

    Mazić Sanja

    2012-01-01

    Full Text Available Arrhythmogenic right ventricular cardiomyopathy/dysplasia is a progressive condition with right ventricular myocardium being replaced by fibro-fatty tissue. It is a hereditary disorder mostly caused by desmosome gene mutations. The prevalence of arrhythmogenic right ventricular cardiomyopathy is about 1/1000-5000. Clinical presentation is usually related to ventricular tachycardias, syncope or presyncopa, or ventricular fibrillation leading to cardiac arrest, mostly in young people and athletes. It may be difficult to make the diagnosis of arrhythmogenic right ventricular cardiomyopathy due to several problems arising from the specificity of electrocardiograph abnormalities, different potential etiologies of ventricular arrhythmias with a left bundle branch morphology, the assessment of the right ventricular structure and function, and the interpretation of endomyocardial biopsy findings. Therefore, standardized diagnostic criteria have been proposed by the Study Group on arrhythmogenic right ventricular cardiomyopathy of the European Society of Cardiology. In order to make the diagnosis of arrhythmogenic right ventricular cardiomyopathy, a number of clinical tests are employed, including the electrocardiogram, echocardiography, myocardial perfusion scintigraphy, myocardial biopsy, right ventricular angiography, cardiac magnetic resonance imaging and genetic testing. The therapeutic options include beta blockers, antiarrhythmic drugs, catheter ablation, and implantable cardioverter defibrillator. The implantable cardioverter defibrillator is the most effective safe-guard against arrhythmic sudden death. Preparticipation screening for sport eligibility has been proven to be effective in detecting asymptomatic patients and sport disqualification has been lifesaving, substantially declining sudden death in young athletes.

  4. Fulminant Peripartum myocarditis associated with sudden cardiac death: a case report.

    Science.gov (United States)

    Ciccone, Marco Matteo; Dentamaro, Ilaria; Carbonara, Santa; Ricci, Gabriella; Vestito, Domenico; Marzullo, Andrea; Tunzi, Francesco; Solarino, Biagio

    2016-01-01

    Myocarditis is an inflammatory disease of myocardium, associated with nonischemic necrosis and degeneration of myocytes. Although the clinical course is rapid, myocarditis can lead to dilated cardiomyopathy with chambers dilatation and ventricular dysfunction. The pathophysiology of myocarditis in humans is not completely understood. There are several etiological agents implicated, mainly viral agents. The clinical presentation is extremely various, with nonspecific systemic symptoms until sudden death. The great variability of symptoms makes the diagnosis, therefore, extremely difficult. We report the case of a 40-year-old woman who developed, after childbirth, hyperthermia associated with neck and left arm pain; initially treated with acetaminophen, without any benefit, the young woman, after few days, died suddenly. The autopsy documented the presence of edematous lungs and enlarged and congested liver. The microbiological tests performed 4 days after death were negative. The heart was normal in shape and volume; a section of the left ventricle wall showed subendocardial discromic areas histologically characterized by multifocal perivascular and interstitial inflammatory infiltrates. These infiltrates consisted mainly of neutrophils with eosinophil component associated with myocyte necrosis and hemorrhagic interstitial infiltration.

  5. Clusters of sudden unexplained death associated with the mushroom, Trogia venenata, in rural Yunnan Province, China.

    Directory of Open Access Journals (Sweden)

    Guo-Qing Shi

    Full Text Available INTRODUCTION: Since the late 1970's, time-space clusters of sudden unexplained death (SUD in northwest Yunnan, China have alarmed the public and health authorities. From 2006-2009, we initiated enhanced surveillance for SUD to identify a cause, and we warned villagers to avoid eating unfamiliar mushrooms. METHODS: We established surveillance for SUD, defined as follows: sudden onset of serious, unexplained physical impairment followed by death in <24 hours. A mild case was onset of any illness in a member of the family or close socially related group of a SUD victim within 1 week of a SUD. We interviewed witnesses of SUD and mild case-persons to identify exposures to potentially toxic substances. We tested blood from mild cases, villagers, and for standard biochemical, enzyme, and electrolyte markers of disease. RESULTS: We identified 33 SUD, a 73% decline from 2002-2005, distributed among 21 villages of 11 counties. We found a previously undescribed mushroom, Trogia venenata, was eaten by 5 of 7 families with SUD clusters compared to 0 of 31 other control-families from the same villages. In T. venenata-exposed persons SUD was characterized by sudden loss of consciousness during normal activities. This mushroom grew nearby 75% of 61 villages that had time-space SUD clusters from 1975 to 2009 compared to 17% of 18 villages with only single SUD (p<0.001, Fisher's exact test. DISCUSSION: Epidemiologic data has implicated T. venenata as a probable cause of clusters of SUD in northwestern Yunnan Province. Warnings to villagers about eating this mushroom should continue.

  6. Sudden infant death syndrome: a case report in Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Dragan Ćajić

    2010-11-01

    Full Text Available Sudden infant death syndrome (SIDS is an idiopathic condition that affects seemingly healthy infants under one year of age, whose death remains unexplained after the performance of a complete postmortem examination, toxicological analyses, genetic testing, death scene investigation, and a review of the mother’s and infant’s medical history. Detailed epidemiological, pathological, and forensic information has been reported regarding SIDS from the developed countries. However, SIDS information from developing countries is either widely scattered or non-existent. This is the first published case report of SIDS from the country of Bosnia and Herzegovina. A previously healthy 3 months old, white male infant was found dead after being placed to sleep in the prone position. The features of this case report closely parallel the classical features of SIDS cited in the world literature. The infant was healthy, male, between the ages of 2-12 months, discovered in the prone position and had a negative postmortem investigation. It is important for developing countries such as Bosnia and Herzegovina to conduct detailed forensic investigations of deaths from SIDS and provide epidemiological, pathological, and circumstances of that information to the world’s collective knowledge.

  7. Common genetic variants associated with sudden cardiac death: the FinSCDgen study.

    Directory of Open Access Journals (Sweden)

    Annukka M Lahtinen

    Full Text Available BACKGROUND: Sudden cardiac death (SCD accounts for up to half of cardiac mortality. The risk of SCD is heritable but the underlying genetic variants are largely unknown. We investigated whether common genetic variants predisposing to arrhythmia or related electrocardiographic phenotypes, including QT-interval prolongation, are associated with increased risk of SCD. METHODOLOGY/PRINCIPAL FINDINGS: We studied the association between 28 candidate SNPs and SCD in a meta-analysis of four population cohorts (FINRISK 1992, 1997, 2002 and Health 2000, n = 27,629 and two forensic autopsy series (The Helsinki Sudden Death Study and The Tampere Autopsy Study, n = 694. We also studied the association between established cardiovascular risk factors and SCD. Causes of death were reviewed using registry-based health and autopsy data. Cox regression and logistic regression models were adjusted for age, sex, and geographic region. The total number of SCDs was 716. Two novel SNPs were associated with SCD: SCN5A rs41312391 (relative risk [RR] 1.27 per minor T allele, 95% CI 1.11-1.45, P = 3.4×10(-4 and rs2200733 in 4q25 (RR 1.28 per minor T allele, 95% CI 1.11-1.48, P = 7.9×10(-4. We also replicated the associations for 9p21 (rs2383207, RR 1.13 per G allele, 95% CI 1.01-1.26, P = 0.036, as well as for male sex, systolic blood pressure, diabetes, cigarette smoking, low physical activity, coronary heart disease, and digoxin use (P<0.05. CONCLUSIONS/SIGNIFICANCE: Two novel genetic variants, one in the cardiac sodium channel gene SCN5A and another at 4q25 previously associated with atrial fibrillation, are associated with SCD.

  8. Sudden Cardiac Death in Brazil: A Community-Based Autopsy Series (2006-2010

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Braggion-Santos

    2015-02-01

    Full Text Available Background: Sudden cardiac death (SCD is a sudden unexpected event, from a cardiac cause, that occurs in less than one hour after the symptoms onset, in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before found dead. Although it is a relatively frequent event, there are only few reliable data in underdeveloped countries. Objective: We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000 residents according to Coroners’ Office autopsy reports. Methods: We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to identify cases of SCD. Specific cause of death as well as demographic information, date, location and time of the event, comorbidities and whether cardiopulmonary resuscitation (CPR was attempted were collected. Results: We identified 899 cases of SCD (20%; the rate was 30/100000 residents per year. The vast majority of cases of SCD involved a coronary artery disease (CAD (64% and occurred in men (67%, between the 6th and the 7th decades of life. Most events occurred during the morning in the home setting (53.3% and CPR was attempted in almost half of victims (49.7%. The most prevalent comorbidity was systemic hypertension (57.3%. Chagas’ disease was present in 49 cases (5.5%. Conclusion: The majority of victims of SCD were men, in their sixties and seventies and the main cause of death was CAD. Chagas’ disease, an important public health problem in Latin America, was found in about 5.5% of the cases.

  9. Physical activity and sudden cardiac death in elders--a Croatian study.

    Science.gov (United States)

    Duraković, Zijad; Duraković, Marjeta Misigoj; Skavić, Josip; Gojanović, Marija Definis

    2011-03-01

    The paper deals with the sudden cardiac death in elders due to physical activity in Croatia and to compare it to other population groups who practice physical activity. The data are a part of a retrospective study dealing with 59 sudden death due to physical activity in men in Croatia: from January 1, 1988 to December 31, 2008. Fifteen aged 65 to 82 years were recreationally engaged in physical activity: six in swimming, four in tennis, one in driving a bicycle, one in jogging, two in bowling and one died during sexual act. Only one had symptoms of pectoral angina, two suffered from arterial hypertension, and two had congestive heart failure. Eleven were without symptoms before exercise. At forensic autopsy, fourteen had coronary heart disease, seven had critical coronary artery stenosis, three had occluded left descendens anterior coronary artery and four critical coronary stenosis, four had a recent myocardial infarctions, and eleven had myocardial scars due to previous myocardial infarctions. Twelve of them had left ventricular hypertrophy: 15-25 mm. In Croatia, about 7per cent of the entire male population undertake recreational physical activity, while 13 per cent of them are elders. A sudden cardiac death due to recreational physical activity in elders reached 1.71/100 000 yearly, in the entire male population engaged in recreational physical exercise: 0.75/100 000 (p = 0.05730), in the total male population aged 15-40 engaged in sports and recreational physical exercise: 0.57/100.0000 (p = 0.00387), in young athletes: 0.15/100 000 (p = 0.00000). Medical examination of all elderly persons has to be done before starting of recreational physical activity: by clinical examination, searching for risk factors for atherosclerosis, performing ECG at rest, stress ECG, and echocardiography and to repeat the medical examination at least once a year Physical activity should start with a warm-up period and with a gradually increasing load, and usually not to exceed 6

  10. The prevalence of mutations in KCNQ1, KCNH2, and SCN5A in an unselected national cohort of young sudden unexplained death cases

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Larsen, Maiken Kudahl; Berge, Knut Erik;

    2012-01-01

    INTRODUCTION: Sudden unexplained death account for one-third of all sudden natural deaths in the young (1-35 years). Hitherto, the prevalence of genopositive cases has primarily been based on deceased persons referred for postmortem genetic testing. These deaths potentially may represent the worst...

  11. Sudden cardiac death after acute ST elevation myocardial infarction: insight from a developing country

    Science.gov (United States)

    Rao, Hygriv B; Sastry, B K S; Korabathina, Radhika; Raju, Krishnam P

    2012-01-01

    Background There is no data concerning sudden cardiac death (SCD) following acute ST elevation myocardial infarction (STEMI) in India. We assessed the incidence and factors influencing SCD following STEMI. Methods Patients with STEMI admitted in our hospital from 2006 to 2009 were prospectively entered into a database. In the period 2010–2011, patients or their kin were periodically contacted and administered a questionnaire to ascertain their survival, and mode of death if applicable. Results Study population comprised of 929 patients with STEMI (mean age 55±17 years) having a mean follow-up of 41±16 months. The total number of deaths was 159, of which 78 were SCD (mean age 62.2±10 years). The cumulative incidence of total deaths and SCD at 1 month, 1, 2, 3 years and at conclusion of the study was 10.1%, 13.2%, 14.6%, 15.8%, 17.3% and 4.9%, 6.5%, 8.0%, 8.9% and 9.7%, respectively. The temporal distribution of SCD was 53.9% at first month, 19.2% at 1 month to 1 year, 15.4% in 1–2 years, 7.6% in 2–3 years and 3.8% beyond 3 years. Comparison between SCD and survivor cohorts by multivariate analysis showed five variables were found to be associated with SCD (age p=0.0163, female gender p=0.0042, severe LV dysfunction p=0.0292, absence of both reperfusion and revascularisation p=0.0373 and lack of compliance with medications p <0.0001). Conclusions SCD following STEMI accounts for about half of the total deaths. It involves younger population and most of these occur within the first month. This data has relevance in prioritising healthcare strategies in India. PMID:27326036

  12. Exploring the risk factors for sudden infant deaths and their role in inflammatory responses to infection

    Directory of Open Access Journals (Sweden)

    Caroline eBlackwell

    2015-03-01

    Full Text Available The risk factors for Sudden Infant Death Syndrome (SIDS parallel those associated with susceptibility to or severity of infectious diseases. There is no evidence that a single infectious agent is associated with SIDS; the common thread appears to be induction of inflammatory responses to infections. In this review, interactions between genetic and environmental risk factors for SIDS are assessed in relation to the hypothesis that many infant deaths result from dysregulation of inflammatory responses to minor infections. Risk factors are assessed in relation to three important stages of infection: 1 bacterial colonisation (frequency or density; 2 induction of temperature-dependent toxins; 3 induction or control of inflammatory responses.In this article we review the interactions among risk factors for SIDS for their effects on induction or control of inflammatory responses. The risk factors studied are genetic factors (sex, cytokine gene polymorphisms among ethnic groups at high or low risk of SID; developmental stage (changes in cortisol and testosterone levels associated with 2-4 month age range; environmental factors (virus infection, exposure to cigarette smoke. These interactions help to explain differences in the incidences of SIDS observed between ethnic groups prior to public health campaigns to reduce these infant deaths.

  13. Polymorphisms in genes of respiratory control and sudden infant death syndrome.

    Science.gov (United States)

    Läer, Katharina; Dörk, Thilo; Vennemann, Marielle; Rothämel, Thomas; Klintschar, Michael

    2015-09-01

    Sudden infant death syndrome (SIDS) is a multifactorial syndrome and assumingly, among other mechanisms, a deficit in respiratory control leads to a failure of arousal and autoresuscitation when the child is challenged by a stressful homeostatic event, e.g., hypoxia. We hypothesize that genetic polymorphisms involved in respiratory control mediated in the medulla oblongata contribute to SIDS. Therefore, a total of 366 SIDS cases and 421 controls were genotyped for 48 SNPs in 41 candidate genes. Genotyping was performed using Fluidigm nanofluidic technology. Results were obtained for 356 SIDS and 406 controls and 38 SNPs. After correction for multiple testing, one SNP retained a nominally significant association with seasonal SIDS: rs1801030 in the phenol sulfotransferase 1A1 gene (subgroup: death occurring during summer). A borderline association could be also observed for rs563649 in the opioid receptor μ1 gene in a recessive model (subgroup: death occurring during autumn). As a conclusion, although these data suggest two SNPs to be associated with different subgroups of SIDS cases, none of them can fully explain the SIDS condition, consistent with its multifactorial etiology. Given the great complexity of respiratory control and our initial findings reported here, we believe it is worthwhile to further investigate genes involved in the respiratory system. PMID:26198620

  14. Detection and prediction of sudden cardiac death (SCD) for personal healthcare.

    Science.gov (United States)

    Shen, Tsu-Wang; Shen, Hsiao-Ping; Lin, Ching-Heng; Ou, Yi-Ling

    2007-01-01

    Sudden Cardiac Death (SCD) is one of continuing challenges to the modern clinician. It is responsible for an estimated 400,000 deaths per year in the United States and millions of deaths worldwide. This research developed a personal cardiac homecare system by sensing Lead-I ECG signals for detecting and predicting SCD events, which also builds in ECG identity verification. A MIT/BIH SCD Holter Database plus our ECG database were investigated. The system includes a self-made ECG amplifier, a NI DAQ card, a laptop computer, LabView and MatLab programs. The wavelet analysis was applied to detect SCD and the overall performance is 87.5% correct detection rate. In addition, artificial neural networks (ANN) were used to predict SCD events. The correct prediction rates by applying least mean square (LMS), decision based neural network (DBNN), and back propagation (BP) neural network were 67.44%, 58.14% and 55.81% respectively. PMID:18002521

  15. Intra-beat Scaling Properties of Cardiac Arrhythmias and Sudden Cardiac Death

    Science.gov (United States)

    Rodríguez, Eduardo; Lerma, Claudia; Echeverría, Juan C.; Alvarez-Ramirez, Jose

    2008-02-01

    We applied detrended fluctuation analysis (DFA) to characterize the intra-beat scaling dynamics of electrocardiographic (ECG) recordings from the PhysioNet Sudden Cardiac Death Holter Database. The main finding of this contribution is that, in such recordings involving different types of arrhythmias; the ECG waveform, besides showing a less-random intra-beat dynamics, becomes more regular during bigeminy, ventricular tachycardia (VT) or even atrial fibrillation (AFIB) and ventricular fibrillation (VF) despite the appearance of erratic traces. Thus, notwithstanding that these cardiac rhythm abnormalities are generally considered as irregular and some of them generated by random impulses or wavefronts, the intra-beat scaling properties suggest that regularity dominates the underlying mechanisms of arrhythmias. Among other explanations, this may result from shorted or restricted -less complex- pathways of conduction of the electrical activity within the ventricles.

  16. Prevalence of modifiable risk factors for sudden infant death syndrome in British Forces Germany.

    Science.gov (United States)

    Miller, S A; Morrison, M M

    1996-06-01

    A questionnaire survey was conducted amongst parents in the military community in British Forces Germany to investigate the prevalence of known and suspected risk factors for Sudden Infant Death Syndrome. Over a thousand questionnaires were returned (response rate 58%) and these showed that the prevalence of babies being placed in the prone position to sleep is now extremely low and the use of room thermometers to help control ambient temperature is widespread. However 29% of the mothers had smoked in pregnancy and 44% of households with a new-born baby had at least one parent who smoked. Additional health promotion activity aimed at reducing the prevalence of smoking in pregnancy and amongst the parents of new-born babies is recommended. PMID:8819036

  17. Sudden cardiac death and chronic kidney disease: From pathophysiology to treatment strategies.

    Science.gov (United States)

    Di Lullo, L; Rivera, R; Barbera, V; Bellasi, A; Cozzolino, M; Russo, D; De Pascalis, A; Banerjee, D; Floccari, F; Ronco, C

    2016-08-15

    Chronic kidney disease (CKD) patients demonstrate higher rates of cardiovascular mortality and morbidity; and increased incidence of sudden cardiac death (SCD) with declining kidney failure. Coronary artery disease (CAD) associated risk factors are the major determinants of SCD in the general population. However, current evidence suggests that in CKD patients, traditional cardiovascular risk factors may play a lesser role. Complex relationships between CKD-specific risk factors, structural heart disease, and ventricular arrhythmias (VA) contribute to the high risk of SCD. In dialysis patients, the occurrence of VA and SCD could be exacerbated by electrolyte shifts, divalent ion abnormalities, sympathetic overactivity, inflammation and iron toxicity. As outcomes in CKD patients after cardiac arrest are poor, primary and secondary prevention of SCD and cardiac arrest could reduce cardiovascular mortality in patients with CKD. PMID:27174593

  18. The Role of Respiratory Infection in Sudden Infant Death Syndrome (SIDS

    Directory of Open Access Journals (Sweden)

    Mage David T.

    2016-06-01

    Full Text Available Introduction: The Sudden Infant Death Syndrome (SIDS is not likely to be explained by a currently measureable presence in all cases and absence in controls, as otherwise it would have been solved already. Indeed, any proposed physiological model for SIDS causation must explain the constant mathematical and statistical properties of SIDS age and gender. We have shown previously that SIDS are characterized by a common 4-parameter lognormal age distribution sparing neonatal infants, by a nominal 50% male excess, and by a higher rate in winter than summer. We test now whether SIDS is closely related to a fulminating prodromal Acute Respiratory Infection (ARI by a common increasing rate with the infants increasing Live Birth Order (LBO, all remaining the same, independent of the change in preferred sleeping positions of the infants, prone or supine.

  19. Electrocardiographic T Wave Abnormalities and the Risk of Sudden Cardiac Death: The Finnish Perspective.

    Science.gov (United States)

    Tikkanen, Jani T; Kenttä, Tuomas; Porthan, Kimmo; Huikuri, Heikki V; Junttila, M Juhani

    2015-11-01

    The identification of patients at risk for sudden cardiac death (SCD) is still a significant challenge to clinicians and scientists. Noninvasive identification of high-risk patients has been of great interest, and several ventricular depolarization and repolarization abnormalities in the standard 12-lead electrocardiogram (ECG) have been associated with increased vulnerability to lethal ventricular arrhythmias. Several benign and pathological conditions can induce changes in repolarization detected as alteration of the ST segment or T wave. Changes in the ST segment and T waves can be early markers of an underlying cardiovascular disease, and even minor ST-T abnormalities have predicted reduced survival and increased risk of SCD in the adult population. In this review, we will discuss the current knowledge of the SCD risk with standard 12-lead ECG T wave abnormalities in the general population, and possible T wave changes in various cardiac conditions predisposing to SCD. PMID:26391699

  20. Next-generation sequencing of 34 genes in sudden unexplained death victims in forensics and in patients with channelopathic cardiac diseases

    OpenAIRE

    Hertz, Christin Løth; Christiansen, Sofie Lindgren; Ferrero, Laura; Fordyce, Sarah Louise; Dahl, Morten; Holst, Anders Gaarsdal; Ottesen, Gyda Lolk; Frank-Hansen, Rune; Bundgaard, Henning; Morling, Niels

    2014-01-01

    Sudden cardiac death (SCD) is responsible for a large proportion of sudden deaths in young individuals. In forensic medicine, many cases remain unexplained after routine postmortem autopsy and conventional investigations. These cases are called sudden unexplained deaths (SUD). Genetic testing has been suggested useful in forensic medicine, although in general with a significantly lower success rate compared to the clinical setting. The purpose of the study was to estimate the frequency of pat...

  1. Family-based cardiac screening in relatives of victims of sudden arrhythmic death syndrome.

    LENUS (Irish Health Repository)

    McGorrian, Catherine

    2013-02-03

    AIMS: Sudden arrhythmic death syndrome (SADS) occurs when a person suffers a sudden, unexpected death, with no cause found at postmortem examination. We aimed to describe the cardiac screening outcomes in a population of relatives of SADS victimsMETHODS AND RESULTS: Prospective and retrospective cohort study of consecutive families attending the Family Heart Screening clinic at the Mater Misericordiae Hospital in Dublin, Ireland, from January 2007 to September 2011. Family members of SADS victims underwent a standard screening protocol. Adjunct clinical and postmortem information was sought on the proband. Families who had an existing diagnosis, or where the proband had epilepsy, were excluded. Of 115 families identified, 73 were found to fit inclusion criteria and were retained for analysis, with data available on 262 relatives. Over half of the screened family members were female, and the mean age was 38.6 years (standard deviation 15.6). In 22 of 73 families (30%), and 36 of 262 family members (13.7%), a potentially inheritable cause of SADS was detected. Of the population screened, 32 patients (12.2%) were treated with medication, and 5 (1.9%) have received implantable cardiac defibrillators. Of the five families with long QT syndrome (LQTS) who had a pathogenic gene mutation identified, three carried two such mutations.CONCLUSION: In keeping with international estimates, 30% of families of SADS victims were found to have a potentially inherited cardiac disease. The most common positive finding was LQTS. Advances in postmortem standards and genetic studies may assist in achieving more diagnoses in these families.

  2. Prevention of sudden cardiac death in the young and in athletes: dream or reality?

    Science.gov (United States)

    Thiene, Gaetano; Carturan, Elisa; Corrado, Domenico; Basso, Cristina

    2010-01-01

    Cardiovascular diseases account for 40% of all deaths in the Western countries, and nearly two thirds of them occur suddenly. Young people (years) are not spared from sudden death (SD) with a rate of 1/100,000 per year. Effort is a trigger with a threefold risk in athletes vs. nonathletes, and sports disqualification is by itself life-saving in people with underlying concealed cardiovascular diseases. Several culprits of cardiac SD may be identified at postmortem and atherosclerotic coronary artery disease is the leading cause (25% of SD cases in the young), mostly consisting of a single obstructive plaque with fibrocellular intimal proliferation. However, the spectrum of cardiovascular substrates is wide and include also congenital diseases of the coronary arteries (mainly anomalous origin), myocardium (arrhythmogenic and hypertrophic cardiomyopathies, myocarditis), valves (aortic stenosis and mitral valve prolapse), and conduction system (ventricular preexcitation, accelerated atrioventricular conduction and block). In up to 20% of cases, the heart is grossly and histologically normal at autopsy (unexplained SD or "mors sine materia"), and inherited ion channel diseases have been implicated (long and short QT syndromes, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia). Targets to treat and prevent SD in the young consist of the following: (a) avoid triggers like effort or emotion, (b) inhibit the onset of arrhythmias with drugs or ablation, (c) switch off arrhythmias with defibrillator, and (d) hinder the recurrence of the disease with genetic counseling and/or therapy. In vivo detection of cardiomyopathies is nowadays feasible by electrocardiogram and/or echocardiography, which resulted in a sharp decline of SD in the athletes in Italy, thanks to obligatory preparticipation screening for sport activity. Genetic screening could play a pivotal role in early detection of asymptomatic mutation carriers of cardiovascular diseases at risk of SD

  3. Regression of electrocardiographic left ventricular hypertrophy during antihypertensive therapy and reduction in sudden cardiac death: the LIFE Study

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Okin, Peter M; Olsen, Michael H;

    2007-01-01

    BACKGROUND: Sudden cardiac death (SCD) occurs more often in patients with ECG left ventricular (LV) hypertrophy. However, whether LV hypertrophy regression is associated with a reduced risk of SCD remains unclear. METHODS AND RESULTS: The Losartan Intervention for End Point Reduction in Hypertens......BACKGROUND: Sudden cardiac death (SCD) occurs more often in patients with ECG left ventricular (LV) hypertrophy. However, whether LV hypertrophy regression is associated with a reduced risk of SCD remains unclear. METHODS AND RESULTS: The Losartan Intervention for End Point Reduction...

  4. Risk of sudden infant death syndrome after immunization with the diphtheria-tetanus-pertussis vaccine.

    Science.gov (United States)

    Griffin, M R; Ray, W A; Livengood, J R; Schaffner, W

    1988-09-01

    To evaluate recent immunization against diphtheria, tetanus, and pertussis (DTP) as a possible risk factor for sudden infant death syndrome (SIDS), we studied the rates of SIDS after the administration of DTP vaccine in a cohort of 129,834 children who were born in four urban Tennessee counties during the period from 1974 through 1984. All the children received at least one DTP immunization in the first year of life at county health-department clinics or from Medicaid providers. Computerized immunization records from these sources were linked with Tennessee birth and death certificates to establish the cohort, ascertain the timing of immunization, and identify cases of SIDS. These children represented 42 percent of the births in the four counties. Among these children, 204 deaths occurred at the ages of 29 to 365 days; 109 deaths were classified as due to SIDS. We estimated the risk of SIDS according to the length of time, up to 30 days, since DTP immunization and compared it with the risk 31 days or more after immunization to calculate the relative risk. With control for age, the relative risk from 0 to 3 days after DTP immunization was 0.18 (95 percent confidence interval, 0.04 to 0.8); from 4 to 7 days, 0.17 (95 percent confidence interval, 0.04 to 0.7); from 8 to 14 days, 0.75 (95 percent confidence interval, 0.4 to 1.5); and from 15 to 30 days, 1.0 (95 percent confidence interval, 0.6 to 1.6). A multivariate analysis in which we controlled for age, sex, race, year, birth weight, and Medicaid enrollment, produced similar results. We conclude that in this large population of children there was no increase in the risk of SIDS after immunization with the DTP vaccine.

  5. Finding the rhythm of sudden cardiac death: new opportunities using induced pluripotent stem cell-derived cardiomyocytes.

    Science.gov (United States)

    Sallam, Karim; Li, Yingxin; Sager, Philip T; Houser, Steven R; Wu, Joseph C

    2015-06-01

    Sudden cardiac death is a common cause of death in patients with structural heart disease, genetic mutations, or acquired disorders affecting cardiac ion channels. A wide range of platforms exist to model and study disorders associated with sudden cardiac death. Human clinical studies are cumbersome and are thwarted by the extent of investigation that can be performed on human subjects. Animal models are limited by their degree of homology to human cardiac electrophysiology, including ion channel expression. Most commonly used cellular models are cellular transfection models, which are able to mimic the expression of a single-ion channel offering incomplete insight into changes of the action potential profile. Induced pluripotent stem cell-derived cardiomyocytes resemble, but are not identical, adult human cardiomyocytes and provide a new platform for studying arrhythmic disorders leading to sudden cardiac death. A variety of platforms exist to phenotype cellular models, including conventional and automated patch clamp, multielectrode array, and computational modeling. Induced pluripotent stem cell-derived cardiomyocytes have been used to study long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, hypertrophic cardiomyopathy, and other hereditary cardiac disorders. Although induced pluripotent stem cell-derived cardiomyocytes are distinct from adult cardiomyocytes, they provide a robust platform to advance the science and clinical care of sudden cardiac death. PMID:26044252

  6. Analysis of risk factors for sudden cardiac death%心源性猝死危险因素分析

    Institute of Scientific and Technical Information of China (English)

    张自云

    2014-01-01

    目的:探讨和分析心源性猝的危险因素。方法收集和整理在我院2012年04月-2013年10月诊治时发生心源性猝死的心肌患者64例为研究对象,对上述收集对象的临床资料进行整理和分析。结果本组单因素分析显示自发性持续室速、心室颤动(心脏骤停)、晕阙、左室流出道梗阻、非持续性室速等因素为心肌疾病患者发生心源性猝死的危险因素;多因素Logistic分析发现自发性持续性室速、心室颤动、晕阙以及猝死家族史是发生心源性猝死的重要危险因素。结论心肌疾病患者发生心源性猝死的为危险因素呈现综合化、多样化,临床治疗中应给予针对性的预防或治疗,这对降低心肌疾病患者心源性猝死率有着积极的意义。%Objective To investigate and analyze the risk factors for sudden cardiac death. Methods Sixty-four patients with cardiomyopathy who suffered sudden cardiac death in our hospital from April 2012 to October 2013 were collected as subjects, and their clinical data were sorted and analyzed. Results The univariate analysis showed that the risk factors for sudden cardiac death in patients with cardiomyopathy included spontaneous sustained ventricular tachycardia, ventricular fibrillation (sudden cardiac arrest), syncope, left ventricular outflow tract obstruction, and nonsustained ventricular tachycardia. The multivariate logistic analysis showed that spontaneous sustained ventricular tachycardia, ventricular fibrillation, syncope, and a family history of sudden death were important risk factors for sudden cardiac death. Conclusion The risk factors for sudden cardiac death in patients with cardiomyopathy are complicated and diverse, and specific prevention or treatment should be adopted in clinical treatment, which is of great significance for reducing the incidence of sudden cardiac death in patients with cardiomyopathy.

  7. From unwitnessed fatality to witnessed rescue: Pharmacologic intervention in sudden unexpected death in epilepsy.

    Science.gov (United States)

    Richerson, George B; Boison, Detlev; Faingold, Carl L; Ryvlin, Philippe

    2016-01-01

    The mechanisms of sudden unexpected death in epilepsy (SUDEP) have been difficult to define, as most cases occur unwitnessed, and physiologic recordings have been obtained in only a handful of cases. However, recent data obtained from human cases and experimental studies in animal models have brought us closer to identifying potential mechanisms. Theories of SUDEP should be able to explain how a seizure starting in the forebrain can sometimes lead to changes in brainstem cardiorespiratory control mechanisms. Herein we focus on three major themes of work on the causes of SUDEP. First, evidence is reviewed identifying postictal hypoventilation as a major contributor to the cause of death. Second, data are discussed that brainstem serotonin and adenosine pathways may be involved, as well as how they may contribute. Finally, parallels are drawn between SIDS and SUDEP, and we highlight similarities pointing to the possibility of shared pathophysiology involving combined failure of respiratory and cardiovascular control mechanisms. Knowledge about the causes of SUDEP may lead to potential pharmacologic approaches for prevention. We end by describing how translation of this work may result in future applications to clinical care. PMID:26749015

  8. From unwitnessed fatality to witnessed rescue: Nonpharmacologic interventions in sudden unexpected death in epilepsy.

    Science.gov (United States)

    Rugg-Gunn, Fergus; Duncan, John; Hjalgrim, Helle; Seyal, Masud; Bateman, Lisa

    2016-01-01

    Sudden unexpected death in epilepsy (SUDEP) risk reduction remains a critical aim in epilepsy care. To date, only aggressive medical and surgical efforts to control seizures have been demonstrated to be of benefit. Incomplete understanding of SUDEP mechanisms limits the development of more specific interventions. Periictal cardiorespiratory dysfunction is implicated in SUDEP; postictal electroencephalography (EEG) suppression, coma, and immobility may also play a role. Nocturnal supervision is protective against SUDEP, presumably by permitting intervention in the case of a life-threatening event. Resuscitative efforts were implemented promptly in near-SUDEP cases but delayed in SUDEP deaths in the Mortality in Epilepsy Monitoring Unit Study (MORTEMUS) study. Nursing interventions--including repositioning, oral suctioning, and oxygen administration--reduce seizure duration, respiratory dysfunction, and EEG suppression in the epilepsy monitoring unit (EMU), but have not been studied in outpatients. Cardiac pacemakers or cardioverter-defibrillator devices may be of benefit in a few select individuals. A role for implantable neurostimulators has not yet been established. Seizure detection devices, including those that monitor generalized tonic-clonic seizure-associated movements or cardiorespiratory parameters, may provide a means to permit timely periictal intervention. However, these and other devices, such as antisuffocation pillows, have not been adequately investigated with respect to SUDEP prevention.

  9. Experience With the Wearable Cardioverter-Defibrillator in Patients at High Risk for Sudden Cardiac Death

    Science.gov (United States)

    Günther, Michael; Quick, Silvio; Pfluecke, Christian; Rottstädt, Fabian; Szymkiewicz, Steven J.; Ringquist, Steven; Strasser, Ruth H.; Speiser, Uwe

    2016-01-01

    Background: This study evaluated the wearable cardioverter-defibrillator (WCD) for use and effectiveness in preventing sudden death caused by ventricular tachyarrhythmia or fibrillation. Methods: From April 2010 through October 2013, 6043 German WCD patients (median age, 57 years; male, 78.5%) were recruited from 404 German centers. Deidentified German patient data were used for a retrospective, nonrandomized analysis. Results: Ninety-four patients (1.6%) were treated by the WCD in response to ventricular tachyarrhythmia/fibrillation. The incidence rate was 8.4 (95% confidence interval, 6.8–10.2) per 100 patient-years. Patients with implantable cardioverter-defibrillator explantation had an incidence rate of 19.3 (95% confidence interval, 12.2–29.0) per 100 patient-years. In contrast, an incidence rate of 8.2 (95% confidence interval, 6.4–10.3) was observed in the remaining cardiac diagnosis groups, including dilated cardiomyopathy, myocarditis, and ischemic and nonischemic cardiomyopathies. Among 120 shocked patients, 112 (93%) survived 24 hours after treatment, whereas asystole was observed in 2 patients (0.03%) with 1 resulting death. ConclusionS: This large cohort represents the first nationwide evaluation of WCD use in patients outside the US healthcare system and confirms the overall value of the WCD in German treatment pathways. PMID:27458236

  10. Effect of Left Ventricular Dysfunction and Viral Load on Risk of Sudden Cardiac Death In Patients with Human Immunodeficiency Virus

    OpenAIRE

    Moyers, Brian S.; Secemsky, Eric A.; Vittinghoff, Eric; Wong, Joseph K.; Diane V Havlir; Priscilla Y Hsue; Tseng, Zian H

    2014-01-01

    Human Immunodeficiency Virus-infected patients are disproportionately affected by cardiovascular disease and sudden cardiac death (SCD). Whether left ventricular (LV) dysfunction predicts SCD in those with human immunodeficiency virus (HIV) is unknown. We sought to determine the impact of LV on SCD in patients with HIV. We previously characterized all SCDs and AIDS deaths in 2860 consecutive patients in a public HIV clinic between 2000 and 2009. Transthoracic echocardiograms (TTEs) performed ...

  11. Association between Clinical and Doppler Echocardiographic Parameters with Sudden Death in Hemodialysis Patients

    Science.gov (United States)

    Barberato, Silvio Henrique; Bucharles, Sérgio Gardano Elias; Barberato, Marcia Ferreira Alves; Pecoits-Filho, Roberto

    2016-01-01

    Background: Sudden cardiac death (SCD) is the leading cause of death in maintenance hemodialysis (HD) patients, but there is little information about underlying risk factors. Objectives: Evaluate the association between clinical and echocardiographic variables with SCD on HD patients. Methods: Retrospective nested case-control study on chronic HD patients who were prospectively followed. The primary endpoint was SCD. Variables were compared by Student t test, Mann-Whitney or Chi-Square, and independent predictors of SCD were evidenced by multivariate logistic regression. Results: We followed 153 patients (50 ± 15 years, 58% men) for 23 ± 14 months and observed 35 deaths, 17 of which were SCD events. When compared to the control group (matched for gender, age, and body mass index) there were no differences regarding time on dialysis, traditional biochemical parameters, blood pressure, smoking, use of cardiovascular protective drugs, ejection fraction, left ventricular dimensions, and diastolic function indices. On the other hand, in the SCD group, we found a higher prevalence of previous heart failure, acute myocardial infarction and diabetes, greater left ventricular mass index, greater left atrial size and lower global myocardial performance. After multivariate logistic regression analysis, diabetes (OR = 2.6; CI = 1.3-7.5; p = 0.023) and left ventricular mass index ≥ 101 g/m2.7 (OR = 1.04; CI = 1.01-1.08; p = 0.028) showed independent association with SCD events. Conclusions: HD patients with diabetes mellitus and left ventricular hypertrophy appear to have the highest risk of SCD. Preventive and therapeutic strategies should be encouraged in addressing these risk factors to minimize the occurrence of SCD in HD patients. PMID:27411094

  12. Entanglement Transfer and Periodic Sudden Death Phenomenon in Two Parallel 1D Spin Chains of Quantum Spin Network

    Institute of Scientific and Technical Information of China (English)

    WANG Zhao-Ming; SHAO Bin; ZOU Jian

    2007-01-01

    We investigate the entanglement transfer in two parallel 1D spin chains of a quantum spin network,and show that the perfect entanglement transfer can be realized at some special times.In addition,the so-called 'sudden death' phenomenon of entanglement is found in the spin network system.

  13. The promise of omega-3 against sudden unexpected death in epilepsy: until further notice, it remains innocent, until proven guilty

    Directory of Open Access Journals (Sweden)

    Fulvio Alexandre Scorza

    2013-01-01

    Full Text Available The present paper highlighted the importance of the recommended levels of fish consumption or omega-3 supplementation in order to minimize the frequency of seizures in people with uncontrolled epilepsy and, especially, to reduce the occurrence of sudden unexpected death in epilepsy (SUDEP.

  14. Early Echocardiographic Deformation Analysis for the Prediction of Sudden Cardiac Death and Life-Threatening Arrhythmias After Myocardial Infarction

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Valeur, Nana; Andersen, Mads Jønsson;

    2013-01-01

    This study sought to hypothesize that global longitudinal strain (GLS) as a measure of infarct size, and mechanical dispersion (MD) as a measure of myocardial deformation heterogeneity, would be of incremental importance for the prediction of sudden cardiac death (SCD) or malignant ventricular ar...

  15. Letter to the Editor : Standardizing the nomenclature for clonal lineages of the sudden oak death pathogen, Phytophthora ramorum

    NARCIS (Netherlands)

    Grünwald, N.J.; Goss, E.M.; Ivors, K.; Garbelotto, M.; Martin, F.N.; Prospero, S.; Hansen, E.; Bonants, P.J.M.; Hamelin, R.C.; Chastagner, M.; Werres, S.; Rizzo, D.M.; Abad, G.; Beales, P.; Bilodeau, G.J.; Blomquist, C.L.; Brasier, C.; Brière, S.C.; Chandelier, A.; Davidson, J.M.; Denman, S.; Elliott, M.; Frankel, S.J.; Goheen, E.M.; Gruyter, de H.; Heungens, K.; James, D.; Kanaskie, A.; McWilliams, M.G.; Man in't Veld, W.; Moralejo, E.; Osterbauer, N.K.; Palm, M.E.; Parke, J.L.; Perez Sierra, A.M.; Shamoun, S.F.; Shishkoff, N.; Tooley, P.W.; Vettraino, A.M.; Webber, J.; Widmer, T.L.

    2009-01-01

    Phytophthora ramorum, the causal agent of sudden oak death and ramorum blight, is known to exist as three distinct clonal lineages which can only be distinguished by performing molecular marker-based analyses. However, in the recent literature there exists no consensus on naming of these lineages. H

  16. Sudden and unexpected death in early life: proceedings of a symposium in honor of Dr. Henry F. Krous.

    Science.gov (United States)

    Kinney, Hannah C; Rognum, Torleiv O; Nattie, Eugene E; Haddad, Gabriel G; Hyma, Bruce; McEntire, Betty; Paterson, David S; Crandall, Laura; Byard, Roger W

    2012-12-01

    Reported here are the proceedings of a symposium given in honor of Dr. Henry F. Krous upon his retirement as Clinical Professor of Pathology and Pediatrics at the University of California Schools of Medicine, and as Director of the San Diego SIDS/SUDC Research Project. Dr. Krous' distinguished 37-year-career was dedicated to research into sudden unexpected death in infancy and childhood, notably the sudden infant death syndrome (SIDS) and sudden unexplained death in childhood (SUDC). The presentations were given at the International Conference on Stillbirth, SIDS, and infant survival on October 5, 2012, in Baltimore, MD, USA. Eight colleagues of Dr. Krous whose own professional careers were touched by his efforts discussed forensic issues related to SIDS, tissue banking, animal models in SIDS, brainstem studies in SIDS, genetic studies in SIDS, establishment of a SUDC registry, neuropathologic research in SUDC, and potential shared mechanisms underlying sudden and unexpected death in early life. The wide scope of the presentations crossed the disciplines of forensic pathology, pediatric pathology, neuropathology, neuroscience, physiology, genetics, and bereavement, and attest to Dr. Krous' far-reaching influence upon SIDS and SUDC research. PMID:22941540

  17. Are individuals within families with premature truly sudden unexplained death at risk during long-term follow-up?

    NARCIS (Netherlands)

    Van Der Werf, Christian; Stiekema, Lotte; Hofman, Nynke; Alders, Marielle; Van Der Wal, Allard C.; Tan, Hanno L.; Van Langen, Irene M.; Wilde, Arthur A.

    2012-01-01

    Introduction: After young sudden unexplained death (SUD), comprehensive cardiologic and genetic examination in surviving first-degree relatives unmasks inherited cardiac disease in ∼40% of families, enabling timely prophylactic treatment. It is unknown, however, whether individuals from diagnosis-ne

  18. LATE POTENTIALS IN A BRADYCARDIA-DEPENDENT LONG QT-SYNDROME ASSOCIATED WITH SUDDEN-DEATH DURING SLEEP

    NARCIS (Netherlands)

    TOBE, TJM; DELANGEN, CDJ; BINKBOELKENS, MTE; MOOK, PH; VIERSMA, JW; LIE, KI; WESSELING, H

    1992-01-01

    The purpose of this study was to determine the incidence of late potentials and their relation to QT prolongation in a family with a high incidence of sudden death during sleep at a young age and bradycardia-dependent QT prolongation (n = 9) and to compare the findings with those in consanguineous f

  19. Sudden death due to rupture of the right internal carotid artery in neurofibromatosis type 1: A case report.

    Science.gov (United States)

    Liang, Yue; Tong, Fang; Zhang, Lin; Li, Wenhe; Zhou, Yiwu

    2016-07-01

    Vascular involvement is a well-recognized manifestation of neurofibromatosis type 1 (NF1) which has the potential to be fatal when disrupted. We here present a case of sudden death due to the fatal arterial rupture resulted from infiltration of the neurofibromas. A 42-year-old man who suffered from NF1 presented a 1-h history of sudden onset of pain in his right cervical region. His condition worsened and became unconscious on his way to the emergency room. Despite resuscitation efforts, he died 30min later without regaining consciousness. Autopsy examination showed that a neurofibroma located around the right internal carotid artery, confirmed immunohistochemically with S-100, vimentin and CD34. Furthermore, proliferation of spindle cells positive for S-100 was seen in the wall of right internal carotid artery, which was disrupted and resulted in a hemorrhage. These findings suggest that the artery was disrupted by neurofibromas in the vascular wall, which led to fragility of the vessel. On the basis of these findings, we concluded that the cause of death was asphyxia resulting from airway obstruction compressed by the hematoma due to the arterial rupture. As the locality of the neurofibroma and hemorrhage were closed to the carotid baroreflex, we considered another possible mechanism of his sudden death, which could be cardiac inhibition induced by vagal stimulation. We hope this case will increase recognition of NF-1 vasculopathy when encountering any sudden death in NF1 patients. PMID:27497331

  20. Predictive Value of Beat-to-Beat QT Variability Index across the Continuum of Left Ventricular Dysfunction: Competing Risks of Non-cardiac or Cardiovascular Death, and Sudden or Non-Sudden Cardiac Death

    Science.gov (United States)

    Tereshchenko, Larisa G.; Cygankiewicz, Iwona; McNitt, Scott; Vazquez, Rafael; Bayes-Genis, Antoni; Han, Lichy; Sur, Sanjoli; Couderc, Jean-Philippe; Berger, Ronald D.; de Luna, Antoni Bayes; Zareba, Wojciech

    2012-01-01

    Background The goal of this study was to determine the predictive value of beat-to-beat QT variability in heart failure (HF) patients across the continuum of left ventricular dysfunction. Methods and Results Beat-to-beat QT variability index (QTVI), heart rate variance (LogHRV), normalized QT variance (QTVN), and coherence between heart rate variability and QT variability have been measured at rest during sinus rhythm in 533 participants of the Muerte Subita en Insuficiencia Cardiaca (MUSIC) HF study (mean age 63.1±11.7; males 70.6%; LVEF >35% in 254 [48%]) and in 181 healthy participants from the Intercity Digital Electrocardiogram Alliance (IDEAL) database. During a median of 3.7 years of follow-up, 116 patients died, 52 from sudden cardiac death (SCD). In multivariate competing risk analyses, the highest QTVI quartile was associated with cardiovascular death [hazard ratio (HR) 1.67(95%CI 1.14-2.47), P=0.009] and in particular with non-sudden cardiac death [HR 2.91(1.69-5.01), P<0.001]. Elevated QTVI separated 97.5% of healthy individuals from subjects at risk for cardiovascular [HR 1.57(1.04-2.35), P=0.031], and non-sudden cardiac death in multivariate competing risk model [HR 2.58(1.13-3.78), P=0.001]. No interaction between QTVI and LVEF was found. QTVI predicted neither non-cardiac death (P=0.546) nor SCD (P=0.945). Decreased heart rate variability (HRV) rather than increased QT variability was the reason for increased QTVI in this study. Conclusions Increased QTVI due to depressed HRV predicts cardiovascular mortality and non-sudden cardiac death, but neither SCD nor excracardiac mortality in HF across the continuum of left ventricular dysfunction. Abnormally augmented QTVI separates 97.5% of healthy individuals from HF patients at risk. PMID:22730411

  1. Sudden, unexpected death of a 15-year-old boy due to pancarditis

    Science.gov (United States)

    Osculati, Antonio; Visonà, Silvia Damiana; Ventura, Francesco; Castelli, Francesca; Andrello, Luisa

    2016-01-01

    Abstract Background: Generally, rheumatic heart disease is, today, sporadic in developed countries, even though it continues to be a major health hazard in the developing ones. It is also a very rare cause of sudden unexpected death. We report a case of a 15-year-old boy who suddenly died at home. Since 3 days he had presented fever and chest pain. The family physician had diagnosed bronchitis and treated the boy with amoxicillin. Methods: Seven hours after death, a forensic autopsy were performed . Before the autopsy, anamnesis and some circumstantial data were collected from the boy's parents. During the autopsy, samples for histological, toxicological and molecular examinations were collected. The samples for the histology (brain, hypophysis, heart and pericardium, lungs, spleen, liver, kidney, adrenal glands) were formalin fixed and paraffin embedded. Each section was stained with Hematoxylin-Eosin. Immunostaining was also performed, with anti-CD 68, anti-CD3, anti-CD 20, anti-myeloperoxidase. Microbiological cultures were performed on cardiac blood, myocardium, pericardial effusion and cerebrospinal fluid samples collected during autopsy. Blood specimens were also processed through PCR, in order to reveal the presence of Enteroviruses, Chickenpox virus, Epstein Barr virus. Also chemical-toxicological examinations for the detection of the main medications and drugs were performed on blood samples. Results: The anamnesis, collected before the autopsy, revealed an acute pharyngitis few weeks before. The autopsy, and the following histological and immunochemical examinations suggested an immunological etiology. The immunohistochemistry, showing a strong positivity of antiCD68 antibodies, integrated with clinical-anamnestic information, leads to hypothesize a rheumatic carditis. Conclusion: In light of this case, at least 3 main messages of great importance for the clinician can be deduced. First, an accurate anamnesis collected by the family physician could have

  2. Can parents adjust to the idea that their child is at risk for a sudden death?: Psychological impact of risk for Long QT Syndrome

    NARCIS (Netherlands)

    Hendriks, K.S.W.H.; Grosfeld, F.J.M.; van Tintelen, J.P.; van Langen, I.M.; Wilde, A.A.M.; van den Bout, J.; ten Kroode, H.F.J.

    2005-01-01

    Can a parent adjust to the idea that its child is at risk for a sudden death? This question is raised by a diagnostic procedure in which children were tested for an inherited Long QT Syndrome (LQTS). This potentially life-threatening but treatable cardiac arrhythmia syndrome may cause sudden death,

  3. Can parents adjust to the idea that their child is at risk for a sudden death? : Psychological impact of risk for Long QT Syndrome

    NARCIS (Netherlands)

    Grosfeld, FJM; van Tintelen, JP; van Langen, IM; Wilde, AAM; van den Bout, J; ten Kroode, HFJ

    2005-01-01

    Can a parent adjust to the idea that its child is at risk for a sudden death? This question is raised by a diagnostic procedure in which children were tested for an inherited Long QT Syndrome (LQTS). This potentially life-threatening but treatable cardiac arrhythmia syndrome may cause sudden death,

  4. Comparison of the Frequency of Sudden Cardiovascular Deaths in Young Competitive Athletes Versus Nonathletes: Should We Really Screen Only Athletes?

    Science.gov (United States)

    Maron, Barry J; Haas, Tammy S; Duncanson, Emily R; Garberich, Ross F; Baker, Andrew M; Mackey-Bojack, Shannon

    2016-04-15

    The issue of sudden death in young athletes and consideration for the most practical and optimal strategy to identify those genetic and/or congenital heart diseases responsible for these tragic events continues to be debated. However, proponents of broad-based and mandatory national preparticipation screening, including with 12-lead electrocardiograms have confined the focus to a relatively small segment of the youthful population who choose to engage in competitive athletic programs at the high school, college, and elite-professional level. Therefore, lost in this discussion of preparticipation screening of athletes is that the larger population of young people not involved in competitive sports (and, therefore, a priori are excluded from systematic screening) who nevertheless may die suddenly of the same cardiovascular diseases as athletes. To substantiate this hypothesis, we accessed the forensic Hennepin County, Minnesota registry in which cardiovascular sudden deaths were 8-fold more common in nonathletes (n = 24) than athletes (n = 3) and threefold more frequent in terms of incidence. The most common diseases responsible for sudden death were hypertrophic cardiomyopathy (n = 6) and arrhythmogenic right ventricular cardiomyopathy (n = 4). These data raise ethical considerations inherent in limiting systematic screening for unsuspected genetic and/or congenital heart disease to competitive athletes. PMID:26949036

  5. Comparison of the Frequency of Sudden Cardiovascular Deaths in Young Competitive Athletes Versus Nonathletes: Should We Really Screen Only Athletes?

    Science.gov (United States)

    Maron, Barry J; Haas, Tammy S; Duncanson, Emily R; Garberich, Ross F; Baker, Andrew M; Mackey-Bojack, Shannon

    2016-04-15

    The issue of sudden death in young athletes and consideration for the most practical and optimal strategy to identify those genetic and/or congenital heart diseases responsible for these tragic events continues to be debated. However, proponents of broad-based and mandatory national preparticipation screening, including with 12-lead electrocardiograms have confined the focus to a relatively small segment of the youthful population who choose to engage in competitive athletic programs at the high school, college, and elite-professional level. Therefore, lost in this discussion of preparticipation screening of athletes is that the larger population of young people not involved in competitive sports (and, therefore, a priori are excluded from systematic screening) who nevertheless may die suddenly of the same cardiovascular diseases as athletes. To substantiate this hypothesis, we accessed the forensic Hennepin County, Minnesota registry in which cardiovascular sudden deaths were 8-fold more common in nonathletes (n = 24) than athletes (n = 3) and threefold more frequent in terms of incidence. The most common diseases responsible for sudden death were hypertrophic cardiomyopathy (n = 6) and arrhythmogenic right ventricular cardiomyopathy (n = 4). These data raise ethical considerations inherent in limiting systematic screening for unsuspected genetic and/or congenital heart disease to competitive athletes.

  6. Integrated Omic Analysis of a Guinea Pig Model of Heart Failure and Sudden Cardiac Death.

    Science.gov (United States)

    Foster, D Brian; Liu, Ting; Kammers, Kai; O'Meally, Robert; Yang, Ni; Papanicolaou, Kyriakos N; Talbot, C Conover; Cole, Robert N; O'Rourke, Brian

    2016-09-01

    Here, we examine key regulatory pathways underlying the transition from compensated hypertrophy (HYP) to decompensated heart failure (HF) and sudden cardiac death (SCD) in a guinea pig pressure-overload model by integrated multiome analysis. Relative protein abundances from sham-operated HYP and HF hearts were assessed by iTRAQ LC-MS/MS. Metabolites were quantified by LC-MS/MS or GC-MS. Transcriptome profiles were obtained using mRNA microarrays. The guinea pig HF proteome exhibited classic biosignatures of cardiac HYP, left ventricular dysfunction, fibrosis, inflammation, and extravasation. Fatty acid metabolism, mitochondrial transcription/translation factors, antioxidant enzymes, and other mitochondrial procsses, were downregulated in HF but not HYP. Proteins upregulated in HF implicate extracellular matrix remodeling, cytoskeletal remodeling, and acute phase inflammation markers. Among metabolites, acylcarnitines were downregulated in HYP and fatty acids accumulated in HF. The correlation of transcript and protein changes in HF was weak (R(2) = 0.23), suggesting post-transcriptional gene regulation in HF. Proteome/metabolome integration indicated metabolic bottlenecks in fatty acyl-CoA processing by carnitine palmitoyl transferase (CPT1B) as well as TCA cycle inhibition. On the basis of these findings, we present a model of cardiac decompensation involving impaired nuclear integration of Ca(2+) and cyclic nucleotide signals that are coupled to mitochondrial metabolic and antioxidant defects through the CREB/PGC1α transcriptional axis. PMID:27399916

  7. Genetic testing and genetic counseling in patients with sudden death risk due to heritable arrhythmias.

    Science.gov (United States)

    Spoonamore, Katherine G; Ware, Stephanie M

    2016-03-01

    Sudden cardiac death due to heritable ventricular arrhythmias is an important cause of mortality, especially in young healthy individuals. The identification of the genetic basis of Mendelian diseases associated with arrhythmia has allowed the integration of this information into the diagnosis and clinical management of patients and at-risk family members. The rapid expansion of genetic testing options and the increasing complexity involved in the interpretation of results creates unique opportunities and challenges. There is a need for competency to incorporate genetics into clinical management and to provide appropriate family-based risk assessment and information. In addition, disease-specific genetic knowledge is required to order and correctly interpret and apply genetic testing results. Importantly, genetic diagnosis has a critical role in the risk stratification and clinical management of family members. This review summarizes the approach to genetic counseling and genetic testing for inherited arrhythmias and highlights specific genetic principles that apply to long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia.

  8. Hypothyroidism renders protection against lethal ventricular arrhythmias in a conscious canine model of sudden death.

    Science.gov (United States)

    Venkatesh, N; Lynch, J J; Uprichard, A C; Kitzen, J M; Singh, B N; Lucchesi, B R

    1991-11-01

    The protective effect of hypothyroidism against lethal ventricular tachyarrhythmias (VT) in the subacute phase of experimental myocardial infarction (MI) was investigated in 10 thyroidectomized dogs using a conscious model of sudden coronary death. Four weeks after surgical ablation of the thyroid, and having established biochemical hypothyroidism, anterior MI was produced by 120 min of occlusion-reperfusion of the left anterior descending coronary artery. In the subacute phase of MI, the inducibility of VT was investigated using programmed ventricular stimulation (PVS), and the effects on spontaneous development of ventricular fibrillation (VF) were studied by production of posterolateral ischemia at a site remote from the area of the previous infarction. Ischemia was produced by the passage of anodal direct current through a silver wire electrode implanted in the left circumflex coronary (LCX) artery. The results were compared to those from a cohort of 20 existing euthyroid controls that had undergone an identical experimental protocol. No differences were found in heart rate and other electrocardiographic parameters such as the PR, QRS, and QT (paced at 2.5 Hz) and the QTc interval between the hypo- and euthyroid groups. During PVS in the subacute phase of anterior MI, the measured threshold voltage and ventricular refractory periods were similar in both groups. The incidence of inducibility of VT was 100% in the euthyroid animals compared to 60% in the hypothyroid dogs, suggesting an antiarrhythmic effect of hypothyroidism. The incidence of sustained vs. nonsustained VT was similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1723767

  9. Power blackouts, sudden death, and flash crashes: The physics of interdependent networks

    Science.gov (United States)

    Stanley, H. Eugene

    2014-03-01

    Recent disasters ranging from abrupt financial ``flash crashes'' and large-scale power outages to sudden death among the elderly dramatically exemplify the fact that the most dangerous vulnerability is hiding in the many interdependencies among different networks. This talk reports recent work quantifying failure mechanisms in interconnected networks, and demonstrates the need to consider mutually dependent network properties in designing resilient systems. Specifically, we have uncovered new laws governing the nature of switching phenomena in coupled networks, and found that phenomena that are continuous ``second order'' phase transitions in isolated networks become discontinuous abrupt ``first order'' transitions in interdependent networks [J. Gao, S. V. Buldyrev, H. E. Stanley, and S. Havlin, ``Novel Behavior of Networks Formed from Interdependent Networks,'' Nature Physics 8, 40 (2012)]. We also report parallel efforts to understand the phenomenon of spontaneous recovery in dynamical networks as occurs, e.g., immediately after a flash crash [A. Majdandzic, B. Podobnik, S. V. Buldyrev, D. Y. Kenett, S. Havlin, and H. E. Stanley, ``Spontaneous Recovery in Dynamic Networks,'' Nature Physics 9, No. 1 (2014)].

  10. Susceptibility to seizure-induced sudden death in DBA/2 mice is altered by adenosine.

    Science.gov (United States)

    Faingold, Carl L; Randall, Marc; Kommajosyula, Srinivasa P

    2016-08-01

    Sudden unexpected death in epilepsy (SUDEP) is rare but is an important public health burden due to the number of patient years lost. Respiratory dysfunction following generalized convulsive seizure is a common sequence of events in witnessed SUDEP cases. The DBA/2 mouse model of SUDEP exhibits generalized convulsive audiogenic seizures (AGSz), which result in seizure-induced respiratory arrest (S-IRA) in ∼75% of these animals, while the remaining DBA/2 mice exhibit AGSz without S-IRA. SUDEP induction may involve actions of adenosine, which is released during generalized seizures in animals and patients and is known to depress respiration. This study examined the effects of systemic administration of agents that alter the actions of adenosine on the incidence of S-IRA in DBA/2 mice. DBA/2 mice that consistently exhibited AGSz without S-IRA showed a significantly increased incidence of S-IRA following treatment with 5-iodotubercidin, which blocks adenosine metabolism. Treatment of DBA/2 mice that consistently exhibited AGSz followed by S-IRA with a non-selective adenosine antagonist, caffeine, or an A2A adenosine receptor subtype-selective antagonist (SCH 442416) significantly reduced S-IRA incidence. By contrast, an A1 adenosine receptor antagonist (DPCPX) was not effective in reducing S-IRA incidence. These findings suggest that preventative approaches for SUDEP should consider agents that reduce the actions of adenosine. PMID:27259068

  11. Assessing Field-Specific Risk of Soybean Sudden Death Syndrome Using Satellite Imagery in Iowa.

    Science.gov (United States)

    Yang, S; Li, X; Chen, C; Kyveryga, P; Yang, X B

    2016-08-01

    Moderate resolution imaging spectroradiometer (MODIS) satellite imagery from 2004 to 2013 were used to assess the field-specific risks of soybean sudden death syndrome (SDS) caused by Fusarium virguliforme in Iowa. Fields with a high frequency of significant decrease (>10%) of the normalized difference vegetation index (NDVI) observed in late July to middle August on historical imagery were hypothetically considered as high SDS risk. These high-risk fields had higher slopes and shorter distances to flowlines, e.g., creeks and drainages, particularly in the Des Moines lobe. Field data in 2014 showed a significantly higher SDS level in the high-risk fields than fields selected without considering NDVI information. On average, low-risk fields had 10 times lower F. virguliforme soil density, determined by quantitative polymerase chain reaction, compared with other surveyed fields. Ordinal logistic regression identified positive correlations between SDS and slope, June NDVI, and May maximum temperature, but high June maximum temperature hindered SDS. A modeled SDS risk map showed a clear trend of potential disease occurrences across Iowa. Landsat imagery was analyzed similarly, to discuss the ability to utilize higher spatial resolution data. The results demonstrated the great potential of both MODIS and Landsat imagery for SDS field-specific risk assessment. PMID:27070424

  12. The 12-lead electrocardiogram and risk of sudden death: current utility and future prospects.

    Science.gov (United States)

    Narayanan, Kumar; Chugh, Sumeet S

    2015-10-01

    More than 100 years after it was first invented, the 12-lead electrocardiogram (ECG) continues to occupy an important place in the diagnostic armamentarium of the practicing clinician. With the recognition of relatively rare but important clinical entities such as Wolff-Parkinson-White and the long QT syndrome, this clinical tool was firmly established as a test for assessing risk of sudden cardiac death (SCD). However, over the past two decades the role of the ECG in risk prediction for common forms of SCD, for example in patients with coronary artery disease, has been the focus of considerable investigation. Especially in light of the limitations of current risk stratification approaches, there is a renewed focus on this broadly available and relatively inexpensive test. Various abnormalities of depolarization and repolarization on the ECG have been linked to SCD risk; however, more focused work is needed before they can be deployed in the clinical arena. The present review summarizes the current knowledge on various ECG risk markers for prediction of SCD and discusses some future directions in this field. PMID:26842119

  13. Soccer and Sudden Cardiac Death in Young Competitive Athletes: A Review

    Directory of Open Access Journals (Sweden)

    John P. Higgins

    2013-01-01

    Full Text Available Sudden cardiac death (SCD in young competitive athletes (<35 years old is a tragic event that has been brought to public attention in the past few decades. The incidence of SCD is reported to be 1-2/100,000 per year, with athletes at a 2.5 times higher risk. Soccer is the most popular sport in the world, played by people of all ages. However, unfortunately it is cardiovascular diseases such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy that have subtly missed screening and claimed the lives of soccer stars such as Marc Vivien Foe and Antonio Puerta during live action on the field and on an internationally televised stage. This paper covers the physiological demands of soccer and the relationship between soccer and SCD. It also reviews the most common causes of SCD in young athletes, discusses the current guidelines in place by The Fédération Internationale de Football Association (FIFA for screening among professional soccer players, and the precautions that have been put in place to prevent SCD on the field in professional soccer.

  14. Angiotensin receptor antagonists to prevent sudden death in heart failure: does the dose matter?

    Science.gov (United States)

    Francia, Pietro; Palano, Francesca; Tocci, Giuliano; Adduci, Carmen; Ricotta, Agnese; Semprini, Lorenzo; Caprinozzi, Massimo; Balla, Cristina; Volpe, Massimo

    2014-01-01

    International guidelines recommend ICD implantation in patients with severe left ventricular dysfunction of any origin only after careful optimization of medical therapy. Indeed, major randomized clinical trials suggest that suboptimal use of fundamental drugs, such as ACE inhibitors (ACE-i) and beta-blockers, may affect ICD shock-free survival, sudden cardiac death (SCD), and overall mortality. While solid evidence in favour of pharmacological therapy based on ACE-i with or without beta-blockers is available, data on SCD in HF patients treated with angiotensin receptor blockers (ARBs) are limited. The present paper systematically analyses the impact of ARBs on SCD in HF and reviews the contributory role of the renin-angiotensin system (RAS) to the establishment of arrhythmic substrates. The following hypothesis is supported: (1) the RAS is a critical component of the electrical remodelling of the failing myocardium, (2) RAS blockade reduces the risk of SCD, and (3) ARBs represent a powerful tool to improve overall survival and possibly reduce the risk of SCD provided that high doses are employed to achieve optimal AT1-receptor blockade.

  15. Sudden infant death syndrome, population mixing and oil-related development in western Norway

    Directory of Open Access Journals (Sweden)

    Graham Bentham

    2009-10-01

    Full Text Available  ABSTRACTA number of features of sudden infant death syndrome (SIDS point to an aetiological role for apparentlyminor infections. The spread of infections is influenced by the rate of contact between infectiouscases and susceptibles in the population. This is likely to differ geographically depending on patternsof social contacts, with epidemics being particularly likely where an influx of migrants leads to highrates of mixing of populations lacking herd immunity. It has been shown that geographical variationsin SIDS deaths in England and Wales are strongly associated with rates of long distance in-migrationinto districts. The large influx of population into parts of western Norway as a result of oil-related developmentprovides an opportunity to examine this issue further. The most intensive development hasbeen in the Stavanger area in the county of Rogaland. Published migration statistics show that therewas a rapid build-up of long distance migration into this area reaching a peak in the late 1970s. Furthernorth, the Bergen area in the county of Hordaland was little affected by oil-related activities in the1970s. However, the more recent development of oil provinces further north has led to more activity inthe Bergen area and an increase in in-migration from the mid 1980s onwards. Annual data from 1969onwards on SIDS deaths in Rogaland and Hordaland counties and for Norway were used to assesswhether trends in SIDS mortality and migration showed any associations. Before the main populationinflux Rogaland had a SIDS rate that was below the Norwegian average. However, since the mid1970s SIDS rates have been significantly in excess of the national average. In Hordaland SIDS rateswere low throughout the 1970s but increased substantially to be significantly in excess of the Norwegianaverage in the late 1980s. In both areas population influxes resulting from oil-related developmentwere therefore followed by a significant increase in mortality rates

  16. Degree Of Diminution In Vagal-Cardiac Activity Predicts Sudden Death In Familial Dysautonomia When Resting Tachycardia Is Absent

    Science.gov (United States)

    Schlegel, T. T.; Marthol, H.; Bucchner, S.; Tutaj, M.; Berlin, D.; Axelrod, F. B.; Hilz, M. J.

    2004-01-01

    Patients with familial dysautonomia (FD) have an increased risk of sudden death, but sensitive and specific predictors of sudden death in FD are lacking. Methods. We recorded 10-min resting high-fidelity 12-lead ECGs in 14 FD patients and in 14 age/gender-matched healthy subjects and studied 25+ different heart rate variability (HRV) indices for their ability to predict sudden death in the FD patients. Indices studied included those from 4 "nonlinear" HRV techniques (detrended fluctuation analysis, approximate entropy, correlation dimension, and PoincarC analyses). The predictive value of PR, QRS, QTc and JTc intervals, QT dispersion (QTd), beat-to-beat QT and PR interval variability indices (QTVI and PRVI) and 12- lead high frequency QRS ECG (150-250 Hz) were also studied. FD patients and controls (C) differed (Pless than 0.0l) with respect to 20+ of the HRV indices (FD less than C) and with respect to QTVI and PRVI (FDBC) and HF QRS- related root mean squared voltages (FDBC) and reduced amplitude zone counts (FD less than C). They differed less with respect to PR intervals (FD less than C) and JTc intervals (FD greater than C) (P less than 0.05 for both) and did not differ at all with respect to QRS and QTc intervals and to QTd. Within 12 months after study, 2 of the 14 patients succumbed to sudden cardiac arrest. The best predictor of sudden death was the degree of diminution in HRV vagal-cardiac (parasympathetic) parameters such as RMSSD, the SDl of Poincare plots, and HF spectral power. Excluding the two FD patients who had resting tachycardia (HR greater than 100, which confounds traditional HRV analyses), the following criteria were independently 100% sensitive and 100% specific for predicting sudden death in the remaining 12 FD patients during spontaneous breathing: RMSSD less than 13 ms and/or PoincarC SD1 less than 9 ms. In FD patients without supine tachycardia, the degree of diminution in parasympathetic HRV parameters (by high-fidelity ECG) predicts

  17. Postmortem computed tomography for detecting causes of sudden death in infants and children. Retrospective review of cases

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the usefulness of postmortem computed tomography (PMCT) in detecting causes of sudden death in infants and children. Our subjects were 15 nontraumatically deceased patients (nine boys and six girls, ranging in age from 20 days after birth to 12 years old, mean age 1.6 years), who had been in a state of cardiopulmonary arrest on arrival at our hospital. PMCT was performed within 2 h after certification of death: head (15 cases), chest (11 cases), and abdomen (12 cases). Blood was collected from 11 of the patients at the time of cardiopulmonary resuscitation. An autopsy was conducted on two. PMCT did not show any traumatic changes indicating child abuse. It was difficult to presume the cause of death with PMCT alone, but the cause of death in 14 of 15 cases could be presumed by combining information from their medical history, clinical course before death, PMCT findings, laboratory data, and bacterial culture. The remaining subject was classified as cause unknown. The causes of sudden death in infants and children were detected at a high rate when we comprehensively investigated the PMCT and other examination findings. (author)

  18. Seasonal Timing of Infant Bronchiolitis, Apnea and Sudden Unexplained Infant Death.

    Directory of Open Access Journals (Sweden)

    Chantel D Sloan

    Full Text Available Rates of Sudden Unexplained Infant Death (SUID, bronchiolitis, and central apnea increase in winter in temperate climates. Though associations between these three conditions are suggested, more work is required to establish if there is a causal pathway linking bronchiolitis to SUID through inducing central apnea. Utilizing a large population-based cohort of infants studied over a 20-year period (n = 834,595, from birth years 1989-2009, we analyzed ecological associations between timing of SUID cases, bronchiolitis, and apnea healthcare visits. Data were analyzed between 2013 and 2015. We used a Cox Proportional Hazards model to analyze possible interactions between maternal smoking and maternal asthma with infant bronchiolitis on time to SUID. SUID and bronchiolitis both occurred more frequently in winter. An increase in bronchiolitis clinical visits occurred within a few days prior to apnea visits. We found a temporal relationship between infant bronchiolitis and apnea. In contrast, no peak in SUID cases was seen during peaks of bronchiolitis. Among those without any bronchiolitis visits, maternal smoking was associated with an increased risk of SUID: Hazard Ratio (HR of 2.38 (95% CI: 2.11, 2.67, p-value <0.001. Maternal asthma was associated with an increased risk of SUID among infants with at least one bronchiolitis visit: HR of 2.40 (95% CI: 1.04, 5.54, p-value = 0.04. Consistent trends between bronchiolitis, apnea, and SUID were not established due to small numbers of SUID cases. However, interaction analysis revealed potential differential associations of bronchiolitis and SUID by maternal smoking, maternal asthma status.

  19. Arousal responses in babies at risk of sudden infant death syndrome at different postnatal ages.

    LENUS (Irish Health Repository)

    Dunne, K P

    1992-03-01

    Hypercarbic and hypoxic arousal responses during sleep were measured in healthy term infants, infants where a previous sibling died from sudden infant death syndrome (SIDS) and infants suffering a clearly defined apparent life threatening event (ALTE) requiring vigorous or mouth to mouth resuscitation. Groups of infants were tested at approximately one, six and 13 weeks postnatally. Arousal was defined as gross body movement with eyes opening and moving or crying. Hypercarbic arousal was by step increases in F1 Co2 until arousal occurred or until endtidal (PETCO2) reached 8.7 KpA (65 mm Hg) Hypoxic arousal was by step decreases in FIO2 until arousal occurred or until an FIO2 of 0.15 had been maintained for 20 minutes. There was no difference in hypercaribic arousal threshold with age in any group. Hypercarbic arousal threshold was significantly higher in siblings (mean 53.4, 53.6, 54.7 mmHg. [7.12, 7.14, 7.29 KPA] at 0, 6, 13 postnatal weeks) compared to controls (mean 50.9, 52.3, 53.0mm Hg. [6.78, 6.97, 7.29 KPS respectively). ALTE infants differed only at 12 weeks having a significantly lower threshold (51.0mmHg. [6.80 KPA] V 53.0mm Hg. (7.06 KPA]) compared to controls. There was no difference in hypoxic arousal response with age in any group. An arousal response to hypoxia occurred in only 22% of ALTE infants and 40% of siblings compared to 67% of normal infants. Deficient sleep arousal, especially to hypoxia, is common in infants and especially those considered at increased risk from SIDS. This deficiency is present in the first postnatal week and did not vary overy the first three months of postnatal life.

  20. Balancing detection and eradication for control of epidemics: sudden oak death in mixed-species stands.

    Directory of Open Access Journals (Sweden)

    Martial L Ndeffo Mbah

    Full Text Available Culling of infected individuals is a widely used measure for the control of several plant and animal pathogens but culling first requires detection of often cryptically-infected hosts. In this paper, we address the problem of how to allocate resources between detection and culling when the budget for disease management is limited. The results are generic but we motivate the problem for the control of a botanical epidemic in a natural ecosystem: sudden oak death in mixed evergreen forests in coastal California, in which species composition is generally dominated by a spreader species (bay laurel and a second host species (coast live oak that is an epidemiological dead-end in that it does not transmit infection but which is frequently a target for preservation. Using a combination of an epidemiological model for two host species with a common pathogen together with optimal control theory we address the problem of how to balance the allocation of resources for detection and epidemic control in order to preserve both host species in the ecosystem. Contrary to simple expectations our results show that an intermediate level of detection is optimal. Low levels of detection, characteristic of low effort expended on searching and detection of diseased trees, and high detection levels, exemplified by the deployment of large amounts of resources to identify diseased trees, fail to bring the epidemic under control. Importantly, we show that a slight change in the balance between the resources allocated to detection and those allocated to control may lead to drastic inefficiencies in control strategies. The results hold when quarantine is introduced to reduce the ingress of infected material into the region of interest.

  1. Examining the strength and possible causes of the relationship between fire history and Sudden Oak Death.

    Science.gov (United States)

    Moritz, Max A; Odion, Dennis C

    2005-06-01

    Fire can be a dominant process in the ecology of forest vegetation and can also affect forest disease dynamics. Little is known about the relationship between fire and an emerging disease epidemic called Sudden Oak Death, which is caused by a new pathogen, Phytophthora ramorum. This disease has spread across a large, fire-prone portion of California, killing great numbers of oaks and tanoaks and infecting most associated woody plants. Suitable hosts cover a much broader geographic range, raising concern over where the disease may spread. To understand the strength and potential sensitivities of a fire-disease relationship, we examined geographic patterns of confirmed P. ramorum infections in relation to past fire history. We found these infections to be extremely rare within the perimeter of any area burned since 1950. This finding is not caused by spatial bias in sampling for the disease, and is robust to variation in host abundance scenarios and to aggregation of closely spaced sampling locations. We therefore investigated known fire-related factors that could result in significantly lower incidence of the disease in relatively recently burned landscapes. Chemical trends in post-fire environments can influence the success of pathogens like P. ramorum, either by increasing plant nutrient stress or by reducing the occurrence of chemicals antagonistic to Phytophthoras. Succession in the absence of fire leads to greater abundance of host species, which will provide increased habitat for P. ramorum; this will also increase intraspecific competition where these trees are abundant, and other density-dependent effects (e.g. shading) can reduce resource allocation to defenses. Despite these findings about a fire-disease relationship, a much deeper understanding is necessary before fire can be actively used as a tool in slowing the epidemic. PMID:15891855

  2. Sudden unexpected death in infancy (SUDI) in the early neonatal period: the role of bed-sharing.

    Science.gov (United States)

    Hoffend, Charlotte; Sperhake, Jan-Peter

    2014-06-01

    The incidence of sudden infant death syndrome (SIDS) has declined substantially, but the proportion of sudden unexpected death in infancy (SUDI) in neonates, newborn on the part of an exhausted mother. Fifty-two percent of the incidents occurred while the mother and her newborn were still hospitalized in a birth clinic. Forty-eight percent of the infants had been sleeping in the parents' bed with mother and/or father. In 11 % of the cases, there was a sofa-sharing situation. Bed-sharing seems to increase the risk for SIDS in the newborn period as well as the risk for accidental suffocation/asphyxia of the baby. Therefore, mothers should not be instructed to bed-share. Particularly during the first 24 h after birth, it may be advisable to check mothers and infants regularly. PMID:24399341

  3. The risk of sudden death in sport in patients with signs of connective tissue dysplasia (literature review

    Directory of Open Access Journals (Sweden)

    Nekhanevych O.B.

    2013-03-01

    Full Text Available Literature review indicates that, despite the disclosure of a number of causes and mechanisms of sudden death in people performing physical activities, this issue remains relevant today. The main cause of sudden death in sport is pathological conditions and heart diseases. Par¬ticular risk group during follow-up over persons involved in physical activity are those with the presence of small anomalies; this may be a ma¬nifestation of connective tissue dysplasia. With all the variety of affected organs and systems in patients with connective tissue dysplasia, cardio¬vascular disorders are the leading pathology determining the quality and pro¬gnosis of life.

  4. Risk Assessment for Sudden Death in Epilepsy: The SUDEP-7 inventory

    Directory of Open Access Journals (Sweden)

    Jennifer L Novak

    2015-12-01

    Full Text Available Background: Sudden Unexpected Death in Epilepsy (SUDEP is a major cause of death in those with drug resistant epilepsy. There is a need for inventories and biomarkers associated with the risk for SUDEP. Objective: To explore the revised SUDEP Risk Inventory (SUDEP-7 in a cohort with Drug Resistant Epilepsy, and determine the association with Heart Rate and other covariates. Methods: 25 subjects with severe drug-resistant epilepsy were enrolled in a clinical trial for epilepsy. Baseline demographics, duration of epilepsy, seizure types, seizure frequency, seizure severity, AED’s, and vital signs were collected. Heart rate variability (HRV was calculated from 1-hour recordings of ECG. A SUDEP Risk Inventory (SUDEP-7 was administered, which included 7 validated and weighted risk factors initially identified by Walczak et al. as factors associated with SUDEP risk.Results: The total score on the revised SUDEP-7 ranged from 1 to 7, mean = 3.4 (sd 1.8. The SUDEP Risk Inventory score was inversely correlated with RMSSD (Pearson r= -0.45, P=0.027. The following variables were significantly associated with RMSSD: epilepsy duration (p=0.02, age (p=0.03, and developmental intellectual disability (p<0.001. The correlation between RMSSD and SUDEP 7 tended to persist also after the adjustment for patient age (r = -0.40, p=0.05. Two subjects died of SUDEP: their SUDEP-7 scores were above average and in the upper 25 and 50th percentiles respectively (6 and 4, mean = 3.4Conclusions: RMSSD, a measure of low frequency heart rate variability, was significantly associated with SUDEP Risk Inventory (SUDEP-7 scores. Using a multivariable model, the covariates of developmental intellectual disability, age, and duration of epilepsy were also significantly associated with decreased HRV. The correlation between decreased HRV and a higher SUDEP-7 score remained unchanged even after the adjustment for patient age. The results suggest that older age, greater duration of

  5. Virus infections and sudden death in infancy: the role of interferon-

    Directory of Open Access Journals (Sweden)

    Sophia eMoscovis

    2015-03-01

    Full Text Available Respiratory infections have been implicated in Sudden Infant Death Syndrome (SIDS. As interferon- (IFN- is a major response to virus infection, we examined: 1 single nucleotide polymorphism (SNP, IFNG T+874A, in SIDS infants, their parents and ethnic groups with different incidences of SIDS; 2 model systems with a monocytic cell line (THP-1 and human peripheral blood monocytes (PBMC for effects of levels of IFN- on inflammatory responses to bacterial antigens identified in SIDS; 3 interactions between genetic and environmental factors on IFN- responses. IFNG T+874A genotypes were determined for: SIDS infants from three countries; families who had a SIDS death; populations with high (Indigenous Australian, medium (Caucasian and low (Bangladeshi SIDS incidences. The effect of IFN- on cytokine responses to endotoxin was examined in model systems with THP-1 cells and human PBMC to endotoxin. The IFN-γ responses to endotoxin and toxic shock syndrome toxin (TSST-1 were assessed in relation to genotype, gender and reported smoking. There was a marginal association with IFNG T+874A genotype and SIDS (P =0.06. Indigenous Australians had significantly higher proportions of the IFNG T+874A SNP (TT associated with high responses of IFN-. THP-1 cells showed a dose dependent effect of IFN- on cytokine responses to endotoxin. For PBMC, IFN- enhanced interleukin (IL-1β, IL-6 and tumor necrosis factor- (TNF- responses but reduced IL-8 and IL-10. Active smoking had a suppressive effect on baseline levels of IFN-. There was no effect of gender or genotype on IFN- responses to bacterial antigens tested;; however, significant differences were observed between genotypes in relation to smoking. The results indicate virus infections contribute to dysregulation of cytokine responses to bacterial antigens and studies on physiological effects of genetic factors must include controls for recent or concurrent infection and exposure to

  6. Communicable disease-related sudden death in the 21st century in Nigeria

    Directory of Open Access Journals (Sweden)

    Akinwusi PO

    2013-10-01

    Full Text Available Patience Olayinka Akinwusi,1,2 Akinwumi Oluwole Komolafe,3 Olanrewaju Olayinka Olayemi,2 Adeleye Abiodun Adeomi4 1Department of Medicine, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria; 2Department of Medicine, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria; 3Department of Morbid Anatomy, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria; 4Department of Community Medicine, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State, Nigeria Background: Some cases of sudden death (SD have been attributed to communicable diseases (CD in middle- and low-income countries of the world even in this 21st century. CDs produce clinical symptoms and signs over several days before culminating in death. They are also amenable to treatment with antimicrobials if affected persons present early. We sought to find out the incidence of CD-related SD at the Ladoke Akintola University of Technology Teaching Hospital (Osogbo, Osun State, Nigeria – a tertiary health facility in southwest Nigeria – and the prevailing associated factors. Methods: We conducted a retrospective study of CD-related SD in adult patients aged 18 years and older that occurred from January 2003 to December 2011. The Statistical Package for the Social Sciences version 16 was used for analysis of the generated data. Percentages and frequencies were calculated. Results: There were 17 (39.6% CD-related SDs out of the 48 cases of SD studied. CD-related SD also accounted for 2.4% of all adult medical admissions. The mean age of the patients was 37.6 ± 11.6 years, age range of 25–62 years, mode of 25 years, and median 34 years. The male-to-female ratio was 1.8:1. Typhoid sepsis was responsible for SD in 47.1% of patients, pulmonary tuberculosis in 17.7% of patients, and lobar pneumonia in 17.7% of patients. The most affected age group was the 20–29-year-old group

  7. Cost Effectiveness of Implantable Cardioverter Defibrillator Therapy versus Drug Therapy for Patients at High Risk of Sudden Cardiac Death

    OpenAIRE

    Spath, Marian A.; Bernie J. O'Brien

    2002-01-01

    The implantable cardioverter defibrillator (ICD) is a therapy for patients at risk of sudden cardiac death due to ventricular tachycardia (VT) or ventricular fibrillation (VF). But the apparent high cost of ICD therapy relative to antiarrhythmic drugs such as amiodarone has raised questions about the cost effectiveness of ICD therapy versus drug therapy. To inform this debate we reviewed the literature on ICD cost effectiveness. An electronic and manual search was conducted for articles publi...

  8. Sudden Death and Myocardial Lesions after Damage to Catecholamine Neurons of the Nucleus Tractus Solitarii in Rat

    OpenAIRE

    Talman, William T.; Dragon, Deidre Nitschke; Jones, Susan Y.; Moore, Steven A.; Lin, Li-Hsien

    2012-01-01

    Lesions that remove neurons expressing neurokinin-1 (NK1) receptors from the nucleus tractus solitarii (NTS) without removing catecholaminergic neurons lead to loss of baroreflexes, labile arterial pressure, myocardial lesions and sudden death. Because destruction of NTS catecholaminergic neurons expressing tyrosine hydroxylase (TH) may also cause lability of arterial pressure and loss of baroreflexes, we sought to test the hypothesis that cardiac lesions associated with lability are not depe...

  9. Vitamin D deficiency is associated with sudden cardiac death, combined cardiovascular events, and mortality in haemodialysis patients

    OpenAIRE

    Drechsler, Christiane; Pilz, Stefan; Obermayer-Pietsch, Barbara; Verduijn, Marion; Tomaschitz, Andreas; Krane, Vera; Espe, Katharina; Dekker, Friedo; Brandenburg, Vincent; März, Winfried; Ritz, Eberhard; Wanner, Christoph

    2010-01-01

    Aims Dialysis patients experience an excess mortality, predominantly of sudden cardiac death (SCD). Accumulating evidence suggests a role of vitamin D for myocardial and overall health. This study investigated the impact of vitamin D status on cardiovascular outcomes and fatal infections in haemodialysis patients. Methods and results 25-hydroxyvitamin D [25(OH)D] was measured in 1108 diabetic haemodialysis patients who participated in the German Diabetes and Dialysis Study and were followed u...

  10. Interactions of infectious symptoms and modifiable risk factors in sudden infant death syndrome. The Nordic Epidemiological SIDS study

    DEFF Research Database (Denmark)

    Helweg-Larsen, K; Banner, Jytte; Oyen, N;

    1999-01-01

    The aim of the study was to investigate the effect of infection on sudden infant death syndrome (SIDS) and to analyse whether modifiable risk factors of SIDS, prone sleeping, covered head and smoking act as effect modifiers. In a consecutive multicentre case-control study of SIDS in Denmark, Norway......, prone sleeping, head covered or parental smoking, was far greater than the sum of each individual factor. These risk factors thus modify the dangerousness of infection in infancy....

  11. Time-series analysis of the relationship between air quality,temperature, and sudden unexplained death in Beijing during 2005-2008

    Institute of Scientific and Technical Information of China (English)

    TIAN Zhao-xing; ZHANG Yan-shen; YAN Wei; ZHAO Wen-kui

    2012-01-01

    Background There is a yearly increase in the rate of sudden unexplained death (SUD),even through extensive physical examination and the testing of a large number of biomarkers,the cause of sudden death in patients previously in good health cannot be fully determined.During clinical practice,a spatial aggregation phenomenon has been observed in the incidence of sudden unexplained death.Previous research has shown that environmental factors,such as air pollution,weather conditions,etc.,have a significant impact on human health.In the wake of the continuous environmental damage,the relationship between environmental factors and sudden unexplained death still needs to be studied.To study the relationship between sudden unexplained death and air quality and temperature,commonly used markers such as particulate matter of aerodynamic diameter <10 μm (PM10),daily average concentration of the gaseous pollutants sulfur dioxide (SO2) and nitrogen dioxide (NO2),and the daily average temperature were investigated.Methods The methods include collecting the data of sudden unexplained death; air quality monitoring; meteorological monitoring from January 1,2005 to December 31,2008; utilizing generalized additive models (GAM); controlling the influential factors such as secular trend,seasonal trend,and Sunday dummy variable; and analyzing the correlation between daily inhalable particle concentration,daily average temperature,and the number of daily SUD.Results There was no statistical significance between the daily inhalable particle and daily incidence of sudden unexplained death.Incidence rate of sudden unexplained death had nonlinear positive correlation with daily temperature.When the temperature was 5℃ above the daily average temperature,the daily incidence of sudden unexplained death went up with the rising temperature.Conclusion Temperature may be one of the key risk factor or precipitating factor of SUD.

  12. Motivation to pursue genetic testing in individuals with a personal or family history of cardiac events or sudden cardiac death.

    Science.gov (United States)

    Erskine, Kathleen E; Hidayatallah, Nadia Z; Walsh, Christine A; McDonald, Thomas V; Cohen, Lilian; Marion, Robert W; Dolan, Siobhan M

    2014-10-01

    Genetic testing is becoming increasingly available for cardiac channelopathies, such as long QT syndrome and Brugada syndrome, which can lead to sudden cardiac death. Test results can be used to shape an individual's medical management and to identify at-risk family members. In our qualitative study, all participants had a personal or family history of a diagnosed cardiac arrhythmia syndrome or sudden cardiac death. Open-ended interviews were conducted individually and in focus groups. Interviews were audio recorded, transcribed verbatim, and analyzed using a qualitative grounded-theory approach. Of 50 participants, 37 described their motivations for pursuing genetic testing for long QT syndrome or another cardiac channelopathy. Participants' motivations included: to find an explanation for a family member's sudden death, to relieve uncertainty regarding a diagnosis, to guide future medical management, to allay concern about children or other family members, and to comply with recommendations of physicians or family members. Perceived reasons not to pursue genetic testing included denial, fear, and lack of information. The genetic counseling and informed consent process can be enhanced by understanding and addressing an individual's internal and external motivations either for or against pursuing genetic testing.

  13. Identifying potential functional impact of mutations and polymorphisms: Linking heart failure, increased risk of arrhythmias and sudden cardiac death.

    Directory of Open Access Journals (Sweden)

    BENOIT eJAGU

    2013-09-01

    Full Text Available Researchers and clinicians have discovered several important concepts regarding the mechanisms responsible for increased risk of arrhythmias, heart failure and sudden cardiac death. One major step in defining the molecular basis of normal and abnormal cardiac electrical behaviour has been the identification of single mutations that greatly increase the risk for arrhythmias and sudden cardiac death by changing channel-gating characteristics. Indeed, mutations in several genes encoding ion channels, such as SCN5A, which encodes the major cardiac Na+ channel, have emerged as the basis for a variety of inherited cardiac arrhythmias such as long QT syndrome, Brugada syndrome, progressive cardiac conduction disorder, sinus node dysfunction or sudden infant death syndrome. In addition, genes encoding ion channel accessory proteins, like anchoring or chaperone proteins, which modify the expression, the regulation of endocytosis and the degradation of ion channel α-subunits have also been reported as susceptibility genes for arrhythmic syndromes. The regulation of ion channel protein expression also depends on a fine-tuned balance among different other mechanisms, such as gene transcription, RNA processing, post-transcriptional control of gene expression by miRNA, protein synthesis, assembly and post-translational modification and trafficking.

  14. Association between resting heart rate and coronary artery disease, stroke, sudden death and noncardiovascular diseases: a meta-analysis

    Science.gov (United States)

    Zhang, Dongfeng; Wang, Weijing; Li, Fang

    2016-01-01

    Background: Resting heart rate is linked to risk of coronary artery disease, stroke, sudden death and noncardiovascular diseases. We conducted a meta-analysis to assess these associations in general populations and in populations of patients with hypertension or diabetes mellitus. Methods: We searched PubMed, Embase and MEDLINE from inception to Mar. 5, 2016. We used a random-effects model to combine study-specific relative risks (RRs). We used restricted cubic splines to assess the dose–response relation. Results: We included 45 nonrandomized prospective cohort studies in the meta-analysis. The multivariable adjusted RR with an increment of 10 beats/min in resting heart rate was 1.12 (95% confidence interval [CI] 1.09–1.14) for coronary artery disease, 1.05 (95% CI 1.01–1.08) for stroke, 1.12 (95% CI 1.02–1.24) for sudden death, 1.16 (95% CI 1.12–1.21) for noncardiovascular diseases, 1.09 (95% CI 1.06–1.12) for all types of cancer and 1.25 (95% CI 1.17–1.34) for noncardiovascular diseases excluding cancer. All of these relations were linear. In an analysis by category of resting heart rate ( 80 beats/min), the RRs were 0.99 (95% CI 0.93–1.04), 1.08 (95% CI 1.01–1.16) and 1.30 (95% CI 1.19–1.43), respectively, for coronary artery disease; 1.08 (95% CI 0.98–1.19), 1.11 (95% CI 0.98–1.25) and 1.08 (95% CI 0.93–1.25), respectively, for stroke; and 1.17 (95% CI 0.94–1.46), 1.31 (95% CI 1.12–1.54) and 1.57 (95% CI 1.39–1.77), respectively, for noncardiovascular diseases. After excluding studies involving patients with hypertension or diabetes, we obtained similar results for coronary artery disease, stroke and noncardiovascular diseases, but found no association with sudden death. Interpretation: Resting heart rate was an independent predictor of coronary artery disease, stroke, sudden death and noncardiovascular diseases over all of the studies combined. When the analysis included only studies concerning general populations, resting

  15. Development of geospatial techniques for ecological analysis: A case study of sudden oak death in California

    Science.gov (United States)

    Guo, Qinghua

    With the recent advancement of geospatial techniques (e.g., remote sensing, Geographical Information Systems, and GPS), geodatasets have grown dramatically in size and number and become more widely distributed. This provides ecologists unprecedented opportunities to explore ecological problems at larger spatial scale than before. At the same time, the wealth of data demands improvements in geospatial techniques in order to fully explore the current data capacity. In this dissertation, I sought to refine, combine, and develop new geospatial techniques that when applied to a real-world ecological problem, generated new and more comprehensive understanding of the ecological system examined. First, I refined several commonly used spatial analytical techniques such as paired quadrat variance (PQV) and Ripley's K functions. I clarified some misinterpretations of PQV methods, and proposed a GIS approach in correcting the edge-effect problem associated with the Ripley's K function in irregular-shaped study areas. Second, I combined several methods to better understand spatial patterns: (1) I combined Ripley's K and semivariance to study point patterns, and (2) I combined PQV, two term local quadrat variance, new local variance, and their three-term counterparts to study transect data. Third, I developed a new environmental niche model to model potential niche using presence-only data. Fourth, I developed a hybrid classifier which integrated an object-based and a knowledge-based classification method in mapping dead trees from high spatial resolution images. Finally, these geospatial methods were applied to analyze and model the spread of a new forest disease "sudden oak death" in California at the landscape and regional scales. At the landscape level, I found that topographic factors were the most influential factors in controlling the presence of dead trees, followed by foliar hosts of the disease. At the regional scale, I found that the majority of disease risk would

  16. Animal models for assessment of infection and inflammation: contributions to elucidating the pathophysiology of sudden infant death syndrome (SIDS

    Directory of Open Access Journals (Sweden)

    Jane eBlood-Siegfried

    2015-03-01

    Full Text Available Sudden Infant Death Syndrome (SIDS is still not well understood. It is a diagnosis of exclusion following the sudden and unexpected death of an infant. There are numerous theories about the etiology of SIDS but the exact cause or causes have never been pinpointed.Examination of theoretical pathologies might only be possible in animal models. Development of these models requires consideration of the genetic, developmental and environmental risk factors associated with SIDS, as they need to explain how the risk factors could contribute to the cause of death. These models were initially developed in common laboratory animals to test various hypotheses to explain these infant deaths - guinea pig, piglet, mouse, neonatal rabbit and neonatal rat. Currently there are growing numbers of researchers using genetically altered animals to examine specific areas of interest. This review describes the different systems and models developed to examine the diverse hypotheses for the cause of SIDS and their potential for defining a causal mechanism or mechanisms.

  17. The importance of a forensics investigation of sudden infant death syndrome: recommendations for developing, low and middle income countries

    Directory of Open Access Journals (Sweden)

    Steven A. Koehler

    2010-11-01

    Full Text Available Sudden infant deaths syndrome (SIDS, the sudden and unexpected death of a normal and healthy infant, has remained a medical and forensic mystery. Despite years of research all attempts to ascertain the exact cause and manner of death have failed. The information collected during the course of the comprehensive investigation by the various investigation agencies and analysis of the data has not been in vain. The epidemiological, demographic, and pathological data have identified distinctive features and risk factors associated with infants that died from SIDS. Epidemiological data has provided the unique characteristics of infants that died of SIDS that differentiates them from non-SIDS infants. Analysis of information from the death scene investigation has identified key risk factor behaviour associated with SIDS, namely the prone sleeping position. Pathological examination of the internal organs, specifically the brain, has shown some differences between SIDS and non-SIDS infants. However, to gain a complete picture of SIDS data, all countries around the world must provide information, even basic information, to understand this syndrome better. Developing countries must understand their role and importance in developing plans to investigate, collect, and disseminate SIDS data to the rest of the world. This paper provides general guidelines for the investigation of SIDS in developing countries.

  18. Postmortem genetic screening for the identification, verification, and reporting of genetic variants contributing to the sudden death of the young.

    Science.gov (United States)

    Methner, D Nicole R; Scherer, Steven E; Welch, Katherine; Walkiewicz, Magdalena; Eng, Christine M; Belmont, John W; Powell, Mark C; Korchina, Viktoriya; Doddapaneni, Harsha Vardhan; Muzny, Donna M; Gibbs, Richard A; Wolf, Dwayne A; Sanchez, Luis A; Kahn, Roger

    2016-09-01

    Each year in the United States, thousands of cases of sudden and unexpected deaths of infants, children, and young adults are assigned an undetermined cause of death after postmortem investigation and autopsy. Heritable genetic variants have been suggested as the cause of up to a third of sudden death (SD) cases. Elucidation of the genetic variants involved in SD cases is important to not only help establish cause and manner of death of these individuals, but to also aid in determining whether familial genetic testing should be considered. Previously, these types of postmortem screenings have not been a feasible option for most county medical examiners' and coroners' offices. We sequenced full exons of 64 genes associated with SD in the largest known cohort (351) of infant and young SD decedents using massively parallel sequencing at 1 yr of age), were found to have a reportable genetic variant contributing to SD. These percentages represent an estimate lower than those previously reported. Overall yields and results likely vary between studies due to differences in evaluation techniques and reporting. Additionally, we recommend ongoing assessment of data, including nonreported novel variants, as technology and literature continually advance. This study demonstrates a strategy to implement molecular autopsies in medicolegal investigations of young SD decedents. PMID:27435932

  19. An approach to predict Sudden Cardiac Death (SCD) using time domain and bispectrum features from HRV signal.

    Science.gov (United States)

    Houshyarifar, Vahid; Chehel Amirani, Mehdi

    2016-08-12

    In this paper we present a method to predict Sudden Cardiac Arrest (SCA) with higher order spectral (HOS) and linear (Time) features extracted from heart rate variability (HRV) signal. Predicting the occurrence of SCA is important in order to avoid the probability of Sudden Cardiac Death (SCD). This work is a challenge to predict five minutes before SCA onset. The method consists of four steps: pre-processing, feature extraction, feature reduction, and classification. In the first step, the QRS complexes are detected from the electrocardiogram (ECG) signal and then the HRV signal is extracted. In second step, bispectrum features of HRV signal and time-domain features are obtained. Six features are extracted from bispectrum and two features from time-domain. In the next step, these features are reduced to one feature by the linear discriminant analysis (LDA) technique. Finally, KNN and support vector machine-based classifiers are used to classify the HRV signals. We used two database named, MIT/BIH Sudden Cardiac Death (SCD) Database and Physiobank Normal Sinus Rhythm (NSR). In this work we achieved prediction of SCD occurrence for six minutes before the SCA with the accuracy over 91%. PMID:27567781

  20. Quality of Life in Young Adult Patients with a Cardiogenetic Condition Receiving an ICD for Primary Prevention of Sudden Cardiac Death

    NARCIS (Netherlands)

    Verkerk, Agnes J.; Vermeer, Alexa M.; Smets, Ellen M.; Dekker, Lukas R.; Wilde, Arthur A.; Van Langen, Irene M.; Christiaans, Imke; Nieuwkerk, Pythia T.

    2015-01-01

    BackgroundProphylactic implantable cardioverter defibrillator (ICD) therapy prevents sudden cardiac death (SCD) among young adults with cardiogenetic conditions, but might reduce quality of life (QoL) due to potential device complications, ongoing medical appointments, and lifestyle restrictions. We

  1. Pathogenesis of sudden unexpected death in a clinical trial of patients with myocardial infarction and left ventricular dysfunction, heart failure, or both

    DEFF Research Database (Denmark)

    Pouleur, Anne-Catherine; Barkoudah, Ebrahim; Uno, Hajime;

    2010-01-01

    The frequency of sudden unexpected death is highest in the early post-myocardial infarction (MI) period; nevertheless, 2 recent trials showed no improvement in mortality with early placement of an implantable cardioverter-defibrillator after MI....

  2. Low rate of cardiac events in first-degree relatives of diagnosis-negative young sudden unexplained death syndrome victims during follow-up

    NARCIS (Netherlands)

    van der Werf, Christian; Stiekema, Lotte; Tan, Hanno L.; Hofman, Nynke; Alders, Marielle; van der Wal, Allard C.; van Langen, Irene M.; Wilde, Arthur A. M.

    2014-01-01

    BACKGROUND: Sudden unexplained death syndrome (SUDS) in young individuals often results from inherited cardiac disease. Accordingly, comprehensive examination in surviving first-degree relatives unmasks such disease in approximately 35% of the families. It is unknown whether individuals from diagnos

  3. Recent Advances in Mechanisms of Sudden Unexpected Death in Epilepsy%癫猝死机制进展

    Institute of Scientific and Technical Information of China (English)

    潘洁; 陆钦池

    2015-01-01

    The risk of sudden death is higher in epilepsy patients than in general population, especially in patients with refractory epilepsy. Sudden unexpected death in epilepsy (SUDEP) is the sudden, unexpected, non-traumatic, and non-drowning death of a patient with epilepsy, excluding documented status epilepticus, and in which postmortem examination does not reveal a structural or toxicological cause of death. Researches of mechanisms of SUDEP mostly have focused on cardiac arrhythmia and respiratory suppression during and after seizures. The recent SUEDP mechanism research advances in aspects of respiratory dysfunction, cardiac dysfunction, impaired consciousness were reviewed, and genetics and cellular elements as well.%癫患者,尤其是难治性癫患者,发生猝死的风险较一般人群要高。癫猝死为癫患者突然发生非外伤、非溺死的死亡,并排除了癫持续状态,尸检未发现造成死亡的器质性或中毒性方面的确切原因。关于癫猝死机制的研究集中在癫发作可能导致的心律失常和呼吸抑制方面。文中对近年来在癫猝死机制中呼吸功能障碍、心脏功能障碍、意识障碍方面,以及分子和基因方面的研究进展进行综述。

  4. Syncope and sudden death from the emergency physician’s perspective: is there room for new biomarkers?

    Directory of Open Access Journals (Sweden)

    Rossella Marino

    2013-10-01

    Full Text Available Syncope is a transient loss of consciousness due to temporary global cerebral hypoperfusion characterized by rapid onset, short duration, and spontaneous complete recovery. Syncope represents 1-2% of emergency department (ED visits and is coupled with a high risk for mortality, prolonged hospital admission, and immediate false diagnosis. Many patients who present to the ED with aspecific symptoms are mainly hospitalized because of diagnostic uncertainty. It is always very important to immediately distinguish syncope of cardiac and non-cardiac origins. Cardiac syncope has higher risk for mortality especially for sudden cardiac death, while non-cardiac one shows risk of repeated events of syncope with poor quality of life. Sudden cardiac death is defined as rapid and unexpected natural death due to cardiac etiology. Researchers from the GREAT Network hypothesized to evaluate some novel biomarkers in order to test acute cardiac condition that can suggest the presence of heart structural diseases, heart failure, and electrical disorders. The primary objective of this study is to test the diagnostic performance from patient history, clinical judgment, and novel biomarkers in the diagnosis of cardiac syncope in patients admitted to the ED. The trial is designed as a prospective international multicenter observational study accounting for 730 patients aged over 40 admitted to the ED with syncope within the last 12 h. A multimarker approach combining markers of different origin and mode of relapse, should add diagnostic information to correctly identify the cardiac conditions and to therefore be pertinent in the early diagnosis of cardiac syncope and in the prediction of cardiac events including sudden death. Future data should be needed to confirm the hypothesis presented here.

  5. Sudden death and rebirth of entanglement for different dimensional systems driven by a classical random external field

    Science.gov (United States)

    Metwally, N.; Eleuch, H.; Obada, A.-S.

    2016-10-01

    The entangled behavior of different dimensional systems driven by classical external random field is investigated. The amount of the survival entanglement between the components of each system is quantified. There are different behaviors of entanglement that come into view decay, sudden death, sudden birth and long-lived entanglement. The maximum entangled states which can be generated from any of theses suggested systems are much fragile than the partially entangled ones. The systems of larger dimensions are more robust than those of smaller dimensions systems, where the entanglement decay smoothly, gradually and may vanish for a very short time. For the class of $2\\times 3$ dimensional system, the one parameter family is found to be more robust than the two parameters family. Although the entanglement of driven $ 2 \\times 3$ dimensional system is very sensitive to the classical external random field, one can use them to generate a long-lived entanglement.

  6. Incidence and etiology of sports-related sudden cardiac death in Denmark--implications for preparticipation screening

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Winkel, Bo Gregers; Theilade, Juliane;

    2010-01-01

    to 5 per year) cases of SrSCD were found, 8 of which had antecedent symptoms. The incidence rate was 1.21 (95% confidence interval [CI]: 0.68 to 2.00) per 100,000 athlete person-years. The most common autopsy findings were arrhythmogenic right ventricular cardiomyopathy (n = 4), sudden unexplained...... death (n = 4), and coronary artery disease (n = 2). The incidence of SCD in the general population age 12 to 35 was 3.76 (95% CI: 3.42 to 4.14) per 100,000 person-years. CONCLUSION: In Denmark, SrSCD is a rare occurrence and the incidence rate is lower than that of SCD in the general population......) and to compare this to the incidence of sudden cardiac death (SCD) in the background population. METHODS: All 5,662 death certificates for decedents in the period 2000 to 2006 in the age group 12 to 35 years in Denmark were read independently by 2 physicians to identify cases of SCD. Information from autopsy...

  7. Correlation between heat shock protein 70 expression in the brain stem and sudden death after experimental traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    ZHAO Lian-xu; XU Xiao-hu; LIU Chao; PAN Su-yue; ZHU Jia-zhen; ZHANG Cheng

    2001-01-01

    Objective: The aim of this study was to determine the patterns of heat-shock protein 70 (HSP70) biosynthesis following traumatic brain injury, and observe the effect of HSP70 induction on the function of the vital center in the brain stem. Methods: Rat models of sudden death resulted form traumatic brain injury were produced, and HSP70 expression in the rat brain stem was determined by immunohistochemistry, the induction of HSP70 mRNA detected by RT-PCR. Results: The level of HSP70 mRNA was prominently elevated in the brain stem as early as 1 5 min following the impact injury, while HSP70 expression was only observed 3 to 6 h after the injury. It was also observed that the levels of HSP70 mRNA but not the protein were elevated in the brain stem of sudden death rats. Conclusion: The synthesis of HSP70 was significantly enhanced in the brain stem following traumatic injury, and the expression of HSP70 is beneficial to eliminate the stress agents, and to sustain the cellular protein homeostasis. When the injury disturbs the synthesis of HSP70 to disarm the protective mechanism of heat-shock proteins, dysfunction of the vital center in the brain stem, and consequently death may occur. Breach in the synchronization of HSP70 mRNA-protein can be indicative of fatal damage to the nerve cells.

  8. Genetic investigations of sudden unexpected deaths in infancy using next-generation sequencing of 100 genes associated with cardiac diseases

    DEFF Research Database (Denmark)

    Hertz, Christin Loeth; Christiansen, Sofie Lindgren; Larsen, Maiken Kudahl;

    2016-01-01

    -generation sequencing (NGS), the coding regions of 100 genes associated with inherited channelopathies and cardiomyopathies were captured and sequenced on the Illumina MiSeq platform. Sixteen (34%) of the SUDI cases had variants with likely functional effects, based on conservation, computational prediction and allele...... victims is important in the forensic setting and a valuable supplement to the clinical investigation in all cases of sudden death.European Journal of Human Genetics advance online publication, 9 September 2015; doi:10.1038/ejhg.2015.198....

  9. Heat stress and sudden infant death syndrome--stress gene expression after exposure to moderate heat stress

    DEFF Research Database (Denmark)

    Rohde, Marianne Cathrine; Corydon, Thomas Juhl; Hansen, Jakob;

    2013-01-01

    The aim of the present study was to investigate stress gene expression in cultured primary fibroblasts established from Achilles tendons collected during autopsies from sudden infant death syndrome (SIDS) cases, and age-matched controls (infants dying in a traumatic event). Expression of 4 stress...... time points measured, and may be less related to heat stress. Being found dead in the prone position (a known risk factor for SIDS) was related to a lower HSPA1B up-regulation in SIDS compared to SIDS found on their side or back. The study demonstrates the potential usefulness of gene expression...

  10. Influence of age, gender, and prodromal symptoms on sudden death in a tertiary care hospital, eastern Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Houssien Kamal Nofal

    2010-01-01

    Full Text Available Background: Sudden death (SD remains an important worldwide public health problem. The incidence of SD and causes vary in different societies, and these differences are influenced also by demographic and clinical factors such as age, gender and prodromal symptoms and signs. This six-year study describes the influence of these factors on SD. Materials and Methods: This is a retrospective study of SD in all age groups undertaken in King Fahd Hospital of the University (KFHU, Eastern Saudi Arabia. All cases of death (1273 total, 1050 expected death and 223 cases of sudden unexpected death that occurred between January 1, 2000 and December 31, 2005 were investigated and subsequently analyzed on demographic and clinical parameters of the deceased patients. The statistical analysis was performed as appropriate to illustrate any possible association between different demographic variables and SD. Results: There were 223 cases of SD (17.5% out of 1273 total deaths in KFHU in the 6-year study period. There was a definite influence of age on the incidence of sudden death (SD as it increased clearly at the two ends of the age spectrum, 32.2% of the cases were infants (from birth to 12 months, and 31.4% were elderly (> 60 year-old. However, among infantile age group, the highest frequency of SD (22.2% of the cases was among the neonates. There was also a significant trend of gender influence on the incidence of SD which was higher in men than women (56% vs. 42%. The influence of prodromal symptoms and signs on SD was variable. Dyspnea and cough as major symptoms of cardiovascular and respiratory disease were the most frequent presenting symptoms in 32.3% of the cases, followed by fever as a sign of infections in 11.7%, premature infants in 10.8%, circulatory collapse in 9.4%, and angina in 7.6% of the cases. Conclusion: The current study indicated a definite influence of age, gender and prodromal symptoms on the incidence of SD. The highest incidence

  11. Morphological abnormalities and cell death in the Asian citrus psyllid (Diaphorina citri) midgut associated with Candidatus Liberibacter asiaticus.

    Science.gov (United States)

    Ghanim, Murad; Fattah-Hosseini, Somayeh; Levy, Amit; Cilia, Michelle

    2016-01-01

    Candidatus Liberibacter asiaticus (CLas) is a phloem-limited, gram-negative, fastidious bacterium that is associated with the development of citrus greening disease, also known as Huanglongbing (HLB). CLas is transmitted by the Asian citrus psyllid (ACP) Diaphorina citri, in a circulative manner. Two major barriers to transmission within the insect are the midgut and the salivary glands. We performed a thorough microscopic analysis within the insect midgut following exposure to CLas-infected citrus trees. We observed changes in nuclear architecture, including pyknosis and karyorrhexis as well as changes to the actin cytoskeleton in CLas-exposed midgut cells. Further analyses showed that the changes are likely due to the activation of programmed cell death as assessed by Annexin V staining and DNA fragmentation assays. These results suggest that exposure to CLas-infected trees induces apoptotic responses in the psyllid midgut that should be further investigated. Understanding the adaptive significance of the apoptotic response has the potential to create new approaches for controlling HLB. PMID:27630042

  12. Morphological abnormalities and cell death in the Asian citrus psyllid (Diaphorina citri) midgut associated with Candidatus Liberibacter asiaticus.

    Science.gov (United States)

    Ghanim, Murad; Fattah-Hosseini, Somayeh; Levy, Amit; Cilia, Michelle

    2016-01-01

    Candidatus Liberibacter asiaticus (CLas) is a phloem-limited, gram-negative, fastidious bacterium that is associated with the development of citrus greening disease, also known as Huanglongbing (HLB). CLas is transmitted by the Asian citrus psyllid (ACP) Diaphorina citri, in a circulative manner. Two major barriers to transmission within the insect are the midgut and the salivary glands. We performed a thorough microscopic analysis within the insect midgut following exposure to CLas-infected citrus trees. We observed changes in nuclear architecture, including pyknosis and karyorrhexis as well as changes to the actin cytoskeleton in CLas-exposed midgut cells. Further analyses showed that the changes are likely due to the activation of programmed cell death as assessed by Annexin V staining and DNA fragmentation assays. These results suggest that exposure to CLas-infected trees induces apoptotic responses in the psyllid midgut that should be further investigated. Understanding the adaptive significance of the apoptotic response has the potential to create new approaches for controlling HLB.

  13. The longitudinal time course of QTc in early infancy. Preliminary results of a prospective sudden infant death syndrome surveillance program.

    Science.gov (United States)

    Schaffer, M S; Trippel, D L; Buckles, D S; Young, R H; Dolan, P L; Gillette, P C

    1991-03-01

    Eleven hundred one healthy neonates in Charleston County, SC, were enrolled in a prospective, serial measurement sudden infant death syndrome/QT surveillance program. Automated computer-enhanced ECGs were recorded at 1 day of age in the hospital nursery and again at 1 week and 1, 2, and 3 months in the participant's home. At 1 year, the families were contacted by phone or mail and questioned as to the health of the child. Validation studies demonstrated the computer-enhanced ECGs to be 96% accurate, whereas traditional ECG recording and measurement was 94% accurate. No systematic differences in the QTc according to race and sex were observed. There were parallel longitudinal time courses for each race and sex group with a significant (P less than .001) shortening of the QTc at 1 week. There was no evidence of tracking of the QTc during the first 3 months of life. In conclusion, (1) automated, enhanced ECG QTc intervals are superior to traditional electrocardiography while retaining the advantages of automation; (2) there is a significant shortening of the QTc during the first month of life; and (3) a home follow-up sudden infant death syndrome surveillance program is feasible and produces accurate, reliable information.

  14. Predictors of appropriate therapy in patients with implantable cardioverter-defibrillator for primary prevention of sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Dennis W. Zhu

    2010-02-01

    Full Text Available The purpose of this study was to evaluate predictors of appropriate therapy in patients with implantable cardioverter-defibrillators (ICD for primary prevention of sudden cardiac death. A retrospective cohort of 321 patients with systolic heart failure undergoing ICD placement for primary prevention of sudden cardiac death was queried with a mean follow-up period of 2.6 years. Appropriate ICD therapy was defined as therapy delivered for termination of a ventricular tachyarrhythmia. Appropriate ICD therapy was delivered in 142 (44% of the patients. In a multivariate model, body mass index ≥28.8 kg/m2 , chronic kidney disease, left ventricular ejection fraction ≤20% and metabolic syndrome were found to be independent predictors of appropriate ICD therapy. Appropriate ICD therapy was associated with higher cardiovascular mortality. These findings show the importance of identification of risk factors, especially metabolic syndrome, in patients following ICD implantation as aggressive treatment of these co-morbidities may decrease appropriate ICD therapy and cardiovascular mortality.

  15. The effect of classification of arrhythmic sudden cardiac death on the efficacy of cardiac resynchronization therapy in the CARE-HF study

    DEFF Research Database (Denmark)

    Uretsky, B.; Cleland, J.G.F.; Freemantle, N.;

    2006-01-01

    Topic(s): The definition of arrhythmic sudden cardiac death (SCD) differs widely among studies, which will affect the frequency with which it is ascribed as the cause of death. Cardiac resynchronization therapy (CRT) was reported to reduce SCD in the CARE-HF study. This could reflect a real effec...

  16. Prognostic factors affecting the all-cause death and sudden cardiac death rates of post myocardial infarction patients with low left ventricular ejection fraction

    Institute of Scientific and Technical Information of China (English)

    DAI Shi-mo; ZHANG Shu; CHEN Ke-ping; HUA Wei; WANG Fang-zheng; CHEN Xin

    2009-01-01

    Background Post myocardial infarction (post-MI) patients with low left ventricular ejection fraction (LVEF) have been candidates for an implantable cardioverter-deflbrillator (ICD) since the Multicenter Automatic Defibrillator Implantation Trail II (MADIT II).However,due to the high costs of ICDs,widespread usage has not been accepted.Therefore,further risk stratification for post-MI patients with low LVEF may aid in the selection of patients that will benefit most from ICD treatment.Methods Four hundred and seventeen post-MI patients with low LVEF (≤35%) were enrolled in the study.All the patients received standard examination and proper treatment and were followed up to observe the all-cause death rate and sudden cardiac death (SCD) rate.Then COX proportional-hazards regression model was used to investigate the clinical factors which affect the all-cause death rate and SCD rate.Results Of 55 patients who died during (32±24) months of follow-up,37 (67%) died suddenly.After adjusting for baseline clinical characteristics,multivariate COX proportional-hazards regression model identified the following variables associated with death from all causes:New York Heart Association (NYHA) heart failure class ≥111 (Hazard ratio:2.361),LVEF ≤20% (Hazard ratio:2.514),sustained ventricular tachycardia (Hazard ratio:6.453),and age ≥70 years (Hazard ratio:3.116).The presence of sustained ventricular tachycardia (Hazard ratio:6.491) and age ≥70 years (Hazard ratio:2.694) were specifically associated with SCD.Conclusions In the post-MI patients with low LVEF,factors as LVEF ≤20%,age ≥70 years,presence of ventricular tachycardia,and NYHA heart failure class≥111 predict an adverse outcome.The presence of sustained ventricular tachycardia and age ≥70 years was associated with occurrence of SCD in these patients.

  17. Effect of left ventricular dysfunction and viral load on risk of sudden cardiac death in patients with human immunodeficiency virus.

    Science.gov (United States)

    Moyers, Brian S; Secemsky, Eric A; Vittinghoff, Eric; Wong, Joseph K; Havlir, Diane V; Hsue, Priscilla Y; Tseng, Zian H

    2014-04-01

    Human immunodeficiency virus (HIV)-infected patients are disproportionately affected by cardiovascular disease and sudden cardiac death (SCD). Whether left ventricular (LV) dysfunction predicts SCD in those with HIV is unknown. We sought to determine the impact of LV dysfunction on SCD in patients with HIV. We previously characterized all SCDs and acquired immunodeficiency syndrome (AIDS) deaths in 2,860 consecutive patients in a public HIV clinic from 2000 to 2009. Transthoracic echocardiograms (TTEs) performed during the study period were identified. The effect of ejection fraction (EF), diastolic dysfunction, pulmonary artery pressure, and LV mass on SCD and AIDS death were evaluated: 423 patients had at least 1 TTE; 13 SCDs and 55 AIDS deaths had at least 1 TTE. In the propensity-adjusted analysis, EF 30% to 39% and EF<30% predicted SCD (hazard ratio [HR] 9.5, 95% confidence interval [CI] 1.7 to 53.3, p=0.01 and HR 38.5, 95% CI 7.6 to 195.0, p<0.001, respectively) but not AIDS death. Diastolic dysfunction also predicted SCD (HR 14.8, 95% CI 4.0 to 55.4, p<0.001) but not AIDS death, even after adjusting for EF. The association between EF<40% and SCD was greater in subjects with detectable versus undetectable HIV RNA (adjusted HR 11.7, 95% CI 2.9 to 47.2, p=0.001 vs HR 2.7, 95% CI 0.3 to 27.6, p=0.41; p=0.07 for interaction). In conclusion, LV systolic dysfunction and diastolic dysfunction predict SCD but not AIDS death in a large HIV cohort, with greater effect in those with detectable HIV RNA. Further investigation is needed to thoroughly evaluate the effect of low EF and HIV factors on SCD incidence and the potential benefit of implantable cardioverter-defibrillator therapy in this high-risk population. PMID:24521717

  18. B-Amyloid Precursor Protein Staining of the Brain in Sudden Infant and Early Childhood Death

    DEFF Research Database (Denmark)

    Jensen, Lisbeth Lund; Banner, Jytte; Ulhøi, Benedicte Parm;

    2013-01-01

    To develop and validate a scoring method for assessing β-amyloid precursor protein (APP) staining in cerebral white matter and to investigate the occurrence, amount and deposition pattern based on the cause of death in infants and young children.......To develop and validate a scoring method for assessing β-amyloid precursor protein (APP) staining in cerebral white matter and to investigate the occurrence, amount and deposition pattern based on the cause of death in infants and young children....

  19. High-protein diet in lactation leads to a sudden infant death-like syndrome in mice.

    Directory of Open Access Journals (Sweden)

    Thomas Walther

    Full Text Available BACKGROUND: It is well accepted that reduced foetal growth and development resulting from maternal malnutrition are associated with a number of chronic conditions in later life. On the other hand such generation-transcending effects of over-nutrition and of high-protein consumption in pregnancy and lactation, a proven fact in all developed societies, are widely unknown. Thus, we intended to describe the generation-transcending effects of a high-protein diet, covering most relevant topics of human life like embryonic mortality, infant death, and physical health in later life. METHODS: Female mice received control food (21% protein or were fed a high protein diet (42% protein during mating. After fertilisation, females stayed on their respective diet until weaning. At birth, pups were put to foster mothers who were fed with standard food or with HP diet. After weaning, control diet was fed to all mice. All offspring were monitored up to 360 days after birth. We determined glucose-tolerance and measured cardiovascular parameters using a tip-catheter. Finally, abdominal fat amount was measured. RESULTS AND CONCLUSIONS: We identified a worried impact of high-protein diet during pregnancy on dams' body weight gain, body weight of newborns, number of offspring, and also survival in later life. Even more important is the discovery that high-protein diet during lactation caused a more than eight-fold increase in offspring mortality. The observed higher newborn mortality during lactation is a hitherto non-described, unique link to the still incompletely understood human sudden infant death syndrome (SIDS. Thus, although offspring of lactating mothers on high-protein diet might have the advantage of lower abdominal fat within the second half of life, this benefit seems not to compensate the immense risk of an early sudden death during lactation. Our data may implicate that both pregnant women and lactating mothers should not follow classical high

  20. Electrocardiographic Screening for Prolonged QT Interval to Reduce Sudden Cardiac Death in Psychiatric Patients: A Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Antoine Poncet

    Full Text Available Sudden cardiac death is a leading cause of mortality in psychiatric patients. Long QT (LQT is common in this population and predisposes to Torsades-de-Pointes (TdP and subsequent mortality.To estimate the cost-effectiveness of electrocardiographic screening to detect LQT in psychiatric inpatients.We built a decision analytic model based on a decision tree to evaluate the cost-effectiveness and utility of LQT screening from a health care perspective. LQT proportion parameters were derived from an in-hospital cross-sectional study. We performed experts' elicitation to estimate the risk of TdP, given extent of QT prolongation. A TdP reduction of 65% after LQT detection was based on positive drug dechallenge rate and through adequate treatment and electrolyte adjustments. The base-case model uncertainty was assessed with one-way and probabilistic sensitivity analyses. Finally, the TdP related mortality and TdP avoidance parameters were varied in a two-way sensitivity analysis to assess their effect on the Incremental Cost-Effectiveness Ratio (ICER.Costs, Quality Ajusted Life Year (QALY, ICER, and probability of cost effectiveness thresholds ($ 10,000, $25,000, and $50,000 per QALY.In the base-case scenario, the numbers of patients needed to screen were 1128 and 2817 to avoid one TdP and one death, respectively. The ICER of systematic ECG screening was $8644 (95%CI, 3144-82 498 per QALY. The probability of cost-effectiveness was 96% at a willingness-to-pay of $50,000 for one QALY. In sensitivity analyses, results were sensitive to the case-fatality of TdP episodes and to the TdP reduction following the diagnosis of LQT.In psychiatric hospitals, performing systematic ECG screening at admission help reduce the number of sudden cardiac deaths in a cost-effective fashion.

  1. Analysis of sudden cardiac death and nursing intervention%心脏性猝死原因分析及护理干预

    Institute of Scientific and Technical Information of China (English)

    杨永红

    2009-01-01

    Abstract: Objective To investigate patients with sudden cardiac death related factors of death in order to prevent the occurrence of sudden death. Analysis of heart in our hospital in July 2004~ December 2008 of 36 cases of sudden death in heart attack patients clinical data to explore factors related to sudden death. The results of 36 cases of sudden death in 19 cases of coronary heart disease patients, many of the mergers of other diseases such as respiratory tract infections, hypertension, diabetes, dilated cardiomyopathy, such as there is an obvious predisposing factor, there are certain characteristics of the season and time of distribution. Active treatment of the original conclusions of the disease, the attention to the prevention and treatment of complications, given the appropriate nursing intervention to avoid a predisposing factor is the prevention of sudden cardiac death of a key.%目的:探讨心脏性猝死病人死亡的相关因素,以预防猝死的发生.方法:分析我院2004年7月~2008年12月猝死的36例心脏病人临床资料,探讨猝死的相关因素.结果:36例猝死病人中冠心病19例,很多合并其它疾病,如呼吸道感染、高血压、糖尿病、扩张型心肌病等,有明显诱发因素,有一定的季节和时间分布特点.结论:积极治疗原发病,注意预防和治疗合并症,给予相应的护理干预,避免诱发因素是预防心脏性猝死的关键.怂

  2. [Pathomorphological changes in the organs of cattle dying in so-called sudden death].

    Science.gov (United States)

    Zhelev, V; de Pino, A M

    1984-01-01

    Studied were morphologically the organs of 10 cattle originating from two provinces of Cuba that suddenly succumbed ( muerte subita ). There were hemorrahagic diathesis, and histologically--general activation of the reticulo-endothelial system, nonsuppurative encephalomyocarditis, interstitial nonsuppurative hepatitis, nephritis, and pneumonia as well as catarrhal hemorrhagic gastroenteritis. In all cases there were among the lymphoid proliferations diffusely disseminated eosinophile leukocytes ( hyperergia ). This finding showed that the disease had run a subacute or chronic course which was made acute by the action of some stress factors (continuous running, intoxications oligoelement disturbances, etc.). The finding was also characteristic of reactive processes taking place under the action of some specific virus that probably took part in the etiology of the disease and required an intermediary host that remained unknown at the time.

  3. [Pathomorphological changes in the organs of cattle dying in so-called sudden death].

    Science.gov (United States)

    Zhelev, V; de Pino, A M

    1984-01-01

    Studied were morphologically the organs of 10 cattle originating from two provinces of Cuba that suddenly succumbed ( muerte subita ). There were hemorrahagic diathesis, and histologically--general activation of the reticulo-endothelial system, nonsuppurative encephalomyocarditis, interstitial nonsuppurative hepatitis, nephritis, and pneumonia as well as catarrhal hemorrhagic gastroenteritis. In all cases there were among the lymphoid proliferations diffusely disseminated eosinophile leukocytes ( hyperergia ). This finding showed that the disease had run a subacute or chronic course which was made acute by the action of some stress factors (continuous running, intoxications oligoelement disturbances, etc.). The finding was also characteristic of reactive processes taking place under the action of some specific virus that probably took part in the etiology of the disease and required an intermediary host that remained unknown at the time. PMID:6730333

  4. Next-generation sequencing of 34 genes in sudden unexplained death victims in forensics and in patients with channelopathic cardiac diseases

    DEFF Research Database (Denmark)

    Hertz, Christin Løth; Christiansen, Sofie Lindgren; Ferrero-Miliani, Laura;

    2015-01-01

    Sudden cardiac death (SCD) is responsible for a large proportion of sudden deaths in young individuals. In forensic medicine, many cases remain unexplained after routine postmortem autopsy and conventional investigations. These cases are called sudden unexplained deaths (SUD). Genetic testing has...... been suggested useful in forensic medicine, although in general with a significantly lower success rate compared to the clinical setting. The purpose of the study was to estimate the frequency of pathogenic variants in the genes most frequently associated with SCD in SUD cases and compare the frequency...... to that in patients with inherited cardiac channelopathies. Fifteen forensic SUD cases and 29 patients with channelopathies were investigated. DNA from 34 of the genes most frequently associated with SCD were captured using NimbleGen SeqCap EZ library build and were sequenced with next-generation sequencing (NGS...

  5. The evidential value of intra-alveolar haemosiderin-macrophages in cases of sudden infant death syndrome (SIDS).

    Science.gov (United States)

    Kernbach-Wighton, G; Albalooshi, Y; Madea, B

    2012-10-10

    Intra-alveolar deposits of haemosiderin have repeatedly been brought into connection with some diagnostic value, such as markers for previous imposed suffocation, smothering due to Munchausen syndrome by proxy or sudden infant death syndrome (SIDS). This study is based on 104 SIDS cases and 14 controls (causes of death, e.g. inflammatory changes, internal haemorrhages, asphyxia, blunt force trauma or acute toxicity). The SIDS group comprised 44 females (aged 7 days to 12 months) and 60 males (aged 12 days to 16 months 8 days) with the ages of the controls ranging from 2 months 3 days to 47 months. Routine histology samples from the lungs were stained with Prussian blue and haemosiderin foci were counted in 20 hpf for each lung lobe by a pathologist blinded to the cause of death. Results were assigned to one of five categories for haemosiderin positivity. Data were analysed by the Levene-test revealing identical variances in both groups and with a two-sample t-test showing the mean values for haemosiderin counts not being significantly different between SIDS and control groups. Although the sizes of both samples differed considerably it is our opinion that the haemosiderin counts did not show sufficient diagnostic value. This outcome supports the latest results of other comparable investigations. Furthermore, it highlights the necessity to assess carefully positive haemosiderin findings to avoid false suspicion. PMID:22704554

  6. Differences in African-American Maternal Self-Efficacy Regarding Practices Impacting Risk for Sudden Infant Death.

    Science.gov (United States)

    Mathews, Anita; Oden, Rosalind; Joyner, Brandi; He, Jianping; McCarter, Robert; Moon, Rachel Y

    2016-04-01

    Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths, including accidental suffocation, account for ~4000 US deaths annually. Parents may have higher self-efficacy with regards to preventing accidental suffocation than SIDS. The objective of this study was to assess self-efficacy in African-American mothers with regards to safe sleep practices and risk for SIDS and accidental suffocation. As part of randomized clinical trial in African-American mothers of newborn infants, mothers completed a baseline survey about knowledge of and attitudes towards safe sleep recommendations, current intent, self-efficacy, and demographics. Tabular and adjusted, regression-based analyses of these cross-sectional data evaluated the impact of the message target (SIDS risk reduction vs. suffocation prevention) on perceived self-efficacy. 1194 mothers were interviewed. Mean infant age was 1.5 days. 90.8 % of mothers planned to place their infant supine, 96.7 % stated that their infant would sleep in the same room, 3.6 % planned to bedshare with the infant, and 72.9 % intended to have soft bedding in the crib. Mothers were more likely to believe that prone placement (70.9 vs. 50.5 %, p sleep area (78.3 vs. 59.5 %, p sleep practices. PMID:26342946

  7. Sudden Infant Death Syndrome and prenatal maternal smoking: rising attributed risk in the Back to Sleep era

    Directory of Open Access Journals (Sweden)

    Batal Holly A

    2005-01-01

    Full Text Available Abstract Background Parental smoking and prone sleep positioning are recognized causal features of Sudden Infant Death. This study quantifies the relationship between prenatal smoking and infant death over the time period of the Back to Sleep campaign in the United States, which encouraged parents to use a supine sleeping position for infants. Methods This retrospective cohort study utilized the Colorado Birth Registry. All singleton, normal birth weight infants born from 1989 to 1998 were identified and linked to the Colorado Infant Death registry. Multivariable logistic regression was used to analyze the relationship between outcomes of interest and prenatal maternal cigarette use. Potential confounders analyzed included infant gender, gestational age, and birth year as well as maternal marital status, ethnicity, pregnancy interval, age, education, and alcohol use. Results We analyzed 488,918 birth records after excluding 5835 records with missing smoking status. Smokers were more likely to be single, non-Hispanic, less educated, and to report alcohol use while pregnant (p Conclusions Due to a decreased overall rate of SIDS likely due to changing infant sleep position, the attributed risk associating maternal smoking and SIDS has increased following the Back to Sleep campaign. Mothers should be informed of the 2-fold increased rate of SIDS associated with maternal cigarette consumption.

  8. Who to target in sudden unexpected death in epilepsy prevention and how? Risk factors, biomarkers, and intervention study designs.

    Science.gov (United States)

    Tomson, Torbjörn; Surges, Rainer; Delamont, Robert; Haywood, Serena; Hesdorffer, Dale C

    2016-01-01

    The risk of dying suddenly and unexpectedly is increased 24- to 28-fold among young people with epilepsy compared to the general population, but the incidence of sudden unexpected death in epilepsy (SUDEP) varies markedly depending on the epilepsy population. This article first reviews risk factors and biomarkers for SUDEP with the overall aim of enabling identification of epilepsy populations with different risk levels as a background for a discussion of possible intervention strategies. The by far most important clinical risk factor is frequency of generalized tonic-clonic seizures (GTCS), but nocturnal seizures, early age at onset, and long duration of epilepsy have been identified as additional risk factors. Lack of antiepileptic drug (AED) treatment or, in the context of clinical trials, adjunctive placebo versus active treatment is associated with increased risks. Despite considerable research, reliable electrophysiologic (electrocardiography [ECG] or electroencephalography [EEG]) biomarkers of SUDEP risk remain to be established. This is an important limitation for prevention strategies and intervention studies. There is a lack of biomarkers for SUDEP, and until validated biomarkers are found, the endpoint of interventions to prevent SUDEP must be SUDEP itself. These interventions, be they pharmacologic, seizure-detection devices, or nocturnal supervision, require large numbers. Possible methods for assessing prevention measures include public health community interventions, self-management, and more traditional (and much more expensive) randomized clinical trials.

  9. Who to target in sudden unexpected death in epilepsy prevention and how? Risk factors, biomarkers, and intervention study designs.

    Science.gov (United States)

    Tomson, Torbjörn; Surges, Rainer; Delamont, Robert; Haywood, Serena; Hesdorffer, Dale C

    2016-01-01

    The risk of dying suddenly and unexpectedly is increased 24- to 28-fold among young people with epilepsy compared to the general population, but the incidence of sudden unexpected death in epilepsy (SUDEP) varies markedly depending on the epilepsy population. This article first reviews risk factors and biomarkers for SUDEP with the overall aim of enabling identification of epilepsy populations with different risk levels as a background for a discussion of possible intervention strategies. The by far most important clinical risk factor is frequency of generalized tonic-clonic seizures (GTCS), but nocturnal seizures, early age at onset, and long duration of epilepsy have been identified as additional risk factors. Lack of antiepileptic drug (AED) treatment or, in the context of clinical trials, adjunctive placebo versus active treatment is associated with increased risks. Despite considerable research, reliable electrophysiologic (electrocardiography [ECG] or electroencephalography [EEG]) biomarkers of SUDEP risk remain to be established. This is an important limitation for prevention strategies and intervention studies. There is a lack of biomarkers for SUDEP, and until validated biomarkers are found, the endpoint of interventions to prevent SUDEP must be SUDEP itself. These interventions, be they pharmacologic, seizure-detection devices, or nocturnal supervision, require large numbers. Possible methods for assessing prevention measures include public health community interventions, self-management, and more traditional (and much more expensive) randomized clinical trials. PMID:26749012

  10. Safe sleep practices and sudden infant death syndrome risk reduction: NICU and well-baby nursery graduates.

    Science.gov (United States)

    Fowler, Aja J; Evans, Patricia W; Etchegaray, Jason M; Ottenbacher, Allison; Arnold, Cody

    2013-11-01

    Our primary objective was to compare parents of infants cared for in newborn intensive care units (NICUs) and infants cared for in well-baby ("general") nurseries with regard to knowledge and practice of safe sleep practices/sudden infant death syndrome risk reduction measures and guidelines. Our secondary objective was to obtain qualitative data regarding reasons for noncompliance in both populations. Sixty participants (30 from each population) completed our survey measuring safe sleep knowledge and practice. Parents of NICU infants reported using 2 safe sleep practices-(a) always placing baby in crib to sleep and (b) always placing baby on back to sleep-significantly more frequently than parents of well infants. Additional findings and implications for future studies are discussed. PMID:24137040

  11. Pediatric Sudden Unexpected Death in Epilepsy: What Have we Learned from Animal and Human Studies, and Can we Prevent it?

    Science.gov (United States)

    Holt, Rebecca L; Arehart, Eric; Hunanyan, Arsen; Fainberg, Nina A; Mikati, Mohamad A

    2016-05-01

    Several factors, such as epilepsy syndrome, poor compliance, and increased seizure frequency increase the risks of sudden unexpected death in epilepsy (SUDEP). Animal models have revealed that the mechanisms of SUDEP involve initially a primary event, often a seizure of sufficient type and severity, that occurs in a brain, which is vulnerable to SUDEP due to either genetic or antecedent factors. This primary event initiates a cascade of secondary events starting, as some models indicate, with cortical spreading depolarization that propagates to the brainstem where it results in autonomic dysfunction. Intrinsic abnormalities in brainstem serotonin, adenosine, sodium-postassium ATPase, and respiratory-control systems are also important. The tertiary event, which results from the above dysfunction, consists of either lethal central apnea, pulmonary edema, or arrhythmia. Currently, it is necessary to (1) continue researching SUDEP mechanisms, (2) work on reducing SUDEP risk factors, and (3) address the major need to counsel families about SUDEP. PMID:27544469

  12. Sudden cardiac death in dogs with remodeled hearts is associated with larger beat-to-beat variability of repolarization

    DEFF Research Database (Denmark)

    Thomsen, Morten Bækgaard; Truin, Michiel; van Opstal, Jurren M;

    2005-01-01

    Increased proarrhythmia in dogs with chronic AV block (AVB) has been explained by ventricular remodeling causing a decrease in repolarization reserve. Beat-to-beat variability of repolarization (BVR) has been suggested to reflect repolarization reserve, in which high variability represents...... diminished reserve and larger propensity for repolarization-dependent ventricular arrhythmia. A subset of chronic AVB dogs (10%) suffers sudden cardiac death (SCD). With the assumption that repolarization defects constitute a potentially lethal proarrhythmic substrate, we hypothesized that BVR in SCD dogs....... In comparison, dogs with acute AVB had low variability (1.3 +/- 0.3 ms; n = 9; P Cardiac electrical remodeling after AVB is associated with an increase in beat-to-beat variability of repolarization. Chronic AVB dogs displaying further elevated variability of repolarization are prone...

  13. Assessment of a Sudden Death Case due to Coronary Artery Disease Based on the PMCT and Forensic Autopsy

    Institute of Scientific and Technical Information of China (English)

    WAN Lei; ZHANG Jian-hua; HUANG Ping; YING Chong-liang; LIU Ning-guo; ZHU Guang-you

    2012-01-01

    It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography (PMCT).This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification (CAC) was clearly displayed using PMCT scan.The entire coronary artery system was almost reconstructed via multiplanar reformation (MPR) and volume-rendering reconstruction (VR),and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software.The results showed that CAC was conspicuous; the total calcium score was 640.3,considerably higher than 400.The pulmonary ground-glass opacity (GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found.The imaging results confirmed those of autopsy.In addition,the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.

  14. Recurrent aborted sudden cardiac death with seizures and rhabdomyolysis due to bulimia-induced hypokalemia: report of one case.

    Science.gov (United States)

    Finsterer, Josef; Stöllberger, Claudia

    2014-06-01

    Recurrent vomiting due to bulimia associated with abuse of furosemide and laxatives causing severe hypokalemia may result in recurrent aborted sudden cardiac death (SCD) and seizures. We report a 25-year-old female with a history of bulimia associated with abuse of furosemide and laxatives since the age of 15 years, migraine since puberty, renal abscesses at age 20 y, and rhabdomyolysis of unknown cause at age 24 y. She experienced aborted SCD due to severe hypokalemia with symptomatic seizures at 21 and 25 years of age. Bulimia patients additionally taking laxatives or furosemide are at particular risk of SCD and rhabdomyolysis and require periodic determination of electrolytes, potassium substitution, and adequate psychiatric therapy and surveillance.

  15. 心脏性猝死的研究进展%Advances in research of cardiac sudden death

    Institute of Scientific and Technical Information of China (English)

    王晓芳; 吴素芬

    2007-01-01

    @@ 1 心脏性猝死的定义 心脏性猝死(Sudden cardiac death,SCD)严重地威胁生命,已引起广泛的重视.SCD是指由于心脏原因引起的,无法预测的自然死亡.从突然出现症状到死亡时间有不同规定,美国心肺血液病研究所定为24 h;世界卫生组织定为6 h.大多数心脏病学者认为从猝死的突发性及意外性而言,主张发病后1 h死亡者为猝死[1].

  16. Studying sudden and unexpected infant deaths in a time of changing death certification and investigation practices: evaluating sleep-related risk factors for infant death in New York City.

    Science.gov (United States)

    Senter, Lindsay; Sackoff, Judith; Landi, Kristen; Boyd, Lorraine

    2011-02-01

    We describe an approach for quantifying and characterizing the extent to which sudden and unexpected infant deaths (SUIDs) result from unsafe sleep environments (e.g., prone position, bedsharing, soft bedding); and present data on sleep-related infant deaths in NYC. Using a combination of vital statistics and medical examiner data, including autopsy and death scene investigation findings, we analyzed any death due to accidental threat to breathing (ATB) (ICD-10 W75 & W84), and deaths of undetermined intent (UND) (Y10-Y34) between 2000 and 2003 in NYC for the presence of sleep-related factors (SRF). Homicide deaths were excluded as were SIDS, since in NYC SIDS is not a certification option if environmental factors were possibly contributors to the death. All 19 ATB and 69 (75%) UND had SRFs as per the OCME investigation. Black infants and infants born to teen mothers had higher SRF death rates for both ATB and UND deaths. Bedsharing was the most common SRF (53%-ATB; 72%-UND deaths); the majority of non-bedsharing infants were found in the prone position (60%-ATB; 78%-UND deaths). We found a high prevalence of SRFs among ATB and UND deaths. This is the first local study to illustrate the importance of knowing how SUIDs are certified in order to ascertain the prevalence of infant deaths with SRFs. Advancing the research requires clarity on the criteria used by local medical examiners to categorize SUIDs. This will help jurisdictions interpret their infant mortality statistics, which in turn will improve education and prevention efforts. PMID:20177757

  17. Sudden unexpected death as a result of primary aortoduodenal fistula identified with postmortem computed tomography.

    Science.gov (United States)

    Williams, Andrew S; Little, D'Arcy L; Herath, Jayantha

    2015-12-01

    Aortoenteric fistula (AEF) is an uncommon source of upper gastrointestinal (GI) tract hemorrhage, commonly occurring in persons with previous aortic surgery. Non-surgery related AEFs (primary AEFs) may occur in association with atherosclerotic lesions, infections, malignancies, or, rarely, result from penetrating/eroding foreign bodies. Given its rarity, primary AEF is not commonly considered in the pathologist's preliminary list of differential diagnoses at the commencement of an autopsy; however, the use of postmortem cross-sectional imaging may allow for the identification of primary AEF as a reasonable differential diagnoses prior to conventional autopsy. The current case outlines the forensic presentation, postmortem computed tomography (PMCT) features, and autopsy findings of a recent case of primary AEF resulting in lethal gastrointestinal hemorrhage. In such cases, PMCT features supporting primary AEF as the underlying cause of death include an atherosclerotic aneurysm abutting a segment of the GI tract with no definite soft tissue plane of separation, luminal GI contents of similar radiographic density to the aortic contents, lack of previous aortic surgery, and lack of a competing explanation for GI hemorrhage or a competing cause of death. Deaths from massive enteric hemorrhage without a medical history to suggest an underlying cause for the hemorrhage would fall under medicolegal jurisdiction and may, by examination of scene and circumstances alone, initially seem suspicious. This case demonstrates how PMCT could be used by a team of expert forensic radiologists and forensic pathologists to rapidly feedback vital information on the cause and manner of death to the criminal justice system. PMID:26464132

  18. Main Predictors of Sudden Cardiac Death in Patients with Q-Wave Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Ravshanbek D Kurbanov

    2015-12-01

    Full Text Available The study included 131 patients (mean age 51.9±9.13 year with Q-wave myocardial infarction (Q-MI. All patients underwent echocardiography and 24-hour ECG monitoring on the 10th through the 14th days of MI. Treatment included thrombolytic therapy, early administration of beta-blockers, antiplatelet agents, anticoagulants, statins, ACE inhibitors, if needed - antiarrhythmics and aldosterone antagonists. Follow-up was 24 months. During the observation period, of the 131 study patients 17(13.0% died suddenly. Our study suggests that the high risk of SCD (in the first 2 years after MI in patients with Q-MI is associated with anterior localization, early pathological LV remodeling, low myocardial contractility, and development of AHF high Killip classes in the early period of MI, as well as the identification of high heart rate at rest, frequent PVCs (mainly polymorphic, systolic dysfunction in the early stages of observation (on the 10th through the 14th days, and older age of patients.

  19. Study on factors and prevention and treatment of sudden cardiac death%心源性猝死诸因素及防治研究

    Institute of Scientific and Technical Information of China (English)

    王蕴强; 翟晓晨

    2015-01-01

    目的:总结与心源性猝死有关的危险因素,为临床上防治心源性猝死疾病提供参考。方法回顾性分析1995年12月~2014年12月期间我部收治抢救的62例心源性猝死患者的临床资料,分析62例心源性猝死患者的临床特点及相关因素。结果(1)急救结果:成功复苏患者为11例,占17.74%,死亡51例,占82.26%。(2)心源性猝死的发生与冠心病相关性很强,占76.48%,猝死前多有严重的心律失常和心功能不全。(3)心源性猝死的常见诱发原因为心理应激状态(35.29%),用力排便(21.57%),运动或过度劳累(19.61%)等。(4)在心源性猝死诸多危险因素中,包括高血压病、糖尿病、高血脂、动脉粥样硬化、吸烟、饮酒等。(5)心源性猝死患者在发病年龄段、性别、发作时间、发作季节、心电图特征、基础疾病等方面差异具有统计学意义(P <0.05)。结论临床上防治心源性猝死的关键,在于提高对心源性猝死的诱发因素和危险因素的重视程度。%Objective To summarize risk factors related to sudden cardiac death and provide reference for the prevention and treatment of sudden cardiac death disease. Methods Clinical data of 62 patients with sudden cardiac death who were admitted to our department from December 1995 to December 2014 were collected. Clinical characteristics and related factors of sudden cardiac death of 62 patients were analyzed retrospectively. Results (1) Results of emergency treatment: 11 resuscitated patients accounted for 17.74 while 51 dead patients accounted for 82.26%. (2) The correlation of sudden cardiac death and coronary heart disease was very strong accounting for 76.48% and most patients had severe arrhythmia and heart failure before sudden death. (3) Common induced factors to sudden cardiac death included psychological stress state (35.29%), straining defecation (21.57%) and exercise or excessive

  20. Anomalous origin of the right coronary artery from the pulmonary artery: an autopsied sudden death case with severe atherosclerotic disease of the left coronary artery.

    Science.gov (United States)

    Nagai, T; Mukai, T; Takahashi, S; Takada, A; Saito, K; Harada, K; Mori, S; Abe, N

    2014-03-01

    Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare anomaly. It may contribute to myocardial ischemia or sudden death, although the lesion is usually asymptomatic. We report a sudden death case of a 58-year-old man with ARCAPA coexisting with severe atherosclerotic coronary artery disease. He had been healthy until he complained of chest pain, several days before death, despite the discovery of heart murmur in childhood and suspicion of valvular heart disease. The autopsy revealed not only typical findings of the right coronary anomaly with well-developed collateral circulations but also severe atherosclerotic lesions of the left coronary artery, and ischemic change of the myocardium in the left and right coronary arterial perfusion territory. In addition to the "coronary steal" phenomenon primarily caused by ARCAPA, the reduced flow of both coronary arteries and further increase of "coronary steal" due to atherosclerotic obstructive coronary disease might have contributed to the patient's death.

  1. Does β-APP staining of the brain in infant bed-sharing deaths differentiate these cases from sudden infant death syndrome?

    DEFF Research Database (Denmark)

    Jensen, Lisbeth Lund; Banner, Jytte; Byard, Roger W

    2014-01-01

    Archival cerebral tissue from infants whose deaths were attributed to sudden infant death syndrome (SIDS) from South Australia and Western Denmark were stained for β-amyloid precursor protein (β-APP) and graded according to a simple scoring chart. The resulting APP scores were correlated...... with sleeping situation (shared vs. alone) showing a significantly higher amount of β-APP staining in the non-bed-sharing, than in the bed-sharing infants (Mann-Whitney, Australia: p = 0.0128, Denmark: p = 0.0014, Combined: p = 0.0031). There was also a marked but non-significant difference in sex distribution...... between bed-sharers and non-bed-sharers with a male to female ratio of 1:1 in the first group and 2:1 in the latter. Of 48 Australian and 76 Danish SIDS infants, β-APP staining was present in 116 (94%) cases. The eight negative cases were all from the Danish cohort. This study has shown that the amount...

  2. Comparison of U.S. and Italian experiences with sudden cardiac deaths in young competitive athletes and implications for preparticipation screening strategies.

    Science.gov (United States)

    Maron, Barry J; Haas, Tammy S; Doerer, Joseph J; Thompson, Paul D; Hodges, James S

    2009-07-15

    Controversy has evolved over the most practical and effective strategy for preparticipation cardiovascular screening of competitive athletes to detect unsuspected cardiovascular disease and prevent sudden death on the athletic field. Athlete screening in the Veneto region of Italy is part of a national program (with 12-lead electrocardiography) that has reported the detection of previously undiagnosed hypertrophic cardiomyopathy and a decrease in the cardiovascular death rate in young athletes. In this study, over time periods of similar length, cardiovascular-related mortality rates in Veneto athletes were compared with those of a demographically similar region of the United States (Minnesota) in which screening is limited to history and physical examination. There were 55 sudden cardiovascular deaths reported in Veneto over 26 years (2.1/year), compared with 22 deaths in 23 years (0.96/year) in Minnesota. Over the recent and comparable 11-year period, 1993 to 2004, 12 deaths were reported in Veneto and 11 in Minnesota. When analyzed as deaths per 100,000 person-years, Veneto exceeded Minnesota for all years combined (1.87 for 1979 to 2004 vs 1.06 for 1985 to 2007, respectively, p = 0.006), although the 2 regions did not differ significantly for 1993 to 2004 (0.87 vs 0.93, respectively, p = 0.88) or most recently for 2001 to 2004 (0.43 vs 0.90, respectively, p = 0.38). In conclusion, sudden cardiovascular deaths in young competitive athletes occurred at a low rate in both Veneto and Minnesota. Despite different preparticipation screening strategies, athlete sudden death rates in these demographically similar regions of the United States and Italy have not differed significantly in recent years. These data do not support a lower mortality rate associated with preparticipation screening programs involving routine electrocardiography and examinations by specially trained personnel.

  3. Relationship between LRP6 polymorphisms and sudden cardiac death in patients with chronic heart failure in Chinese han population

    Institute of Scientific and Technical Information of China (English)

    GUO Qi; CHU Jian-min; REN Lan; CHEN Xu-hua; PU Jie-lin; ZHANG Shu

    2016-01-01

    AIM:Chronic heart failure (CHF), caused by ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM), is among the leading causes of mortality and morbidity worldwide .Low-density lipoprotein receptor-related protein 6 (LRP6) plays a criti-cal role in regulating Wnt signaling .Dysregulated Wnt signaling contributes to high incidence of arrhythmias .Thus, there might be an association between genetic variations of LRP6 and sudden cardiac death ( SCD) .The objective of the study was to examine the associ-ation between common variants of LRP6 and prognosis of CHF patients .METHODS:From July 2005 to December 2009, patients with CHF referred from 10 hospitals and participants without structural heart disease in China were undergone a prospective study .The sin-gle-nucleotide polymorphism rs 2302684 was selected to evaluate the effect of LRP6 polymorphisms on the survival of the patients .RE-SULTS:A total of 1 887 patients (1 437 with CHF and 450 in the control group)were finally enrolled for the analysis.During a medi-an follow-up of 61 months, a total of 546 (38.00%) patients died, including 201(36.81%) cases with SCD and 345 (63.19%) ca-ses with NSCD.No end point event occurred in the control group .Patients carrying A allele of rs2302684 had increased risks of all-cause death (PA in LRP6 is associated with an increased risk of all-cause death and SCD in patients with CHF in Chinese Han population , and the association is more prevalent in patients with CHF caused by ICM.Thus, LRP6 might be added as a novel predictor of SCD and could provide an attractive and direct therapeutic target in SCD prevention .

  4. Inappropriate mediastinal baroreceptor reflex as a possible cause of sudden infant death syndrome - Is thorough burping before sleep protective?

    Science.gov (United States)

    Flaig, Christian

    2007-01-01

    Despite extensive research, a link between the assumed mechanisms of death and known risk factors for sudden infant death syndrome (SIDS) has not yet been established. Modifiable risk factors such as prone sleeping position, nicotine exposure and thermal stress and non-avoidable risk factors like male gender and some risky socio-economic conditions could be detected, but the etiology of SIDS remains unknown. In many SIDS cases histopathological findings suggest an involvement of vital autonomic control functions and unidentified trigger factors seem to play a role. From a hypothetical point of view, a developmental sympatheticovagal imbalance of the cardiovascular reflex control could cause a predisposition for SIDS. An assumed gastroesophageal trigger impulse is possibly developed during the first weeks of life and could lead to the infant's vagal reflex death. Air swallowed during feeding escapes through the esophagus while the infant is sleeping. The temporarily bloated esophagus exerts pressure on neighboring mediastinal baroreceptors, which is potentially misinterpreted as a rise in arterial pressure. The following cardiodepressoric baroreceptor reflex could lead to arterial hypotension, bradycardia and cardiac arrest. Sleeping in prone position may create an increased thoracic pressure on mediastinal baroreceptors, causing a more pronounced vagal reflex and an increased likelihood of SIDS. Prone position in connection with soft objects in the infant's sleeping environment potentially generates an increased oculobulbar pressure, resulting in an additional cardiodepressoric condition (Aschner-Dagnini phenomenon). From the sixth month of life onwards the sympatheticovagal balance seems to have matured sufficiently to compensate the life-threatening challenges in most infants. Insufficient postprandial burping could either create another independent modifiable risk factor or present the missing link to a common trigger mechanism for SIDS. Further investigations

  5. Sudden death following accidental ingestion of a button battery by a 17-month-old child: a case study.

    Science.gov (United States)

    Guinet, T; Gaulier, J M; Moesch, C; Bagur, J; Malicier, D; Maujean, G

    2016-09-01

    Cases of ingesting button batteries by children are not common clinical situations in forensic medicine. Although it can be a cause of death when associated with digestive perforations, no cases of sudden death have been reported in the literature. We report the case of a 17-month-old girl who presented at home with haematemesis, followed by failed cardiopulmonary resuscitation. The child had been treated on two occasions for nasopharyngitis, 14 and 18 days prior to her death. The post-mortem scan revealed a radio-opaque foreign body in the oesophagus. The autopsy revealed the presence of a round button battery, 20 mm in diameter, blocking the lumen of the oesophagus in its upper third, associated with two parietal oesophageal ruptures opposite each other. There was limited digestive haemorrhage, but above all significant bronchial inhalation of blood. Toxicology analyses showed slightly increased blood levels of the heavy metals of which the battery was composed (lithium, chromium, manganese and molybdenum). The anatomopathological analyses confirmed the recent nature of these ruptures. Ingestions of button batteries localised at the level of the oesophagus are the cases linking to the highest risk of complications, particularly for batteries with a diameter of more than 20 mm and in children under the age of 4. The main difficulty in such clinical situations is identifying when the ingestion occurred, as more often than not, no witnesses are present. We discuss the advantages of anatomopathology and toxicology examinations targeted towards heavy metals in these forensic situations. PMID:26886106

  6. Immunohistochemical Analysis of Brainstem Lesions in the Autopsy Cases with Severe Motor and Intellectual Disabilities Showing Sudden Unexplained Death.

    Science.gov (United States)

    Hayashi, Masaharu; Sakuma, Hiroshi

    2016-01-01

    It is known that patients with severe motor and intellectual disabilities (SMID) showed sudden unexplained death (SUD), in which autopsy failed to identify causes of death. Although the involvement of brainstem dysfunction is speculated, the detailed neuropathological analysis still remains to be performed. In order to clarify pathogenesis, we investigated the brainstem functions in autopsy cases of SMID showing SUD. We immunohistochemically examined expressions of tyrosine hydroxylase, tryptophan hydroxylase, substance P, methionine-enkephalin, and c-fos in the serial sections of the midbrain, pons, and medulla oblongata in eight SUD cases and seven controls, having neither unexplained death nor pathological changes in the brain. Expressions of tyrosine hydroxylase and tryptophan hydroxylase were reduced in two of eight cases, and those of substance P and/or methionine-enkephalin were augmented in the pons and medulla oblongata in seven of eight cases, including the aforementioned two cases, when compared with those in controls. The hypoglossal nucleus and/or the dorsal vagal nucleus demonstrated increased neuronal immunoreactivity for c-fos in seven of eight cases, although there was no neuronal loss or gliosis in both the nuclei. Controls rarely showed immunoreactivity for c-fos in the medulla oblongata. These data suggest the possible involvement of brainstem dysfunction in SUD in patients with SMID, and consecutive neurophysiological evaluation of brainstem functions, such as all-night polysomnography and blink reflex, may be useful for the prevention of SUD, because some parameters in the neurophysiological examination are known to be related to the brainstem catecholamine neurons and the spinal tract nucleus of trigeminal nerve. PMID:27445960

  7. Prenatal diagnosis of medium-chain acyl-CoA dehydrogenase (MCAD) deficiency in a family with a previous fatal case of sudden unexpected death in childhood

    DEFF Research Database (Denmark)

    Gregersen, N; Winter, V; Jensen, P K;

    1995-01-01

    Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is a potentially fatal inherited disease with a carrier frequency of approximately 1:100 in most Caucasian populations. The disease is implicated in sudden unexpected death in childhood. A prevalent disease-causing point mutation (A985G...

  8. Comparison of inoculation methods for characterizing relative aggressiveness of two soybean sudden-death syndrome pathogens, Fusarium virguliforme and F. tucumaniae

    Science.gov (United States)

    Fusarium tucumaniae and F. virguliforme are the primary etiological agents of sudden-death syndrome (SDS) of soybean in Argentina and the United States, respectively. Five isolates of F. tucumaniae and four of F. virguliforme were tested for pathogenicity to soybeans, by comparing a toothpick method...

  9. Elevated heart rate triggers action potential alternans and sudden death. translational study of a homozygous KCNH2 mutation.

    Directory of Open Access Journals (Sweden)

    Ulrich Schweigmann

    Full Text Available BACKGROUND: Long QT syndrome (LQTS leads to arrhythmic events and increased risk for sudden cardiac death (SCD. Homozygous KCNH2 mutations underlying LQTS-2 have previously been termed "human HERG knockout" and typically express severe phenotypes. We studied genotype-phenotype correlations of an LQTS type 2 mutation identified in the homozygous index patient from a consanguineous Turkish family after his brother died suddenly during febrile illness. METHODS AND RESULTS: Clinical work-up, DNA sequencing, mutagenesis, cell culture, patch-clamp, in silico mathematical modelling, protein biochemistry, confocal microscopy were performed. Genetic analysis revealed a homozygous C-terminal KCNH2 mutation (p.R835Q in the index patient (QTc ∼506 ms with notched T waves. Parents were I° cousins - both heterozygous for the mutation and clinically unremarkable (QTc ∼447 ms, father and ∼396 ms, mother. Heterologous expression of KCNH2-R835Q showed mildly reduced current amplitudes. Biophysical properties of ionic currents were also only nominally changed with slight acceleration of deactivation and more negative V50 in R835Q-currents. Protein biochemistry and confocal microscopy revealed similar expression patterns and trafficking of WT and R835Q, even at elevated temperature. In silico analysis demonstrated mildly prolonged ventricular action potential duration (APD compared to WT at a cycle length of 1000 ms. At a cycle length of 350 ms M-cell APD remained stable in WT, but displayed APD alternans in R835Q. CONCLUSION: Kv11.1 channels affected by the C-terminal R835Q mutation display mildly modified biophysical properties, but leads to M-cell APD alternans with elevated heart rate and could precipitate SCD under specific clinical circumstances associated with high heart rates.

  10. The Investigation of Athletic Sudden Death in Universities of Shaanxi Province%陕西省高等学校运动性猝死现象研究

    Institute of Scientific and Technical Information of China (English)

    杨胜来; 郭清镯

    2012-01-01

    采用文献资料调研、逻辑分析、问卷调查与数理统计等方法,通过典型案例分析,研究陕西省高等学校运动性猝死现象.结果表明:4月和11月是运动性猝死高发月份,气温变化快是主演的诱因,主要涉及体育测试和跑步;6月是游泳相关的猝死发生的密集时间;中午和下午各种诱因易引发猝死;大一新生是最容易发生运动性猝死的年级;男性猝死高于女性;西安地区高于其他地区.高等学校可以通过建立应急预案,普及急救常识、严格执行体检制度并使之成为学生能否参加体育运动的依据等预防对策可以有效预防运动性猝死.%Through literature research, logical analysis, questionnaire survey and mathematical statistics method, using analysis of typical cases, this paper studies the athletic sudden death of Shaanxi province higher school. The results showed that: April and November is the high-risk months of athletic sudden death , which mainly involving sports testing and running; June is swimming related sudden death happened dense time; most athletic sudden death happened at the noon and afternoon, caused a variety of incentives ; freshman is most likely to exercise-induced sudden death grades; male sudden death than women. Colleges and universities can prevent athletic sudden death effectively by establishment of the contingency plans for universal access to first aid, strictly carry out physical examination system.

  11. Heat-modified citrus pectin induces apoptosis-like cell death and autophagy in HepG2 and A549 cancer cells.

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    Lionel Leclere

    Full Text Available Cancer is still one of the leading causes of death worldwide, and finding new treatments remains a major challenge. Previous studies showed that modified forms of pectin, a complex polysaccharide present in the primary plant cell wall, possess anticancer properties. Nevertheless, the mechanism of action of modified pectin and the pathways involved are unclear. Here, we show that citrus pectin modified by heat treatment induced cell death in HepG2 and A549 cells. The induced cell death differs from classical apoptosis because no DNA cleavage was observed. In addition, Z-VAD-fmk, a pan-caspase inhibitor, did not influence the observed cell death in HepG2 cells but appeared to be partly protective in A549 cells, indicating that heat-modified citrus pectin might induce caspase-independent cell death. An increase in the abundance of the phosphatidylethanolamine-conjugated Light Chain 3 (LC3 protein and a decrease in p62 protein abundance were observed in both cell types when incubated in the presence of heat-modified citrus pectin. These results indicate the activation of autophagy. To our knowledge, this is the first time that autophagy has been revealed in cells incubated in the presence of a modified form of pectin. This autophagy activation appears to be protective, at least for A549 cells, because its inhibition with 3-methyladenine increased the observed modified pectin-induced cytotoxicity. This study confirms the potential of modified pectin to improve chemotherapeutic cancer treatments.

  12. Parental understanding and self-blame following sudden infant death: a mixed-methods study of bereaved parents' and professionals' experiences

    Science.gov (United States)

    Griffiths, Frances; Sidebotham, Peter

    2016-01-01

    Objectives Improvements in our understanding of the role of modifiable risk factors for sudden infant death syndrome (SIDS) mean that previous reassurance to parents that these deaths were unpreventable may no longer be appropriate. This study aimed to learn of bereaved parents' and healthcare professionals' experiences of understanding causes of death following detailed sudden unexpected death in infancy (SUDI) investigations. The research questions were: How do bereaved parents understand the cause of death and risk factors identified during detailed investigation following a sudden unexpected infant death? What is the association between bereaved parents' mental health and this understanding? What are healthcare professionals' experiences of sharing such information with families? Design This was a mixed-methods study using a Framework Approach. Setting Specialist paediatric services. Participants Bereaved parents were recruited following detailed multiagency SUDI investigations; 21/113 eligible families and 27 professionals participated giving theoretical saturation of data. Data collection We analysed case records from all agencies, interviewed professionals and invited parents to complete the Hospital Anxiety and Depression Scale (HADS) and questionnaires or in-depth interviews. Results Nearly all bereaved parents were able to understand the cause of death and several SIDS parents had a good understanding of the relevant modifiable risk factors even when these related directly to their actions. Paediatricians worried that discussing risk factors with parents would result in parental self-blame and some deliberately avoided these discussions. Over half the families did not mention blame or blamed no one. The cause of death of the infants of these families varied. 3/21 mothers expressed overwhelming feelings of self-blame and had clinically significant scores on HADS. Conclusions Bereaved parents want detailed information about their child's death. Our study

  13. The medico-legal investigation of sudden, unexpected and/or unexplained infant deaths in South Africa: where are we--and where are we going?

    Science.gov (United States)

    du Toit-Prinsloo, L; Dempers, J J; Wadee, S A; Saayman, G

    2011-03-01

    Sudden Infant Death Syndrome (SIDS) has been reported to be the leading cause of death in infants under 1 year of age in many countries. Unfortunately, a paucity of published research data exists in South Africa, with regard to the incidence of and investigation into the circumstances surrounding Sudden Unexplained Deaths in Infants (SUDI) and/or SIDS. Currently, even though most academic centers conform to a protocol consistent with internationally accepted standards, there exists no nationally accepted infant death investigation protocol in South Africa. It is the aim of this study to review the current practice of infant death investigation in two representative but geographically and demographically distinct centers. Retrospective case audit over a five-year period (2000-2004) was conducted at two large medico-legal mortuaries in Pretoria (Gauteng) and Tygerberg (Cape Town). Case files on all infants younger than 1 year of age were reviewed. The outcome measures included number of deaths, demographic details and the nature and final outcome of the post mortem examinations. A total of 512 cases were identified as possible SIDS cases and of these, 171 was classified as SIDS. The study showed marked inter-case and inter-divisional variation in terms of the investigation of infant deaths at the two institutions. It is envisaged that this study will focus attention on the current lack of usable data regarding sudden/unexplained/unexpected infant deaths in South Africa, and aid in the formulation and implementation of a practical (yet internationally accountable) infant death investigation protocol, which could facilitate comparisons with other countries and initiate further structured research in this field.

  14. Post-mortem Whole exome sequencing with gene-specific analysis for autopsy-negative sudden unexplained death in the young: a case series.

    Science.gov (United States)

    Narula, Nupoor; Tester, David J; Paulmichl, Anna; Maleszewski, Joseph J; Ackerman, Michael J

    2015-04-01

    Annually, thousands of sudden deaths in individuals under 35 years remain unexplained following comprehensive medico-legal autopsy. Previously, post-mortem genetic analysis by Sanger sequencing of four major cardiac channelopathy genes revealed that approximately one-fourth of these autopsy-negative sudden unexplained death in the young (SUDY) cases harbored an underlying mutation. However, there are now over 100 sudden death-predisposing cardiac channelopathy-, cardiomyopathy-, and metabolic disorder-susceptibility genes. Here, we set out to determine whether post-mortem whole exome sequencing (WES) is an efficient strategy to detect ultra-rare, potentially pathogenic variants. We performed post-mortem WES and gene-specific analysis of 117 sudden death-susceptibility genes for 14 consecutively referred Caucasian SUDY victims (average age at death 17.4 ± 8.6 years) to identify putative SUDY-associated mutations. On average, each SUDY case had 12,758 ± 2,016 non-synonymous variants, of which 79 ± 15 localized to these 117 genes. Overall, eight ultra-rare variants (seven missense, one in-frame insertion) absent in three publically available exome databases were identified in six genes (three in TTN, and one each in CACNA1C, JPH2, MYH7, VCL, RYR2) in seven of 14 cases (50 %). Of the seven missense alterations, two (T171M-CACNA1C, I22160T-TTN) were predicted damaging by three independent in silico tools. Although WES and gene-specific surveillance is an efficient means to detect rare genetic variants that might underlie the pathogenic cause of death, accurate interpretation of each variant is challenging. Great restraint and caution must be exercised otherwise families may be informed prematurely and incorrectly that the root cause has been found.

  15. Lack of association of the serotonin transporter polymorphism with the sudden infant death syndrome in the San Diego Dataset.

    Science.gov (United States)

    Paterson, David S; Rivera, Keith D; Broadbelt, Kevin G; Trachtenberg, Felicia L; Belliveau, Richard A; Holm, Ingrid A; Haas, Elisabeth A; Stanley, Christina; Krous, Henry F; Kinney, Hannah C; Markianos, Kyriacos

    2010-11-01

    Dysfunction of medullary serotonin (5-HT)-mediated respiratory and autonomic function is postulated to underlie the pathogenesis of the majority of sudden infant death syndrome (SIDS) cases. Several studies have reported an increased frequency of the LL genotype and L allele of the 5-HT transporter (5-HTT) gene promoter polymorphism (5-HTTLPR), which is associated with increased transcriptional activity and 5-HT transport in vitro, in SIDS cases compared with controls. These findings raise the possibility that this polymorphism contributes to or exacerbates existing medullary 5-HT dysfunction in SIDS. In this study, we tested the hypothesis that the frequency of LL genotype and L allele are higher in 179 SIDS cases compared with 139 controls of multiple ethnicities in the San Diego SIDS Dataset. We observed no significant association of genotype or allele with SIDS cases either in the total cohort or on stratification for ethnicity. These observations do not support previous findings that the L allele and/or LL genotype of the 5-HTTLPR are associated with SIDS.

  16. Identification of Fusarium virguliforme FvTox1-Interacting Synthetic Peptides for Enhancing Foliar Sudden Death Syndrome Resistance in Soybean.

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    Bing Wang

    Full Text Available Soybean is one of the most important crops grown across the globe. In the United States, approximately 15% of the soybean yield is suppressed due to various pathogen and pests attack. Sudden death syndrome (SDS is an emerging fungal disease caused by Fusarium virguliforme. Although growing SDS resistant soybean cultivars has been the main method of controlling this disease, SDS resistance is partial and controlled by a large number of quantitative trait loci (QTL. A proteinacious toxin, FvTox1, produced by the pathogen, causes foliar SDS. Earlier, we demonstrated that expression of an anti-FvTox1 single chain variable fragment antibody resulted in reduced foliar SDS development in transgenic soybean plants. Here, we investigated if synthetic FvTox1-interacting peptides, displayed on M13 phage particles, can be identified for enhancing foliar SDS resistance in soybean. We screened three phage-display peptide libraries and discovered four classes of M13 phage clones displaying FvTox1-interacting peptides. In vitro pull-down assays and in vivo interaction assays in yeast were conducted to confirm the interaction of FvTox1 with these four synthetic peptides and their fusion-combinations. One of these peptides was able to partially neutralize the toxic effect of FvTox1 in vitro. Possible application of the synthetic peptides in engineering SDS resistance soybean cultivars is discussed.

  17. Infarto agudo do miocárdio e morte súbita documentada Acute myocardial infarction and documented sudden death

    Directory of Open Access Journals (Sweden)

    Gustavo Carvalho

    2005-01-01

    Full Text Available Homem, sexagenário, deu entrada na emergência com dor torácica duvidosa e lipotímia. Investigado e estratificado, teve eletrocardiogramas e marcadores séricos de injúria miocárdica seriados negativos para isquemia miocárdica, e teste ergométrico sem critérios para isquemia miocárdica. Contudo, apresentou morte súbita presenciada dentro do hospital enquanto fazia uso da monitorização eletrocardiográfica contínua com o holter, que evidenciou, em seus traçados, infarto agudo do miocárdico complicado com arritmia ventricular complexa (taquicardia e fibrilação ventricular, que culminou em morte refratária às manobras de reanimação cardio-respiratória.A sexagenarian man sought the emergency unit complaining of dubious chest pain and lipothymia. He was investigated and stratified. His serial electrocardiograms and serum markers for myocardial injury were negative for myocardial ischemia, as was his exercise test. However, the patient died suddenly inside the hospital while under continuous electrocardiographic Holter monitoring, which evidenced acute myocardial infarction complicated by complex ventricular arrhythmia (ventricular tachycardia and fibrillation, which culminated in death refractory to the cardiopulmonary resuscitation maneuvers.

  18. Contemporary strategies for risk stratification and prevention of sudden death with the implantable defibrillator in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Maron, Barry J; Maron, Martin S

    2016-05-01

    Hypertrophic cardiomyopathy (HCM) is regarded as the most common nontraumatic cause of sudden death (SD) in young people (including trained athletes). Introduction of implantable cardioverter-defibrillators (ICD) to HCM 15 years ago represented a new paradigm for clinical practice and probably the most significant advance in management of this disease. ICDs offer protection against SD by terminating potentially lethal ventricular tachyarrhythmias (11%/year secondary and 4%/year primary prevention), although implant decisions are weighed against the possibility of device-related complications (5%/year). ICDs have altered the natural history of HCM, creating the opportunity for extended or normal longevity for many patients. However, assessing SD risk and targeting appropriate candidates for prophylactic device therapy can be compounded by unpredictability of the underlying arrhythmogenic substrate, evident by delays ≥10 years between implant and first ICD intervention. Multiple or a single strong risk marker within the clinical profile of an individual HCM patient can justify consideration for a primary-prevention ICD when combined with physician judgment and shared decision making. The role of the mathematical SD risk score proposed by the European Society of Cardiology to identify patients who benefit from ICD therapy is incompletely resolved. Contemporary treatment interventions and advanced risk stratification using ≥1 conventional markers have served the HCM patient population well, with reduced disease-related mortality rates across all age groups to <1%/year, due largely to the penetration of ICDs into HCM practice. Prevention of SD has now become an integral, albeit challenging, component of HCM management, contributing importantly to its emergence as a contemporary treatable cardiac disease. PMID:26749314

  19. Landscape epidemiology and control of pathogens with cryptic and long-distance dispersal: sudden oak death in northern Californian forests.

    Directory of Open Access Journals (Sweden)

    João A N Filipe

    2012-01-01

    Full Text Available Exotic pathogens and pests threaten ecosystem service, biodiversity, and crop security globally. If an invasive agent can disperse asymptomatically over long distances, multiple spatial and temporal scales interplay, making identification of effective strategies to regulate, monitor, and control disease extremely difficult. The management of outbreaks is also challenged by limited data on the actual area infested and the dynamics of spatial spread, due to financial, technological, or social constraints. We examine principles of landscape epidemiology important in designing policy to prevent or slow invasion by such organisms, and use Phytophthora ramorum, the cause of sudden oak death, to illustrate how shortfalls in their understanding can render management applications inappropriate. This pathogen has invaded forests in coastal California, USA, and an isolated but fast-growing epidemic focus in northern California (Humboldt County has the potential for extensive spread. The risk of spread is enhanced by the pathogen's generalist nature and survival. Additionally, the extent of cryptic infection is unknown due to limited surveying resources and access to private land. Here, we use an epidemiological model for transmission in heterogeneous landscapes and Bayesian Markov-chain-Monte-Carlo inference to estimate dispersal and life-cycle parameters of P. ramorum and forecast the distribution of infection and speed of the epidemic front in Humboldt County. We assess the viability of management options for containing the pathogen's northern spread and local impacts. Implementing a stand-alone host-free "barrier" had limited efficacy due to long-distance dispersal, but combining curative with preventive treatments ahead of the front reduced local damage and contained spread. While the large size of this focus makes effective control expensive, early synchronous treatment in newly-identified disease foci should be more cost-effective. We show how the

  20. Accelerated activation of SOCE current in myotubes from two mouse models of anesthetic- and heat-induced sudden death.

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    Viktor Yarotskyy

    Full Text Available Store-operated calcium entry (SOCE channels play an important role in Ca(2+ signaling. Recently, excessive SOCE was proposed to play a central role in the pathogenesis of malignant hyperthermia (MH, a pharmacogenic disorder of skeletal muscle. We tested this hypothesis by characterizing SOCE current (ISkCRAC magnitude, voltage dependence, and rate of activation in myotubes derived from two mouse models of anesthetic- and heat-induced sudden death: 1 type 1 ryanodine receptor (RyR1 knock-in mice (Y524S/+ and 2 calsequestrin 1 and 2 double knock-out (dCasq-null mice. ISkCRAC voltage dependence and magnitude at -80 mV were not significantly different in myotubes derived from wild type (WT, Y524S/+ and dCasq-null mice. However, the rate of ISkCRAC activation upon repetitive depolarization was significantly faster at room temperature in myotubes from Y524S/+ and dCasq-null mice. In addition, the maximum rate of ISkCRAC activation in dCasq-null myotubes was also faster than WT at more physiological temperatures (35-37°C. Azumolene (50 µM, a more water-soluble analog of dantrolene that is used to reverse MH crises, failed to alter ISkCRAC density or rate of activation. Together, these results indicate that while an increased rate of ISkCRAC activation is a common characteristic of myotubes derived from Y524S/+ and dCasq-null mice and that the protective effects of azumolene are not due to a direct inhibition of SOCE channels.

  1. Primary Prevention of Sudden Cardiac Death in Adults with Transposition of the Great Arteries: A Review of Implantable Cardioverter-Defibrillator Placement.

    Science.gov (United States)

    Sodhi, Sandeep S; Cedars, Ari M

    2015-08-01

    Transposition of the great arteries encompasses a set of structural congenital cardiac lesions that has in common ventriculoarterial discordance. Primarily because of advances in medical and surgical care, an increasing number of children born with this anomaly are surviving into adulthood. Depending upon the subtype of lesion or the particular corrective surgery that the patient might have undergone, this group of adult congenital heart disease patients constitutes a relatively new population with unique medical sequelae. Among the more common and difficult to manage are cardiac arrhythmias and other sequelae that can lead to sudden cardiac death. To date, the question of whether implantable cardioverter-defibrillators should be placed in this cohort as a preventive measure to abort sudden death has largely gone unanswered. Therefore, we review the available literature surrounding this issue. PMID:26413012

  2. Usefulness of Cardiac Sympathetic Nerve Imaging Using (123)Iodine-Metaiodobenzylguanidine Scintigraphy for Predicting Sudden Cardiac Death in Patients With Heart Failure.

    Science.gov (United States)

    Kasama, Shu; Toyama, Takuji; Kurabayashi, Masahiko

    2016-01-01

    The autonomic nervous system plays an important role in the human heart. Activation of the cardiac sympathetic nervous system is a cardinal pathophysiological abnormality associated with the failing human heart. Myocardial imaging using (123)I-metaiodobenzylguanidine (MIBG), an analog of norepinephrine, can be used to investigate the activity of norepinephrine, the predominant neurotransmitter of the sympathetic nervous system. Many clinical trials have demonstrated that (123)I-MIBG scintigraphic parameters predict cardiac adverse events, especially sudden cardiac death, in patients with heart failure. In this review, we summarize results from published studies that have focused on the use of cardiac sympathetic nerve imaging using (123)I-MIBG scintigraphy for risk stratification of sudden cardiac death in patients with heart failure.

  3. 早期复极综合征与特发性室颤及猝死%Idiopathic ventricular fibrillation and sudden death associated with early repolarization syndrome.

    Institute of Scientific and Technical Information of China (English)

    陈漠水

    2011-01-01

    Early repolarization syndrome (ERS) is a well-recognized idiopathic electrocardiographic phenomenon characterized by prominent J wave and a positive large T wave and ST-segment elevation, concave to the top, predominantly in left precordial (V3~V6 ) leads. It was generally thought that ERS is benign, but recently a growing number of case reports indicate that in some instances, ERS repeatedly induces idiopathic ventricular fibrillation which causes sudden death, suggesting that ERS is associated with idiopathic ventricular fibrillation and sudden death.However, the mechanism of its arrhythmogenic potential still remains unknown. Therefore, patients with ERS who have chest pain, unexplained syncope or other symptoms and at high risks of family history of sudden death should be automatically transferred implantable cardiac defibrillator (ICD) to improve the prognosis. This review summarizes the current state of knowledge concerning ERS associated with idiopathic ventricular fibrillation and sudden death.%早期复极综合征(ERS)是一种以心电图上表现为J波增大或J点抬高,胸前导联V3-V6弓背向下的ST段抬高和高大而直立的T波的特征性的心电改变,通常认为是一种正常心电图的良性变异,但近来报道早期复极综合征在一些情况下可诱发特发性心室颤动,导致猝死,机制尚未明确.对于有胸痛、晕厥等症状或(和)猝死家族史等的高危ERS患者,应植入型心脏自动转律除颤器(ICD)以改善预后.

  4. Hesperidin from Citrus seed induces human hepatocellular carcinoma HepG2 cell apoptosis via both mitochondrial and death receptor pathways.

    Science.gov (United States)

    Banjerdpongchai, Ratana; Wudtiwai, Benjawan; Khaw-On, Patompong; Rachakhom, Wasitta; Duangnil, Natthachai; Kongtawelert, Prachya

    2016-01-01

    Citrus seeds are full of phenolic compounds, such as flavonoids. The aims of this study were to identify the types of flavonoids in Citrus seed extracts, the cytotoxic effect, mode of cell death, and signaling pathway in human hepatic cancer HepG2 cells. The flavonoids contain anticancer, free radical scavenging, and antioxidant activities. Neohesperidin, hesperidin, and naringin, active flavanone glycosides, were identified in Citrus seed extract. The cytotoxic effect of three compounds was in a dose-dependent manner, and IC50 levels were determined. The sensitivity of human HepG2 cells was as follows: hesperidin > naringin > neohesperidin > naringenin. Hesperidin induced HepG2 cells to undergo apoptosis in a dose-dependent manner as evidenced by the externalization of phosphatidylserine and determined by annexin V-fluorescein isothiocyanate and propidium iodide staining using flow cytometry. Hesperidin did not induce the generation of reactive oxygen species, which was determined by using 2',7'-dichlorohydrofluorescein diacetate and flow cytometry method. The number of hesperidin-treated HepG2 cells with the loss of mitochondrial transmembrane potential increased concentration dependently, using 3,3'-dihexyloxacarbocyanine iodide employing flow cytometry. Caspase-9, -8, and -3 activities were activated and increased in hesperidin-treated HepG2 cells. Bcl-xL protein was downregulated whereas Bax, Bak, and tBid protein levels were upregulated after treatment with hesperidin in a dose-dependent manner. In conclusion, the bioflavanone from Citrus seeds, hesperidin, induced human HepG2 cell apoptosis via mitochondrial pathway and death receptor pathway. Citrus seed flavonoids are beneficial and can be developed as anticancer drug or food supplement, which still needs further in vivo investigation in animals and human beings. PMID:26194866

  5. Sudden unexpected infant death (SUDI in a newborn due to medium chain acyl CoA dehydrogenase (MCAD deficiency with an unusual severe genotype

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    Lovera Cristina

    2012-10-01

    Full Text Available Abstract Medium chain acyl CoA dehydrogenase deficiency (MCAD is the most common inborn error of fatty acid oxidation. This condition may lead to cellular energy shortage and cause severe clinical events such as hypoketotic hypoglycemia, Reye syndrome and sudden death. MCAD deficiency usually presents around three to six months of life, following catabolic stress as intercurrent infections or prolonged fasting, whilst neonatal-onset of the disease is quite rare. We report the case of an apparently healthy newborn who suddenly died at the third day of life, in which the diagnosis of MCAD deficiency was possible through peri-mortem blood-spot acylcarnitine analysis that showed very high concentrations of octanoylcarnitine. Genetic analysis at the ACADM locus confirmed the biochemical findings by demonstrating the presence in homozygosity of the frame-shift c.244dup1 (p.Trp82LeufsX23 mutation, a severe genotype that may explain the unusual and very early fatal outcome in this newborn. This report confirms that inborn errors of fatty acid oxidation represent one of the genetic causes of sudden unexpected deaths in infancy (SUDI and underlines the importance to include systematically specific metabolic screening in any neonatal unexpected death.

  6. A case of cardiac sudden death related to abnormality of sympathetic nervous disturbance detected by {sup 123}I-metaiodobenzylguanidine (MIBG)

    Energy Technology Data Exchange (ETDEWEB)

    Igarashi, Masaki; Matsukawa, Seishirou; Morishita, Takeshi [Toho Univ., Tokyo (Japan). School of Medicine

    1996-11-01

    A case of cardiac sudden death was reported. A female, 64 years old patient with multiple myeloma had been treated with total dose of 790 mg of adriamycin. Although treadmill examination, dobutamine-loaded cardiac echography and thallium-loaded myocardial scintigraphy gave normal findings, Holter ECG revealed bigeminy and discontinuous ventricular tachycardia. Mexiletine was not tolerated. {sup 123}I-MIBG image gave deficit of lateral to posterior wall and increased washing rate of 65%. At 36 days after hospitalization, the ventricular tachycardia changed to fatal fibrillation. The sympathetic nervous disturbance detected by the enhanced washing rate of {sup 123}I-MIBG might have participated in the death. (K.H.)

  7. Next-generation sequencing of 100 candidate genes in young victims of suspected sudden cardiac death with structural abnormalities of the heart

    DEFF Research Database (Denmark)

    Hertz, C L; Christiansen, S L; Ferrero-Miliani, Laura;

    2016-01-01

    -two cases had non-diagnostic structural cardiac abnormalities and 20 cases, diagnosed with a cardiomyopathy post-mortem (ARVC = 14, HCM = 6), served as comparators. Fifteen (29 %) of the deceased individuals with non-diagnostic findings had variants with likely functional effects based on conservation......BACKGROUND: In sudden, unexpected, non-traumatic death in young individuals, structural abnormalities of the heart are frequently identified at autopsy. However, the findings may be unspecific and cause of death may remain unclear. A significant proportion of these cases are most likely caused...... with non-diagnostic structural abnormalities of the heart. METHODS AND RESULTS: We screened 72 suspected SCD cases (

  8. Increased risk of sudden and non-sudden cardiovascular death in patients with atrial fibrillation/flutter following acute myocardial infarction

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Abildstrøm, Steen Z; Ottesen, Michael M;

    2005-01-01

    AIMS: Atrial fibrillation (AF) is a common complication in patients with acute myocardial infarction and is associated with an increase in the risk of death. The excess mortality associated with AF complicating acute myocardial infarction has not been studied in detail. Observations indicate...

  9. CPR in medical schools: learning by teaching BLS to sudden cardiac death survivors – a promising strategy for medical students?

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    Herkner Harald

    2006-04-01

    Full Text Available Abstract Background Cardiopulmonary resuscitation (CPR training is gaining more importance for medical students. There were many attempts to improve the basic life support (BLS skills in medical students, some being rather successful, some less. We developed a new problem based learning curriculum, where students had to teach CPR to cardiac arrest survivors in order to improve the knowledge about life support skills of trainers and trainees. Methods Medical students who enrolled in our curriculum had to pass a 2 semester problem based learning session about the principles of cardiac arrest, CPR, BLS and defibrillation (CPR-D. Then the students taught cardiac arrest survivors who were randomly chosen out of a cardiac arrest database of our emergency department. Both, the student and the Sudden Cardiac Death (SCD survivor were asked about their skills and knowledge via questionnaires immediately after the course. The questionnaires were then used to evaluate if this new teaching strategy is useful for learning CPR via a problem-based-learning course. The survey was grouped into three categories, namely "Use of AED", "CPR-D" and "Training". In addition, there was space for free answers where the participants could state their opinion in their own words, which provided some useful hints for upcoming programs. Results This new learning-by-teaching strategy was highly accepted by all participants, the students and the SCD survivors. Most SCD survivors would use their skills in case one of their relatives goes into cardiac arrest (96%. Furthermore, 86% of the trainees were able to deal with failures and/or disturbances by themselves. On the trainer's side, 96% of the students felt to be well prepared for the course and were considered to be competent by 96% of their trainees. Conclusion We could prove that learning by teaching CPR is possible and is highly accepted by the students. By offering a compelling appreciation of what CPR can achieve in using

  10. TYCHO Brahe's Empiric Methods, His Instruments, His Sudden Escape from Denmark and a New Theory About His Death

    Science.gov (United States)

    Thykier, C.

    1992-07-01

    by the young new King Christian IV. Almost all of Tycho Brahe's privileges given to him by the late King Frederik II were taken from him. Shortly after that, he gathered his family and assistants and went to Rostock, from where he wrote a letter to Christian IV saying that he would contemplate returning to Denmark if the king would give him back his privileges. Christian very sternly answered the astronomer that if he should hope to return to Denmark he had to act like a servant. Tycho was too proud to go down to his knees for the king and never returned. So the reason for Tycho's acceptance of the invitation by Emperor Rudolf to come to Prague was that Christian IV would not continue the very considerable financial support to Tycho of about one percentage of the state income. The latest historical research has indicated that a "camarilla" of enemies stood behind Christian IV's aversion against Tycho. Tycho was not merely an astronomer, but also an astrologer and alchemist. As far as we know he never tried to make gold; his alchemic experiments were of medical character. This was not legal without permission from the Church and the University. Both the clergy and the doctors of the university envied the great scientist because princes and learned people preferred to visit Tycho at his "private university" on the island of Hven instead of visiting the University of Copenhagen. A new theory about Tycho's death has appeared. It has always been told that he died of a burst urinary bladder because he drank too much at parties. According to forensic medicine, however, this cannot be true. Tycho lived for some time after he became ill, and a bursted bladder would cause sudden death. A more plausible explanation would be that Tycho poisoned himself with his very strong medicines containing heavy metals like mercury and arsenic.

  11. Hemorragia pulmonar masiva presentada como muerte súbita neonatal Massive pulmonary haemorrhage presented as sudden neonatal death

    Directory of Open Access Journals (Sweden)

    J. Blanco Pampín

    2003-04-01

    Full Text Available La hemorragia pulmonar masiva en los recién nacidos, es una patología grave con una elevada tasa de mortalidad. En el presente artículo, se describe el caso de una recién nacida que fallece súbitamente, tras un intervalo de vida de 4 días, sin signos patológicos ni manifestaciones clínicas previas. Durante el parto había sufrido una severa anoxia. Repentinamente, presenta un cuadro de disnea progresiva y hemoptisis. Tras varios intentos infructuosos de reanimación, fallece al cabo de una hora en el Servicio de Urgencias. La autopsia reveló fundamentalmente, la existencia de una hemorragia pulmonar masiva difusa. Macroscópicamente, el tamaño de los pulmones era normal, existiendo un incremento ponderal de los mismos y una consistencia carnosa con amplias e intensas áreas hemorrágicas. La tráquea y los bronquios principales se encontraban ocupados por sangre líquida. Microscópicamente, se apreciaron infiltrados hemorrágicos pulmonares intraalveolares e intersticiales, así como en el hígado y en ambos riñones. La investigación toxicológica fue negativa. No se observaron otras alteraciones patológicas. Teniendo en cuenta los datos de la historia clínica obstétrica y los hallazgos anatomopatológicos, se llegó a la conclusión de que el fallecimiento se produjo por un una hemorragia pulmonar masiva, relacionada con la anoxia desarrollada durante el trabajo de parto.Massive pulmonary haemorrhage in newborns is a catastrophic event with a high rate of mortality. A case of unexpected death in a four-day-old female newborn, who died after a period without previous pathological signs and clinical manifestations, is described. She had suffered severe asphyxia atbirth. Suddenly, she presented increasing dyspnea and haemoptysis. After an unsuccessful attempt at resuscitation, she died 1 hour after admission to the Emergency Department. At autopsy a massive and diffuse intrapulmonary haemorrhage was found. On gross examination the

  12. 10例哮喘猝死患者死因分析%Death Analyses for 10 cases of patients with Sudden death in asthma

    Institute of Scientific and Technical Information of China (English)

    李红兵; 王廷杰(通讯作者); 王平飞; 冉梅; 张雪漫; 王红军; 周兴荣

    2013-01-01

    目的探讨支气管哮喘猝死的诱因以减少哮喘猝死发生。方法回顾性地复习并分析10例哮喘猝死患者的临床相关病史资料,结果10例患者中,9女1男,年龄21-53岁,平均年龄40.7岁。哮喘病史1-40年不等,平均约18.7年。发病季节和时间:1-2月发病3例,5-8月7例;有3例在夜间8-10p m时突发呼吸困难加重,7例在早晨至中午时突发;可能诱因:5例与进食(如鱼类、肉食等)有关,3例可能与感染加重有关,1例在登山活动中,1例在注射斯奇康后。10例患者中3例有哮喘家族史。本组病例中5例患者曾到呼吸专科进行过诊治,但依从性均差,其余5例从未到呼吸专科诊治。10例患者均未接受规范化治疗。5例在心肺复苏后急查血常规, WBC12.4—18.16x109/L者3例,嗜酸性粒细胞明显增高者2例。10例哮喘猝死患者均经心肺复苏,5例当即死亡,4例死于脑死亡及其它并发症,1例存留智力障碍。讨论:诱发和增加哮喘猝死的因素多种,如中青年女性、冬季与夏季、食物过敏、感染加重,家族史等,缺乏及时就医;加强对哮喘患者的防治教育和规范性治疗,及加强院前急救十分重要,可提高对支气管哮喘的防治水平,减少治哮喘猝死的发生。%Objective To approach predisposition of Sudden death in asthma(SDA) and decrease SDA.Methods 10 cases history and related data of SDA were reviewed and analyzed.Results It was 10 cases, famale 9 and male 1, age 21-53 years old, mean 40.7 years. In which asthma history was 1—40years, mean 18,7 years.attack season and time:attack in January to February had 3 cases, attack in May to August 7 cases;attack in 8-10 pm had suddenly exacerbated dyspnea,7 cases attack in morning to noon; probable predispositions had that 5 cases were related to foods( fishes, meats ect ),3 cases were related to infections, 1 case in climbing, 1 case after getted a

  13. A Common Polymorphism of the Human Cardiac Sodium Channel Alpha Subunit (SCN5A Gene Is Associated with Sudden Cardiac Death in Chronic Ischemic Heart Disease.

    Directory of Open Access Journals (Sweden)

    Boglárka Marcsa

    Full Text Available Cardiac death remains one of the leading causes of mortality worldwide. Recent research has shed light on pathophysiological mechanisms underlying cardiac death, and several genetic variants in novel candidate genes have been identified as risk factors. However, the vast majority of studies performed so far investigated genetic associations with specific forms of cardiac death only (sudden, arrhythmogenic, ischemic etc.. The aim of the present investigation was to find a genetic marker that can be used as a general, powerful predictor of cardiac death risk. To this end, a case-control association study was performed on a heterogeneous cohort of cardiac death victims (n=360 and age-matched controls (n=300. Five single nucleotide polymorphisms (SNPs from five candidate genes (beta2 adrenergic receptor, nitric oxide synthase 1 adaptor protein, ryanodine receptor 2, sodium channel type V alpha subunit and transforming growth factor-beta receptor 2 that had previously been shown to associate with certain forms of cardiac death were genotyped using sequence-specific real-time PCR probes. Logistic regression analysis revealed that the CC genotype of the rs11720524 polymorphism in the SCN5A gene encoding a subunit of the cardiac voltage-gated sodium channel occurred more frequently in the highly heterogeneous cardiac death cohort compared to the control population (p=0.019, odds ratio: 1.351. A detailed subgroup analysis uncovered that this effect was due to an association of this variant with cardiac death in chronic ischemic heart disease (p=0.012, odds ratio = 1.455. None of the other investigated polymorphisms showed association with cardiac death in this context. In conclusion, our results shed light on the role of this non-coding polymorphism in cardiac death in ischemic cardiomyopathy. Functional studies are needed to explore the pathophysiological background of this association.

  14. Two Sudden and Unexpected Deaths of Patients with Schizophrenia Associated with Intramuscular Injections of Antipsychotics and Practice Guidelines to Limit the Use of High Doses of Intramuscular Antipsychotics.

    Science.gov (United States)

    Wahidi, Nasratullah; Johnson, Katie M; Brenzel, Allen; de Leon, Jose

    2016-01-01

    Intravenous haloperidol has been associated with torsades de pointes (TdP). These two sudden deaths were probable adverse drug reactions (ADRs) following intramuscular (IM) antipsychotics. The autopsies described lack of heart pathology and were highly compatible with the possibility of TdP in the absence of risk factors other than the accumulation of antipsychotics with a high serum peak after the last injection, leading to death within hours. The first case was a 27-year-old African-American male with schizophrenia but no medical issues. His death was probably caused by repeated IM haloperidol injections of 10 mg (totaling 35 mg in 2 days). The second case involves a 42-year-old African-American female with metabolic syndrome. Her probable cause of death was the last ziprasidone IM injection of 20 mg in addition to (1) three extra haloperidol doses (2 hours before the ziprasidone injection, 5 mg oral haloperidol; approximately 21 hours earlier, 5 mg oral haloperidol; and 2 days prior, one 10 mg IM haloperidol injection), (2) 10 mg/day of scheduled oral haloperidol for 6 days before death, and (3) a long-acting paliperidone injection of 156 mg 18 days before death. The study of haloperidol glucuronidation and its impairment in some African-Americans is urgently recommended. PMID:27597919

  15. Sudden death as presenting symptom caused by cardiac primary multicentric left ventricle rhabdomyoma, in an 11-month-old baby. An immunohistochemical study

    Directory of Open Access Journals (Sweden)

    Neri Margherita

    2012-12-01

    Full Text Available Abstract This case report describes a sudden cardiac death in an apparent healthy 11-month-old infant caused by a multifocal cardiac rhabdomyoma. Parents reported that a few days before the child had fallen to the ground getting a little superficial injury to the scalp. The authors hypothesize that it may have been a transient loss of consciousness episode caused by the cardiac tumour. After the gross examination, histological investigation supported by immunohistochemical analysis using antibody anti- Myoglobin, Actin, Vimentin, Desmin, CD34, S-100, Ki-67 was carried out for the diagnosis. Death was attributed to a multifocal cardiac rhabdomyoma, a benign tumour of striated muscle, which has been completely asymptomatic. In particular, one mass filled the entire posterior wall of the left ventricle. The insidious development of benign cardiac tumours also in infants and children is outlined, focusing on the responsible mechanisms of sudden death in such cases and providing a reference for additional study on these subjects. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7163626988365078

  16. Next-generation sequencing of 34 genes in sudden unexplained death victims in forensics and in patients with channelopathic cardiac diseases.

    Science.gov (United States)

    Hertz, C L; Christiansen, S L; Ferrero-Miliani, L; Fordyce, S L; Dahl, M; Holst, A G; Ottesen, G L; Frank-Hansen, R; Bundgaard, H; Morling, N

    2015-07-01

    Sudden cardiac death (SCD) is responsible for a large proportion of sudden deaths in young individuals. In forensic medicine, many cases remain unexplained after routine postmortem autopsy and conventional investigations. These cases are called sudden unexplained deaths (SUD). Genetic testing has been suggested useful in forensic medicine, although in general with a significantly lower success rate compared to the clinical setting. The purpose of the study was to estimate the frequency of pathogenic variants in the genes most frequently associated with SCD in SUD cases and compare the frequency to that in patients with inherited cardiac channelopathies. Fifteen forensic SUD cases and 29 patients with channelopathies were investigated. DNA from 34 of the genes most frequently associated with SCD were captured using NimbleGen SeqCap EZ library build and were sequenced with next-generation sequencing (NGS) on an Illumina MiSeq. Likely pathogenic variants were identified in three out of 15 (20%) forensic SUD cases compared to 12 out of 29 (41%) patients with channelopathies. The difference was not statistically significant (p = 0.1). Additionally, two larger deletions of entire exons were identified in two of the patients (7%). The frequency of likely pathogenic variants was >2-fold higher in the clinical setting as compared to SUD cases. However, the demonstration of likely pathogenic variants in three out of 15 forensic SUD cases indicates that NGS investigations will contribute to the clinical investigations. Hence, this has the potential to increase the diagnostic rate significantly in the forensic as well as in the clinical setting.

  17. Changes in the epidemiological pattern of sudden infant death syndrome in southeast Norway, 1984-1998: implications for future prevention and research

    OpenAIRE

    Arnestad, M; Andersen, M.; Vege, A; Rognum, T

    2001-01-01

    AIM—To look for changes in risk factors for sudden infant death syndrome (SIDS) after decrease and stabilisation of the SIDS rate.
METHODS—Questionnaires were distributed to parents of 174 SIDS infants, dying between 1984 and 1998, and 375 age and sex matched controls in southeast Norway.
RESULTS—The proportion of infants sleeping prone has decreased, along with the decrease in SIDS rate for the region during the periods studied, but over half of the SIDS victims are stil...

  18. An etiopathogenesis analysis of sudden death cause for Baird' s tapir%猝死中美貘死亡原因分析

    Institute of Scientific and Technical Information of China (English)

    刘燕; 郑常明; 李林海; 阎鹤; 丁楠; 赵京; 张成林; 张海杰; 杨明海

    2012-01-01

    November 2011, a two-year-old Baird's tapir (Tapirus bairdii) suddenly died in the Beijing Zoo. This paper records the pathogen testing results. Cultures showed that the organs of Baird' s tapir did not contain any bacteria, but there were two main bacteria Clostridium perfringens and Streptococcus bovis, in the intestinal contents. The serotype of the C. perfringens was found to be type A by multiplex PCR method. Clinical characteristics and autopsy pathology ultimately determined that C. perfringens type A was the primary pathogen in the death of the Baird' s tapir, The role of S. bovis was minor.

  19. The influences of dipole-dipole interaction and detuning on the sudden death of entanglement between two atoms in the Tavis-Cummings model

    Institute of Scientific and Technical Information of China (English)

    ChenLi; Shao Xiao-Qiang; Zhang Shou

    2009-01-01

    The influences of dipole-dipole interaction and detuning on the entanglement between two atoms with different initial tripartite entangled W-like states in the Tavis-Cummings model have been investigated by means of Wootters' concurrence, respectively. The results show that the entanglement between the two atoms can be enhanced via apprco-priately tuning the strength of dipole-dipole interaction of two atoms or the detunings between atom and cavity, and the so-called sudden death effect can be weakened simultaneously.

  20. The frequency of a disease-causing point mutation in the gene coding for medium-chain acyl-CoA dehydrogenase in sudden infant death syndrome

    DEFF Research Database (Denmark)

    Banner, Jytte; Gregersen, N; Kølvraa, S;

    1993-01-01

    syndrome is still a matter of controversy. The present study investigated 120 well-defined cases of sudden infant death syndrome in order to detect the frequency of the most common disease-causing point mutation in the gene coding for medium-chain acyl-CoA dehydrogenase (G985) compared with the frequency...... in the general population. A highly specific polymerase chain reaction assay was applied on dried blood spots. No over-representation of homo- or heterozygosity for G985 appears to exist in such a strictly defined population, for which reason it may be more relevant to look at a broader spectrum of clinical...

  1. Unpredicted Sudden Death due to Recurrent Infratentorial Hemangiopericytoma Presenting as Massive Intratumoral Hemorrhage: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Toshihide Tanaka

    2014-01-01

    Full Text Available Unpredicted sudden death arising from hemangiopericytoma with massive intracranial hemorrhage is quite rare. We encountered a patient with recurrent infratentorial hemangiopericytoma presenting as life-threatening massive intracerebral hemorrhage. A 43-year-old man who had undergone craniotomy for total resection of an infratentorial hemangiopericytoma 17 months earlier presented with morning headache and generalized convulsions. Computed tomography revealed a massive hematoma in the right infratentorial region causing tonsillar herniation and emergency surgery was performed to evacuate the hematoma. Histological findings revealed hemangiopericytoma with hemorrhage. Neurological status remained unimproved and brain death was confirmed postoperatively. Hemangiopericytoma presenting as massive hemorrhage is quite rare. Since the risk of life-threatening massive hemorrhage should be considered, careful postoperative long-term follow-up is very important to identify tumor recurrences, particularly in the posterior cranial fossa, even if the tumor is completely removed.

  2. Unpredicted Sudden Death due to Recurrent Infratentorial Hemangiopericytoma Presenting as Massive Intratumoral Hemorrhage: A Case Report and Review of the Literature.

    Science.gov (United States)

    Tanaka, Toshihide; Kato, Naoki; Hasegawa, Yuzuru; Murayama, Yuichi

    2014-01-01

    Unpredicted sudden death arising from hemangiopericytoma with massive intracranial hemorrhage is quite rare. We encountered a patient with recurrent infratentorial hemangiopericytoma presenting as life-threatening massive intracerebral hemorrhage. A 43-year-old man who had undergone craniotomy for total resection of an infratentorial hemangiopericytoma 17 months earlier presented with morning headache and generalized convulsions. Computed tomography revealed a massive hematoma in the right infratentorial region causing tonsillar herniation and emergency surgery was performed to evacuate the hematoma. Histological findings revealed hemangiopericytoma with hemorrhage. Neurological status remained unimproved and brain death was confirmed postoperatively. Hemangiopericytoma presenting as massive hemorrhage is quite rare. Since the risk of life-threatening massive hemorrhage should be considered, careful postoperative long-term follow-up is very important to identify tumor recurrences, particularly in the posterior cranial fossa, even if the tumor is completely removed.

  3. 21例精神科老年病人猝死的现况及原因分析%ANALYSIS THE STATE AND CAUSES OF 21 GERIATRIC PSYCHIATRIC PATIENTS SUFFERED FROM SUDDEN DEATH

    Institute of Scientific and Technical Information of China (English)

    张燕

    2011-01-01

    [Objective] To elaborate the 21 geriatric psychiatric patients who suffered from sudden death, to reduce the incidence of sudden death in psychiatric hospital. [Methods] Retrospectively analyzed cases of sudden death occurred during recent 11 years in our hospital. [Results] The incidence of sudden death was 0.17%. In autumn and winter, 04: 00-07: 59 was the peak time of sudden death. 98.48% psychiatric patients accompanied with physical diseases. Patients taking clozapine, chlorpromazine, perphenazine or haloperidol in sudden death cases accounted for a higher proportion, and cases with combinations of drugs were more. [Conclusion] In sudden death cases, most of patients accompany with physical diseases, so such patients should be carefully given antipsychotic drugs.%[目的]描述精神科21例老年住院患者猝死的现况,为降低精神病住院患者猝死发生率提供依据.[方法]对近11年来在某院住院期间发生猝死病例的临床资料进行回顾性调查分析.[结果]11年内猝死发生率0.17%.冬、秋季,04:00~07:59时间段为猝死高峰期.98.48%伴有躯体疾病.服用氯氮平、氯丙嗪、奋乃静、氟哌啶醇者在猝死病例中占较高比例,且联合用药者较多.[结论]精神科猝死病例中伴有躯体疾病者较多,对此类患者应谨慎应用抗精神病药物.

  4. Postmortem diagnosis of Marfan syndrome in a case of sudden death due to aortic rupture: Detection of a novel FBN1 frameshift mutation.

    Science.gov (United States)

    Wang, Yunyun; Chen, Shu; Wang, Rongshuai; Huang, Sizhe; Yang, Mingzhen; Liu, Liang; Liu, Qian

    2016-04-01

    To investigate the sudden death of a 36-year-old Chinese man, a medicolegal autopsy was performed, combining forensic pathological examinations and genetic sequencing analysis to diagnose the cause of death. Genomic DNA samples were extracted from blood and subjected to high-throughput sequencing. Major findings included a dilated aortic root with a ruptured and dissected aorta and consequent tamponade of the pericardial sac. Moreover, arachnodactyly and other skeletal deformities were noted. By sequencing the fibrillin-1 gene (FBN1), five genetic variations were found, including four previously known single nucleotide polymorphisms (SNPs) and a novel frameshift mutation, leading to the diagnosis of Marfan syndrome. The frameshift mutation (c.4921delG, p.glu1641llysFsX9) detected in exon 40 led to a stop codon after the next 8 amino acids. The four SNPs included a splice site mutation (c.3464-5 G>A, rs11853943), a synonymous mutation (p.Asn625Asn, rs25458), and two missense mutations (p.Pro1148Ala, rs140598; p.Cys472Tyr, rs4775765). Genetic screening was recommended for the relatives as it was reported that the father and brother of the deceased had died at the ages of 40 and 25, respectively, from sudden cardiac failure. The son of the deceased lacked the relevant mutations. This report emphasizes the important contribution of medicolegal postmortem analysis on the molecular pathogenesis study of Marfan syndrome and early diagnosis of at-risk relatives. PMID:26905825

  5. Postmortem diagnosis of Marfan syndrome in a case of sudden death due to aortic rupture: Detection of a novel FBN1 frameshift mutation.

    Science.gov (United States)

    Wang, Yunyun; Chen, Shu; Wang, Rongshuai; Huang, Sizhe; Yang, Mingzhen; Liu, Liang; Liu, Qian

    2016-04-01

    To investigate the sudden death of a 36-year-old Chinese man, a medicolegal autopsy was performed, combining forensic pathological examinations and genetic sequencing analysis to diagnose the cause of death. Genomic DNA samples were extracted from blood and subjected to high-throughput sequencing. Major findings included a dilated aortic root with a ruptured and dissected aorta and consequent tamponade of the pericardial sac. Moreover, arachnodactyly and other skeletal deformities were noted. By sequencing the fibrillin-1 gene (FBN1), five genetic variations were found, including four previously known single nucleotide polymorphisms (SNPs) and a novel frameshift mutation, leading to the diagnosis of Marfan syndrome. The frameshift mutation (c.4921delG, p.glu1641llysFsX9) detected in exon 40 led to a stop codon after the next 8 amino acids. The four SNPs included a splice site mutation (c.3464-5 G>A, rs11853943), a synonymous mutation (p.Asn625Asn, rs25458), and two missense mutations (p.Pro1148Ala, rs140598; p.Cys472Tyr, rs4775765). Genetic screening was recommended for the relatives as it was reported that the father and brother of the deceased had died at the ages of 40 and 25, respectively, from sudden cardiac failure. The son of the deceased lacked the relevant mutations. This report emphasizes the important contribution of medicolegal postmortem analysis on the molecular pathogenesis study of Marfan syndrome and early diagnosis of at-risk relatives.

  6. Renin–angiotensin system inhibition is not associated with increased sudden cardiac death, cardiovascular mortality or all-cause mortality in patients with aortic stenosis

    DEFF Research Database (Denmark)

    Bang, Casper N; Greve, Anders M; Køber, Lars;

    2014-01-01

    to moderate AS. METHODS: All patients (n=1873) from the Simvastatin and Ezetimibe in Aortic Stenosis study: asymptomatic patients with AS and preserved left ventricular (LV) ejection fraction were included. Risks of sudden cardiac death (SCD), cardiovascular death and all-cause mortality according to RASI...... cardiovascular and 205 all-cause deaths occurred. RASI was not associated with SCD (HR: 1.19 [95%CI: 0.50-2.83], p=0.694), cardiovascular (HR: 1.05 [95%CI: 0.62-1.77], p=0.854) or all-cause mortality (HR: 0.81 [95%CI: 0.55-1.20], p=0.281). This was confirmed in propensity matched analysis (all p>0.......05). In separate analyses, RASI was associated with larger reduction in systolic blood pressure (p=0.001) and less progression of LV mass (p=0.040). CONCLUSIONS: RASI was not associated with SCD, cardiovascular or all-cause mortality in asymptomatic AS patients. However, RASI was associated with a potentially...

  7. A Resource Kit for Reducing the Risk of Sudden Infant Death Syndrome (SIDS) in African American Communities

    Science.gov (United States)

    ... 808SIDS Web site: http: / / infantandchildloss. org Center for Loss and Life Transition Address: 3735 Broken Bow Road, Fort Collins, CO 80526 Phone: (970) 2266050 Web site: ... and Unexpected Infant /Child Death and Preganancy Loss Re source Center Address: P.O. Box 571272, ...

  8. The biophysical characterization of the first SCN5A mutation R1512W identified in Chinese sudden unexplained nocturnal death syndrome.

    Science.gov (United States)

    Zheng, Jinxiang; Zhou, Feng; Su, Terry; Huang, Lei; Wu, Yeda; Yin, Kun; Wu, Qiuping; Tang, Shuangbo; Makielski, Jonathan C; Cheng, Jianding

    2016-06-01

    Increasing evidence observed in clinical phenotypes show that abrupt breathing disorders during sleep may play an important role in the pathogenesis of sudden unexplained nocturnal death syndrome (SUNDS). The reported Brugada syndrome causing mutation R1512W in cardiac sodium channel α subunit encoded gene SCN5A, without obvious loss of function of cardiac sodium channel in previous in vitro study, was identified as the first genetic cause of Chinese SUNDS by us. The R1512W carrier was a 38-year-old male SUNDS victim who died suddenly after tachypnea in nocturnal sleep without any structural heart disease. To test our hypothesis that slight acidosis conditions may contribute to the significant loss of function of mutant cardiac sodium channels underlying SUNDS, the biophysical characterization of SCN5A mutation R1512W was performed under both extracellular and intracellular slight acidosis at pH 7.0. The cDNA of R1512W was created using site-directed mutagenesis methods in the pcDNA3 plasmid vector. The wild type (WT) or mutant cardiac sodium channel R1512W was transiently transfected into HEK293 cells. Macroscopic voltage-gated sodium current (INa) was measured 24 hours after transfection with the whole-cell patch clamp method at room temperature in the HEK293 cells. Under the baseline conditions at pH 7.4, R1512W (-175 ± 15 pA/pF) showed about 30% of reduction in peak INa compared to WT (-254 ± 23 pA/pF, P  0.05) but decreased peak INa in R1512W (P death of SUNDS cases in the setting of genetic defect. PMID:27281089

  9. Muerte súbita en un varón con astrocitoma no diagnosticado Sudden death in a male due to undiagnosed astrocytoma

    Directory of Open Access Journals (Sweden)

    M. Subirana Domènech

    2011-09-01

    Full Text Available El diagnóstico de tumoraciones cerebrales en los servicios de patología forense es muy poco frecuente y suelen llegar a ellos ya sea como consecuencia de muertes súbitas o en el contexto de denuncias por mala praxis médica. Dentro de la escasa frecuencia, la mayoría de ellos son únicamente hallazgos incidentales de autopsia, como en el caso de muchos meningiomas, pero en otros puede ser la causa de muerte. Presentamos el caso de un varón paquistaní de 40 años, con barrera idiomática, que consultó en un servicio de urgencias por un cuadro de cefalea, náuseas y vómitos y que falleció después del alta médica con el diagnóstico de cuadro respiratorio de vías altas. La autopsia y los estudios anatomopatológicos evidenciaron un astrocitoma grado II.Brain tumors are seldom studied in forensic pathology services and they are seen in circumstances such as sudden unexpected death or in malpractice complaints. In most cases they are incidental findings, like meningioma, and in few cases they are the cause of death. We present the case of a 40 years old male Pakistani with linguistic barrier suffering from headache and vomiting who was diagnosed as a flue and died suddenly. Forensic autopsy and histopathologic studies showed a grade II astrocytoma.

  10. Cisto coloide no terceiro ventrículo e morte súbita em jovem Colloid cyst in the third ventricle and sudden death in young man

    Directory of Open Access Journals (Sweden)

    Angela Augusta Ferreira de Alencar

    2010-12-01

    Full Text Available Morte súbita de jovem, sexo masculino, 23 anos, assintomático, suscitou verificação de óbito. Antes queixou-se de cefaleia excruciante, em sala de aula, caindo sobre o computador. Encéfalo apresentou edema e congestão vascular. Sem herniações. Cortes coronais evidenciaram dilatação dos ventrículos laterais e nódulo aderido ao teto do terceiro ventrículo. À microscopia o diagnóstico foi cisto coloide do terceiro ventrículo. A ameaça de morte súbita em portadores de cisto coloide é sério problema diagnóstico na emergência médica. A relevância deste caso está em lembrar aos médicos que esta entidade deve permanecer como diagnóstico diferencial nas cefaleias em crianças, adolescentes e adultos jovens.Sudden death of 23 year-old asymptomatic male patient led to further investigation into its cause. Previously, he had complained of excruciating headache in the classroom, falling on the computer. His brain showed edema and vascular congestion without herniation. Coronal sections showed dilatation of the lateral ventricles and nodule attached to the roof of the third ventricle. The microscopic diagnosis was colloid cyst of third ventricle. The threat of sudden death among colloid cyst patients is a serious diagnostic problem in medical emergencies. The relevance of this case is to remind doctors that this entity should remain as differential diagnosis in headaches among children, adolescents and young adults.

  11. Sudden Death by Pulmonary Thromboembolism due to a Large Uterine Leiomyoma with a Parasitic Vein to the Mesentery

    Directory of Open Access Journals (Sweden)

    Varsha Podduturi

    2014-01-01

    Full Text Available The pathophysiology of venous thrombosis is classically attributed to alterations in one or more components of Virchow’s triad: hypercoagulability, stasis, and damage to the vascular endothelium. Deep vein thrombosis (DVT may lead to pulmonary thromboembolism (PE, and the latter is culpable for many deaths annually in the United States; however, DVT as a complication of uterine leiomyoma has rarely been reported. We report a case of a 57-year-old woman whose death was due to a large pedunculated subserosal leiomyoma externally compressing the pelvic veins resulting in stasis and venous thrombosis leading to fatal PE. The association of large pelvic masses with venous thrombosis has clinical implications, since prophylactic surgery could be life-saving.

  12. ATP Depletion Via Mitochondrial F1F0 Complex by Lethal Factor is an Early Event in B. Anthracis-Induced Sudden Cell Death

    Directory of Open Access Journals (Sweden)

    Mitchell W. Woodberry

    2009-08-01

    Full Text Available Bacillus anthracis’ primary virulence factor is a tripartite anthrax toxin consisting of edema factor (EF, lethal factor (LF and protective antigen (PA. In complex with PA, EF and LF are internalized via receptor-mediated endocytosis. EF is a calmodulin- dependent adenylate cyclase that induces tissue edema. LF is a zinc-metalloprotease that cleaves members of mitogen-activated protein kinase kinases. Lethal toxin (LT: PA plus LF-induced death of macrophages is primarily attributed to expression of the sensitive Nalp1b allele, inflammasome formation and activation of caspase-1, but early events that initiate these processes are unknown. Here we provide evidence that an early essential event in pyroptosis of alveolar macrophages is LF-mediated depletion of cellular ATP. The underlying mechanism involves interaction of LF with F1F0-complex gamma and beta subunits leading to increased ATPase activity in mitochondria. In support, mitochondrial DNA-depleted MH-S cells have decreased F1F0 ATPase activity due to the lack of F06 and F08 polypeptides and show increased resistance to LT. We conclude that ATP depletion is an important early event in LT-induced sudden cell death and its prevention increases survival of toxin-sensitive cells.

  13. Long QT, alteration of calcium-phosphate product, prevalence of ventricular arrhythmias and sudden death in peritoneal dialysis patients: a Holter study

    Directory of Open Access Journals (Sweden)

    Pierluigi Di Loreto

    2013-03-01

    Full Text Available Materials and methods We studied 79 patients on peritoneal dialysis. Each underwent 24-h electrocardiography (Holter monitoring and measurement of the rate-corrected QT interval (QTc. We analyzed the correlation between QTc and plasma levels of Ca++, PO4−, K+, Na+, Mg++, and parathyroid hormone (PTH. Results The mean QTc was 0.445 ± 0.04 s. In 55 patients, the QTc was prolonged (> 0.45 s. Mean laboratory values for the group were: PTH 344 ± 25 pg/mL, Ca++ 9.27 ± 0.11 mg/dL, PO4− 5.5 ± 1.5 mg/dL, Na+ 139.6 ± 3.4 mmol/L, K+ 4.04 ± 0.64 mmol/L, and Mg++ 2.52 ± 0.43 mg/dL. Holter monitoring revealed complex premature ventricular contractions in 44 patients, monomorphic premature ventricular contractions in 16, and nonsustained ventricular tachycardia (NSVT in 10. The QTc was significantly correlated with plasma levels of PO4− (r = 0.045, p < 0.05, PTH (r = 0.077, p < 0.02, and Ca++ (r = 0.076, p < 0.02. Eleven patients had Lown class 4a or 4b ventricular arrhythmias, and their mean QTc was 465 ± 0.02 ms. Ten had NSVT and their QTc was 464 ± 0.03 ms. Eleven patients died suddenly (mean QTc 465 ± 0.03 ms; all 11 had either NSTV or Lown class 4 ventricular arrhythmias. Conclusions Long QTc seems to be associated with an increased prevalence of ventricular arrhythmias that may be the cause of sudden cardiac death.

  14. Repeated mass strandings of Miocene marine mammals from Atacama Region of Chile point to sudden death at sea.

    Science.gov (United States)

    Pyenson, Nicholas D; Gutstein, Carolina S; Parham, James F; Le Roux, Jacobus P; Chavarría, Catalina Carreño; Little, Holly; Metallo, Adam; Rossi, Vincent; Valenzuela-Toro, Ana M; Velez-Juarbe, Jorge; Santelli, Cara M; Rogers, David Rubilar; Cozzuol, Mario A; Suárez, Mario E

    2014-04-22

    Marine mammal mass strandings have occurred for millions of years, but their origins defy singular explanations. Beyond human causes, mass strandings have been attributed to herding behaviour, large-scale oceanographic fronts and harmful algal blooms (HABs). Because algal toxins cause organ failure in marine mammals, HABs are the most common mass stranding agent with broad geographical and widespread taxonomic impact. Toxin-mediated mortalities in marine food webs have the potential to occur over geological timescales, but direct evidence for their antiquity has been lacking. Here, we describe an unusually dense accumulation of fossil marine vertebrates from Cerro Ballena, a Late Miocene locality in Atacama Region of Chile, preserving over 40 skeletons of rorqual whales, sperm whales, seals, aquatic sloths, walrus-whales and predatory bony fish. Marine mammal skeletons are distributed in four discrete horizons at the site, representing a recurring accumulation mechanism. Taphonomic analysis points to strong spatial focusing with a rapid death mechanism at sea, before being buried on a barrier-protected supratidal flat. In modern settings, HABs are the only known natural cause for such repeated, multispecies accumulations. This proposed agent suggests that upwelling zones elsewhere in the world should preserve fossil marine vertebrate accumulations in similar modes and densities. PMID:24573855

  15. Early warning and comprehensive treatment in sudden cardiac death%心脏性猝死的预警与综合防治

    Institute of Scientific and Technical Information of China (English)

    黄子通; 杨正飞

    2012-01-01

    心脏性猝死( sudden cardiac death,SCD)从发病到死亡非常快,常发生在看似健康的人,通常又不可预测,死亡率极高,国内院外SCD生存率不到1%,最近我们对珠三角地区191.5万人口流行病学调查的结果为出院生存率2.85%,而国外先进水平可达到10%~30%.为探索适合我国院外SCD的防治措施,我们在国内最早提出提高院外心搏骤停患者复苏生存率的主要策略,包括:①院外远程生命信息(心电、呼吸、血压)监测;②对高危人群家属心肺复苏(CPR)培训;③自动体外除颤仪(automated external defibrillator,AED)进入家庭及公众启动除颤计划(public access defibrillation,PAD);④建立新型家庭—社区—医院—120急救网络平台.%Sudden cardiac death ( SCD) is an emergent and unpredictable event in the so-called healthy population with a rapid deterioration and a high mortality. According to the domestic historical literature, the survival of SCD is less than 1 %. In a recent epidemiological investigation on SCD victims among 1. 91 million populations in Pearl River Delta Region, the survival rate is 2. 85%. Nevertheless, the total survival rate abroad is much higher (10% ~ 30% ). In order to explore a suitable method to improve the early warning and treatment of SCD in China, we therefore propose the intervention strategies in enhancing survival out of hospital, including remote-monitoring of vital signs ( electrocardiogram, respiratory, blood pressure) out of hospital, CPR training for potential victims of SCD and their families, public access defibrillation and household AED plan, and the establishment of enhanced family-community-hospital Emergency medical system.

  16. 1型糖尿病与猝死览%Type 1 diabetes mellitus and sudden death

    Institute of Scientific and Technical Information of China (English)

    韩睿; 田浩明

    2001-01-01

    @@发生在1型糖尿病年轻患者夜间猝死的事件,称为"睡眠死亡综合征(death in bed syndrome)[1]”,其病因未明.本文就目前所见的这种综合征的资料作一综述. 一、睡眠死亡综合征的背景 1991年Tattersall和Gill报道22例年轻的1型糖尿病患者发生猝死的事件,其共同特征是:晚上发生无法预测的猝死,患者于次日发现安静地死在床上[2].患者的年龄多在40岁以下,糖尿病病程从数月到25年不等,大部份患者平素看起来健康,血糖控制在正常水平且夜间常有低血糖发生的经历,尸检报告没有发现解剖学方面的异常.故首次将这种猝死称为"睡眠死亡综合征”.而早在1979年Tunbrige对50岁以下死亡的糖尿病患者进行研究时记录有16人死于低血糖,而其中7人有这种典型睡眠死亡综合征的特点.此外,1991年以来,斯堪的纳维亚半岛已经报道80例以上的病例,其临床特征与睡眠死亡综合征中描述的一样.尽管这种猝死普遍发生在年轻的1型糖尿病患者中,但其机制不明.有人认为与胰岛素应用有关,但Tattersall和Gill没有发现证据支持这个观点.所以他们提出一个与自主神经功能异常有关的假说来解释这类事件.这种异常可能易致特殊致死性的心率紊乱,而夜间低血糖加重这种心率紊乱.

  17. 51例猝死尸检解剖的临床病理分析%The anatomy of 51 cases of sudden death autopsy clinical pathology analysis

    Institute of Scientific and Technical Information of China (English)

    李晓霞; 卫建平

    2015-01-01

    Objective Through the studying and analyzing the etiology and clinical pathology characteristic of the events of autopsy in basic-level hospitals, it provides some references for the diagnosis and prevention of unexplained cases of the sudden death. Methods Collection 51 cases of pathological autopsy happened in Changzhi people's hospital of Shanxi Province (from 2004 to 2012), to conduct research and analysis the cause of death and the clinical pathology characteristic. Results 49 cases found the exact cause of death during the 51 cases of autopsy, accounting for 96%, of which the most common is the cardiovascular disease, accounting for 52.9%; the followed-by is the central nervous system diseases, accounting for 11.8%; the pulmonary embolism, ac-counting for 10%. Conclusions Through the autopsy cases of etiology and the clinical pathology characteristic analysis of scientific system, not only can clear the cause of death, also can help to improve the level of clinical diagnosis and treatment.%目的:通过对基层医院尸检病例的死亡原因及临床病理学特点进行研究和分析,为不明原因猝死病例的诊断和预防提供一定的依据参考。方法收集山西省长治市人民医院病理科2004年1月—2012年12月发生的51例病理尸体解剖资料,对其死因及临床病理学特点进行研究及分析。结果51例尸检中49例找到了确切死亡的原因,占96%,其中以心血管疾病最常见,占52.9%,其次是中枢系统疾病,占11.8%;再次是肺动脉栓塞,占10%。结论通过对尸检病例的病因和其临床病理学特点进行科学系统的分析,不仅可以明确死因,也可以有助于提高临床诊治水平。

  18. 急性乙醇中毒时猝死原因及防范%The Causes and Prevention Measures for the Sudden Death in Acute Alcoholic Intoxication

    Institute of Scientific and Technical Information of China (English)

    许静; 孟庆义

    2011-01-01

    This paper discussed the causes and prevention measures for the sudden death in acute alcoholic intoxication. The main causes included the mis - aspiration, acute pancreatitis, cardiac emergencies, cerebral hemorrhage, disulfiram - like reaction, hypothermia, rhabdomyolysis, and hypotonic state after gastric lavage. That was instructive for the clinician to diagnosis and treatment for acute alcoholic intoxication and to avoid the medical malpractice in the clinical work.%本文对急性乙醇中毒时猝死的原因及防范措施进行了分析阐述,主要猝死原因有误吸、急性胰腺炎、心脏急症、脑出血、双硫仑样反应、低体温、横纹肌溶解和洗胃后低渗.希望能为临床医生正确地诊断与治疗急性乙醇中毒及避免医疗失误提供借鉴.

  19. Sudden cardiac death after repair of anomalous origin of left coronary artery from right sinus of Valsalva with an interarterial course : Case report and review of the literature.

    Science.gov (United States)

    Nguyen, A L; Haas, F; Evens, J; Breur, J M P J

    2012-11-01

    Anomalous aortic origin of the coronary artery from the opposite sinus with interarterial course (AAOCA) is a rare condition with a high risk of sudden cardiac death (SCD) during or after strenuous exertion. SCD after repair of this anomaly is extremely rare. Here we present a 15-year-old athlete who collapsed on the basketball court in whom an anomalous origin of the left coronary artery from the right sinus of Valsalva with interarterial course (ALCA) was diagnosed. In spite of extensive pre-sport participation testing, SCD occurred shortly after surgical correction. We reviewed the literature to establish an evidence-based recommendation to aid physicians in conducting the optimal pre-sport participation management for the prevention of SCD in patients with a surgically corrected AAOCA/ALCA, especially for those who participate in strenuous exercise. Review of the literature (60 articles with 325 patients) reveals that post-surgical, pre-sport participation testing varies greatly but that mortality after surgical repair is extremely low (1.5 %). In conclusion, SCD can still rarely occur after repair of AAOCA despite extensive pre-sport participation testing. This should raise awareness among physicians treating these patients and raises the question whether or not return-to-play guidelines need to be revised. PMID:23055055

  20. Effect of amiodarone therapy on mortality in patients with left ventricular dysfunction and asymptomatic complex ventricular arrhythmias: Argentine Pilot Study of Sudden Death and Amiodarone (EPAMSA).

    Science.gov (United States)

    Garguichevich, J J; Ramos, J L; Gambarte, A; Gentile, A; Hauad, S; Scapin, O; Sirena, J; Tibaldi, M; Toplikar, J

    1995-09-01

    The efficiency of prophylactic antiarrhythmic treatment with amiodarone in reducing 1-year mortality in patients with reduced left ventricular ejection fraction ( < 35%) and asymptomatic ventricular arrhythmias (Lown classes 2 and 4) was investigated in a prospective, multicenter, randomized, controlled study. Among 127 patients who entered the study, 61 were assigned to no antiarrhythmic therapy (control group [CG] and 66 to amiodarone treatment (amiodarone group [AG]). Amiodarone was administered at a dosage of 800 mg/day for 2 weeks followed by 400 mg/day thereafter. A 12-month follow-up was completed for 106 patients (57 in the AG and 49 in the CG). Amiodarone reduced the overall mortality rate, which was 10.5% in the AG versus 28.6% in the CG (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.10 to 0.84; log-rank test 0.02) and sudden death rate, which was 7.0% in the AG versus 20.4% in the CG (OR 0.29; 95% CI 0.08 to 1.00; log-rank test 0.04). Side effects were rare, and in only three patients did amiodarone treatment have to be discontinued.

  1. A study on correlation between QRS complex duration and plasma BNP and the sudden cardiac death in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    Chong-Hui He; Xin Jin; Wen-Qing Tan; Ya-Xiang Chen; Xiao-Cong Lin

    2015-01-01

    Objective: To explore the correlation between QRS complex duration and brain natriuretic peptide (BNP) and the sudden cardiac death (SCD) in chronic heart failure (CHF). Methods:258 patients with CHF treated in this hospital from February 2012 to June 2014 were selected as the observation group. 250 volunteers who received the health examination over the same period were randomly selected as the control group. The basic data of all patients was recorded. It then compared LVEF, left ventricular end-diastolic diameter, QRS complex duration and BNP between two groups. Results: The proportion of hypertension, hyperlipidemia, diabetes, DCM and ICM was higher in the observation group, while LVEF was lower and left ventricular end-diastolic diameter, QRS complex duration and BNP were higher than ones in the control group. Patients with SCD occupied 10.47% (27/278) of all patients with CHF. According to the logistic regression analysis, it obtained 4 related factors for SCD in patients with CHF, namely LVEF, left ventricular end-diastolic diameter, QRS complex duration and BNP, with the statistical difference between two groups (P<0.05). Conclusion: Patients with CHF may have the dangerous factors of hypertension and hyperlipidemia. In addition, the increase of QRS complex duration and plasma BNP for patients with CHF indicates the big risk of SCD.

  2. The Role of Genetic Testing in the Identification of Young Athletes with Inherited Primitive Cardiac Disorders at Risk of Exercise Sudden Death

    Science.gov (United States)

    Tiziano, Francesco Danilo; Palmieri, Vincenzo; Genuardi, Maurizio; Zeppilli, Paolo

    2016-01-01

    Although relatively rare, inherited primitive cardiac disorders (IPCDs) in athletes have a deep social impact since they often present as sudden cardiac death (SCD) of young and otherwise healthy persons. The diagnosis of these conditions is likely underestimated due to the lack of shared clinical criteria and to the existence of several borderline clinical pictures. We will focus on the clinical and molecular diagnosis of the most common IPCDs, namely hypertrophic cardiomyopathies, long QT syndrome, arrhythmogenic right ventricular cardiomyopathy, and left ventricular non-compaction. Collectively, these conditions account for the majority of SCD episodes and/or cardiologic clinical problems in athletes. In addition to the clinical and instrumental tools for the diagnosis of IPCD, the viral technological advances in genetic testing have facilitated the molecular confirmation of these conditions. However, genetic testing presents several issues: the limited sensitivity (globally, around 50%), the low prognostic predictive value, the probability to find pathogenic variants in different genes in the same patient, and the risk of non-interpretable results. In this review, we will analyze the pros and cons of the different clinical approaches for the presymptomatic identification, the diagnosis and management of IPCD athletes, and we will discuss the indications to the genetic testing for patients and their relatives, particularly focusing on the most complex scenarios, such as presymptomatic tests, uncertain results, and unexpected findings. PMID:27617263

  3. Gas dispersal potential of infant bedding of sudden death cases. (I): CO2 accumulation around the face of infant mannequin model.

    Science.gov (United States)

    Sakai, Jun; Takahashi, Shirushi; Funayama, Masato

    2009-04-01

    We assessed CO(2) gas dispersal potential of bedding that had actually been used by 26 infants diagnosed with sudden unexpected infant death using a baby mannequin model. The age of victims ranged from 1 to 12 months. In some cases, the parents alleged that the infant faces were not covered with bedding when they were found. The parent's memories, however, may not have been accurate; therefore, we examined the potential for gas dispersal based on the supposition that the bedding had covered their faces. The mannequin was connected with a respirator set on the tidal volume and respiratory rates matched with the baby's age. Before measuring, CO(2) flow was regulated in 5%+/-0.1% of end-tidal PCO(2). After the model was placed on each bedding condition, measurements were performed at least five times under each respiratory condition. Four cases showed a plateau of FiCO(2) <4.8%, 15 were 4.8-12%, and the other seven were 12% or more, when they reached a plateau. Of course, our model does not take large tissue stores of CO(2) into account. However, our model could show the potential gas dispersal ability of bedding. Especially, the latter seven bedding could have high rebreathing potential if they covered the infant's faces and the probability of environmental asphyxia should be considered. PMID:19375372

  4. Gas dispersal potential of infant bedding of sudden death cases (II): Mathematical simulation of O2 deprivation around the face of infant mannequin model.

    Science.gov (United States)

    Sakai, Jun; Takahashi, Shirushi; Funayama, Masato

    2009-04-01

    We assessed O(2) gas deprivation potential of bedding that had actually been used by 26 infants diagnosed with sudden unexpected infant death using FiCO(2) time course of baby mannequin model. All cases were the same ones in our poster paper (I). Mathematically, time-FiCO(2) (t) graphs were given as FiCO(2) (t)=C(1-e(Dt)). Here, "C" approximates the maximum FiCO(2) value, while "D" is the velocity to reach maximum FiCO(2). FiO(2) in a potential space around the mannequin's nares was estimated using a formula: FiO(2)=0.21-FiCO(2)/RQ. RQ is the respiratory quotient, and the normal human value is 0.8. The graph pattern of FiO(2) is roughly the inverse of the FiCO(2) time course. Four cases showed the bottom of estimated FiO(2) to be more than 15%, 15 were 15-6%, and the other seven were 6% or less. Considering the minimal tissue stores of O(2), changes in FiO(2) may be affected by both CO(2) production and gas movement around the infant's face. Especially, the latter seven cases may suggest the participation of the role not only of CO(2) accumulation but also of the decrease of O(2) around the face. PMID:19342284

  5. Sudden cardiac death after repair of anomalous origin of left coronary artery from right sinus of Valsalva with an interarterial course : Case report and review of the literature.

    Science.gov (United States)

    Nguyen, A L; Haas, F; Evens, J; Breur, J M P J

    2012-11-01

    Anomalous aortic origin of the coronary artery from the opposite sinus with interarterial course (AAOCA) is a rare condition with a high risk of sudden cardiac death (SCD) during or after strenuous exertion. SCD after repair of this anomaly is extremely rare. Here we present a 15-year-old athlete who collapsed on the basketball court in whom an anomalous origin of the left coronary artery from the right sinus of Valsalva with interarterial course (ALCA) was diagnosed. In spite of extensive pre-sport participation testing, SCD occurred shortly after surgical correction. We reviewed the literature to establish an evidence-based recommendation to aid physicians in conducting the optimal pre-sport participation management for the prevention of SCD in patients with a surgically corrected AAOCA/ALCA, especially for those who participate in strenuous exercise. Review of the literature (60 articles with 325 patients) reveals that post-surgical, pre-sport participation testing varies greatly but that mortality after surgical repair is extremely low (1.5 %). In conclusion, SCD can still rarely occur after repair of AAOCA despite extensive pre-sport participation testing. This should raise awareness among physicians treating these patients and raises the question whether or not return-to-play guidelines need to be revised.

  6. The Role of Genetic Testing in the Identification of Young Athletes with Inherited Primitive Cardiac Disorders at Risk of Exercise Sudden Death.

    Science.gov (United States)

    Tiziano, Francesco Danilo; Palmieri, Vincenzo; Genuardi, Maurizio; Zeppilli, Paolo

    2016-01-01

    Although relatively rare, inherited primitive cardiac disorders (IPCDs) in athletes have a deep social impact since they often present as sudden cardiac death (SCD) of young and otherwise healthy persons. The diagnosis of these conditions is likely underestimated due to the lack of shared clinical criteria and to the existence of several borderline clinical pictures. We will focus on the clinical and molecular diagnosis of the most common IPCDs, namely hypertrophic cardiomyopathies, long QT syndrome, arrhythmogenic right ventricular cardiomyopathy, and left ventricular non-compaction. Collectively, these conditions account for the majority of SCD episodes and/or cardiologic clinical problems in athletes. In addition to the clinical and instrumental tools for the diagnosis of IPCD, the viral technological advances in genetic testing have facilitated the molecular confirmation of these conditions. However, genetic testing presents several issues: the limited sensitivity (globally, around 50%), the low prognostic predictive value, the probability to find pathogenic variants in different genes in the same patient, and the risk of non-interpretable results. In this review, we will analyze the pros and cons of the different clinical approaches for the presymptomatic identification, the diagnosis and management of IPCD athletes, and we will discuss the indications to the genetic testing for patients and their relatives, particularly focusing on the most complex scenarios, such as presymptomatic tests, uncertain results, and unexpected findings.

  7. Incidence of sudden cardiac death associated with coronary artery occlusion in dogs with hypertension and left ventricular hypertrophy is reduced by chronic beta-adrenergic blockade.

    Science.gov (United States)

    Dellsperger, K C; Martins, J B; Clothier, J L; Marcus, M L

    1990-09-01

    Because beta-adrenergic blockade has as one of its many effects altered electrophysiological abnormalities after dogs with left ventricular hypertrophy have been subjected to coronary occlusion, we tested the hypothesis that metoprolol (200-400 mg/day) would reduce mortality rates in dogs with one-kidney, one clip left ventricular hypertrophy while a similar reduction in arterial pressure with enalapril (20-40 mg/day) would not. Dogs with left ventricular hypertrophy were given metoprolol or enalapril for 5-7 days before a 3-hour coronary occlusion. Infarct size and risk area were measured with triphenyltetrazolium chloride stain and barium angiography, respectively. For control (n = 15), left ventricular hypertrophy (n = 17), left ventricular hypertrophy plus metoprolol (n = 12), and left ventricular hypertrophy plus enalapril (n = 15) groups, mean arterial pressure, ratio of infarct size to risk area, and dogs experiencing sudden death were 110 +/- 4, 142 +/- 4, 121 +/- 7, and 120 +/- 3 mm Hg; 44 +/- 5%, 65 +/- 5%, 44 +/- 7%, and 30 +/- 4%; and 27%, 65%, 17%, and 53%, respectively. Thus, the excessive increase in early mortality occurring when dogs with hypertension and left ventricular hypertrophy undergo coronary occlusion is interrupted with beta-blockade, possibly via electrophysiological effects rather than by changes in arterial pressure or infarct size. PMID:1975521

  8. The Investigation of Sudden Arrhythmic Death Syndrome (SADS – the current approach to family screening and the future role of genomics & stem cell technology

    Directory of Open Access Journals (Sweden)

    Vishal eVyas

    2013-09-01

    Full Text Available SADS is defined as sudden death under the age of 40 years old in the absence of structural heart disease. Family screening studies are able to identify a cause in up to 50% of cases-most commonly long QT syndrome, Brugada and early repolarisation syndrome, and catecholaminergic polymorphic ventricular tachycardia using standard clinical screening investigations including pharmacological challenge testing. These diagnoses may be supported by genetic testing which can aid cascade screening and may help guide management. In the current era it is possible to undertake molecular autopsy provided suitable samples of DNA can be obtained from the proband. With the evolution of rapid sequencing techniques it is possible to sequence the whole exome for candidate genes. This major advance offers the opportunity to identify novel causes of lethal arrhythmia but also poses the challenge of managing the volume of data generated and evaluating variants of unknown significance. The emergence of induced pluripotent stem cell technology could enable evaluation of the electrophysiological relevance of specific ion channel mutations in the proband or their relatives and will potentially enable screening of idiopathic ventricular fibrillation survivors combining genetic and electrophysiological studies in derived myocytes. This also could facilitate the assessment of personalised preventative pharmacological therapies. This review will evaluate the current screening strategies in SADS families, the role of molecular autopsy and genetic testing and the potential applications of molecular and cellular diagnostic strategies on the horizon.

  9. Muerte súbita en un joven con Síndrome de Marfan Sudden death in a young man with Marfan's Syndrome

    Directory of Open Access Journals (Sweden)

    J. Blanco Pampín

    2005-10-01

    cardiovascular ones, which frequently lead to death. Cardiovascular complications involve mainly the valves and the aorta, in fact at this level is common finding cystic medial degeneration areas, characterized by apoptosis and by the loss of vascular smooth muscle cells. Although the specific biological defect is unknown, it has been thought to be an increase of the hialuronic acid synthesis, an increase of the collagen and elastine solubility, the alteration in the ratio collagen type-1 and type-3 and more recently, the presence of collagen-alpha2 chains. The interest of this syndrome in forensic pathology is that it can be present as a sudden death without any previous manifestation, being very important to identify carefully all the autopsy findings to relate them with this syndrome. It has also an epidemiologic interest with the aim of communicating the information that may be of medical importance to other family´s members. We report a case with these characteristics in a young man without previous symptoms who died suddenly at the disco's exit. The macroscopic examination showed aortic dissection in the extrapericardical portion, considered as cause of the death. The case is also illustrated with the specific histopathologic study.

  10. Alcohol consumption and sudden unexpected death in epilepsy: experimental approach Consumo de álcool e morte súbita em epilepsia: uma abordagem experimental

    Directory of Open Access Journals (Sweden)

    Carla A. ScorzaI

    2009-12-01

    Full Text Available Using the pilocarpine model of epilepsy, we investigated the effects of alcohol consumption on the frequency of seizures in animals with epilepsy as well the underlying a possible association between alcohol intake and sudden unexpected death in epilepsy (SUDEP occurrence. Rats were divided randomly into two groups: (A rats with epilepsy and (B rats with epilepsy that received a daily dose of ethanol solution (350 mg kg-1, i.p. for 30 days. The basal frequency of seizures observed in the A and B groups during the first 30 days were 3.4±1.5 and 3.2±1.9 seizures per week per animal, respectively. In B group, it was observed a significant seizure increase (11.6±5.3 during the first 2 weeks of alcohol administration and quite interesting, one rat died suddenly after a generalized tonic-clonic seizure during this period. We concluded in our experimental study that exist a possible association between alcohol abuse and SUDEP occurrence.Utilizando o modelo de epilepsia induzido pela pilocarpina, investigamos os efeitos do consumo de álcool sobre a frequência de crises epilépticas em animais com epilepsia, como também uma possível associação entre a ingestão de álcool e ocorrência de morte súbita e inesperada nas epilepsias (SUDEP. Os animais foram randomicamente divididos em dois grupos: (A ratos com epilepsia e (B ratos com epilepsia que receberam uma dose diária de etanol (350 mg kg-1, i.p. por 30 dias consecutivos. A frequência basal de crises epilépticas observadas nos grupos A e B durante os primeiros 30 dias foram de 3,4±1,5 e 3,2±1,9 crises por semana/animal, respectivamente. No grupo B, ocorreu aumento significativo na frequência de crises (11,6±5,3 durante as duas primeiras semanas de administração do álcool e de forma interessante, um animal morreu subitamente após uma crise generalizada tônico-clonica durante esse período. Concluímos em nossa abordagem experimental que existe uma possível associação entre o

  11. Sudden Cardiac Death of Incarcerated Prisoners:A Study of 75 Cases%被监管人员心源性猝死75例分析

    Institute of Scientific and Technical Information of China (English)

    于岚; 董利民; 侯现军; 时凯; 徐凯

    2014-01-01

    目的:探讨监管场所内被监管人员心源性猝死(sudden cardiac death,SCD)的特点和影响因素。方法收集2000-2013年75例河南省监管场所内被监管人员SCD解剖案例,从猝死者生前所在监管场所生活环境、心理因素以及身体受限制方式等方面进行回顾性分析,结合组织病理学改变,研究监管场所中特殊因素对SCD的影响。结果75例猝死者中,生前有慢性病史者21例(28%),经解剖后确诊有潜在心血管疾病者75例(100%)。结论被监管人员SCD仍以原有潜在心脏结构病变为病理基础,监管场所特殊环境、被看管人员心理应激因素以及对其肢体限制等是SCD的促发因素。%Objective To investigate the characteristics and influencing factors leading to sudden cardiac death (SCD) of incarcerated prisoners. Methods Seventy-five SCD cases of prisoners between 2000 and 2013 in Henan province were collected, and environment, psychological and physical factors were retro-spectively analyzed. Combined with histopathological results, specific factors of SCD were also studied. Results In the 75 cases, 21 cases (28%) had definite chronic past medical histories, and 75 cases (100%) had cardiovascular disease confirmed by autopsy. Conclusion Due to presence of the potential cardiac diseases, special incarcerated environment, psychological stress, and body-restraint might be the precipitat-ing factors in SCD of those prisoners.

  12. Sudden Infant Death Syndrome (SIDS)

    Science.gov (United States)

    ... the brain that may help control breathing and awakening during sleep. If a baby is breathing stale ... grief counseling, support, and referrals. And growing public awareness of SIDS and precautions to prevent it should ...

  13. The effect of crop sequences on soil microbial, chemical and physical indicators and its relationship with soybean sudden death syndrome (complex of Fusarium species

    Directory of Open Access Journals (Sweden)

    Carolina Perez-Brandan

    2013-12-01

    Full Text Available The effect of crop sequences on soil quality indicators and its relationship with sudden death syndrome (SDS, a complex of Fusarium species was evaluated by physical, chemical, biochemical and molecular techniques. Regarding physical aspects, soybean/maize and maize monoculture exhibited the highest stable aggregate level, with values 41% and 43% higher than in soybean monoculture, respectively, and 133% higher than in bean monoculture. Bulk density (BD was higher in soybean monoculture, being 4% higher than in bean monoculture. The chemical parameters organic matter, total N, P, K, Mg, Ca, and water holding capacity also indicated that soybean/maize and maize monoculture improved soil quality. Fungal and bacterial community fingerprints generated using Terminal Restriction Fragment Length Polymorphism analysis of intergenic transcribed spacer regions of rRNA genes and 16S rRNA genes, respectively, indicated a clear separation between the rotations. Fatty acid profiles evaluated by FAME showed that bean monoculture had higher biomass of Gram (+ bacteria and stress indicators than maize monoculture, while the soybean/maize system showed a significant increase in total microbial biomass (total FAMEs content in comparison with soybean and bean monoculture. The incidence of SDS (Fusarium crassistipitatum was markedly higher (15% under soybean monoculture than when soybean was grown in rotation with maize. In the present work, soil microbial properties were improved under soybean/maize relative to continuous soybean. The improvement of soil health was one of the main causes for the reduction of disease pressure and crop yield improvement due to the benefits that crop rotation produces for soil quality.

  14. The effect of crop sequences on soil microbial, chemical and physical indicators and its relationship with soybean sudden death syndrome (complex of Fusarium species)

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Brandan, C.; Arzeno, J. L.; Huidobro, J.; Conforto, C.; Grumberg, B.; Hilton, S.; Bending, G. D.; Meriles, J. M.; Vargas-Gil, S.

    2014-06-01

    The effect of crop sequences on soil quality indicators and its relationship with sudden death syndrome (SDS, a complex of Fusarium species) was evaluated by physical, chemical, biochemical and molecular techniques. Regarding physical aspects, soybean/maize and maize mono culture exhibited the highest stable aggregate level, with values 41% and 43% higher than in soybean mono culture, respectively, and 133% higher than in bean mono culture. Bulk density (BD) was higher in soybean monoculture, being 4% higher than in bean monoculture. The chemical parameters organic matter, total N, P, K, Mg, Ca, and water holding capacity also indicated that soybean/maize and maize monoculture improved soil quality. Fungal and bacterial community fingerprints generated using Terminal Restriction Fragment Length Polymorphism analysis of intergenic transcribed spacer regions of rRNA genes and 16S rRNA genes, respectively, indicated a clear separation between the rotations. Fatty acid profiles evaluated by FAME showed that bean monoculture had higher biomass of Gram (+) bacteria and stress indicators than maize monoculture, while the soybean/maize system showed a significant increase in total microbial biomass (total FAMEs content) in comparison with soybean and bean monoculture. The incidence of SDS (Fusarium crassistipitatum) was markedly higher (15%) under soybean monoculture than when soybean was grown in rotation with maize. In the present work, soil microbial properties were improved under soybean/maize relative to continuous soybean. The improvement of soil health was one of the main causes for the reduction of disease pressure and crop yield improvement due to the benefits that crop rotation produces for soil quality. (Author)

  15. Risk of Mortality (Including Sudden Cardiac Death and Major Cardiovascular Events in Atypical and Typical Antipsychotic Users: A Study with the General Practice Research Database

    Directory of Open Access Journals (Sweden)

    Tarita Murray-Thomas

    2013-01-01

    Full Text Available Objective. Antipsychotics have been associated with increased cardiac events including mortality. This study assessed cardiac events including mortality among antipsychotic users relative to nonusers. Methods. The General Practice Research Database (GPRD was used to identify antipsychotic users, matched general population controls, and psychiatric diseased nonusers. Outcomes included cardiac mortality, sudden cardiac death (SCD, all-cause mortality (excluding suicide, coronary heart disease (CHD, and ventricular arrhythmias (VA. Sensitivity analyses were conducted for age, dose, duration, antipsychotic type, and psychiatric disease. Results. 183,392 antipsychotic users (115,491 typical and 67,901 atypical, 544,726 general population controls, and 193,920 psychiatric nonusers were identified. Nonusers with schizophrenia, dementia, or bipolar disorder had increased risks of all-cause mortality compared to general population controls, while nonusers with major depression had comparable risks. Relative to psychiatric nonusers, the adjusted relative ratios (aRR of all-cause mortality in antipsychotic users was 1.75 (95% CI: 1.64–1.87; cardiac mortality 1.72 (95% CI: 1.42–2.07; SCD primary definition 5.76 (95% CI: 2.90–11.45; SCD secondary definition 2.15 (95% CI: 1.64–2.81; CHD 1.16 (95% CI: 0.94–1.44; and VA 1.16 (95% CI: 1.02–1.31. aRRs of the various outcomes were lower for atypical versus typical antipsychotics (all-cause mortality 0.83 (95% CI: 0.80–0.85; cardiac mortality 0.89 (95% CI: 0.82–0.97; and SCD secondary definition 0.76 (95% CI: 0.55–1.04. Conclusions. Antipsychotic users had an increased risk of cardiac mortality, all-cause mortality, and SCD compared to a psychiatric nonuser cohort.

  16. Muerte súbita en un joven adulto con diagnóstico de síndrome de Tietze Sudden cardiac death in a young adult with diagnosed with Tietze syndrome

    Directory of Open Access Journals (Sweden)

    F.R. Breijo-Márquez

    2010-03-01

    Full Text Available Alcanzar el diagnóstico de certeza en el dolor torácico subagudo o crónico debe ser una meta básica para predecir una posible muerte súbita, como ocurrió en este caso, que fue una muerte súbita de origen cardíaco: arritmia cardíaca con patrón electrocardiográfico de intervalo PQ corto junto a intervalo QT largo.Achieving certainty in the diagnosis of subacute or chronic chest pain should be a basic goal to predict possible sudden death, as in this case, it was a sudden cardiac death: cardiac arrhythmia with an electrocardiographic pattern of Short PQ interval alongside a Long QT interval.

  17. THE ANALYSIS OF FORENSIC PATHOLOGY OF CEREBROVAS CULAR MALFORMATIONS CAUSING SUDDEN DEATH%脑血管畸形致猝死的法医病理分析

    Institute of Scientific and Technical Information of China (English)

    刘萨日娜; 苏丽娟; 贾富全; 武彦

    2012-01-01

    Objective: We aim to study the forensic pathological characteristics of sudden death caused by cerebral vascular malformation. Methods: We analyzed 39 cases of cerebral vascular malformation. The samples were collected from Inner Mongolia Medical College between 1998 and 2010. Results:34 cases were young men in our samples(91. 89% ). Thus young men were the major people died of the lesion. Fight and wound was the main remote cause of the lesion. 24 cases (61. 54% ) belonged to this situation. Vascular rupture and bleeding was the most death cause of subjected people. Arteriovenous malformation was the most common pathological type of cerebral vascular malformation. The malformation type occupied 92.30% ( 36cases ). Cerebral vascular malformation often occurred in brain bottom, subarachnoid, lateral ventricles, cerebellum and brain stem. The subarachnoid was the most bleeding position which wasl6cases(41. 00% ). Conclusion:The identification of cerebral vascular malformation was very difficult. It was probably to make the objective,comprehensive and accurate identification conclusions combining forensic pathological characteristics with other examinations ( MRI, cerebral angiography and so on).%目的:探讨脑血管畸形致猝死的法医病理学特点.方法:对1998 ~2010年间内蒙古医学院法医学教研室39例脑血管畸形案例进行分析.结果:脑血管畸形猝死以青壮年男性为主,有34例(占91.9%),斗殴外伤为明显诱因,有24例(61.54%),破裂出血是主要死因.脑血管畸形的病理类型以脑动静脉畸形最为常见,有36例(92.3%),常发生于脑底部、蛛网膜下腔、侧脑室、小脑及脑干.出血类型以蛛网膜下腔出血最为常见,有16例(41%).结论:脑血管畸形的鉴定比较困难,根据其法医病理学特点,结合其他检查方法(如头部MRI,脑血管造影),才能做出客观、全面、准确的鉴定结论.

  18. Primary prevention of sudden cardiac death of the young athlete: the controversy about the screening electrocardiogram and its innovative artificial intelligence solution.

    Science.gov (United States)

    Chang, Anthony C

    2012-03-01

    The preparticipation screening for athlete participation in sports typically entails a comprehensive medical and family history and a complete physical examination. A 12-lead electrocardiogram (ECG) can increase the likelihood of detecting cardiac diagnoses such as hypertrophic cardiomyopathy, but this diagnostic test as part of the screening process has engendered considerable controversy. The pro position is supported by argument that international screening protocols support its use, positive diagnosis has multiple benefits, history and physical examination are inadequate, primary prevention is essential, and the cost effectiveness is justified. Although the aforementioned myriad of justifications for routine ECG screening of young athletes can be persuasive, several valid contentions oppose supporting such a policy, namely, that the sudden death incidence is very (too) low, the ECG screening will be too costly, the false-positive rate is too high, resources will be allocated away from other diseases, and manpower is insufficient for its execution. Clinicians, including pediatric cardiologists, have an understandable proclivity for avoiding this prodigious national endeavor. The controversy, however, should not be focused on whether an inexpensive, noninvasive test such as an ECG should be mandated but should instead be directed at just how these tests for young athletes can be performed in the clinical imbroglio of these disease states (with variable genetic penetrance and phenotypic expression) with concomitant fiscal accountability and logistical expediency in this era of economic restraint. This monumental endeavor in any city or region requires two crucial elements well known to business scholars: implementation and execution. The eventual solution for the screening ECG dilemma requires a truly innovative and systematic approach that will liberate us from inadequate conventional solutions. Artificial intelligence, specifically the process termed "machine

  19. Situation analysis and nursing countermeasure of 15 years psychiatric inpatients with sudden death%精神科住院病人15年猝死情况分析与护理对策

    Institute of Scientific and Technical Information of China (English)

    冯春杰; 安春梅

    2012-01-01

    Objective: Nursing perspectives on the causes of sudden death of mental patients and care requirements of hospitalized psychiatric patients to reduce mortality measures. Methods; A retrospective medical record reading method. Cases of sudden death, one by one according to the survey with self -registration of medical information, and univariate statistical analysis. Results: 22 cases of sudden death in 6 patients with physical illness, clozapine , chlorpromazine, perphenazme in the high proportion of patients with sudden death, and the combination of drugs more. In addition to the body of patients with sudden death related to the situation, the various types of anti - psychiatric drugs on sudden death also has a direct or indirect relationship. Conclusion : All hospitalized patients receiving anttpsychotics in the treatment of early stage should be closely observed. Especially for young adutts for the first time hospitalized, frail, suffering from cardiovascular disease, high dose or two of the joint use of antipsychotics in patients, should be attached great importance to the nursing work closely observed changes, strengthen the sense of responsibility , to step up inspection and timely detection of problems and timely treatment.%目的:从护理角度了解精神病病人猝死的原因及护理要求,探讨降低精神病病人住院猝死率的措施.方法:采用回顾阅读病历的方法,对猝死病例,用自制调查表逐一按照病历登记的有关资料进行统计分析.结果:22例猝死者中6例伴有躯体疾病,猝死病人除与躯体状况有关外,各类抗精神病药物对猝死也有直接或间接的关系.服用氯氮平、氯丙嗪、奋乃静者在猝死病人中占较高比例,且合用药物者较多.结论:对所有住院接受抗精神病药物治疗的病人,在治疗早期都应进行严密观察.特别是对青壮年首次住院、年老体弱、患有心脑血管疾病、用药剂量偏离或两种抗精

  20. Prevention of sudden death in hypertrophic cardiomyopathy (HCM):implanted defibrillators in HCM%肥厚型心肌病猝死预防:肥厚型心肌病患者除颤器置入

    Institute of Scientific and Technical Information of China (English)

    Barry J Maron; Paolo Spirito

    2009-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden cardiac death in young people. The implantable cardioverter-defibrillator (ICD), has recently proved to be a safe and effective therapeutic intervention in patients with HCM, both for the primary and secondary prevention of sudden death. Based on recent substantial experience, the ICD intervenes appropriately to termiante ventricular tachycardia/fibrillation (VT/VF), at a rate of 5.5%/year. ICD discharge rate is 4%/year in those patients implanted prophylactically due to one or more major risk markers, but often with considerable delays of up to 10 years before the device is required to intervene appropriately to terminate potentially letal ventricular tachyarrhythmias. Primary prevention of VT/VF occurs with similar frequency in high-risk patients having either 1,2 or ≥ 3 noninvasive risk markers, and about one-third of patients with appropriate device interventions had been implanted for only one risk factor. The ICD has proved reliable in HCM despite the extreme and complex phenotypes often present with massive degrees of left vcntricular hypertrophy, microvascular ischemia, diastolic dysfunction, or dynamic left ventricular outflow tract obstruction. Failure to convert life-threatening ventrieular tachyarrhythmias to normal rhythm is extraordinarily rare. In conclusion, in high-risk HCM patients, ICDs perform in a highly effective fashion,frequently preventing sudden death by aborting primary life-threatening ventricular tachyarrhythmias. A single marker of high risk can be sufficient evidence to justify the recommendation for a prophylactic ICD in selected patients with HCM.

  1. Three-Grade Screening System for the Prevention of Sudden Cardiac Death in Elite Chinese Athletes%中国优秀运动员运动性猝死三级预防筛查体系的研究

    Institute of Scientific and Technical Information of China (English)

    马云; 张晓红; 赵亮; 胡小琴; 梁辰; 牟秀霞; 张健; 桑立红; 李璟; 苏萍; 周林芝; 郭红

    2011-01-01

    目的:通过对我国竞技体育运动员心脏疾病的流行病学筛查与预防,建立竞技体育运动员运动性猝死的三级预防体系.方法:2000年~2008年奥运会备战周期中的中国国家队优秀运动员1806名,依照心血管疾病三级预防的要求,以心脏疾病的筛查作为心血管危险因素基线调查资料,掌握运动员群体心血管疾病患病率及疾病谱:确立随访目标予以跟踪随诊;进行长期指导和治疗.结果:建立三级预防体系和长期监护指导,可以有效控制运动员的心血管病危险因素,减少发病率,改善心脏功能,在降低心源性运动性猝死方面起到了明显的效果.%Objective Based on epidemioiogical survey, this study aimed to construct a three-grade screening system for the prevention of Sudden Cardiac Death in elite Chinese athletes. Methods During 2000-2008' s Olympic preparation cycles, total 1806 elite athletes from Chinese national teams were sampled. Based on the cardiovascular risk factors for screening evidences, the prevalence and distribution of cardiovascular diseases in those Chinese athletes were investigated. Results and Conclusion Through a three-grade screening system for Sudden Cardiac Death, early diagnosis and prevention of cardiovascular diseases in athletes could be effectively improved and Sudden Cardiac Death accidents could be effectively reduced.

  2. Tumor disembrioplástico neuroepitelial: un caso de muerte súbita en un paciente joven epiléptico Dysembryoplastic neuroepithelial tumor: a case of sudden death in a young epileptic patient

    Directory of Open Access Journals (Sweden)

    B. Biritxinaga

    2010-12-01

    Full Text Available Las muertes súbitas por tumores intracraneales no diagnosticados en vida son muy raras. En el presente artículo se presenta el caso de un paciente joven que es hallado muerto durante el sueño. Como único antecedente de interés destaca la presencia desde la infancia de crisis epilépticas de difícil control medicamentoso. Las pruebas de imagen no habían mostrado en vida alteraciones reseñables. En la autopsia se evidencia un tumor de 0,5 x 1 cm en la corteza cerebral del lóbulo parietal izquierdo, sin efecto masa. A la vista de los hallazgos del estudio histopatológico e inmunohistoquímico se realiza el diagnóstico de tumor disembrioplástico neuroepitelial (TDN simple. Se establece como causa de la muerte el trastorno epiléptico orgánico secundario al tumor. El TDN es un tumor cerebral de muy baja frecuencia (0,2-1% de los tumores cerebrales y normalmente se asocia a crisis epilépticas fármaco-resistentes. Este caso demuestra que ante una muerte súbita e inexplicada asociada a epilepsia es fundamental la realización de una autopsia médico-legal a fin de reconocer la causa y los factores de riesgo relacionados con la epilepsia y la muerte.Sudden deaths due to intracranial tumors that have not been diagnosed in life are very rare. In this paper we present the case of a young patient who died during sleep. The only medical antecedent was drug-resistant epilepsy suffered since childhood. Neuroimage techniques did not show any alteration prior to death. The autopsy showed in the cerebral cortex of the left parietal lobe the presence of a tumor of 0.5 x 1 cm without mass effect. In view of the findings of histopathological and immunohistochemical studies a diagnosis of dysembryoplastic neuroepithelial tumor (DNT simple was made. The cause of sudden death was attributed to an organic seizure disorder secondary to the tumor. DNT is very infrequent (0.2-1% of brain tumors and it is usually associated with drug-resistant seizures. This

  3. Muerte súbita por metástasis de melanoma en aurícula derecha: Revisión de los tumores cardiacos Sudden death due to metastasis of melanoma in right atrium: Review of cardiac tumours

    Directory of Open Access Journals (Sweden)

    S. Díaz-Ruiz

    2011-03-01

    Full Text Available Los tumores cardiacos son entidades clínicas muy raras, sin embargo tienen especial interés desde el punto de vista médico-forense porque pueden ser la causa de una muerte súbita. Presentamos el caso de un varón de 38 años de edad con un melanoma de coroides que fallece de forma súbita cuatro años después de realizarse el diagnóstico. La autopsia médico legal y el estudio histopatológico mostraron un tromboembolismo pulmonar originado sobre una metástasis de melanoma en la aurícula derecha. En el presente artículo llevamos a cabo una revisión general de los tumores cardiacos.Cardiac tumors are rare clinical entity, however, they have an especial interest in forensic medicine because they can be the source of sudden death. We report a case of a 38-years old male who had been diagnosed with primary choroidal melanoma some years before his sudden death. Forensic autopsy and histopathologic examination revealed pulmonary embolism due to a melanoma metastasis in the right atrium. In addition, in this article we conduct a general review of cardiac tumors.

  4. Proyecciones del Grupo de Investigación en MuerteSúbita 20 añosdespués de sucreación/ Projections of the Research Group on Sudden Death 20 years after its foundation

    Directory of Open Access Journals (Sweden)

    Luis A. Ochoa Montes

    2015-10-01

    Full Text Available Given the challenge posed by cardiovascular sudden death to healthcare systems worldwide, it is very important a multi- and interdisciplinary approach that integrates allmedical and non-medical aspects involved in its assistance. After analyzing the results of the epidemiological research carried out in Cuba over 20 years by the Research Group on Sudden Death, which highlight the importance of this health problem because of its high incidence and its economic, family and social impact, future projections of this working group in addressing this disease were defined. The aim of this article is to describe these projections in order to achieve a better care for these patients. Projections include: better competence and performance in their knowledge and actions, and reaching a consensus to establish a universal definition for its study, diagnosis, and recording of statistical data. The scientific exchange among the various specialties and working groups involved in its medical care is essential to face its high incidence and to generate joint strategies to lessen its impact.

  5. Citrus Genomics

    OpenAIRE

    Talon, Manuel; Gmitter, Fred G.Jr.

    2008-01-01

    Citrus is one of the most widespread fruit crops globally, with great economic and health value. It is among the most difficult plants to improve through traditional breeding approaches. Currently, there is risk of devastation by diseases threatening to limit production and future availability to the human population. As technologies rapidly advance in genomic science, they are quickly adapted to address the biological challenges of the citrus plant system and the world's industries. The hist...

  6. La importancia de la investigación del lugar de la muerte y de la entrevista familiar en casos de muerte súbita e inesperada del lactante The importance of the death scene investigation and family interview in cases of sudden unexpected infant death

    Directory of Open Access Journals (Sweden)

    B. Aguilera

    2002-10-01

    Full Text Available El Síndrome de Muerte Súbita del Lactante (SMSL es la principal causa de muerte súbita e inesperada del lactante durante el período postneonatal en los países desarrollados. Se define como la muerte súbita e inesperada de un lactante que permanece inexplicada después de la revisión de la historia clínica, examen del lugar de la muerte y realización de una autopsia completa, incluyendo análisis complementarios. En los últimos tiempos se ha puesto en evidencia que casos de muerte intencional fueron catalogados como SMSL por una deficiente investigación de las circunstancias y el lugar de la muerte. Queremos hacer hincapié en la importancia de esta parte de la investigación postmortem y resumimos algunas de las recomendaciones publicadas al respecto..The sudden infant death syndrome (SIDS is the principal cause of sudden unexpected death during the post neonatal period in developed countries. It is defined as the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation including a complete autopsy with the relevant analyses, examination of the death scene and a review of the clinical history. Recently it was shown that cases of infanticide had been diagnosed as SIDS because of poor investigation of the circumstances and scene of death. In this report we stress the importance of this part of the post mortem investigation and we summarize some of the guidelines published on the subject.

  7. 体育运动对癫痫猝死症的影响:并非单纯运动%Physical activity in sudden unexpected death in epilepsy: much more than a simple sport

    Institute of Scientific and Technical Information of China (English)

    Ricardo M.ARIDA; Carla A.SCORZA; Beny SCHMIDT; Marly de ALBUQUERQUE; Esper A.CAVALHEIRO; Fulvio A.SCORZA

    2008-01-01

    癫痫猝死(sudden unexpected death in epilepsy,SUDEP)是癫痫患者最蓖要的直接与癫痫相关的死亡原因.其潜在病理机制尚未阐明,但癫痫发作时和发作间期的心律失常,电解质紊乱,致心律失常药物或癫痫电活动通过自主神经系统向心脏的传导,很可能与SUDEP的发病机理有关.引人注意的足,临床和实验数据都显示体力活动可以降低癫痫发作频率,并促进癫痫患者的心血管健康.基于上述情况,本文综述了体育锻炼可能预防SUDEP发生的相关文献内容.%Sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Additionally, potential pathomechanisms for SUDEP is unknown, but it is very probable that cardiac arrhythmia during and between seizures, electrolyte disturbances, arrhythmogenic drugs or transmission of epileptic activity via the autonomic nervous system to the heart may play a potential role. Quite interestingly, clinical and experimental data have shown that physical activity can decrease seizure frequency, as well as lead to improved cardiovascular health in patients with epilepsy. Based on these facts, the purpose of this article is to review the body of literature of the possible contribution of physical exercise to the SUDEP prevention in a comprehensive manner.

  8. Genome sequences of two Phytophthora species responsible for Sudden Oak Death and Soybean Root Rot provide novel insights into their evolutionary origins and mechanisms of pathogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Tyler, Brett M.; Tripathi, Sucheta; Aerts, Andrea; Bensasson, Douda; Dehal, Paramvir; Dubchak, Inna; Garbelotto, Matteo; Gijzen, Mark; Huang, Wayne; Ivors, Kelly; Jiang, Rays; Kamoun, Sophien; Krampis, Konstantinos; Lamour, Kurt; McDonald, Hayes; Medina, Monica; Morris, Paul; Putnam, Nik; Rash, Sam; Salamov, Asaf; Smith, Brian; Smith, Joe; Terry, Astrid; Torto, Trudy; Grigoriev, Igor; Rokhsar, Daniel; Boore, Jeffrey

    2005-12-01

    The approximately 60 species of Phytophthora are all destructive pathogens, causing rots of roots, stems, leaves and fruits of a wide range of agriculturally and ornamentally important plants (1). Some species, such as P. cinnamomi, P. parasitica and P. cactorum, each attack hundreds of different plant host species, whereas others are more restricted. Some of the crops where Phytophthora infections cause the greatest financial losses include potato, soybean, tomato, alfalfa, tobacco, peppers, cucurbits, pineapple, strawberry, raspberry and a wide range of perennial tree crops, especially citrus, avocado, almonds, walnuts, apples and cocoa, and they also heavily affect the ornamental, nursery and forestry industries. The economic damage overall to crops in the United States by Phytophthora species is estimated in the tens of billions of dollars, including the costs of control measures, and worldwide it is many times this amount (1). In the northern midwest of the U.S., P. sojae causes $200 million in annual losses to soybean alone, and worldwide causes around $1-2 billion in losses per year. P. infestans infections resulted in the Irish potato famine last century and continues to be a difficult and worsening problem for potato and tomato growers worldwide, with worldwide costs estimated at $5 billion per year.

  9. Relationship between late ventricular potentials and myocardial {sup 123}I-metaiodobenzylguanidine scintigraphy in patients with dilated cardiomyopathy with mild to moderate heart failure: results of a prospective study of sudden death events

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Shu [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Gunma (Japan); Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Toyama, Takuji; Kaneko, Yoshiaki; Kurabayashi, Masahiko [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Gunma (Japan); Iwasaki, Toshiya; Sumino, Hiroyuki; Kumakura, Hisao; Minami, Kazutomo; Ichikawa, Shuichi [Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Matsumoto, Naoya [Nihon University School of Medicine, Department of Cardiology, Tokyo (Japan); Sato, Yuichi [Health Park Clinic, Department of Imaging, Gunma (Japan)

    2012-06-15

    Late ventricular potentials (LPs) are considered to be useful for identifying patients with heart failure at risk of developing ventricular arrhythmias. {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy, which is used to evaluate cardiac sympathetic activity, has demonstrated cardiac sympathetic denervation in patients with malignant ventricular tachyarrhythmias. This study was undertaken to clarify the relationship between LPs and {sup 123}I-MIBG scintigraphy findings in patients with dilated cardiomyopathy (DCM). A total of 56 patients with DCM were divided into an LP-positive group (n = 24) and an LP-negative group (n = 32). During the compensated period, the delayed heart/mediastinum count (H/M) ratio, delayed total defect score (TDS), and washout rate (WR) were determined from {sup 123}I-MIBG images and plasma brain natriuretic peptide (BNP) concentrations were measured. Left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF) were simultaneously determined by echocardiography. LVEDV, LVESV, LVEF and plasma BNP concentrations were similar in the two groups. However, TDS was significantly higher (35 {+-} 8 vs. 28 {+-} 6, p < 0.005), the H/M ratio was significantly lower (1.57 {+-} 0.23 vs. 1.78 {+-} 0.20, p < 0.005), and the WR was significantly higher (60 {+-} 14% vs. 46 {+-} 12%, p < 0.001) in the LP-positive than in the LP-negative group. The average follow-up time was 4.5 years, and there were nine sudden deaths among the 56 patients (16.1%). In logistic regression analysis, the incidences of sudden death events were similar in those LP-negative with WR <50%, LP-negative with WR {>=}50% and LP-positive with WR <50% (0%, 10.0% and 14.3%, respectively), but was significantly higher (41.2%) in those LP-positive with WR {>=}50% (p < 0.01, p < 0.05, and p < 0.05, respectively). The present study demonstrated that the values of cardiac {sup 123}I-MIBG scintigraphic parameters

  10. Expression of sterol regulatory element-binding transcription factor (SREBF 2 and SREBF cleavage-activating protein (SCAP in human atheroma and the association of their allelic variants with sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Kytömäki Leena

    2008-12-01

    Full Text Available Abstract Background Disturbed cellular cholesterol homeostasis may lead to accumulation of cholesterol in human atheroma plaques. Cellular cholesterol homeostasis is controlled by the sterol regulatory element-binding transcription factor 2 (SREBF-2 and the SREBF cleavage-activating protein (SCAP. We investigated whole genome expression in a series of human atherosclerotic samples from different vascular territories and studied whether the non-synonymous coding variants in the interacting domains of two genes, SREBF-2 1784G>C (rs2228314 and SCAP 2386A>G, are related to the progression of coronary atherosclerosis and the risk of pre-hospital sudden cardiac death (SCD. Methods Whole genome expression profiling was completed in twenty vascular samples from carotid, aortic and femoral atherosclerotic plaques and six control samples from internal mammary arteries. Three hundred sudden pre-hospital deaths of middle-aged (33–69 years Caucasian Finnish men were subjected to detailed autopsy in the Helsinki Sudden Death Study. Coronary narrowing and areas of coronary wall covered with fatty streaks or fibrotic, calcified or complicated lesions were measured and related to the SREBF-2 and SCAP genotypes. Results Whole genome expression profiling showed a significant (p = 0.02 down-regulation of SREBF-2 in atherosclerotic carotid plaques (types IV-V, but not in the aorta or femoral arteries (p = NS for both, as compared with the histologically confirmed non-atherosclerotic tissues. In logistic regression analysis, a significant interaction between the SREBF-2 1784G>C and the SCAP 2386A>G genotype was observed on the risk of SCD (p = 0.046. Men with the SREBF-2 C allele and the SCAP G allele had a significantly increased risk of SCD (OR 2.68, 95% CI 1.07–6.71, compared to SCAP AA homologous subjects carrying the SREBF-2 C allele. Furthermore, similar trends for having complicated lesions and for the occurrence of thrombosis were found, although the

  11. Certification of deaths attributable to epilepsy

    OpenAIRE

    Langan, Y.; Nashef, L; Sander, J

    2002-01-01

    Methods: All 1997 death entries mentioning epilepsy as a cause of death in those 16–50 years were examined and classified as sudden unexpected death in epilepsy (SUDEP), other epilepsy related deaths, or non-epilepsy deaths.

  12. Familial sudden death is an important risk factor for primary ventricular fibrillation: a case-control study in acute myocardial infarction patients.

    NARCIS (Netherlands)

    Dekker, L.R.; Bezzina, C.R.; Henriques, J.P.; Tanck, M.W.; Koch, K.T.; Alings, M.W.; Arnold, A.E.R.; Boer, M.J. de; Gorgels, A.P.; Michels, H.R.; Verkerk, A.; Verheugt, F.W.A.; Zijlstra, F.; Wilde, A.A.M.

    2006-01-01

    BACKGROUND: Primary ventricular fibrillation (VF) accounts for the majority of deaths during the acute phase of myocardial infarction. Identification of patients at risk for primary VF remains very poor. METHODS AND RESULTS: We performed a case-control study in patients with a first ST-elevation myo

  13. Familial sudden death is an important risk factor for primary ventricular fibrillation : A case-control study in acute myocardial infarction patients

    NARCIS (Netherlands)

    Dekker, Lukas R. C.; Bezzina, Connie R.; Henriques, Jose P. S.; Tanck, Michael W.; Koch, Karel T.; Alings, Marco W.; Arnold, Alfred E. R.; de Boer, Menko-Jan; Gorgels, Anton P. M.; Michels, H. Rolf; Verkerk, Agnes; Verheugt, Freek W. A.; Zijlstra, Felix; Wilde, Arthur A. M.

    2006-01-01

    Background - Primary ventricular fibrillation (VF) accounts for the majority of deaths during the acute phase of myocardial infarction. Identification of patients at risk for primary VF remains very poor. Methods and Results - We performed a case-control study in patients with a first ST-elevation m

  14. Mortes súbitas em bovinos causadas pela ingestão de Mascagnia sp (Malpighiaceae, no Estado de Santa Catarina Sudden death in cattle by Mascagnia sp (Malpighiaceae in the State of Santa Catarina, Brazil

    Directory of Open Access Journals (Sweden)

    Aldo Gava

    1998-01-01

    Full Text Available No Litoral de Santa Catarina vem ocorrendo uma doença de bovinos caracterizada por "morte súbita". Para esclarecer a etiologia, foram conduzidos experimentos em bovinos nos quais se reproduziu a enfermidade pela administração oral de Mascagnia sp. Doses únicas de 5 g/kg das folhas frescas de Mascagnia sp causaram intoxicação não letal. Doses únicas de 7,5 g/kg causaram intoxicação letal em um de dois bovinos e dose de 10 g/kg a morte de outros dois. Nessas dosagens de 5 a 10 g/kg as manifestações clínicas eram observadas quando os animais eram movimentados, e consistiram em cansaço, jugular ingurgitada, leves tremores musculares e às vezes contrações bruscas; taquicardia já notada antes do exercício se acentuava. Finalmente os animais se deitavam ou caíram subitamente. A evolução da intoxicação nos dois animais em que foi acompanhada até a morte, foi de 40 e 75 minutos. As mais altas doses administradas (15 e 20 g/kg provocaram um quadro de intoxicação protraída; os animais se mostraram lerdos e apáticos, evitando quaisquer movimentos; foram encontrados mortos 7h45min e 21 horas após terem sido observados os primeiros sinais clínicos. Esses dois últimos experimentos mostram que a movimentação é um fator importante para a manifestação da "morte súbita". Os principais achados de necropsia foram coloração vermelha intensa da mucosa do intestino delgado e edema da parede da vesícula biliar. As mais importantes alterações histológicas foram degeneração hidrópico-vacuolar do epitélio tubular renal em três dos cinco bovinos que morreram.In the coastal areas of the State of Santa Catarina occurs a disease in cattle characterized by "sudden death". The disease was reproduced in bovines by oral administration of Mascagnia sp. Single doses of 5 g/kg of the fresch leaves of Mascagnia sp caused non-lethal poisoning; single doses of 7,5 g/kg caused lethal poisoning in one of two bovines and doses of 10 g

  15. Case analysis of sudden death of psychiatric patients within recent ten years%近十年住院精神病患者猝死病例分析

    Institute of Scientific and Technical Information of China (English)

    刘计

    2015-01-01

    目的::对住院精神病患者猝死原因进行了回顾性调查分析,寻找经验和规律。方法:采用自编调查表对患者的性别、年龄、病程、住院次数、精神疾病诊断、合并躯体疾病诊断、住院服药情况、死亡原因、死亡时间等进行逐一调查分析。结果:猝死患者在性别上没有明显差别,年龄多在45岁以上,病程上很多是20年以上,反复住院多次,长期服用抗精神病药,死亡前部分有心电图异常等情况,死亡时间半数在节假日的晚上或者是清晨。提示长期服药的中、老年患者;伴有躯体疾病,特别是心脏疾病的精神病患者容易出现猝死,特别是在节假日等工作人员稀少,疏于查房,忽略了必须重点关注的患者。结论:重点关注中、老年长期患病、长期服药的精神病患者,应经常进行心电图等辅助检查,密切观察病情变化,对伴有躯体疾病的精神病患者,在节假日期间要重点交班,特别关注。%Objective: To search for factors contributing to sudden death of hospitalized psychiatric patients through a retro-spective investigation and analysis on the medical cases. Methods:A progressive analysis was done on the following factors, such as sex, age, course of disease, number of hospitalization, diagnosis of mental illness, diagnosis of physical illness annexed, conditions of hospitalization and medication, direct causes to death, and time of death by using a self-drafted investigation form. Results:The pa-tients of sudden death showed no difference in sex. Mainly, they were aged above 45 years old, were suffered the psychosis for more than 20 years and frequently hospitalized, and chronically took anti-psychotic drugs. Part of them showed abnormal electrocardiograms prior to death. Half of them died in the evening or dawn of holidays or festivals. It should be prompted that the middle-aged or senior patients who chronically took

  16. 类胰蛋白酶和类糜蛋白酶表达在过敏反应死亡与冠心病猝死者组织中的表达%Expression of tryptase and chymase in anaphylactic death and sudden coronary death and their significance in forensic medicine

    Institute of Scientific and Technical Information of China (English)

    付立平; 张付瑶; 王涛; 王慧君

    2012-01-01

    Objective To investigate the relationship between the expression of tryptase and chymase with anaphylactic death and sudden coronary death (SCD) , and their diagnostic significanpe in forensic pathology. Methods Autopsy heart and lung samples (n = 70) collected during 2008 -2011 in our department were divided into 4 groups. Group A (20cases) died of sudden death with coronary heart disease (SCD) ;group B (20 cases) ,non -sudden death with coronary heart disease;group C (lOcases) died of anaphylaxis sudden death; Group group D:20 cases died of any cause without atherosclerosis. Tryptase and chymase were detected by immunohistochemistry ( SP method) and image analysis. Results The OD values of trypase in the ischemic myocardium and lung tissue were significantly higher in SCD, CHD, sudden anaphylactic death groups than that in the control group, with statistically significant differences among the groups (P 0. 05). Conclusions Chymase protein level is increased in sudden coronary death (SCD) and anaphylactic death patients. However, chymase only accounts for 3% of the total protein in mast cells, and the expression of this protease is not sufficient as an evidence to identify anaphylactic death and coronary heart disease death. Tryptase is increased in the heart and lung of sudden coronary death ( SCD) and anaphylactic death patients, and could be used as an important reference for medical identification of sudden death from anaphylaxis and coronary heart disease.%目的 探讨类胰蛋白酶( tryptase)和类糜蛋白酶(chymase)在过敏反应死亡中表达及其与过敏反应死亡和冠心病猝死的关系,为过敏反应死亡的病理诊断和法医学鉴定提供新的形态学依据.方法 从本教研室2008-2011年尸检档案中挑选病例70例,并搜集其原始档案资料、福尔马林固定包埋的心脏及肺脏蜡块,复阅HE切片.分为四组:A组:冠心病猝死(SCD,20例);B组:冠心病非猝死者(CHD,20例);C组:过敏性猝死(10例)

  17. An analysis of the materials on a sudden unexplained death in Heqing county of Yunnan Province%云南省鹤庆县一起不明原因猝死事件资料分析

    Institute of Scientific and Technical Information of China (English)

    杨林; 唐雪; 习严梅; 施国庆; 黄文丽; 曾光; 赵溯; 王跃兵; 李灿彪; 段炳华; 陆步来; 赵红; 马琳; 董毅

    2014-01-01

    sum up epidemiological features ,clinical manifestations ,experimental results and pathological characteristics of the accident to provide basis for discussing etiology of the sudden unex-plained death in Yunnan and preventing such death .Methods A field epidemiological survey was conduc-ted and four physical examinations (4 th ,5 th ,6 th and 18 th August ) were arranged for the family and vil-lagers of the departed ,including electrocardiography .Serum was collected from 28 family members and resi-dents ,which was sent to a provincial people's hospital within 12 hours after collection for testing electrolyte , liver&kidney functions ,glucose ,blood lipid ,myocardial enzyme ,troponin ,myoglobin and C-reactive pro-tein ,etc .Materials were collected from cases meeting the corresponding conditions by corpse dissection .Epi-demiological materials of cases suffering from the same disease and all materials produced during hospitaliza-tion were gathered for meticulous ,objective and systematic analysis .Results this accident happened in a season (August ) with a high incidence of sudden unexplained death in Yunnan . Four out of seven family members suddenly died within 20 hours and there presented a phenomenon of familial aggregation .All sudden deaths were young peasants ,among whom there were more females than males (3/1) .They neither had spe-cial clinical manifestations nor felt sick before death ,who died merely several minutes after the onset of ill-ness and whose families had no special dietary histories within 1 month before death .After examining the health of family members and villagers ,42 cases felt faint ,suffered from chest tightness and fatigue ,all of whom were treated .There exhibited significant changes in four electrocardiogram results .The change rate was the highest on the 2nd day (77 .27% ) ,followed by the 1st day (69 .75% ) ,3rd day (58 .82% ) and the 15th day (35 .71% ) .The greatest changes occurred to ST-T (abnormality) ,Q-T interval (prolonged

  18. Miocarditis aguda y muerte súbita en jóvenes: Presentación de un caso Acute myocarditis and sudden death in the young: Case report

    Directory of Open Access Journals (Sweden)

    J. Lucena

    2007-07-01

    Full Text Available La miocarditis puede ser definida simplemente como una inflamación del miocardio. Actualmente se considera una miocardiopatía adquirida producida por una amplia variedad de agentes infecciosos, habitualmente virus, así como toxinas y drogas. La presentación clínica de la enfermedad varía desde síntomas sistémicos inespecíficos hasta muerte súbita. Diversas series autópsicas han diagnosticado una miocarditis aguda como causa de muerte súbita en niños y adultos jóvenes entre el 4-12%. Por otra parte, la miocarditis se ha identificado como causa de miocardiopatía dilatada hasta en el 9% de los casos. La miocarditis en una de los diagnósticos que más a menudo pasa desapercibido macroscópicamente ya que en la mayor parte de los casos el corazón es absolutamente normal por lo que el diagnóstico requiere siempre el examen microscópico siguiendo los criterios de Dallas. Es aconsejable la caracterización del virus mediante Reacción en Cadena de la Polimerasa. Presentamos el caso de una joven que presentó una muerte súbita debida a una miocarditis aguda linfocitaria.Myocarditis could be defined simply as an inflammation of the myocardium. Nowadays it is considered an acquired cardiomyopathy produced by a wide variety of infectious agents, mainly viruses, as well as toxins and drugs. The clinical presentation of the disease varies from unspecific systemic symptoms to sudden death. Some post-mortem series have diagnosed an acute myocarditis as the cause of sudden death in children and young adults between 4-12% of cases. On the other hand, myocarditis has been identified as the cause of dilated cardiomyopathy in 9% of cases. Myocarditis is a diagnostic challenge in the autopsy room because in the great majority of cases the heart is completely normal on gross examination. For that reason, microscopical diagnosis according to the Dallas criteria is always mandatory. The characterization of the virus trough Polimerase Chain Reaction

  19. Sudden Stratospheric Warming Compendium

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Sudden Stratospheric Warming Compendium (SSWC) data set documents the stratospheric, tropospheric, and surface climate impacts of sudden stratospheric warmings....

  20. 独立董事有价值吗?--基于独立董事突然死亡的事件研究%Do Independent Directors Have Values? --An Empirical Study on Sudden Deaths of Independent Directors

    Institute of Scientific and Technical Information of China (English)

    顾亮; 刘振杰; 张耀伟

    2014-01-01

    Based on the assumptions of efficient capital market hypothesis and rational investor hypothesis,and taking the cas-es of sudden deaths of independent directors of listed companies as our research object, which happened from 30th June, 2003 to 30th June,2011 in China,we designed the research on the basis of case studies and analyzed the impacts of deaths of corporate independent directors on corporate market value,meanwhile,we investigated the differentiate impacts of differences in identity and professional background of independent directors on corporate value. We found that the sudden deaths of inde-pendent directors lowered the value of corporate significantly;the death of the independent directors whose educational back-ground was economics and management caused more reduction on corporate value significantly, compared with the indepen-dent directors whose educational background was science and engineering;the difference in identity of independent directors had notable different effects on the change of corporate value. The fact, which sudden deaths of independent directors reduce corporate value,proves that independent directors can bring values to listed companies from one aspect.%文章以上市公司独立董事突然死亡为研究对象,基于有效市场和理性投资者假设,在事件研究方法的基础上,利用我国上市公司2003年6月30日-2011年6月30日独立董事突然死亡的事件为样本,分析了独立董事死亡对公司价值的影响。在以上研究的基础上,通过独立董事身份背景和专业背景的分类,考察了独立董事身份背景差异和专业背景差异对公司价值的影响。实证的结果说明,独立董事突然死亡显著降低公司的价值,由于专业背景的不同,拥有经济管理专业背景的独立董事突然死亡带来的企业价值降低显著高于理工专业背景的独立董事,同时研究结果表明,拥有政府官员和教授专家身份背景的

  1. Postmortem diagnosis of cytomegalovirus and accompanying other infection agents by real-time PCR in cases of sudden unexpected death in infancy (SUDI).

    Science.gov (United States)

    Yagmur, Gulhan; Ziyade, Nihan; Elgormus, Neval; Das, Taner; Sahin, M Feyzi; Yildirim, Muzaffer; Ozgun, Ayse; Akcay, Arzu; Karayel, Ferah; Koc, Sermet

    2016-02-01

    As an opportunistic pathogen with high mortality rates, Cytomegalovirus (CMV) may lead to fatal disseminated CMV infection of the premature and newborn; thus necessitating the demonstration of CMV-DNA with clinical history and/or histopathological findings of CMV infection and defining other bacterial and viral infection agents with real-time polymerase chain reaction (RT-PCR) in udden unexpected death in infancy (SUDI) cases as we aimed in this study. 314 (144 female, 170 male) SUDI cases were prospectively investigated from January 2013 to January 2015 in Istanbul Forensic Medicine Institution. The study includes 87 tissue samples of 39 cases for post-mortem histopathological examination of interstitial pneumonia, myocarditis, meningitis, encephalitis, hepatitis, colitis or tubulointerstitial nephritis and/or accompanying chronic sialadenitis. CMV-DNA was found positive in 35 (40.2%) salivary gland, 19 (21.8%) lung, 1 (1.1%) tonsil, and 1 (1.1%) brain tissues. CMV sialadenitis and/or CMV pneumonia associated with other viral and/or bacterial agents were detected in 23 (60%) of 39 infant cases. The demonstration of CMV-DNA would significantly clarify the cause of death and collection of epidemiological data in SUDI cases with clinical history and histopathological findings of CMV infection accompanying chronic CMV sialadenitis. Furthermore, CMV suppresses the immune system, and may predispose to other bacterial and/or viral infections in these cases. Post-mortem molecular investigations are useful in explaining cause of death in SUDI with a suspicion of infection in forensic autopsies.

  2. Risk factors for sudden infant death syndrome in a developing country Fatores de risco para síndrome da morte súbita do lactente em um país em desenvolvimento

    Directory of Open Access Journals (Sweden)

    Ana Paula Silveira Pinho

    2008-06-01

    Full Text Available OBJECTIVE: To analyze whether previously identified risk factors for sudden death syndrome have a significant impact in a developing country. METHODS: Retrospective longitudinal case-control study carried out in Porto Alegre, Southern Brazil. Cases (N=39 were infants born between 1996 and 2000 who died suddenly and unexpectedly at home during sleep and were diagnosed with sudden death syndrome. Controls (N=117 were infants matched by age and sex who died in hospitals due to other conditions. Data were collected from postmortem examination records and questionnaires answers. A conditional logistic model was used to identify factors associated with the outcome. RESULTS: Mean age at death of cases was 3.2 months. The frequencies of infants regarding gestational age, breastfeeding and regular medical visits were similar in both groups. Sleeping position for most cases and controls was the lateral one. Supine sleeping position was found for few infants in both groups. Maternal variables, age below 20 years (OR=2, 95% CI: 1.1; 5.1 and smoking of more than 10 cigarettes per day during pregnancy (OR=3, 95% CI: 1.3; 6.4, significantly increased the risk for the syndrome. Socioeconomic characteristics were similar in both groups and did not affect risk. CONCLUSIONS: Infant-maternal and socioeconomic profiles of cases in a developing country closely resembled the profile described in the literature, and risk factors were similar as well. However, individual characteristics were identified as risks in the population studied, such as smoking during pregnancy and maternal age below 20 years.OBJETIVO: Analisar se fatores de risco previamente identificados para a síndrome da morte súbita do lactente têm impacto significativo em um país em desenvolvimento. MÉTODOS: Estudo retrospectivo, longitudinal, de caso-controle pareado realizado em Porto Alegre, RS. Os casos (N=39 foram lactentes nascidos entre 1996 e 2000 que morreram subitamente e inesperadamente em

  3. Citrus leprosis research update

    Science.gov (United States)

    Citrus leprosis is one of the oldest citrus diseases, but is also one of the most important emerging citrus diseases in South and Central America, and it is apparently spreading northward towards the U.S. Research in our labs and by others has shown that citrus leprosis disease is caused by a compl...

  4. THE EXPRESSIONS OF HIF-1α AND Bax AND THEIR CORRELATION IN SUDDEN CARDIAC DEATH%心脏性猝死心肌组织HIF-1α和Bax表达及其相关性

    Institute of Scientific and Technical Information of China (English)

    刘德衍; 袁磊; 杨彦华; 纪萍; 于建宪; 张七一; 林梅

    2011-01-01

    目的 探讨缺氧诱导因子1 alpha(HIF-1α)和Bax蛋白在心脏性猝死(SCD)者心肌组织中的表达与相关性,并为法医学鉴定SCD提供客观依据.方法 应用免疫组织化学方法,检测25例SCD者心肌组织中HIF-1α和Bax蛋白的表达,并以25例非SCD者心肌组织作为对照.结果 SCD者心肌组织HIF-1α与Bax的表达明显高于对照组(uc=6.083、5.573,P<0.01).在SCD心肌组织中,HIF-1α表达与Bax表达呈正相关(r=0.736,P<0.01).结论 HIF-1α与Bax表达的增高与SCD的发生有一定的相关性,HIF-1α与Bax可望作为诊断SCD较为客观的病理形态学指标.%Objective To investigate the expressions of hypoxia-inducible factor-1 alpha (HIF-1α) and Bcl-2 associated X protein (Bax) and their correlation in myocardium of sudden cardiac death (SCD) and provide an objective evidence for forensic identification.Methods The expressions of HIF-la and Bax in myocardium of 25 SCD were detected using immunohistochemical technique, and 25 of non-sudden cardiac death served as controls.Results The expressions of HIF-1α and Bax in myocardium of the SCD were significantly higher than that of the control (Uc = 6.083,5.573;P<0.01), and the expressions were positively correlated (r=0.736,P<0.01) Conclusion The elevation of the expressions of HIF-1α and Bax is associated with SCD to a certain extent.The HIF-1α and Bax will hopefully become a relatively objective pathomorphologic index in the diagnosis of SCD.

  5. Síndrome de Kounis: una posibilidad a tener en cuenta como causa de muerte súbita cardiaca Kounis syndrome: a possibility to be considered as a cause of sudden cardiac death

    Directory of Open Access Journals (Sweden)

    P. Molina

    2012-03-01

    Full Text Available El llamado síndrome miocárdico alérgico, angina alérgica o síndrome de Kounis, se define como la aparición de un síndrome coronario agudo por vasoespasmo secundario a la activación de mastocitos y células inflamatorias interrelacionadas que se produce en las reacciones de hipersensibilidad, anafilácticas y anafilactoides. Presentamos un caso de muerte súbita en un adulto joven compatible con un síndrome de Kounis, donde el estudio histopatológico demuestra patología asmática y una trombosis en la arteria coronaria descendente anterior sobre una placa erosionada con numerosos eosinófilos y mastocitos en el trombo, en la placa subyacente, en la pared muscular y en la adventicia. La entrevista familiar posterior confirmó el antecedente de atopia y una clínica previa al fallecimiento compatible con un episodio asmático. Como dicen muchos expertos, el Síndrome de Kounis no es una enfermedad rara, pero sí es una enfermedad raramente diagnosticada. Debemos tenerla presente y descartarla ante una muerte súbita en el contexto de una reacción alérgica o de antecedentes de atopia, alergia o asma alérgico.Kounis syndrome has been defined as the concurrence of an acute coronary syndromes with allergic or hypersensitivity as well as with anaphylactic or anaphylactoid reactions. The main pathophysiological mechanism is the vasospasm of epicardial coronary arteries due to increased inflammatory mediators that are released during the underlaying allergic events. We present a case of sudden death in an atopic young adult with histopathological findings of asthma and thrombosis in left anterior descending coronary artery with presence of eosinophils and mast cell. Kounis syndrome is not a rare disease but is a rarely diagnosed condition which should always be kept in mind when dealing with a cardiac sudden death with clinical history of atopy or allergy or in a context of allergic reactions.

  6. [Forensic medical estimation of the morphological changes in the myocardium and hypothalamo-pituitary-adrenal system in case of sudden cardiac death].

    Science.gov (United States)

    Pigolkin, Iu I; Dolzhanskiĭ, O V; Gromova, T M

    2012-01-01

    This morphological, morphometric, and immunohistochemical study of the myocardium, adrenal gland, and hypothalamus included 50 corpses of men aged from 25-49 years deceased by reason of acute coronary failure associated with coronary heart disease. The commonest lesions in the myocardium were contractures (54.3 +/- 3.5% [51.2; 57.8%]), cyclic deformation (44.7 +/- 6.3% [38.2; 51.4%]), and dissociation of cardiomyocytes (61.2 +/- 2.3% [56.3; 64.8%]). The sinoatrial and atrioventricular nodes of the heart contained large amounts of adrenaline-positive cells (45.6 +/- 4.5% [40.1; 48.7%]) and 34.2 +/- 2.9% [31.2; 37.4%]). The equally large numbers of adrenaline-positive cells were detected in the adrenal medulla (67.2 +/- 6.8% [61.9; 74.3%]). The arcuate, supraoptic, and paraventricular nuclei of the hypothalamus underwent reversible changes of neutron content (the degree of damage 25.6 +/- 4.8% [21.2; 29.8%]) and contained large amounts of noradrenaline-positive and dopamine-positive neural cells (54.2 +/- 3.6% [51.4; 59.3%]) and 28.7 +/- 2.1% [23.4; 31.7%]) respectively. It is concluded that the morphometric and immunohistochemical changes detected in the present study can be used as the additional forensic medical criteria for diagnostics of death from acute coronary failure associated with coronary heart disease.

  7. La causa y la manera de la muerte indeterminada: a propósito de un caso de muerte súbita en adolescente, portador de una tumoración quística intestinal, descubierta durante la autopsia Cause and Manner of Death Undetermined: regarding a case of sudden death in an adolescent with an intestinal cystic tumour, discovered during autopsy

    Directory of Open Access Journals (Sweden)

    A. Garfia

    2002-04-01

    Full Text Available Presentamos un caso de muerte inesperada súbita, acaecida en un sujeto de 19 años, el cual presentó, en las horas previas al fallecimiento, un cuadro de mareos, náuseas y vómitos que fue tratado en el Centro de Atención Primaria con analgésicos y antiespasmódicos. Después de pocas horas de evolución el indivíduo fue trasladado de nuevo, por los familiares, al Centro Médico, en estado de inconsciencia. A pesar de la aplicación de maniobras de resucitación el sujeto presentó parada cardiorrespiratoria y exitus. Durante la autopsia Médico- Legal se demostró la existencia de una tumoración mesentérica, localizada en el ileon distal. El cadáver despedía un olor "sui generis" que le recordó al Médico Forense el típico de algunos plaguicidas organofosforados. Se avanzaron los siguientes diagnósticos de la causa de la muerte en el informe de autopsia: 1 Shock séptico por absceso intestinal. 2 Intoxicación mortal por plaguicidas. 3 Muerte súbita cardiaca. La investigación químico-toxicológica resultó negativa. El estudio anatomopatológico no demostró lesiones cardiacas que pudiesen justificar la muerte y, el de la tumoración mesentérica demostró que se trataba de una duplicación intestinal, de tipo quístico, con discreta inflamación crónica de la pared; no se pusieron de manifiesto ulceraciones, hemorragias ni lesiones vasculares o isquémicas intestinales que pudiesen justificar una muerte súbita de causa digestiva. La causa y la manera de la muerte se consideraron de tipo indeterminado.We present a case of sudden and unexpected death in a 19 year-old, who in the hours prior to his death presented a clinical picture of dizziness, nausea and vomiting which was treated at the First-Aid Centre with analgesics and antispasmodics. After a few hours the patient was again taken to the Medical Centre by his relatives, by then unconscious. In spite of resuscitation measures the patient presented cardio-respiratory arrest

  8. Hallazgo de una hiperplasia lipomatosa del septum interauricular en un caso de muerte súbita Finding of a lipomatous hyperplasia in the interatrial septum in a case of sudden death

    Directory of Open Access Journals (Sweden)

    D. Sánchez-Quintana

    2011-12-01

    Full Text Available La hiperplasia lipomatosa del septum interauricular (HLSI es una entidad benigna de naturaleza desconocida que se caracteriza por la acumulación de grasa no encapsulada en el interior del surco interauricular sin participación de la fosa oval. A pesar de su carácter benigno, clínicamente se ha asociado con arritmias cardiacas, generalmente de origen supraventricular, insuficiencia cardiaca y muerte súbita. Presentamos el caso de una mujer de edad media (47 años, con obesidad mórbida e insuficiencia cardiaca congestiva, que falleció súbitamente y la autopsia puso de manifiesto una HLSI. El estudio macroscópico de la pieza de resección mostró un tamaño de 5 x 2,5 cm y la histología típica de esta entidad, es decir, adipocitos maduros y pocos lipoblastos entremezclados con miocitos auriculares. Hemos analizado microscópicamente los nodos sinoauricular y auriculoventricular, lo que puso de manifiesto que la infiltración grasa los rodeada pero no los aislaba del miocardio auricular de trabajo circundante. El miocardio del ventrículo izquierdo y del tabique interventricular presentaba áreas con una intensa fibrosis intersticial por isquémica crónica y que esta fibrosis pudo ser la causa de una arritmia ventricular y muerte súbita. Aunque esta entidad es cada vez más frecuentemente reconocida gracias al desarrollo creciente de las técnicas de imagen no invasivas, rara vez necesita ser corregida quirúrgicamente.The lipomatous hyperplasia of the interatrial septum (LHIS is a benign entity of unknown nature, characterized by the accumulation of fat tissue not encapsulated into the interatrial groove without participation of the fossa ovalis. Despite its benign nature, it has been clinically associated with cardiac arrhythmias, usually of supraventricular origin, heart failure and sudden death. We present the case of a woman of middle age (47 years, with morbid obesity and heart failure congestive who died suddenly and the autopsy

  9. General anxiety, depression, and physical health in relation to symptoms of heart-focused anxiety- a cross sectional study among patients living with the risk of serious arrhythmias and sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Hamang Anniken

    2011-11-01

    Full Text Available Abstract Objective To investigate the role of three distinct symptoms of heart-focused anxiety (cardio-protective avoidance, heart-focused attention, and fear about heart sensations in relation to general anxiety, depression and physical health in patients referred to specialized cardio-genetics outpatient clinics in Norway for genetic investigation and counseling. Methods Participants were 126 patients (mean age 45 years, 53.5% women. All patients were at higher risk than the average person for serious arrhythmias and sudden cardiac death (SCD because of a personal or a family history of an inherited cardiac disorder (familial long QT syndrome or hypertrophic cardiomyopathy. Patients filled in, Hospital Anxiety and Depression Scale, Short-Form 36 Health Survey, and Cardiac Anxiety Questionnaire, two weeks before the scheduled counseling session. Results The patients experienced higher levels of general anxiety than expected in the general population (mean difference 1.1 (p Conclusion Avoidance and fear may be potentially modifiable symptoms. Because these distinct symptoms may have important roles in determining general anxiety, depression and physical health in at-risk individuals of inherited cardiac disorders, the present findings may have implications for the further development of genetic counseling for this patient group.

  10. Vision Loss, Sudden

    Science.gov (United States)

    ... of age-related macular degeneration. Spotlight on Aging: Vision Loss in Older People Most commonly, vision loss ... Some Causes and Features of Sudden Loss of Vision Cause Common Features* Tests Sudden loss of vision ...

  11. 外显子组测序对1例青壮年猝死的分子遗传学分析%Molecular Genetic Analysis of One Sudden Unexplained Death in the Young by Whole Exome Sequencing

    Institute of Scientific and Technical Information of China (English)

    王纯; 王辉; 许心舒; 许传超; 赖小平; 陈锐; 林汉光; 邱升元

    2015-01-01

    Objective To find the mutation of disease-causing genes of sudden unexplained death syn-drome (SU D S ) in the young by whole exome sequencing in one case. Methods O ne SU D S case was found no obvious fatal pathological changes after conventional autopsy and pathological examination. The whole exome sequencing was performed with the Ion Torrent PGMTM Systemwith hg19 as reference se-quence for sequencing data. The functions of mutations were analyzed by PhyloP, PolyPhen2 and SIFT. A three-step bioinformatics filtering procedure was carried out to identify possible significative single nu-cleotide variation (SN V ), which was missense mutation with allele frequency <1% of myocardial cell. Results Four rare suspicious pathogenic SN V were identified. C ombined with the analysis of convention-al autopsy and pathological examination, the mutation MYOM 2 (8_2054058_G/A ) was assessed as high-risk deleterious mutation by PolyPhen2 and SIFT, respectively. Conclusion Based on the second genera-tion sequencing technology, analysis of whole exome sequencing can be a newmethod for the death cause investigation of SU D S. The gene MYOM2 is a newcandidate SU D S pathogenic gene for mecha-nismresearch.%目的:以1例青壮年不明原因猝死综合征(sudden unexplained death syndrome,SUDS)案例为研究对象,采用全外显子组测序技术,在全外显子组水平寻找与SUDS相关的致病基因突变。方法对1例常规尸体解剖及病理学检验未发现明显致死性病理改变的SUDS病例样本,利用Ion Torrent PGMTM系统进行全外显子组测序。测序数据以hg19为参照序列,并通过PhyloP、PolyPhen2、SIFT等软件进行突变功能分析。最后设置三重条件过滤筛选有意义的单核苷酸变异:选取错义突变-等位基因频率<1%-蛋白质功能预测。结果共发现4个罕见的可疑致病性单核苷酸变异。结合尸体解剖及病理学检验的结果,确定1个“高危害性”突变MYOM2(8

  12. 76 FR 23449 - Citrus Canker, Citrus Greening, and Asian Citrus Psyllid; Interstate Movement of Regulated...

    Science.gov (United States)

    2011-04-27

    ... to movement. Citrus canker is a plant disease that is caused by the bacterium Xanthomonas citri subsp... quarantined for citrus canker are found in Sec. 301.75-6. Citrus greening, also known as Huanglongbing disease of citrus, is considered to be one of the most serious citrus diseases in the world. Citrus...

  13. 78 FR 63369 - Citrus Canker, Citrus Greening, and Asian Citrus Psyllid; Interstate Movement of Regulated...

    Science.gov (United States)

    2013-10-24

    ... citrus canker are found in Sec. 301.75-6. Citrus greening, also known as Huanglongbing disease of citrus, is considered to be one of the most serious citrus diseases in the world. Citrus greening is a... areas of the world where the disease is endemic, citrus trees decline and die within a few years and...

  14. Cardiomiopatia hipertrófica: importância dos eventos arrítmicos em pacientes com risco de morte súbita Hypertrophic cardiomyopathy: the importance of arrhythmic events in patients at risk for sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Jorge Medeiros

    2006-11-01

    ística supraventricular; 2- síncopes recorrentes na minoria dos pacientes (16%, que, entretanto, não se associaram à presença de eventos arrítmicos; 3- presença de septo interventricular superior a 30 mm, ao ecocardiograma, se associou à ocorrência de terapia de choque precoce (p = 0,003; 4- ausência de preditores clínicos ou funcionais.OBJECTIVE: It is controversial the correlation between complex ventricular arrhythmia of hypertrophic cardiomyopathy and cardiac sudden death (CSD. In patients with hypertrophic cardiomyopathy and at risk for CSD that have been undergone implantable cardioverter-defibrillator (ICD implantation, we evaluated: a- occurrence of arrhythmic events; b- clinical event occurrence and its correlation with arrhythmic events; c- ICD shock therapy occurrence and clinical-functional correlation; d- prognosis clinical-functional predictors. METHODS: Twenty-six patients have been studied. They presented hypertrophic cardiomyopathy and risk factors for CSD. These patients underwent ICD implantation, period May, 2000 through January, 2004 (average follow-up - 19 months. Fourteen patients (53.8% were female and the mean age was 42.7. Sixteen patients (61.5% ICD was performed due to primary prevention for sudden death and ten (38.5% secondary prevention. Twenty patients (76.9% had had syncope, previus to ICD implantation, half of them associated with ventricular fibrillation or sustained ventricular tachycardia; 15 had had family sudden death; 12 patients (46.2% presented non-sustained ventricular tachycardia at 24-hour Holter and 5 (19.2% showed the ventricular septum thickness larger than 30 mm. RESULTS: During the follow-up, 4 shocks therapy were recorded by ICD in potentially lethal arrythmias (3 sustained ventricular tachycardia and 1 ventricular fibrillation. There was one death, due to likely stroke. Four patients had syncope recurrence, with no arrhythmic event recorded by ICD. The statistical analysis has showed precocity significance of ICD shock, in

  15. Sudden Death Due to Undiagnosed Wilkie Syndrome.

    Science.gov (United States)

    Baber, Yeliena Fay; OʼDonnell, Chris

    2016-06-01

    A 56-year-old transgender woman with mitochondrial encephalomyopathy, lactic acidosis, and strokelike episodes syndrome and diabetes presented to hospital with headaches and experiencing with malnutrition. She was agitated and refused medical and physical assistance. Soon after admission, she started to vomit and developed abdominal pain, becoming rapidly unresponsive on the ward after attending the radiology department, and was pronounced deceased. Autopsy revealed a cachectic transgender woman with a grossly distended stomach and proximal duodenum containing 2 L of liquid. The postmortem computed tomography scan showed compression of the duodenum by the superior mesenteric artery, diagnostic of Wilkie syndrome. Superior mesenteric artery syndrome, or Wilkie syndrome, was first described in 1861 by Von Rokitansky. It is an uncommon but well-recognized clinical entity characterized by compression of the third, or transverse, portion of the duodenum between the aorta and the superior mesenteric artery. This results in chronic, intermittent, or acute complete or partial duodenal obstruction. It is a well-recognized complication of anorexia. PMID:26963629

  16. Morphological diagnosis of sudden cardiac death

    DEFF Research Database (Denmark)

    Hougen, H P; Valenzuela, Antonio Jesus Sanchez; Villanueva, E;

    1989-01-01

    The study reveals preliminary results of a bilateral project involving the Institute of Forensic Medicine, University of Copenhagen (Denmark) and the Institute of Legal Medicine, University of Granada (Spain). Morphological findings were compared to the results of thanatochemical analyses of peri...

  17. Hábitos de sono relacionados à síndrome da morte súbita do lactente: estudo populacional Sleeping habits related to sudden infant death syndrome: a population-based study

    Directory of Open Access Journals (Sweden)

    Lorena Teresinha Consalter Geib

    2006-02-01

    Full Text Available O estudo transversal, que descreve os hábitos de sono com risco potencial para a síndrome da morte súbita do lactente, incluiu todas as crianças nascidas vivas em 2003, em Passo Fundo, Rio Grande do Sul, Brasil, com coleta de dados nas Declarações de Nascidos Vivos e em entrevistas, analisados com estatística descritiva e teste de qui-quadrado. Dos 2.634 nascidos vivos, selecionaram-se 2.285 (86,75%, com exclusão de 8,4% e perda de 5,2%. Dentre os hábitos protetores, constatou-se, em 77% dos lactentes, uso de vestuário adequado, 90% envolvidos frouxamente, 69% com cobertas de espessura fina, 98% dormindo no quarto dos pais e 56%, no berço. Dos hábitos com potencial risco, observaram-se decúbito lateral (92%, uso de travesseiro (88% e os pés distanciados da borda inferior do berço (96%. Nas classes econômicas pobres, o hábito da criança de compartilhar a cama foi significativo (p = 0,00. Assim, num município com baixa prevalência de síndrome da morte súbita, os lactentes são expostos tanto a hábitos de sono protetores como de risco, sugerindo que, em populações desfavorecidas de países em desenvolvimento, outros fatores de risco dessa síndrome devam ser considerados.This cross-sectional study on sleeping habits with potential risk for sudden infant death syndrome included all live births in Passo Fundo, Rio Grande do Sul, Brazil, in 2003 with data collection from Certificates of Live Birth and interviews, analyzed with descriptive statistics and the qui-squared test. From the 2,634 live births, 2,285 children were selected (86.75%, with 8.4% exclusion and 5.2% losses. Protective habits included 77% of infants with appropriate clothing, 90% loosely wrapped, 69% with thin blankets, 98% sleeping in the parents' bedroom, and 56% in the crib. Potentially risky habits included lateral decubitus (92%, use of a pillow (88%, and feet far from the lower edge of the crib (96%. Among low-income families, bed-sharing with other

  18. Causes of Death in Athletes

    Directory of Open Access Journals (Sweden)

    A.L. Khodasevich

    2012-06-01

    Full Text Available The literature survey, concerning the causes of death in athletes, contains traumas, doping and cardiac pathology. The article presents clinicopathologic characteristics of different forms of cardiac pathologies, causing sudden death in athletes.

  19. Miocardiopatía hipertrófica como causa de muerte súbita en una mujer joven Hypertrophic cardiomyopathy presenting as sudden death in a young woman

    Directory of Open Access Journals (Sweden)

    A. Rico

    2007-01-01

    Full Text Available La miocardiopatía hipertrófica (MCH es una enfermedad genética muy heterogénea, con múltiples loci, identificándose para cada gen múltiples mutaciones. Está considerada en Estados Unidos la causa más frecuente de muerte súbita (MS en jóvenes, fundamentalmente atletas, siendo en ocasiones la primera manifestación de la enfermedad. La MCH se caracteriza morfológicamente por una hipertrofia asimétrica del ventrículo izquierdo y/o derecho con un patrón histopatológico caracterizado por desestructuración ("disarray" de los miocardiocitos en una matriz de tejido conectivo prominente así como hipertrofia de la íntima de las arterias coronarias intramurales. Se expone el caso de una mujer joven, de 25 años, diagnosticada clínicamente y con antecedentes familiares de MS por MCH en su madre, que presentó una MS mientras dormía.Hypertrophic cardiomyopathy (HCM is a genetic and very heterogeneous disease with multiple loci, and with several mutations identified for every gene. In USA, it is regarded as the most common cause of sudden death (SD in young people (mainly athletes, and occasionally SD is the initial presentation of the disease. HCM is morphologically characterized by an asymmetric hypertrophy of left and/or right ventricle with a histopathological pattern of cardiac myocytes dearrangement in a prominent connective tissue matrix, as well as intimal hypertrophy of intramural coronary arteries. In this paper, we present the case of a 25 year-old woman, clinically diagnosed with HCM, and with family history of HCM in her mother, who experienced a SD while sleeping.

  20. Value of MRI in predicting sudden cardiac death in patients with ischemic cardiomyopathy%MRI预测缺血性心肌病患者并发心源性猝死的价值

    Institute of Scientific and Technical Information of China (English)

    林长坚; 金奇; 吴立群

    2011-01-01

    @@ 冠心病是心源性猝死(sudden cardiac death,SCD)者最常见的病因,所占百分率可达80%[1].由冠心病导致心肌瘢痕形成的缺血性心肌病患者,其SCD发生率明显升高[2-3].射血分数降低是此类患者发生SCD的重要预测因子,但该指标仍缺乏较高的特异度及灵敏度[4].目前,SCD的预测主要围绕心肌电不稳定机制展开,包括T波电交替、心率振荡和心率变异性等[5].但对于缺血性心肌病患者产生心肌电不稳定的病理基质,如心肌瘢痕、瘢痕边缘区的检测,同样能提供有效的预测价值.近年来迅速发展的心脏磁共振(cardiac magnetic resonance,CMR)技术具有很高的组织分辨率和无创性等优点,可显示缺血性心肌病患者的心肌瘢痕及瘢痕边缘区,有助于SCD的危险分层及预测.

  1. Ethical Significance of Health Education Intervention for Subhealth from the Cases of World Celebrities' Sudden Death%从世界名人猝死谈开展亚健康教育干预的伦理学意义

    Institute of Scientific and Technical Information of China (English)

    阮伟清; 廖生武

    2013-01-01

    Through the analysis on the cases of world celebrities'sudden death which happened over and over again, this paper considered that the main reason was the physical and mental health problems, and on this basis, the deeply thinking on the health education on subhealth was carried out by using the health ethics related knowledge. The authors proposed that the health education is the prevention of disease, and is the promotion of the the healthy development. The ethical significance of health education is helping the individual to develop health, is the necessary means to build the healthy society, is the inevitable outcome of the development of medical science, it is helpful to control the medical behavior of monopoly and improve the doctor - patient relationship.%通过对一再发生的世界名人猝死的现象进行分析,认为其主要原因在于身心健康问题,并在此基础上引用健康伦理学的相关知识对开展亚健康教育进行了深层次地思考,指出亚健康教育是预防疾病、促进健康的科学,开展亚健康教育的伦理学意义在于其是帮助个体实现健康发展的有效渠道;是构建健康型社会的必要手段;是医学科学发展的必然结果;有利于控制医疗行为的垄断,改善医患关系.

  2. 大学生体育活动猝死纠纷案件解决机制探究%The Dispute Case of College Students' Sudden Death in Sports Activities and its Settlement Mechanism

    Institute of Scientific and Technical Information of China (English)

    潘昌盛

    2016-01-01

    The dispute case of college students' sudden death in sports activities occurs when there are great differences between the demands of the students' parents and the cognizance of the organizers of sports activities over their responsibility bearing and their compensation amount .These great differences between the parties in the dispute case root in the lack of legal provisions and the lack of social consensus on the issue in China .Such cases occur frequently at present .It triggers a series of negative social issues in China .The keys to solve this kind of case lie in that the responsibility subject should be clearer in legal provisions ,the liability amount should be made more detailed ,and the subjectivity of the judicial path should be fully exploited in practice.%大学生体育活动猝死纠纷案件的发生,在于学生家长的诉求与体育活动举办方在责任承担和赔偿数额认定上的巨大分歧.案件各方分歧,根源于法律规定的缺失和社会在该问题上的共识缺位.此类案件频繁发生,引发了一系列社会负面问题.解决此类案件的关键在于,责任主体和责任额度要更加明细化,司法路径的主体性要得到充分的发挥.

  3. Exome Sequencing Identifies a Novel LMNA Splice-Site Mutation and Multigenic Heterozygosity of Potential Modifiers in a Family with Sick Sinus Syndrome, Dilated Cardiomyopathy, and Sudden Cardiac Death.

    Science.gov (United States)

    Zaragoza, Michael V; Fung, Lianna; Jensen, Ember; Oh, Frances; Cung, Katherine; McCarthy, Linda A; Tran, Christine K; Hoang, Van; Hakim, Simin A; Grosberg, Anna

    2016-01-01

    The goals are to understand the primary genetic mechanisms that cause Sick Sinus Syndrome and to identify potential modifiers that may result in intrafamilial variability within a multigenerational family. The proband is a 63-year-old male with a family history of individuals (>10) with sinus node dysfunction, ventricular arrhythmia, cardiomyopathy, heart failure, and sudden death. We used exome sequencing of a single individual to identify a novel LMNA mutation and demonstrated the importance of Sanger validation and family studies when evaluating candidates. After initial single-gene studies were negative, we conducted exome sequencing for the proband which produced 9 gigabases of sequencing data. Bioinformatics analysis showed 94% of the reads mapped to the reference and identified 128,563 unique variants with 108,795 (85%) located in 16,319 genes of 19,056 target genes. We discovered multiple variants in known arrhythmia, cardiomyopathy, or ion channel associated genes that may serve as potential modifiers in disease expression. To identify candidate mutations, we focused on ~2,000 variants located in 237 genes of 283 known arrhythmia, cardiomyopathy, or ion channel associated genes. We filtered the candidates to 41 variants in 33 genes using zygosity, protein impact, database searches, and clinical association. Only 21 of 41 (51%) variants were validated by Sanger sequencing. We selected nine confirmed variants with minor allele frequencies G, a novel heterozygous splice-site mutation as the primary mutation with rare or novel variants in HCN4, MYBPC3, PKP4, TMPO, TTN, DMPK and KCNJ10 as potential modifiers and a mechanism consistent with haploinsufficiency.

  4. Exome Sequencing Identifies a Novel LMNA Splice-Site Mutation and Multigenic Heterozygosity of Potential Modifiers in a Family with Sick Sinus Syndrome, Dilated Cardiomyopathy, and Sudden Cardiac Death.

    Directory of Open Access Journals (Sweden)

    Michael V Zaragoza

    Full Text Available The goals are to understand the primary genetic mechanisms that cause Sick Sinus Syndrome and to identify potential modifiers that may result in intrafamilial variability within a multigenerational family. The proband is a 63-year-old male with a family history of individuals (>10 with sinus node dysfunction, ventricular arrhythmia, cardiomyopathy, heart failure, and sudden death. We used exome sequencing of a single individual to identify a novel LMNA mutation and demonstrated the importance of Sanger validation and family studies when evaluating candidates. After initial single-gene studies were negative, we conducted exome sequencing for the proband which produced 9 gigabases of sequencing data. Bioinformatics analysis showed 94% of the reads mapped to the reference and identified 128,563 unique variants with 108,795 (85% located in 16,319 genes of 19,056 target genes. We discovered multiple variants in known arrhythmia, cardiomyopathy, or ion channel associated genes that may serve as potential modifiers in disease expression. To identify candidate mutations, we focused on ~2,000 variants located in 237 genes of 283 known arrhythmia, cardiomyopathy, or ion channel associated genes. We filtered the candidates to 41 variants in 33 genes using zygosity, protein impact, database searches, and clinical association. Only 21 of 41 (51% variants were validated by Sanger sequencing. We selected nine confirmed variants with minor allele frequencies G, a novel heterozygous splice-site mutation as the primary mutation with rare or novel variants in HCN4, MYBPC3, PKP4, TMPO, TTN, DMPK and KCNJ10 as potential modifiers and a mechanism consistent with haploinsufficiency.

  5. Identification and Functional Characterization of a Novel CACNA1C-Mediated Cardiac Disorder Characterized by Prolonged QT Intervals with Hypertrophic Cardiomyopathy, Congenital Heart Defects, and Sudden Cardiac Death

    Science.gov (United States)

    Boczek, Nicole J.; Ye, Dan; Jin, Fang; Tester, David J.; Huseby, April; Bos, J. Martijn; Johnson, Aaron J.; Kanter, Ronald; Ackerman, Michael J.

    2016-01-01

    Background A portion of sudden cardiac deaths (SCD) can be attributed to structural heart diseases such as hypertrophic cardiomyopathy (HCM) or cardiac channelopathies such as long QT syndrome (LQTS); however, the underlying molecular mechanisms are quite distinct. Here, we identify a novel CACNA1C missense mutation with mixed loss-of-function/gain-of-function responsible for a complex phenotype of LQTS, HCM, SCD, and congenital heart defects (CHDs). Methods and Results Whole exome sequencing (WES) in combination with Ingenuity Variant Analysis was completed on three affected individuals and one unaffected individual from a large pedigree with concomitant LQTS, HCM, and CHDs and identified a novel CACNA1C mutation, p.Arg518Cys, as the most likely candidate mutation. Mutational analysis of exon 12 of CACNA1C was completed on 5 additional patients with a similar phenotype of LQTS plus a personal or family history of HCM-like phenotypes, and identified two additional pedigrees with mutations at the same position, p.Arg518Cys/His. Whole cell patch clamp technique was used to assess the electrophysiological effects of the identified mutations in CaV1.2, and revealed a complex phenotype, including loss of current density and inactivation in combination with increased window and late current. Conclusions Through WES and expanded cohort screening, we identified a novel genetic substrate p.Arg518Cys/His-CACNA1C, in patients with a complex phenotype including LQTS, HCM, and CHDs annotated as cardiac-only Timothy syndrome. Our electrophysiological studies, identification of mutations at the same amino acid position in multiple pedigrees, and co-segregation with disease in these pedigrees provides evidence that p.Arg518Cys/His is the pathogenic substrate for the observed phenotype. PMID:26253506

  6. Bed-sharing in the absence of hazardous circumstances: is there a risk of sudden infant death syndrome? An analysis from two case-control studies conducted in the UK.

    Directory of Open Access Journals (Sweden)

    Peter S Blair

    Full Text Available OBJECTIVE: The risk of sudden infant death syndrome (SIDS among infants who co-sleep in the absence of hazardous circumstances is unclear and needs to be quantified. DESIGN: Combined individual-analysis of two population-based case-control studies of SIDS infants and controls comparable for age and time of last sleep. SETTING: Parents of 400 SIDS infants and 1386 controls provided information from five English health regions between 1993-6 (population: 17.7 million and one of these regions between 2003-6 (population:4.9 million. RESULTS: Over a third of SIDS infants (36% were found co-sleeping with an adult at the time of death compared to 15% of control infants after the reference sleep (multivariate OR = 3.9 [95% CI: 2.7-5.6]. The multivariable risk associated with co-sleeping on a sofa (OR = 18.3 [95% CI: 7.1-47.4] or next to a parent who drank more than two units of alcohol (OR = 18.3 [95% CI: 7.7-43.5] was very high and significant for infants of all ages. The risk associated with co-sleeping next to someone who smoked was significant for infants under 3 months old (OR = 8.9 [95% CI: 5.3-15.1] but not for older infants (OR = 1.4 [95% CI: 0.7-2.8]. The multivariable risk associated with bed-sharing in the absence of these hazards was not significant overall (OR = 1.1 [95% CI: 0.6-2.0], for infants less than 3 months old (OR = 1.6 [95% CI: 0.96-2.7], and was in the direction of protection for older infants (OR = 0.1 [95% CI: 0.01-0.5]. Dummy use was associated with a lower risk of SIDS only among co-sleepers and prone sleeping was a higher risk only among infants sleeping alone. CONCLUSION: These findings support a public health strategy that underlines specific hazardous co-sleeping environments parents should avoid. Sofa-sharing is not a safe alternative to bed-sharing and bed-sharing should be avoided if parents consume alcohol, smoke or take drugs or if the infant is pre-term.

  7. Utilidad de la determinación de la fracción I de la Troponina cardíaca (cTnI, en el diagnóstico de la muerte súbita de origen cardíaco en autopsias forenses Usefulness of cardiac troponin I (cTnI in the diagnosis of sudden cardiac death in forensic autopsies

    Directory of Open Access Journals (Sweden)

    E. Navarro

    2007-07-01

    Full Text Available Objetives: To evaluate practical usefulness of cardiac Troponin analysis (cTnI in peripheral blood levels, in order to improve diagnosis of sudden cardiac death in routine forensic cases. Comparing these levels with Myoglobin and MB-CK blood levels in the same type of samples. Material and methods: We have studied 97 medico legal autopsies performed in the Pathology Service of the Institute of Legal Medicine (Alicante. In every case we analyzed sample of serum from peripheral blood (femoral, by Microparticle Enzyme Immunoassay (MEIA Axsym system (Abbott Diagnostics. Causes of death were classified into 6 groups according: 1 Death of cardiac origin (n=42; 2 Traumatic deaths (n=19; 3 Death by asphyxia (n=12; 4 Natural deaths of non-cardiac origin (n=8; 5 Miscellaneous group (n=6, and 6 Traumatic death with Thoracic trauma (n=10. Data was analysed by means of SPSS 14.0 statistical software program (SPSS Inc, 2005. Results: cTnI levels were significantly high in cases of sudden cardiac death, but it were also high in the group of thoracic trauma, which could raise diagnosis problems between these groups, as was shown previously in the literature. Conclusions: The determination of cTnI is more efficient than CKMB and Myoglobine in the diagnosis of sudden cardiac death. However, the elevation of mean levels of this marker in cases of severe thoracic traumatism limits its diagnostic usefulness in these situations.

  8. Surface Electrocardiogram Predictors of Sudden Cardiac Arrest

    Science.gov (United States)

    Abdelghani, Samy A.; Rosenthal, Todd M.; Morin, Daniel P.

    2016-01-01

    Background: Heart disease is a major cause of death in industrialized nations, with approximately 50% of these deaths attributable to sudden cardiac arrest. If patients at high risk for sudden cardiac arrest can be identified, their odds of surviving fatal arrhythmias can be significantly improved through prophylactic implantable cardioverter defibrillator placement. This review summarizes the current knowledge pertaining to surface electrocardiogram (ECG) predictors of sudden cardiac arrest. Methods: We conducted a literature review focused on methods of predicting sudden cardiac arrest through noninvasive electrocardiographic testing. Results: Several electrocardiographic-based methods of risk stratification of sudden cardiac arrest have been studied, including QT prolongation, QRS duration, fragmented QRS complexes, early repolarization, Holter monitoring, heart rate variability, heart rate turbulence, signal-averaged ECG, T wave alternans, and T-peak to T-end. These ECG findings have shown variable effectiveness as screening tools. Conclusion: At this time, no individual ECG finding has been found to be able to adequately stratify patients with regard to risk for sudden cardiac arrest. However, one or more of these candidate surface ECG parameters may become useful components of future multifactorial risk stratification calculators. PMID:27660578

  9. 76 FR 8603 - Citrus Seed Imports; Citrus Greening and Citrus Variegated Chlorosis

    Science.gov (United States)

    2011-02-15

    ... disease of citrus and referred to below as HLB) is considered to be one of the most serious citrus... world where the disease is endemic, citrus trees decline and die within a few years and may never.... Manjunath. Asian Citrus Psyllids (Sternorrhyncha: Psyllidae) and Greening Disease of Citrus: A...

  10. “足球运动猝死”国外研究进展%Progress in the research of foreign literature for Sudden Cardiac Death (SCD)in soccer

    Institute of Scientific and Technical Information of China (English)

    刘宇; 陈钢

    2016-01-01

    Several soccer players died during games in recent years,which has triggered the academ-ic controversy on whether soccer is a high risk of sudden cardiac death sports event.By taking this as an entry point,the authors studied the foreign literature and found that SCD in the field of soccer has age and gender tendency;Inducement such as CAD and HCM,athlete heart and cardiac remod-eling,cardiac shock,taking and abuse of illicit drugs is the principal cause of SCD.The main measures to avoid and prevent SCD include primary screening,medical assessment by means of clin-ical preventive medicine and setting up specialized sports registration agencies for targeted SCD po-tential population.At present,there is no evidence that soccer is an event of high risk to induce SCD.%近年来,数名球员猝死足球赛场,引发了足球运动是否是一项高度诱发心脏性猝死的运动项目的学术争议。以此为研究切入点,通过对外文文献资料进行整理研究发现:足球运动领域的心脏性猝死存在年龄和性别倾向;冠状动脉疾病和肥大型心肌病、运动员式心脏和心脏重塑、心脏震荡、服用和滥用违禁药品是心脏性猝死的主要诱因;规避和预防心脏性猝死的主要措施包括:预选筛查、运用现场临床医学预防手段进行医疗评估和在全国范围内针对潜在人群设立专门的运动人口登记注册机构。目前,尚无研究证明足球运动是一项诱发心脏性猝死的高风险的运动。

  11. The receptor like kinase at Rhg1-a/Rfs2 caused pleiotropic resistance to sudden death syndrome and soybean cyst nematode as a transgene by altering signaling responses

    Directory of Open Access Journals (Sweden)

    Srour Ali

    2012-08-01

    Full Text Available Abstract Background Soybean (Glycine max (L. Merr. resistance to any population of Heterodera glycines (I., or Fusarium virguliforme (Akoi, O’Donnell, Homma & Lattanzi required a functional allele at Rhg1/Rfs2. H. glycines, the soybean cyst nematode (SCN was an ancient, endemic, pest of soybean whereas F. virguliforme causal agent of sudden death syndrome (SDS, was a recent, regional, pest. This study examined the role of a receptor like kinase (RLK GmRLK18-1 (gene model Glyma_18_02680 at 1,071 kbp on chromosome 18 of the genome sequence within the Rhg1/Rfs2 locus in causing resistance to SCN and SDS. Results A BAC (B73p06 encompassing the Rhg1/Rfs2 locus was sequenced from a resistant cultivar and compared to the sequences of two susceptible cultivars from which 800 SNPs were found. Sequence alignments inferred that the resistance allele was an introgressed region of about 59 kbp at the center of which the GmRLK18-1 was the most polymorphic gene and encoded protein. Analyses were made of plants that were either heterozygous at, or transgenic (and so hemizygous at a new location with, the resistance allele of GmRLK18-1. Those plants infested with either H. glycines or F. virguliforme showed that the allele for resistance was dominant. In the absence of Rhg4 the GmRLK18-1 was sufficient to confer nearly complete resistance to both root and leaf symptoms of SDS caused by F. virguliforme and provided partial resistance to three different populations of nematodes (mature female cysts were reduced by 30–50%. In the presence of Rhg4 the plants with the transgene were nearly classed as fully resistant to SCN (females reduced to 11% of the susceptible control as well as SDS. A reduction in the rate of early seedling root development was also shown to be caused by the resistance allele of the GmRLK18-1. Field trials of transgenic plants showed an increase in foliar susceptibility to insect herbivory. Conclusions The inference that soybean has

  12. PHARMACOLOGICAL IMPORTANCE OF CITRUS FRUITS

    OpenAIRE

    Amita Tomar *, Mridula Mall and Pragya Rai

    2013-01-01

    This paper reviews the pharmacological importance of citrus fruits. Citrus fruits are used for various pharmacological importance. According to literature the citrus fruit possess anti-cancer, antimicrobial, antioxidant, antiulcer, anti-inflammatory, and hypolipidemic and hepatoprotective properties.

  13. Patología coronaria no arteriosclerótica como causa de muerte súbita en adultos: Casuística del Instituto de Medicina Legal de Valencia (1997-2005 Nonatherosclerotic coronary artery disease presenting as sudden death in adults: Casuistic from the Institute of Legal Medicine of Valencia (Spain (1997-2005

    Directory of Open Access Journals (Sweden)

    F. Carratalá Calvo

    2005-10-01

    Full Text Available Introducción y objetivos. En los países industrializados, la causa más frecuente de muerte súbita cardíaca (MSC en el adulto es la isquemia miocárdica aguda por arterioesclerosis coronaria. Sin embargo, existen otras patologías coronarias, congénitas o adquiridas, que pueden producir isquemia miocárdica y muerte súbita: origen anómalo, hipoplasia, estenosis del ostium, aneurisma, disección, localización alta del ostium, puente miocárdico, vasculitis. El objetivo del presente trabajo es revisar la casuística de este tipo de patología coronaria no arterioesclerótica en las 8003 autopsias realizadas en el Instituto de Medicina Legal de Valencia (IMLV entre los años 1997-2005. Método: Los criterios de inclusión de los casos para este estudio han sido: edad superior a 14 años, patología coronaria no arterioesclerótica como causa de muerte y circunstancias de la muerte compatibles con la definición de muerte súbita. Resultados: Se han encontrado 9 casos de muerte súbita en adultos con patología coronaria no arterioesclerótica como causa de muerte: 2 casos de puente miocárdico, 6 casos de disección coronaria y 1 caso de origen anómalo de coronaria. Conclusiones: La patología coronaria no arterioesclerótica, aunque es poco frecuente como causa de MSC, debemos conocerla y poder diagnosticarla macroscópicamente en la sala de autopsias. Siempre debe descartarse otra posible causa de muerte mediante los estudios complementarios químico-toxicológicos e histopatológicos. Es importante conseguir la máxima información clínica anterior al fallecimiento que pueda ayudar al diagnóstico en vida de este tipo de patologías, ya que en la mayoría de los casos sigue siendo un hallazgo postmortem.Introduction and objectives. Coronary atherosclerosis is the most frequent cause of acute myocardial ischemia and sudden cardiac death in industrialized countries. However, there are others diseases, congenital or acquired, that can

  14. Citrus Waste Biomass Program

    Energy Technology Data Exchange (ETDEWEB)

    Karel Grohman; Scott Stevenson

    2007-01-30

    Renewable Spirits is developing an innovative pilot plant bio-refinery to establish the commercial viability of ehtanol production utilizing a processing waste from citrus juice production. A novel process based on enzymatic hydrolysis of citrus processing waste and fermentation of resulting sugars to ethanol by yeasts was successfully developed in collaboration with a CRADA partner, USDA/ARS Citrus and Subtropical Products Laboratory. The process was also successfully scaled up from laboratory scale to 10,000 gal fermentor level.

  15. Geomagnetic Storm Sudden Commencements

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Storm Sudden Commencements (ssc) 1868 to present: STORM1 and STORM2 Lists: (Some text here is taken from the International Association of Geomagnetism and Aeronomy...

  16. Sudden Cardiac Arrest

    Science.gov (United States)

    ... Heart Risk Factors & Prevention Heart Diseases & Disorders Atrial Fibrillation (AFib) Sudden Cardiac Arrest (SCA) SCA: Who's At Risk? Prevention of SCA What Causes SCA? SCA Awareness Atrial Flutter Heart Block Heart Failure Sick Sinus Syndrome Substances & Heart Rhythm Disorders Symptoms & ...

  17. Sudden Ionospheric Disturbances (SID)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Sudden ionospheric disturbances (SID) are caused by solar flare enhanced X-rays in the 1 to 10 angstrom range. Solar flares can produce large increases of...

  18. Hemoperitoneo masivo consecutivo a perforación espontánea de la vesícula biliar: A propósito de un caso de muerte súbita Massive haemoperitoneum as a complication of spontaneous rupture of the gallbladder: Report of a sudden death

    Directory of Open Access Journals (Sweden)

    P.M. Garamendi

    2002-04-01

    Full Text Available Se presenta un caso de hemoperitoneo masivo consecutivo a perforación espontánea de la vesícula biliar asociada con colelitiasis, obstrucción del conducto cístico y colecistitis aguda hemorrágica que produjo como primera manifestación la muerte súbita en un varón adulto. En la literatura médica este tipo de situación clínica y anatomopatológica es excepcional. Los casos descritos de perforaciones espontáneas de la vesícula biliar con hemoperitoneo asociado son menos de 50 desde 1858. Desde 1952 solo existe otra referencia de 1991 de un hallazgo similar, aunque no asociado a colelitiasis, como causa de muerte súbita.We report a case of sudden death due to massive haemoperitoneum as a complication of spontaneous rupture of the gallbladder associated with cholelithiasis, obstruction of the cystic duct and acute haemorrhagic cholecystitis. Death occurred in an adult male previously asymptomatic. This is an unusual circumstance in the medical literature. Since 1858, less than 50 cases of spontaneous rupture of the gallbladder associated with haemoperitoneum have been reported. Since 1952, there is only one other case of sudden death with this clinical condition, reported in 1991, but not associated with cholelithiasis.

  19. Antimutagenicity and Anticancer Effects of Citrus Medica Fruit Juice

    Directory of Open Access Journals (Sweden)

    Majd Ahmad

    2009-10-01

    Full Text Available Currently cancer is considered as one of the main factors of mortality globally. Many chemicals in our environment can cause genetic mutations and are potentially responsible for millions of cancer-related deaths. Nowadays the scientists are looking for food materials which can potenthially prevent the cancer occurrence. The purpose of this research is to examine antimutagenicity and anticancer effect of Citrus Medica fruit juice.In present study human astrocytoma cancer cells were cultured in DMEM (Gibco,supplemented with 10% fetal calf serum,peniciline-streptomycin,L-glutamine and incubated at 37 ºC for 2 days.In addition cancer cell line were treated by half-ripe and ripe Citrus Medica fruit juice and cellular vital capacity was determined by MTT. The Citrus Medica fruit juice was subsequenthy evaluated in terms of antimutagenicity and anticancer properties by a standard reverse mutation assay (Ames Test. This was performed with histidine auxotroph strain of Salmonella typhimurium (TA100 .Thus, it requires histidine from a foreign supply to ensure its growth.The aforementioned strain gives rise to reverted colonies when expose to carcinogen substance (Sodium Azide. During MTT, human astrocytoma cell line revealed to have a meaningful cell death when compared with controls (P<0.01. In Ames Test the fruit juice prevented the reverted mutations and the hindrance percent of half-ripe Citrus Medica was 71.7% and ripe Citrus Medica was 34.4% in antimutagenicity test and this value in anticancer test was 83.3% and 50% in half-ripe Citrus Medica and ripe Citrus Medica respectively.This is the first study that have revealed antimutagenicity and anticancer effect of Citrus Medica fruit juice and the effects were higher in half-ripe Citrus Medica in comparison to the riprned one.

  20. Cercosporoid diseases of Citrus.

    Science.gov (United States)

    Huang, Feng; Groenewald, J Z; Zhu, Li; Crous, P W; Li, Hongye

    2015-01-01

    Citrus leaves and fruits exhibiting disease symptoms ranging from greasy spot, yellow spot, small or large brown spot, black dot, and brown dot were sampled from Fujian, Guangdong, Guizhou, Hunan, Jiangxi, Yunnan, Zhejiang provinces and the Guangxi Zhuang Autonomous Region in China. In total 82 isolates representing various cercosporoid genera were isolated from these disease symptoms, which were supplemented with eight Citrus cercosporoid isolates collected from other countries. Based on a morphological and phylogenetic study using sequence data from the nuclear ribosomal DNA's ITS1-5.8S-ITS2 regions (ITS), and partial actin (act), β-tubulin (tub2), 28S nuclear ribosomal RNA (28S rDNA) and translation elongation factor 1-α (tef1) genes, these strains were placed in the following genera: Cercospora, Pallidocercospora, Passalora, Pseudocercospora, Verrucisporota and Zasmidium. All isolates tended to be sterile, except the Zasmidium isolates associated with citrus greasy spot-like symptoms, which subsequently were compared with phylogenetically similar isolates occurring on Citrus and other hosts elsewhere. From these results four Zasmidium species were recognized on Citrus, namely Z. indonesianum on Citrus in Indonesia, Z. fructicola and Z. fructigenum on Citrus in China and Z. citri-griseum, which appears to have a wide host range including Acacia, Citrus, Eucalyptus and Musa, as well as a global distribution.

  1. Facts on Sudden Infant Death Syndrome/Sudden Unexpected Infant Death (SIDS/SUID)

    Science.gov (United States)

    ... are pregnant and do not expose babies to second-hand smoke after they are born. New research also warns of the dangers of third-hand smoke, the chemicals left behind on clothing, in homes and in cars. • For sleep, use ...

  2. Sudden Unexpected Infant Death and Sudden Infant Death Syndrome: Reducing the Risk

    Science.gov (United States)

    ... Share Pregnancy and Infant Loss Support, Inc. Centering Corporation Creating a Safe Sleep Environment Learn more about ... PPT, MPEG) on this site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file ...

  3. Sudden Hearing Loss.

    Science.gov (United States)

    Vaughan, John C.

    1997-01-01

    Patients with a sudden dramatic decline in hearing usually require rapid diagnosis and treatment. Unfortunately, the treatment of this condition continues to be controversial and an exact etiology in most cases has been inconclusive. Nevertheless, physicians have reached a consensus regarding several broad principles, which are presented in this…

  4. Geodesics at Sudden Singularities

    CERN Document Server

    Barrow, John D

    2013-01-01

    We show that a general solution of the Einstein equations that describes approach to a sudden spacetime singularity does not experience geodesic incompleteness. This generalises the result established for isotropic and homogeneous universes. Further discussion of the weakness of the singularity is also included.

  5. Fuel from citrus waste

    Energy Technology Data Exchange (ETDEWEB)

    1979-08-01

    University of Florida researchers are looking for methods of using citrus peel to produce fuel for the citrus industry by using the methane gas given off in a special continuous digestion vessel. They are trying to discover ways to reduce the peel oil content of oranges as this oil inhibits the growth of organisms which produce the methane. The citrus industry currently utilizes orange peel and pulp to make cattle feed, but since the peel has to be dried this step consumes a lot of energy.

  6. Study on the relationship between the kaliopenia and sudden death of young and middle-aged population in Shenzhen City%深圳市青中年人群猝死与低钾血症相关性的研究

    Institute of Scientific and Technical Information of China (English)

    何崇辉; 张有猛; 邵斌; 曹玲; 陈亚想; 林小聪; 肖应林

    2014-01-01

    目的:研究分析深圳市青中年人群猝死与低钾血症的相关性,为此类人群防控措施的制定提供依据。方法于2012年5月~2013年11月选取深圳市青中年人1126例为研究对象,将其中各类心血管疾病发生率、猝死率及低血钾率进行统计及分析,同时对不同血钾水平者的各类心血管疾病发生率进行比较,并调查分析不同钾摄入情况者的各类心血管疾病发生率及猝死率,同时以Logistic分析处理低血钾与心血管疾病及猝死的关系。结果1126例青中年人中共有20例死亡,死亡率为1.78%,共有109例发生各类心血管疾病,发生率为9.68%,且低血钾者的各类心血管疾病发生率及总发生率均高于血钾正常者,而重度者则高于轻度与中度者,中度则高于轻度者,差异均具统计学意义(P均<0.05);钾摄入较低者的各类心血管疾病发生率及猝死率均高于钾摄入一般及钾摄入较高者,而钾摄入一般者则高于钾摄入较高者,且经Logistic分析处理低血钾与心血管疾病及猝死有密切的关系,差异均具统计学意义(P均<0.05)。结论深圳市青中年人群猝死与低钾血症有密切的关系,应重视对此类人群进行钾摄入。%Objective To study and analyze the relationship between the kaliopenia and sudden death of young and middle-aged population in Shenzhen City,in order to provide evidence for the prevention and control measures of those people. Methods 1 126 young and middle-aged population from May 2012 to November 2013 were the research object,and the various cardiovascular diseases rates,sudden death rate and kaliopenia rate were analyzed,then the various cardiovascular diseases rates of people with different blood potassium levels were compared,and the various cardiovascular diseases rates and sudden death rate of people with different potassium intake situation were investigate and analyzed,then the

  7. Citrus diseases with global ramifications including citrus canker and huanglongbing

    Science.gov (United States)

    Although there are a number of diseases that plague citrus production worldwide, two bacterial diseases are particularly problematic. Both are of Asian origin and currently cause severe economic damage: Asiatic citrus canker (ACC) and citrus huanglongbing (HLB). Although ACC has been found in the ...

  8. PHARMACOLOGICAL IMPORTANCE OF CITRUS FRUITS

    Directory of Open Access Journals (Sweden)

    Amita Tomar *, Mridula Mall and Pragya Rai

    2013-01-01

    Full Text Available This paper reviews the pharmacological importance of citrus fruits. Citrus fruits are used for various pharmacological importance. According to literature the citrus fruit possess anti-cancer, antimicrobial, antioxidant, antiulcer, anti-inflammatory, and hypolipidemic and hepatoprotective properties.

  9. Death and Death Anxiety

    OpenAIRE

    Gonca Karakus; Zehra Ozturk; Lut Tamam

    2012-01-01

    Although death and life concepts seem so different from each other, some believe that death and life as a whole that death is accepted as the goal of life and death completes life. In different cultures, societies and disciplines, there have been very different definitions of death which changes according to personality, age, religion and cultural status of the individual. Attitudes towards death vary dramatically according to individuals. As for the death anxiety, it is a feeling which start...

  10. The epidemiological analysis of patients in pre-hospital sudden cardiac death for our large and medium sized cities%我国大中城市院前心脏性猝死流行病学调查分析

    Institute of Scientific and Technical Information of China (English)

    张在其; 李金年; 林才经; 刘向; 陆家韬; 孟庆华; 宁哗; 裴雅春; 孙文会; 熊悦安; 张斌; 骆福添; 赵兴吉; 欧阳文伟; 陈文标; 陈玮莹; 郭彦池; 杨正飞; 黄子通; 陈兵; 陈锋; 公保才旦; 黄力; 柯俊; 赖欣; 李继良

    2010-01-01

    目的 调查我国大中城市院前心脏性猝死患者流行病学情况,探讨院前心脏性猝死病例特点.方法 我国8个大中城市急救中心系统数据库中导出2008年度全部死亡数据,就其有完整记录的资料进行统计分析.结果 ①院前心脏性猝死的调度时间、到达时间、现场时间、返回时间、总时间、急救半径分别为(2.12±1.02)min、(14.10±7.05)min、(24.79±12.08)min、(13.79±6.61)min、(54.80±25.36)min、7.90±3.92(km);②院前心脏性猝死的病例数以第一季度为最多,且最多时间段是8:00~10:00,最少时间段是2:00~4:00;③男性院前心脏性猝死明显多于女性,但年龄明显小于女性;④院前心脏性猝死目击者CPR为4.48%,医护人员现场CPR成功率2.26%.结论 ①心脏性猝死已成为我国大中城市最常见的院前死亡原因;②加强心血管病防治,提高中老年患者的常见急危重症早期识别与院前急救水平以及普及公众CPR对降低死亡有重要意义.%Objective To investigate the epidemiological information of patients in pre-hospital sudden cardiac death for our large and medium-sized cities and probe the patients' characteristic. Methods The death data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country. The thorough records of death data were conducted to statistical analysis. Results ①The scheduling time, running time, rescue time, returning time, total time and service radius in the sudden cardiac death group were (2. 12 ± 1.02 ), ( 14. 10 ± 7. 05 ), (24. 79 ± 12.08 ), ( 13.79 ± 6.61 ), (54. 80 ± 25. 36 ) minutes and 7.90 ± 3.92 (km)respectively. ②The patients' amount of sudden cardiac death group was at most in first quarter, and the most time slice of patients' amount was 8:00 ~ 10:00, and the least time slice of patients' amount was 2:00 ~ 4:00. ③The sudden cardiac death amount of male patients was more than that

  11. Neurocysticercosis causing sudden death:a case report

    Institute of Scientific and Technical Information of China (English)

    Martinez Fernanda; Seley Celeste; Marchesi Liliana; Fontanarossa Victoria; Rodriguez Dominique; Troncoso Alcides

    2010-01-01

    We report an acute case of a native man from Bolivia suffered from cephalalgia which rapidly worsened and ended in his sudden and unexpected death. Magnetic resonance imaging (MRI) of the brain was obtained. Features demonstrated on brainMRI scan were consistent with a diagnosis of neurocysticercosis (NCC). An autopsy showed the presence of intraventricular Taenia solium (T. solium) cysts which caused blockage of cerebrospinal fluid and secondary hydrocephalus. Due to the increasing travel movements of people neurocysticercosis must be considered as a cause of unexplained sudden death.

  12. The promise of omega-3 against sudden unexpected death in epilepsy: until further notice, it remains innocent, until proven guilty Promessa do ômega-3 contra a morte súbita em epilepsia: até segunda ordem, continua inocente, até que se prove o contrário

    Directory of Open Access Journals (Sweden)

    Fulvio Alexandre Scorza

    2013-01-01

    Full Text Available The present paper highlighted the importance of the recommended levels of fish consumption or omega-3 supplementation in order to minimize the frequency of seizures in people with uncontrolled epilepsy and, especially, to reduce the occurrence of sudden unexpected death in epilepsy (SUDEP.O presente trabalho destacou a importância dos níveis recomendados de consumo de peixe ou suplementação de ômega-3 com o intuito de minimizar a frequência de crises epilépticas em pessoas com epilepsia refratária e, especialmente, de reduzir a ocorrência de morte súbita inesperada em epilepsia (SUDEP.

  13. The promise of omega-3 against sudden unexpected death in epilepsy: until further notice, it remains innocent, until proven guilty Promessa do ômega-3 contra a morte súbita em epilepsia: até segunda ordem, continua inocente, até que se prove o contrário

    Directory of Open Access Journals (Sweden)

    Fulvio Alexandre Scorza

    2012-01-01

    Full Text Available The present paper highlighted the importance of the recommended levels of fish consumption or omega-3 supplementation in order to minimize the frequency of seizures in people with uncontrolled epilepsy and, especially, to reduce the occurrence of sudden unexpected death in epilepsy (SUDEP.O presente trabalho destacou a importância dos níveis recomendados de consumo de peixe ou suplementação de ômega-3 com o intuito de minimizar a frequência de crises epilépticas em pessoas com epilepsia refratária e, especialmente, de reduzir a ocorrência de morte súbita inesperada em epilepsia (SUDEP.

  14. Sudden sensorineural hearing loss.

    Science.gov (United States)

    Stew, B T; Fishpool, S J C; Williams, H

    2012-02-01

    Sudden onset sensorineural hearing loss is a medical emergency that continues to be poorly understood despite being recognized in the literature since 1944 (De Kleyn, 1944). A commonly used criterion to qualify for this diagnosis is a sensorineural hearing loss over three contiguous pure-tone frequencies of 30 dB or more that develops within 72 hours. The vast majority of cases are unilateral and the estimated annual incidence is 20 per 100 000 persons (Nosrati-Zarenoe et al, 2007). A cause for the hearing loss is only identified in up to 10% of cases but 50% of patients will improve spontaneously (Penido et al, 2009).

  15. 77 FR 59709 - Citrus Greening and Asian Citrus Psyllid; Quarantine and Interstate Movement Regulations

    Science.gov (United States)

    2012-10-01

    ...) 851-2286. SUPPLEMENTARY INFORMATION: Background Citrus greening, also known as Huanglongbing disease of citrus, is considered to be one of the most serious citrus diseases in the world. Citrus greening... citrus greening disease. In areas of the world where the disease is endemic, citrus trees decline and...

  16. Antioxidant activity of Citrus fruits.

    Science.gov (United States)

    Zou, Zhuo; Xi, Wanpeng; Hu, Yan; Nie, Chao; Zhou, Zhiqin

    2016-04-01

    Citrus is well-known for its nutrition and health-promotion values. This reputation is derived from the studies on the biological functions of phytochemicals in Citrus fruits and their derived products in the past decades. In recent years, the antioxidant activity of Citrus fruits and their roles in the prevention and treatment of various human chronic and degenerative diseases have attracted more and more attention. Citrus fruits are suggested to be a good source of dietary antioxidants. To have a better understanding of the mechanism underlying the antioxidant activity of Citrus fruits, we reviewed a study on the antioxidant activity of the phytochemicals in Citrus fruits, introduced methods for antioxidant activity evaluation, discussed the factors which influence the antioxidant activity of Citrus fruits, and summarized the underlying mechanism of action. Some suggestions for future study were also presented. PMID:26593569

  17. Antioxidant activity of Citrus fruits.

    Science.gov (United States)

    Zou, Zhuo; Xi, Wanpeng; Hu, Yan; Nie, Chao; Zhou, Zhiqin

    2016-04-01

    Citrus is well-known for its nutrition and health-promotion values. This reputation is derived from the studies on the biological functions of phytochemicals in Citrus fruits and their derived products in the past decades. In recent years, the antioxidant activity of Citrus fruits and their roles in the prevention and treatment of various human chronic and degenerative diseases have attracted more and more attention. Citrus fruits are suggested to be a good source of dietary antioxidants. To have a better understanding of the mechanism underlying the antioxidant activity of Citrus fruits, we reviewed a study on the antioxidant activity of the phytochemicals in Citrus fruits, introduced methods for antioxidant activity evaluation, discussed the factors which influence the antioxidant activity of Citrus fruits, and summarized the underlying mechanism of action. Some suggestions for future study were also presented.

  18. Sudden gains in psychotherapy

    OpenAIRE

    Auður Sjöfn Þórisdóttir 1986

    2014-01-01

    Verkefni þetta samanstendur af fræðilegu yfirliti og rannsóknagrein til birtingar í vísindatímarit. Verkefnið fjallar um tiltekið mynstur breytinga á einkennum geðraskana í sálfræðimeðferð, sem kallast skyndiframfarir (e. sudden gains) og þekkist af skyndilegum og miklum breytingum á einkennum milli tveggja meðferðartíma. Í fræðilega yfirlitinu er farið yfir hvernig þetta breytingamynstur hefur verið skilgreint og skýrt og sagt frá helstu niðurstöðum rannsókna á þessu sviði. Fjallað er um ann...

  19. Citrus stubborn disease (CSD)

    Science.gov (United States)

    CSD is caused by Spiroplasma citri, a phloem-limited, cell-wall-less bacterium. S. citri is transmitted in a propagative, circulative manner by several leafhoppers including Circulifer tenellus and Scaphytopius nitridus in citrus-growing regions of California and Arizona and by C. haematoceps (syn....

  20. Cercosporoid diseases of Citrus

    NARCIS (Netherlands)

    Huang, Feng; Groenewald, J.Z.; Zhu, Li; Crous, P.W.; Li, Hongye

    2015-01-01

    Citrus leaves and fruits exhibiting disease symptoms ranging from greasy spot, yellow spot, small or large brown spot, black dot, and brown dot were sampled from Fujian, Guangdong, Guizhou, Hunan, Jiangxi, Yunnan, Zhejiang provinces and the Guangxi Zhuang Autonomous Region in China. In total 82 isol