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Sample records for range causing sudden

  1. What Causes Sudden Cardiac Arrest?

    Science.gov (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  2. Sudden unexpected death caused by stroke

    DEFF Research Database (Denmark)

    Ågesen, Frederik Nybye; Risgaard, Bjarke; Zachariasardóttir, Sára

    2018-01-01

    Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered...... sudden death by stroke. Methods We conducted a retrospective, nationwide study including all deaths within Danish borders between 2000-2009 and 2007-2009 in persons aged 1-35 years and 36-49 years, respectively. Two physicians identified all sudden death cases through review of all death certificates....... All available autopsy reports and records from hospitals and general practitioners were retrieved and a neurologist identified all sudden death by stroke cases. Results Of the 14,567 deaths in the 10-year period, there were 1,698 sudden death cases, of which 52 (3%) were sudden death by stroke...

  3. Rare cause of bilateral sudden deafness.

    Science.gov (United States)

    Vos, F I; Merkus, P; van Nieuwkerk, E B J; Hensen, E F

    2016-10-08

    In this paper, we describe the case of a 62-year-old female with recurring episodes of sudden deafness with vertigo and facial paresis. Within a month's time, this resulted in bilateral deafness and vestibular areflexia. Erroneously, the patient was diagnosed with sudden deafness of unknown origin and subsequently with neuroborreliosis (Lyme disease). The true diagnosis of relapsing polychondritis (RP) was revealed 9 months after initial presentation. The diagnostic delay is in part explained by the fact that, by definition, the disease has to relapse before the diagnosis can be made, but also by its pluriform clinical presentation. Timely identification of RP as the cause of this profound sensorineural hearing loss proved to be important. It was key in instigating adequate follow-up, and allowed for cochlear implantation before total cochlear obliteration, which might have hampered optimal hearing rehabilitation. 2016 BMJ Publishing Group Ltd.

  4. Assigning cause for sudden unexpected infant death.

    Science.gov (United States)

    Hunt, Carl E; Darnall, Robert A; McEntire, Betty L; Hyma, Bruce A

    2015-06-01

    We have reached a conundrum in assigning cause of death for sudden unexpected infant deaths. We summarize the discordant perspectives and approaches and how they have occurred, and recommend a pathway toward improved consistency. This lack of consistency affects pediatricians and other health care professionals, scientific investigators, medical examiners and coroners, law enforcement agencies, families, and support or advocacy groups. We recommend that an interdisciplinary international committee be organized to review current approaches for assigning cause of death, and to identify a consensus strategy for improving consistency. This effort will need to encompass intrinsic risk factors or infant vulnerability in addition to known environmental risk factors including unsafe sleep settings, and must be sufficiently flexible to accommodate a progressively expanding knowledge base.

  5. Infectious causes of sudden infant death syndrome.

    Science.gov (United States)

    Alfelali, Mohammad; Khandaker, Gulam

    2014-12-01

    Investigators have long suspected the role of infection in sudden infant death syndrome (SIDS). Evidence of infectious associations with SIDS is accentuated through the presence of markers of infection and inflammation on autopsy of SIDS infants and isolates of some bacteria and viruses. Several observational studies have looked into the relation between seasonality and incidence of SIDS, which often showed a winter peak. These all may suggest an infectious aetiology of SIDS. In this review we have summarised the current literature on infectious aetiologies of SIDS by looking at viral, bacterial, genetic and environmental factors which are believed to be associated with SIDS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. On the causes of collapse and sudden death by Avicenna.

    Science.gov (United States)

    Nathan, B; Wray, R

    1997-06-01

    Avicenna's views on the causes of collapse and sudden death are presented from a literal translation of the mediaeval Arabic text. Medical knowledge based on observation mixed with pure abstract reasoning forms the essence of Avicenna's medical writings.

  7. 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...... review of death certificates. Autopsy reports were collected. A multivariable logistic regression model was used to identify both clinical characteristics and risk factors associated with SNCD. RESULTS: We identified 1039 autopsied cases of sudden death, of which 286 (28%) were classified as SNCD...

  8. [Severe cervical kyphosis causing sudden inspiratory stridor].

    Science.gov (United States)

    Andersen, Karen Lise Dahl; Bach, Allan; Iversen, Rikke Haahr; Skaarup, Søren Helbo

    2017-05-08

    An 85-year-old woman was brought to an accident and emergency department with breathing difficulties accompanied by inspiratory stridor. She was being treated for hypertension and severe osteoporosis which had caused thoracal and cervical fractures of the columna. Intubation was initiated as she desaturated and deteriorated despite maximum oxygen therapy. The intubation revealed a subglottic stenosis as a consequence of a recent osteoporotic fracture in the cervical columna. This represents a rare cause of respiratory failure as all other cardial, pulmonary and allergic aetiologies had been eliminated.

  9. 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

    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......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...... 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...

  10. [Sudden death in traffic due to natural causes (author's transl)].

    Science.gov (United States)

    Krauland, W

    1978-03-28

    Together with the increase in motorisation sudden death at the wheel by natural causes has also gained more importance although this is not a very frequent occurrence. Scattered reports on such cases in the literature are summarized and discussed with regard to recognition, frequency, age and sex distribution, pathological changes and marginal problems, e. g. diagnostic difficulties, risk and prevention. At the top of the list of the causes of sudden natural death at the wheel are disturbances of the cardiovascular circulation and under this heading the ischemical heart diseases with 83%. The frequency peak lies in the sixties age group and in the case of the ischemical diseases generally in the seventies age group which is an indication that driving is particularly a burden for the circulation. The percentage of women (2.6%) is approx. 10 times less than it is in sudden deaths generally, this obviously being due to the fact that women in advanced years do not drive as often as men. In approx. 50% of cases the sudden natural death takes place when the vehicle is stationary. Serious accidents are seldom. Diagnostic difficulties occur when alcohol has been consumed or when in an accident caused by the sickness the victim is fatally injured or when the question of guilt is not clear. Restrictive measures will not completely prevent sudden death when driving; it is most important that a patient with a history of myocardial infarction or of advanced age should be advised of the dangers of driving by the physician treating him.

  11. The most common cause of sudden cardiac death in athletes

    Directory of Open Access Journals (Sweden)

    Topalović Nikola

    2016-01-01

    Full Text Available The positive impact of exercise on cardiovascular health is well known. Athletes, who are constantly physically active, are considered to be the healthiest members of our society. That is why their sudden death, during the training or competition, attracts the attention of the general public. Rarely, tragic events of sudden cardiac death (SCD are the reason for questioning if by many positive there are also negative impact of physical exercise. The first case of SCD is recorded as far back as the year 490 BC, when the Greek soldier Pheidippides died after he conveyed news of the great victory of the Greeks over the Persians. Risk of SCD is recognized in the middle of the twentieth century. In our region, discussion about this issue began after the World Basketball Championship, which was held in Ljubljana in 1970, because of the sudden death of the national team member Trajko Rajkovic. One of the important goals of modern sports medicine is to reduce the risk of SCD in athletes to 'inevitable rarity'. Definition of SCD is considered to be any unexpected death due to sudden cardiac arrest. Pedo (Pedoe has divided all causes of SCD in the sport into three categories: Commotio cordis (agitation of the heart, which results from blunt impact to the athletes chest with consequent fatal disorder of heart rhythm; SCD of athletes under the age of 35 because of structural, congenital and inflammatory heart disease, which includes hypertrophic cardiomyopathy as the most important cause of sudden cardiac death, congenital anomalies of the coronary arteries, arrhythmogenic right ventricular cardiomyopathy, myocarditis and other; SCD of athletes older than 35 years which is most common due coronary artery disease - atherosclerosis (the dominant risk in the marathon and half-marathon. .

  12. [Cardiovascular diseases as a cause of sudden death in athletes].

    Science.gov (United States)

    Halawa, Bogumił

    2004-01-01

    Cardiac arrhythmias are the reason of the most sudden deaths in athletes. The annual risk of sudden death at athletes is between 5 to 10 per one million. Benign arrhythmia including bradyarrhythmias, atrial and ventricular premature contractions are common in the athletes. Supraventricular arrhythmias such as atrial fibrillation, nodal reciprocal entrant tachycardia and Wolff-Parkinson-White syndrome are less common. Perhaps the rarest and the most dangerous arrhythmias are ventricular arrhythmias, among them arrhythmias secondary to hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, long QT syndrome, and anomalous origin of coronary arteries. Asymptomatic bradyarrhythmias (if the heart rate in bradyarrhythmia appropriate increases with exercise), supraventricularis tachycardias, and atrial premature contractions without structural heart disease are not the contraindication to sports Athletes with premature ventricular contraction, nonsustained ventricular tachycardia and non structural heart disease are without athletic restrictions as long as the arrhythmias do not worsen and they not cause dyspnea or presyncope during exertion. Frequent or multiform premature ventricular contraction or sustained ventricular tachycardia indicate a higher risk, and all participation in athletic should be restricted.

  13. Cardiac symptoms before sudden cardiac death caused by hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Lynge, Thomas Hadberg; Risgaard, Bjarke; Jabbari, Reza

    2016-01-01

    AIMS: Hypertrophic cardiomyopathy (HCM) is a frequent cause of sudden cardiac death (SCD) among the young (SCDY). The aim of this study was to characterize symptoms before SCDY due to HCM. METHODS AND RESULTS: Through review of all death certificates, we identified all SCDs in Danes aged 1-35 years...... in 2000-2009. Nationwide we included all deaths (n = 8756) and identified 431 autopsied SCDYs. All available records from hospitals and general practitioners were retrieved. To compare symptoms, we included a control groups consisting of traffic accident victims (n = 74). In the 10-year study period, 431...... autopsied SCDY cases were reviewed and 38 cases (9%) were included, of which 22 (58%) had morphologic findings diagnostic of HCM and 16 (42%) had findings suggestive, but not diagnostic, of HCM ('possible HCM'). Cardiac symptoms >1 h prior to death were reported in 21 (55%) of cases, and 16 (42%) sought...

  14. Causes of sudden cardiac arrest in young athletes.

    Science.gov (United States)

    Westrol, Michael S; Kapitanyan, Raffi; Marques-Baptista, Andreia; Merlin, Mark A

    2010-07-01

    Knowledge of sudden cardiac death in young athletes is imperative for all physicians and allied health professionals. The complete differential diagnosis of a young patient with sudden cardiac arrest will result in proper work-up and treatment. In this article, we review several etiologies of sudden cardiac death, including hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, Wolff-Parkinson-White syndrome, long QT syndrome, Brugada syndrome, and commotio cordis. Clinical findings, work-up, treatment, long-term management, and athlete preparticipation screening guidelines are discussed.

  15. 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.

  16. Adult sudden death caused by aspiration of chewing gum.

    Science.gov (United States)

    Njau, S N

    2004-01-28

    A case of a fatal foreign material aspiration is presented in the following text. A 24-year-old white male died suddenly. A piece of chewing gum lodged in a pool of frothy fluid was revealed at autopsy. Microscopic examinations revealed atelectasia emphysema, eosinophilic exudate and empty spaces. Blood and urine samples were analyzed, for alcohol and drug use by fluorescence polarization immunoassay (FPIA) on an Abbott AXSYM system. No alcohol or other drugs were detected in blood or urine.

  17. Predicting and preventing sudden death from cardiac causes.

    Science.gov (United States)

    Gilman, J K; Jalal, S; Naccarelli, G V

    1994-08-01

    Sudden cardiac death usually occurs secondary to a ventricular tachyarrhythmia. Even under ideal circumstances only 20% of patients who have an out-of-hospital cardiac arrest survive to hospital discharge. Therefore, aggressive treatment and screening of high-risk patients are mandatory to improve survival rates. Risk stratification of high-risk patients, such as the post-myocardial infarction (MI) population, has been of limited value. Between 70% and 85% of "high-risk" post-MI patients, as defined by these screening tests, will not have a sustained ventricular tachyarrhythmia over several years of follow-up. The use of beta-blockers and possibly amiodarone may have some benefit in reducing mortality in high-risk patients after an MI. Several ongoing trials are studying the use of serial drug testing, amiodarone, and implantable cardioverter-defibrillators in reducing the incidence of sudden cardiac death in patients with potentially lethal ventricular arrhythmias. Although implantable cardioverter-defibrillators appear to be superior to antiarrhythmic drugs in reducing sudden cardiac death, total mortality may not be altered. In sustained ventricular tachyarrhythmias, sotalol and amiodarone appear to be superior to other drugs in preventing arrhythmia recurrence. Ongoing trials, such as the Antiarrhythmic Drug versus Implantable Device (AVID) trial may define the best strategy in these high-risk patients.

  18. Unusual causes of sudden anuria in renal transplant patients.

    Science.gov (United States)

    Abutaleb, Nasrulla; Obaideen, Abdulmunaem; Zakaria, Mahmoud; El Jubab, Abdulwahab; Hamza, Abdulmajeed; Younis, Seddiq; Adem, Muhalab

    2007-06-01

    Sudden unexplained anuria in renal transplant patients could well be secondary to occult internal hemorrhage rather than the usual vascular thrombotic or obstructive event, even in the completely stable patient. Urgent intervention in such bleeding states can save a patient's life and graft function. Graft survival is very exceptional in graft artery or vein thrombosis. Contrary to hemorrahagic events, life is usually not threatened by thrombotic events involving the renal graft vasculature. We present here three unfortunate cases that shared the problem of unexpected anuria due to a hemorrhagic event in apparently stable renal transplant patients.

  19. [Analysis of the sudden heart death causes in selected sample of dead].

    Science.gov (United States)

    Ondrusková, J; Sovová, E; Ivanová, K; Loyka, S; Táborský, M

    2011-07-01

    Sudden cardiac death (SCD) is death from cardiac causes within one hour of the onset of symptoms. In the Czech Republic, there is no SCD registry, analyses of SCD causes are rare and there is no functional connection between the results of an autopsy on a person with SCD and examination of relatives who are at risk of a similar disease. The authors reviewed available autopsy records of the Department of Forensic Medicine and Medical Law of the University Hospital Olomouc over a specified period of time to find persons with severe coronary artery disease, heart failure or deaths from unknown causes in a specific age range. Subsequently, the available information about the circumstances of SCD was analyzed.

  20. Decomposition and N cycling changes in redwood forests caused by sudden oak death

    Science.gov (United States)

    Richard C. Cobb; David M. Rizzo

    2012-01-01

    Phytophthora ramorum is an emergent pathogen in redwood forests which causes the disease sudden oak death. Although the disease does not kill coast redwood (Sequoia sempervirens), extensive and rapid mortality of tanoak (Notholithocarpus densiflorus) has removed this...

  1. [Cardiac fibroma: A rare cause of sudden child death].

    Science.gov (United States)

    Humez, Sarah; Gibier, Jean-Baptiste; Recher, Morgan; Leteurtre, Stéphane; Leroy, Xavier; Devisme, Louise

    2015-10-01

    We report the case of a 3-year-old child who died from the consequences of a cardio-respiratory arrest despite reanimation procedures. Echocardiography and magnetic resonance imaging (MRI) revealed a mass of the free wall of the left ventricle. Autopsy confirmed the existence of a solitary myocardial tumor, well-circumscribed, firm, with a whitish and trabeculated cut surface. Histologically, the tumor consisted of bundles of spindle-shaped and regular cells mingling with collagen and elastic fibers, insinuating themselves between myocytes in periphery. Calcifications were present. After immunohistochemistry, the cells were highlighted by anti-actin smooth muscle antibody; but they were not highlighted by anti-desmin, anti-β catenin and anti-Ki67 antibodies. The diagnosis of cardiac fibroma was made. The primary cardiac tumors of child are rare and usually benign. They are essentially represented by rhabdomyoma and fibroma. Cardiac fibroma mostly occurs during the first year of life. It can be revealed by cardiac insufficiency, arrhythmia, chest pain or sudden death. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Sudden unexpected infant death: differentiating natural from abusive causes in the emergency department.

    Science.gov (United States)

    Bechtel, Kirsten

    2012-10-01

    Sudden unexpected infant deaths (SUIDs) are deaths in infants younger than 12 months that occur suddenly, unexpectedly, and without obvious cause in the emergency department (ED). Sudden infant death syndrome, the leading cause of SUID in the United States, is much more common, but fatal child abuse and neglect have been sometimes mistaken for sudden infant death syndrome. The distinction between these 2 entities can only be made after a thorough investigation of the scene, interview of caregivers, and a complete forensic autopsy. Development of ED guidelines for the reporting and evaluation of SUID, in collaboration with the local medical examiner and child death review teams, will enable ED practitioners to collect important information in a compassionate manner that will be valuable to the investigating personnel.

  3. Mapping global potential risk of mango sudden decline disease caused by fungus Ceratocystis fimbriata

    Science.gov (United States)

    Mango Sudden Decline (MSD), sometimes referred to as mango wilt, is an important disease of mango caused by one of the most significant fungal species causing disease in woody plants, Ceratocystis fimbriata. This species is mainly disseminated by the mango bark beetle, Hypocryphalus mangiferae (Steb...

  4. Cardiac gene defects can cause sudden cardiac death in young people.

    Science.gov (United States)

    Kauferstein, Silke; Kiehne, Nadine; Neumann, Thomas; Pitschner, Heinz-Friedrich; Bratzke, Hansjürgen

    2009-01-01

    In Europe, sudden cardiac death (SCD) is one of the most common causes of death. Although sudden cardiac death usually happens in older people, 5% to 10% of the affected individuals are young and apparently healthy. Sudden death in infants, children, and young adults is relatively rare, with an incidence of 1 to 5 per 100 000 persons per year. Nonetheless, up to 7000 asymptomatic children die in the USA each year, almost half of them without any warning signs or symptoms. Selective literature review. Although structural cardiovascular abnormalities explain most cases of sudden cardiac death in young people, the cause of death remains unexplained after autopsy in 10% to 30% of cases. Potentially lethal ion channel disorders (channelopathies) such as the long QT syndromes (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and the Brugada syndrome (BrS) may account for at least one-third of these unexplained cases. Most of these diseases are hereditary with autosomal-dominant transmission, i.e., there is a 50% chance that the children of affected individuals will be affected themselves. Post-mortem genetic screening for sequence variations in cardiac ion channel genes has become an important forensic tool for elucidating the cause of sudden cardiac death. Moreover, it allows the identification of other family members bearing the previously undiagnosed gene defect, who can then undergo a cardiological evaluation if indicated by their clinical history.

  5. Cardiac Mixoma a Cause of Sudden Death in Childhood a Case Report

    Directory of Open Access Journals (Sweden)

    Arzu Akçay Turan

    2009-04-01

    Full Text Available The primary tumors of the heart are quite rare and, it’s frequency in the autopsy series is reported between 0,0017-0,28 %. Among the entire age groups, myxomas are seen to form half percent of these tumors. Despite the cardiac myxomas are histologically benign, they are classified among the fatal tumors, causing tendency to cardiac obstruction and embolism. In this study, by examining the history and autopsy findings of a 9 year old sudden death case of which left atrial myxoma is detected in the autopsy; it is aimed to point to cardiac myxomas which can be seen as the cause of sudden death especially in the early ages in the legal autopsies Keywords: Cardiac myxoma, sudden cardiac death, autopsy

  6. Circumstances and causes of out-of-hospital cardiac arrest in sudden death survivors

    NARCIS (Netherlands)

    de Vreede-Swagemakers, J. J.; Gorgels, A. P.; Dubois-Arbouw, W. I.; Dalstra, J.; Daemen, M. J.; van Ree, J. W.; Stijns, R. E.; Wellens, H. J.

    1998-01-01

    To study the circumstances and medical profile of out-of-hospital sudden cardiac arrest (SCA) patients in whom resuscitation was attempted by the ambulance service, and to identify causes of SCA in survivors and factors that influence resuscitation success rate. During a five year period (1991-95)

  7. Cardiomyopathies as a Cause of Sudden Cardiac Death (SCD in Egypt: Recognition and Preventive Strategies Needed

    Directory of Open Access Journals (Sweden)

    Nora Fnon

    2016-06-01

    Full Text Available This study aimed at evaluating the epidemiological characteristics and pathological features of different types of cardiomyopathies in Egypt, highlighting the role of the forensic pathologist in identifying cases of cardiomyopathies and initiating for their families a possible genetic study aiming at prevention of sudden death. All cases with sudden cardiac death (SCD due to cardiomyopathies during the period from the beginning of January 2010 until the end of December 2014 (5 years were included in this study. All hearts underwent detailed gross and histological examination. Circumstances of death, medical history, and post-mortem pathological findings were thoroughly  investigated. Out of 535 cases of sudden cardiac death, there were 22 cases (4.1% diagnosed as having cardiomyopathies; sudden death was their first presentation. Eighteen cases (81.8% were male, with the 4th decade (11 cases, 50% being the most affected age; severe physical activity and exertion were evident in death circumstances of 14 cases (63.6%; pathological evaluation revealed that hypertrophic cardiomyopathy was the most frequent type, being diagnosed in 10 cases (45%. Cardiomyopathies are an infrequent cause of sudden cardiac death. Most deaths are in children and adults, so cases are of high social impact that demands multidisciplinary research and resources. In all cases of SCD, forensic autopsy should be done. Forensic study is the key to identifying an affected family and the starting point regarding assessing them.

  8. Sudden infant death syndrome caused by cardiac arrhythmias: only a matter of genes encoding ion channels?

    Science.gov (United States)

    Sarquella-Brugada, Georgia; Campuzano, Oscar; Cesar, Sergi; Iglesias, Anna; Fernandez, Anna; Brugada, Josep; Brugada, Ramon

    2016-03-01

    Sudden infant death syndrome is the unexpected demise of a child younger than 1 year of age which remains unexplained after a complete autopsy investigation. Usually, it occurs during sleep, in males, and during the first 12 weeks of life. The pathophysiological mechanism underlying the death is unknown, and the lethal episode is considered multifactorial. However, in cases without a conclusive post-mortem diagnosis, suspicious of cardiac arrhythmias may also be considered as a cause of death, especially in families suffering from any cardiac disease associated with sudden cardiac death. Here, we review current understanding of sudden infant death, focusing on genetic causes leading to lethal cardiac arrhythmias, considering both genes encoding ion channels as well as structural proteins due to recent association of channelopathies and desmosomal genes. We support a comprehensive analysis of all genes associated with sudden cardiac death in families suffering of infant death. It allows the identification of the most plausible cause of death but also of family members at risk, providing cardiologists with essential data to adopt therapeutic preventive measures in families affected with this lethal entity.

  9. 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 CoA dehydrog......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...

  10. Incidence and causes of sudden death in U.S. college athletes.

    Science.gov (United States)

    Maron, Barry J; Haas, Tammy S; Murphy, Caleb J; Ahluwalia, Aneesha; Rutten-Ramos, Stephanie

    2014-04-29

    The goal of this study was to reliably define the incidence and causes of sudden death in college student-athletes. The frequency with which cardiovascular-related sudden death occurs in competitive athletes importantly influences considerations for pre-participation screening strategies. We assessed databases (including autopsy reports) from both the U.S. National Registry of Sudden Death in Athletes and the National Collegiate Athletic Association (2002 to 2011). Over the 10-year study period, 182 sudden deaths occurred (age 20 ± 1.7 years; 85% male; 64% white), 52 resulting from suicide (n = 31) or drug abuse (n = 21) and 64 probably or likely attributable to cardiovascular causes (6/year). Of these 64 athletes, 47 had a confirmed post-mortem diagnosis; the most common were hypertrophic cardiomyopathy in 21 and congenital coronary anomalies in 8. The 4,052,369 athlete participations (in 30 sports over 10 years) incurred mortality risks as follows: suicide and drugs combined, 1.3/100,000 athlete participation-years (5 deaths/year); and documented cardiovascular disease, 1.2/100,000 athlete participation-years (4 deaths/year). Notably, cardiovascular deaths were 5-fold more common in African-American athletes than in white athletes (3.8 vs. 0.7/100,000 athlete participation-years; p college student-athletes, risk of sudden death due to cardiovascular disease is relatively low, with mortality rates similar to suicide and drug abuse, but less than expected in the general population, although highest in African-American athletes. A substantial minority of confirmed cardiovascular deaths would not likely have been reliably detected by pre-participation screening with 12-lead electrocardiograms. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  11. 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 ionization...

  12. 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

    A number of rare inherited metabolic disorders are known to lead to death in infancy. Deficiency of medium-chain acyl CoA dehydrogenase has, on clinical grounds, been related particularly to sudden infant death syndrome. The contribution of this disorder to the etiology of sudden infant death...... 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...... presentations of inherited metabolic disorders and examine a wider range of sudden death in infancy....

  13. Trends in socioeconomic inequalities in risk of sudden infant death syndrome, other causes of infant mortality, and stillbirth in Scotland: population based study

    Science.gov (United States)

    Wood, Angela M; Pasupathy, Dharmintra; Pell, Jill P; Fleming, Michael

    2012-01-01

    Objectives To compare changes in inequalities in sudden infant death syndrome with other causes of infant mortality and stillbirth in Scotland, 1985-2008. Design Retrospective cohort study. Setting Scotland 1985-2008, analysed by four epochs of six years. Participants Singleton births of infants with birth weight >500 g born at 28-43 weeks’ gestation. Main outcome measures Sudden infant death syndrome, other causes of postneonatal infant death, neonatal death, and stillbirth. Odds ratios expressed as the association across the range of seven categories of Carstairs deprivation score. Results The association between deprivation and the risk of all cause stillbirth and infant death varied between the four epochs (P=0.04). This was wholly explained by variation in the risk of sudden infant death syndrome (Prate of sudden infant death syndrome from 1990 to 1993. Among women living in areas of high deprivation, there was a slower decline in sudden infant death syndrome rates between 1992 and 2004. Consequently, the odds ratio for the association between socioeconomic deprivation and sudden infant death syndrome increased from 2.04 (95% confidence interval 1.53 to 2.72) in 1985-90, to 7.52 (4.62 to 12.25) in 1991-6, and 9.50 (5.46 to 16.53) in 1997-2002 but fell to 1.78 (0.87 to 3.65) in 2002-8. The interaction remained significant after adjustment for maternal characteristics. Conclusion The rate of sudden infant death syndrome declined throughout Scotland in the early 1990s. The decline had a later onset and was slower among women living in areas of high deprivation, probably because of slower uptake of recommended changes in infant sleeping position. The effect was to create a strong independent association between deprivation and sudden infant death syndrome where one did not exist before. PMID:22427307

  14. Small aortic root as a cause of sudden death in a young adult - A controversial topic revisited

    NARCIS (Netherlands)

    de Gouveia, Rosa Henriquez; Becker, Anton E.

    2002-01-01

    Background: Sudden cardiac death over the age of 35 years is mostly due to coronary atherosclerosis, whereas under the age of 35 years, a variety of mainly congenital malformations prevail. However, hypoplasia of the aortic root in adults, first introduced by Laurie in 1968 as a cause of sudden

  15. Supraventricular arrhythmia as the cause of sudden death in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Madariaga, I; Carmona, J R; Mateas, F R; Lezaun, R; de los Arcos, E

    1994-01-01

    Electrophysiological studies with simultaneous echocardiographic control and invasive measurement of intravascular pressures were carried out in a 13-year-old boy with hypertrophic cardiomyopathy who was hospitalized after an episode of aborted sudden death. Ventricular stimulation did not induce ventricular tachycardia, but atrial stimulation induced atrial fibrillation, atrial flutter and non-sustained ventricular tachycardia. Atrial stimulation (S1) at 200 beats.min-1 (10-15 s) also induced significant repolarization abnormalities in the 5-10 post-stimulation beats. Akinesia of the ventricular septum and posterior wall without opening of the mitral valve was documented by echocardiography. A complete anterior systolic motion, not observed under basal conditions, was detected in the first post-stimulation beat. Atrial stimulation at rates over 120 beats.min-1 caused a drop in systolic blood pressure, a rise in pulmonary artery pressure, and a decrease in cardiac output. Despite therapy with propranolol and amiodarone, the patient died suddenly.

  16. Heart rate turbulence predicts all-cause mortality and sudden death in congestive heart failure patients.

    Science.gov (United States)

    Cygankiewicz, Iwona; Zareba, Wojciech; Vazquez, Rafael; Vallverdu, Montserrat; Gonzalez-Juanatey, Jose R; Valdes, Mariano; Almendral, Jesus; Cinca, Juan; Caminal, Pere; de Luna, Antoni Bayes

    2008-08-01

    Abnormal heart rate turbulence (HRT) has been documented as a strong predictor of total mortality and sudden death in postinfarction patients, but data in patients with congestive heart failure (CHF) are limited. The aim of this study was to evaluate the prognostic significance of HRT for predicting mortality in CHF patients in New York Heart Association (NYHA) class II-III. In 651 CHF patients with sinus rhythm enrolled into the MUSIC (Muerte Subita en Insuficiencia Cardiaca) study, the standard HRT parameters turbulence onset (TO) and slope (TS), as well as HRT categories, were assessed for predicting total mortality and sudden death. HRT was analyzable in 607 patients, mean age 63 years (434 male), 50% of ischemic etiology. During a median follow up of 44 months, 129 patients died, 52 from sudden death. Abnormal TS and HRT category 2 (HRT2) were independently associated with increased all-cause mortality (HR: 2.10, CI: 1.41 to 3.12, P 120 ms. HRT is a potent risk predictor for both heart failure and arrhythmic death in patients with class II and III CHF.

  17. Trends in socioeconomic inequalities in risk of sudden infant death syndrome, other causes of infant mortality, and stillbirth in Scotland: population based study.

    Science.gov (United States)

    Wood, Angela M; Pasupathy, Dharmintra; Pell, Jill P; Fleming, Michael; Smith, Gordon C S

    2012-03-16

    To compare changes in inequalities in sudden infant death syndrome with other causes of infant mortality and stillbirth in Scotland, 1985-2008. Retrospective cohort study. Scotland 1985-2008, analysed by four epochs of six years. Singleton births of infants with birth weight >500 g born at 28-43 weeks' gestation. Sudden infant death syndrome, other causes of postneonatal infant death, neonatal death, and stillbirth. Odds ratios expressed as the association across the range of seven categories of Carstairs deprivation score. The association between deprivation and the risk of all cause stillbirth and infant death varied between the four epochs (P=0.04). This was wholly explained by variation in the risk of sudden infant death syndrome (Psudden infant death syndrome from 1990 to 1993. Among women living in areas of high deprivation, there was a slower decline in sudden infant death syndrome rates between 1992 and 2004. Consequently, the odds ratio for the association between socioeconomic deprivation and sudden infant death syndrome increased from 2.04 (95% confidence interval 1.53 to 2.72) in 1985-90, to 7.52 (4.62 to 12.25) in 1991-6, and 9.50 (5.46 to 16.53) in 1997-2002 but fell to 1.78 (0.87 to 3.65) in 2002-8. The interaction remained significant after adjustment for maternal characteristics. The rate of sudden infant death syndrome declined throughout Scotland in the early 1990s. The decline had a later onset and was slower among women living in areas of high deprivation, probably because of slower uptake of recommended changes in infant sleeping position. The effect was to create a strong independent association between deprivation and sudden infant death syndrome where one did not exist before.

  18. Positive and negative sudden impulses caused by fast forward and reverse interplanetary shocks

    Energy Technology Data Exchange (ETDEWEB)

    Andrioli, Vania Fatima; Savian, Jairo Francisco, E-mail: vaniafatima@gmail.com, E-mail: savian@lacesm.ufsm.br [Space Science Laboratory of Santa Maria - LACESM/CT - UFSM, Universidade Federal de Santa Maria - UFSM, Centro Tecnologico, Santa Maria, RS (Brazil); Echer, Ezequiel, E-mail: eecher@dge.inpe.br [National Institute for Space Research - INPE - MCT, Sao Jose dos Campos, SP (Brazil); Schuch, Nelson Jorge, E-mail: njschuch@lacesm.ufsm.br [Southern Regional Space Research Center - CRSPE/INPE - MCT, Universidade Federal de Santa Maria - UFSM, Santa Maria, RS (Brazil)

    2007-07-01

    Fast forward interplanetary shocks (FFS) are characterized by positive jump in all interplanetary plasma parameters (solar wind speed, temperature and density) and interplanetary magnetic field. However the fast reverse interplanetary shocks (FRS) are characterized by negative jump in all mentioned parameters except solar wind speed. Observations show that FFS cause positive sudden impulses (SI) while FRS cause negative SI in the H-component of the geomagnetic field. In this work we investigate the SI caused by interplanetary shocks. We use the observed plasma parameters, upstream and downstream, to calculate the variation of dynamic pressure. We observe that the SI amplitude is larger for positive SI than for negative ones, as a consequence of the fact that FFS have larger dynamic pressure variations as compared to FRS. (author)

  19. Sudden onset odontoid fracture caused by cervical instability in hypotonic cerebral palsy.

    Science.gov (United States)

    Shiohama, Tadashi; Fujii, Katsunori; Kitazawa, Katsuhiko; Takahashi, Akiko; Maemoto, Tatsuo; Honda, Akihito

    2013-11-01

    Fractures of the upper cervical spine rarely occur but carry a high rate of mortality and neurological disabilities in children. Although odontoid fractures are commonly caused by high-impact injuries, cerebral palsy children with cervical instability have a risk of developing spinal fractures even from mild trauma. We herein present the first case of an odontoid fracture in a 4-year-old boy with cerebral palsy. He exhibited prominent cervical instability due to hypotonic cerebral palsy from infancy. He suddenly developed acute respiratory failure, which subsequently required mechanical ventilation. Neuroimaging clearly revealed a type-III odontoid fracture accompanied by anterior displacement with compression of the cervical spinal cord. Bone mineral density was prominently decreased probably due to his long-term bedridden status and poor nutritional condition. We subsequently performed posterior internal fixation surgically using an onlay bone graft, resulting in a dramatic improvement in his respiratory failure. To our knowledge, this is the first report of an odontoid fracture caused by cervical instability in hypotonic cerebral palsy. Since cervical instability and decreased bone mineral density are frequently associated with cerebral palsy, odontoid fractures should be cautiously examined in cases of sudden onset respiratory failure and aggravated weakness, especially in hypotonic cerebral palsy patients. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  20. Diurnal temperature range as a novel risk factor for sudden infant death.

    Science.gov (United States)

    Chu, Chen; Zhou, WenHao; Gui, YongHao; Kan, HaiDong

    2011-10-01

    To assess the relationship between diurnal temperature range (DTR) and sudden infant death (SID) between 2001 and 2004 in Shanghai, China. We conducted a time-stratified case-crossover analysis to estimate the percent increase of SID associated with changes in DTR after adjustment for daily weather conditions (temperature and relative humidity) and outdoor air pollution. DTR was significantly associated with daily SID. An increase of 1 °C in the current-day (L0) and in the 2-day moving average (L01) DTR corresponds to a 1.56% (95% CI: 0.97%, 2.15%) and a 1.89% (95% CI: 1.17%, 2.60%) increase in SID, respectively. An increased DTR was associated with an increased risk of SID in Shanghai. More studies are needed to understand the effect of DTR on infant deaths. Copyright © 2011 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

  1. Variations in Cause-of-Death Determination for Sudden Unexpected Infant Deaths.

    Science.gov (United States)

    Shapiro-Mendoza, Carrie K; Parks, Sharyn E; Brustrom, Jennifer; Andrew, Tom; Camperlengo, Lena; Fudenberg, John; Payn, Betsy; Rhoda, Dale

    2017-07-01

    To quantify and describe variation in cause-of-death certification of sudden unexpected infant deaths (SUIDs) among US medical examiners and coroners. From January to November 2014, we conducted a nationally representative survey of US medical examiners and coroners who certify infant deaths. Two-stage unequal probability sampling with replacement was used. Medical examiners and coroners were asked to classify SUIDs based on hypothetical scenarios and to describe the evidence considered and investigative procedures used for cause-of-death determination. Frequencies and weighted percentages were calculated. Of the 801 surveys mailed, 60% were returned, and 377 were deemed eligible and complete. Medical examiners and coroners classification of infant deaths varied by scenario. For 3 scenarios portraying potential airway obstruction and negative autopsy findings, 61% to 69% classified the death as suffocation/asphyxia. In the last scenario, which portrayed a healthy infant in a safe sleep environment with negative autopsy findings, medical examiners and coroners classified the death as sudden infant death syndrome (38%) and SUID (30%). Reliance on investigative procedures to determine cause varied, but 94% indicated using death scene investigations, 88% full autopsy, 85% toxicology analyses, and 82% medical history review. US medical examiners and coroners apply variable practices to classify and investigate SUID, and thus, they certify the same deaths differently. This variability influences surveillance and research, impacts true understanding of infant mortality causes, and inhibits our ability to accurately monitor and ultimately prevent future deaths. Findings may inform future strategies for promoting standardized practices for SUID classification. Copyright © 2017 by the American Academy of Pediatrics.

  2. Stress-mediated Allee effects can cause the sudden collapse of honey bee colonies.

    Science.gov (United States)

    Booton, Ross D; Iwasa, Yoh; Marshall, James A R; Childs, Dylan Z

    2017-05-07

    The recent rapid decline in global honey bee populations could have significant implications for ecological systems, economics and food security. No single cause of honey bee collapse has yet to be identified, although pesticides, mites and other pathogens have all been shown to have a sublethal effect. We present a model of a functioning bee hive and introduce external stress to investigate the impact on the regulatory processes of recruitment to the forager class, social inhibition and the laying rate of the queen. The model predicts that constant density-dependent stress acting through an Allee effect on the hive can result in sudden catastrophic switches in dynamical behaviour and the eventual collapse of the hive. The model proposes that around a critical point the hive undergoes a saddle-node bifurcation, and that a small increase in model parameters can have irreversible consequences for the entire hive. We predict that increased stress levels can be counteracted by a higher laying rate of the queen, lower levels of forager recruitment or lower levels of natural mortality of foragers, and that increasing social inhibition can not maintain the colony under high levels of stress. We lay the theoretical foundation for sudden honey bee collapse in order to facilitate further experimental and theoretical consideration. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. 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)....

  4. Sudden oak death-caused changes to surface fuel loading and potential fire behavior in Douglas-fir-tanoak forests

    Science.gov (United States)

    Y.S. Valachovic; C.A. Lee; H. Scanlon; J.M. Varner; R. Glebocki; B.D. Graham; D.M. Rizzo

    2011-01-01

    We compared stand structure and fuel loading in northwestern California forests invaded by Phytophthora ramorum, the cause of sudden oak death, to assess whether the continued presence of this pathogen alters surface fuel loading and potential fire behavior in ways that may encumber future firefighting response. To attempt to account for these...

  5. causes of sudden natural death: a medico-legal autopsy study

    African Journals Online (AJOL)

    2012-10-10

    Oct 10, 2012 ... sudden natural death was cardio-vascular disease and that the complications of hypertension .... were valvular heart disease, 3.2% (8/246); ischaemic heart disease, 2.8% (7/246); Hypertrophic cardio- ... and acute severe asthma occurred in 18% (14/78) and 10% (8/78) of cases respectively (Table 3).

  6. Sudden exposure to sand bath as a cause of death in Pullets ...

    African Journals Online (AJOL)

    A postmortem examination conducted on 15 dead pullets has revealed blood coagulation in the heart and hepatization of lungs. This finding is associated with the sudden exposure of the pullets to sand bath which scared the birds and resulted in gathering to one corner of the house. This in turn resulted in shortage of ...

  7. Systemic Polyarteritis Nodosa as the Cause of Sudden Onset Bilateral Sensorineural Hearing Loss Following Lassa Virus Infection

    Science.gov (United States)

    2016-07-05

    following Lassa virus infection Authors: Kathleen A. Cashman1*, Eric R. Wilkinson1, Paul R. Facemire2†, Todd M. Bell2‡, Carl I. Shaia2ῗ, Connie S...Detachment, Ft. Hood, TX 75644 Abstract: Lassa virus (LASV) causes a severe, often fatal hemorrhagic disease in endemic regions of Africa and sudden-onset...patients has not been identified. Here, we show that a cynomolgus macaque experimentally infected with Lassa virus who survived the initial infection

  8. How could analyzing the activity of two matrix metalloproteinases unveil the cause of sudden cardiac death.

    Science.gov (United States)

    Sosa, Ivan; Grubesic, Aron

    2016-12-01

    Sudden cardiac death is natural, unexpected death, related to cardiovascular disease. Its postmortem elucidation is significant, as the family of the deceased aspires to prevent other sudden deaths. Irrespective of the proper etiological entity, the myocardial collagen matrix remodels, associated with the progression of cardiovascular diseases. It has become evident that many mediators such as humoral factors, transforming growth factor (TGF)-β1 among them, are involved in the remodeling process. Cardiac remodeling is the balance of regenerative and eliminatory processes that include enzymes involved in the degradation of extracellular matrix (ECM) components. Enzymes capable of degrading native fibrillar collagen are interstitial collagenases, specifically matrix metalloproteinases (MMP)-1 and MMP-8. Here, we suggest a technique of visualizing turnover of collagen in cardiac tissue. © The Author(s) 2016.

  9. Sudden post-traumatic sciatica caused by a thoracic spinal meningioma.

    Science.gov (United States)

    Mariniello, Giuseppe; Malacario, Francesca; Dones, Flavia; Severino, Rocco; Ugga, Lorenzo; Russo, Camilla; Elefante, Andrea; Maiuri, Francesco

    2016-10-01

    Spinal meningiomas usually present with slowly progressive symptoms of cord and root compression, while a sudden clinical onset is very rare. A 35-year-old previously symptom-free woman presented sudden right sciatica and weakness of her right leg following a fall with impact to her left foot. A neurological examination showed paresis of the right quadriceps, tibial and sural muscles, increased bilateral knee and ankle reflexes and positive Babinski sign. Magnetic resonance imaging (MRI) revealed the presence of a spinal T11 meningioma in the left postero-lateral compartment of the spinal canal; at this level, the spinal cord was displaced to the contralateral side with the conus in the normal position. At surgery, a meningioma with dural attachment of the left postero-lateral dural surface was removed. The intervention resulted in rapid remission of both pain and neurological deficits. Spinal meningiomas may exceptionally present with sudden pain and neurological deficits as result of tumour bleeding or post-traumatic injury of the already compressed nervous structures, both in normal patients and in those with conus displacement or tethered cord. In this case, the traumatic impact of the left foot was transmitted to the spine, resulting in stretching of the already compressed cord and of the contralateral lombosacral roots. This case suggests that low thoracic cord compression should be suspected in patients with post-traumatic radicular leg pain with normal lumbar spine MRI. © The Author(s) 2016.

  10. [Sudden cardiac death in athletes is usually caused by undiagnosed heart disease. Cardiac screening of young athletes under discussion].

    Science.gov (United States)

    Börjesson, Mats; Nylander, Eva

    Sudden death during exercise in young athletes is usually caused by previously undiagnosed heart disease. The most frequent underlying diseases are hypertrophic cardiomyopathy, coronary artery anomalies and arrhythmogenic right ventricular cardiomyopathy. The possibility of carrying out screening to prevent these tragic cardiac deaths in young athletes has been discussed. A history of sudden cardiac death at a young age among relatives and/or the occurrence of exercise related symptoms in the active sportsperson may identify some of the individuals at risk. A pathological ECG is also a risk factor, especially in combination with a history of abnormal findings upon physical examination. For a correct evaluation of the young athlete, it is important to be aware of the normal variation of cardiac findings in athletes ("athlete's heart").

  11. Connexin43 Mutation Causes Heterogeneous Gap Junction Loss and Sudden Infant Death

    Science.gov (United States)

    Van Norstrand, David W.; Asimaki, Angeliki; Rubinos, Clio; Dolmatova, Elena; Srinivas, Miduturu; Tester, David J.; Saffitz, Jeffrey E.; Duffy, Heather S.; Ackerman, Michael J.

    2012-01-01

    Background An estimated 10-15% of sudden infant death syndrome (SIDS) may stem from channelopathy-mediated lethal arrhythmias. Loss of the GJA1-encoded gap junction channel protein connexin43 (Cx43) is known to underlie formation of lethal arrhythmias. GJA1 mutations have been associated with cardiac diseases including atrial fibrillation. Therefore, GJA1 is a plausible candidate gene for premature sudden death. Methods and Results GJA1 open reading frame mutational analysis was performed using PCR, DHPLC, and direct DNA sequencing on DNA from 292 SIDS cases. Immunofluorescence and dual whole cell patch-clamp studies were performed to determine functionality of mutant gap junctions. Immunostaining for gap junction proteins was performed on SIDS-associated paraffin-embedded cardiac tissue. Two rare, novel missense mutations, E42K and S272P, were detected in 2 of 292 SIDS cases, a 2-month-old white male and a 3-month-old white female, respectively. Analysis of the E42K victim’s parental DNA demonstrated a de novo mutation. Both mutations involved highly conserved residues and were absent in over 1000 ethnic-matched reference alleles. Immunofluorescence demonstrated no trafficking abnormalities for either mutation and S272P demonstrated wildtype junctional conductance. However, junctional conductance measurements for the E42K mutation demonstrated a loss-of-function not rescued by wildtype. Moreover, the E42K victim cardiac tissue demonstrated a mosaic immunostaining pattern for Cx43 protein. Conclusions This study provides the first molecular and functional evidence implicating a GJA1 mutation as a novel pathogenic substrate for SIDS. E42K-Cx43 demonstrated a trafficking-independent reduction in junctional coupling in vitro as well as demonstrating a mosaic pattern of mutational DNA distribution in deceased cardiac tissue, suggesting a novel mechanism of Cx43-associated sudden death. PMID:22179534

  12. Differentiating cause-of-death terminology for deaths coded as sudden infant death syndrome, accidental suffocation, and unknown cause: an investigation using US death certificates, 2003-2004.

    Science.gov (United States)

    Kim, Shin Y; Shapiro-Mendoza, Carrie K; Chu, Susan Y; Camperlengo, Lena T; Anderson, Robert N

    2012-03-01

    We compared written text on infant death certificates for deaths coded as sudden infant death syndrome (R95), unknown cause (R99), and accidental suffocation (W75). Using US mortality files supplemented with the death certifiers' written text for all infant deaths with International Classification of Diseases (ICD)-10 assigned codes R95, R99, and W75, we formed cause-of-death subcategories from common themes identified from the written text. Among all infant deaths in 2003-2004, the underlying cause of death was listed as R99 for 2128 deaths, R95 for 4408 deaths, and W75 for 931 deaths. Among the postneonatal deaths, the differences in subcategories varied between assigned ICD-10 codes: for R99-coded deaths, 45.8% were categorized as "Unknown" and 48.6% as "Pending"; for R95-coded deaths, 67.7% were categorized as "sudden infant death syndrome (SIDS)"; and for W75-coded deaths, 76.4% were categorized as "Suffocation." Examination of the written text on the death certificates demonstrates variability in the assigned ICD-10 codes which could have an important effect on the estimates of SIDS cases in the United States. 2011 American Academy of Forensic Sciences. Published 2011. This article is a U.S. Government work and is in the public domain in the U.S.A.

  13. Postmortem diagnosis of infectious heart diseases: A mystifying cause of Sudden Infant Death.

    Science.gov (United States)

    Gaaloul, Imed; Riabi, Samira; Evans, Mark; Hunter, Timothy; Huber, Sally; Aouni, Mahjoub

    2016-05-01

    Sudden infant death (SID) is an unresolved problem of high relevance and previous studies have indicated a role of viral heart infections. The diagnosis remains difficult in clinical practice using routine diagnostic tests and must be substantially improved. A prospective study based on post-mortem samples from SID victims whose heart disease was not clinically recognized was conducted for 4 years in a Tunisian University Hospital. Pediatric cases of unnatural death served as controls. Both SID victims and controls were investigated for possible coxsackievirus-B (CV-B) infection in heart tissue. During the study period, 39 cases with a male predominance (77%) were reported. There was no positive family history of coronary artery disease among the victims. In 35 cases (90%), low birth weight and/or critical development period were reported. All SID victims had complained of mild fever and insomnia for a few days preceding death, which required infectious laboratory investigations marked with an elevated white blood cell count (WBC) and C-reactive protein (CRP). The cardiac biomarkers were also elevated. The histopathological investigations of the heart tissue samples revealed signs of myocardial and pericardial inflammation. Enterovirus was detected by immunohistochemistry (IHC) and PCR from myocardial samples from 6 cases (15.3%) having myocarditis and 3 cases (7.7%) having perimyocarditis. The current study is of great interest and is aimed at urging health professionals to adopt systematically long intensive heart care in infants with underlying vulnerability as well as new diagnostic approaches including histopathology complemented with IHC and molecular pathology. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. 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

  15. α1-Syntrophin Mutations Identified in Sudden Infant Death Syndrome Cause an Increase in Late Cardiac Sodium Current

    Science.gov (United States)

    Cheng, Jianding; Van Norstrand, David W.; Medeiros-Domingo, Argelia; Valdivia, Carmen; Tan, Bi-hua; Ye, Bin; Kroboth, Stacie; Vatta, Matteo; Tester, David J.; January, Craig T.; Makielski, Jonathan C.; Ackerman, Michael J.

    2009-01-01

    Background Sudden infant death syndrome (SIDS) is a leading cause of death during the first 6 months after birth. About 5%-10% of SIDS may stem from cardiac channelopathies like long QT syndrome (LQTS). We recently implicated mutations in α1-syntrophin (SNTA1) as a novel cause of LQTS, whereby mutant SNTA1 released inhibition of associated neuronal nitric oxide synthase (nNOS) by the plasma membrane Ca-ATPase PMCA4b causing increased peak and late sodium current (INa) via S-nitrosylation of the cardiac sodium channel. This study determined the prevalence and functional properties of SIDS-associated SNTA1 mutations. Methods and Results Using PCR, DHPLC, and DNA sequencing of SNTA1's open reading frame, 6 rare (absent in 800 reference alleles) missense mutations (G54R, P56S, T262P, S287R, T372M and G460S) were identified in 8 (∼3%) out of 292 SIDS cases. These mutations were engineered using PCR-based overlap-extension and were co-expressed heterologously with SCN5A, nNOS and PMCA4b in HEK293 cells. INa was recorded using the whole-cell method. A significant 1.4-1.5 fold increase in peak INa and 2.3-2.7 fold increase in late INa compared with controls was evident for S287R-, T372M-, and G460S-SNTA1, and was reversed by an nNOS inhibitor. These 3 mutations also caused a significant depolarizing shift in channel inactivation thereby increasing the overlap of the activation and inactivation curves to increase window current. Conclusions Abnormal biophysical phenotypes implicate mutations in SNTA1 as a novel pathogenic mechanism for the subset of channelopathic SIDS. Functional studies are essential to distinguish pathogenic perturbations in channel interacting proteins like α1-syntrophin from similarly rare but innocuous ones. PMID:20009079

  16. Optimizing conditions of a cell-free toxic filtrate stem cutting assay to evaluate soybean genotype responses to Fusarium species that cause sudden death syndrome

    Science.gov (United States)

    Cell-free toxic culture filtrates from Fusarium virguliforme, the causal fungus of soybean sudden death syndrome (SDS), cause foliar symptoms on soybean stem-cuttings similar to those obtained from root inoculations in whole plants and those observed in production fields. The objectives of this stud...

  17. Sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Neeraj Parakh

    2015-01-01

    Full Text Available Sudden cardiac death is one of the most common cause of mortality worldwide. Despite significant advances in the medical science, there is little improvement in the sudden cardiac death related mortality. Coronary artery disease is the most common etiology behind sudden cardiac death, in the above 40 years population. Even in the apparently healthy population, there is a small percentage of patients dying from sudden cardiac death. Given the large denominator, this small percentage contributes to the largest burden of sudden cardiac death. Identification of this at risk group among the apparently healthy individual is a great challenge for the medical fraternity. This article looks into the causes and methods of preventing SCD and at some of the Indian data. Details of Brugada syndrome, Long QT syndrome, Genetics of SCD are discussed. Recent guidelines on many of these causes are summarised.

  18. Sudden death victims

    NARCIS (Netherlands)

    Ceelen, Manon; van der Werf, Christian; Hendrix, Anneke; Naujocks, Tatjana; Woonink, Frits; de Vries, Philip; van der Wal, Allard; Das, Kees

    2015-01-01

    The goal of this study was to ascertain accordance between cause of death established by the forensic physician and autopsy results in young sudden death victims in the Netherlands. Sudden death victims aged 1-45 years examined by forensic physicians operating in the participating regions which also

  19. Evidence against Barium in the Mushroom Trogia venenata as a Cause of Sudden Unexpected Deaths in Yunnan, China

    Science.gov (United States)

    Zhang, Ying; Li, Yanchun; Wu, Gang; Feng, Bang; Yoell, Shanze; Yu, Zefen; Zhang, Keqin

    2012-01-01

    This study examined barium concentrations in the mushroom Trogia venenata, the leading culprit for sudden unexpected deaths in Yunnan, southwest China. We found that barium concentrations in T. venenata from Yunnan were low and comparable to other foods, inconsistent with barium concentrations in this mushroom as a significant contributor to these deaths. PMID:23042168

  20. Inborn Errors of Metabolism That Cause Sudden Infant Death : A Systematic Review with Implications for Population Neonatal Screening Programmes

    NARCIS (Netherlands)

    van Rijt, Willemijn J.; Koolhaas, Genevieve D.; Bekhof, Jolita; Fokkema, M. Rebecca Heiner; de Koning, Tom J.; Visser, Gepke; Schielen, Peter C. J. I.; Spronsen, van FrancJan; Derks, Terry G. J.

    2016-01-01

    BACKGROUND: Many inborn errors of metabolism (IEMs) may present as sudden infant death (SID). Nowadays, increasing numbers of patients with IEMs are identified pre-symptomatically by population neonatal bloodspot screening (NBS) programmes. However, some patients escape early detection because their

  1. Inborn Errors of Metabolism That Cause Sudden Infant Death : A Systematic Review with Implications for Population Neonatal Screening Programmes

    NARCIS (Netherlands)

    van Rijt, Willemijn J.; Koolhaas, Geneviève D.; Bekhof, Jolita; Heiner Fokkema, M. Rebecca; de Koning, Tom J.; Visser, Gepke; Schielen, Peter C J I; van Spronsen, Francjan J.; Derks, Terry G J

    Background: Many inborn errors of metabolism (IEMs) may present as sudden infant death (SID). Nowadays, increasing numbers of patients with IEMs are identified pre-symptomatically by population neonatal bloodspot screening (NBS) programmes. However, some patients escape early detection because their

  2. Sudden infant death syndrome

    Science.gov (United States)

    ... required by law into an unexplained cause of death may make these feelings more painful. A member of a local chapter of the National Foundation for Sudden Infant Death Syndrome may assist with counseling and reassurance to ...

  3. The role of respiratory failure caused by congenital central nervous system abnormalities and the effect of β-casomorphins in sudden infant death syndrome pathogenesis

    Directory of Open Access Journals (Sweden)

    Barbara Sumińska-Ziemann

    2015-08-01

    Full Text Available The aim of the paper is to discuss the role of respiratory failure caused by endogenous (both structural and functional abnormalities in the central nervous system and exogenous food-derived opioid-like peptides in the pathogenesis of sudden infant death syndrome (SIDS. By stimulating μ-opioid receptors, opioid-like peptides may suppress the tonic activity of the respiratory centre in the brain stem.

  4. Adaptation of muscles of the lumbar spine to sudden imbalance in patients with lower back pain caused by military training.

    Science.gov (United States)

    Gao, Ying; Shi, Jian-guo; Ye, Hong; Liu, Zhi-rong; Zheng, Long-bao; Ni, Zhi-ming; Fan, Liang-quan; Wang, Jian; Hou, Zhen-hai

    2014-11-01

    This study aims to investigate the effects of sudden load changes (expected and unexpected imbalance) on the activity of muscles of the lumbar spine and their central motor control strategy in military personnel with or without chronic low back pain (LBP). Bilateral sudden imbalance was examined (2 × 2 factorial design). The 117th PLA Hospital, Hangzhou, China Twenty-one male subjects with lower back pain and 21 male healthy control subjects were active members of the Nanjing Military Region land forces. Independent variables: LBP vs. healthy controls and imbalance anticipation (expected and unexpected imbalance). rapid reaction time (RRT) and intensity of rapid reaction (IRR) of bilateral lumbar (L3-L4) erector spinae (ES), lumbar (L5-S1) multifidus (MF), and abdominal external oblique muscles. Results Under expected or unexpected sudden imbalance conditions, subjects with LBP demonstrated significantly greater IRR than healthy controls in ipsilateral and contralateral ES and MF, respectively (P muscles and a significant time expectation effect on RRT of contralateral MF muscles were also observed. RRT of the contralateral ES muscles was significantly lower than that of the ipsilateral ES muscles (P muscles in patients with chronic LBP. The activation amplitude increased. The results may provide a theoretical basis for a study on the pathogenesis of chronic LBP.

  5. Expanding the cardiac spectrum of Noonan syndrome with RIT1 variant: Left main coronary artery atresia causing sudden death.

    Science.gov (United States)

    Ramond, Francis; Duband, Sébastien; Croisille, Pierre; Cavé, Hélène; Teyssier, Georges; Adouard, Véronique; Touraine, Renaud

    2017-06-01

    Noonan syndrome is a well-known genetic condition associating congenital heart defects, short stature, and distinctive facial features. Pulmonary valve stenosis and hypertrophic cardiomyopathy are the most frequent cardiac abnormalities, the latter being associated with a higher mortality. Here we report for the first time, a case of congenital left main coronary artery atresia in a Noonan syndrome associated with RIT1 variant, leading to unrescued sudden death. This case-report supports the already-suspected severity of the RIT1-related Noonan syndrome compared to average Noonan syndrome, and should encourage clinicians to be very cautious with these patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. [Application of MSCT's coronary artery calcification score in evaluation of sudden death caused by coronary artery disease].

    Science.gov (United States)

    Wan, Lei; Ying, Chong-Liang; Liu, Ning-Guo; Xia, Wen-Tao; Wang, Ya-Hui; Wei, Hua; Zhu, Guang-You

    2013-12-01

    To access application value of multi-slice spiral computed tomography (MSCT) and coronary artery calcium scoring (CACS) in investigation the coronary artery disease (CAD), and to explore the effective way of virtual autopsy to evaluate the sudden death due to CAD. Nine cases of sudden cardiac death were collected to analyze MSCT before the autopsy. The quantitative analysis of the degree of coronary artery calcium was made by Agatston's method. The CACS of all the subjects were calculated based on the diagnostic criteria for CAD, in which calcium scoring was more than 400. The results of CACS were compared with that of the autopsy. Only 2 cases got the high calcium scoring which were more than 400 in the 9 cases died of CAD confirmed by the autopsy. The prediction rate of CACS for CAD was only 22.2%. Pulmonary edema of different severity was found in both autopsy and MSCT. There was a higher morbidity rate in the left anterior descending of coronary artery than the other branches. Obvious calcification of coronary artery can be detected by MSCT and calculating CACS. To detect subtle calcification needs other technologies such as postmortem angiography.

  7. [Sudden death and myocardial infarction caused by thrombosis of normal coronary arteries: an anatomic study of 3 cases].

    Science.gov (United States)

    Loire, R; Tabib, A; Pinede, L

    1997-10-01

    The anatomic lesions of two cases of sudden death (one man and one 24 years old woman) and of one case of rapidly fatal myocardial infarction (51 years old woman) are described. The coronary lesions were exclusively thrombotic with no associated atherosclerosis or pre-existing arterial wall change. The thrombi were occlusive from the outset or were constituted in successive mural stages, the last being occlusive and giving rise to the clinical symptoms (sudden death and/or myocardial infarction). Several points are discussed. The concept of normal coronary artery must be confirmed by anatomic examination: coronary angiography is not sufficient for the diagnosis of dangerous atherosclerotic plaques which are not particularly stenotic, eccentric, lipidic and fragile. Thrombogenic factors are better understood and some may play a role in these cases of "primary thrombosis", by they of plasma or platelet origin. The trigger role of spasm cannot be ignored as some of the spastic and thrombotic factors are similar. The preferential coronary site of these thromboses may be explained by constitutional changes (arterial hypolasia with narrow lumen) or acquired lesions (repeated arterial trauma due to shearing by the movements of the underlying left ventricle transmitted to the epicardial coronary arteries).

  8. Sudden death in Lesch-Nyhan disease

    Science.gov (United States)

    Neychev, Vladimir Kostadinov; Jinnah, H A

    2012-01-01

    To increase awareness of sudden and unexpected death in Lesch-Nyhan disease (LND) and to explore its potential causes, we report the anteceding clinical features and laboratory evaluations of five males with LND who ultimately experienced sudden and unexpected death, along with three additional males who suffered serious respiratory events during life. The ages of patients ranged from 2 to 45 years. The cause of sudden death in LND appears to have a respiratory rather than a cardiogenic basis. All cases cannot be linked readily with a single respiratory process. Instead, different respiratory processes appear to operate in different cases. These may include aspiration, laryngospasm, central apnea, cyanotic breath-holding spells, and high cervical spine damage. Better recognition of these processes will help to guide appropriate workup and management that could include chest imaging, endoscopy of the airways, polysomnography, electroencephalogram, and brain and/or spine imaging. PMID:17044962

  9. 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

  10. A population-based autopsy study of sudden, unexpected deaths from natural causes among persons 5 to 39 years old during a 12-year period.

    Science.gov (United States)

    Anderson, R E; Hill, R B; Broudy, D W; Key, C R; Pathak, D

    1994-12-01

    All unexpected deaths in New Mexico from 1977 to 1988 were reviewed. By statute each such death must be reported to the Office of the Medical Examiner (OMI) and according to institutional policy autopsied even when death is presumed to be from natural causes. From this group the 650 index cases that form the basis of this report were obtained. The crude rate of sudden, unexpected death among New Mexico residents 5 to 39 years old during the study period was 6.6/100,000 persons at risk. As documented by autopsy, the underlying cause of death in a majority of these cases (53.4%) was related to cardiovascular disease and alcoholism. Male persons in general are at increased risk for sudden, unexpected death, and American Indian and black male persons are at greater risk than their Anglo and Hispanic counterparts. American Indians account for a disproportionate share of the unexpected deaths resulting from alcoholism, and black male persons are at particular risk for unexpected death resulting from cardiovascular diseases. This report emphasizes the importance of life style and diet in the well-being of persons 5 to 39 years old.

  11. Genetics of sudden cardiac death

    NARCIS (Netherlands)

    Bezzina, Connie R.; Lahrouchi, Najim; Priori, Silvia G.

    2015-01-01

    Sudden cardiac death occurs in a broad spectrum of cardiac pathologies and is an important cause of mortality in the general population. Genetic studies conducted during the past 20 years have markedly illuminated the genetic basis of the inherited cardiac disorders associated with sudden cardiac

  12. Sudden Death in Young People--Heart Problems Often Blamed

    Science.gov (United States)

    Sudden death in young people: Heart problems often blamed Sudden death in young people is rare, but those at ... causes and treatments. By Mayo Clinic Staff Sudden death in people younger than 35, often due to ...

  13. Temporal trends in sudden infant death syndrome in Canada from 1991 to 2005: contribution of changes in cause of death assignment practices and in maternal and infant characteristics

    Science.gov (United States)

    Gilbert, Nicolas L; Fell, Deshayne B; Joseph, K S; Liu, Shiliang; León, Juan Andrés; Sauve, Reg

    2012-01-01

    Gilbert NL, Fell DB, Joseph KS, Liu S, León JA, Sauve R, for the Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System. Temporal trends in sudden infant death syndrome in Canada from 1991 to 2005: contribution of changes in cause of death assignment practices and in maternal and infant characteristics. Paediatric and Perinatal Epidemiology 2012; 26: 124–130. The rate of sudden infant death syndrome (SIDS) declined significantly in Canada and the US between the late 1980s and the early 2000s. In the US, this decline was shown to be due in part to a shift in diagnosis, as deaths from accidental suffocation and strangulation in bed and from other ill-defined and unspecified cause increased concurrently. This study was undertaken to determine whether there was such a shift in diagnosis from SIDS to other causes of death in Canada, and to quantify the true temporal decrease in SIDS. Cause-specific infant death rates were compared across three periods: 1991–95, 1996–2000 and 2001–05 using the Canadian linked livebirth-infant death file. The temporal decline in SIDS was estimated after adjustment for maternal and infant characteristics such as maternal age and small-for-gestational age using logistic regression. Deaths from SIDS decreased from 78.4 [95% confidence interval (CI) 73.4, 83.4] per 100 000 livebirths in 1991–95, to 48.5 [95% CI 44.3, 52.7] in 1996–2000 and to 34.6 [95% CI 31.0, 38.3] in 2001–05. Mortality rates from other ill-defined and unspecified causes and accidental suffocation and strangulation in bed remained stable. The temporal decline in SIDS between 1991–95 and 2001–05 did not change substantially after adjustment for maternal and infant factors. It is unlikely that the temporal decline of SIDS in Canada was due to changes in cause-of-death assignment practices or in maternal and infant characteristics. PMID:22324498

  14. Sudden parental death from external causes and risk of suicide in the bereaved offspring: A national study.

    Science.gov (United States)

    Burrell, Lisa Victoria; Mehlum, Lars; Qin, Ping

    2018-01-01

    Previous research has revealed an association between parental bereavement from external causes and risk of suicide in offspring. Few studies have however provided insights into specific influences of cause of death, gender of the deceased and bereaved, age at bereavement and suicide, and time since bereavement. The present nested case-control study was based on data from three longitudinal registers. Subjects comprised 19 015 persons who died from suicide at an age of 11-64 years during 1969-2012 (cases), and 332 046 live comparison individuals matched for gender and date of birth. Information about deceased parents' cause and date of death, and sociodemographic data was retrieved and merged. Data were analysed with conditional logistic regression. Losing a parent to suicide, transport accidents and other external causes of death was associated with an increased suicide risk in offspring. Parental suicide was associated with a substantially higher suicide risk than transport accidents and other external causes. These effects were equally strong for daughters and sons, and for the loss of a mother, father or both parents. Suicide risk was highest in younger bereaved offspring, and bereavement had both short and long-term impacts on suicide risk. In conclusion, all offspring exposed to parental death by external causes have an increased suicide risk, independent of factors related to the exposure. The consequences are long lasting, and offspring should be offered follow-up in primary healthcare. Younger offspring bereaved by parental suicide have the highest risk and may be targeted for prevention and intervention programs in specialist healthcare. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. [Sudden death in athletes].

    Science.gov (United States)

    Kulbertus, H

    2001-05-01

    Sudden death is rare in the young athlete. The causes may vary. In the US, hypertrophic cardiomyopathy plays the predominant role whereas in Europe right ventricular arrhythmogenic dysplasia and atherosclerosis of the coronary arteries are more frequent. Other causes such as congenital anomalies of the coronary vessels, myocarditis, Marfan's disease, the long QT, the Brugada and the Wollf-Parkinson-White syndromes exist, but are rare. Attentive preparticipation screening (clinical history and medical examination) is mandatory in all future young athletes.

  16. Localized Pigmented Villonodular Synovitis of the Hip: Sudden-Onset Pain Caused by Torsion of the Tumor Pedicle

    Directory of Open Access Journals (Sweden)

    Kiyokazu Fukui

    2013-01-01

    Full Text Available Pigmented villonodular synovitis is a rare, benign, but potentially locally aggressive disease that should be considered in younger patients who present with monoarticular joint symptoms and pathology. We present the case of a 33-year-old woman with a mass arising from her right hip joint that was examined using a multimodal radiological approach. Because her clinical presentation mimicked that of synovial osteochondromatosis of the hip, surgical dislocation was performed. Histopathological examination of the resected specimen confirmed the diagnosis of localized pigmented villonodular synovitis, with the mass consisting of proliferation of fibrohistiocytic cells, abundant hemosiderin, foamy histiocytes, and occasional giant cells. Because of the presence of tumor necrosis, we hypothesize that torsion of the tumor pedicle was the cause of acute presentation.

  17. Temporal trends in sudden infant death syndrome in Canada from 1991 to 2005: contribution of changes in cause of death assignment practices and in maternal and infant characteristics.

    Science.gov (United States)

    Gilbert, Nicolas L; Fell, Deshayne B; Joseph, K S; Liu, Shiliang; León, Juan Andrés; Sauve, Reg

    2012-03-01

    The rate of sudden infant death syndrome (SIDS) declined significantly in Canada and the US between the late 1980s and the early 2000s. In the US, this decline was shown to be due in part to a shift in diagnosis, as deaths from accidental suffocation and strangulation in bed and from other ill-defined and unspecified cause increased concurrently. This study was undertaken to determine whether there was such a shift in diagnosis from SIDS to other causes of death in Canada, and to quantify the true temporal decrease in SIDS. Cause-specific infant death rates were compared across three periods: 1991-95, 1996-2000 and 2001-05 using the Canadian linked livebirth-infant death file. The temporal decline in SIDS was estimated after adjustment for maternal and infant characteristics such as maternal age and small-for-gestational age using logistic regression. Deaths from SIDS decreased from 78.4 [95% confidence interval (CI) 73.4, 83.4] per 100 000 livebirths in 1991-95, to 48.5 [95% CI 44.3, 52.7] in 1996-2000 and to 34.6 [95% CI 31.0, 38.3] in 2001-05. Mortality rates from other ill-defined and unspecified causes and accidental suffocation and strangulation in bed remained stable. The temporal decline in SIDS between 1991-95 and 2001-05 did not change substantially after adjustment for maternal and infant factors. It is unlikely that the temporal decline of SIDS in Canada was due to changes in cause-of-death assignment practices or in maternal and infant characteristics. © 2012 Blackwell Publishing Ltd.

  18. Sudden Death Following Exercise; a Case Series Study

    Directory of Open Access Journals (Sweden)

    Fares Najari

    2016-04-01

    Full Text Available Introduction: Natural and unexpected death that happens within less than one hour of first symptom occurrence is called sudden death. Cardiovascular diseases are the main known reason of sudden death and more than 75% of sudden deaths in athletes are assigned to it. Here we reported the autopsy results of all cases with sudden death following exercise that were referred to forensic center of Tehran, Iran, from 2009 to 2014. Methods: In this cross sectional study all subjects who were registered to forensic medicine center of Tehran, Iran, from 2009 to 2014, as a case of sudden death following exercise were evaluated. Demographic data and medical history as well as autopsy and toxicology findings were retrospectively gathered using profiles of the deceased. Results were reported using descriptive analysis. Results: 14 cases were registered as sudden death following exercise in forensic medicine profiles during the study period. Exploring the files of the mentioned deceased, revealed five non-compatible cases in this regard. Finally, 9 eligible cases were enrolled (88.9% male. The mean age of the deceased was 28.66 ± 10.86 years (range: 7 – 40. Toxicological tests were available for 7 cases, one of which was positive for tramadol. Sudden death following football was reported most frequently (44.4%. Only 3 (33.3% cases had herald signs such as chest pain, syncope, or loss of consciousness. 1 case (11.11% had a positive history of sudden death in relatives. Conclusion: Although most sudden death victims are asymptomatic until the event, all those who suffer from symptoms such as chest pain, shortness of breath, dizziness, fatigue and irregular heart rate during physical activities, should be screened regarding common probable causes of sudden death.

  19. Can the direct cardiac effects of the electric pulses generated by the TASER X26 cause immediate or delayed sudden cardiac arrest in normal adults?

    Science.gov (United States)

    Ideker, Raymond E; Dosdall, Derek J

    2007-09-01

    There is only a small amount of experimental data about whether the TASER X26, a nonlethal weapon that delivers a series of brief electrical pulses to cause involuntary muscular contraction to temporarily incapacitate an individual, can initiate ventricular fibrillation to cause sudden cardiac arrest either immediately or sometime after its use. Therefore, this paper uses the fundamental law of electrostimulation and experimental data from the literature to estimate the likelihood of such events. Because of the short duration of the TASER pulses, the large duration of the cardiac cell membrane time constant, the small fraction of current from electrodes on the body surface that passes through the heart, and the resultant high pacing threshold from the body surface, the fundamental law of electrostimulation predicts that the TASER pulses will not stimulate an ectopic beat in the large majority of normal adults. Since the immediate initiation of ventricular fibrillation in a normal heart requires a very premature stimulated ectopic beat and the threshold for such premature beats is higher than less premature beats, it is unlikely that TASER pulses can immediately initiate ventricular fibrillation in such individuals through the direct effect of the electric field generated through the heart by the TASER. In the absence of preexisting heart disease, the delayed development of ventricular fibrillation requires the electrical stimuli to cause electroporation or myocardial necrosis. However, the electrical thresholds for electroporation and necrosis are many times higher than that required to stimulate an ectopic beat. Therefore, it is highly unlikely that the TASER X26 can cause ventricular fibrillation minutes to hours after its use through direct cardiac effects of the electric field generated by the TASER.

  20. Sudden Unexpected Infant Death and Sudden Infant Death Syndrome: Reducing the Risk

    Science.gov (United States)

    ... caregivers can take to reduce the risk of sudden infant death syndrome (SIDS) and other sleep-related deaths. Grief ... researchers don’t know the exact causes of Sudden Infant Death Syndrome (SIDS). However, research shows parents and caregivers ...

  1. Sudden Cardiac Arrest (SCA)

    Science.gov (United States)

    ... Arrest (SCA) Back to Heart Diseases & Disorders Sudden Cardiac Arrest (SCA) Sudden Cardiac Arrest ( SCA ) occurs when the heart stops beating, abruptly ... to saving someone who is having a sudden cardiac arrest , it is important to understand the difference. The ...

  2. Sudden cardiac death in athletes

    Directory of Open Access Journals (Sweden)

    Fábio Camilo Pellegrino dos Santos

    2012-11-01

    Full Text Available ABSTRACT The most accepted definition of sudden cardiac death nowadays is an unexplained death occurred suddenly within one hour of symptom onset. If it was not witnessed, individuals need to had been observed for at least 24 hours before the event and should be discarded the possibility of non cardiac causes of sudden death, pulmonary embolism or extensive malignancy. The term athlete refers to individuals of any age who participate in collective or individual regular physical activity, as well as physical training program for regular competitions. The sudden death of a young athlete, whether amateur or professional, especially during competitions, is always dramatic, with strong negative social impact and in the media. The fact that sports are recommended as a formula for longevity and quality of life makes these events a cause for concern in sports and society in general.

  3. Sudden cardiac death in the pediatric population.

    Science.gov (United States)

    Gillette, P C; Garson, A

    1992-01-01

    Sudden death in children as in adults is usually due to cardiac disease. Sudden death in the pediatric population may be divided into the sudden infant death syndrome, sudden death in previously apparently healthy children, and sudden death in patients with known cardiac disease. The sudden infant death syndrome is not proved to be due to a cardiac cause and may well be due to central nervous system and/or pulmonary causes. However, interest remains in the cardiac hypothesis. Recent work from our laboratory shows that screening for prolonged QT interval in normal infants is not likely to detect those prone to sudden infant death syndrome. In children with apparently normal hearts, symptoms of syncope or palpitation should be given close attention. Detailed electrocardiography and echocardiography will detect many, but not all, children with subtle forms of heart disease. Vigorous treatment may prevent sudden death in many of these children. Some sort of screening program should be devised for varsity athletes. Children with congenital heart defects are now, for the most part, corrected early in life, so that the congenital heart defect itself rarely causes sudden, unexpected death. The residua and sequelae of the heart defect and the surgery to repair it, however, may lead to sudden death. Improvements in surgical technique and earlier repair of congenital cardiac defects will ameliorate this problem. Prospective evaluation of postoperative patients and attention to dysrhythmias can prevent sudden deaths in those who are prone to them.

  4. Sudden Cardiac Death

    DEFF Research Database (Denmark)

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

    2017-01-01

    Objectives This study sought to describe the use of pharmacotherapy in a nationwide cohort of young patients with sudden cardiac death (SCD). Background Several drugs have been associated with an increased risk of SCD and sudden arrhythmic death syndrome (SADS). It remains unclear how...... pharmacotherapy may contribute to the overall burden of SCD in the general population. Methods This was a nationwide study that included all deaths that occurred between 2000 and 2009 and between 2007 and 2009 in people age 1 to 35 years and 36 to 49 years, respectively. Two physicians identified all SCDs through...... review of death certificates. Autopsy reports were collected. Pharmacotherapy prescribed within 90 days before SCD was identified in the Danish Registry of Medicinal Product Statistics. Results We identified 1,363 SCDs; median age was 38 years (interquartile range: 29 to 45 years), and 72% (n = 975) were men...

  5. Sudden infant death syndrome

    National Research Council Canada - National Science Library

    Adams, Stephen M; Ward, Chad E; Garcia, Karla L

    2015-01-01

    Sudden infant death syndrome (SIDS) is the sudden unexpected death of a child younger than one year during sleep that cannot be explained after a postmortem evaluation including autopsy, a thorough history, and scene evaluation...

  6. 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. This...

  7. Sudden natural death in Khartoum Mortuary | Mohamed | Sudan ...

    African Journals Online (AJOL)

    Background: The sudden natural death is defined as: Death occurs within 24 hours from the onset of symptoms. The disclosing of the causes of sudden natural death is important for prevention and improving outcome. The objectives of this study were to determine the causes of sudden natural death in Khartoum Mortuary

  8. [The Sudden Infant Death Syndrome.

    Science.gov (United States)

    Florida's Health, 1976

    1976-01-01

    This collection of articles on the Sudden Infant Death Syndrome (SIDS), drawn from a southeastern regional symposium on the subject, summarizes much of what is known about the occurrence of SIDS, including current information about its causes. The background of state action in Florida is reviewed, with emphasis on the need for increased public and…

  9. 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

  10. 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…

  11. What Is Sudden Cardiac Arrest?

    Science.gov (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  12. Canalopatías arritmogénicas como causa de muerte súbita en pediatría Arrhythmic canal diseases causing sudden death in children

    Directory of Open Access Journals (Sweden)

    Michel Cabrera Ortega

    2009-12-01

    Full Text Available La muerte súbita cardíaca de niños con corazón estructuralmente sano está estrechamente relacionada con las canalopatías arritmogénicas. Se presenta una revisión actualizada sobre las canalopatías y la relación de éstas con la muerte súbita. Se analiza especialmente la aplicación del método clínico y la importancia del trazado electrocardiográfico como herramientas indispensables para el certero diagnóstico de estas entidades.Cardiac sudden death in children with a heart structurally healthy is closely related to arrhythmic canal diseases. An update review on canal diseases and its relation to the sudden death is presented. The application of clinical method is analyzed, as well as the significance of electrocardiographic recordings like essential tools for an accuracy diagnosis of these entities.

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

    Directory of Open Access Journals (Sweden)

    Gajewski Kelly

    2010-01-01

    Full Text Available 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.

  14. Canalopatías arritmogénicas como causa de muerte súbita en pediatría Arrhythmic canal diseases causing sudden death in children

    OpenAIRE

    Michel Cabrera Ortega; Luis Mario Sollet López; Francisco Javier Ozores Suárez

    2009-01-01

    La muerte súbita cardíaca de niños con corazón estructuralmente sano está estrechamente relacionada con las canalopatías arritmogénicas. Se presenta una revisión actualizada sobre las canalopatías y la relación de éstas con la muerte súbita. Se analiza especialmente la aplicación del método clínico y la importancia del trazado electrocardiográfico como herramientas indispensables para el certero diagnóstico de estas entidades.Cardiac sudden death in children with a heart structurally healthy ...

  15. Bronchus-associated lymphoid tissue (BALT) in the lungs of children who had died from sudden infant death syndrome and other causes.

    Science.gov (United States)

    Tschernig, T; Kleemann, W J; Pabst, R

    1995-06-01

    Bronchus-associated lymphoid tissue (BALT) is well characterised in rabbits and rats. In humans, however, it does not seem to be present in the healthy adult lung, although it can develop after certain microbial stimulation. In the present study a consecutive series of lungs from 88 children who had died of sudden infant death syndrome (SIDS) and 34 control cases of comparable age were examined for the presence of BALT. BALT was present in 36.4% of the patients who had died of SIDS and in 44.1% of the control cases. The probability of finding BALT increased with age, with similar kinetics in both groups. Future studies need to define when and at what rate BALT disappears as children get older. In young children BALT may act as an entry site for antigens to initiate an immune response, as is well documented for the gut-associated lymphoid system.

  16. Drugs, QTc prolongation and sudden cardiac death

    OpenAIRE

    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 apparent cause. Another early case of sudden death was Phidippides, the young Greek messenger, who collapsed and died after he ran 26.2 miles from Marathon to Athens to deliver the news of the Greek victo...

  17. Proceedings of the sudden oak death sixth science symposium

    Science.gov (United States)

    Susan J. Frankel; Katharine M. Harrell

    2017-01-01

    The Sudden Oak Death Sixth Science Symposium provided a forum for current research on sudden oak death, caused by the exotic quarantine pathogen Phytophthora ramorum. More than 50 submissions describing papers or posters on the following sudden oak death/P. ramorum topics are included: biology, genetics, nursery and wildland...

  18. Snake fungal disease caused by Ophidiomyces ophiodiicola in a free-ranging mud snake (Farancia abacura).

    Science.gov (United States)

    Last, Lisa A; Fenton, Heather; Gonyor-McGuire, Jessica; Moore, Matthew; Yabsley, Michael J

    2016-11-01

    Snake fungal disease is an emerging infectious disease caused by the fungus Ophidiomyces ophiodiicola leading to severe dermatitis and facial disfiguration in numerous free-ranging and captive snakes. A free-ranging mud snake (Farancia abacura) from Bulloch County, Georgia, was presented for autopsy because of facial swelling and emaciation. Extensive ulceration of the skin, which was especially severe on the head, and retained shed were noted on external examination. Microscopic examination revealed severe heterophilic dermatitis with intralesional fungal hyphae and arthroconidia consistent with O. ophiodiicola A skin sample incubated on Sabouraud dextrose agar yielded a white-to-tan powdery fungal culture that was confirmed to be O. ophiodiicola by polymerase chain reaction and sequence analysis. Heavy infestation with adult tapeworms (Ophiotaenia faranciae) was present within the intestine. Various bacterial and fungal species, interpreted to either be secondary invaders or postmortem contaminants, were associated with oral lesions. Although the role of these other organisms in the overall health of this individual is not known, factors such as concurrent infections or immunosuppression should be considered in order to better understand the overall manifestation of snake fungal disease, which remains poorly characterized in its host range and geographic distribution. © 2016 The Author(s).

  19. Fluorosis as a probable cause of chronic lameness in free ranging eastern grey kangaroos (Macropus giganteus).

    Science.gov (United States)

    Clarke, Emily; Beveridge, Ian; Slocombe, Ron; Coulson, Graeme

    2006-12-01

    A population of eastern grey kangaroos (Macropus giganteus) inhabiting heathland and farmland surrounding an aluminum smelter at Portland, Victoria, Australia, exhibited clinical signs of lameness. An investigation was undertaken to determine the cause of this lameness. Hematology, necropsy, histopathology, fecal egg count, total worm count, reproductive status, and the population age range were examined and failed to reveal any additional underlying disease state. The specific problem of lameness was addressed with bone histopathology, radiography, quantitative ultrasonography, microradiography, and multielement analysis of bone ash samples. The significant lesions observed were: osteophytosis of the distal tibia and fibula, tarsal bones, metatarsus IV, and proximal coccygeal vertebrae; osteopenia of the femur, tibia, and metatarsus IV; incisor enamel hypoplasia; stained, uneven, and abnormal teeth wear; abnormal bone matrix mineralization and mottling; increased bone density; and elevated bone fluoride levels. Microradiography of affected kangaroos exhibited "black osteons," which are a known manifestation of fluorosis. Collectively, these lesions were consistent with a diagnosis of fluorosis.

  20. Sudden Infant Death Syndrome.

    Science.gov (United States)

    Barnett, Henry L.; And Others

    There is a growing body of evidence that Sudden Infant Death Syndrome (SIDS) victims are not completely normal and healthy, as was once believed. A variety of new information from several disciplines strongly suggests that the infant who dies suddenly and unexpectedly may do so because of subtle developmental, neurologic, cardiorespiratory, and…

  1. Sudden Cardiac Death.

    Science.gov (United States)

    Goldberger

    1999-08-01

    Great strides have been made in the approach to the management of sudden cardiac death. Patients who have been successfully resuscitated from an episode of sudden cardiac death are at high risk of recurrence. Much larger groups of patients who have not had episodes of sudden cardiac death are also at substantial risk for this event, however. Because the survival rates associated with out-of-hospital cardiac arrest are dismal, these high-risk populations must be targeted for prophylaxis. Beta-blockers have been shown to be an effective pharmacologic therapy in patients who have had myocardial infarction and, most recently, in patients with congestive heart failure. When possible, these agents should be used in these populations. No class I or class III antiarrhythmic drugs, with the possible exception of amiodarone, have been shown to have efficacy as prophylactic agents for the reduction of mortality in these populations. In patients who have hemodynamically significant sustained ventricular tachyarrhythmias or an aborted episode of sudden cardiac death, the current therapy of choice is an implantable cardioverter-defibrillator (ICD). For prophylaxis of sudden cardiac death in patients who have not had a previous event, several approaches may be considered. Currently, the best therapeutic approach for prophylaxis of sudden cardiac death seems to be the ICD; however, use of this device can be justified only in patients at substantial risk of sudden cardiac death. Defining the high-risk populations that will benefit from ICDs is critical in managing the problem of sudden cardiac death.

  2. Familial very long chain acyl-CoA dehydrogenase deficiency as a cause of neonatal sudden infant death: improved survival by prompt diagnosis.

    Science.gov (United States)

    Scalais, Emmanuel; Bottu, Jean; Wanders, Ronald J A; Ferdinandusse, Sacha; Waterham, Hans R; De Meirleir, Linda

    2015-01-01

    In neonates, very long chain acyl-CoA dehydrogenase (VLCAD) deficiency is often characterized by cardiomyopathy, hepatic encephalopathy, or severe hypoketotic hypoglycemia, or a combination thereof. The purpose of this study was to further elucidate a familial VLCAD deficiency in three patients, two of whom died in the neonatal period. We report on a family with VLCAD deficiency. Acyl-carnitine profiles were obtained from dried blood spot and/or from oxidation of (13) C-palmitate by cultured skin fibroblasts. In the index patient, VLCAD deficiency was ascertained by enzyme activity measurement in fibroblasts and by molecular analysis of ACADVL. At 30 hr of life, the proband was diagnosed with hypoglycemia (1.77 mmol/L), rhabdomyolysis (CK: 12966 IU/L) and hyperlactacidemia (10.6 mmol/L). Acylcarnitine profile performed at 31 hr of life was consistent with VLCAD deficiency and confirmed by cultured skin fibroblast enzyme activity measurement. Molecular analysis of ACADVL revealed a homozygous splice-site mutation (1077 + 2T>C). The acyl-carnitine profile obtained from the sibling's original newborn screening cards demonstrated a similar, but less pronounced abnormal profile. In the proband, the initial metabolic crisis was controlled with 10% dextrose solution and oral riboflavin followed by specific diet (Basic-F and medium chain triglyceride (MCT). This clinical report demonstrates a familial history of repeated neonatal deaths explained by VLCAD deficiency, and the clinical evolution of the latest affected, surviving sibling. It shows that very early metabolic screening is an effective approach to avoid sudden unexpected death. © 2014 Wiley Periodicals, Inc.

  3. Supravalvular aortic stenosis with sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Pradeep Vaideeswar

    2015-01-01

    Full Text Available Sudden cardiac death (SCD most commonly results from previously undiagnosed congenital, acquired, or hereditary cardiac diseases. Congenital aortic valvular, subvalvular, and supravalvular disease with left ventricular outflow tract obstruction is an important preventable cause of sudden death. This report documents sudden death presumably due to acute myocardial ischemia in a young male with an undiagnosed supravalvular aortic stenosis (SVAS due to a rare association of isolation of coronary sinuses of Valsalva. Congenital supravalvular pulmonary stenosis and mitral valvular dysplasia were also present.

  4. [Sudden death in competitive athletes].

    Science.gov (United States)

    Juszczyk, Zdzisław

    2007-01-01

    In athletes under the age of 35 years the incidence of sudden death is low, most causes to be due to ventricular arrhythmias, usually provoked by exertion, and nearly always occur in the presence of structural heart disease or abnormalities in the conduction system. The most common structural disease is hypertrophic cardiomyopathy followed by coronary artery anomalies, idiopathic dilated cardiomyopathy, arrhythmogenic right ventricular dysplasia, aortic stenosis, myocarditis, the Wolff-Parkinson-White syndrome, and long QT syndrome. The evaluation of athletes with symptoms of cardiac arrhythmias, syncope, family history of sudden death require a complete cardiac workup. If they have documented hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, idiopathic dilated cardiomyopathy, long QT syndrome, family history presentation with sudden death, and septal thickness greater than 20 mm competitive athletics are generally prohibited. In athletes with asymptomatic bradyarrhythmia, supraventricular tachycardias and atrial premature contractions without structural heart disease all competitive sports are allowed if heart rate in bradyarrhythmia appropriately increases with exercise. Athletes with premature ventricular contraction, nonsustained ventricular tachycardia and non structural heart disease are without athletic restriction as long as the arrhythmia does not worsen on exertion and cause dyspnea, presyncope or syncope.

  5. Sudden hearing loss in children.

    Science.gov (United States)

    Ječmenica, Jovana; Bajec-Opančina, Aleksandra

    2014-08-01

    Sudden sensorineural hearing loss (SSHL) is defined as a unilateral or bilateral sensorineural hearing loss with at least 30 dB decrease in threshold in 3 contiguous test frequencies occurring over 72 hours or less. It is very rare in children. Sudden hearing loss is a symptom that suggests that there is a problem in the inner ear, surrounding structures, or the whole organism. The etiology and development of this disorder are still not fully understood. The literature contains numerous models of the pathogenesis of SSHL, with childhood SSHL having certain peculiarities. In practical terms, the multifactorial nature of SSHL is important in the choice of diagnostic methods and treatment methods. It is important to determine the cause and effect relationship between the underlying disease and hearing loss. © The Author(s) 2014.

  6. Sudden hearing loss: Our experience in treatment with vasoactive therapy

    Directory of Open Access Journals (Sweden)

    Živić Ljubica

    2008-01-01

    Full Text Available Introduction A specific title "sudden hearing loss" refers to illness which is characterized by a sudden, rapid sensoneural hearing loss mostly in one ear without obvious causes, accompanied with dizziness, and without vestibular symptomatology. It is defined as a hearing loss for more than 30 dB on 3 or more successive frequencies which appear in 72 hours. Objective The main goal of our paper was to estimate success of implementation of vasoactive method in patients with sudden hearing loss of senso-neural type in different ranges in hospital conditions. METHOD Our research covered 37 patients hospitalized because of a sudden hearing loss of sensoneural type in different ranges. Diagnosis, in all patients, was established by clinical ORL examination, audiology and vestibular examination. R including CT and MR, neurological, internist and laboratory examinations were used in order to exclude other aetiology. In monitored patients, we started treatment with vasoactive therapy, ampules of xanthinol nicotinate (one ampule of 2 ml, 300 mg or ampules of pentoxiphylline (one ampule of 5 ml, 100 mg in form of infusions with addition of vitamins with an everyday gradual increase of dosage up to 12 ampules of xanthinol nicotinate and up to 5 ampules of pentoxiphylline. Then we started with an everyday decrease of dosage down to the first one. Results After the complete curing protocol, we found out that in patients with light and medium senso-neural damages of hearing sense (23 or 62%, hearing recovery was complete. In patients with heavy damage of hearing (9 or 24%, partial success was evidenced. The most difficult cases, with complete hearing loss, heavy buzzing and vertiginous problem (5 or 14% responded to therapy, so buzzing and vertiginous problems disappeared but hearing was not improved. Conclusion Usage of vasoactive medicaments in hospital conditions in treatment of sudden hearing loss gives good results and it is the closest to aetiological

  7. Sudden cardiac death in athletes

    OpenAIRE

    Bockeria O.L.; Ispir’yan A.Yu.

    2013-01-01

    Cases of sudden cardiac death (SCD) in young athletes during physical exercises are rare. According to the data of prospective population study performed in Veneto (Italy), incidence of SCD is 2.3 cases per year (2.6 among men and 1.1 among women) per 100,000 athletes aged 12 to 35 years for all reasons. Out of them 2.1 cases of SCD were caused by cardiovascular diseases. Coronary artery disease is the most frequent cause of SCD in athletes aged over 35 years. Also there are a number of other...

  8. Slowing spread of sudden oak death in Oregon forests, 2001–2015

    Science.gov (United States)

    Alan Kanaskie; Randy Wiese; Danny Norlander; Jon Laine; Sarah Navarro; Ellen Michaels Goheen; Ron Rhatigan; Everett Hansen; Wendy Sutton; Paul Reeser; Nik Grunwald; Zhian Kamvar; Nancy Osterbauer

    2017-01-01

    Sudden oak death, caused by Phytophthora ramorum, is lethal to tanoak (Notholithocarpus densiflorus) and threatens this species throughout its range in Oregon. The disease was first discovered in coastal southwest Oregon forests in July 2001. An interagency team attempted to eradicate the pathogen through a program of...

  9. 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...

  10. The Novel Desmin Mutant p.A120D Impairs Filament Formation, Prevents Intercalated Disk Localization, and Causes Sudden Cardiac Death

    DEFF Research Database (Denmark)

    Brodehl, Andreas; Dieding, Mareike; Klauke, Bärbel

    2013-01-01

    The intermediate filament protein desmin is encoded by the gene DES and contributes to the mechanical stabilization of the striated muscle sarcomere and cell contacts within the cardiac intercalated disk. DES mutations cause severe skeletal and cardiac muscle diseases with heterogeneous phenotype...

  11. Why did life expectancy in Central and Eastern Europe suddenly improve in the 1990s? An analysis by cause of death.

    Science.gov (United States)

    Mackenbach, Johan P; Karanikolos, Marina; Lopez Bernal, Jamie; Mckee, Martin

    2015-12-01

    The upturn of life expectancy in Central and Eastern Europe in the 1990s, after a period of stagnation or even decline, is one of the main events in European population history of the late 20th century, but has not been satisfactorily explained. Turning points in total and cause-specific mortality in the Czech Republic, Bulgaria, Hungary, Poland, Romania and Slovakia were determined using joinpoint regression. Changes in life expectancy in the 10 years following country-specific turning points were decomposed by age and cause of death using Arriaga's method. Among men, the turning points for all-cause mortality coincided with those for ischaemic heart disease in all six countries, and sometimes also with those for liver cirrhosis, road traffic accidents and lung cancer. Among women, the pattern was more diffuse. In the 10 years since the turning point for all-cause mortality, life expectancy increased by around four years for men and three years for women in most countries. Declines in mortality from cardiovascular disease explain between a third and a half of the increase in life expectancy in all countries, but beyond this the contributing causes of death often varied considerably. Although the upturn of life expectancy in Central and Eastern Europe started at different points in time, improvements in prevention and/or treatment of ischaemic heart disease appear to have played a role in all six countries. Other factors, such as changes in alcohol consumption and road traffic safety, have, however, also made important contributions in some countries. © 2015 the Nordic Societies of Public Health.

  12. 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 ICD-10 code for SIDS (R95) in the Danish Cause of Death registry. Design. A retrospective analysis of all infant deaths (death certificates and autopsy reports were read. Results. We identified 192 SUDI cases (10% of total deaths, 0.42 per 1000 births......) with autopsy performed in 87% of cases. In total, 49% of autopsied SUDI cases were defined as SIDS (5% of all deaths, 0.22 per 1000 births); Cardiac cause of death was denoted in 24% of cases. The Danish Cause of Death Registry misclassified 30% of SIDS cases. Conclusions. A large proportion of infant deaths...

  13. 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.

  14. Causes and consequences of range size variation: the influence of traits, speciation, and extinction

    Directory of Open Access Journals (Sweden)

    Steven M. Vamosi

    2012-12-01

    Full Text Available The tremendous variation in species richness observed among related clades across the tree of life has long caught the imagination of biologists. Recently, there has been growing attention paid to the possible contribution of range size variation, either alone or in combination with putative key innovations, to these patterns. Here, we review three related topics relevant to range size evolution, speciation, and extinction. First, we provide a brief overview of the debate surrounding patterns and mechanisms for phylogenetic signal in range size. Second, we discuss some recent findings regarding the joint influence of traits and range size on diversification. Finally, we present the preliminary results of a study investigating whether range size is negatively correlated with contemporary extinction risk in flowering plants.

  15. Range of motion caused by design of the total hip prosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Herrlin, K.; Selvik, G.; Pettersson, H.; Lidgren, L.

    In a clinical material of total hip prostheses, a study was performed of the range of femoral motion until impingement occurred between the neck of the femoral stem and the rim of the acetabular socket. The results were compared with the physiologic range of motion, and the clinically relevant motion restriction was measured. Restriction was most common in flexion. There was a correlation between the prosthetic design and the restriction due to impingement.

  16. A SUDDEN DEATH OF SPORTSMEN

    Directory of Open Access Journals (Sweden)

    Miroslav Femić

    2006-06-01

    Full Text Available Introduction: A sudden death is defined as a sudden cessation of heart work which happens within six hours, revionsly of good helth(1. The main characteristio of this phenomenon is tipically its beginning during or directly after a training or a competition which means after an intensive physical effort a causal factor. The first case of a sudden death because of physical effort was recorded in ancient 490 BC when a Greec called Pheidippides was running from Marathon Feild to Athens (42km to announce the news about the victory of the Athenians over the Persians. That is howa long distance runners discipline was defined in sport and got its name marathon. In medicine it is defined as an entity of a sudden death of sportsmen after an intensive physical effort which is nowdays a current problem and an object of varions researches in medicine as well as in sports medicine of sports experts. A method of work: The authors published the statistic data processing obtained from accessible literature. The statistical analysis processes: a cause of a death on the basis of an autophsy, a frequency of the death in general population and death of sportsmen those under the age of 35 and over 35 (sportsmen and sportswotren, sort of sports the dead went in for, comparasion of them and giving conclusions and measures of prevention. Here we think about a big importance of sistematic checkup of the sportsmen, use and misuse of incriminated stimulants, the infuence of genetics in families of the sportsmen with heart diseases.The aim of work is to point to and warn of more and more frequent cases of sudden death of sportsmen and that it isn t drawn a moral from that:there are clubs and parents who still don t do the obligation to take their members and children to a sistematic checkup regularily. A systematic checkup should include all searches which would point out a negative influence of intensive physical effort (training, matches on heath. Those tests are also

  17. Upslope agricultural expansion caused mammal range contractions in China over the past two millennia

    DEFF Research Database (Denmark)

    Teng, Shuqing; Xu, Chi; Svenning, Jens-Christian

    in ancient China over the past two millennia, we analyzed the patterns of mammal range contractions and their associations with historical climate change and agricultural population dynamics. We found that it was the long-term upslope spread of agricultural population that consistently contracted the mammal...... distributions in China during the study period, while periodic warming and cooling may have contributed to temporary range fluctuations. Our study provides direct evidence that biotic interactions can overshadow climate in terms of driving species distributions even at large spatiotemporal scales and suggests...

  18. Site-specific range uncertainties caused by dose calculation algorithms for proton therapy

    Science.gov (United States)

    Schuemann, J.; Dowdell, S.; Grassberger, C.; Min, C. H.; Paganetti, H.

    2014-08-01

    The purpose of this study was to assess the possibility of introducing site-specific range margins to replace current generic margins in proton therapy. Further, the goal was to study the potential of reducing margins with current analytical dose calculations methods. For this purpose we investigate the impact of complex patient geometries on the capability of analytical dose calculation algorithms to accurately predict the range of proton fields. Dose distributions predicted by an analytical pencil-beam algorithm were compared with those obtained using Monte Carlo (MC) simulations (TOPAS). A total of 508 passively scattered treatment fields were analyzed for seven disease sites (liver, prostate, breast, medulloblastoma-spine, medulloblastoma-whole brain, lung and head and neck). Voxel-by-voxel comparisons were performed on two-dimensional distal dose surfaces calculated by pencil-beam and MC algorithms to obtain the average range differences and root mean square deviation for each field for the distal position of the 90% dose level (R90) and the 50% dose level (R50). The average dose degradation of the distal falloff region, defined as the distance between the distal position of the 80% and 20% dose levels (R80-R20), was also analyzed. All ranges were calculated in water-equivalent distances. Considering total range uncertainties and uncertainties from dose calculation alone, we were able to deduce site-specific estimations. For liver, prostate and whole brain fields our results demonstrate that a reduction of currently used uncertainty margins is feasible even without introducing MC dose calculations. We recommend range margins of 2.8% + 1.2 mm for liver and prostate treatments and 3.1% + 1.2 mm for whole brain treatments, respectively. On the other hand, current margins seem to be insufficient for some breast, lung and head and neck patients, at least if used generically. If no case specific adjustments are applied, a generic margin of 6.3% + 1.2 mm would be

  19. Cardiac screening to prevent sudden death in young athletes

    OpenAIRE

    Schmehil, Christopher; Malhotra, Devika; Patel, Dilip R.

    2017-01-01

    Sudden cardiac death (SCD) is a sudden and unexpected death caused by loss of heart of function. SCD may occur in any population, but when it occurs on the playing field in a young individual, communities worldwide are affected. Although these events are rare, media coverage of sudden cardiac arrests in young athletes have created the impression that these events are far more common than they appear. With a heightened awareness of SCD in young athletes, screening methods have been developed t...

  20. The long-term trend in the diurnal temperature range over Asia and its natural and anthropogenic causes

    OpenAIRE

    Liu, L.; Li, Z.; X. Yang; Gong, H; Li, C; Xiong, A.

    2016-01-01

    Understanding the causes of long-term temperature trends is at the core of climate change studies. Any observed trend can result from natural variability or anthropogenic influences or both. In the present study, we evaluated the performance of 18 climate models from the Coupled Model Intercomparison Project Phase 5 on simulating the Asian diurnal temperature range (DTR) and explored the potential causes of the long-term trend in the DTR by examining the response of the DTR to natural forcing...

  1. Common Causes of Traumatic Ventriculitis in Free range and Intensively Managed Poultry in Zaria, Nigeria

    Directory of Open Access Journals (Sweden)

    Kaltungo Bilkisu Yunusa

    Full Text Available The gizzard or ventriculus in birds is susceptible to mechanical damage or traumatic injuries referred to as traumatic ventriculitis when subjected to the causative agents. The condition affects both intensively and extensively managed birds. Palm kennel cake is commonly used as a chief source of protein and fat in poultry rations, most poultry that are kept intensively on deep litter system in the study area use wood shavings collected from carpentry workshops as litter material while poultry on extensive system of management have access to refuse dumps where sharp objects are commonly found. Traumatic ventriculitis can hardly be detected and managed clinically. From our clinical records, nails of various sizes, bolts and nuts, sharp objects like pieces of wood, palm kennel shells and wires of various sizes are the major causes of traumatic ventriculitis. Major causes of traumatic ventriculitis or hardware disease in poultry in the study areas are hereby discussed and three cases presented in chickens as case studies. Locally and manually compounded poultry feeds, access to refuse dumps, litter materials to be used in poultry houses and litters in poultry houses were renovation works had occurred should be screened for metallic and hard sharp objects to prevent or reduce risk of ingesting and the occurrence of hardware disease. [Vet. World 2011; 4(11.000: 511-514

  2. Gouty tophi caused limited knee range of motion: a case report.

    Science.gov (United States)

    Kijkunasathian, Chusak; Woratanarat, Patarawan; Saengpetch, Nadhaporn

    2009-12-01

    Gout is a disease of purine metabolism characterized by monosodium urate crystal deposition. Gouty tophi can mimic many conditions such as infection or neoplasm. We descriptively presented a case of a 29-year-old male with gouty toph. Data was obtained from patient chart. This patient presented with limited knee joint range of motion after sport injury. Arthroscopic examination was performed in order to confirm the diagnosis of the meniscal injury. The result showed the synovium with white toothpaste-like chalky urate crystals in the joint cartilage. An atypical presentation of gouty tophi can sometime mislead to diagnose an internal derangement of the knee.

  3. Diminishing proportional risk of sudden death with advancing age: implications for prevention of sudden death.

    Science.gov (United States)

    Krahn, Andrew D; Connolly, Stuart J; Roberts, Robin S; Gent, Michael

    2004-05-01

    Advances in primary and secondary prevention of sudden death have led to a wide array of potentially beneficial therapies. Identification of patients most likely to benefit would be of use when considering costly interventions such as an implantable defibrillator. We sought to determine the effect of advancing age on the mode of death in the Amiodarone Trialists Metanalysis. Patients (n = 6252; age, 61.2+/-10.5 years; 83% men) were included in an analysis of predictors of sudden death (SD) and all-cause death (ACD), based on baseline variables at enrollment. Patients were divided into 5 age groups: 80 years. During a mean of 16.8+/-10.3 months of follow-up, there were 1023 deaths, with an annual overall mortality rate of 11.7%. Both sudden death and nonsudden death rates increased with age, although the increase of nonsudden death with age was more dramatic. The overall proportion of death that was sudden (SD/ACD ratio) was 0.41, falling from 0.51 before age 50 years to 0.26 after age 80 years (P =.002 for trend). The SD/ACD ratio was not affected by sex, New York Heart Association Class, or left ventricular ejection fraction. Although the incidence of sudden death increases with age, the proportion of death that is sudden diminishes markedly. This finding may influence the yield of interventions targeted at prevention of sudden death.

  4. Secondary sympatry caused by range expansion informs on the dynamics of microendemism in a biodiversity hotspot.

    Directory of Open Access Journals (Sweden)

    Romain Nattier

    Full Text Available Islands are bounded areas where high endemism is explained either by allopatric speciation through the fragmentation of the limited amount of space available, or by sympatric speciation and accumulation of daughter species. Most empirical evidence point out the dominant action of allopatric speciation. We evaluate this general view by looking at a case study where sympatric speciation is suspected. We analyse the mode, tempo and geography of speciation in Agnotecous, a cricket genus endemic to New Caledonia showing a generalized pattern of sympatry between species making sympatric speciation plausible. We obtained five mitochondrial and five nuclear markers (6.8 kb from 37 taxa corresponding to 17 of the 21 known extant species of Agnotecous, and including several localities per species, and we conducted phylogenetic and dating analyses. Our results suggest that the diversification of Agnotecous occurred mostly through allopatric speciation in the last 10 Myr. Highly microendemic species are the most recent ones (<2 Myr and current sympatry is due to secondary range expansion after allopatric speciation. Species distribution should then be viewed as a highly dynamic process and extreme microendemism only as a temporary situation. We discuss these results considering the influence of climatic changes combined with intricate soil diversity and mountain topography. A complex interplay between these factors could have permitted repeated speciation events and range expansion.

  5. Probable causes of increasing brucellosis in free-ranging elk of the Greater Yellowstone Ecosystem

    Science.gov (United States)

    Cross, P.C.; Cole, E.K.; Dobson, A.P.; Edwards, W.H.; Hamlin, K.L.; Luikart, G.; Middleton, A.D.; Scurlock, B.M.; White, P.J.

    2010-01-01

    While many wildlife species are threatened, some populations have recovered from previous overexploitation, and data linking these population increases with disease dynamics are limited. We present data suggesting that free-ranging elk (Cervus elaphus) are a maintenance host for Brucella abortus in new areas of the Greater Yellowstone Ecosystem (GYE). Brucellosis seroprevalence in free-ranging elk increased from 0-7% in 1991-1992 to 8-20% in 2006-2007 in four of six herd units around the GYE. These levels of brucellosis are comparable to some herd units where elk are artificially aggregated on supplemental feeding grounds. There are several possible mechanisms for this increase that we evaluated using statistical and population modeling approaches. Simulations of an age-structured population model suggest that the observed levels of seroprevalence are unlikely to be sustained by dispersal from supplemental feeding areas with relatively high seroprevalence or an older age structure. Increases in brucellosis seroprevalence and the total elk population size in areas with feeding grounds have not been statistically detectable. Meanwhile, the rate of seroprevalence increase outside the feeding grounds was related to the population size and density of each herd unit. Therefore, the data suggest that enhanced elk-to-elk transmission in free-ranging populations may be occurring due to larger winter elk aggregations. Elk populations inside and outside of the GYE that traditionally did not maintain brucellosis may now be at risk due to recent population increases. In particular, some neighboring populations of Montana elk were 5-9 times larger in 2007 than in the 1970s, with some aggregations comparable to the Wyoming feeding-ground populations. Addressing the unintended consequences of these increasing populations is complicated by limited hunter access to private lands, which places many ungulate populations out of administrative control. Agency-landowner hunting access

  6. Sudden Infant Death Syndrome (SIDS)

    Science.gov (United States)

    Sudden infant death syndrome (SIDS) Overview Sudden infant death syndrome (SIDS) is the unexplained death, usually during sleep, of a seemingly healthy baby ... year old. SIDS is sometimes known as crib death because the infants often die in their cribs. ...

  7. 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...

  8. Sudden cardiac arrest risk in young athletes

    African Journals Online (AJOL)

    Underlying cardiac abnormalities are the main cause of unexpected death in athletes on field. These abnormalities have been associated with a previous history of syncope, a family history of sudden cardiac arrest (SCA), cardiac murmur, a history of over-exhaustion post exercise and ventricular tachyarrhythmia during ...

  9. Sudden cardiac arrest in sports - need for uniform registration

    DEFF Research Database (Denmark)

    Solberg, E E; Borjesson, M; Sharma, S

    2016-01-01

    There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities....

  10. Sudden Infant Death Syndrome with Harlequin Fetus

    Directory of Open Access Journals (Sweden)

    Selahattin Katar

    2007-01-01

    Full Text Available The harlequin fetus, a severe variant of ichthyosis, occurs rarely, and these babies die within the first few days of life. Early retinoid therapy may improve the disorder and help increase survival rates. The exact cause of the sudden infant death syndrome of the suckling is not known and the incidence approximately is 0.1-0.3 %. In general, these babies looked well and healthy at the time of the sleeping but were found dead in their bed in the morning. We report a harlequin fetus with sudden infant death syndrome.

  11. Cytokines and sudden infant death.

    Science.gov (United States)

    Vennemann, Mechtild M T; Loddenkötter, Brigitte; Fracasso, Tony; Mitchell, Edwin A; Debertin, Annette S; Larsch, Klaus P; Sperhake, Jan P; Brinkmann, Bernd; Sauerland, Cristina; Lindemann, Monika; Bajanowski, Thomas

    2012-03-01

    It has been hypothesised that inflammatory reactions could play an important role in the pathway(s) leading to sudden and unexpected death in infancy. On a molecular level, these reactions are regulated by various cytokines. To characterise the role of IL-1ß, IL-6 and TNFα more precisely, the concentrations of these cytokines were determined quantitatively using specific ELISA techniques in serum and cerebrospinal fluid (CSF) in 119 cases of sudden infant death. The infants were grouped into four categories (SIDS, SIDS with infection, natural death due to infection and unnatural death). A good correlation was found between CSF and serum for IL-6 (Spearman correlation coefficients (SCC), 0.73) and also for TNFα (SCC, 0.57), although the CSF concentrations were lower than that from the serum. There were no significant differences between the categories of death for any of the serum or CSF cytokines. Compared with normal values, increased serum concentrations of IL-1ß, IL-6 and TNFα were found in 70%, 69% and 38% of the cases respectively, indicating possible agonal or post-mortem changes of cytokine concentrations. In three cases very high cytokine concentrations were found (mainly for IL-6). This may have contributed to the mechanism of death (cytokine storm) in two of the cases. In a small group of patients, very high cytokine concentrations are a possible explanation for the cause of death ("cytokine storm").

  12. Sudden death of cardiac origin and psychotropic drugs.

    Science.gov (United States)

    Timour, Quadiri; Frassati, Dominique; Descotes, Jacques; Chevalier, Philippe; Christé, Georges; Chahine, Mohamed

    2012-01-01

    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.

  13. 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.

  14. How Is Sudden Cardiac Arrest Treated?

    Science.gov (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  15. How Is Sudden Cardiac Arrest Diagnosed?

    Science.gov (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  16. Underestimation of sudden deaths among patients with seizures and epilepsy.

    Science.gov (United States)

    Devinsky, Orrin; Friedman, Daniel; Cheng, Jocelyn Y; Moffatt, Ellen; Kim, Anthony; Tseng, Zian H

    2017-08-29

    To determine the definite and potential frequency of seizures and epilepsy as a cause of death (COD) and how often this goes unrecognized. Prospective determination of seizures or epilepsy and final COD for individuals aged 18-90 years with out-of-hospital sudden cardiac deaths (SCDs) from the population-based San Francisco POST SCD Study. We compared prospective seizure or epilepsy diagnosis and final COD as adjudicated by a multidisciplinary committee (pathologists, electrophysiologists, and a vascular neurologist) vs retrospective adjudication by 2 epileptologists with expertise in seizure-related mortality. Of 541 SCDs identified during the 37-month study period (mean age 62.8 years, 69% men), 525 (97%) were autopsied; 39/525 (7.4%) had seizures or epilepsy (mean age: 58 years, range: 27-92; 67% men), comprising 17% of 231 nonarrhythmic sudden deaths. The multidisciplinary team identified 15 cases of epilepsy, 6 sudden unexpected deaths in epilepsy (SUDEPs), and no deaths related to acute symptomatic seizures. The epileptologists identified 25 cases of epilepsy and 8 definite SUDEPs, 10 possible SUDEPs, and 5 potential cases of acute symptomatic seizures as a COD. Among the 25 patients identified with epilepsy by the epileptologists, they found definite or possible SUDEP in 72% (18/25) vs 24% (6/25) by the multidisciplinary group (6/15 cases they identified with epilepsy). The epileptologists identified acute symptomatic seizures as a potential COD in 5/14 patients with alcohol-related seizures. Epilepsy is underdiagnosed among decedents. Among patients with seizures and epilepsy who die suddenly, seizures and SUDEP often go unrecognized as a potential or definite COD. © 2017 American Academy of Neurology.

  17. 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

  18. 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.

    Science.gov (United States)

    Srour, Ali; Afzal, Ahmed J; Blahut-Beatty, Laureen; Hemmati, Naghmeh; Simmonds, Daina H; Li, Wenbin; Liu, Miao; Town, Christopher D; Sharma, Hemlata; Arelli, Prakash; Lightfoot, David A

    2012-08-02

    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. 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. The inference that soybean has adapted part of an existing pathogen recognition and

  19. Habitat fragmentation and species extirpation in freshwater ecosystems; causes of range decline of the Indus river dolphin (Platanista gangetica minor).

    Science.gov (United States)

    Braulik, Gill T; Arshad, Masood; Noureen, Uzma; Northridge, Simon P

    2014-01-01

    Habitat fragmentation of freshwater ecosystems is increasing rapidly, however the understanding of extinction debt and species decline in riverine habitat fragments lags behind that in other ecosystems. The mighty rivers that drain the Himalaya - the Ganges, Brahmaputra, Indus, Mekong and Yangtze - are amongst the world's most biodiverse freshwater ecosystems. Many hundreds of dams have been constructed, are under construction, or are planned on these rivers and large hydrological changes and losses of biodiversity have occurred and are expected to continue. This study examines the causes of range decline of the Indus dolphin, which inhabits one of the world's most modified rivers, to demonstrate how we may expect other vertebrate populations to respond as planned dams and water developments come into operation. The historical range of the Indus dolphin has been fragmented into 17 river sections by diversion dams; dolphin sighting and interview surveys show that river dolphins have been extirpated from ten river sections, they persist in 6, and are of unknown status in one section. Seven potential factors influencing the temporal and spatial pattern of decline were considered in three regression model sets. Low dry-season river discharge, due to water abstraction at irrigation barrages, was the principal factor that explained the dolphin's range decline, influencing 1) the spatial pattern of persistence, 2) the temporal pattern of subpopulation extirpation, and 3) the speed of extirpation after habitat fragmentation. Dolphins were more likely to persist in the core of the former range because water diversions are concentrated near the range periphery. Habitat fragmentation and degradation of the habitat were inextricably intertwined and in combination caused the catastrophic decline of the Indus dolphin.

  20. Habitat fragmentation and species extirpation in freshwater ecosystems; causes of range decline of the Indus river dolphin (Platanista gangetica minor.

    Directory of Open Access Journals (Sweden)

    Gill T Braulik

    Full Text Available Habitat fragmentation of freshwater ecosystems is increasing rapidly, however the understanding of extinction debt and species decline in riverine habitat fragments lags behind that in other ecosystems. The mighty rivers that drain the Himalaya - the Ganges, Brahmaputra, Indus, Mekong and Yangtze - are amongst the world's most biodiverse freshwater ecosystems. Many hundreds of dams have been constructed, are under construction, or are planned on these rivers and large hydrological changes and losses of biodiversity have occurred and are expected to continue. This study examines the causes of range decline of the Indus dolphin, which inhabits one of the world's most modified rivers, to demonstrate how we may expect other vertebrate populations to respond as planned dams and water developments come into operation. The historical range of the Indus dolphin has been fragmented into 17 river sections by diversion dams; dolphin sighting and interview surveys show that river dolphins have been extirpated from ten river sections, they persist in 6, and are of unknown status in one section. Seven potential factors influencing the temporal and spatial pattern of decline were considered in three regression model sets. Low dry-season river discharge, due to water abstraction at irrigation barrages, was the principal factor that explained the dolphin's range decline, influencing 1 the spatial pattern of persistence, 2 the temporal pattern of subpopulation extirpation, and 3 the speed of extirpation after habitat fragmentation. Dolphins were more likely to persist in the core of the former range because water diversions are concentrated near the range periphery. Habitat fragmentation and degradation of the habitat were inextricably intertwined and in combination caused the catastrophic decline of the Indus dolphin.

  1. Genetic investigation of 100 heart genes in sudden unexplained death victims in a forensic setting

    DEFF Research Database (Denmark)

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

    2016-01-01

    In forensic medicine, one-third of the sudden deaths remain unexplained after medico-legal autopsy. A major proportion of these sudden unexplained deaths (SUD) are considered to be caused by inherited cardiac diseases. Sudden cardiac death (SCD) may be the first manifestation of these diseases...

  2. Mutations in KIAA0586 Cause Lethal Ciliopathies Ranging from a Hydrolethalus Phenotype to Short-Rib Polydactyly Syndrome

    Science.gov (United States)

    Alby, Caroline; Piquand, Kevin; Huber, Céline; Megarbané, André; Ichkou, Amale; Legendre, Marine; Pelluard, Fanny; Encha-Ravazi, Ferechté; Abi-Tayeh, Georges; Bessières, Bettina; El Chehadeh-Djebbar, Salima; Laurent, Nicole; Faivre, Laurence; Sztriha, László; Zombor, Melinda; Szabó, Hajnalka; Failler, Marion; Garfa-Traore, Meriem; Bole, Christine; Nitschké, Patrick; Nizon, Mathilde; Elkhartoufi, Nadia; Clerget-Darpoux, Françoise; Munnich, Arnold; Lyonnet, Stanislas; Vekemans, Michel; Saunier, Sophie; Cormier-Daire, Valérie; Attié-Bitach, Tania; Thomas, Sophie

    2015-01-01

    KIAA0586, the human ortholog of chicken TALPID3, is a centrosomal protein that is essential for primary ciliogenesis. Its disruption in animal models causes defects attributed to abnormal hedgehog signaling; these defects include polydactyly and abnormal dorsoventral patterning of the neural tube. Here, we report homozygous mutations of KIAA0586 in four families affected by lethal ciliopathies ranging from a hydrolethalus phenotype to short-rib polydactyly. We show defective ciliogenesis, as well as abnormal response to SHH-signaling activation in cells derived from affected individuals, consistent with a role of KIAA0586 in primary cilia biogenesis. Whereas centriolar maturation seemed unaffected in mutant cells, we observed an abnormal extended pattern of CEP290, a centriolar satellite protein previously associated with ciliopathies. Our data show the crucial role of KIAA0586 in human primary ciliogenesis and subsequent abnormal hedgehog signaling through abnormal GLI3 processing. Our results thus establish that KIAA0586 mutations cause lethal ciliopathies. PMID:26166481

  3. Detection on Structural Sudden Damage Using Continuous Wavelet Transform and Lipschitz Exponent

    Directory of Open Access Journals (Sweden)

    Bo Chen

    2015-01-01

    Full Text Available The degradation of civil engineering structures may lead to a sudden stiffness reduction in a structure and such a sudden damage will cause a discontinuity in the dynamic responses. The detection on structural sudden damage has been actively carried out in this study. The signal singularity of the acceleration responses with sudden stiffness reduction is characterized by the coefficients of continuous wavelet transform with fine scales. A detection approach based on the CWT is proposed in terms of the decomposed detail coefficients of continuous wavelet transform to detect the damage time instant and location. The Lipschitz exponent is mathematically used to estimate the local properties of certain function and is applied to reflect the damage severity. Numerical simulation using a five-story shear building under different types of excitation is carried out to assess the validity of the proposed detection approach for the building at different damage levels. The sensitivity of the damage index to the intensity and frequency range of measurement noise is also investigated. The effects of both measurement noise intensity and frequency range on the damage detection are numerically investigated.

  4. Potential Central Nervous System Involvement in Sudden Unexpected Infant Deaths and the Sudden Infant Death Syndrome.

    Science.gov (United States)

    Thach, Bradley T

    2015-07-01

    Sudden unexpected infant death (SUID) in infancy which includes Sudden Infant Death Syndrome (SIDS) is the commonest diagnosed cause of death in the United States for infants 1 month to 1 year of age. Central nervous system mechanisms likely contribute to many of these deaths. We discuss some of these including seizure disorders, prolonged breath holding, arousal from sleep and its habituation, laryngeal reflex apnea potentiated by upper airway infection, and failure of brainstem-mediated autoresuscitation. In the conclusions section, we speculate how lives saved through back sleeping might result in later developmental problems in certain infants who otherwise might have died while sleeping prone. © 2015 American Physiological Society.

  5. 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...... of fatal arrhythmia and sudden cardiac death a patient is, the more attention should be given to the potassium homeostasis....

  6. [Prevention of sudden cardiac death by the implantable cardioverter defibrilator].

    Science.gov (United States)

    Kovacević, Dragan V; Milosavljević, Anastazija Stojisić; Topalov, Vasilije; Mihajlović, Bogoljub; Sakac, Dejan; Kozlovacki, Ziva

    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 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.

  7. [Sudden cardiovascular death in adults: Study of 361 autopsy cases].

    Science.gov (United States)

    Mesrati, M A; Belhadj, M; Aissaoui, A; HajSalem, N; Oualha, D; Boughattas, M; Messaoudi, I; Hammedi, F; Zakhama, A; Chadly, A

    2017-02-01

    To describe epidemiological aspects of sudden cardiovascular death and to specify the etiopathogenic characteristics. Our study is retrospective and descriptive. It included 361 cases of sudden cardiovascular death, which underwent autopsy in forensic medicine department of Monastir during eight years, from 1st January 2004 to 31st December 2011. The incidence of sudden cardiovascular death was 9 per 100,000 person. A marked male predominance was noted. The mean age was 55.75 years. In our series, myocardial infarction represents the leading cause of sudden cardiovascular death, 57.8% of cases. Other etiologies were hypertrophic cardiomyopathy (4.7%), heart failure (1.9%), arrhythmogenic right ventricular dysplasia (2.8%), valvular disease (2%), cardio-myo-pericarditis (1.9%), hydatid cyst of the heart (0.8%), ruptured aneurysm (2.5%), pulmonary embolism (1.9%) and aortic dissection (1.3%). A sudden cardiovascular death at work was found in 25 cases. These cases pose essentially a problem of imputability. Sudden cardiac death is usually the complication of underlying heart disease, sometimes overlooked. Several risk factors are involved. Sudden cardiac death in healthy heart or death caused by arrhythmia is an important entity seeking the intervention of several actors (forensic doctor, cardiologist, geneticist, media…) for prevention. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Sudden Cardiac Death in Athletes - What Can be Done?

    Directory of Open Access Journals (Sweden)

    Joydeep Ghosh

    2006-07-01

    Full Text Available Sudden death in athletes is a rare event but brings with it an impact that goes beyond sport. There are many causes of sudden death during exercise. While the responsibility of preventing or treating them lays with us physicians, preparticipation screening is largely ineffective and impractical. Definitive, large scale prospective research is required in order to design the most cost-effective system for screening of athletes. In the meanwhile rapid access to defibrillators by trained personnel remains the best possible approach to abort sudden death.

  9. Direct functional consequences of ZRS enhancer mutation combine with secondary long range SHH signalling effects to cause preaxial polydactyly.

    Science.gov (United States)

    Johnson, Edward J; Neely, David M; Dunn, Ian C; Davey, Megan G

    2014-08-15

    Sonic hedgehog (SHH) plays a central role in patterning numerous embryonic tissues including, classically, the developing limb bud where it controls digit number and identity. This study utilises the polydactylous Silkie (Slk) chicken breed, which carries a mutation in the long range limb-specific regulatory element of SHH, the ZRS. Using allele specific SHH expression analysis combined with quantitative protein analysis, we measure allele specific changes in SHH mRNA and concentration of SHH protein over time. This confirms that the Slk ZRS enhancer mutation causes increased SHH expression in the posterior leg mesenchyme. Secondary consequences of this increased SHH signalling include increased FGF pathway signalling and growth as predicted by the SHH/GREM1/FGF feedback loop and the Growth/Morphogen models. Manipulation of Hedgehog, FGF signalling and growth demonstrate that anterior-ectopic expression of SHH and induction of preaxial polydactyly is induced secondary to increased SHH signalling and Hedgehog-dependent growth directed from the posterior limb. We predict that increased long range SHH signalling acts in combination with changes in activation of SHH transcription from the Slk ZRS allele. Through analysis of the temporal dynamics of anterior SHH induction we predict a gene regulatory network which may contribute to activation of anterior SHH expression from the Slk ZRS. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  10. [Genetics of sudden unexplained death].

    Science.gov (United States)

    Campuzano, Oscar; Allegue, Catarina; Brugada, Ramon

    2014-03-20

    Sudden unexplained death is defined by death without a conclusive diagnosis after autopsy and it is responsible for a large percentage of sudden deaths. The progressive interaction between genetics and forensics in post-mortem studies has identified inheritable alterations responsible for pathologies associated with arrhythmic sudden death. The genetic diagnosis of the deceased enables the undertaking of preventive measures in family members, many of them asymptomatic but at risk. The implications of this multidisciplinary translational medical approach are complex, requiring the dedication of a specialized team. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  11. Cardiac disease and risk of sudden death in the young: the burden of the phenomenon.

    Science.gov (United States)

    Fishbein, Michael C

    2010-01-01

    Sudden cardiovascular death is a rare but catastrophic event in young men and women throughout the world. Sudden death is difficult to study. Factors that need elucidation are (1) the definition of sudden death; (2) diagnosis of the cause of sudden death; (3) the true incidence of sudden death, and (4) age and gender of individuals being studied. The "burden" of sudden death is far-reaching and involves medical, emotional, and economic burdens on the family members at risk, the entire family of the victim, and society in general. The pathologist trying to evaluate a case of sudden death also has a burden to make the correct diagnosis, especially since the cause of the sudden death may determine risk to the victim's family members. Sudden death is difficult to prevent since it may be the first and last manifestation of the cardiovascular disease. Also, paradoxically, the greatest number of deaths occurs in "low-risk" groups. The most common causes of cardiovascular deaths in the young are cardiomyopathy, coronary anomaly, obstructive coronary artery disease, myocarditis, valvular disease, channelopathy, and aortic disease leading to dissection or rupture. Many sudden deaths in the young occur during or shortly after exercise. Appropriate pre-participation screening of competitive athletes can reduce the incidence of sudden cardiovascular death in the young. Which measures to try to prevent these rare deaths are indicated and/or cost effective is a matter of discussion and controversy. Copyright © 2010 Elsevier Inc. All rights reserved.

  12. Cardiac Potassium Channel Dysfunction in Sudden Infant Death Syndrome

    OpenAIRE

    Rhodes, Troy E.; Abraham, Robert A.; Welch, Richard C.; Vanoye, Carlos G.; Crotti, Lia; Arnestad, Marianne; Insolia, Roberto; Pedrazzini, Matteo; Ferrandi, Chiara; Vege, Ashild; Rognum, Torleiv; Roden, Dan M.; Schwartz, Peter J.; George, Alfred L.

    2007-01-01

    Life-threatening arrhythmias have been suspected as one cause of the sudden infant death syndrome (SIDS), and this hypothesis is supported by the observation that mutations in arrhythmia susceptibility genes occur in 5–10% of cases. However, the functional consequences of cardiac potassium channel gene mutations associated with SIDS and how these alleles might mechanistically predispose to sudden death are unknown. To address these questions, we studied four missense KCNH2 (encoding HERG) var...

  13. Sudden transition and sudden change from open spin environments

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Zheng-Da [Zhejiang Institute of Modern Physics and Physics Department, Zhejiang University, Hangzhou 310027 (China); School of Science, Jiangnan University, Wuxi 214122 (China); Xu, Jing-Bo, E-mail: xujb@zju.edu.cn [Zhejiang Institute of Modern Physics and Physics Department, Zhejiang University, Hangzhou 310027 (China); Yao, Dao-Xin [State Key Laboratory of Optoelectronic Materials and Technologies, School of Physics and Engineering, Sun Yat-sen University, Guangzhou 510275 (China); Department of Physics and Astronomy, University of Tennessee, Knoxville, TN 37996 (United States)

    2014-11-15

    We investigate the necessary conditions for the existence of sudden transition or sudden change phenomenon for appropriate initial states under dephasing. As illustrative examples, we study the behaviors of quantum correlation dynamics of two noninteracting qubits in independent and common open spin environments, respectively. For the independent environments case, we find that the quantum correlation dynamics is closely related to the Loschmidt echo and the dynamics exhibits a sudden transition from classical to quantum correlation decay. It is also shown that the sudden change phenomenon may occur for the common environment case and stationary quantum discord is found at the high temperature region of the environment. Finally, we investigate the quantum criticality of the open spin environment by exploring the probability distribution of the Loschmidt echo and the scaling transformation behavior of quantum discord, respectively. - Highlights: • Sudden transition or sudden change from open spin baths are studied. • Quantum discord is related to the Loschmidt echo in independent open spin baths. • Steady quantum discord is found in a common open spin bath. • The probability distribution of the Loschmidt echo is analyzed. • The scaling transformation behavior of quantum discord is displayed.

  14. Symptoms Before Sudden Arrhythmic Death Syndrome

    DEFF Research Database (Denmark)

    Glinge, Charlotte; Jabbari, Reza; Risgaard, Bjarke

    2015-01-01

    INTRODUCTION: No studies in an unselected and nationwide setting have characterized the symptoms and medical history of patients with sudden arrhythmic death syndrome (SADS). The aim of this study was to identify and describe the symptoms and medical history of patients before the presentation...... of SADS. METHODS AND RESULTS: We have previously identified all of the autopsied sudden cardiac deaths (SCD; n = 314) in Danes aged 1-35 years between 2000 and 2006. After comprehensive pathological and toxicological investigation did not reveal a cause of SCD, 136 of the patients were identified as SADS....... The National Patient Registry was utilized to obtain information on all in- and outpatient activity in Danish hospitals. All medical records from hospitals and general practitioners, including death certificates and autopsy reports were reviewed. Before death, 48 (35%) SADS patients had cardiac symptoms; among...

  15. The Spectrum of Epidemiology Underlying Sudden Cardiac Death

    Science.gov (United States)

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

    2015-01-01

    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 suffer 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 due to inherited disorders. Coronary heart disease (CHD) is known to be the most common pathology underlying SCD, followed by cardiomyopathies, inherited arrhythmia syndromes, and valvular heart disease. Over the past three decades, declines in SCD rates have not been as steep as for other causes of CHD deaths, and there is a growing fraction of SCDs not due to CHD and/or 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 prior to 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. PMID:26044246

  16. Cost-effectiveness analysis of preventing sudden cardiac death with an implantable cardioverter defibrillator versus amiodarone

    OpenAIRE

    Mijajlović Marina

    2012-01-01

    Sudden cardiac death is natural death caused by previous heart disease, when within an hour from the onset of symptoms ensue loss of consciousness and cessation of circulation. Many studies have confirmed that malignant ventricular arrhythmias are the most common cause of sudden cardiac death. Alternatives for prevention of sudden cardiac death are antiarrhythmic drug treatment, primarily amiodarone, and implantation of cardioverter defibrillator. The aim of this pharmacoeconomic study was to...

  17. Vision Loss, Sudden

    Science.gov (United States)

    ... Search Drug Interactions Pill Identifier Commonly searched drugs Aspirin Metformin Warfarin Tramadol Lactulose Ranitidine News & Commentary Recent ... three general causes: Clouding of normally transparent eye structures Abnormalities of the retina (the light-sensing structure ...

  18. 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.

  19. Sudden hearing loss associated with methylphenidate therapy.

    Science.gov (United States)

    Karapinar, Ugur; Saglam, Omer; Dursun, Engin; Cetin, Bilal; Salman, Nergis; Sahan, Murat

    2014-01-01

    An 8-year-old child diagnosed with attention deficit/hyperactivity disorder presented to our Department of Otolaryngology 4 days after suffering hearing loss, loss of balance, tinnitus, and fullness sensation of the left ear. Her symptoms occured with the first dose of methylphenidate. The medical history and physical examination revealed no other diseases associated with sudden hearing loss. The audiogram revealed a total hearing loss on the left ear. Stapedial reflexes, distortion product and transient-evoked otoacoustic emissions were absent in left ear. The absence of clinical, laboratory and radiological evidence of a possible cause for complaints, an association between methylphenidate and sudden hearing loss was suggested. The patient received a standard course of oral corticosteroid and hyperbaric oxygen therapy. Weekly otological and audiological examinations were performed. Conservative and medical treatments offered no relief from hearing loss. Sudden hearing loss is a serious and irreversible adverse effect of methylphenidate. Therefore, the risk of hearing loss should be taken into consideration when initiating methylphenidate therapy.

  20. Arrhythmias and sudden death in heart failure.

    Science.gov (United States)

    Stevenson, W G; Sweeney, M O

    1997-09-01

    Survival of patients with heart failure has improved over the past decade due to advances in medical therapy. Sudden death continues to cause 20 to 50% of deaths. Ventricular arrhythmias are common in patients with heart failure. Ventricular hypertrophy, scars from prior myocardial infarction, sympathetic activation, and electrolyte abnormalities contribute. Some sudden deaths are due to bradyarrhythmias and electromechanical dissociation rather than ventricular arrhythmias. The risks and benefits of antiarrhythmic therapies continue to be defined. Class I antiarrhythmic drugs should be avoided due to proarrhythmic and negative inotropic effects that may increase mortality. For patients resuscitated from sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) amiodarone or an implantable cardioverter defibrillator (ICD) should be considered. ICDs markedly reduce sudden death in VT/VF survivors, but in advanced heart failure, this may not markedly extend survival. Catheter or surgical ablation can be considered for selected patients with bundle branch reentry VT or difficult to control monomorphic VT. For patients who have not had sustained VT/VF antiarrhythmic therapy should generally be avoided, but may benefit some high risk patients. Amiodarone may be beneficial in patients with advanced heart failure and rapid resting heart rates. ICDs may improve survival in selected survivors of myocardial infarction who have inducible VT.

  1. Biases in the diurnal temperature range in Central Europe in an ensemble of regional climate models and their possible causes

    Science.gov (United States)

    Kyselý, Jan; Plavcová, Eva

    2012-09-01

    The study examines how regional climate models (RCMs) reproduce the diurnal temperature range (DTR) in their control simulations over Central Europe. We evaluate 30-year runs driven by perfect boundary conditions (the ERA40 reanalysis, 1961-1990) and a global climate model (ECHAM5) of an ensemble of RCMs with 25-km resolution from the ENSEMBLES project. The RCMs' performance is compared against the dataset gridded from a high-density stations network. We find that all RCMs underestimate DTR in all seasons, notwithstanding whether driven by ERA40 or ECHAM5. Underestimation is largest in summer and smallest in winter in most RCMs. The relationship of the models' errors to indices of atmospheric circulation and cloud cover is discussed to reveal possible causes of the biases. In all seasons and all simulations driven by ERA40 and ECHAM5, underestimation of DTR is larger under anticyclonic circulation and becomes smaller or negligible for cyclonic circulation. In summer and transition seasons, underestimation tends to be largest for the southeast to south flow associated with warm advection, while in winter it does not depend on flow direction. We show that the biases in DTR, which seem common to all examined RCMs, are also related to cloud cover simulation. However, there is no general tendency to overestimate total cloud amount under anticyclonic conditions in the RCMs, which suggests the large negative bias in DTR for anticyclonic circulation cannot be explained by a bias in cloudiness. Errors in simulating heat and moisture fluxes between land surface and atmosphere probably contribute to the biases in DTR as well.

  2. Biases in the diurnal temperature range in Central Europe in an ensemble of regional climate models and their possible causes

    Energy Technology Data Exchange (ETDEWEB)

    Kysely, Jan [Institute of Atmospheric Physics AS CR, Prague 4 (Czech Republic); Plavcova, Eva [Institute of Atmospheric Physics AS CR, Prague 4 (Czech Republic); Charles University, Faculty of Mathematics and Physics, Prague (Czech Republic)

    2012-09-15

    The study examines how regional climate models (RCMs) reproduce the diurnal temperature range (DTR) in their control simulations over Central Europe. We evaluate 30-year runs driven by perfect boundary conditions (the ERA40 reanalysis, 1961-1990) and a global climate model (ECHAM5) of an ensemble of RCMs with 25-km resolution from the ENSEMBLES project. The RCMs' performance is compared against the dataset gridded from a high-density stations network. We find that all RCMs underestimate DTR in all seasons, notwithstanding whether driven by ERA40 or ECHAM5. Underestimation is largest in summer and smallest in winter in most RCMs. The relationship of the models' errors to indices of atmospheric circulation and cloud cover is discussed to reveal possible causes of the biases. In all seasons and all simulations driven by ERA40 and ECHAM5, underestimation of DTR is larger under anticyclonic circulation and becomes smaller or negligible for cyclonic circulation. In summer and transition seasons, underestimation tends to be largest for the southeast to south flow associated with warm advection, while in winter it does not depend on flow direction. We show that the biases in DTR, which seem common to all examined RCMs, are also related to cloud cover simulation. However, there is no general tendency to overestimate total cloud amount under anticyclonic conditions in the RCMs, which suggests the large negative bias in DTR for anticyclonic circulation cannot be explained by a bias in cloudiness. Errors in simulating heat and moisture fluxes between land surface and atmosphere probably contribute to the biases in DTR as well. (orig.)

  3. Aldosterone and Cortisol affect the risk of sudden cardiac death in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    2012-06-01

    Conclusions: The joint presence of high aldosterone and high cortisol levels strongly increased the incidence of sudden cardiac death as well as all-cause mortality in hemodialyzed type 2 diabetic patients. Whether blockade of the mineralocorticoid receptor decreases the risk of sudden death without causing side effects must be examined in future trials.

  4. Sudden Death from Glue-Sniffing

    OpenAIRE

    Sugawara, Norisuke; Makisumi, Toshiro; Furuno, Junji

    1992-01-01

    This case dealswith an 18 year-old young male who suddenly died while amusing himself by glue-sniffing together with a friend in a very narrow toilet beneath a stairway in the company where he worked. Therefore, the purepose of elucidating the cause of death, gas chromatographic analyses were carried out on the laquer thinner which was discovered at the acene and on the variety of tissues of the cadaver. As a result, five ingredients (acetone, ethyl acetate, n-butanol, toluene, and n-butyl ac...

  5. Heart Failure and Sudden Cardiac Death.

    Science.gov (United States)

    Saour, Basil; Smith, Bryan; Yancy, Clyde W

    2017-12-01

    The Centers for Diseases Control and Prevention estimates that 5.7 million adults in the United States suffer from heart failure and 1 in 9 deaths in 2009 cited heart failure as a contributing cause. Almost 50% of patients who are diagnosed with heart failure die within 5 years of diagnosis. Cardiovascular disease is a public health burden. The prognosis of patients with heart failure has improved significantly. However, the risk for death remains high. Managing sudden death risk and intervening appropriately with primary or secondary prevention strategies are of paramount importance. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Sudden cardiac death and acute drunken state: Autopsy study

    Directory of Open Access Journals (Sweden)

    Miletić Borislav

    2010-01-01

    Full Text Available Introduction. Sudden natural death occurs unexpectedly in apparently healthy subjects, or in persons during an apparent benign phase in the course of disease. The most common cause is sudden cardiac death, which is sometimes the first and last manifestation of coronary heart disease. Alcohol directly influences excitation of myocytes, and therefore provokes arrhythmias and possibly, sudden cardiac death. Objective. To establish the frequency of sudden cardiac death in cases of acute alcohol intoxication, to determine blood alcohol concentration at the moment of death, and to determine frequency and level of ethanol intoxication in chronic alcohol abusers, as well as causes of sudden death in those cases. Method. Retrospective autopsy study was performed for a three-year-period. We analyzed cases of sudden natural death, in relation to age and gender, cause of death, and blood alcohol concentration (at least 0.5 g/L. We considered the person to be a chronic alcoholic abuser if gross examination of organs during autopsy showed changes typical for excessive and habitual alcohol consumption. Results. Our sample consisted of 997 cases: 720 men and 277 women, average age 62.0±15.2 years (min=11; max=98. Total of 753 of them died of sudden cardiac death: much more men (χ2=167.364; p=0.000, significantly younger than women (t=6.203; p=0.000. We determined acute alcohol intoxication in 73 persons - average blood alcohol concentration 1.85±1.01 g/L (min=0.55; max=3.85, and 61 of them died of cardiovascular diseases (χ2=236.781; df=5; p=0.000. Conclusion. In our observed sample, not many persons were under acute alcohol intoxication (around 7%. Most commonly, they were chronic alcohol abusers who died due to exacerbation of chronic heart disease, mildly or moderately intoxicated - the younger, the drunker.

  7. Training can modify back muscle response to sudden trunk loading.

    Science.gov (United States)

    Pedersen, Mogens Theisen; Essendrop, Morten; Skotte, Jørgen H; Jørgensen, Kurt; Fallentin, Nils

    2004-10-01

    Sudden, unexpected loading to the trunk has been reported in the literature as a potential cause of low-back disorders. This study's aim was to investigate the effect of "readiness training" on the response to sudden back loading among untrained healthy individuals. The study included 19 participants and 19 matched controls. All were employees at the National Institute of Occupational Health. The participants received ten 45-min training sessions during a 4-week period. The training focused on reactions to a variety of expected and unexpected sudden trunk loadings, including balance and coordination exercises. Before and after the training, all subjects were tested for reaction to sudden trunk loading (SL). This entailed applying a horizontal force of 58 N to the subject's upper back. Elapsed time--measured between SL and stopping--decreased significantly in the training group (from 337 to 311 ms) compared with the control group. The improved stopping time was associated with a changed EMG signal, characterized by an increase in the early parts of the response (up to 225 ms) and a subsequent decrease. EMG onset latency was unaffected by training. This study is apparently one of the first to demonstrate that the response to sudden trunk loading can be improved in healthy subjects without an increase in pre-activation and associated trunk stiffness. In perspective, the results indicate a possibility for a training-induced reduction of the risk of low-back injuries, e.g., in nurses exposed to sudden trunk perturbations during patient handling.

  8. 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...... 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...

  9. Investigating Insight as Sudden Learning

    Science.gov (United States)

    Ash, Ivan K.; Jee, Benjamin D.; Wiley, Jennifer

    2012-01-01

    Gestalt psychologists proposed two distinct learning mechanisms. Associative learning occurs gradually through the repeated co-occurrence of external stimuli or memories. Insight learning occurs suddenly when people discover new relationships within their prior knowledge as a result of reasoning or problem solving processes that re-organize or…

  10. Sudden, unexpected death due to glioblastoma: report of three fatal cases and review of the literature

    OpenAIRE

    Riezzo, Irene; Zamparese, Rosanna; Neri, Margherita; de Stefano, Francesco; Parente, Ruggero; Pomara, Cristoforo; Turillazzi, Emanuela; Ventura, Francesco; Fineschi, Vittorio

    2013-01-01

    Abstract Sudden death from an undiagnosed primary intracranial neoplasm is an exceptionally rare event, with reported frequencies in the range of 0.02% to 2.1% in medico-legal autopsy series and only 12% of all cases of sudden, unexpected death due to primary intracranial tumors are due to glioblastomas. We present three cases of sudden, unexpected death due to glioblastoma, with different brain localization and expression. A complete methodological forensic approach by means of autopsy, hist...

  11. Sudden cardiac death in athletes.

    Science.gov (United States)

    Schmied, C; Borjesson, M

    2014-02-01

    A 'paradox of sport' is that in addition to the undisputed health benefits of physical activity, vigorous exertion may transiently increase the risk of acute cardiac events. In general, the risk of sudden cardiac death (SCD) approximately doubles during physical activity and is 2- to 3-fold higher in athletes compared to nonathletes. The incidence of SCD in young athletes is in fact very low, at around 1-3 per 100,000, but attracts much public attention. Variations in incidence figures may be explained by the methodology used for data collection and more importantly by differences between subpopulations of athletes. The incidence of SCD in older (≥ 35 years) athletes is higher and may be expected to rise, as more and older individuals take part in organized sports. SCD is often the first clinical manifestation of a potentially fatal underlying cardiovascular disorder and usually occurs in previously asymptomatic athletes. In the young (cardiac abnormalities, whilst coronary artery disease (CAD) is the most common cause in older athletes. Cardiac screening including family/personal history, physical examination and resting electrocardiogram (ECG) may identify individuals at risk and has the potential to decrease the risk of SCD in young athletes. Screening including the ECG has a high sensitivity for underlying disease in young athletes, but the specificity needs to be improved, whereas the sensitivity of screening without the use of ECG is very low. The screening modality recommended for young athletes is of limited value in older athletes, who should receive individualized screening with cardiac stress testing for patients with high risk of underlying CAD. As cardiovascular screening will never be able to identify all athletes at risk, adequate preparedness is vital in case of a potentially fatal event at the sporting arena/facility. Firstly, we will review the magnitude of the problem of SCD in athletes of different ages, as well as the aetiology. Secondly, we

  12. Sudden Cardiac Arrest during Participation in Competitive Sports.

    Science.gov (United States)

    Landry, Cameron H; Allan, Katherine S; Connelly, Kim A; Cunningham, Kris; Morrison, Laurie J; Dorian, Paul

    2017-11-16

    The incidence of sudden cardiac arrest during participation in sports activities remains unknown. Preparticipation screening programs aimed at preventing sudden cardiac arrest during sports activities are thought to be able to identify at-risk athletes; however, the efficacy of these programs remains controversial. We sought to identify all sudden cardiac arrests that occurred during participation in sports activities within a specific region of Canada and to determine their causes. In this retrospective study, we used the Rescu Epistry cardiac arrest database (which contains records of every cardiac arrest attended by paramedics in the network region) to identify all out-of-hospital cardiac arrests that occurred from 2009 through 2014 in persons 12 to 45 years of age during participation in a sport. Cases were adjudicated as sudden cardiac arrest (i.e., having a cardiac cause) or as an event resulting from a noncardiac cause, on the basis of records from multiple sources, including ambulance call reports, autopsy reports, in-hospital data, and records of direct interviews with patients or family members. Over the course of 18.5 million person-years of observation, 74 sudden cardiac arrests occurred during participation in a sport; of these, 16 occurred during competitive sports and 58 occurred during noncompetitive sports. The incidence of sudden cardiac arrest during competitive sports was 0.76 cases per 100,000 athlete-years, with 43.8% of the athletes surviving until they were discharged from the hospital. Among the competitive athletes, two deaths were attributed to hypertrophic cardiomyopathy and none to arrhythmogenic right ventricular cardiomyopathy. Three cases of sudden cardiac arrest that occurred during participation in competitive sports were determined to have been potentially identifiable if the athletes had undergone preparticipation screening. In our study involving persons who had out-of-hospital cardiac arrest, the incidence of sudden cardiac

  13. Sudden death victims forensic physician and autopsy results.

    Science.gov (United States)

    Ceelen, Manon; van der Werf, Christian; Hendrix, Anneke; Naujocks, Tatjana; Woonink, Frits; de Vries, Philip; van der Wal, Allard; Das, Kees

    2015-08-01

    The goal of this study was to ascertain accordance between cause of death established by the forensic physician and autopsy results in young sudden death victims in the Netherlands. Sudden death victims aged 1-45 years examined by forensic physicians operating in the participating regions which also underwent an autopsy between January 2006 and December 2011 were included (n = 70). Cause of death established by the forensic physician based on the external medicolegal examination was compared with autopsy findings using the ICD10-classification. Autopsy findings revealed that the majority of sudden death victims have died from a cardiac disease (n = 51, 73%). Most of the presumed heart disease related cases were confirmed by autopsy (n = 13, 87%). On the contrary, a large number of deaths caused by circulatory diseases were not recognised by the forensic physician (n = 38, 75%). In most of these cases, the forensic physician was forced to report an undetermined cause due to the lack of a solid explanation for death. Cause of death reported by the forensic physician appeared to be in agreement with the autopsy results in 12 cases (17%). Cause of death determination in young sudden death victims is a difficult task for forensic physicians due to the limited tools available during the medicolegal examination. An effort should be made to standardize extensive post-mortem investigation after sudden death in the young. Autopsy can provide valuable information regarding the cause of death, which is of great importance in view of the identification of inheritable diseases among decedents and their families. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  14. Sudden Infant Death Syndrome: Facts for Caregivers.

    Science.gov (United States)

    Texas Child Care, 2000

    2000-01-01

    Presents risk factors and prevention measures related to Sudden Infant Death Syndrome. Offers infant sleep recommendations and five discussion questions to test knowledge of Sudden Infant Death Syndrome. (DLH)

  15. Sudden Cardiac Arrest (SCA) Risk Assessment

    Science.gov (United States)

    ... Specialist Share Twitter Facebook SCA Risk Assessment Sudden Cardiac Arrest (SCA) occurs abruptly and without warning, and two- ... and health conditions. Start Risk Assessment The Sudden Cardiac Arrest (SCA) Risk Assessment Tool is supported in part ...

  16. Sudden Unexpected Death in Epilepsy (SUDEP)

    Science.gov (United States)

    ... this? Submit What's this? Submit Button Sudden Unexpected Death in Epilepsy (SUDEP) Recommend on Facebook Tweet Share ... living with epilepsy, the risk of Sudden Unexpected Death in Epilepsy (SUDEP) is an important concern. SUDEP ...

  17. Geographically structured host specificity is caused by the range expansions and host shifts of a symbiotic fungus

    Science.gov (United States)

    Wolfe, Benjamin E; Pringle, Anne

    2012-01-01

    The inability to associate with local species may constrain the spread of mutualists arriving to new habitats, but the fates of introduced, microbial mutualists are largely unknown. The deadly poisonous ectomycorrhizal fungus Amanita phalloides (the death cap) is native to Europe and introduced to the East and West Coasts of North America. By cataloging host associations across the two continents, we record dramatic changes in specificity among the three ranges. On the East Coast, where the fungus is restricted in its distribution, it associates almost exclusively with pines, which are rarely hosts of A. phalloides in its native range. In California, where the fungus is widespread and locally abundant, it associates almost exclusively with oaks, mirroring the host associations observed in Europe. The most common host of the death cap in California is the endemic coast live oak (Quercus agrifolia), and the current distribution of A. phalloides appears constrained within the distribution of Q. agrifolia. In California, host shifts to native plants are also associated with a near doubling in the resources allocated to sexual reproduction and a prolonged fruiting period; mushrooms are twice as large as they are elsewhere and mushrooms are found throughout the year. Host and niche shifts are likely to shape the continuing range expansion of A. phalloides and other ectomycorrhizal fungi introduced across the world. PMID:22134645

  18. 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

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

    NARCIS (Netherlands)

    de Nijs, M.I.; Vink, Aryan; Bergmann, W.; Szatmári, V.

    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. Fatal Gastrointestinal Perforations in sudden death cases in Last 10 ...

    African Journals Online (AJOL)

    Gastrointestinal perforation occurs when the wall of the gastro-intestinal tract like stomach, small intestine or large bowel develops a hole through its entire thickness. This retrospective study was aimed to identify pattern of GIT perforations that caused sudden deaths in this part of the world. The study was conducted in ...

  1. Linking sudden oak death with spatial economic value transfer

    Science.gov (United States)

    Tom Holmes; Bill Smith

    2008-01-01

    Sudden oak death (caused by Phytophthora ramorum) is currently having a dramatic impact on the flow of ecosystem services provided by trees and forests in California. Timber species in California are not thought to be at risk of mortality from this pathogen and, consequently, economic impacts accrue to non-market values of trees such as aesthetics,...

  2. Protecting Trees from Sudden Oak Death before Infection

    Science.gov (United States)

    C. Lee; Y. Valachovic; M. Garbelotto

    2010-01-01

    Phytophthora ramorum, an introduced invasive plant pathogen that causes sudden oak death, has killed over a million tanoak, coast live oak, Shreve oak, and California black oak trees along the California coastal region from Monterey through Humboldt Counties. Most trees infected with P. ramorum will eventually die, including...

  3. Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith

    OpenAIRE

    Fulvio A. Scorza; Esper A. Cavalheiro; Jaderson Costa da Costa

    2016-01-01

    ABSTRACT Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in people with intractable epilepsy. Probably, optimization of seizure control will prevent some of these deaths. Briefly, we integrated in this paper some data about the epidemiology, risk factors, etiology, and preventative measures in the management of SUDEP.

  4. Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith

    Directory of Open Access Journals (Sweden)

    Fulvio A. Scorza

    2016-07-01

    Full Text Available ABSTRACT Sudden unexpected death in epilepsy (SUDEP is the most common cause of death in people with intractable epilepsy. Probably, optimization of seizure control will prevent some of these deaths. Briefly, we integrated in this paper some data about the epidemiology, risk factors, etiology, and preventative measures in the management of SUDEP.

  5. Sudden cardiac arrest risk in young athletes | Gradidge | South ...

    African Journals Online (AJOL)

    Underlying cardiac abnormalities are the main cause of unexpected death in athletes on field. These abnormalities have been associated with a previous history of syncope, a family history of sudden cardiac arrest (SCA), cardiac murmur, a history of over-exhaustion post exercise and ventricular tachyarrhythmia during ...

  6. Detection of sudden death syndrome using a multispectral imaging sensor

    Science.gov (United States)

    Sudden death syndrome (SDS), caused by the fungus Fusarium solani f. sp. glycines, is a widespread mid- to late-season disease with distinctive foliar symptoms. This paper reported the development of an image analysis based method to detect SDS using a multispectral image sensor. A hue, saturation a...

  7. 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

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

    NARCIS (Netherlands)

    Straus, SMJM; Kors, JA; De Bruin, ML; van der Hooft, CS; Hofman, A; Heeringa, J; Deckers, JW; Kingma, JH; Sturkenboom, MCJM; Stricker, BHC; Witteman, JCM

    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

  9. The yield of family screening in sudden unexplained death in the young

    NARCIS (Netherlands)

    Van De Werf, C.; Hofman, N.; Tan, H.L.; Van Langen, I.M.; Wilde, A.A.M.

    2009-01-01

    Objectives: When autopsy is performed after sudden death of a young person, cause of death remains undetermined in 6-65%, which is termed sudden unexplained death (SUD). In these cases molecular autopsy and cardiological and genetic examination in surviving first degree relatives is known to unmask

  10. Sudden unexpected death in children with a previously diagnosed cardiovascular disorder

    NARCIS (Netherlands)

    Polderman, Florens N.; Cohen, Joeri; Blom, Nico A.; Delhaas, Tammo; Helbing, Wim A.; Lam, Jan; Sobotka-Plojhar, Marta A.; Temmerman, Arno M.; Sreeram, Narayanswani

    2004-01-01

    BACKGROUND: It is known that children with previously diagnosed heart defects die suddenly. The causes of death are often unknown. OBJECTIVE: The aim of the study was to identify all infants and children within the Netherlands with previously diagnosed heart disease who had a sudden unexpected death

  11. Sudden unexpected death in children with a previously diagnosed cardiovascular disorder

    NARCIS (Netherlands)

    Polderman, F.N.; Cohen, Joeri; Blom, N.A.; Delhaas, T.; Helbing, W.A.; Lam, J.; Sobotka-Plojhar, M.A.; Temmerman, Arno M.; Sreeram, N.

    2004-01-01

    Background: It is known that children with previously diagnosed heart defects die suddenly. The causes of death are often unknown. Objective: The aim of the study was to identify all infants and children within the Netherlands with previously diagnosed heart disease who had a sudden unexpected death

  12. Innovation and dedication underpin management of sudden oak death (Phytophthora ramorum) in California and Oregon forests

    Science.gov (United States)

    Susan J. Frankel

    2017-01-01

    This special issue of Forest Phytophthoras serves as part of the proceedings from the Sixth Sudden Oak Death Science Symposium held June 21 -23, 2016 at Fort Mason Center in San Francisco, CA, USA. The symposium marked almost 16 years to the day that David Rizzo (UC Davis) and Matteo Garbelotto (UC Berkeley) identified the cause of sudden oak death to be a previously...

  13. 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

    2015-06-05

    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. © 2015 American Heart Association, Inc.

  14. Pediatric Sudden Sensorineural Hearing Loss.

    Science.gov (United States)

    Kizilay, Ahmet; Koca, Çiğdem Firat

    2016-06-01

    Sudden sensorineural hearing loss is defined as sudden unilateral or bilateral sensorineural hearing loss with at least 30 dB decrease in threshold in 3 contiguous test frequencies occurring over 72 hours or less. It is rare among children. The mechanism of the process and prognosis of the disorder remains unclear. The current incidence of sudden sensorineural hearing loss among pediatric population is unknown. The authors carried out a retrospective chart analysis of patients under 15 years of age from 2004 to 2015, who consulted to the Otolaryngology Head and Neck Surgery Department of Inonu University Medical Faculty. Age, sex, number of affected ear and side, audiometric evaluations, medical follow-up, treatment method, duration of treatment recovery, associated complaints; tinnitus and/or vertigo, presence of mumps disease were recorded for each patient. A 4-frequency pure-tone average (500, 1000, 2000, and 4000 Hz) was calculated for each ear. Complete recovery, defined as some hearing level compared with the nonaffected ear, was observed in 3 patients (21.4 %) and there was no partial hearing recovery. The hearing loss of 11 patient remained unchanged after prednisolone treatment. Two of the 11 patients had bilaterally total sensorineural hearing loss and evaluated as appropriate for cochlear implantation. Sex of patient and laterality of hearing loss were not correlated with hearing recovery. Sensorineural hearing loss among pediatrics has been the issue of otolaryngologists. The incidence, etiology, and treatment methods should be more studied.

  15. Strategies for the prevention of sudden cardiac death during sports.

    Science.gov (United States)

    Corrado, Domenico; Drezner, Jonathan; Basso, Cristina; Pelliccia, Antonio; Thiene, Gaetano

    2011-04-01

    Sudden cardiac death of a young athlete is the most tragic event in sports and devastates the family, the sports medicine team, and the local community. Such a fatality represents the first manifestation of cardiac disease in up to 80% of young athletes who remain asymptomatic before sudden cardiac arrest occurs; this explains the limited power of screening modalities based solely on history and physical examination. The long-running Italian experience showed that electrocardiogram (ECG) screening definitively improves the sensitivity of pre-participation evaluation for heart diseases and substantially reduces the risk of death in the athletic field (primary prevention). However, some cardiac conditions, such as coronary artery diseases, present no abnormalities on 12-lead ECG. Moreover, cardiac arrest due to non-penetrating chest injury (commotio cordis) cannot be prevented by screening. This justifies the efforts for implementing programmes of early external defibrillation of unpredictable arrhythmic cardiac arrest. This article reviews the epidemiology of sudden cardiac arrest in the athlete in terms of incidence, sport-related risk, underlying causes, and the currently available prevention programmes such as pre-participation screening and early external defibrillation by using automated external defibrillators. The best strategy is to combine synergistically primary prevention of sudden cardiac death by pre-participation identification of athletes affected by at-risk cardiomyopathies and secondary prevention with back-up defibrillation of unpredictable sudden cardiac arrest on the athletic field.

  16. Lives forever changed: family bereavement experiences after sudden cardiac death.

    Science.gov (United States)

    Mayer, D Dale M; Rosenfeld, Anne G; Gilbert, Kathleen

    2013-11-01

    To describe the bereavement experiences of families who survived the sudden cardiac death of a family member and identify meanings of loss. Approximately 325,000 people experience sudden cardiac death (SCD) annually. It is important to examine family experiences after SCD because of the life altering impact of death on surviving family members. A descriptive design, using the qualitative method of narrative analysis, was used to analyze family stories of bereavement. Five themes were identified across seven families: sudden cardiac death … boom; saying goodbye; grief unleashes volatile emotional reactions; life goes on … but never back to normal; and meanings in loss. This study adds to an understanding of family bereavement and findings suggest that providing information about the cause of death and allowing family members to tell their stories are potentially important interventions for clinicians who interact with bereaved families. © 2013.

  17. The prevention of sudden death in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Sachdev, Bhavesh; Hamid, M Shoaib; Elliott, Perry M

    2002-05-01

    Hypertrophic cardiomyopathy (HCM) is a familial myocardial disease caused by mutations in cardiac sarcomeric proteins. HCM is characterised by myocyte disarray and myocardial fibrosis. Most patients are largely asymptomatic but some are prone to a number of disease-related complications, the most problematic of which is sudden cardiac death. Diagnosing patients who are at risk has not been easy because of the clinical heterogeneity of the disease, the frequent absence of symptoms prior to sudden cardiac death and the relatively low disease prevalence and annual mortality rates. To date, both low-dose amiodarone and internal cardioverter/defibrillator implantation have been advocated in high-risk individuals. Further improvements in clinical understanding and risk stratification are necessary to identify HCM patients who are at high risk of sudden death.

  18. 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

  19. Who Is at Risk for Sudden Cardiac Arrest?

    Science.gov (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  20. How Can Death Due to Sudden Cardiac Arrest Be Prevented?

    Science.gov (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  1. Occurrence of specific environmental risk factors in brain tissues of sudden infant death and sudden intrauterine unexpected death victims assessed with gas chromatography-tandem mass spectrometry.

    Science.gov (United States)

    Termopoli, Veronica; Famiglini, Giorgio; Palma, Pierangela; Magrini, Laura; Cappiello, Achille

    2015-03-01

    Sudden infant death syndrome (SIDS) and sudden intrauterine unexpected death syndrome (SIUDS) are an unresolved teaser in the social-medical and health setting of modern medicine and are the result of multifactorial interactions. Recently, prenatal exposure to environmental contaminants has been associated with negative pregnancy outcomes, and verification of their presence in fetal and newborn tissues is of crucial importance. A gas chromatography-tandem mass spectrometry (MS/MS) method, using a triple quadrupole analyzer, is proposed to assess the presence of 20 organochlorine pesticides, two organophosphate pesticides, one carbamate (boscalid), and a phenol (bisphenol A) in human brain tissues. Samples were collected during autopsies of infants and fetuses that died suddenly without any evident cause. The method involves a liquid-solid extraction using n-hexane as the extraction solvent. The extracts were purified with Florisil cartridges prior to the final determination. Recovery experiments using lamb brain spiked at three different concentrations in the range of 1-50 ng g(-1) were performed, with recoveries ranging from 79 to 106%. Intraday and interday repeatability were evaluated, and relative standard deviations lower than 10% and 18%, respectively, were obtained. The selectivity and sensitivity achieved in multiple reaction monitoring mode allowed us to achieve quantification and confirmation in a real matrix at levels as low as 0.2-0.6 ng g(-1). Two MS/MS transitions were acquired for each analyte, using the Q/q ratio as the confirmatory parameter. This method was applied to the analysis of 14 cerebral cortex samples (ten SIUDS and four SIDS cases), and confirmed the presence of several selected compounds.

  2. Unravelling the mysteries of sudden unexpected death in epilepsy.

    Science.gov (United States)

    Hampel, K G; Rocamora Zuñiga, R; Quesada, C M

    2017-04-18

    Sudden unexpected death in epilepsy (SUDEP) is the most frequent cause of premature death in epileptic patients. Most SUDEP events occur at night and frequently go unnoticed; the exact pathophysiological mechanisms of this phenomenon therefore remain undetermined. Nevertheless, most cases of SUDEP are attributed to an infrequent yet extremely severe complication of epileptic seizures. We conducted a systematic literature search on PubMed. Our review article summarises scientific evidence on the classification, pathophysiological mechanisms, risk factors, biomarkers, and prevention of SUDEP. Likewise, we propose new lines of research and critically analyse findings that are relevant to clinical practice. Current knowledge suggests that SUDEP is a heterogeneous phenomenon caused by multiple factors. In most cases, however, SUDEP is thought to be due to postictal cardiorespiratory failure triggered by generalised tonic-clonic seizures and ultimately leading to cardiac arrest. The underlying pathophysiological mechanism involves multiple factors, ranging from genetic predisposition to environmental factors. Risk of SUDEP is higher in young adults with uncontrolled generalised tonic-clonic seizures. However, patients apparently at lower risk may also experience SUDEP. Current research focuses on identifying genetic and neuroimaging biomarkers that may help determine which patients are at high risk for SUDEP. Antiepileptic treatment is the only preventive measure proven effective to date. Night-time monitoring together with early resuscitation may reduce the risk of SUDEP. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. State-Level Implementation of Health and Safety Policies to Prevent Sudden Death and Catastrophic Injuries Within Secondary School Athletics.

    Science.gov (United States)

    Adams, William M; Scarneo, Samantha E; Casa, Douglas J

    2017-09-01

    Sudden death and catastrophic injuries during sport can be attenuated with the implementation of evidence-based health and safety policies. However, the extent of the implementation of these policies within secondary school athletics is unknown. To provide an assessment of the implementation of health and safety policies pertaining to the leading causes of sudden death and catastrophic injuries in sport within secondary school athletics in the United States. Descriptive epidemiology study. A rubric for evidence-based practices for preventing the leading causes of death and catastrophic injuries in sport was created. The rubric comprised 5 equally weighted sections for sudden cardiac arrest, head injuries, exertional heat stroke, appropriate medical coverage, and emergency preparedness. State high school athletic association (SHSAA) policies, enacted legislation, and Department of Education policies were extensively reviewed for all 50 states and the District of Columbia. States meeting the specific criteria in the rubric, which required policies to be mandated for all SHSAA member schools, were awarded credit; the weighted scores were tabulated to calculate an aggregate score. States were then ranked from 1 (best) to 51 (worst) based on the aggregate score achieved. The median score on the rubric was 47.1% (range, 23.00%-78.75%). States ranked 1 through 10 (from 78.75% to 56.98%) were North Carolina, Kentucky, Massachusetts, New Jersey, South Dakota, Missouri, Washington, Hawaii, Wisconsin, and Georgia, respectively. States ranked 11 through 20 (from 56.03% to 50.55%) were Arkansas, New York, Mississippi, West Virginia, Oregon, Illinois, Tennessee, Arizona, Texas, and District of Columbia, respectively. States ranked 21 through 30 (from 49.40% to 44.00%) were Virginia, Pennsylvania, Florida, New Mexico, Alabama, Maine, Rhode Island, Indiana, Nevada, and Utah, respectively. States ranked 31 through 40 (from 43.93% to 39.80%) were Ohio, Delaware, Alaska, Vermont

  4. State-Level Implementation of Health and Safety Policies to Prevent Sudden Death and Catastrophic Injuries Within Secondary School Athletics

    Science.gov (United States)

    Adams, William M.; Scarneo, Samantha E.; Casa, Douglas J.

    2017-01-01

    Background: Sudden death and catastrophic injuries during sport can be attenuated with the implementation of evidence-based health and safety policies. However, the extent of the implementation of these policies within secondary school athletics is unknown. Purpose: To provide an assessment of the implementation of health and safety policies pertaining to the leading causes of sudden death and catastrophic injuries in sport within secondary school athletics in the United States. Study Design: Descriptive epidemiology study. Methods: A rubric for evidence-based practices for preventing the leading causes of death and catastrophic injuries in sport was created. The rubric comprised 5 equally weighted sections for sudden cardiac arrest, head injuries, exertional heat stroke, appropriate medical coverage, and emergency preparedness. State high school athletic association (SHSAA) policies, enacted legislation, and Department of Education policies were extensively reviewed for all 50 states and the District of Columbia. States meeting the specific criteria in the rubric, which required policies to be mandated for all SHSAA member schools, were awarded credit; the weighted scores were tabulated to calculate an aggregate score. States were then ranked from 1 (best) to 51 (worst) based on the aggregate score achieved. Results: The median score on the rubric was 47.1% (range, 23.00%-78.75%). States ranked 1 through 10 (from 78.75% to 56.98%) were North Carolina, Kentucky, Massachusetts, New Jersey, South Dakota, Missouri, Washington, Hawaii, Wisconsin, and Georgia, respectively. States ranked 11 through 20 (from 56.03% to 50.55%) were Arkansas, New York, Mississippi, West Virginia, Oregon, Illinois, Tennessee, Arizona, Texas, and District of Columbia, respectively. States ranked 21 through 30 (from 49.40% to 44.00%) were Virginia, Pennsylvania, Florida, New Mexico, Alabama, Maine, Rhode Island, Indiana, Nevada, and Utah, respectively. States ranked 31 through 40 (from 43

  5. Dynamic model for kinesin-mediated long-range transport and its local traffic jam caused by tau proteins

    Science.gov (United States)

    Nam, Woochul; Epureanu, Bogdan I.

    2017-01-01

    In neurons, several intracellular cargoes are transported by motor proteins (kinesins) which walk on microtubules (MTs). However, kinesins can possibly unbind from the MTs before they reach their destinations. The unbound kinesins randomly diffuse in neurons until they bind to MTs. Then, they walk again along the MTs to continue their tasks. Kinesins repeat this cycle of motion until they transport their cargoes to the destinations. However, most previous models mainly focused on the motion of kinesins when they walk on MTs. Thus, a new model is required to encompass the various types of kinesin motion. We developed a comprehensive model and studied the long-range axonal transport of neurons using the model. To enhance reliability of the model, it was constructed based on multiphysics on kinesin motion (i.e., chemical kinetics, diffusion, fluid dynamics, nonlinear dynamics, and stochastic characteristics). Also, parameter values for kinesin motions are carefully obtained by comparing the model predictions and several experimental observations. The axonal transport can be degraded when a large number of binding sites on MTs are blocked by excessive tau proteins. By considering the interference between walking kinesins and tau molecules on MTs, effects of tau proteins on the axonal transport are studied. One of the meaningful predictions obtained from the model is that the velocity is not an effective metric to estimate the degradation of the transport because the decrease in velocity is not noticeable when the concentration of tau protein is not high. However, our model shows that the transport locally changes near tau molecules on MTs even when the change in the velocity is not significant. Thus, a statistical method is proposed to detect this local change effectively. The advantage of this method is that a value obtained from this method is highly sensitive to the concentration of tau protein. Another benefit of this method is that this highly sensitive value can

  6. Aetiology of sudden cardiac death in sport: a histopathologist's perspective.

    Science.gov (United States)

    Sheppard, Mary N

    2012-11-01

    In the UK, when a young person dies suddenly, the coroner is responsible for establishing the cause of death. They will ask a consultant pathologist to carry out an autopsy in order to ascertain when, where and how that person died. Once the cause of death is established and is due to natural causes, the coroner can issue a death certificate. Importantly, the coroner is not particularly interested in the cause of death as long as it is due to natural causes, which avoids the need for an inquest (a public hearing about the death). However, if no identifiable cause is established at the initial autopsy, the coroner can refer the heart to a cardiac pathologist, since the cause of death is usually due to heart disease in most cases. Consultant histopathologists are responsible for the analysis of human tissue from both living individuals and the dead in order to make a diagnosis of disease. With recent advancements in the management protocols for routine autopsy practice and assessment following the sudden death of a young individual, this review describes the role of the consultant histopathologist in the event of a sudden death of a young athletic individual, together with the older middle-aged 'weekend warrior' athlete. It provides concise mechanisms for the main causes of sudden cardiac death (including coronary artery disease, cardiomyopathies, valve abnormalities, major vessel ruptures and electrical conduction abnormalities) based on detailed autopsy data from our specialised cardiac pathology laboratory. Finally, the review will discuss the role of the histopathologist in the event of a 'negative' autopsy.

  7. Laryngeal inflammation in the sudden infant death syndrome.

    Science.gov (United States)

    Scadding, Glenis K; Brock, Christine; Chouiali, Fazila; Hamid, Qutayaba

    2014-01-01

    Sudden infant death syndrome (SIDS) is marked by 'the sudden death of an infant that is unexpected by history and remains unexplained after a thorough forensic autopsy and a detailed death scene investigation'. The cause is unknown. Excessive subglottic submucosal glandular tissue and excessive sulphated mucus glycoprotein in the larynges of SIDS babies have been previously reported from our institution. We now report on laryngeal immunohistology. Larynges from 7 children who died from Sudden Infant Death Syndrome (SIDS) at under 16 weeks of age were examined immunohistologically and compared to those from 8 age- matched control infants who died from other causes. The SIDS babies had increased inflammatory changes in the laryngeal epithelium and sub- epithelium with raised numbers of cells staining for elastase (pdeaths involve preceding inflammation. Although death may be sudden and unexpected it appears that, at least in some SIDS victims, there is a preceding inflammatory process in the larynx which may allow hyper-reactivity of laryngeal reflexes and consequent apnoea. This observation concurs with others in the SIDS literature and offers a field for further research and possible prevention.

  8. Sudden death in racing Thoroughbred horses: an international multicentre study of post mortem findings.

    Science.gov (United States)

    Lyle, C H; Uzal, F A; McGorum, B C; Aida, H; Blissitt, K J; Case, J T; Charles, J T; Gardner, I; Horadagoda, N; Kusano, K; Lam, K; Pack, J D; Parkin, T D; Slocombe, R F; Stewart, B D; Boden, L A

    2011-05-01

    To improve the understanding of exercise related sudden death in Thoroughbred racehorses. To describe the post mortem findings in cases of sudden death associated with exercise in 268 Thoroughbred racehorses. Gross and histological post mortem findings of 268 cases of sudden death were collated and reviewed. Cases originated from 6 racing jurisdictions around the world. Sudden death was defined as acute collapse and death in a closely observed and previously apparently healthy Thoroughbred racehorse, during, or within one hour after, exercise. Cause of death as determined by the attending pathologist was categorised as definitive, presumptive or unexplained and compared between the different populations. Cardiopulmonary lesions recorded at post mortem examination were compared between different populations. Pathologists recorded a definitive cause of death in 53% (143/268) of cases. Major definitive causes of sudden death included cardiac failure, apparent pulmonary failure, pulmonary haemorrhage, haemorrhage associated with pelvic fractures or with idiopathic blood vessel rupture, and spinal cord injury. A presumptive cause of death was made in 25% (67/268) of cases and death remained unexplained in 22% (58/268) of cases. There were several statistically significant inter-population differences in the cause of death and in reporting of cardiopulmonary lesions. Sudden death can be attributed to a variety of causes. Causes of sudden death and the lesions found in cases of exercise-related sudden death are similar in different racing jurisdictions. However, the lesions are often not specific for the cause of death and determination of the cause of death is therefore affected by interpretation by the individual pathologist. © 2010 EVJ Ltd.

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

    Science.gov (United States)

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

    2016-06-22

    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. A previously healthy 12-year-old male West Highland white terrier was found dead during its 1-week stay in a kennel. The dog was known to have a cardiac murmur. On necropsy, a pedunculated neoplasia was found attached to the interventricular aspect of the left ventricular outflow tract, resulting in almost complete obstruction of the aorta. As this was the only abnormality identified, the tumor was considered as the cause of sudden death. Histopathologic findings were compatible with a myxoma. Benign intraluminal tumors of the heart are very rare in dogs, but may have fatal consequences. Echocardiography could have revealed the cause of the cardiac murmur of this previously asymptomatic dog. Surgical removal could have been possible, as the tumor was pedunculated.

  10. Regeneration and tanoak mortality in coast redwood stands affected by sudden oak death

    Science.gov (United States)

    Benjamin S. Ramage; Kevin L. OHara; Alison B. Forreste

    2012-01-01

    Sudden oak death, an emerging disease caused by the exotic pathogen Phytophthora ramorum, is impacting coast redwood (Sequoia sempervirens) forests throughout coastal California. The most severely affected species, tanoak (Notholithocarpus densiflorus), is currently widespread and abundant in the redwood...

  11. 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

    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 incidence of venous thromboembolism was 0.9 per 1000 per year in the background population, and less than one-thousandth of these were children. Consequently it is not likely that venous thrombosis is a major cause of sudden infant death syndrome. On the other hand, this does not exclude other known...

  12. From Africa to Europe and back: refugia and range shifts cause high genetic differentiation in the Marbled White butterfly Melanargia galathea

    OpenAIRE

    Rödder Dennis; Lens Luc; Habel Jan C; Schmitt Thomas

    2011-01-01

    Abstract Background The glacial-interglacial oscillations caused severe range modifications of biota. Thermophilic species became extinct in the North and survived in southern retreats, e.g. the Mediterranean Basin. These repeated extinction and (re)colonisation events led to long-term isolation and intermixing of populations and thus resulted in strong genetic imprints in many European species therefore being composed of several genetic lineages. To better understand these cycles of repeated...

  13. [Sudden cardiac death: Are women different?

    Science.gov (United States)

    Karam, N; Marijon, E; Bougouin, W; Spaulding, C; Jouven, X

    2016-12-01

    Sudden cardiac death is a major public health problem with around 40,000 cases per year in France. Epidemiological, clinical and prognostic differences according to gender have been described in most cardiovascular diseases, including sudden cardiac death. In this article, we will review gender differences in sudden cardiac death incidence, circumstance of occurrence, management, and prognosis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Sudden infant death syndrome, sleep, and seizures.

    Science.gov (United States)

    Hoppenbrouwers, Toke

    2015-06-01

    benign febrile seizures seen in 7% of infants before 6 months play a role in the terminal pathway in a subset of sudden infant death syndrome victims. Supporting evidence: (1) lack of 5-hydroxitryptamine, one consistent finding in sudden infant death syndrome that Kinney et al coined a developmental serotonopathy, is consistent with risk for seizures. (2) Non-rapid eye movement sleep increasing during the age of highest risk for sudden infant death syndrome facilitates some seizures (seizure gate). (3) Sudden unexpected death in epilepsy is associated with severe hypoxemia and hypercapnia during postictal generalized electroencephalographic (EEG) suppression. In toddlers, sudden unexplained deaths are associated with hippocampal abnormalities and some seizures. (4) The sudden nature of both deaths warrants an exploration of similarities in the terminal pathway. Moreover, sudden infant death syndrome, febrile seizures, sudden unexplained death in childhood, and sudden unexpected death in epilepsy share some of the following risk factors: prone sleeping, infections, hyperthermia, preterm birth, male gender, maternal smoking, and mutations in genes that regulate sodium channels. State-of-the-art molecular studies can be exploited to test this hypothesis. © The Author(s) 2014.

  15. A Prospective Study of Sudden Cardiac Death among Children and Young Adults.

    Science.gov (United States)

    Bagnall, Richard D; Weintraub, Robert G; Ingles, Jodie; Duflou, Johan; Yeates, Laura; Lam, Lien; Davis, Andrew M; Thompson, Tina; Connell, Vanessa; Wallace, Jennie; Naylor, Charles; Crawford, Jackie; Love, Donald R; Hallam, Lavinia; White, Jodi; Lawrence, Christopher; Lynch, Matthew; Morgan, Natalie; James, Paul; du Sart, Desirée; Puranik, Rajesh; Langlois, Neil; Vohra, Jitendra; Winship, Ingrid; Atherton, John; McGaughran, Julie; Skinner, Jonathan R; Semsarian, Christopher

    2016-06-23

    Sudden cardiac death among children and young adults is a devastating event. We performed a prospective, population-based, clinical and genetic study of sudden cardiac death among children and young adults. We prospectively collected clinical, demographic, and autopsy information on all cases of sudden cardiac death among children and young adults 1 to 35 years of age in Australia and New Zealand from 2010 through 2012. In cases that had no cause identified after a comprehensive autopsy that included toxicologic and histologic studies (unexplained sudden cardiac death), at least 59 cardiac genes were analyzed for a clinically relevant cardiac gene mutation. A total of 490 cases of sudden cardiac death were identified. The annual incidence was 1.3 cases per 100,000 persons 1 to 35 years of age; 72% of the cases involved boys or young men. Persons 31 to 35 years of age had the highest incidence of sudden cardiac death (3.2 cases per 100,000 persons per year), and persons 16 to 20 years of age had the highest incidence of unexplained sudden cardiac death (0.8 cases per 100,000 persons per year). The most common explained causes of sudden cardiac death were coronary artery disease (24% of cases) and inherited cardiomyopathies (16% of cases). Unexplained sudden cardiac death (40% of cases) was the predominant finding among persons in all age groups, except for those 31 to 35 years of age, for whom coronary artery disease was the most common finding. Younger age and death at night were independently associated with unexplained sudden cardiac death as compared with explained sudden cardiac death. A clinically relevant cardiac gene mutation was identified in 31 of 113 cases (27%) of unexplained sudden cardiac death in which genetic testing was performed. During follow-up, a clinical diagnosis of an inherited cardiovascular disease was identified in 13% of the families in which an unexplained sudden cardiac death occurred. The addition of genetic testing to autopsy

  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. Gender, Age and Season as Modifiers of the Effects of Diurnal Temperature Range on Emergency Room Admissions for Cause-Specific Cardiovascular Disease among the Elderly in Beijing.

    Science.gov (United States)

    Zheng, Shan; Wang, Minzhen; Li, Bei; Wang, Shigong; He, Shilin; Yin, Ling; Shang, Kezheng; Li, Tanshi

    2016-04-27

    Diurnal temperature range (DTR) is an important index of climate change and variability. It is also a risk factor affecting human health. However, limited evidence is available to illustrate the effect of DTR modification on cause-specific cardiovascular disease among the elderly. A semi-parametric generalized additive model (GAM) was used to analyze the exposure-effect relationship between DTR and daily emergency room (ER) admissions for cause-specific cardiovascular diseases among the elderly from 2009 to 2011 in Beijing. We examined the effects of DTR for stratified groups by gender and age, and examined the effects of DTR in the warm season and cold season for cause-specific cardiovascular diseases. Significant associations were found between DTR and ER admissions for all cardiovascular and cerebrovascular disease among elderly males, while DTR was significantly associated with ER admissions for all cardiovascular disease, ischemic heart disease and cerebrovascular disease among elderly females. People aged 75 years and older were more vulnerable to DTR. DTR caused greater adverse effects on both genders in the warm season, whereas the effect estimates on females were higher in cold season than in warm season. A short-term increase of DTR was significantly associated with ER admissions for cause-specific cardiovascular disease among the elderly in Beijing. Gender, age and season may modify the acute health effect of DTR. Some prevention programs that target the high risk subgroups in the elderly for impending large temperature changes may reduce the impact of DTR on people's health.

  18. The sudden success of prose

    DEFF Research Database (Denmark)

    Mortensen, Lars Boje

    2017-01-01

    . It is also suggested that the exactly contemporary rise of French and Old Norse prose (c. 1200-1230) most probably is connected. The four literatures are each shown in chronological charts so as to visualize the timeline and the relation between poetic and prosaic works. The article furthermore reflects......The article presents a new model for understanding the sudden success of prose in four literatures: Greek, Latin, French and Old Norse. Through comparison and quantitative observations, and by focusing on the success of prose rather than its invention, it is shown that in all four cases two...... reading aloud) has been underplayed in previous scholarship mostly focused on authorial choices and invention. For two of the literatures (Greek, French) the fast dynamics of the rise of prose has already been identified and discussed, but for the two others (Latin, Old Norse), the observation is new...

  19. Neurochemical Alterations in Sudden Unexplained Perinatal Deaths—A Review

    Directory of Open Access Journals (Sweden)

    Nazeer Muhammad

    2018-01-01

    Full Text Available Sudden unexpected perinatal collapse is a major trauma for the parents of victims. Sudden infant death syndrome (SIDS is unexpected and mysterious death of an apparently healthy neonate from birth till 1 year of age without any known causes, even after thorough postmortem investigations. However, the incidence of sudden intrauterine unexplained death syndrome (SIUDS is seven times higher as compared with SIDS. This observation is approximated 40–80%. Stillbirth is defined as death of a fetus after 20th week of gestation or just before delivery at full term without a known reason. Pakistan has the highest burden of stillbirth in the world. This basis of SIDS, SIUDS, and stillbirths eludes specialists. The purpose of this study is to investigate factors behind failure in control of these unexplained deaths and how research may go ahead with improved prospects. Animal models and physiological data demonstrate that sleep, arousal, and cardiorespiratory malfunctioning are abnormal mechanisms in SIUDS risk factors or in newborn children who subsequently die from SIDS. This review focuses on insights in neuropathology and mechanisms of SIDS and SIUDS in terms of different receptors involved in this major perinatal demise. Several studies conducted in the past decade have confirmed neuropathological and neurochemical anomalies related to serotonin transporter, substance P, acetylcholine α7 nicotine receptors, etc., in sudden unexplained fetal and infant deaths. There is need to focus more on research in this area to unveil the major curtain to neuroprotection by underlying mechanisms leading to such deaths.

  20. Declining risk of sudden death in heart failure

    DEFF Research Database (Denmark)

    Shen, Li; Jhund, Pardeep S.; Petrie, Mark C.

    2017-01-01

    BACKGROUND The risk of sudden death has changed over time among patients with symptomatic heart failure and reduced ejection fraction with the sequential introduction of medications including angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, and mineralocorti......BACKGROUND The risk of sudden death has changed over time among patients with symptomatic heart failure and reduced ejection fraction with the sequential introduction of medications including angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, beta......-blockers, and mineralocorticoid-receptor antagonists. We sought to examine this trend in detail. METHODS We analyzed data from 40,195 patients who had heart failure with reduced ejection fraction and were enrolled in any of 12 clinical trials spanning the period from 1995 through 2014. Patients who had an implantable...... rates of sudden death were assessed at different time points after randomization and according to the length of time between the diagnosis of heart failure and randomization. RESULTS Sudden death was reported in 3583 patients. Such patients were older and were more often male, with an ischemic cause...

  1. Risk Factors, Protective Factors, and Current Recommendations to Reduce Sudden Infant Death Syndrome: A Review.

    Science.gov (United States)

    Carlin, Rebecca F; Moon, Rachel Y

    2017-02-01

    Sudden infant death syndrome remains the leading cause of death in infants aged 1 month to 1 year in the United States. While its exact cause is unknown, sudden infant death syndrome is believed to be multifactorial, ie, occurs in infants with underlying biological vulnerability who experience an exogenous stressor, such as prone/side sleeping or soft bedding, during a critical developmental period. Much genetic and physiologic evidence points to impaired arousal responses to hypercarbia and hypoxia, which ultimately leads to asphyxia. Known risk factors for infants include prone and side sleeping, soft bedding, bed sharing, inappropriate sleep surfaces (including sofas), exposure to tobacco smoke, and prematurity; protective factors include breastfeeding, pacifier use, room sharing, and immunizations. Despite our improved understanding of the physiologic mechanisms that cause sudden infant death, the mainstay of risk reduction continues to be a safe sleep environment, as most infants who die suddenly and unexpectedly do so in unsafe sleep environments.

  2. Sudden cardiac death and coronary disease in the young

    DEFF Research Database (Denmark)

    Zachariasardóttir, Sára; Risgaard, Bjarke; Ågesen, Frederik Nybye

    2017-01-01

    BACKGROUND: Sudden cardiac death caused by coronary artery disease (CAD-SCD) is the most frequent cause of SCD in persons ... have previously identified all sudden cardiac deaths in Denmark through review of death certificates and autopsy reports including all deaths between 2000 and 2006 in individuals aged 18-35years and all deaths between 2007 and 2009 in individuals aged 18-49years. In this study we included the 197...... to death. CONCLUSION: This nationwide study found several differences in the pathologic lesions of the heart in victims aged 18-35 and 36-49years, which might be associated with different disease progression leading to death in these age groups. We also report a high frequency of cardiac symptoms prior...

  3. Sudden death in a young patient with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    María Tamargo

    2017-08-01

    Full Text Available Sudden cardiac death (SCD in young patients without structural heart disease is frequently due to inherited channelopathies such as long QT syndrome (LQTS, Brugada syndrome or Catecholaminergic polymorphic ventricular tachycardia. Accordingly, the addition of genetic testing to clinical data may be useful to identify the cause of the sudden death in this population. Mutations in the KCNQ1 encoded Kv7.1 channel are related to type 1 LQTS, familial atrial fibrillation (AF, short QT syndrome, and SCD. We present a clinical case where the presence of AF after resuscitation in a young man with cardiac arrest was the key clinical data to suspect an inherited disorder and genetic testing was the main determinant for identifying the cause of the cardiac arrest. The KCNQ1 p.Arg231His mutation explained the combined phenotype of AF and susceptibility to ventricular arrhythmias. The case highlights the importance of continued research in genetics and molecular mechanisms of channelopathies.

  4. Sudden Cardiac Death in Children. Part 1

    Directory of Open Access Journals (Sweden)

    Ye.V. Pshenichnaya

    2013-02-01

    Full Text Available This article presents the prevalence, terminology, classification of sudden cardiac death. A description of congenital structural heart diseases associated with a risk of sudden cardiac death is given. The issues of etiology and pathogenesis of life-threatening conditions are described in detail.

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

    Science.gov (United States)

    Liebrechts-Akkerman, Germaine; Bovée, 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 cases were available for systematic review, including brain autopsy in 135 cases. An explanation for the cause of death in 19 patients (10.2%) was found. Twelve patients had bronchopneumonia, 3 showed extensive aspiration, 2 had signs of a metabolic disorder, 1 had sepsis, and 1 had meningitis. Frequent nonspecific findings were congestion (66%), edema (47%), small hemorrhages (18%), and lymphoid aggregates (51%) in the lungs; congestion of the liver (23%); and asphyctic bleeding in the kidney (44%), adrenal gland (23%), and thymus (17%). Statistical associations were found for infection with starry sky macrophages in the thymus (P  =  0.004), with calcification (P  =  0.023), or with debris in the Hassal's corpuscles (P  =  0.034). In this study, in 10.2% of cases the histological findings were incompatible with SIDS or USID. Furthermore, several frequent nonspecific histological findings in the thymus that point toward an infection were found.

  6. Melatonin concentrations in the sudden infant death syndrome

    Science.gov (United States)

    Sturner, W. Q.; Lynch, H. J.; Deng, M. H.; Gleason, R. E.; Wurtman, R. J.

    1990-01-01

    The melatonin levels in various body fluids of the sudden infant death syndrome (SIDS) infants are compared with those of infants of comparable age who died of other causes to examine a possible relationship between pineal function and SIDS. After adjusting for age differences, cerebrospinal fluid melatonin levels are found to be significantly lower in the SIDS infants. It is suggested that diminished melatonin production may be characteristic of SIDS and could represent an impairment in the maturation of physiologic circadian organization.

  7. Observations of Stratospheric Sudden Warmings in Earth Rotation Variations

    OpenAIRE

    Neef, Lisa Johanna; Walther, Sophia; Matthes, Katja; Kodera, Kunihiko

    2014-01-01

    Stratospheric sudden warmings (SSWs) are extreme events in the polar stratosphere that are both caused by and have effects on the tropospheric flow. This means that SSWs are associated with changes in the angular momentum of the atmosphere, both before and after their onset. Because these angular momentum changes are transferred to the solid Earth, they can be observed in the rate of the Earth's rotation and the wobble of its rotational pole. By comparing observed Earth rotation variations to...

  8. Giant left anterior descending artery aneurysm resulting in sudden death

    Directory of Open Access Journals (Sweden)

    Chan-Hee Lee

    2016-07-01

    Full Text Available Coronary artery aneurysm is a rare congenital or vascular inflammation-based anomaly for which the clinical course and optimal timing of treatment remain unclear. Here, we report a case of sudden death caused by a giant coronary artery aneurysm of the left anterior descending artery that presented with chest pain. This case suggests that urgent interventional or surgical repair is needed when a large coronary aneurysm presents with acute ischemic symptoms.

  9. Cardiac Channelopathies and Sudden Death: Recent Clinical and Genetic Advances.

    Science.gov (United States)

    Fernández-Falgueras, Anna; Sarquella-Brugada, Georgia; Brugada, Josep; Brugada, Ramon; Campuzano, Oscar

    2017-01-29

    Sudden cardiac death poses a unique challenge to clinicians because it may be the only symptom of an inherited heart condition. Indeed, inherited heart diseases can cause sudden cardiac death in older and younger individuals. Two groups of familial diseases are responsible for sudden cardiac death: cardiomyopathies (mainly hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic cardiomyopathy) and channelopathies (mainly long QT syndrome, Brugada syndrome, short QT syndrome, and catecholaminergic polymorphic ventricular tachycardia). This review focuses on cardiac channelopathies, which are characterized by lethal arrhythmias in the structurally normal heart, incomplete penetrance, and variable expressivity. Arrhythmias in these diseases result from pathogenic variants in genes encoding cardiac ion channels or associated proteins. Due to a lack of gross structural changes in the heart, channelopathies are often considered as potential causes of death in otherwise unexplained forensic autopsies. The asymptomatic nature of channelopathies is cause for concern in family members who may be carrying genetic risk factors, making the identification of these genetic factors of significant clinical importance.

  10. A computer case definition for sudden cardiac death.

    Science.gov (United States)

    Chung, Cecilia P; Murray, Katherine T; Stein, C Michael; Hall, Kathi; Ray, Wayne A

    2010-06-01

    To facilitate studies of medications and sudden cardiac death, we developed and validated a computer case definition for these deaths. The study of community dwelling Tennessee Medicaid enrollees 30-74 years of age utilized a linked database with Medicaid inpatient/outpatient files, state death certificate files, and a state 'all-payers' hospital discharge file. The computerized case definition was developed from a retrospective cohort study of sudden cardiac deaths occurring between 1990 and 1993. Medical records for 926 potential cases had been adjudicated for this study to determine if they met the clinical definition for sudden cardiac death occurring in the community and were likely to be due to ventricular tachyarrhythmias. The computerized case definition included deaths with (1) no evidence of a terminal hospital admission/nursing home stay in any of the data sources; (2) an underlying cause of death code consistent with sudden cardiac death; and (3) no terminal procedures inconsistent with unresuscitated cardiac arrest. This definition was validated in an independent sample of 174 adjudicated deaths occurring between 1994 and 2005. The positive predictive value of the computer case definition was 86.0% in the development sample and 86.8% in the validation sample. The positive predictive value did not vary materially for deaths coded according to the ICO-9 (1994-1998, positive predictive value = 85.1%) or ICD-10 (1999-2005, 87.4%) systems. A computerized Medicaid database, linked with death certificate files and a state hospital discharge database, can be used for a computer case definition of sudden cardiac death. Copyright (c) 2009 John Wiley & Sons, Ltd.

  11. Gender, Age and Season as Modifiers of the Effects of Diurnal Temperature Range on Emergency Room Admissions for Cause-Specific Cardiovascular Disease among the Elderly in Beijing

    Directory of Open Access Journals (Sweden)

    Shan Zheng

    2016-04-01

    Full Text Available Background: Diurnal temperature range (DTR is an important index of climate change and variability. It is also a risk factor affecting human health. However, limited evidence is available to illustrate the effect of DTR modification on cause-specific cardiovascular disease among the elderly. Methods: A semi-parametric generalized additive model (GAM was used to analyze the exposure-effect relationship between DTR and daily emergency room (ER admissions for cause-specific cardiovascular diseases among the elderly from 2009 to 2011 in Beijing. We examined the effects of DTR for stratified groups by gender and age, and examined the effects of DTR in the warm season and cold season for cause-specific cardiovascular diseases. Results: Significant associations were found between DTR and ER admissions for all cardiovascular and cerebrovascular disease among elderly males, while DTR was significantly associated with ER admissions for all cardiovascular disease, ischemic heart disease and cerebrovascular disease among elderly females. People aged 75 years and older were more vulnerable to DTR. DTR caused greater adverse effects on both genders in the warm season, whereas the effect estimates on females were higher in cold season than in warm season. Conclusions: A short-term increase of DTR was significantly associated with ER admissions for cause-specific cardiovascular disease among the elderly in Beijing. Gender, age and season may modify the acute health effect of DTR. Some prevention programs that target the high risk subgroups in the elderly for impending large temperature changes may reduce the impact of DTR on people’s health.

  12. Serum Magnesium and Sudden Death in European Hemodialysis Patients.

    Directory of Open Access Journals (Sweden)

    Camiel L M de Roij van Zuijdewijn

    Full Text Available Despite suggestions that higher serum magnesium (Mg levels are associated with improved outcome, the association with mortality in European hemodialysis (HD patients has only scarcely been investigated. Furthermore, data on the association between serum Mg and sudden death in this patient group is limited. Therefore, we evaluated Mg in a post-hoc analysis using pooled data from the CONvective TRAnsport STudy (CONTRAST, NCT00205556, a randomized controlled trial (RCT evaluating the survival risk in dialysis patients on hemodiafiltration (HDF compared to HD with a mean follow-up of 3.1 years. Serum Mg was measured at baseline and 6, 12, 24 and 36 months thereafter. Cox proportional hazards models, adjusted for confounders using inverse probability weighting, were used to estimate hazard ratios (HRs of baseline serum Mg on all-cause mortality, cardiovascular mortality, non-cardiovascular mortality and sudden death. A generalized linear mixed model was used to investigate Mg levels over time. Out of 714 randomized patients, a representative subset of 365 (51% were analyzed in the present study. For every increase in baseline serum Mg of 0.1 mmol/L, the HR for all-cause mortality was 0.85 (95% CI 0.77-94, the HR for cardiovascular mortality 0.73 (95% CI 0.62-0.85 and for sudden death 0.76 (95% CI 0.62-0.93. These findings did not alter after extensive correction for potential confounders, including treatment modality. Importantly, no interaction was found between serum phosphate and serum Mg. Baseline serum Mg was not related to non-cardiovascular mortality. Mg decreased slightly but statistically significant over time (Δ -0.011 mmol/L/year, 95% CI -0.017 to -0.009, p = 0.03. In short, serum Mg has a strong, independent association with all-cause mortality, cardiovascular mortality and sudden death in European HD patients. Serum Mg levels decrease slightly over time.

  13. Post-mortem genetic analysis in juvenile cases of sudden cardiac death.

    Science.gov (United States)

    Campuzano, Oscar; Sanchez-Molero, Olallo; Allegue, Catarina; Coll, Monica; Mademont-Soler, Irene; Selga, Elisabet; Ferrer-Costa, Carles; Mates, Jesus; Iglesias, Anna; Sarquella-Brugada, Georgia; Cesar, Sergi; Brugada, Josep; Castellà, Josep; Medallo, Jordi; Brugada, Ramon

    2014-12-01

    The reason behind a sudden death of a young individual remains unknown in up to 50% of postmortem cases. Pathogenic mutations in genes encoding heart proteins are known to cause sudden cardiac death. The aim of our study was to ascertain whether genetic alterations could provide an explanation for sudden cardiac death in a juvenile cohort with no-conclusive cause of death after comprehensive autopsy. Twenty-nine cases cases, while in good quality cases the analysis of 55 genes associated with sudden cardiac death was performed using Next Generation Sequencing technology. Thirty-five genetic variants were identified in 12 cases (41.37%). Ten genetic/variants in genes encoding cardiac ion channels were identified in 8 cases (27.58%). We also identified 9 cases (31.03%) carrying 25 genetic variants in genes encoding structural cardiac proteins. Nine cases carried more than one genetic variation, 5 of them combining structural and non-structural genes. Our study supports the inclusion of molecular autopsy in forensic routine protocols when no conclusive cause of death is identified. Around 40% of sudden cardiac death young cases carry a genetic variant that could provide an explanation for the cause of death. Because relatives could be at risk of sudden cardiac death, our data reinforce their need of clinical assessment and, if indicated, of genetic analysis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Causes of sudden natural death: A medicolegal (coroner's) autopsy ...

    African Journals Online (AJOL)

    vascular systemprincipally death due to complications of hypertension which was seen in 88.2% of the cardio-vascular system diseases. Immune/infectious diseases (mainly AIDS), gastro-intestinal/hepatic lesions and respiratory diseases were seen ...

  15. Comparative Susceptibility of Plants Native to the Appalachian Range of the United States to Inoculation With Phytophthora ramorum

    Science.gov (United States)

    R.G. Linderman; Patricia B. de Sá; E.A. Davis

    2008-01-01

    Phytophthora ramorum, cause of sudden oak death of trees or ramorum blight of other plant species, has many hosts. Some geographic regions, such as the Appalachian range of the eastern United States, are considered high risk of becoming infested with the pathogen because known susceptible plants occur there and climatic characteristics appear...

  16. Heart Attack or Sudden Cardiac Arrest: How Are They Different?

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Heart Attack or Sudden Cardiac Arrest: How Are They Different? Updated:Sep 19,2016 ... flow to the heart is blocked, and sudden cardiac arrest is when the heart malfunctions and suddenly stops ...

  17. Molecular and Functional Characterization of Novel Glycerol-3-Phosphate Dehydrogenase 1–Like Gene (GPD1-L) Mutations in Sudden Infant Death Syndrome

    Science.gov (United States)

    Van Norstrand, David W.; Valdivia, Carmen R.; Tester, David J.; Ueda, Kazuo; London, Barry; Makielski, Jonathan C.; Ackerman, Michael J.

    2012-01-01

    Background Autopsy-negative sudden unexplained death, including sudden infant death syndrome, can be caused by cardiac channelopathies such as Brugada syndrome (BrS). Type 1 BrS, caused by mutations in the SCN5A-encoded sodium channel, accounts for ≈20% of BrS. Recently, a novel mutation in the glycerol-3-phosphate dehydrogenase 1–like gene (GPD1-L) disrupted trafficking of SCN5A in a multigenerational family with BrS. We hypothesized that mutations in GPD1-L may be responsible for some cases of sudden unexplained death/sudden infant death syndrome. Methods and Results Using denaturing high-performance liquid chromatography and direct DNA sequencing, we performed comprehensive open-reading frame/splice site mutational analysis of GPD1-L on genomic DNA extracted from necropsy tissue of 83 unrelated cases of sudden unexplained death (26 females, 57 males; average age, 14.6±10.7 years; range, 1 month to 48 years). A putative, sudden unexplained death–associated GPD1-L missense mutation, E83K, was discovered in a 3-month-old white boy. Further mutational analysis was then performed on genomic DNA derived from a population-based cohort of 221 anonymous cases of sudden infant death syndrome (84 females, 137 males; average age, 3±2 months; range, 3 days to 12 months), revealing 2 additional mutations, I124V and R273C, in a 5-week-old white girl and a 1-month-old white boy, respectively. All mutations occurred in highly conserved residues and were absent in 600 reference alleles. Compared with wild-type GPD1-L, GPD1-L mutations coexpressed with SCN5A in heterologous HEK cells produced a significantly reduced sodium current (Psudden infant death syndrome via a secondary loss-of-function mechanism whereby perturbations in GPD1-L precipitate a marked decrease in the peak sodium current and a potentially lethal BrS-like proarrhythmic substrate. PMID:17967976

  18. Map of debris flows caused by rainfall during 1996 in parts of the Reedsport and Deer Head Point quadrangles, Douglas County, southern Coast Range, Oregon

    Science.gov (United States)

    Coe, Jeffrey A.; Michael, John A.; Burgos, Marianela Mercado

    2011-01-01

    This 1:12,000-scale map shows an inventory of debris flows caused by rainfall during 1996 in a 94.4 km2 area in the southern Coast Range of Oregon. This map and associated digital data are part of a larger U.S. Geological Survey study of debris flows in the southern Coast Range. Available evidence indicates that the flows were triggered by a rain storm that occurred between November 17 and 19. The closest rain gage in the Coast Range (Goodwin Peak) recorded 245 mm during the storm. Maximum rainfall intensity during the storm was 13.2 mm/hr on November 18. Debris flows were photogrammetrically mapped from 1:12,000-scale aerial photographs flown in May, 1997. The inventory is presented on imagery derived from LiDAR data acquired in 2008. We classified mapped debris flows into four categories based on the type of debris-flow activity: (1) discrete slide source areas, (2) predominantly erosion, (3) predominantly transport or mixed erosion and deposition, and (4) predominantly deposition. Locations of woody-debris jams are also shown on the map. The area encompassed by debris flows is 2.1 percent of the 94.4 km2 map area.

  19. Sudden aortic death-proposal for a comprehensive diagnostic approach in forensic and in clinical pathology practice

    NARCIS (Netherlands)

    de Boer, Hans H.; Dedouit, Fabrice; Chappex, Nina; van der Wal, Allard C.; Michaud, Katarzyna

    2017-01-01

    Backgrounds Aortic rupture or dissection as immediate cause of sudden death is encountered in forensic and clinical autopsy practice. Despite a common denominator of 'sudden aortic death' (SAD), we expect that in both settings the diagnostic workup, being either primarily legal or primarily disease

  20. Prediction and Prevention of Sudden Cardiac Death.

    Science.gov (United States)

    Morin, Daniel P; Homoud, Munther K; Estes, N A Mark

    2017-12-01

    Sudden death is a major problem, with significant impact on public health. Many conditions predispose to sudden cardiac death and sudden cardiac arrest (SCA), foremost among them coronary artery disease, and an effective therapy exists in the form of the implantable cardioverter defibrillator. Risk stratification for SCA remains imperfect, especially for patients with nonischemic cardiomyopathy. Ongoing trials may make it easier to identify those at high risk, and potentially those at very low risk, in the future. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Pre-participation screening for the prevention of sudden cardiac death in athletes

    OpenAIRE

    Borrione, Paolo; Quaranta, Federico; Ciminelli, Emanuela

    2013-01-01

    Pre-partecipation screening is the systematic practice of medically evaluating large populations of athletes before participation in sport activities for the purpose of identifying abnormalities that could cause disease progression or sudden death. In order to prevent sudden cardiac death (SCD), cardiovascular screening should include a strategy for excluding high-risk subjects from athletic and vigorous exercise. There are two major screening programmes in the world. In the United States com...

  2. Sudden Unexpected Infant Deaths: Sleep Environment and Circumstances

    Science.gov (United States)

    Schnitzer, Patricia G.; Covington, Theresa M.; Dykstra, Heather K.

    2012-01-01

    Objectives. We sought to describe the characteristics and sleep circumstances of infants who die suddenly and unexpectedly and to examine similarities and differences in risk factors among infants whose deaths are classified as resulting from sudden infant death syndrome (SIDS), suffocation, or undetermined causes. Methods. We used 2005 to 2008 data from 9 US states to assess 3136 sleep-related sudden unexpected infant deaths (SUIDs). Results. Only 25% of infants were sleeping in a crib or on their back when found; 70% were on a surface not intended for infant sleep (e.g., adult bed). Importantly, 64% of infants were sharing a sleep surface, and almost half of these infants were sleeping with an adult. Infants whose deaths were classified as suffocation or undetermined cause were significantly more likely than were infants whose deaths were classified as SIDS to be found on a surface not intended for infant sleep and to be sharing that sleep surface. Conclusions. We identified modifiable sleep environment risk factors in a large proportion of the SUIDs assessed in this study. Our results make an important contribution to the mounting evidence that sleep environment hazards contribute to SUIDs. PMID:22515860

  3. 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

  4. Sudden death of a child due to respiratory diphtheria.

    Science.gov (United States)

    Swain, Rajanikanta; Behera, Chittaranjan; Arava, Sudheer Kumar; Kundu, Naveen

    2016-06-01

    A four-year-old girl presented to the emergency department with respiratory distress. Death occurred despite attempted resuscitation. The illness was not clinically diagnosed. Her father revealed that she had a fever and sore throat for the last four days and was not immunised for diphtheria. Characteristic gross and microscopic pathology of respiratory diphtheria and microbiological findings were observed. The cause of death was acute respiratory failure consequent upon upper airway obstruction from diphtheria. Forensic pathologists should remember that the diphtheria cases can cause sudden death especially in developing countries. © The Author(s) 2016.

  5. Towards Better Understanding of the Pathogenesis of Neuronal Respiratory Network in Sudden Perinatal Death

    Directory of Open Access Journals (Sweden)

    Riffat Mehboob

    2017-07-01

    Full Text Available Sudden perinatal death that includes the victims of sudden infant death syndrome, sudden intrauterine death syndrome, and stillbirth are heartbreaking events in the life of parents. Most of the studies about sudden perinatal death were reported from Italy, highlighting two main etiological factors: prone sleeping position and smoking. Other probable contributory factors are prematurity, male gender, lack of breastfeeding, respiratory tract infections, use of pacifiers, infant botulism, extensive use of pesticides and insecticides, etc. However, extensive studies across the world are required to establish the role of these factors in a different subset of populations. Previous studies confirmed the widely accepted hypothesis that neuropathology of the brainstem is one of the main cause of sudden perinatal death. This study is an effort to summarize the neuropathological evaluation of the brainstems and their association to sudden perinatal death. Brainstem nuclei in vulnerable infants undergo certain changes that may alter the sleep arousal cycle, cardiorespiratory control, and ultimately culminate in death. This review focuses on the roles of different brainstem nuclei, their pathologies, and the established facts in this regard in terms of it’s link to such deaths. This study will also help to understand the role of brainstem nuclei in controlling the cardiorespiratory cycles in sudden perinatal death and may provide a better understanding to resolve the mystery of these deaths in future. It is also found that a global initiative to deal with perinatal death is required to facilitate the diagnosis and prevention in developed and as well as developing countries.

  6. Towards Better Understanding of the Pathogenesis of Neuronal Respiratory Network in Sudden Perinatal Death.

    Science.gov (United States)

    Mehboob, Riffat; Kabir, Mahvish; Ahmed, Naseer; Ahmad, Fridoon Jawad

    2017-01-01

    Sudden perinatal death that includes the victims of sudden infant death syndrome, sudden intrauterine death syndrome, and stillbirth are heartbreaking events in the life of parents. Most of the studies about sudden perinatal death were reported from Italy, highlighting two main etiological factors: prone sleeping position and smoking. Other probable contributory factors are prematurity, male gender, lack of breastfeeding, respiratory tract infections, use of pacifiers, infant botulism, extensive use of pesticides and insecticides, etc. However, extensive studies across the world are required to establish the role of these factors in a different subset of populations. Previous studies confirmed the widely accepted hypothesis that neuropathology of the brainstem is one of the main cause of sudden perinatal death. This study is an effort to summarize the neuropathological evaluation of the brainstems and their association to sudden perinatal death. Brainstem nuclei in vulnerable infants undergo certain changes that may alter the sleep arousal cycle, cardiorespiratory control, and ultimately culminate in death. This review focuses on the roles of different brainstem nuclei, their pathologies, and the established facts in this regard in terms of it's link to such deaths. This study will also help to understand the role of brainstem nuclei in controlling the cardiorespiratory cycles in sudden perinatal death and may provide a better understanding to resolve the mystery of these deaths in future. It is also found that a global initiative to deal with perinatal death is required to facilitate the diagnosis and prevention in developed and as well as developing countries.

  7. Sudden Infant Death Syndrome (SIDS) and Vaccines

    Science.gov (United States)

    ... this? Submit What's this? Submit Button Sudden Infant Death Syndrome (SIDS) Recommend on Facebook Tweet Share Compartir ... an international network of vaccine safety experts. SIDS deaths declined due to recommendations to put infants on ...

  8. Sudden transition from finite temperature spin environments

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Zheng-Da; He, Qi-Liang; Xu, Hang-Shi [Zhejiang Institute of Modern Physics and Physics Department, Zhejiang University, Hangzhou 310027 (China); Xu, Jing-Bo, E-mail: xujb@zju.edu.cn [Zhejiang Institute of Modern Physics and Physics Department, Zhejiang University, Hangzhou 310027 (China)

    2012-10-01

    We investigate the phenomenon of sudden transition from finite temperature critical environments in the study of quantum correlations of a two-qubit system coupled to independent thermal Ising baths. The influence of the temperature and external field of bath on the critical time of sudden transition is also explored. It is found that the phenomenon of sudden transition can be used to detect the critical points of thermal spin environments. How to protect quantum correlations of the system is also examined by applying a series of π-phase pulses. -- Highlights: ► The sudden transition phenomenon from thermal critical environments is studied. ► How to detect quantum critical points of thermal Ising baths is explored. ► The quantum discord can be protected against thermal bath by π-phase pulses.

  9. Counselling patients with sudden, irreversible sight loss

    Directory of Open Access Journals (Sweden)

    Jasmine Thombs

    2017-03-01

    Full Text Available Sudden loss of vision is devastating to the patient and close relatives. This article discusses how to talk with someone who has lost their vision and how to help them with their concerns and questions.

  10. Weight charts of infants dying of sudden infant death in England.

    Science.gov (United States)

    Scheimberg, Irene; Ashal, Husna; Kotiloglu-Karaa, Esin; French, Paul; Kay, Philippa; Cohen, Marta C

    2014-01-01

    The organ weights in cases of sudden infant death syndrome (SIDS) and undetermined deaths in previously healthy infants do not correspond to "the normal range" of organ weights in international standard charts for infants currently in use in some institutions. The aim of our study was to ascertain the organ weights of infants dying suddenly and unexpectedly in England and for whom a cause of death was not found, therefore falling under the category of SIDS or undetermined. We collated the organs weights from 2 institutions covering between them the South East and North of England including London, Yorkshire, and Derbyshire. The cases from The Royal London Hospital were autopsied between 1997 and 2013, and the cases from Sheffield Children's Hospital were autopsied between 2006 and 2013. There were 188 babies who had been born at term (62 female and 126 male) and 26 ex-premature babies (15 female and 11 male). Organs of male babies were slightly heavier than those of female babies but as there was no significant differences male and female babies were considered together. Comparison with standard charts (from 1932 and 1962) and with more recent charts confirmed the discrepancy between the older charts commonly in use with more recent measurements, including ours. The main reason for these differences is that babies in the recent charts were previously healthy babies with no long term disease and improved in the health of the population.

  11. Fibromuscular hyperplasia of the pulmonary artery in sudden infant and perinatal unexpected death.

    Science.gov (United States)

    Ottaviani, Giulia; Lavezzi, Anna Maria; Matturri, Luigi

    2009-01-01

    The purpose of this study was to describe cases presenting with fibromuscular hyperplasia of the pulmonary arteries that could belong to the group of sudden infant death syndrome (SIDS) and sudden unexpected perinatal death "gray zone" or borderline cases. In a total of 12 cases, eight females and four males, ranging in age from 39 gestational weeks to 93 postnatal days, dying suddenly and unexpectedly, a fibromuscular hyperplasia of the pulmonary artery was detected. Postmortem examinations were requested with a clinical SIDS or sudden unexpected perinatal death. A complete autopsy was performed, including close examination of the brainstem and cardiac conduction system. Histological examination showed the presence of various degrees of fibromuscular hyperplasia with fibrosis of the right (six cases), left (five cases) or both (one case) pulmonary arteries. In our cases, fibromuscular hyperplasia of the pulmonary artery alone might or might not have accounted for the sudden deaths, if it had not been for the concomitant presence of hypoplasia of the arcuate nucleus in the brainstem and/or cardiac conduction system abnormalities. Therefore, they were classified as SIDS/sudden unexpected perinatal death gray zone or borderline cases. Necropsy studies of sudden infant and perinatal death should always include an accurate gross and histological examination of the pulmonary arteries, as well as of the brainstem and cardiac conduction system.

  12. Next generation sequencing for molecular confirmation of hereditary sudden cardiac death syndromes.

    Science.gov (United States)

    Márquez, Manlio F; Cruz-Robles, David; Ines-Real, Selene; Vargas-Alarcón, Gilberto; Cárdenas, Manuel

    2015-01-01

    Hereditary sudden cardiac death syndromes comprise a wide range of diseases resulting from alteration in cardiac ion channels. Genes involved in these syndromes represent diverse mutations that cause the altered encoding of the diverse proteins constituting these channels, thus affecting directly the currents of the corresponding ions. In the present article we will briefly review how to arrive to a clinical diagnosis and we will present the results of molecular genetic studies made in Mexican subjects attending the SCD Syndromes Clinic of the National Institute of Cardiology of Mexico City. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  13. Eccentric Left Ventricular Hypertrophy and Sudden Death in Patients with End-Stage Kidney Disease.

    Science.gov (United States)

    de Roij van Zuijdewijn, Camiel L M; Hansildaar, Romy; Bots, Michiel L; Blankestijn, Peter J; van den Dorpel, Marinus A; Grooteman, Muriel P C; Kamp, Otto; ter Wee, Piet M; Nubé, Menso J

    2015-01-01

    Both all-cause and cardiovascular mortality risks are extremely high in patients with end-stage kidney disease (ESKD). Sudden death accounts for approximately one-quarter of all fatal events. Left ventricular hypertrophy (LVH) is a known risk factor for mortality and can be divided in 2 types: concentric and eccentric. This study evaluated possible differences in all-cause mortality, cardiovascular mortality and sudden death between prevalent ESKD patients with concentric and eccentric LVH. Participants of the CONvective TRAnsport STudy (CONTRAST) who underwent transthoracic echocardiography (TTE) at baseline were analyzed. In patients with LVH, a relative wall thickness of ≤0.42 was considered eccentric and >0.42 was considered concentric hypertrophy. Cox proportional hazards models, adjusted for potential confounders, were used to calculate hazard ratios (HRs) of patients with eccentric LVH versus patients with concentric LVH for all-cause mortality, cardiovascular mortality and sudden death. TTE was performed in 328 CONTRAST participants. LVH was present in 233 participants (71%), of which 87 (37%) had concentric LVH and 146 (63%) eccentric LVH. The HR for all-cause mortality of eccentric versus concentric LVH was 1.14 (p = 0.52), 1.79 (p = 0.12) for cardiovascular mortality and 4.23 (p = 0.02) for sudden death in crude analyses. Propensity score-corrected HR for sudden death in patients with eccentric LVH versus those with concentric LVH was 5.22 (p = 0.03). (1) The hazard for all-cause mortality, cardiovascular mortality and sudden death is markedly increased in patients with LVH. (2) The sudden death risk is significantly higher in ESKD patients with eccentric LVH compared to subjects with concentric LVH. © 2015 S. Karger AG, Basel.

  14. 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 patients with left ventricular dysfunction, heart failure, or both after myocardial infarction to assess the incidence and timing of sudden unexpected death or cardiac arrest with resuscitation in relation to the left ventricular ejection fraction. RESULTS: Of 14,609 patients, 1067 (7 percent) had an event...... percent confidence interval, 0.11 to 0.18 percent) after 2 years. Patients with a left ventricular ejection fraction of 30 percent or less were at highest risk in this early period (rate, 2.3 percent per month; 95 percent confidence interval, 1.8 to 2.8 percent). Nineteen percent of all sudden deaths...

  15. 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...... asthma as a previous hospital admittance because of asthma (of any severity) or when asthma was considered to have influenced the death according to the death certificate. The purpose of this study is to increase the medical focus on young persons with uncontrolled asthma and thereby hopefully aid...... in preventing sudden unexpected deaths. We therefore aimed to describe clinical characteristics, symptoms, causes of death, and contact with the healthcare system prior to sudden unexpected death in young persons with uncontrolled asthma. METHODS: Through the review of death certificates, we found 625 sudden...

  16. Sudden infant death syndrome in Brazil: fact or fancy?

    Directory of Open Access Journals (Sweden)

    Francesca Maia Woida

    Full Text Available CONTEXT AND OBJECTIVE: The true incidence of sudden infant death syndrome (SIDS in Brazil is unknown. The aim here was to identify SIDS cases in the city of Ribeirão Preto, State of São Paulo, between 2000 and 2005, in order to estimate its incidence. DESIGN AND SETTING: Retrospective analysis of data on live births and infant deaths in Ribeirão Preto and from autopsies of infants performed at the Death Verification Service of the Interior (SVOI between 2000 and 2005. RESULTS: There were 47,356 live births and 537 deaths, with infant mortality rates ranging from 12.9‰ to 10.9‰ of live births. Among the 24 infants who died possibly due to SIDS and who were autopsied at the SVOI, six were from families living in the municipality (0.13‰ of live births: three (50% were diagnosed as SIDS, and one each (16.66% as indeterminate cause, bronchoaspiration and cerebral edema. Two deaths occurred in the first month of life (33.33% and one each (16.66% at two, four, six and eight months. Two deaths each (33.33% occurred in the months of February and December, one each in August and October (16.66%. Four cases (66.7% occurred in the summer and one each (16.66% in winter and spring. There was 5:1 predominance of males over females. CONCLUSIONS: The frequency of SIDS was lower than what has been reported worldwide and in the Brazilian literature, thus suggesting underdiagnosis, indicating the lack of any specific postmortem protocol for SIDS identification and showing the need to implement this.

  17. Sudden infant death syndrome in Brazil: fact or fancy?

    Science.gov (United States)

    Woida, Francesca Maia; Saggioro, Fabiano Pinto; Ferro, Maria Alice Rossato; Peres, Luiz Cesar

    2008-01-02

    The true incidence of sudden infant death syndrome (SIDS) in Brazil is unknown. The aim here was to identify SIDS cases in the city of Ribeirão Preto, State of São Paulo, between 2000 and 2005, in order to estimate its incidence. Retrospective analysis of data on live births and infant deaths in Ribeirão Preto and from autopsies of infants performed at the Death Verification Service of the Interior (SVOI) between 2000 and 2005. There were 47,356 live births and 537 deaths, with infant mortality rates ranging from 12.9 to 10.9 of live births. Among the 24 infants who died possibly due to SIDS and who were autopsied at the SVOI, six were from families living in the municipality (0.13 of live births): three (50%) were diagnosed as SIDS, and one each (16.66%) as indeterminate cause, bronchoaspiration and cerebral edema. Two deaths occurred in the first month of life (33.33%) and one each (16.66%) at two, four, six and eight months. Two deaths each (33.33%) occurred in the months of February and December, one each in August and October (16.66%). Four cases (66.7%) occurred in the summer and one each (16.66%) in winter and spring. There was 5:1 predominance of males over females. The frequency of SIDS was lower than what has been reported worldwide and in the Brazilian literature, thus suggesting underdiagnosis, indicating the lack of any specific postmortem protocol for SIDS identification and showing the need to implement this.

  18. Long QT syndrome and sudden unexpected infant death.

    Science.gov (United States)

    Van Niekerk, Chantal; Van Deventer, Barbara Ströh; du Toit-Prinsloo, Lorraine

    2017-09-01

    Long QT syndrome (LQTS) is an inheritable primary electric disease of the heart characterised by abnormally long QT intervals and a propensity to develop atrial and ventricular tachyarrhythmias. It is caused by an inherited channelopathy responsible for sudden cardiac death in individuals with structurally normal hearts. Long QT syndrome can present early in life, and some studies suggest that it may be associated with up to 20% of sudden unexplained infant death (SUID), particularly when associated with external stressors such as asphyxia, which is commonly seen in many infant death scenes. With an understanding of the genetic defects, it has now been possible to retrospectively analyse samples from infants who have presented to forensic pathology services with a history of unexplained sudden death, which may, in turn, enable the implementation of preventative treatment for siblings previously not known to have pathogenic genetic variations. In this viewpoint article, we will discuss SUID, LQTS and postmortem genetic analysis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Cardiac screening to prevent sudden death in young athletes.

    Science.gov (United States)

    Schmehil, Christopher; Malhotra, Devika; Patel, Dilip R

    2017-07-01

    Sudden cardiac death (SCD) is a sudden and unexpected death caused by loss of heart of function. SCD may occur in any population, but when it occurs on the playing field in a young individual, communities worldwide are affected. Although these events are rare, media coverage of sudden cardiac arrests in young athletes have created the impression that these events are far more common than they appear. With a heightened awareness of SCD in young athletes, screening methods have been developed to try and prevent these events from occurring. The American Heart Associations (AHA) currently employs history and physical examination alone during the preparticipation physical exam (PPE), which clears a young athlete for participation in sports. There has been recent discussion on whether to include screening electrocardiogram (ECG) in the PPE especially after one study in Italy by Corrado et al. found that using routine ECG reduced the annual incidence of SCD by 90%. In this article we will discuss how effective the current screening recommendations are, whether routine ECG use should be included in the PPE and if it is cost effective, and review other screening modalities that may be useful in the detection of young athletes at risk for SCD.

  20. Potential Asphyxia and Brainstem Abnormalities in Sudden and Unexpected Death in Infants

    Science.gov (United States)

    Randall, Bradley B.; Paterson, David S.; Haas, Elisabeth A.; Broadbelt, Kevin G.; Duncan, Jhodie R.; Mena, Othon J.; Krous, Henry F.; Trachtenberg, Felicia L.

    2013-01-01

    OBJECTIVE: Sudden and unexplained death is a leading cause of infant mortality. Certain characteristics of the sleep environment increase the risk for sleep-related sudden and unexplained infant death. These characteristics have the potential to generate asphyxial conditions. We tested the hypothesis that infants may be exposed to differing degrees of asphyxia in sleep environments, such that vulnerable infants with a severe underlying brainstem deficiency in serotonergic, γ-aminobutyric acid-ergic, or 14-3-3 transduction proteins succumb even without asphyxial triggers (eg, supine), whereas infants with intermediate or borderline brainstem deficiencies require asphyxial stressors to precipitate death. METHODS: We classified cases of sudden infant death into categories relative to a “potential asphyxia” schema in a cohort autopsied at the San Diego County Medical Examiner’s Office. Controls were infants who died with known causes of death established at autopsy. Analysis of covariance tested for differences between groups. RESULTS: Medullary neurochemical abnormalities were present in both infants dying suddenly in circumstances consistent with asphyxia and infants dying suddenly without obvious asphyxia-generating circumstances. There were no differences in the mean neurochemical measures between these 2 groups, although mean measures were both significantly lower (P infants dying suddenly and unexpectedly. Brainstem abnormalities were associated with both asphyxia-generating and non–asphyxia generating conditions. Heeding safe sleep messages is essential for all infants, especially given our current inability to detect underlying vulnerabilities. PMID:24218471

  1. Cost-effectiveness analysis of preventing sudden cardiac death with an implantable cardioverter defibrillator versus amiodarone

    Directory of Open Access Journals (Sweden)

    Mijajlović Marina

    2012-01-01

    Full Text Available Sudden cardiac death is natural death caused by previous heart disease, when within an hour from the onset of symptoms ensue loss of consciousness and cessation of circulation. Many studies have confirmed that malignant ventricular arrhythmias are the most common cause of sudden cardiac death. Alternatives for prevention of sudden cardiac death are antiarrhythmic drug treatment, primarily amiodarone, and implantation of cardioverter defibrillator. The aim of this pharmacoeconomic study was to compare the cost-effectiveness of implantable cardioverter defibrillator and amiodarone in preventing sudden cardiac death. The Markov model was designed based on data from the literature, and analyzed using the software TreeAge®. The time horizon was five years. The duration of one cycle was one month. Effect for each model state was expressed in quality-adjusted life years gained (QALYs. The Monte Carlo simulation was used for 1.000 hypothetical patients. Implantation of cardioverter defibrillator proved to be pharmacoeconomically inferior method of preventing sudden cardiac death, nearly twelve times more expensive than applying amiodarone, i.e. 621.833,18 dinars per QALY gained in comparison to 52.644,25 dinars per QALY gained for amiodarone. The study showed that the method with superior cost/effectiveness ratio was preventing sudden cardiac death by amiodarone. It is expected that further research will indicate a subpopulation in which the implantable cardioverter defibrillator will show better cost/effectiveness ratio than amiodarone.

  2. Research on a Sudden Explosion and its Environmental Impact

    Science.gov (United States)

    Ye, Maosheng; Ma, Hui; Ni, Qingwei

    2017-12-01

    A sudden blast was chosen as the studied topic. Also, one computer based virtual experimentation was used to estimate the dimensional impact of initial pollutant plume from blasts. Self-made method using Mathcad code was used to generate the output for the period of the first tenth of a second (1deci-second) to 1minute (60s) of the blast at the point source. It also depicted long-range air pollution travel within the first 1 to 10 minutes. In the case study, it assumed an average directional diffusivity of 1720 m2s-1 which is about 25 per cent of the average generated speed of common explosives. The newly developed model revealed a plume cloud impact of 6.8×107µgm-3 in the first 1millisecond (0.01s) which decayed suddenly to a value of 1.7×107µgm-3 in the first 1decisecond (0.1s). The impact concentration at the point source by the end of the first second (1.0s) was 3.2×105µgm-3 which implied a 99.5% sudden decay when compared to 0.01s concentration value at the emission point source. Computerized experiments observed that air pollutants release from explosives/blasts were dispersed into the atmosphere in the first few seconds by forceful injection instead of by gradual dispersion as is the case with normal air pollutants plume releases.

  3. From Africa to Europe and back: refugia and range shifts cause high genetic differentiation in the Marbled White butterfly Melanargia galathea

    Directory of Open Access Journals (Sweden)

    Rödder Dennis

    2011-07-01

    Full Text Available Abstract Background The glacial-interglacial oscillations caused severe range modifications of biota. Thermophilic species became extinct in the North and survived in southern retreats, e.g. the Mediterranean Basin. These repeated extinction and (recolonisation events led to long-term isolation and intermixing of populations and thus resulted in strong genetic imprints in many European species therefore being composed of several genetic lineages. To better understand these cycles of repeated expansion and retraction, we selected the Marbled White butterfly Melanargia galathea. Fourty-one populations scattered over Europe and the Maghreb and one population of the sibling taxon M. lachesis were analysed using allozyme electrophoresis. Results We obtained seven distinct lineages applying neighbour joining and STRUCTURE analyses: (i Morocco, (ii Tunisia, (iii Sicily, (iv Italy and southern France, (v eastern Balkans extending to Central Europe, (vi western Balkans with western Carpathian Basin as well as (vii south-western Alps. The hierarchy of these splits is well matching the chronology of glacial and interglacial cycles since the Günz ice age starting with an initial split between the galathea group in North Africa and the lachesis group in Iberia. These genetic structures were compared with past distribution patterns during the last glacial stage calculated with distribution models. Conclusions Both methods suggest climatically suitable areas in the Maghreb and the southern European peninsulas with distinct refugia during the last glacial period and underpin strong range expansions to the North during the Postglacial. However, the allozyme patterns reveal biogeographical structures not detected by distribution modelling as two distinct refugia in the Maghreb, two or more distinct refugia at the Balkans and a close link between the eastern Maghreb and Sicily. Furthermore, the genetically highly diverse western Maghreb might have acted as source

  4. From Africa to Europe and back: refugia and range shifts cause high genetic differentiation in the Marbled White butterfly Melanargia galathea.

    Science.gov (United States)

    Habel, Jan C; Lens, Luc; Rödder, Dennis; Schmitt, Thomas

    2011-07-21

    The glacial-interglacial oscillations caused severe range modifications of biota. Thermophilic species became extinct in the North and survived in southern retreats, e.g. the Mediterranean Basin. These repeated extinction and (re)colonisation events led to long-term isolation and intermixing of populations and thus resulted in strong genetic imprints in many European species therefore being composed of several genetic lineages. To better understand these cycles of repeated expansion and retraction, we selected the Marbled White butterfly Melanargia galathea. Fourty-one populations scattered over Europe and the Maghreb and one population of the sibling taxon M. lachesis were analysed using allozyme electrophoresis. We obtained seven distinct lineages applying neighbour joining and STRUCTURE analyses: (i) Morocco, (ii) Tunisia, (iii) Sicily, (iv) Italy and southern France, (v) eastern Balkans extending to Central Europe, (vi) western Balkans with western Carpathian Basin as well as (vii) south-western Alps. The hierarchy of these splits is well matching the chronology of glacial and interglacial cycles since the Günz ice age starting with an initial split between the galathea group in North Africa and the lachesis group in Iberia. These genetic structures were compared with past distribution patterns during the last glacial stage calculated with distribution models. Both methods suggest climatically suitable areas in the Maghreb and the southern European peninsulas with distinct refugia during the last glacial period and underpin strong range expansions to the North during the Postglacial. However, the allozyme patterns reveal biogeographical structures not detected by distribution modelling as two distinct refugia in the Maghreb, two or more distinct refugia at the Balkans and a close link between the eastern Maghreb and Sicily. Furthermore, the genetically highly diverse western Maghreb might have acted as source or speciation centre of this taxon, while the

  5. 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.

  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); 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. Statistical and Modeling Techniques for Studying the Sudden Infant Death Syndrome

    Science.gov (United States)

    Lindsey, Helen L.

    1976-01-01

    The intention of this research is to contribute additional data, hopefully bearing on the solution to some of the problems and indirectly, the cause(s) of Sudden Infant Death Syndrome, and to present ideas for consideration for future SIDS research. (Author/RK)

  8. Douglas-Fir Tussock Moth- and Douglas-Fir Beetle-Caused Mortality in a Ponderosa Pine/Douglas-Fir Forest in the Colorado Front Range, USA

    Directory of Open Access Journals (Sweden)

    José F. Negrón

    2014-12-01

    Full Text Available An outbreak of the Douglas-fir tussock moth, Orgyia pseudotsugata McDunnough, occurred in the South Platte River drainage on the Pike-San Isabel National Forest in the Colorado Front Range attacking Douglas-fir, Pseudotsuga menziesii (Mirb. Franco. Stocking levels, species composition, and tree size in heavily and lightly defoliated stands were similar. Douglas-fir tussock moth defoliation resulted in significant Douglas-fir mortality in the heavily defoliated stands, leading to a change in dominance to ponderosa pine, Pinus ponderosa Lawson. Douglas-fir beetle, Dendroctonus pseudotsuqae Hopkins, populations increased following the defoliation event but caused less mortality, and did not differ between heavily and lightly defoliated stands. Douglas-fir tussock moth-related mortality was greatest in trees less than 15 cm dbh (diameter at 1.4 m above the ground that grew in suppressed and intermediate canopy positions. Douglas-fir beetle-related mortality was greatest in trees larger than 15 cm dbh that grew in the dominant and co-dominant crown positions. Although both insects utilize Douglas-fir as its primary host, stand response to infestation is different. The extensive outbreak of the Douglas-fir tussock moth followed by Douglas-fir beetle activity may be associated with a legacy of increased host type growing in overstocked conditions as a result of fire exclusion.

  9. Wrong place, wrong time: climate change-induced range shift across fragmented habitat causes maladaptation and declined population size in a modelled bird species

    NARCIS (Netherlands)

    Cobben, M.M.P.; Verboom, J.; Opdam, P.F.M.; Hoekstra, R.F.; Jochem, R.; Smulders, M.J.M.

    2012-01-01

    Many species are locally adapted to decreased habitat quality at their range margins, and therefore show genetic differences throughout their ranges. Under contemporary climate change, range shifts may affect evolutionary processes at the expanding range margin due to founder events. Additionally,

  10. Morte súbita em bovinos causada pela ingestão de Pseudocalymma elegans (Bignoniaceae no município de Rio Bonito, RJ Sudden death in cattle caused by ingestion of Pseudocalymma elegans (Bignoniaceae in the county of Rio Bonito, Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Michel A. Helayel

    2009-07-01

    Full Text Available Descreve-se a intoxicação natural por Pseudocalymma elegans em pelo menos um bovino em Rio Bonito, RJ e a reprodução experimental dessa intoxicação em três bovinos e em 3 coelhos com exemplares dessa planta colhida no local onde ocorreu a morte. Necropsia e histopatologia do bovino naturalmente intoxicado não revelaram alterações significativas. A administração, por via oral, de 1g/kg da brotação da planta causou a morte do bovino dentro de 5h e 30 minutos após o início da administração, já pela administração de 0,5 g/kg, a morte do animal ocorreu após 76 horas e 36 minutos. A dose de 0,25g/kg foi capaz de causar sintomas, mas não levou a morte. A sintomatologia caracterizou-se por arritmia cardíaca, taquicardia, aumento da freqüência respiratória, relutância em se mover, pulso venoso positivo, jugulares e grandes vasos ingurgitados, queda ao solo e movimentos de pedalagem, seguindo-se o óbito. À necropsia foram verificadas alterações compatíveis com às observadas na insuficiência cardíaca aguda, e o exame histopatológico revelou a lesão renal típica (degeneração hidrópica em túbulos contornados distais de intoxicação por plantas que causam "morte súbita". Nos coelhos, a evolução variou entre menos de um minuto a dois minutos. O exame histopatológico do rim de dois coelhos também revelou a lesão microscópica característica. Essa planta ainda não havia sido mapeada nessa área do Estado do Rio de Janeiro. Conclui-se que a planta pode ser mais tóxica do que anteriormente descrito.Natural poisoning by Pseudocalymma elegans, a plant that causes "sudden death" and only occurs in the State of Rio de Janeiro, is described in a cow. This condition was experimentally reproduced in three calves and three rabbits with the plant collected in the area where the deaths had occurred. Postmortem and histopathological examinations of the natural case in the cow did not reveal significant alterations. Oral

  11. Increased risk of sudden cardiac arrest in obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Warnier, Miriam Jacoba; Blom, Marieke Tabo; Bardai, Abdennasser

    2013-01-01

    BACKGROUND: We aimed to determine whether (1) patients with obstructive pulmonary disease (OPD) have an increased risk of sudden cardiac arrest (SCA) due to ventricular tachycardia or fibrillation (VT/VF), and (2) the SCA risk is mediated by cardiovascular risk-profile and/or respiratory drug use....... METHODS: A community-based case-control study was performed, with 1310 cases of SCA of the ARREST study and 5793 age, sex and SCA-date matched non-SCA controls from the PHARMO database. Only incident SCA cases, age older than 40 years, that resulted from unequivocal cardiac causes...

  12. Classification of sudden and arrhythmic death

    DEFF Research Database (Denmark)

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

    1997-01-01

    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...... 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...... 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...

  13. Homozygosity for a severe novel medium-chain acyl-CoA dehydrogenase (MCAD) mutation IVS3-1G > C that leads to introduction of a premature termination codon by complete missplicing of the MCAD mRNA and is associated with phenotypic diversity ranging from sudden neonatal death to asymptomatic

    DEFF Research Database (Denmark)

    Korman, Stanley H; Gutman, Alisa; Brooks, Rivka

    2004-01-01

    Virtually all patients with medium-chain acyl-CoA dehydrogenase deficiency (MCADD) are homozygous or compound heterozygous for the 985A > G mutation, which limits the study of a possible genotype/phenotype correlation. A newborn Palestinian infant died suddenly on the second day of life. A previous...... and the first reported splice mutation in the MCAD gene that has been functionally characterized. The association of homozygosity for a null mutation with lethal neonatal presentation in the index patient and presumably the previous infant suggested a genotype/phenotype correlation. However, a 6-year...

  14. Sudden ionospheric disturbances in solar cycle 24

    Science.gov (United States)

    Bothmer, Volker; Bernert, Barbara

    2014-05-01

    Sudden ionospheric disturbances in solar cycle 24 Within the framework of the UN International Space Weather Initiative, and building upon the achievements of the International Heliophysical Year, the German project SIMONE (Sun Ionosphere MOnitoring NEtwork) operates several SID monitors provided by the University of Stanford. Here we present an overview of sudden ionospheric disturbances recorded since 2006 at the high school Gymnasium Walsrode until to date. The continous measurements allow a detailed comparison of locally measured SIDs with the general trend of solar activity during the current solar maximum. We further show that the measurements reveal specific information on the variable response of the dayside ionosphere to solar flares.

  15. Undiagnosed intracranial lipoma associated with sudden death

    Directory of Open Access Journals (Sweden)

    Carlos Durão

    2017-03-01

    Full Text Available Intracranial lipomas represent less than 0.1% of all intracranial tumors. They are usually located in the callus area and often asymptomatic. This paper presents a sudden death case after an episode of convulsions on a 39 years old woman with a history of migraines and seizures since adolescence. The autopsy revealed the presence of an undiagnosed massive brain lipoma (60 × 35 mm associated with atrophy of the corpus callosum. Although very rare and seldom malignant these may be associated with seizures and sudden death.

  16. Acute reversible Charles Bonnet syndrome precipitated by sudden severe anemia.

    Science.gov (United States)

    Kaeser, Pierre-Francois; Borruat, Francois-Xavier

    2009-01-01

    To report the sudden onset of reversible Charles Bonnet syndrome precipitated byacute severe anemia. The charts of three patients (Usher syndrome, bilateral macular degeneration, and bilateral retinal vein occlusion) with acute Charles Bonnet syndrome in the setting of severe anemia were reviewed. Anemia resulted from bladder surgery, recto-colitis, and severe urinary tract infection. Hemoglobin ranged from 78 to 86 g/L. Decreased visual acuity and formed visual hallucinations (giants, flowers, animals) were present in all three patients. Rapid reversal of Charles Bonnet syndrome and visual acuity improvement followed blood transfusion. Acute severe anemia can precipitate Charles Bonnet syndrome, which may be reversible by blood transfusion.

  17. Sudden Infant Death Syndrome and Left Ventricular Hypertrabeculation-Hidden Arrhythmogenic Entity?

    Directory of Open Access Journals (Sweden)

    G. Saayman

    2010-09-01

    Full Text Available Left ventricular noncompaction/hypertrabeculation is a condition which is characterized by a highly trabeculated, “spongy” myocardium. It can present at any age with heart failure, arrhythmia and/or thromboembolic events. A wide variety of mutations have been found to be a cause of hypertrabeculation and it is possible that there is a continuum of hypertrophic cardiomyopathy, dilated cardiomyopathy and hypertrabeculation/noncompaction. We present a case of left ventricular hypertrabeculation which presented as sudden infant death syndrome and we propose that this entity may be a hidden cause of arrhythmic death in some infants presenting as sudden infant death syndrome.

  18. Reporting a sudden death due to accidental gasoline inhalation.

    Science.gov (United States)

    Martínez, María Antonia; Ballesteros, Salomé; Alcaraz, Rafael

    2012-02-10

    The investigation of uncertain fatalities requires accurate determination of the cause of death, with assessment of all factors that may have contributed to it. Gasoline is a complex and highly variable mixture of aliphatic and aromatic hydrocarbons that can lead to cardiac arrhythmias due to sensitization of the myocardium to catecholamines or acts as a simple asphyxiant if the vapors displace sufficient oxygen from the breathing atmosphere. This work describes a sudden occupational fatality involving gasoline. The importance of this petroleum distillate detection and its quantitative toxicological significance is discussed using a validated analytical method. A 51 year-old Caucasian healthy man without significant medical history was supervising the repairs of the telephone lines in a manhole near to a gas station. He died suddenly after inhaling gasoline vapors from an accidental leak. Extensive blistering and peeling of skin were observed on the skin of the face, neck, anterior chest, upper and lower extremities, and back. The internal examination showed a strong odor of gasoline, specially detected in the respiratory tract. The toxicological screening and quantitation of gasoline was performed by means of gas chromatography with flame ionization detector and confirmation was performed using gas chromatography-mass spectrometry. Disposition of gasoline in different tissues was as follows: heart blood, 35.7 mg/L; urine, not detected; vitreous humor, 1.9 mg/L; liver, 194.7 mg/kg; lung, 147.6 mg/kg; and gastric content, 116,6 mg/L (2.7 mg total). Based upon the toxicological data along with the autopsy findings, the cause of death was determined to be gasoline poisoning and the manner of death was accidental. We would like to alert on the importance of testing for gasoline, and in general for volatile hydrocarbons, in work-related sudden deaths involving inhalation of hydrocarbon vapors and/or exhaust fumes. Copyright © 2011 Elsevier Ireland Ltd. All rights

  19. Morphological diagnosis of sudden cardiac death

    DEFF Research Database (Denmark)

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

    1989-01-01

    of pericardial fluid and myocardium in the same cases of sudden death of cardiac origin. Fifty cases were included, and the results of the macroscopic, histochemical, histological and cytological examinations revealed that the NBT test and microscopy are valuable methods in diagnosing infarctions, while...

  20. Alcohol Use and Sudden Infant Death Syndrome

    Science.gov (United States)

    Friend, Karen B.; Goodwin, Matthew S.; Lipsitt, Lewis P.

    2004-01-01

    Despite general evidence of fetal toxicities associated with sudden infant death syndrome (SIDS), there has been limited research focusing on the effects of parental alcohol use on SIDS occurrence, either directly or in interaction with other risk conditions. The purpose of this paper is to review the literature on parental, especially maternal,…

  1. Epidemiological Features of Sudden Infant Death Syndrome

    Directory of Open Access Journals (Sweden)

    V.V. Medvedevа

    2015-07-01

    Full Text Available The paper presents an analysis of some epidemiological characteristics of sudden infant death syndrome (SIDS in the Donbass region for a period of 1994–2014. The prevalence and specific relevance of SIDS, dynamics of specific gravity of SIDS in the structure of infantile mortality is shown.

  2. Relationship between platelet parameters and sudden ...

    African Journals Online (AJOL)

    Relationship between platelet parameters and sudden sensorineural hearing loss: a systematic review and meta-analysis. ... Data source: A PubMed, Science Direct, Scopus, OVID, EMBASE and Google Scholar search (date last searchedApril2016) search was done. No restrictions of time, language and location were ...

  3. 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...

  4. Sudden death syndrome of soybean in Argentina

    Science.gov (United States)

    Sudden death syndrome (SDS) is one of the most common and widely spread root disease affecting soybean [Glycine max (L.) Merr.] in Argentina where it is an economically important crop. This disease was first discovered in this country in 1992 in the Pampas Region, and the following year in Northwest...

  5. Sudden Sensory-Neural Hearing Loss

    OpenAIRE

    Fariba Slambol Nassaj

    1993-01-01

    Sudden hearing loss is a type of hearing loss that occurs in three successive frequencies by more than 30 dB and in less than 72 hours. Every 10 person in 100000 in the world and 25000 people in USA suffer this kind of hearing loss. The average age of the onset is 43 years old.

  6. Sudden Gains during Therapy of Social Phobia

    Science.gov (United States)

    Hofmann, Stefan G.; Schultz, Stefan M.; Meuret, Alicia E.; Moscovitch, David A.; Suvak, Michael

    2006-01-01

    The present study investigated the phenomenon of sudden gains in 107 participants with social phobia (social anxiety disorder) who received either cognitive-behavioral group therapy or exposure group therapy without explicit cognitive interventions, which primarily used public speaking situations as exposure tasks. Twenty-two out of 967…

  7. Sudden (reversible) sensorineural hearing loss in pregnancy.

    LENUS (Irish Health Repository)

    Kenny, R

    2011-03-01

    Sudden hearing loss directly associated with pregnancy or birth is a little known and rare occurrence. The temporary, unilateral, low-frequency sensorineural hearing loss in this case was reported after the birth of the patient\\'s first child, and again during the third trimester of her second pregnancy.

  8. Sudden viscous dissipation of compressing turbulence

    OpenAIRE

    Davidovits, S.; Fisch, N. J.

    2015-01-01

    Compression of turbulent plasma can amplify the turbulent kinetic energy, if the compression is fast compared to the viscous dissipation time of the turbulent eddies. A sudden viscous dissipation mechanism is demonstrated, whereby this amplified turbulent kinetic energy is rapidly converted into thermal energy, suggesting a new paradigm for fast ignition inertial fusion.

  9. Sudden Viscous Dissipation of Compressing Turbulence.

    Science.gov (United States)

    Davidovits, Seth; Fisch, Nathaniel J

    2016-03-11

    Compression of turbulent plasma can amplify the turbulent kinetic energy, if the compression is fast compared to the viscous dissipation time of the turbulent eddies. A sudden viscous dissipation mechanism is demonstrated, whereby this amplified turbulent kinetic energy is rapidly converted into thermal energy, suggesting a new paradigm for fast ignition inertial fusion.

  10. The effect of sudden depressurization on pilots at cruising altitude.

    Science.gov (United States)

    Muehlemann, Thomas; Holper, Lisa; Wenzel, Juergen; Wittkowski, Martin; Wolf, Martin

    2013-01-01

    The standard flight level for commercial airliners is ∼12 km (40 kft; air pressure: ∼ 200 hPa), the maximum certification altitude of modern airliners may be as high as 43-45 kft. Loss of structural integrity of an airplane may result in sudden depressurization of the cabin potentially leading to hypoxia with loss of consciousness of the pilots. Specialized breathing masks supply the pilots with oxygen. The aim of this study was to experimentally simulate such sudden depressurization to maximum design altitude in a pressure chamber while measuring the arterial and brain oxygenation saturation (SaO(2) and StO(2)) of the pilots. Ten healthy subjects with a median age of 50 (range 29-70) years were placed in a pressure chamber, breathing air from a cockpit mask. Pressure was reduced from 753 to 148 hPa within 20 s, and the test mask was switched to pure O(2) within 2 s after initiation of depressurization. During the whole procedure SaO(2) and StO(2) were measured by pulse oximetry, respectively near-infrared spectroscopy (NIRS; in-house built prototype) of the left frontal cortex. During the depressurization the SaO(2) dropped from median 93% (range 91-98%) to 78% (62-92%) by 16% (6-30%), while StO(2) decreased from 62% (47-67%) to 57% (43-62%) by 5% (3-14%). Considerable drops in oxygenation were observed during sudden depressurization. The inter-subject variability was high, for SaO(2) depending on the subjects' ability to preoxygenate before the depressurization. The drop in StO(2) was lower than the one in SaO(2) maybe due to compensation in blood flow.

  11. 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

  12. 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

    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...... 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......, the incidence of venous thromboembolism was 0.9 per 1000 per year in the background population, and less than one-thousandth of these were children. Consequently it is not likely that venous thrombosis is a major cause of sudden infant death syndrome. On the other hand, this does not exclude other known...

  13. Cardiac Ion Channelopathies and the Sudden Infant Death Syndrome

    Science.gov (United States)

    2012-01-01

    The sudden infant death syndrome (SIDS) causes the sudden death of an apparently healthy infant, which remains unexplained despite a thorough investigation, including the performance of a complete autopsy. The triple risk model for the pathogenesis of SIDS points to the coincidence of a vulnerable infant, a critical developmental period, and an exogenous stressor. Primary electrical diseases of the heart, which may cause lethal arrhythmias as a result of dysfunctioning cardiac ion channels (“cardiac ion channelopathies”) and are not detectable during a standard postmortem examination, may create the vulnerable infant and thus contribute to SIDS. Evidence comes from clinical correlations between the long QT syndrome and SIDS as well as genetic analyses in cohorts of SIDS victims (“molecular autopsy”), which have revealed a large number of mutations in ion channel-related genes linked to inheritable arrhythmogenic syndromes, in particular the long QT syndrome, the short QT syndrome, the Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. Combining data from population-based cohort studies, it can be concluded that at least one out of five SIDS victims carries a mutation in a cardiac ion channel-related gene and that the majority of these mutations are of a known malignant phenotype. PMID:23304551

  14. Sudden infant death syndrome: diagnostic practices and investigative policies, 2004.

    Science.gov (United States)

    Camperlengo, Lena T; Shapiro-Mendoza, Carrie K; Kim, Shin Y

    2012-09-01

    Using a 2004 population-based survey of all US medical examiner and coroner offices, we examined the characteristics of offices accepting an infant death case and calculated the percentage of offices that had death scene investigation or autopsy policies for the investigation of sudden unexpected infant death (SUID). We also calculated the percentage of offices that used and did not use sudden infant death syndrome (SIDS) as a cause of death, and we compared differences in characteristics among those offices.Of medical examiner and coroner offices, 52% did not report an infant death in 2004. Of the 7957 infant deaths reported, 43% occurred in jurisdictions that experienced 1 or 2 infant deaths. Of the offices that used SIDS as a classification, 34% did not have policies for conducting death scene investigations and autopsies for SUID. At least 5% of offices that reported an infant death did not use SIDS as a cause of death classification. These findings have important implications for understanding recent trends in SIDS and SUID. Supporting the implementation of national standards for investigating and certifying infant deaths could provide guidelines for consistent practices in medical examiner and coroner offices.

  15. [Sudden death of a young man as late sequelae complicating a pediatric disease: About a case].

    Science.gov (United States)

    Pierry, Clémence; Franchet, Camille; Tuchtan-Torrents, Lucile; Macon, Céline; Torrents, Julia; Capuani, Caroline; Piercecchi-Marti, Marie-Dominique

    2017-04-01

    In France, sudden death is responsible every year for 40,000 deaths. The most frequent etiology is cardiac disease. Atheromatous-related pathology is the most common etiology beyond 35, but cardiomyopathies and channelopathies are responsible for a significant number of deaths in young adults. Some acquired disorders can also cause sudden cardiac death. We report the case of a 17-year-old man who died suddenly after sport. Autopsy and pathological study found multiple giant coronary aneurysms. Thrombosis and fibrous scar of myocardial ischemic events were observed. These lesions were in favor of late sequelae of Kawasaki disease. Kawasaki disease is a rare but not exceptional cause of sudden cardiac death in young adults. In the lack of known clinical history, some aspects, even not specific, should evoke this diagnosis. Even in front of apparent good clinical tolerance, these sequelae require appropriate follow-up because of a significant risk of sudden death. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Bed sharing is more common in sudden infant death syndrome than in explained sudden unexpected deaths in infancy.

    Science.gov (United States)

    Möllborg, Per; Wennergren, Göran; Almqvist, Petra; Alm, Bernt

    2015-08-01

    Despite its declining incidence, sudden infant death syndrome (SIDS) is still an important cause of death in infancy. This study investigated the environmental circumstances associated with SIDS, by analysing data from all sudden unexpected deaths in infancy (SUDI) in Sweden from 2005 to 2011. All Swedish infants forensically autopsied up to the age of 365 days from 2005 to 2011 were included. Medical records were obtained from the hospitals and supplementary data from the Swedish Medical Birth Register. Of the 261 infants, 136 were defined as SIDS and 125 as explained SUDI. The documentation in the medical records was poor when it came to issues such as bed sharing, sleep position, smoking, breastfeeding and pacifier use. The main findings were a significantly higher prevalence of bed sharing in SIDS than in explained deaths (odds ratio 7.77, 95% confidence interval 2.36-25.57) and that prone sleeping was still overrepresented. Bronchopneumonia, other infections and congenital anomalies were the most common causes of explained SUDI. Bed sharing and prone sleeping were more common in SIDS than in explained SUDI. Sparse data in medical records were a problem, and the authors are now working with the National Board of Health and Welfare on a project to establish new routines. ©2015 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  17. Coupled catastrophes: sudden shifts cascade and hop among interdependent systems.

    Science.gov (United States)

    Brummitt, Charles D; Barnett, George; D'Souza, Raissa M

    2015-11-06

    An important challenge in several disciplines is to understand how sudden changes can propagate among coupled systems. Examples include the synchronization of business cycles, population collapse in patchy ecosystems, markets shifting to a new technology platform, collapses in prices and in confidence in financial markets, and protests erupting in multiple countries. A number of mathematical models of these phenomena have multiple equilibria separated by saddle-node bifurcations. We study this behaviour in its normal form as fast-slow ordinary differential equations. In our model, a system consists of multiple subsystems, such as countries in the global economy or patches of an ecosystem. Each subsystem is described by a scalar quantity, such as economic output or population, that undergoes sudden changes via saddle-node bifurcations. The subsystems are coupled via their scalar quantity (e.g. trade couples economic output; diffusion couples populations); that coupling moves the locations of their bifurcations. The model demonstrates two ways in which sudden changes can propagate: they can cascade (one causing the next), or they can hop over subsystems. The latter is absent from classic models of cascades. For an application, we study the Arab Spring protests. After connecting the model to sociological theories that have bistability, we use socioeconomic data to estimate relative proximities to tipping points and Facebook data to estimate couplings among countries. We find that although protests tend to spread locally, they also seem to 'hop' over countries, like in the stylized model; this result highlights a new class of temporal motifs in longitudinal network datasets. © 2015 The Authors.

  18. Exome sequencing-based molecular autopsy of formalin-fixed paraffin-embedded tissue after sudden death.

    Science.gov (United States)

    Bagnall, Richard D; Ingles, Jodie; Yeates, Laura; Berkovic, Samuel F; Semsarian, Christopher

    2017-10-01

    Sudden death in the young is a devastating complication of inherited heart disorders. Finding the precise cause of death is important, but it is often unresolved after postmortem investigation. The addition of postmortem genetic testing, i.e., the molecular autopsy, can identify additional causes of death. We evaluated DNA extracted from formalin-fixed paraffin-embedded postmortem tissue for exome sequencing-based molecular autopsy after sudden death in the young. We collected clinical and postmortem information from patients with sudden death. Exome sequencing was performed on DNA extracted from fixed postmortem tissue. Variants relevant to the cause of death were sought. Five patients with genetically unresolved sudden death were recruited. DNA extracted from fixed postmortem tissue was degraded. Exome sequencing achieved 20-fold coverage of at least 82% of coding regions. A threefold excess of singleton variants was found in the exome sequencing data of one patient. We found a de novo SCN1A frameshift variant in a patient with sudden unexpected death in epilepsy and a LMNA nonsense variant in a patient with dilated cardiomyopathy. DNA extracted from fixed postmortem tissue is applicable to exome sequencing-based molecular autopsy. Fixed postmortem tissues are an untapped resource for exome-based studies of rare causes of sudden death.Genet Med advance online publication 23 March 2017.

  19. [Sudden cardiac death due to sarcoidosis. Case report].

    Science.gov (United States)

    Sejben, István; Som, Zoltán; Cserni, Gábor

    2017-07-01

    Sarcoidosis is a systemic granulomatous disease of unknown aetiology, which is characterized by bilateral hilar lymphadenopathy and pulmonary disease. Clinically detected cardiac involvement occurs in 5% of sarcoid patients, although cardiac manifestations are discovered in 25% of the cases at autopsy. Sarcoid heart disease frequently causes atrioventricular block. The authors present the case of a 44-year-old man with bradycardia. On admission, second degree Mobitz II, then third degree atrioventricular block was diagnosed. Coronarography showed normal coronary arteries. 2.5 years following artificial Biotronik Entovis DR type pacemaker implantation, sudden cardiac death occurred. Autopsy revealed sarcoidosis with cardiac, pulmonary, splenic, renal and lymph node involvement. In case of young or middle-aged patients with atrioventricular block, it is best to search for other causes if the most common coronary origin can be excluded. Orv Hetil. 2017; 158(27): 1067-1070.

  20. Early repolarization, acute emotional stress and sudden death.

    Science.gov (United States)

    Palmiere, Cristian; Lesta, Maria del Mar; Vanhaebost, Jessica; Mangin, Patrice; Augsburger, Marc; Vogt, Pierre

    2014-05-01

    We herein report the case of a 36-year-old man who died suddenly after a fight with another man. Forensic investigations included unenhanced computed tomography, postmortem angiography, autopsy, histology, neuropathology, toxicology, and biochemistry and allowed a traumatic cause of death to be excluded. An electrocardiogram recorded some years prior to death revealed the presence of an early repolarization pattern. Based on the results of all investigations, the cause of death was determined to be cardiac arrhythmia and cardiac arrest during an emotionally stressful event associated with physical assault. Direct third party involvement, however, was excluded, and the manner of death was listed as natural. The case was not pursued any further by the public prosecutor. © 2013 American Academy of Forensic Sciences.

  1. T-wave alternans and sudden cardiac death.

    Science.gov (United States)

    El-Menyar, Ayman; Asaad, Nidal

    2008-03-01

    Sudden cardiac death (SCD) is the leading cause of mortality in patients with ischemic heart disease and left ventricular dysfunction. The majority of SCD are due to ventricular tachyarrhythmias. SCD strikes many asymptomatic patients and often is the first manifestation of heart disease. Thus, reliable determination of arrhythmic risk is warranted to guide preventive therapy. To highlight the prognostic value of microvolt-level electrical alternans of the T-wave (MTWA) in patients at risk for SCD, most of the pertinent published articles in the Medline, Scopus, and EBSCO Host research databases have been reviewed. MTWA has been proposed to be a strong and independent predictor of all-cause and arrhythmic mortality. The high predictive value of MTWA in patient with cardiomyopathy varies significantly depending on the population studied. Combining with other indices or having serial MTWA readings could overcome MTWA limitations. Redefining MTWA readings may expand its prognostic utility.

  2. Discordance in investigator-reported and adjudicated sudden death in TIOSPIR

    Directory of Open Access Journals (Sweden)

    Robert A. Wise

    2017-03-01

    Full Text Available Accurate and consistent determination of cause of death is challenging in chronic obstructive pulmonary disease (COPD patients. TIOSPIR (N=17 135 compared the safety and efficacy of tiotropium Respimat 5/2.5 µg with HandiHaler 18 µg in COPD patients. All-cause mortality was a primary end-point. A mortality adjudication committee (MAC assessed all deaths. We aimed to investigate causes of discordance in investigator-reported and MAC-adjudicated causes of death and their impact on results, especially cardiac and sudden death. The MAC provided independent, blinded assessment of investigator-reported deaths (n=1302 and assigned underlying cause of death. Discordance between causes of death was assessed descriptively (shift tables. There was agreement between investigator-reported and MAC-adjudicated deaths in 69.4% of cases at the system organ class level. Differences were mainly observed for cardiac deaths (16.4% investigator, 5.1% MAC and deaths assigned to general disorders including sudden death (17.4% investigator, 24.6% MAC. Reasons for discrepancies included investigator attribution to the immediate (e.g. myocardial infarction (MI over the underlying cause of death (e.g. COPD and insufficient information for a definitive cause. Cause-specific mortality varies in COPD, depending on the method of assignment. Sudden death, witnessed and unwitnessed, is common in COPD and often attributed to MI without supporting evidence.

  3. Incidence and Etiology of Sudden Cardiac Death: New Updates for Athletic Departments.

    Science.gov (United States)

    Asif, Irfan M; Harmon, Kimberly G

    Sudden cardiac death (SCD) in a young athlete is a tragic event and is the leading medical cause of death in this population. The precise incidence of SCD in young athletes has been subject of debate, with studies reporting drastically different rates (1:917,000 athlete-years (AYs) to 1:3000 AYs) depending on the methodological design of the investigation or the targeted population. A literature search was performed in PubMed using the terms: incidence, sudden cardiac death, sudden death, sudden cardiac arrest, etiology, pathology, registry, athlete, young, children, and adolescents. Articles were reviewed for relevance and included if they contained information on the incidence of SCD in athletes or young persons up to the age of 35 years. Clinical review. Level 5. Studies of high quality and rigor consistently yield an incidence of 1:50,000 AYs in college athletes and between 1:50,000 and 1:80,000 AYs for high school athletes, with certain subgroups that appear to be at particularly high risk, including the following: men, basketball players, and African Americans. Initial reports suggest that the most common cause of SCD is hypertrophic cardiomyopathy (HCM). However, more comprehensive investigations in the United States and international populations-athletes, nonathletes, and military-support that the most common finding on autopsy in young individuals with SCD is actually a structurally normal heart (autopsy-negative sudden unexplained death). SCD is the leading cause of death in athletes during exercise and usually results from intrinsic cardiac conditions that are triggered by the physiologic demands of vigorous exercise. Current rates of SCD appear to be at least 4 to 5 times higher than previously estimated, with men, African Americans, and male basketball players being at greatest risk. Emerging data suggest that the leading finding associated with SCD in athletes is actually a structurally normal heart (autopsy-negative sudden unexplained death).

  4. Dentate gyrus abnormalities in sudden unexplained death in infants: morphological marker of underlying brain vulnerability.

    Science.gov (United States)

    Kinney, Hannah C; Cryan, Jane B; Haynes, Robin L; Paterson, David S; Haas, Elisabeth A; Mena, Othon J; Minter, Megan; Journey, Kelley W; Trachtenberg, Felicia L; Goldstein, Richard D; Armstrong, Dawna D

    2015-01-01

    Sudden unexplained death in infants, including the sudden infant death syndrome, is likely due to heterogeneous causes that involve different intrinsic vulnerabilities and/or environmental factors. Neuropathologic research focuses upon the role of brain regions, particularly the brainstem, that regulate or modulate autonomic and respiratory control during sleep or transitions to waking. The hippocampus is a key component of the forebrain-limbic network that modulates autonomic/respiratory control via brainstem connections, but its role in sudden infant death has received little attention. We tested the hypothesis that a well-established marker of hippocampal pathology in temporal lobe epilepsy-focal granule cell bilamination in the dentate, a variant of granule cell dispersion-is associated with sudden unexplained death in infants. In a blinded study of hippocampal morphology in 153 infants with sudden and unexpected death autopsied in the San Diego County medical examiner's office, deaths were classified as unexplained or explained based upon autopsy and scene investigation. Focal granule cell bilamination was present in 41.2% (47/114) of the unexplained group compared to 7.7% (3/39) of the explained (control) group (p infants with sudden unexplained death may represent a developmental vulnerability that leads to autonomic/respiratory instability or autonomic seizures, and sleep-related death when the infants are challenged with homeostatic stressors. Importantly, these lesions can be recognized in microscopic sections prepared in current forensic practice. Future research is needed to determine the relationship between hippocampal and previously reported brainstem pathology in sudden infant death.

  5. GJB2 and mitochondrial 12S rRNA susceptibility mutations in sudden deafness.

    Science.gov (United States)

    Chen, Kaitian; Sun, Liang; Zong, Ling; Wu, Xuan; Zhan, Yuan; Dong, Chang; Cao, Hui; Tang, Haocheng; Jiang, Hongyan

    2016-06-01

    Genetic susceptibility may play an important role in the pathogenesis of sudden deafness. However, the specific genes involved are largely unknown. We sought to explore the frequency of GJB2 and mitochondrial 12S rRNA susceptibility mutations in patients with sudden deafness. Between September 2011 and May 2012, 62 consecutive patients with sudden deafness were seen. In 50 of these, no etiological factors for sudden deafness were found. We detected GJB2 and mitochondrial 12S rRNA variants by direct sequencing in these 50 patients and in 53-aged matched controls with normal hearing. In addition, we undertook functional analyses of the mitochondrial mutations which we detected, applying structural and phylogenetic analysis. GJB2 sequencing identified six mutations, including three pathogenic mutations (c.235delC, c.299-300delAT, c.109G>A) and three polymorphisms, in the study participants, giving an allele frequency of 15.0 %. A homozygous c.109G>A mutation was detected in two participants. A total of 16 variants in mitochondrial 12S rRNA gene were identified in the participants. No significant differences were found in GJB2 heterozygosity or in mitochondrial 12S rRNA variants between patients with sudden deafness and in controls. Our results suggest that the homozygous GJB2 c.109G>A mutation may be a cause of sudden deafness involving both ears. This finding should increase awareness of the likely role of genetic factors in the etiology of sudden deafness in general.

  6. Teaching Child Care Providers to Reduce the Risk of SIDS (Sudden Infant Death Syndrome)

    Science.gov (United States)

    Byington, Teresa; Martin, Sally; Reilly, Jackie; Weigel, Dan

    2011-01-01

    Keeping children safe and healthy is one of the main concerns of parents and child care providers. SIDS (Sudden Infant Death Syndrome) is the leading cause of death in infants 1 month to 12 months of age. Over 2,000 infants die from SIDS every year in the United States, and almost 15% of these deaths occur in child care settings. A targeted…

  7. 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

  8. Eccentric Left Ventricular Hypertrophy and Sudden Death in Patients with End-Stage Kidney Disease

    NARCIS (Netherlands)

    De Roij Van Zuijdewijn, Camiel L M; Hansildaar, Romy; Bots, Michiel L.; Blankestijn, Peter J.; Van Den Dorpel, Marinus A.; Grooteman, Muriel P C; Kamp, Otto; Ter Wee, Piet M.; Nubé, Menso J.

    2015-01-01

    Background/Aims: Both all-cause and cardiovascular mortality risks are extremely high in patients with end-stage kidney disease (ESKD). Sudden death accounts for approximately one-quarter of all fatal events. Left ventricular hypertrophy (LVH) is a known risk factor for mortality and can be divided

  9. 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...

  10. Greenhouse Inoculation Methods for Evaluating Resistance of Soybean to Sudden Death Syndrome

    Science.gov (United States)

    Sudden death syndrome (SDS) caused by the soil borne fungus Fusarium solani f. sp. glycines (FSG) (syn. Fusarium virguliforme Akoi, O’Donnell, Homma and Lattanzi), is a major disease in soybean [Glycine max (L.) Merr.]. Selection for SDS resistance in the field is difficult because of the impact of ...

  11. Susceptibility to Phytophthora ramorum in California bay laurel, a key foliar host of sudden oak death

    Science.gov (United States)

    Brian L. Anacker; Nathan E. Rank; Daniel Hüberli; Matteo Garbelotto; Sarah Gordon; Rich Whitkus; Tami Harnik; Matthew Meshriy; Lori Miles; Ross K. Meentemeyer

    2008-01-01

    Sudden oak death, caused by the water mold Phytophthora ramorum, is a plant disease responsible for the death of hundreds of thousands of oak and tanoak trees. Some foliar hosts play a major role in the epidemiology of this disease. Upon infection by P. ramorum, these foliar hosts express non-fatal leaf lesions from which large...

  12. Analysis of populations of the sudden oak death pathogen in Oregon forests

    Science.gov (United States)

    Zhian N. Kamvar; Everett M. Hansen; Alan M. Kanaskie; Meredith M. Larsen; Niklaus J. Grünwald

    2017-01-01

    Sudden oak death, caused by the oomycete Phytophthora ramorum, was first discovered in California toward 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 epidemic and sampled symptomatic tanoak trees from...

  13. Assessing Methods to Protect Susceptible Oak and Tanoak Stands from Sudden Oak Death

    Science.gov (United States)

    Tedmund Swiecki; Elizabeth Bernhardt

    2010-01-01

    Landowners and managers have been seeking ways to protect susceptible oak (Quercus) species and tanoak (Lithocarpus densiflorus) from sudden oak death (SOD) caused by Phytophthora ramorum. Because disease epidemiology differs between tanoaks and susceptible oaks, we are testing different control strategies...

  14. Sudden cardiac arrest in sports - need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation

    NARCIS (Netherlands)

    Solberg, E.E.; Borjesson, M.; Sharma, S.; Papadakis, M.; Wilhelm, M.; Drezner, J.A.; Harmon, K.G.; Alonso, J.M.; Heidbuchel, H.; Dugmore, D.; Panhuyzen-Goedkoop, N.M.; Mellwig, K.P.; Carre, F.; Rasmusen, H.; Niebauer, J.; Behr, E.R.; Thiene, G.; Sheppard, M.N.; Basso, C.; Corrado, D.

    2016-01-01

    There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities.

  15. Cerebral Paragonimiasis Presenting with Sudden Death.

    Science.gov (United States)

    Amaro, Deirdre E; Cowell, Annie; Tuohy, Marion J; Procop, Gary W; Morhaime, Jacquelyn; Reed, Sharon L

    2016-12-07

    A 58-year-old Korean-born woman with a history of seizures and psychiatric issues was found dead at home. Autopsy was notable for large, calcified nodules that had nearly replaced her right temporal lobe. Histologic examination revealed the presence of Paragonimus eggs. This case demonstrates a rare manifestation of an aberrantly migrated lung fluke that resulted in epilepsy and sudden death years after the initial infection. © The American Society of Tropical Medicine and Hygiene.

  16. [Sudden death in Versailles: A review of a cardiovascular treatrise by Dionis (1710)].

    Science.gov (United States)

    Charlier, P

    2017-05-12

    In 1710, the surgeon Pierre Dionis publishes a Dissertation on sudden death. Echoing and expanding the work of his Roman colleague Jean Marie Lancisi, he describes and analyzes dozens of cases of sudden death observed by him. A large number of cases was followed by autopsies allowing clinicopathological confrontation. Are proposed causes of death (pulmonary embolism, myocardial infarction, hemorrhagic stroke, arterial rupture, etc.), pathophysiological mechanisms based on the ancient theory of humors, and preventive actions to avoid these unexpected deaths. In this article, we oppose these old data to those of current literature. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. Sterile site infection at autopsy in sudden unexpected deaths in infancy.

    Science.gov (United States)

    Goldwater, P N

    2009-04-01

    To examine and compare bacteriological findings at autopsy of cases of sudden unexpected infant death and those of deaths from other cause. Autopsy report review of 130 sudden infant death syndrome (SIDS) cases (2004 definition), 32 cases of sudden unexpected death in infancy (SUDI) due to infection and 33 cases of non-infectious sudden deaths. Qualitative assessment of normally sterile site (NSS; heart blood, spleen or cerebrospinal fluid) bacteriology in SIDS and age-matched comparison deaths that occurred in the late 1980s and early 1990s. Comparative sterile site bacteriological findings. Sterile site infection was rare in cases of sudden accidental death (eg, motor vehicle accident or drowning); however, the finding of true pathogens such as Staphylococcus aureus in sterile sites in SIDS and deaths associated with infection was relatively common. 10.76% of SIDS had S aureus present in a sterile site, compared with 18.75% of cases of infection-related deaths. S aureus was not found in sudden accidental deaths. The incidence of coliform bacteria in NSS in SIDS was not significantly different from that seen in deaths from other cause. NSS bacteriology yielded no growth in 45.4% of sudden accidental deaths, 43% of SIDS and 28.1% of infectious causes of death. The finding of S aureus in NSS in a large proportion of cases of SIDS would indicate that a proportion of these babies died of staphylococcal disease. Although the differences in NSS isolation of S aureus in the three infant groups did not quite achieve significance, on the basis of these findings and the characteristic virulence of S aureus, it is recommended that sudden unexpected deaths from which S aureus is isolated from NSS be considered for reclassification. The incidence of coliform bacteria in NSS in SIDS is not significantly different from that in deaths from another cause (both accidental and infectious). From these findings it is recommended that the opinion of a consultant microbiologist be

  18. Clinical Laboratory and Epidemiological Features of Sudden Exanthema in Children Saint-Petersburg

    OpenAIRE

    E. V. Sharipova; I. V. Babachenko; Yu. I. Sichkovskaja; Yu. Yu. Chernyshova

    2016-01-01

    The paper studies the clinical and epidemiological features of one of the acute clinical forms of infection caused by the human herpes virus type 6 — «sudden exanthema » — in children of St. Petersburg. The study involved 149 children hospitalized aged 6 months to 15 years in the period from 2012 to 2014. Sudden rash confirmed by molecular genetic studies in 38 children. The disease is mainly observed in patients of the first two years of life. Rash and toxic syndromes dominated in clinical p...

  19. Clinical Laboratory and Epidemiological Features of Sudden Exanthema in Children Saint-Petersburg

    Directory of Open Access Journals (Sweden)

    E. V. Sharipova

    2016-01-01

    Full Text Available The paper studies the clinical and epidemiological features of one of the acute clinical forms of infection caused by the human herpes virus type 6 — «sudden exanthema » — in children of St. Petersburg. The study involved 149 children hospitalized aged 6 months to 15 years in the period from 2012 to 2014. Sudden rash confirmed by molecular genetic studies in 38 children. The disease is mainly observed in patients of the first two years of life. Rash and toxic syndromes dominated in clinical picture.

  20. Sudden onset of paraplegia secondary to an unusual presentation of pediatric synovial sarcoma.

    Science.gov (United States)

    Guo, Ailing; Guo, Fuyou

    2016-12-01

    Spinal synovial sarcoma (SS) is an extremely rare malignant tumor in children. We report an unusual pediatric synovial sarcoma located in the thoracic spine at T9-T10 levels. A 10-year-old boy was admitted with a 1-month history of progressive back pain and low fever for 7 days as well as sudden onset of paraplegia for 1 day. The primary diagnosis was considered for spinal inflammatory abscess; subsequently, the patient underwent total resection with a good recovery and confirmed SS by SYT-SSX gene translocation. The possibility of sudden paraplegia caused by unusual SS involved in the spine should be highlighted.

  1. The physiological determinants of sudden infant death syndrome.

    Science.gov (United States)

    Garcia, Alfredo J; Koschnitzky, Jenna E; Ramirez, Jan-Marino

    2013-11-01

    It is well-established that environmental and biological risk factors contribute to Sudden Infant Death Syndrome (SIDS). There is also growing consensus that SIDS requires the intersection of multiple risk factors that result in the failure of an infant to overcome cardio-respiratory challenges. Thus, the critical next steps in understanding SIDS are to unravel the physiological determinants that actually cause the sudden death, to synthesize how these determinants are affected by the known risk factors, and to develop novel ideas for SIDS prevention. In this review, we will examine current and emerging perspectives related to cardio-respiratory dysfunctions in SIDS. Specifically, we will review: (1) the role of the preBötzinger complex (preBötC) as a multi-functional network that is critically involved in the failure to adequately respond to hypoxic and hypercapnic challenges; (2) the potential involvement of the preBötC in the gender and age distributions that are characteristic for SIDS; (3) the link between SIDS and prematurity; and (4) the potential relationship between SIDS, auditory function, and central chemosensitivity. Each section underscores the importance of marrying the epidemiological and pathological data to experimental data in order to understand the physiological determinants of this syndrome. We hope that a better understanding will lead to novel ways to reduce the risk to succumb to SIDS. Copyright © 2013. Published by Elsevier B.V.

  2. Sudden infant death due to Lactococcal infective endocarditis.

    Science.gov (United States)

    Taniguchi, K; Nakayama, M; Nakahira, K; Nakura, Y; Kanagawa, N; Yanagihara, I; Miyaishi, S

    2016-03-01

    Infective endocarditis (IE) of infants is rare, most of which occur associated with congenital heart disease or its cardiac surgery. We experienced a case of sudden death of a four-month-old male infant without congenital heart disease. It was elucidated by postmortem examination that the dead had suffered severe IE, which led him to death. In the microbiological genetic analysis using histological section, the pathogen causing inflammation in the present case was identified as Lactococcus lactis subspecies, although Staphylococci have been reported to be common and important one. Previously reported infectious diseases by Lactococcus lactis subspecies were all adult cases and this is the first report of an infantile death due to Lactococcal IE according to our knowledge. Any fatal disease may be included in sudden death cases targeted for forensic autopsy, even if it is rare. It is expected for forensic pathologists that they note such case and share each experience among themselves and other medical fields to develop a strategy for prevention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Evolution and significance of the triple risk model in sudden infant death syndrome.

    Science.gov (United States)

    Spinelli, Jade; Collins-Praino, Lyndsey; Van Den Heuvel, Corinna; Byard, Roger W

    2017-02-01

    Sudden infant death syndrome (SIDS) is a leading cause of death in infants, although the mechanisms leading to death remain unclear. Multiple theories have emerged over time, with one of the most influential hypotheses being the triple risk model. This model, first devised in 1972 and later revised in 1994 by Filiano and Kinney, is still widely used in assisting with conceptualising and understanding sudden death in infancy. This model has evolved over time, with each version stressing that SIDS is likely to occur when certain risk factors coincide, suggesting that the lethal mechanisms in SIDS are likely to be multifactorial. All versions of the triple risk model from 1972 to the present have emphasised the complexity of SIDS and serve as useful guides for current and future research into the enigma of sudden and unexpected death in infancy. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  4. Ignored Disease or Diagnostic Dustbin? Sudden Infant Death Syndrome in the British Context

    Science.gov (United States)

    Ferguson, Angus H.

    2015-01-01

    Sudden Infant Death Syndrome (SIDS) was defined in 1969 and incorporated into the International Classification of Diseases a decade later. To advocates of SIDS as a diagnosis, medical interest in sudden infant death was long overdue. However, the definition of SIDS lacked positive diagnostic criteria, provoking some to view it as a ‘diagnostic dustbin’ for the disposal of problematic cases where cause of death was unclear. This paper examines the development of medical interest in sudden infant death in Britain during the middle decades of the twentieth century. It highlights the importance of recognising the historicity of SIDS as a diagnosis facilitated by changes in law and medicine over the course of the nineteenth and twentieth centuries. It suggests that SIDS provides a definitive case study of the medicalisation of life and death, and a unique example of an officially recognised disease that had no symptoms, signs, pathology or patients. PMID:26217070

  5. Why and how to support screening strategies to prevent sudden death in athletes.

    Science.gov (United States)

    Thiene, Gaetano; Corrado, Domenico; Rigato, Ilaria; Basso, Cristina

    2012-05-01

    Sudden death in athletes occurs because of the existence of hidden cardiovascular disorders which, during effort, may jeopardize the electrical stability of the heart, triggering ventricular tachycardia and/or fibrillation. Apart from rare conditions of ion channel diseases in the setting of a structurally normal heart, in which the disorder may be easily diagnosed on basal or stress test ECG, cardiac abnormalities at risk of causing sudden death may affect the aorta (Marfan syndrome), the coronary arteries (congenital coronary artery anomalies, premature coronary atherosclerosis), the myocardium (hypertrophic and arrhythmogenic cardiomyopathy), the valves (bicuspid aortic valve, mitral valve prolapse) and the conduction system (pre-excitation syndromes). These structural heart disorders may be detected by ECG and/or echo. The employment of these tools at pre-participation screening can help to identify concealed anomalies, which may play a major role in early diagnosis, risk stratification, and prevention of sudden death.

  6. Sudden Cardiac Arrest due to Brugada Syndrome: a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    R Soleimanirad

    2013-04-01

    Full Text Available Brugada Syndrome is a rare cause of sudden cardiac arrest and has a unique ECG pattern. In fact, with ST-segment elevation down sloping in the right precordial leads (v1-v3, RBBB pattern in lateral leads and J-point elevation is revealed. We must notice and avoid trigger factors of this syndrome during general anesthesia. Patient is a 39 old man who attended to emergency department with sudden cardiac arrest and resuscitate. He was transferred to ICU for management of hypoxic ischemic encephalopathy. Complementary studies concluded the diagnosis of Brugada syndrome. We must consider Brugada syndrome within patients with family history of sudden cardiac arrest. Moreover, we must avoid trigger factors of this syndrome such as fever, bradicardia and electrolyte abnormality (specialy Na, Ca abnormalities during general anesthesia and if they appear, we should treat them.

  7. SUDDEN NATURAL DEATHS IN MEDICOLEGAL CASES- AN AUTOPSY BASED STUDY

    Directory of Open Access Journals (Sweden)

    C. S. Sreedevi

    2017-01-01

    Full Text Available BACKGROUND Death occurring in apparently healthy individual in a case of natural death may arise suspicion of foul play. In these circumstances these cases may be subjected to medicolegal autopsy. The disease condition may be unknown to the individual and the relatives. This study was done to review the exact cause of death in sudden unexpected deaths, and enabling or assisting the legal authorities in detection of crime, to prove or disprove the foul play. Body mass index is the most frequently used indicator of body fatness. An attempt is made to find out whether there is any significant relationship between BMI and the risk for sudden cardiac death. MATERIALS AND METHODS Data of 50 cases of sudden unexpected death brought for medicolegal autopsy at govt. T.D. medical college Alappuzha in the year 2010 were studied and information were collected from the postmortem records. Data was entered in the proforma. The histopathological examination findings of relevant cases were studied. Analysis was done using MS EXCEL and Chi-square test was used as the test of significance in the comparison between two categorical variables. RESULTS In 50 cases, male predominance was observed and 88% were males in which 50% of males died of atherosclerotic occlusive coronary artery disease and among females 33% died of myocardial infarction. While considering the systemic distribution of cause of death, the cardiovascular system was found to be most commonly affected, 33 cases (66% followed by respiratory system 7 cases (14%. In 4 (8% cases gastrointestinal system was affected. In Two cases (4% central nervous system was affected and others were generalized infection, which constituted 2 cases. Out of 33 cases observed in cardiovascular system the commonest cause being the atherosclerotic occlusive coronary artery diseases involving 27 cases (81.81% in which the predominant involvement was seen in left anterior descending artery 21 cases (77.77% followed by right

  8. "I Was in Year 5 and I Failed Maths": Identifying the Range and Causes of Maths Anxiety in First Year Pre-Service Teachers

    Science.gov (United States)

    Wilson, Sue

    2015-01-01

    Mathematics anxiety affects primary pre-service teachers' engagement with and future teaching of mathematics. The study aimed to assess the level and range of mathematics anxiety in first year pre-service teachers entering their teacher education course, and to investigate the sources of this anxiety as perceived and identified by them. Data…

  9. Douglas-fir tussock moth- and Douglas-fir beetle-caused mortality in a ponderosa pine/Douglas-fir forest in the Colorado Front Range, USA

    Science.gov (United States)

    Jose F. Negron; Ann M. Lynch; Willis C. Schaupp; Vladimir Bocharnikov

    2014-01-01

    An outbreak of the Douglas-fir tussock moth, Orgyia pseudotsugata McDunnough, occurred in the South Platte River drainage on the Pike-San Isabel National Forest in the Colorado Front Range attacking Douglas-fir, Pseudotsuga menziesii (Mirb.) Franco. Stocking levels, species composition, and tree size in heavily and lightly defoliated stands were similar. Douglas-fir...

  10. A numerical study on the flow through a plane symmetric sudden ...

    African Journals Online (AJOL)

    The numerical analysis and performance simulation of a sudden expansion with fence viewed as a diffuser are presented in this paper. SIMPLE algorithm is used to solve two-dimensional steady differential equations for conservation of mass and momentum. The Reynolds number is in the range of 20 to 100 and fence ...

  11. Sudden Oak Death-Induced Tanoak Mortality in Coast Redwood Forests: Current and Predicted Impacts to Stand Structure

    Directory of Open Access Journals (Sweden)

    Kevin L. O’Hara

    2010-08-01

    Full Text Available Tanoak (Notholithocarpus densiflorus syn. Lithocarpus densiflorus is one of the most widespread and abundant associates of coast redwood (Sequoia sempervirens, but little is known about the structural relationships between these two species. Knowledge of such relationships is essential for a thorough understanding of the impacts of sudden oak death (caused by the exotic pathogen Phytophthora ramorum, which is currently decimating tanoak populations throughout the redwood range. In this study, we utilized a stratified plot design and a stand reconstruction technique to assess structural impacts, at present and in the future, of this emerging disease. We found that residual trees in diseased plots were more aggregated than trees in unaffected plots, and we predicted that the loss of tanoak will lead to the following short-term changes: greater average diameter, height, height-to-live-crown, and crown length, as well as an increase in average nearest neighbor differences for diameter, height, and crown length. In addition, plots lacking tanoak (living or dead—as compared to plots with tanoak—exhibited greater average diameter and increased nearest neighbor differences with regard to diameter, height, and crown length. We also conducted a preliminary exploration of how sudden oak death-induced structural changes compare with typical old-growth characteristics, and how this disease may affect the structure of old-growth forests.

  12. Takayasu Arteritis of the Coronary Arteries Presenting as Sudden Death in a White Teenager.

    Science.gov (United States)

    Hlavaty, Leigh; Diaz, Francisco; Sung, LokMan

    2015-09-01

    Takayasu arteritis is a rare disease that expresses chronic, large vessel inflammation. The etiology remains unclear and its presentation depends on the affected arteries. With coronary artery involvement, manifestations range from chest pain and shortness of breath to sudden death. We report a case of a 15-year-old white girl who presented with syncope immediately before passing. On autopsy, all 3 major coronary arteries grossly contained multiple proximal lesions that were consistent with Takayasu arteritis, microscopically. Takayasu arteritis solely affecting multiple coronary arteries is exceedingly rare. This report discusses the significance of coronary involvement in Takayasu arteritis at autopsy and sudden death.

  13. Adaptation to sudden unexpected loading of the low back--the effects of repeated trials.

    Science.gov (United States)

    Skotte, J H; Fallentin, N; Pedersen, M T; Essendrop, M; Strøyer, J; Schibye, B

    2004-10-01

    The purpose of this study was to investigate short-term changes in reactions to sudden unexpected loading of the low back. The study utilized a set-up where a horizontal force of 58 N pointing forward suddenly was applied to the upper part of the subject's trunk. EMG activity from the erector spinae muscles and trunk movement data were recorded during 10 trials for 19 subjects. The analysis included EMG reaction time, mean rectified EMG amplitude during the period 50-250 ms after the sudden loading, and time elapsed until stopping of the forward movement of the trunk (stopping time). Reaction time means ranged from 66 to 97 ms (79+/-9 ms), and no difference was found between the trials. Conversely, the mean stopping time for the first trial (468 ms) was significantly higher than for trials 3-10 (359- 371 ms), and the average EMG amplitude during the period 50-250 ms after the sudden loading was lower for the first trial. This study showed that some subjects adapted to sudden unexpected loadings of the low back through a reduction in stopping time and a progression in EMG response during the first few trials. This possible adaptation to repeated trials have been overlooked in previous studies.

  14. Natural and Undetermined Sudden Death: Value of Post-Mortem Genetic Investigation.

    Directory of Open Access Journals (Sweden)

    Olallo Sanchez

    Full Text Available Sudden unexplained death may be the first manifestation of an unknown inherited cardiac disease. Current genetic technologies may enable the unraveling of an etiology and the identification of relatives at risk. The aim of our study was to define the etiology of natural deaths, younger than 50 years of age, and to investigate whether genetic defects associated with cardiac diseases could provide a potential etiology for the unexplained cases.Our cohort included a total of 789 consecutive cases (77.19% males <50 years old (average 38.6±12.2 years old who died suddenly from non-violent causes. A comprehensive autopsy was performed according to current forensic guidelines. During autopsy a cause of death was identified in most cases (81.1%, mainly due to cardiac alterations (56.87%. In unexplained cases, genetic analysis of the main genes associated with sudden cardiac death was performed using Next Generation Sequencing technology. Genetic analysis was performed in suspected inherited diseases (cardiomyopathy and in unexplained death, with identification of potentially pathogenic variants in nearly 50% and 40% of samples, respectively.Cardiac disease is the most important cause of sudden death, especially after the age of 40. Close to 10% of cases may remain unexplained after a complete autopsy investigation. Molecular autopsy may provide an explanation for a significant part of these unexplained cases. Identification of genetic variations enables genetic counseling and undertaking of preventive measures in relatives at risk.

  15. Aortic Dissection and Sudden Unexpected Deaths: A Retrospective Study of 31 Forensic Autopsy Cases.

    Science.gov (United States)

    Li, Yang; Li, Ling; Mu, Hong-Shu; Fan, Shuan-Liang; He, Fang-Gang; Wang, Zhen-Yuan

    2015-09-01

    Acute aortic dissection (AAD) is the most common cause of sudden unexpected death related to aortic diseases. A retrospective study of 31 sudden unexpected deaths caused by AAD was conducted at Xi'an Jiaotong University Forensic Center from 2001 to 2012. We summarized the forensic characteristics of AAD and assessed the clinically diagnostic accuracy of AAD. The characteristics of sudden unexpected death due to AAD were male predominant (male: female=6.7:1), relatively young with the mean age of 44, and predominance of type A dissection (77.4%). Cardiac tamponade was the most frequent cause of sudden death (87.1%). Of the 31 cases, 26 (83.9%) patients were not recognized clinically and were misdiagnosed with acute myocardial infarction, coronary artery disease, cholecystitis, acute gastroenteritis, renal/urinary lithiasis, or acute pancreatitis. In summary, AAD can be difficult to recognize, diagnosis is therefore sometimes delayed or missed. The medicolegal death investigation can help physicians have a better understanding of AAD. © 2015 American Academy of Forensic Sciences.

  16. Sudden cardiac death in athletes and its preventive strategies: review article

    Directory of Open Access Journals (Sweden)

    Farzin Halabchi

    2017-12-01

    Full Text Available Sudden cardiac death in sport, although rare, but is a tragic event, attracting the media and public attention. Sport and exercise may act as a trigger for sudden cardiac death. Risk of sudden death in young athletes with cardiovascular disease is 2.5 times more frequent than non-athlete individuals. More than 90% of cases of sudden death occur during or immediately after training or competition. Incidence of sudden cardiac death in any population, including athletes, is related to multiple factors such as gender, age, race, nationality, diagnostic screening methods and preventive measures for sudden cardiac death. Otherwise, incidence rate of sudden cardiac death is linked to the used definition and method of diagnosis. Different cardiovascular disorders may result in death of young athletes and hypertrophic cardiomyopathy, congenital coronary anomalies, arrhythmogenic right ventricular dysplasia and aortic rupture are among the most common causes. Marfan syndrome, dilated cardiomyopathy, viral myocarditis, Wolff-Parkinson-White (WPW syndrome, congenital long QT syndrome, Brugada syndrome and commotio cordis are reported as other etiologies. In older athletes (more than 35 years, ischemic coronary heart disease is responsible for majority of the cases similar to the general population. Because the outcome of sudden cardiac arrest in sports is very poor except in few cases, proper national strategies are needed to diminish the burden of sudden death in young athletes. It seems that there are two main strategies to achieve this goal: A Primary prevention with use of purposeful pre-participation evaluation programs. This evaluation should focuss on the proper history and physical examination. Nevertheless, there is significant debate between American and European countries regarding the use of paraclinical investigations (especially ECG. American heart association does not recommend ECG as an essential part of evaluation. In contrast, European

  17. Lyme disease: sudden hearing loss as the sole presentation.

    Science.gov (United States)

    Espiney Amaro, C; Montalvão, P; Huins, C; Saraiva, J

    2015-02-01

    Lyme disease is an uncommon tick-borne multisystemic infection caused by Borrelia burgdorferi. The most common clinical manifestation is erythema migrans. In this report, a very unusual presentation of this condition is described, in which sudden onset sensorineural hearing loss was the sole presenting symptom. Case report and review of English-language literature. A patient presented with sensorineural hearing loss, with no other symptoms or signs. Acute Lyme infection was detected by laboratory tests. Magnetic resonance imaging showed signs of labyrinthitis of the same inner ear. After hyperbaric oxygen and systemic antibiotic treatment, the patient showed total hearing recovery, and magnetic resonance imaging showed complete resolution of the labyrinthitis. To our knowledge, this is the first reported case of Lyme disease presenting only with sensorineural hearing loss. Borreliosis should be considered as an aetiological factor in sensorineural hearing loss. Adequate treatment may provide total recovery and prevent more severe forms of Lyme disease.

  18. Aortoiliac occlusive disease presenting as sudden onset paraplegia.

    Science.gov (United States)

    Lai, Chien-Hung; Wang, Cheng-Hsien; Wu, Shih-Yun; Shih, Hong-Mo

    2014-07-01

    Thromboembolism and atherosclerotic stenosis both can cause arterial occlusion. Aortoiliac occlusive disease involving bifurcation of the aortoiliac artery induces symptoms of ischemia such as claudication and pain of buttocks and thighs, decreased bilateral femoral pulses, and impotence. Here, we describe a 58-year-old woman with a past history of atrial fibrillation and lacuna stroke with minimal right side weakness. She presented to our emergency department with sudden onset bilateral pain in the legs and paraplegia. A comprehensive examination revealed paresthesia and decreasing bilateral distal pulses. Computed tomographic imaging showed filling defects over the low abdominal aorta just above the bifurcation of the common iliac artery and bilateral femoral arteries. Acute aortic embolic occlusion was suspected. Her symptoms were resolved after emergent thrombectomy for acute limb ischemia. Physicians need to be aware of aortoiliac embolic occlusive disease which may present as acute paraplegia. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Ventricular arrhythmias and sudden death in tetralogy of Fallot.

    Science.gov (United States)

    Maury, Philippe; Sacher, Frederic; Rollin, Anne; Mondoly, Pierre; Duparc, Alexandre; Zeppenfeld, Katja; Hascoet, Sebastien

    2017-05-01

    Malignant ventricular arrhythmias and sudden cardiac death may late happen in repaired tetralogy of Fallot, although probably less frequently than previously thought, especially with the advent of new surgical techniques/management. Ventricular tachycardias are caused by reentry around the surgical scars/patches and valves. Many predictive factors have been proposed, which suffer from poor accuracy. There is currently no recommended indication for prophylactic implantable cardioverter defibrillator implantation-except maybe in the case of multiple risk factors-while radiofrequncy ablation may be proposed in secondary prevention with or even without a back-up implantable cardioverter defibrillator in selected cases. Repeated cardiological investigations and monitoring should be proposed for every operated patient. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Sudden infant death syndrome and abnormal metabolism of thiamin.

    Science.gov (United States)

    Lonsdale, Derrick

    2015-12-01

    Although it has been generally accepted that moving the infant from the prone to the supine position has solved the problem of sudden infant death syndrome (SIDS), it has been hypothesized that this is an insufficient explanation and that a mixture of genetic risk, some form of stressful incident and marginal brain metabolism is proportionately required. It is suggested that each of these three variables, with dominance in one or more of them, act together in the common etiology. Much has been written about the association of thiamin and magnesium but the finding of extremely high concentrations of serum thiamin in SIDs victims has largely caused rejection of thiamin as being involved in the etiology. The publication of abnormal brainstem auditory evoked potentials strongly suggests that there are electrochemical changes in the brainstem affecting the mechanisms of automatic breathing and the control of cardiac rhythm. The brainstem, cerebellum and limbic system of the brain are known to be highly sensitive to thiamin deficiency (pseudo-hypoxia) and the pathophysiology is similar to a mild continued deprivation of oxygen. Little attention has been paid to the complex metabolism of thiamin. Dietary thiamin requires the cooperation of the SLC19 family of thiamin transporters for its absorption into cells and recent information has shown that transporter SNPs may be relatively common and can be expected to increase genetic risk. Thiamin must be phosphorylated to synthesize thiamin pyrophosphate (TPP), well established in its vital action in glucose metabolism. TPP is also a cofactor for the enzyme 2-hydroxyacyl-CoA lyase (HACL1) in the peroxisome, emphasizing its importance in alpha oxidation and plasmalogen synthesis in cell membrane physiology. The importance of thiamine triphosphate (TTP) in energy metabolism is still largely unknown. Thiamin metabolism has been implicated in hyperemesis gravidarum and iatrogenic Wernicke encephalopathy has been reported when the

  1. Disruption of SATB2 or its long-range cis-regulation by SOX9 causes a syndromic form of Pierre Robin sequence.

    Science.gov (United States)

    Rainger, Jacqueline K; Bhatia, Shipra; Bengani, Hemant; Gautier, Philippe; Rainger, Joe; Pearson, Matt; Ansari, Morad; Crow, Jayne; Mehendale, Felicity; Palinkasova, Bozena; Dixon, Michael J; Thompson, Pamela J; Matarin, Mar; Sisodiya, Sanjay M; Kleinjan, Dirk A; Fitzpatrick, David R

    2014-05-15

    Heterozygous loss-of-function (LOF) mutations in the gene encoding the DNA-binding protein, SATB2, result in micrognathia and cleft palate in both humans and mice. In three unrelated individuals, we show that translocation breakpoints (BPs) up to 896 kb 3' of SATB2 polyadenylation site cause a phenotype which is indistinguishable from that caused by SATB2 LOF mutations. This syndrome comprises long nose, small mouth, micrognathia, cleft palate, arachnodactyly and intellectual disability. These BPs map to a gene desert between PLCL1 and SATB2. We identified three putative cis-regulatory elements (CRE1-3) using a comparative genomic approach each of which would be placed in trans relative to SATB2 by all three BPs. CRE1-3 each bind p300 and mono-methylated H3K4 consistent with enhancer function. In silico analysis suggested that CRE1-3 contain one or more conserved SOX9-binding sites, and this binding was confirmed using chromatin immunoprecipitation on cells derived from mouse embryonic pharyngeal arch. Interphase bacterial artificial chromosome fluorescence in situ hybridization measurements in embryonic craniofacial tissues showed that the orthologous region in mice exhibits Satb2 expression-dependent chromatin decondensation consistent with Satb2 being a target gene of CRE1-3. To assess their in vivo function, we made multiple stable reporter transgenic lines for each enhancer in zebrafish. CRE2 was shown to drive SATB2-like expression in the embryonic craniofacial region. This expression could be eliminated by mutating the SOX9-binding site of CRE2. These observations suggest that SATB2 and SOX9 may be acting together via complex cis-regulation to coordinate the growth of the developing jaw.

  2. Cardiac Potassium Channel Dysfunction in Sudden Infant Death Syndrome

    Science.gov (United States)

    Rhodes, Troy E.; Abraham, Robert A.; Welch, Richard C.; Vanoye, Carlos G.; Crotti, Lia; Arnestad, Marianne; Insolia, Roberto; Pedrazzini, Matteo; Ferrandi, Chiara; Vege, Ashild; Rognum, Torleiv; Roden, Dan M.; Schwartz, Peter J.; George, Alfred L.

    2008-01-01

    Life-threatening arrhythmias have been suspected as one cause of the sudden infant death syndrome (SIDS), and this hypothesis is supported by the observation that mutations in arrhythmia susceptibility genes occur in 5–10% of cases. However, the functional consequences of cardiac potassium channel gene mutations associated with SIDS and how these alleles might mechanistically predispose to sudden death are unknown. To address these questions, we studied four missense KCNH2 (encoding HERG) variants, one compound KCNH2 genotype, and a missense KCNQ1 mutation all previously identified in Norwegian SIDS cases. Three of the six variants exhibited functional impairments while three were biophysically similar to wild-type channels (KCNH2 variants V279M, R885C, S1040G). When coexpressed with WT-HERG, R273Q and K897T/R954C generated currents resembling the rapid component of the cardiac delayed rectifier current (IKr) but with significantly diminished amplitude. Action potential modeling demonstrated that this level of functional impairment was sufficient to evoke increased action potential duration and pause-dependent early afterdepolarizations. By contrast, KCNQ1-I274V causes a gain-of-function in IKs characterized by increased current density, faster activation, and slower deactivation leading to accumulation of instantaneous current upon repeated stimulation. Action potential simulations using a Markov model of heterozygous I274V-IKs incorporated into the Luo-Rudy (LRd) ventricular cell model demonstrated marked rate-dependent shortening of action potential duration predicting a short QT phenotype. Our results indicate that certain potassium channel mutations associated with SIDS confer overt functional defects consistent with either LQTS or SQTS, and further emphasize the role of congenital arrhythmia susceptibility in this syndrome. PMID:18222468

  3. The sudden emergence of pathogenicity in insect–fungus symbioses threatens naive forest ecosystems

    Science.gov (United States)

    Hulcr, Jiri; Dunn, Robert R.

    2011-01-01

    Invasive symbioses between wood-boring insects and fungi are emerging as a new and currently uncontrollable threat to forest ecosystems, as well as fruit and timber industries throughout the world. The bark and ambrosia beetles (Curculionidae: Scolytinae and Platypodinae) constitute the large majority of these pests, and are accompanied by a diverse community of fungal symbionts. Increasingly, some invasive symbioses are shifting from non-pathogenic saprotrophy in native ranges to a prolific tree-killing in invaded ranges, and are causing significant damage. In this paper, we review the current understanding of invasive insect–fungus symbioses. We then ask why some symbioses that evolved as non-pathogenic saprotrophs, turn into major tree-killers in non-native regions. We argue that a purely pathology-centred view of the guild is not sufficient for explaining the lethal encounters between exotic symbionts and naive trees. Instead, we propose several testable hypotheses that, if correct, lead to the conclusion that the sudden emergence of pathogenicity is a new evolutionary phenomenon with global biogeographical dynamics. To date, evidence suggests that virulence of the symbioses in invaded ranges is often triggered when several factors coincide: (i) invasion into territories with naive trees, (ii) the ability of the fungus to either overcome resistance of the naive host or trigger a suicidal over-reaction, and (iii) an ‘olfactory mismatch’ in the insect whereby a subset of live trees is perceived as dead and suitable for colonization. We suggest that individual cases of tree mortality caused by invasive insect–fungus symbionts should no longer be studied separately, but in a global, biogeographically and phylogenetically explicit comparative framework. PMID:21752822

  4. Risky behaviors of mothers with infants on sudden infant death syndrome in Turkey.

    Science.gov (United States)

    Erdoğan, Çiğdem; Turan, Türkan

    2017-12-02

    Sudden infant death syndrome is the most common cause of death during the post-neonatal period. Factors such as sleeping position, bed sharing, pillow use, smoking during pregnancy and the breastfeeding period constitute risk factors for sudden infant death syndrome. This study aims to identify the risky behaviors of mothers with infants that may put their children at risk for sudden infant death syndrome. This is a cross-sectional, descriptive study. Data were collected using a questionnaire that was developed by the researchers. The questionnaire was filled out by 456 mothers who applied to the family health center between October 2014 and January 2015. The greatest risk factor is the infant's sleeping position. A total of 77.9% of the mothers put their babies in bed in a non-supine position; 65.8% used a pillow when they put their babies in bed, 52.9% used a soft mattress, and 28.5% shared their beds with their babies. Prone sleeping was more likely to occur when smoke was present in the home or a pillow was used. Nurses should notify families of the risky behaviors that can cause sudden infant death syndrome and plan appropriate nursing care. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. 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.

  6. Serotypes of Escherichia coli in sudden infant death syndrome.

    Science.gov (United States)

    Pearce, J L; Bettelheim, K A; Luke, R K J; Goldwater, P N

    2010-02-01

    To examine the diversity of Escherichia coli serotypes found in the intestinal contents of infants who died of Sudden Infant Death Syndrome (SIDS) compared with that in comparison infants. Over the 3-year period, 1989-1991, in South Australia and Victoria (Australia), a total of 687 E. coli isolates from 231 patients with SIDS (348 isolates), 98 infants who had died from other causes (144 isolates) and 160 healthy infants (195 isolates) were studied. The isolates from patients with SIDS were found to represent 119 different serotypes; the isolates from 'other cause' infants represent 97 different serotypes; and the isolates from healthy infants represent 117 different serotypes. The seven common serotypes isolated most frequently from infants with SIDS belonged to those associated with extra-intestinal infections in humans. Compared to healthy infants (6%), these were found in significantly higher proportions among infants who died of other causes (13%, P < 0.05) or infants with SIDS (18.7%, P = 0.0002). Despite these sources yielding a wide variety of serotypes of E. coli, a pattern of certain potential pathotypes of E. coli being associated with SIDS is apparent. While SIDS remains one of the most important diagnoses of postneonatal death, its causes are still unexplained. If E. coli has a role in the pathogenesis of SIDS (as suggested by the pathotypes identified on the basis of serotype), further studies may reveal novel virulence factors that may clarify the role of this bacterium in SIDS.

  7. Febrile seizures prior to sudden cardiac death

    DEFF Research Database (Denmark)

    Stampe, Niels Kjær; Glinge, Charlotte; Jabbari, Reza

    2018-01-01

    Aims: Febrile seizure (FS) is a common disorder affecting 2-5% of children up to 5 years of age. The aim of this study was to determine whether FS in early childhood are over-represented in young adults dying from sudden cardiac death (SCD). Methods and results: We included all deaths (n = 4595...... with FS was sudden arrhythmic death syndrome (5/8; 62.5%). Conclusion: In conclusion, this study demonstrates a significantly two-fold increase in the frequency of FS prior to death in young SCD cases compared with the two control groups, suggesting that FS could potentially contribute in a risk......) nationwide and through review of all death certificates, we identified 245 SCD in Danes aged 1-30 years in 2000-09. Through the usage of nationwide registries, we identified all persons admitted with first FS among SCD cases (14/245; 5.7%) and in the corresponding living Danish population (71 027/2 369 785...

  8. Novel interactions between wildfire and sudden oak death influence sexual and asexual regeneration in coast redwood forests

    Science.gov (United States)

    Allison B. Simler; Margaret R. Metz; Ross K. Meentemeyer; Kerri M. Frangioso; David M. Rizzo

    2017-01-01

    Novel interactions between compounded disturbances can leave lasting ecological legacies on communities and alter regeneration trajectories. Sudden oak death (SOD), caused by Phytophthora ramorum, is a biotic disturbance, an emerging disease causing widespread oak and tanoak mortality in California’s coastal forests....

  9. Sudden sensorineural hearing loss and vertigo associated with arterial occlusive disease: three case reports and literature review

    OpenAIRE

    Castro Junior, Ney Penteado de; Almeida, Clemente Isnard Ribeiro de; Campos, Carlos Alberto Herrerias de

    2007-01-01

    Sudden sensorineural hearing loss and vertigo (SSNHLV) has multifactorial causes, of which viral, autoimmune and vascular insufficiency are the most common. The therapeutic management for SSNHLV includes antiviral drugs, corticosteroids, vasodilators, normovolemic hemodilution therapy and hyperbaric oxygen therapy. Vertebrobasilar occlusive disease and carotid occlusive disease are seldom related to SSNHLV. Discussions concerning SSNHLV caused by occlusive vascular disease are important and n...

  10. Ancient isolation and independent evolution of the three clonal lineages of the exotic sudden oak death pathogen Phytophthora ramorum

    Science.gov (United States)

    E.M. Goss; I. Carbone; N.J. Grünwald

    2009-01-01

    The genus Phytophthora includes some of the most destructive plant pathogens affecting agricultural and native ecosystems and is responsible for a number of recent emerging and re-emerging infectious diseases of plants. Sudden oak death, caused by the exotic pathogen P. ramorum, has caused extensive mortality of oaks...

  11. Differentiation in stag beetles, Neolucanus swinhoei complex (Coleoptera: Lucanidae): four major lineages caused by periodical Pleistocene glaciations and separation by a mountain range.

    Science.gov (United States)

    Tsai, Cheng-Lung; Wan, Xia; Yeh, Wen-Bin

    2014-09-01

    Taxonomic debates on Neolucanus swinhoei complex consisting of N. swinhoei, N. doro doro, N. doro horaguchii, and N. euganiae, distributed exclusively in Taiwan, have been ongoing for several decades because of their overlapping morphological characters. To clarify their taxonomic status and phylogeographical history, we analyzed nine morphological characteristics and four molecular amplicons. Phylogenetic inferences based on COI+16S rDNA+wingless showed one eastern and three western lineages, with the latter consisting of one low-hill and two montane lineages. Intermingled DNA sequences from different populations within each lineage, many low FST values, and a high variance component between lineages indicate the possibility of gene flow among populations. However, positive relationships were observed between the genetic divergences of 16S rDNA and its FST values with geographic distance. A divergence estimation based on COI+16S revealed that these beetles might have originated from Asian mainland and differentiated into western and eastern lineages ca. 1Mya, with the differentiation of the western lineages occurring approximately 0.50-0.75Mya. Isolation by mountain ranges and limited flying capability of these beetles as well as populations retreat to and expansion from refugia in response to glaciation cycles have resulted in the current distribution of N. swinhoei complex. Although most morphological characters are variable and undistinguishable, multi-dimensional scaling analysis based on measurable characteristics could recognize hill N. swinhoei as a cluster distinct from the others. However, based on the realities of genetic admixture, shared phylogeographical history and overlapping characteristics, all of these stag beetles should be regarded as Neolucanus swinhoei Bates, 1866. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Contrast-enhanced MR imaging of the endolymphatic sac in patients with sudden hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Naganawa, Shinji; Koshikawa, Tokiko; Fukatsu, Hiroshi; Ishigaki, Takeo [Department of Radiology, Nagoya University School of Medicine (Japan); Nakashima, Tsutomu [Department of Otolayngology, Nagoya University School of Medicine (Japan); Ichinose, Nobuyasu [Toshiba Nasu Operations, Tochigi (Japan)

    2002-05-01

    Our objective was to evaluate the frequency of contrast enhancement of the endolymphatic sac in patients with sudden hearing loss. Forty consecutive patients with sudden sensorineural hearing loss (20 males and 20 females; age range 11-82 years), 40 age-matched control subjects, and 5 patients with Meniere's disease were examined using the same imaging protocol on a 1.5-T MR system. Pre- and post-contrast-enhanced T1-weighted 3D spoiled gradient-echo sequence (3D SPGR; TR/TE=23/10 ms, no. of excitations=1, flip angle=30 ) images were obtained using a voxel size of 0.6 x 0.7 x 0.8 mm{sup 3}. Contrast enhancement in the area of the endolymphatic sac was assessed by two radiologists, and the frequency of contrast enhancement was compared between the three study groups. Enhancement of the ipsilateral endolymphatic sac was observed in 30 of the 40 patients with sudden hearing loss (75%). Twenty of these 30 patients also showed enhancement on the contralateral side, and 1 patient showed enhancement only on the contralateral side. Only 1 of the 5 patients with Meniere's disease showed enhancement. Nine of the 40 control subjects (22.5%) showed enhancement (bilateral enhancement in 5 subjects, unilateral in 4). The frequency of enhancement in patients with sudden hearing loss was significantly higher than that in control subjects (P<0.0001) or patients with Meniere's disease (P<0.05). The frequency of contrast enhancement of the endolymphatic sac is significantly increased in patients with sudden hearing loss, but further study is necessary to clarify the relationship between this finding and the pathophysiology of sudden hearing loss. (orig.)

  13. The stigma perceived by people bereaved by suicide and other sudden deaths: A cross-sectional UK study of 3432 bereaved adults.

    Science.gov (United States)

    Pitman, Alexandra L; Osborn, David P J; Rantell, Khadija; King, Michael B

    2016-08-01

    To test the hypothesis that perceived stigma scores in young adults bereaved by suicide are significantly higher than in young adults bereaved by other sudden deaths, whether blood-related to the deceased or not. We conducted a cross-sectional study of all staff and students aged 18-40 at 37 UK higher educational institutions in 2010, and identified 3432 respondents who had experienced a sudden bereavement of a close contact since reaching the age of 10, either due to sudden natural causes, sudden unnatural causes, or suicide. We used multivariable regression to compare scores on the stigma, shame, responsibility and guilt subscales of the Grief Experience Questionnaire, adjusting for socio-demographic factors and pre-bereavement psychopathology. People bereaved by suicide (n=614) had higher stigma scores than people bereaved by sudden natural death (n=2106; adjusted coefficient=2.52; 95% CI=2.13-2.90; p=people bereaved by sudden unnatural death (n=712; adjusted coefficient=1.69; 95% CI=1.25-2.13; p=people bereaved by suicide, whether compared with bereavement by sudden natural death or sudden unnatural death. Associations were not modified by whether the bereaved was blood-related to the deceased or not. Stigma was perceived more acutely by the relatives and friends of those who died by suicide than those bereaved by other causes of sudden natural or sudden unnatural death. Their high levels of perceived stigma, shame, responsibility and guilt require qualitative investigation to identify whether these grief dimensions limit social functioning, help-seeking behaviour and/or support offered. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  14. [Sudden cardiac death: A better understanting for a better prevention].

    Science.gov (United States)

    Waldmann, V; Bougouin, W; Karam, N; Albuisson, J; Cariou, A; Jouven, X; Marijon, E

    2017-09-01

    Sudden cardiac death is defined as a natural and unexpected death, in a previous apparently healthy individual. It represents a major public health issue, with up to 50% of the cardiovascular mortality. Using data from the Paris Sudden Death Expertise Centre registry, this article summarises the main cardiovascular abnormalities associated with sudden cardiac death, the different preventives approaches, and provides a systematic diagnostic approach. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. Thrombus composition in sudden cardiac death from acute myocardial infarction.

    Science.gov (United States)

    Silvain, Johanne; Collet, Jean-Philippe; Guedeney, Paul; Varenne, Olivier; Nagaswami, Chandrasekaran; Maupain, Carole; Empana, Jean-Philippe; Boulanger, Chantal; Tafflet, Muriel; Manzo-Silberman, Stephane; Kerneis, Mathieu; Brugier, Delphine; Vignolles, Nicolas; Weisel, John W; Jouven, Xavier; Montalescot, Gilles; Spaulding, Christian

    2017-04-01

    It was hypothesized that the pattern of coronary occlusion (thrombus composition) might contribute to the onset of ventricular arrhythmia and sudden cardiac death (SCD) in myocardial infarction (MI). The TIDE (Thrombus and Inflammation in sudden DEath) study included patients with angiographically-proven acute coronary occlusion as the cause of a ST elevation MI (STEMI) complicated by Sudden Cardiac Death (SCD group) or not (STEMI group). Thrombi were obtained by thrombo-aspiration before primary percutaneous coronary stenting and analyzed with a quantitative method using scanning electron microscopy. We compared the composition of the thrombi responsible for the coronary occlusion between the two groups and evaluated factors influencing its composition. We included 121 patients and found that thrombus composition was not different between the SCD group (n=23) and the STEMI group (n=98) regarding content of fibrin fibers (60.3±18.4% vs. 62.4±18.4% respectively, p=0.68), platelets (16.3±19.2% vs. 15.616.7±%, p=0.76), erythrocytes (14.6±12.5% vs. 13±12.1%, p=0.73) and leukocytes (0.6±0.9% vs. 0.8±1.5%, p=0.93). Thrombus composition did not differ between patients receiving upstream-use of glycoprotein IIb/IIIa platelet receptor inhibitors (GPI) and patients free of GPI. The only factor found to influence thrombus composition was the ischemic time from symptom onset to primary PCI, with a decreased content in fibrin fibers (57.8±18.5% vs. 71.9±10.1%, p=0.0008) and a higher platelet content (19.2±19.1% vs. 7.9±5.7% p=0.014) in early presenters (6h of ischemic time). Composition of intracoronary thrombi in STEMI patients does not differ between those presenting with and without SCD. Time from symptom onset to coronary reperfusion seems to be the strongest factor influencing thrombus composition in MI. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. KRITERIA DIAGNOSIS DAN DIAGNOSIS BANDING SUDDEN DEAFNESS (SSNHL

    Directory of Open Access Journals (Sweden)

    Arvindan Subramaniam

    2016-03-01

    Full Text Available Introduction: Sudden deafness or sudden sensorineural hearing loss (SSNHL is defined as sensorineural hearing loss of more than 30 dB at three consecutive frequencies within 3 days of onset, often unilateral and idiopathic. Etiology of sudden deafness is still not known, but there are many theories put forward by the experts as a risk factor for sudden deafness. The prevalence of sudden deafness 5-30 per 100,000 people per year. Distribution of men and women almost equally, with the peak age of 50-60 years. Sudden deafness diagnosis is made based on history, physical examination and audiometry. Sudden deafness has three characteristics; acute, sensorineural hearing loss and unknown etiology. Additional characteristics may include vertigo, tinnitus and the absence of cranial nerve involvement. Management of sudden deafness include conservative therapy with multiple modalities. Case: Patient male, 40 years, Bali, Hindu present with hearing loss since ± 2 weeks ago. Patients previously complained of heat in the ear ± 2 days ago accompanied by a downward hearing and ears. A history of vomiting, coughs and colds denied. History of treatment at the hospital and was hospitalized for ± 2 weeks. Patients had never suffered from the same disease. No history of sinusitis, allergy, anemia, autoimmune and other systemic diseases. Patients also had never experienced trauma and underwent nasal surgery before. Keywords:sudden deafness, sensorineural, audiometry.

  17. Sudden unexpected death in a mouse model of Dravet syndrome

    Science.gov (United States)

    Kalume, Franck; Westenbroek, Ruth E.; Cheah, Christine S.; Yu, Frank H.; Oakley, John C.; Scheuer, Todd; Catterall, William A.

    2013-01-01

    Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in intractable epilepsies, but physiological mechanisms that lead to SUDEP are unknown. Dravet syndrome (DS) is an infantile-onset intractable epilepsy caused by heterozygous loss-of-function mutations in the SCN1A gene, which encodes brain type-I voltage-gated sodium channel NaV1.1. We studied the mechanism of premature death in Scn1a heterozygous KO mice and conditional brain- and cardiac-specific KOs. Video monitoring demonstrated that SUDEP occurred immediately following generalized tonic-clonic seizures. A history of multiple seizures was a strong risk factor for SUDEP. Combined video-electroencephalography-electrocardiography revealed suppressed interictal resting heart-rate variability and episodes of ictal bradycardia associated with the tonic phases of generalized tonic-clonic seizures. Prolonged atropine-sensitive ictal bradycardia preceded SUDEP. Similar studies in conditional KO mice demonstrated that brain, but not cardiac, KO of Scn1a produced cardiac and SUDEP phenotypes similar to those found in DS mice. Atropine or N-methyl scopolamine treatment reduced the incidence of ictal bradycardia and SUDEP in DS mice. These findings suggest that SUDEP is caused by apparent parasympathetic hyperactivity immediately following tonic-clonic seizures in DS mice, which leads to lethal bradycardia and electrical dysfunction of the ventricle. These results have important implications for prevention of SUDEP in DS patients. PMID:23524966

  18. Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following childhood sexual abuse

    Directory of Open Access Journals (Sweden)

    Antje Krüger

    2014-09-01

    Full Text Available Background: Exposure-based treatment approaches are first-line interventions for patients suffering from posttraumatic stress disorder (PTSD. However, the dissemination of exposure-based treatments for PTSD is challenging, as a large proportion of clinicians report being concerned about symptoms worsening as a result of this type of intervention and are therefore reluctant to offer it to patients with PTSD. However, there is only little empirical evidence to date on the pattern of symptom worsening during exposure-based treatment for PTSD. Objective: The goal of the present study was to explore the frequency of sudden losses and sudden gains in the course of an exposure-based treatment programme for female patients suffering from PTSD related to childhood sexual abuse who also show severe comorbidity. In addition, the relationship between sudden changes and treatment outcome was examined. Methods: Female participants (N=74 were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. The pattern of symptom change was assessed via weekly assessments using the Posttraumatic Diagnostic Scale (PDS. Sudden changes were computed as suggested by the literature on sudden gains. Results: During treatment, only one participant (3% experienced a sudden loss, whereas 25% of participants experienced sudden gains. In the waiting condition, 8% of the participants experienced sudden losses and 5% experienced sudden gains during the same time period. No symptom worsening was observed in response to exposure sessions. However, sudden gains occurred during exposure and non-exposure treatment weeks. Patients with sudden gains showed better treatment outcome in the post-treatment and follow-up assessments. Conclusions: Exposure-based treatment did not lead to PTSD symptom worsening in the study sample. Results show that sudden gains occur frequently during PTSD treatment and have a prognostic value for treatment outcome.

  19. Bursts of ULF noise excited by sudden changes of solar wind dynamic pressure

    Directory of Open Access Journals (Sweden)

    V. Safargaleev

    2002-11-01

    Full Text Available We present the results of analysis of the dayside magnetic pulsation response to a sudden change in solar wind dynamic pressure. We concentrate on the events when a burst or a series of short-lived bursts in the Pc1 frequency range with the repetition period of 7–15 min were observed on the ground around the local noon. Not every impulse of large amplitude caused this phenomenon. We have found that the ULF bursts were excited when the spectrograms of the DMSP satellites showed a signature of 10–30 keV ions in the vicinity of the magnetic flux tube of the ground observatory, that may be related to a geomagnetic storm preceding the event. In light of this finding a possible model of the phenomenon is suggested in which the hot protons influence significantly both the generation and modulation of Pc1 activity.Key words. Magnetospheric physics (solar wind – magnetosphere interaction; MHD waves and instabilities; storms and substorms

  20. Bursts of ULF noise excited by sudden changes of solar wind dynamic pressure

    Directory of Open Access Journals (Sweden)

    V. Safargaleev

    Full Text Available We present the results of analysis of the dayside magnetic pulsation response to a sudden change in solar wind dynamic pressure. We concentrate on the events when a burst or a series of short-lived bursts in the Pc1 frequency range with the repetition period of 7–15 min were observed on the ground around the local noon. Not every impulse of large amplitude caused this phenomenon. We have found that the ULF bursts were excited when the spectrograms of the DMSP satellites showed a signature of 10–30 keV ions in the vicinity of the magnetic flux tube of the ground observatory, that may be related to a geomagnetic storm preceding the event. In light of this finding a possible model of the phenomenon is suggested in which the hot protons influence significantly both the generation and modulation of Pc1 activity.

    Key words. Magnetospheric physics (solar wind – magnetosphere interaction; MHD waves and instabilities; storms and substorms

  1. Sudden Unexpected Death in a Child with Vomiting and Diarrhea due to Intracranial Mass Lesion

    Directory of Open Access Journals (Sweden)

    Esra Betül Akkoyun

    2017-12-01

    Full Text Available Nausea and vomiting are common sequelae of a multitude of disorders that can range from mild to severe conditions. Intracranial mass lesions can occasionally present with vomiting followed by acute neurological deterioration and sudden death, although they are usually accompanied by ongoing neurological symptoms. We aimed to report an unusual presentation of an intracranial mass resulting in death to increase awareness among pediatric emergency physicians. A previously healthy 15-month-old boy presented to the pediatric emergency department (PED with nausea, vomiting and diarrhea. He did not have any symptom of a neurological disorder. He acutely deteriorated, developed cardiopulmonary arrest and was intubated. His cranial computed tomography showed dilatation of the third and the lateral ventricles caused by a 3x4x2 cm tumor in the posterior fossa with an evidence of hemorrhage in the tumor with minimal tonsillar herniation. An emergent extra-ventricular drainage was performed to relieve elevated intracranial pressure. He did not show any improvement and died 9 hours after admission. Common symptoms in PED like nausea and vomiting are mostly due to benign etiologies such as gastroenteritis. One should always keep in mind that there may be an underlying intracranial pathology and further investigation should not be delayed.

  2. Sudden infant death triggered by dive reflex

    Science.gov (United States)

    Matturri, L; Ottaviani, G; Lavezzi, A M

    2005-01-01

    The dive reflex is the reflex mechanism most frequently considered in the aetiopathogenesis of sudden infant death syndrome (SIDS). This seems to persist in human beings as an inheritance from diver birds and amphibians. It has been reported that washing the face with cold water or plunging into cold water can provoke cardiac deceleration through the intervention of the ambiguus and the vagal dorsal nuclei. This report describes a case of SIDS that offers a unique insight into the role of the dive reflex in determining a lethal outcome. Examination of the brainstem on serial sections revealed severe bilateral hypoplasia of the arcuate nucleus and gliosis of the other cardiorespiratory medullary nuclei. The coronary and cardiac conduction arteries presented early atherosclerotic lesions. The possible role of parental cigarette smoking in the pathogenesis of arcuate nucleus hypoplasia and early coronary atherosclerotic lesions is also discussed. PMID:15623488

  3. Pathophysiology and prevention of sudden cardiac death.

    Science.gov (United States)

    Goyal, Vineet; Jassal, Davinder S; Dhalla, Naranjan S

    2016-03-01

    Sudden cardiac death (SCD) is known to occur in individuals with diverse diseases. Each disease state has a specific etiology and pathophysiology, and is diagnosed and treated differently. Etiologies for SCD include cardiac arrhythmias, coronary artery disease, congenital coronary artery anomalies, hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, dilated cardiomyopathy, and aortic valve stenosis. A potential unifying mechanism of SCD in these diseases involves a massive stimulation of the sympathetic nervous system's stress response and the subsequent elevation of circulating catecholamines. The diagnosis of cardiac diseases that contribute to an increased risk for SCD is accomplished by a combination of different techniques including electrocardiography, echocardiography, magnetic resonance imaging, and invasive cardiac catheterization. Several therapies including anti-arrhythmic drugs, β-blockers, and antiplatelet agents may be used as medical treatment in patients for the prevention of SCD. Invasive therapies including percutaneous angioplasty, coronary artery bypass surgery, and implantable cardioverter-defibrillators are also used in the clinical management of SCD.

  4. Escherichia coli and Sudden Infant Death Syndrome.

    Science.gov (United States)

    Bettelheim, Karl A; Goldwater, Paul N

    2015-01-01

    This review examines the association of strains of Escherichia coli with sudden infant death syndrome (SIDS) and the possible role these bacteria play in this enigmatic condition. The review addresses evidence for E. coli in SIDS infants, potential sources of E. coli in the environment, colonization by commensal and pathogenic strains, the variety of currently accepted pathotypes, and how these pathotypes could compromise intestinal integrity and induce inflammation. Both intestinal and extraintestinal pathotypes are compared in relation to the apparent liability in which virulence traits can be gained or lost by strains of E. coli. The way in which E. coli infections fit with current views on infant sleeping position and other SIDS risk factors is highlighted.

  5. Escherichia coli and Sudden Infant Death Syndrome

    Directory of Open Access Journals (Sweden)

    Paul Nathan Goldwater

    2015-07-01

    Full Text Available This review examines the association of strains of Escherichia coli with Sudden Infant Death Syndrome (SIDS and the possible role of these bacteria play in this enigmatic condition. The review addresses evidence for E. coli in SIDS infants, potential sources of E. coli in the environment, colonisation by commensal and pathogenic strains, the variety of currently accepted pathotypes, and how these pathotypes could compromise intestinal integrity and induce inflammation. Both intestinal and extraintestinal pathotypes are compared in relation to the apparent lability in which virulence traits can be gained or lost by strains of E. coli. The way in which E. coli infections fit with current views on infant sleeping position and other SIDS risk factors is highlighted.

  6. [Investigation of the sudden infant death syndrome: a multidisciplinary approach is required].

    Science.gov (United States)

    Limelette, Anne; Boulagnon, Camille; Terrade, Caroline; N'guyen, Yohan; Guillard, Thomas; Andréoletti, Laurent; Garnotel, Roselyne; Digeon, Béatrice; De Champs, Christophe; Fornes, Paul; Lévêque, Nicolas

    2013-01-01

    The concept of sudden infant death syndrome (SIDS) is defined as the sudden, unexpected death of an infant less than a year old which remains unexplained after in-depth investigations comprising a complete autopsy, biological analyses, and a clinical examination of the circumstances surrounding the death. This definition underlines the importance of finding the cause of this disease in order to improve preventative measures to reduce the number of deaths due to sudden infant death syndrome. Among the causes of SIDS, pediatric infectious diseases may be neglected and must be systematically sought after. We report upon a SIDS death case of a four and a half month-old that occurred during his sleep. Following the absence of an evident cause of death a scientific autopsy was performed. The histological examination of pulmonary tissue revealed broncolitic lesions associated with numerous micro-abscesses. The post mortem microbiological analyses revealed evidence of an infection by the respiratory syncytial virus complicated by a bacterial infection due to Haemophilus influenzae. The case underlines the necessity of a multidisciplinary approach to researching SIDS, involving both clinicians and biologists, in order to determine the causes of these deaths.

  7. Sudden twin infant death on the same day: a case report and review of the literature.

    Science.gov (United States)

    Huang, Ping; Yu, Rongjun; Li, Shiying; Qin, Zhiqiang; Liu, Ningguo; Zhang, Jianhua; Zou, Donghua; Chen, Yijiu

    2013-06-01

    Sudden infant death syndrome (SIDS) is a major contributor to infant mortality. The cause of death is unknown: suggested possibilities include cardiovascular disease, anaphylactic shock, and suffocation. The occurrence of simultaneous sudden infant death syndrome is uncommon, such cases being extremely rare in forensic pathologic practice. We report two 10-week-old male twins who appeared well at the time of their evening feeding, yet died while sleeping on their backs. Both infants had petechial hemorrhages on the visceral pleura, epicardial surface of the heart, and thymus gland. Microscopic examination revealed pulmonary edema, intra-alveolar hemorrhage, and minor lymphocytic infiltration, again in both infants. In this report, we discuss the risk factors for SIDS, which should be considered individually or in combination as possible causes of death.

  8. Incidence of sudden cardiac death in professional cycling: Sudden cardiac death and exercise

    OpenAIRE

    Santos-Lozano, Alejandro; Sanchís-Gomar, Fabián; Garatachea, Nuria; Arrarás-Flores, Ángel; Pareja Galeano, Helios; Fiuza Luces, María del Carmen; Joyner, Michael J.; Lucía Mulas, Alejandro

    2016-01-01

    Low-moderate intensity aerobic exercise (e.g., brisk walking for 30–60 min/day) has well-documented beneficial cardiovascular effects, whereas those of strenuous endurance exercise (SEE) e.g., marathon running, are more controversial. Notably, the increasing popularity of SEE has contributed to the growth of sports-related sudden cardiac death (SCD) over the last decade. In this regard, Pineda et al. have underlined the importance of appropriate precompetition screening in order to minimize t...

  9. Sudden Unexpected Infant Deaths May Be Underestimated: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166269.html Sudden Unexpected Infant Deaths May Be Underestimated: Study Lack of standardized death ... U.S. Institute of Child Health and Human Development. Sudden Infant Death Syndrome (SIDS) is deemed a distinct form of ...

  10. New Areas for Preventive Programing: Sudden Infant Death Syndrome.

    Science.gov (United States)

    Lowman, Joseph

    Crisis intervention programs for persons experiencing the sudden death of family members or surviving natural disasters have been advocated as methods of primary prevention, although few have actually been implemented. A program utilizing nurses to deliver grief intervention to parents losing a baby to Sudden Infant Death Syndrome (SIDS) was…

  11. Antipsychotics and the risk of sudden cardiac death

    NARCIS (Netherlands)

    Straus, S.M.J.M.; Bleumink, G.S.; Dieleman, J.P.; van der Lei, J.; 't Jong, G.W.; Kingma, J. Herre; Sturkenboom, M.C J M; Stricker, B.H C

    2004-01-01

    Background Antipsychotics have been associated with prolongation of the corrected QT interval and sudden cardiac death. Only a few epidemiological studies have investigated this association. We performed a case-control study to investigate the association between use of antipsychotics and sudden

  12. The prevalence of HIV in the sudden, unexplained and unexpected ...

    African Journals Online (AJOL)

    Purpose: To determine the prevalence of HIV in the sudden, unexplained and unexpected (SUU) death population admitted to the Pretoria Medico-Legal Laboratory. Methods: This study was conducted at the Pretoria Medico-Legal Laboratory. Blood samples were obtained from decedents who died suddenly and/or ...

  13. A honey bee can threat ear: Sudden sensorineural hearing loss.

    Science.gov (United States)

    Düzenli, Ufuk; Bozan, Nazım; Ayral, Abdurrahman; Yalınkılıç, Abdülaziz; Kıroğlu, Ahmet Faruk

    2017-11-01

    Sudden sensorineural hearing loss is an otologic emergency. Many etiological factors can lead to this pathology. Honey bee (Apis mellifera) sting may lead to local and systemic reactions due to sensitization of the patient. In this paper we described a sudden sensorineural hearing loss occurred after honey bee sting. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Influence of sudden stratospheric warmings on tropospheric winds

    NARCIS (Netherlands)

    Hinssen, Y.B.L.; van Delden, A.J.; Opsteegh, T.

    2011-01-01

    The influence of changes in the zonal mean stratospheric potential vorticity, associated with sudden stratospheric warmings, on the zonal mean zonal wind in the troposphere is investigated by piecewise potential vorticity inversion. The focus is on the major sudden stratospheric warming that

  15. Sudden cardiac death in Nigerians - The Ile - Ife experience

    African Journals Online (AJOL)

    reports from other parts of the worldw'm'12 where it has been documented that about a third of victims of sudden cardiac death do not have a past history of heart disease. The pre- cise role of activity, physical and emotional, in triggering the terminal events of sudden cardiac death is controversial. Our. finding that majority of ...

  16. Spreading depolarization in the brainstem mediates sudden cardiorespiratory arrest in mouse SUDEP models

    OpenAIRE

    Aiba, Isamu; Noebels, Jeffrey L.

    2015-01-01

    Cardiorespiratory collapse after a seizure is the leading cause of sudden unexpected death in epilepsy (SUDEP) in young persons, but why only certain individuals are at risk is unknown. To identify a mechanism for this lethal cardiorespiratory failure, we examined whether genes linked to increased SUDEP risk lower the threshold for spreading depolarization (SD), a self-propagating depolarizing wave that silences neuronal networks. Mice carrying mutations in Kv1.1 potassium channels (−/−) and ...

  17. Exercise-related sudden cardiac arrest in London: incidence, survival and bystander response

    OpenAIRE

    Edwards, Melanie J; Fothergill, Rachael T

    2015-01-01

    Objective The study aimed to (1) establish the incidence of exercise-related sudden cardiac arrest (SCA) in London, (2) investigate survival from exercise-related SCA and (3) examine factors related to survival. Method This retrospective observational study examined 2 years’ data from the London Ambulance Service (LAS) cardiac arrest registry for patients in whom resuscitation was attempted following an out-of-hospital cardiac arrest (OHCA), a cardiac cause was presumed and the arrest occurre...

  18. Sudden Suspected Death in Emergency Department: Autopsy Results

    Directory of Open Access Journals (Sweden)

    Mehtap GURGER

    2014-09-01

    Full Text Available SUMMARY: Objectives: Sudden deaths occur within 24 hours after symptoms' onset and are caused by cardiac, neurological and pulmonary diseases. Autopsy is the gold standard in determining cause of death. In this study, death's etiology was evaluated in cases applied to our department that underwent autopsy with sudden death indication. Methods: This study included cases aged 18 or older with sudden, suspected, non-traumatic death applying to our department between 2008 and 2012. Patients' age, sex, death time, co-morbid diseases, initial signs, cardiac rhythm, and autopsy findings were recorded after reviewing patient charts. Results: The study included 46 patients. Mean age was 45.73±19.6. Of the cases, 84.78% applied to emergency with cardiopulmonary arrest. Thirty-two cases (69.6% were male. The most frequent cause of death was cardiovascular diseases (52.2%, followed by central nervous system disorders (21.7%, intoxications (15.2%, and respiratory diseases (10.9%. The most common diseases were myocardial infarction (45.7%, subarachnoid hemorrhage (8.7%, and chronic obstructive pulmonary disease. There were three drug ingestions, three carbon monoxide intoxications, and one corrosive material ingestion among the intoxication cases. Conclusions: Sudden deaths are rarely encountered. Emergency clinicians should consider cause in differential diagnosis and provide appropriate approaches at first evaluation. ÖZET: Amaç: Ani ölümler semptomlar başladıktan sonra 24 saat içerisinde oluşur. En yaygın nedenleri kardiyak, nörolojik ve pulmoner hastalıkları içerir. Otopsi bu ölümlerin nedenini tespit etmede altın standarttır. Bu çalışmada acil servisimize başvuran ani ölüm olgularının otopsi bulgularına göre ölüm nedenlerini değerlendirdik. Gereç ve Yöntem: Bu retrospektif çalışmaya 2008–2012 yılları arasında acil servisimize başvuran, yaşları 18 ve üzeri olan, nontravmatik, ani, şüpheli ölüm vakaları al

  19. Mobile phone usage does not affect sudden sensorineural hearing loss.

    Science.gov (United States)

    Sagiv, D; Migirov, L; Madgar, O; Nakache, G; Wolf, M; Shapira, Y

    2018-01-01

    Recent studies found that mobile phone users had a significantly greater risk of having elevated thresholds in speech frequencies. This study investigated the correlation between the laterality of sudden sensorineural hearing loss, handedness and the preferred ear for mobile phone use. The study included all patients who presented with sudden sensorineural hearing loss to the Department of Otolaryngology - Head and Neck Surgery in our tertiary referral medical centre between 2014 and 2016. Patients were asked to indicate their dominant hand and preferred ear for mobile phone use. The study comprised 160 patients. No correlation was found between the dominant hand or preferred ear for mobile phone use and the side of sudden sensorineural hearing loss. There was no correlation between the side of the sudden sensorineural hearing loss (preferable or non-preferable for mobile phone use) and audiometric characteristics. No correlation was found between the laterality of ears used for mobile phone and sudden sensorineural hearing loss.

  20. Bubble motion in sudden expansion in vertical pipe flow

    Energy Technology Data Exchange (ETDEWEB)

    Kondo, Koichi [Marine Technical College, Ashiya, Hyogo (Japan); Yoshida, Kenji; Matsumoto, Tadayoshi; Okawa, Tomio; Kataoka, Isao [Osaka Univ., Suita, Osaka (Japan)

    2002-07-01

    Experimental studies were made on the multi-dimensional behavior of upward gas-liquid two-phase flow through the vertical round tube with an axisymmetric sudden expansion, which is one of the typical multi-dimensional channel geometry. The direct observation using high-speed video camera was performed and revealed the multi-dimensional dynamic flow behavior affected by the sudden expansion. Characteristic phenomena were observed such as bubble break-up, deformation due to the strong share of liquid flow, or liquid micro jet penetration through the gas-slug, and so on. From these results, the flow regime map at the below or above of the sudden expansion part was classified. The phase distributions in sudden expansion were also showed in detail that how the two-phase flow develops along the direction of the downstream of the sudden expansion. (J.P.N.)

  1. Systems-level perspective of sudden infant death syndrome.

    Science.gov (United States)

    Salomonis, Nathan

    2014-09-01

    Sudden infant death syndrome (SIDS) remains one of the primary causes of infant mortality in developed countries. Although the causes of SIDS remain largely inconclusive, some of the most informative associations implicate molecular, genetic, anatomical, physiological, and environmental (i.e., infant sleep) factors. Thus, a comprehensive and evolving systems-level model is required to understand SIDS susceptibility. Such models, by being powerful enough to uncover indirect associations, could be used to expand our list of candidate targets for in-depth analysis. We present an integrated WikiPathways model for SIDS susceptibility that includes associated cell systems, signaling pathways, genetics, and animal phenotypes. Experimental and literature-based gene-regulatory data have been integrated into this model to identify intersecting upstream control elements and associated interactions. To expand this pathway model, we performed a comprehensive analysis of existing proteomics data from brainstem samples of infants with SIDS. From this analysis, we discovered changes in the expression of several proteins linked to known SIDS pathologies, including factors involved in glial cell production, hypoxia regulation, and synaptic vesicle release, in addition to interactions with annotated SIDS markers. Our results highlight new targets for further consideration that further enrich this pathway model, which, over time, can improve as a wiki-based, community curation project.

  2. Past and current cause-specific mortality in Eisenmenger syndrome

    DEFF Research Database (Denmark)

    Hjortshøj, Cristel M Sørensen; Kempny, Aleksander; Jensen, Annette Schophuus

    2017-01-01

    Aims: Eisenmenger syndrome (ES) is associated with considerable morbidity and mortality. Therapeutic strategies have changed during the 2000s in conjunction with an emphasis on specialist follow-up. The aim of this study was to determine the cause-specific mortality in ES and evaluate any relevant....... Over a median follow-up of 6.1 years (interquartile range 2.1-21.5 years) 558 deaths were recorded; cause-specific mortality was identified in 411 (74%) cases. Leading causes of death were heart failure (34%), infection (26%), sudden cardiac death (10%), thromboembolism (8%), haemorrhage (7%), and peri...... changes between 1977 and 2015. Methods and results: This is a retrospective, descriptive multicentre study. A total of 1546 patients (mean age 38.7 ± 15.4 years; 36% male) from 13 countries were included. Cause-specific mortality was examined before and after July 2006, 'early' and 'late', respectively...

  3. Acute coronary syndrome caused by anomalous origin of the right ...

    African Journals Online (AJOL)

    Acute coronar .s' ndmme caused b anomalous art 'in on the rt '/1[ corona!" arler ruin the 10 t sinus 0 ' Valxalva - A. S. Assiri'. y s . . . . to high incidence of Sudden Cardiac Deathfijl Full-spectrum of clinical presentation including origin, myocardial infarction and even sudden death have been described. 6. In 1992, Taylor and ...

  4. Syncope and the risk of sudden cardiac death: Evaluation, management, and prevention

    Directory of Open Access Journals (Sweden)

    Ryan J. Koene, MD

    2017-12-01

    Full Text Available Syncope is a clinical syndrome defined as a relatively brief self-limited transient loss of consciousness (TLOC caused by a period of inadequate cerebral nutrient flow. Most often the trigger is an abrupt drop of systemic blood pressure. True syncope must be distinguished from other common non-syncope conditions in which real or apparent TLOC may occur such as seizures, concussions, or accidental falls. The causes of syncope are diverse, but in most instances, are relatively benign (e.g., reflex and orthostatic faints with the main risks being accidents and/or injury. However, in some instances, syncope may be due to more worrisome conditions (particularly those associated with cardiac structural disease or channelopathies; in such circumstances, syncope may be an indicator of increased morbidity and mortality risk, including sudden cardiac death (SCD. Establishing an accurate basis for the etiology of syncope is crucial in order to initiate effective therapy. In this review, we focus primarily on the causes of syncope that are associated with increased SCD risk (i.e., sudden arrhythmic cardiac death, and the management of these patients. In addition, we discuss the limitations of our understanding of SCD in relation to syncope, and propose future studies that may ultimately address how to improve outcomes of syncope patients and reduce SCD risk. Keywords: Syncope, Sudden cardiac death, Risk assessment

  5. Ependymal alterations in sudden intrauterine unexplained death and sudden infant death syndrome: possible primary consequence of prenatal exposure to cigarette smoking

    Directory of Open Access Journals (Sweden)

    Matturri Luigi

    2010-07-01

    Full Text Available Abstract Background The ependyma, the lining providing a protective barrier and filtration system separating brain parenchyma from cerebrospinal fluid, is still inadequately understood in humans. In this study we aimed to define, by morphological and immunohistochemical methods, the sequence of developmental steps of the human ependyma in the brainstem (ventricular ependyma and thoracic spinal cord (central canal ependyma of a large sample of fetal and infant death victims, aged from 17 gestational weeks to 8 postnatal months. Additionally, we investigated a possible link between alterations of this structure, sudden unexplained fetal and infant death and maternal smoking. Results Our results demonstrate that in early fetal life the human ependyma shows a pseudostratified cytoarchitecture including many tanycytes and ciliated cells together with numerous apoptotic and reactive astrocytes in the subependymal layer. The ependyma is fully differentiated, with a monolayer of uniform cells, after 32 to 34 gestational weeks. We observed a wide spectrum of ependymal pathological changes in sudden death victims, such as desquamation, clusters of ependymal cells in the subventricular zone, radial glial cells, and the unusual presence of neurons within and over the ependymal lining. These alterations were significantly related to maternal smoking in pregnancy. Conclusions We conclude that in smoking mothers, nicotine and its derivatives easily reach the cerebrospinal fluid in the fetus, immediately causing ependymal damage. Consequently, we suggest that the ependyma should be examined in-depth first in victims of sudden fetal or infant death with mothers who smoke.

  6. Definition of Sudden Infant Death and Sudden Intrauterine Unexpected Death Syndromes (SIDS and SIUDS with Regard to the Anatomo-Pathological Examination

    Directory of Open Access Journals (Sweden)

    Giulia Ottaviani

    2016-09-01

    Full Text Available 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 six-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 will become necessary.

  7. Systematic evaluation of the root cause of non-linearity in liquid chromatography/tandem mass spectrometry bioanalytical assays and strategy to predict and extend the linear standard curve range.

    Science.gov (United States)

    Yuan, Long; Zhang, Duxi; Jemal, Mohammed; Aubry, Anne-Francoise

    2012-06-30

    The linear range of a liquid chromatography/tandem mass spectrometry (LC/MS/MS) bioanalytical assay is typically about three orders of magnitude. A broader standard curve range is favored since it can significantly reduce the time, labor and potential errors related to sample dilution - one of the bottlenecks in sample analysis. Using quadratic regression to fit the standard curve can, to a certain degree, extend the dynamic range. However, the use of a quadratic regression is controversial, particularly in regulated bioanalysis. A number of compounds, with different physicochemical properties and ionization efficiencies, were evaluated to understand the cause of the non-linear behavior of the standard curve. The standard curve behavior is primarily associated with the absolute analyte response but not the analyte concentration, the properties of the analyte, or the nature of the matrix when a stable-isotope-labeled internal standard (SIL-IS) is used. For all the test compounds, a non-linear curve was observed when signals exceeded a certain response, which depends on the detector used in the mass spectrometer. With typical API4000 instruments used for the experiments, this critical response level was determined to be ~1 E+6 counts per second (cps) and it was successfully used to predict the linear ranges for the test compounds. By simultaneously monitoring two selective reaction monitoring (SRM) channels of different intensity and using SIL-IS, a linear range of five orders of magnitude was achieved. In this work, the root cause of the non-linear behavior of the standard curve when using a SIL-IS was investigated and identified. Based on the findings, an improved multiple SRM channels approach was proposed and successfully applied to obtain a linear dynamic range of five orders of magnitude for one test compound. This approach may work particularly well for LC/MS/MS bioanalytical assay of dried blood spot (DBS) samples, for which a direct dilution is cumbersome

  8. Perceived Stigma of Sudden Bereavement as a Risk Factor for Suicidal Thoughts and Suicide Attempt: Analysis of British Cross-Sectional Survey Data on 3387 Young Bereaved Adults

    Directory of Open Access Journals (Sweden)

    Alexandra Pitman

    2017-03-01

    Full Text Available The sudden death of a friend or relative, particularly by suicide, is a risk factor for suicide. People who experience sudden bereavement report feeling highly stigmatised by the loss, potentially influencing access to support. We assessed whether perceived stigma following sudden bereavement is associated with suicidal thoughts and suicide attempt. We analysed cross-sectional survey data on 3387 young adults bereaved by the sudden death of a close contact. We tested the association of high versus low perceived stigma (on the stigma sub-scale of the Grief Experience Questionnaire with post-bereavement suicidal ideation and suicide attempt, using random effects logistic regression, adjusting for socio-demographic factors, pre-bereavement psychopathology, and mode of sudden bereavement (natural causes/unnatural causes/suicide. Subjects with high perceived stigma scores were significantly more likely to report post-bereavement suicidal thoughts (adjusted odds ratio (AOR = 2.74; 95% confidence interval (CI = 1.93–3.89 and suicide attempt (AOR = 2.73; 95% CI = 2.33–3.18 than those with low stigma scores. People who feel highly stigmatised by a sudden bereavement are at increased risk of suicidal thoughts and suicide attempt, even taking into account prior suicidal behaviour. General practitioners, bereavement counsellors, and others who support people bereaved suddenly, should consider inquiring about perceived stigma, mental wellbeing, and suicidal thoughts, and directing them to appropriate sources of support.

  9. Perceived Stigma of Sudden Bereavement as a Risk Factor for Suicidal Thoughts and Suicide Attempt: Analysis of British Cross-Sectional Survey Data on 3387 Young Bereaved Adults.

    Science.gov (United States)

    Pitman, Alexandra; Rantell, Khadija; Marston, Louise; King, Michael; Osborn, David

    2017-03-09

    The sudden death of a friend or relative, particularly by suicide, is a risk factor for suicide. People who experience sudden bereavement report feeling highly stigmatised by the loss, potentially influencing access to support. We assessed whether perceived stigma following sudden bereavement is associated with suicidal thoughts and suicide attempt. We analysed cross-sectional survey data on 3387 young adults bereaved by the sudden death of a close contact. We tested the association of high versus low perceived stigma (on the stigma sub-scale of the Grief Experience Questionnaire) with post-bereavement suicidal ideation and suicide attempt, using random effects logistic regression, adjusting for socio-demographic factors, pre-bereavement psychopathology, and mode of sudden bereavement (natural causes/unnatural causes/suicide). Subjects with high perceived stigma scores were significantly more likely to report post-bereavement suicidal thoughts (adjusted odds ratio (AOR) = 2.74; 95% confidence interval (CI) = 1.93-3.89) and suicide attempt (AOR = 2.73; 95% CI = 2.33-3.18) than those with low stigma scores. People who feel highly stigmatised by a sudden bereavement are at increased risk of suicidal thoughts and suicide attempt, even taking into account prior suicidal behaviour. General practitioners, bereavement counsellors, and others who support people bereaved suddenly, should consider inquiring about perceived stigma, mental wellbeing, and suicidal thoughts, and directing them to appropriate sources of support.

  10. Efficacy of multimodality approach to sudden hearing loss.

    Science.gov (United States)

    Naiboğllu, Bariş; Külekçi, Semra; Sürmeli, Mehmet; Verim, Ayşegül; Kalaycik Ertugay, Çiğdem; İhvan, Önder; Şeneldir, Lütfü; Zer Toros, Sema

    2015-01-01

    This study aims to investigate whether addition of intratympanic steroid (ITS) to systemic steroid and hyperbaric oxygen (HBO) is effective in the treatment of sudden hearing loss (SHL). Between January 2008 and October 2011, 58 patients diagnosed with SHL were enrolled in the study. Twenty patients (11 males, 9 females; mean age 45.3±21 years; range 24 to 66 years) who received systemic steroid and HBO composed group 1, while 38 patients (19 males, 19 females; mean age 41.6±16 years; range 25 to 61 years) who received ITS in addition to systemic steroid and HBO composed group 2. Post-treatment hearing improvement was statistically significant in both groups in terms of the mean pure tone according to the Siegel's criteria (p0.05). However, there was a strong statistically significant difference in terms of profound hearing loss over 90 dB (phearing loss in group 1 benefited treatment, while addition of ITS to the treatment yielded success in six of 12 patients with profound hearing loss (50%) in group 2 (p<0.05). Addition of ITS to systemic steroid and HBO treatment may yield better results in patients with SHL. However, ITS injection seems beneficial for patients with profound SHL.

  11. Cold-Induced Sudden Reversible Lowering of in Vivo Chlorophyll Fluorescence after Saturating Light Pulses 1

    Science.gov (United States)

    Larcher, Walter; Neuner, Gilbert

    1989-01-01

    In chilling-sensitive plants (Glycine max, Saintpaulia ionantha, Saccharum officinarum) a sudden reversible drop in chlorophyll fluorescence occurs during photosynthetic induction immediately following saturating light pulses at low temperatures in the range 4 to 8°C. A comparison of two soybean cultivars of different chilling sensitivities revealed that this phenomenon, termed lowwave, indicates specific thresholds of low temperature stress. Its occurrence under controlled chilling can be regarded as a quantitative marker for screening chilling susceptibility in angiosperms. PMID:16666615

  12. Primary Cardiac Fibroma and Cardiac Conduction System Alterations in a Case of Sudden Death of a 4-month-old Infant

    Science.gov (United States)

    Mecchia, Donatella; Lavezzi, Anna Maria; Matturri, Luigi

    2013-01-01

    A 4-month-old female infant considered to be in good health died suddenly and unexpectedly. Post- mortem examination was requested, with clinical diagnosis of sudden infant death syndrome. At autopsy the infant was described in good health. Histo- logical examination of the heart found a cardiac fibroma compressing the atrio-ventricular node and the examination of the cardiac conduction system showed an accessory fiber of Mahaim (nodo-ventricular) and cartilaginous metaplasia of the cardiac fibrous body. Probably the concomitant presence of cardiac conduction system abnormalities and a septal fibroma, compressing the atrio-ventricular node, could have an important role in causing the sudden death. PMID:23847693

  13. Prematurity and sudden infant death syndrome: United States 2005-2007.

    Science.gov (United States)

    Malloy, M H

    2013-06-01

    In 1987, the sudden infant death syndrome (SIDS) rate in the United States was 1.2 per 1000 live births. By the year 2005, the SIDS rate had dropped more than half to approximately 0.5 per 1000 live births. In 1987, the risk of SIDS was 2.32 times greater for extremely premature infants compared with term infants. The objective of this analysis was to determine if with the falling SIDS rate there has been a change in the risk for SIDS among preterm infants. Data were obtained from the United States Linked Infant Birth and Death Certificate Public User Period files for the years 2005 to 2007. The adjusted odds ratios (ORs) for postneonatal out-of-hospital death by gestational age were determined by logistic regression modeling. Over the 3-year period, there were 5203 postneonatal out-of-hospital deaths attributable to SIDS; 2010 attributable to other sudden deaths; 1270 attributable to suffocation in bed; and 3681 attributable to other causes. The adjusted OR for SIDS among the most preterm infants (24 to 28 weeks gestation) was significantly increased compared with term infants, OR(adj)=2.57 (95% confidence interval=2.08, 3.17), as were the adjusted ORs for the other causes of sudden infant death. Despite the marked drop in the incidence of SIDS since 1987, the risk for SIDS among preterm infants remains elevated. Other causes of sudden infant death for which SIDS is often mistaken reflect similar levels of increased risk among preterm infants.

  14. Serotonin in the sudden infant death syndrome.

    Science.gov (United States)

    Waters, Karen

    2010-11-01

    It seems likely that some infants who die from sudden infant death syndrome (SIDS) have a brainstem abnormality of the serotonergic system. Evidence suggests that infants who died from SIDS had defective respiratory and/or autonomic responses that led to death instead of recovery after an acute insult. The serotonergic neuromodulator system has roles in the control of cardiac autonomic and respiratory function, as well as now being identified as abnormal in infants with SIDS. This manuscript reviews the multiple roles of serotonin with reference to the functional aspects of the relevant brain regions. Correlations with pre- or postnatal exposure to stressors, or an underlying genetic process are also reviewed. Together, these studies indicate that perturbed function of the serotonin system will have significant physiological impact during early development. Understanding the functional importance of these systems assists understanding of the pathogenesis of SIDS. In conclusion, whether an infant inherits serotonergic defects and is therefore "inherently vulnerable", or whether postnatal stressors can induce the abnormalities, any functional abnormalities of the serotonergic system that result are likely to be subclinical in the majority of cases and not easily detected with current medical tools. Copyright 2010 Prous Science, S.A.U. or its licensors. All rights reserved.

  15. Cardiac Innervation and Sudden Cardiac Death

    Science.gov (United States)

    Fukuda, Keiichi; Kanazawa, Hideaki; Aizawa, Yoshiyasu; Ardell, Jeffrey L.; Shivkumar, Kalyanam

    2015-01-01

    Afferent and efferent cardiac neurotransmission via the cardiac nerves intricately modulates nearly all physiological functions of the heart (chronotropy, dromotropy, lusitropy and inotropy). Afferent information from the heart is transmitted to higher levels of the nervous system for processing (intrinsic cardiac nervous system, extracardiac-intrathoracic ganglia, spinal cord, brain stem and higher centers) which ultimately results in efferent cardiomotor neural impulses (via the sympathetic and parasympathetic nerves). This system forms interacting feedback loops that provide physiological stability for maintaining normal rhythm and life-sustaining circulation. This system also ensures that there is fine-tuned regulation of sympathetic-parasympathetic balance in the heart under normal and stressed states in the short (beat to beat), intermediate (minutes-hours) and long term (days-years). This important neurovisceral /autonomic nervous system also plays a major role in the pathophysiology and progression of heart disease, including heart failure and arrhythmias leading to sudden cardiac death (SCD). Transdifferentiation of neurons in heart failure, functional denervation, cardiac and extra-cardiac neural remodeling have also been identified and characterized during the progression of disease. Recent advances in understanding the cellular and molecular processes governing innervation and the functional control of the myocardium in health and disease provides a rational mechanistic basis for development of neuraxial therapies for preventing SCD and other arrhythmias. Advances in cellular, molecular, and bioengineering realms have underscored the emergence of this area as an important avenue of scientific inquiry and therapeutic intervention. PMID:26044253

  16. Sudden decoherence transitions for quantum discord

    Science.gov (United States)

    Lim, Hyungjun; Joynt, Robert

    2014-04-01

    We investigate the disappearance of discord in 2- and multi-qubit systems subject to decohering influences. We formulate the computation of quantum discord and quantum geometric discord in terms of the generalized Bloch vector, which gives useful insights on the time evolution of quantum coherence for the open system, particularly the comparison of entanglement and discord. We show that the analytical calculation of the global geometric discord is NP-hard in the number of qubits, but a similar statement for global entropic discord is more difficult to prove. We present an efficient numerical method to calculating the quantum discord for a certain important class of multipartite states. In agreement with previous work for 2-qubit cases (Mazzola et al 2010 Phys. Rev. Lett. 104 200401), we find situations in which there is a sudden transition from classical to quantum decoherence characterized by the discord remaining relatively robust (classical decoherence) until a certain point from where it begins to decay quickly whereas the classical correlation decays more slowly (quantum decoherence). However, we find that as the number of qubits increases, the chance of this kind of transition occurring becomes small.

  17. [Bilateral versus unilateral sudden sensorineural hearing loss].

    Science.gov (United States)

    Ni, Maomei; Li, Dehong; Peng, Weihui; Peng, Yikun; Ren, Juanjuan

    2010-01-01

    To analyze the clinical characteristics and treatment effect between bilateral (bi-) and unilateral (uni-) sudden sensorineural hearing loss (SSNHL). Four hundred and eighty cases of SSNHL were retrospective study, which were divided into two groups of bi-SSNHL (n = 40) and uni-SSNHL (n = 440). Clinical characteristics and treatment effects were compared of the two groups. The incidence rate of bi-SSNHL was 8.3 percent and uni-SSNHL was 91.7 percent of all patients with SSNHL. Bi-SSNHL occurs more commonly in patients of old age, diabetes mellitus, and lipid panes abnormalities compared to uni-SSNHL. Twenty-eight ears in the bi-SSNHL group showed hearing recovery (35%), compared with 56.4 percent of patients with uni-SSNHL. Bi-SSNHL and uni-SSNHL may have a completely different clinical characteristics and treatment effect, that implies a different pathophysiology and prognosis. Recognition their different clinical characteristics and treatment effect between bilateral and unilateral SSNHL can help in counseling and managing the patients and correctly evaluate the prognosis.

  18. Hearing Recovey in Patients Suffering Sudden Deafness

    Directory of Open Access Journals (Sweden)

    Parviz Eslami

    1992-04-01

    Full Text Available The study included 80 patients treated for sudden deafness over the last 5-7 years. Case history, laboratory findings, pure-tone audiogram and electronystagmography (ENG findings were noted. If any abnormalities had been recorded in ENG studies, the studies were redone. ORL status was redefined and audiograms were obtained in all patients. When becoming ill, the 80 patients had not differed from the normal population in common cardiovascular risk factors. None of them had had signs of viral infection (paired serum samples had been taken at 2-week intervals; routine examinations had been done for common viral antigens. As many as 31 of the 80 patients with acute hearing loss had had abnormalities such as spontaneous nystagmus (PN, hypoexcitability (HE and directional preponderance (DP in the bithermal caloric tests (+44 degrees C, + 30 degrees C of their ENG studies. Twenty of the 31 patients still had abnormal ENG studies after 5-7 years. Only 1 subject had positional nystagmus, and none had subjective vertigo. Patients with an abnormal ENG study showed a poor recovery of the speech reception threshold, whereas those with a normal ENG study showed slightly significant (p less than 0.05 recovery.

  19. Forest stand dynamics and sudden oak death: Mortality in mixed-evergreen forests dominated by coast live oak

    Science.gov (United States)

    L.B. Brown; B. Allen-Diaz

    2009-01-01

    Sudden oak death (SOD), caused by the recently discovered non-native invasive pathogen, Phytophthora ramorum, has already killed tens of thousands of native coast live oak and tanoak trees in California. Little is known of potential short and long term impacts of this novel plant–pathogen interaction on forest structure and composition. Coast live...

  20. Phytophthora ramorum canker (Sudden Oak Death) disease risk and progress in coast live oak, 2000-2012

    Science.gov (United States)

    Tedmund J. Swiecki; Elizabeth Bernhardt

    2015-01-01

    From 2000 through 2012, we collected annual observations on disease symptoms and stand conditions in 128 coast live oak plots in forests affected by sudden oak death (SOD), caused by the introduced pathogen Phytophthora ramorum. Elevated rainfall in one or both of the previous wet seasons was associated with pulses of new infections. However,...

  1. Modeling when, where, and how to manage a forest epidemic, motivated by sudden oak death in California

    Science.gov (United States)

    Nik J. Cunniffe; Richard C. Cobb; Ross K. Meentemeyer; David M. Rizzo; Christopher A. Gilligan

    2016-01-01

    Sudden oak death, caused by Phytophthora ramorum, has killed millions of oak and tanoak in California since its first detection in 1995. Despite some localized small-scale management, there has been no large-scale attempt to slow the spread of the pathogen in California. Here we use a stochastic spatially-explicit model parameterized using data on...

  2. Development of a management plan for coast live oak forests affected by sudden oak death in East Bay Regional Parks

    Science.gov (United States)

    Brice A. McPherson; Joshua O’Neill; Gregory Biging; Maggi Kelly; David L. Wood

    2015-01-01

    The East Bay Regional Park District maintains the largest urban park system in the United States, comprising over 45 000 ha, and more than 1900 km of trails, with extensive forests bordering residential areas. Sudden oak death (SOD), caused by the introduced oomycete Phytophthora ramorum, was first detected in a district park in 2001. Both...

  3. Predicting the economic costs and property value losses attributed to sudden oak death damage in California (2010-2020)

    Science.gov (United States)

    Kent Kovacs; Tomas Václavík; Robert G. Haight; Arwin Pang; Nik J. Cunniffe; Christopher A. Gilligan; Ross K. Meentemeyer

    2011-01-01

    Phytophthora ramorum, cause of sudden oak death, is a quarantined, non-native, invasive forest pathogen resulting in substantial mortality in coastal live oak (Quercus agrifolia) and several other related tree species on the Pacific Coast of the United States. We estimate the discounted cost of oak treatment, removal, and...

  4. A case-crossover analyses of fine particulate matter and out-of-hospital sudden unexpected death

    Science.gov (United States)

    Out-of-hospital sudden unexpected deaths (OHSUD) are natural deaths that occur without obvious underlying causes and account for nearly 1 in 6 deaths in the United States. Ambient air pollution is known to be causally related to overall mortality, therefore, we hypothesized that ...

  5. Short-term QT variability markers for the prediction of ventricular arrhythmias and sudden cardiac death: A systematic review

    NARCIS (Netherlands)

    M.N. Niemeijer (Maartje); M.E. van den Berg (Marten); M. Eijgelsheim (Mark); G. van Herpen (Gerard); B.H.Ch. Stricker (Bruno); J.A. Kors (Jan); P.R. Rijnbeek (Peter)

    2014-01-01

    textabstractSudden cardiac death (SCD) is a major health burden and is primarily caused by ventricular arrhythmias. Currently, the most well-known marker for the risk of ventricular arrhythmias is QT/QTc prolongation. Animal studies indicate that QT variability might be a better indicator. Our

  6. Sudden cardiac arrest in sports - need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation.

    OpenAIRE

    Solberg, EE; Borjesson, M; Sharma, S; Papadakis, M; Wilhelm, M; Drezner, JA; Harmon, KG; Alonso, JM; Heidbuchel, H; Dugmore, D; Panhuyzen-Goedkoop, NM; Mellwig, KP; Carre, F; Rasmusen, H; Niebauer, J

    2015-01-01

    There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about available data and provides comprehensive suggestions for standard definitions and a guide for uniform registration parameters of SCA/SCD. The parameters ...

  7. POSTMORTEM STUDY OF HISTOPATHOLOGICAL LESIONS OF HEART IN CASES OF SUDDEN DEATH - AN INCIDENTAL FINDINGS

    Directory of Open Access Journals (Sweden)

    Chandrakala

    2016-01-01

    Full Text Available OBJECTIVE To study the histopathological lesions of Heart in cases of sudden death. METHOD During the period from 1st July 2014 to 30 November 2015, out of 144 medicolegal autopsies, 120 autopsies of heart were received. Five specimen of heart were autolyzed so 115 autopsy specimen of heart were included for study. Routine H and E staining is used for microscopic examination. RESULT Out of 115 cases, 74 cases shows atherosclerosis, 33 cases shows features of myocardial infarction, myocardial hypertrophy found in 60 cases, 11 cases shows myocarditis, vaso-occlusive crisis in sickle cell was present in 6 cases and pericarditis present in 1 case. In 29 cases, there was no identifiable cause of death even after complete gross and microscopic autopsy was performed. CONCLUSION It was concluded that myocardial infarction due to atherosclerotic ischaemic heart disease is probably the commonest diagnosis made in majority of sudden death cases subjected to medicolegal autopsies. Histological findings must be evaluated with great attention for preventing incorrect conclusion to identify causes of deaths in sudden death cases.

  8. Gender differences in sudden cardiac death in the young-a nationwide study

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Risgaard, Bjarke; Bjune, Thea

    2017-01-01

    Background: Hitherto, sudden cardiac death (SCD) in the young has been described with no distinction between genders. SCD occurs more often in men (SCDm) than women (SCDw), but this disparity is not understood and has not been investigated systematically in a nationwide setting. Our objective......=0.02) and died less often in a public place (16 vs. 26%, p=0.01). Age at death, ratios of autopsies and sudden unexplained deaths, and comorbidities, did not differ. Causes of SCD were largely comparable between genders. The incidence rate of SCDw was half of that of SCDm (1.8 vs. 3.6 per 100...... was to report gender differences in SCD in the young in a nationwide (Denmark) setting. Methods: All deaths in persons aged 1-35 years nationwide in Denmark between 2000 and 2009 were included. Death certificates and autopsy reports were obtained. The extensive health care registries in Denmark were used...

  9. Enlarged Vestibular Aqueduct Syndrome: Sudden Hearing Loss in a Child with a Cerebral Shunt.

    Science.gov (United States)

    Wendt, Wendi-Jo; Hashikawa, Andrew

    2017-07-04

    Enlarged vestibular aqueduct syndrome (EVAS) is the most common congenital ear anomaly that causes sensorineural hearing loss in children and may predispose a child to sudden hearing loss from sudden pressure changes or minor head trauma. We report a case of a 4-year-old boy with a history of a ventriculoperitoneal shunt and migraines who presented to the emergency department with parental and child care provider reports of acute hearing loss, without a history of trauma, infection, or hardware malfunction, who was diagnosed with bilateral EVAS. Diagnosis of EVAS occurs with specific temporal bone imaging with either high-resolution, thin-cut computed tomography or magnetic resonance imaging scans. Enlarged vestibular aqueduct syndrome is typically refractory to medical treatment and often results in hearing loss that is too severe to benefit from amplification, requiring cochlear implantation.

  10. 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

    : All deaths in persons aged 1 to 49 years were included in 2007 to 2009. Death certificates were reviewed by 2 physicians. History of previous admissions to hospital was assessed, and discharge summaries were read. Sudden unexpected death cases were identified and autopsy reports were collected......BACKGROUND: Knowledge of the burden and causes of sudden cardiac death (SCD) is sparse in persons agedreport SCD incidence rates and autopsy findings in persons aged 1 to 49 years. METHODS AND RESULTS....... In the 3-year study period, there were 7849 deaths of which we identified 893 (11%) SCD cases. The annual incidence rate per 100 000 persons increased from 2.3 (95% confidence interval, 2.0-2.7) to 21.7 (95% confidence interval, 20.2-23.4) in persons aged 1 to 35 and 36 to 49 years, respectively. Coronary...

  11. On the Question of the Diagnosis of Sudden Infant Death Syndrome

    Directory of Open Access Journals (Sweden)

    L. L. Nisevich

    2015-01-01

    Full Text Available Sudden Infant Death Syndrome (SIDS is one of the leading causes of postneonatal mortality of infants in most developed countries. This paper presents data on terminology and on the study of SIDS in developed countries, and also examines problems of SIDS diagnostic inRussia in comparison with the results of own researches, analyzes risk factors, which are universal as for SIDS, and also for perinatal and infant death in general. The large variability of SIDS diagnosis in Russia suggests that this diagnosis often does not comply with international standard: post-mortem examination of community-acquired sudden death cases is often carried out by a forensic expert, but not by a children's pathologist, and they do not use virological and microbiological methods of investigation. In some cases, there is no infant's record or case record from children's polyclinic.

  12. Sudden progression of lumbar disk protrusion during vertebral axial decompression traction therapy.

    Science.gov (United States)

    Deen, H Gordon; Rizzo, Thomas D; Fenton, Douglas S

    2003-12-01

    Vertebral axial decompression (VAX-D) is a form of spinal traction that is widely promoted as an effective and safe treatment of degenerated and herniated lumbar intervertebral disks. Information targeted at the general public emphasizes that the treatment is completely risk-free. We describe a patient with a large lumbar disk protrusion who experienced sudden, severe exacerbation of radicular pain during a VAX-D therapy session. Follow-up magnetic resonance imaging of the lumbar region showed marked enlargement of the disk protrusion, and urgent microdiskectomy was required. To our knowledge, this is the first reported complication of VAX-D therapy. This case shows that VAX-D therapy has the potential to cause sudden deterioration requiring urgent surgical intervention.

  13. Risk factors for sudden cardiac death among patients with schizophrenia.

    Science.gov (United States)

    Hou, Ping-Yi; Hung, Galen Chin-Lun; Jhong, Jia-Rong; Tsai, Shang-Ying; Chen, Chiao-Chicy; Kuo, Chian-Jue

    2015-10-01

    Patients with schizophrenia suffer from excessive premature mortality, and sudden cardiac death (SCD) is receiving growing attention as a potential cause. The present study investigated the incidence of SCD and its risk factors in a large schizophrenia cohort. We enrolled a consecutive series of 8264 patients diagnosed with schizophrenia (according to DSM-III-R and DSM-IV criteria) who were admitted to a psychiatric center in northern Taiwan from January 1, 1985 through December 31, 2008. By linking with national mortality database, 64 cases of SCD were identified. The standardized mortality ratio (SMR) for SCD was estimated. The cases were matched with controls randomly selected using risk-set sampling in a 1:2 ratio. A standardized chart review process was used to collect socio-demographic and clinical characteristics and the prescribed drugs for each study subject. Multivariate conditional logistic regression analysis was used to identify correlates of SCD at the index admission and the latest admission. The SMR for SCD was 4.5. For the clinical profiles at the index admission, physical disease (adjusted risk ratio [aRR]=2.91, Paggressive behaviors (aRR=3.99, Paggressive behaviors (aRR=3.26, Paggression is a crucial risk factor that deserves ongoing work for clarifying the mechanisms mediating SCD in schizophrenia. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Genomic risk factors in sudden infant death syndrome

    Science.gov (United States)

    2010-01-01

    Sudden infant death syndrome (SIDS) is a major contributor to postneonatal infant death, and is the third leading cause of infant mortality in the USA. While public health efforts have reduced these deaths in recent years, the pathogenesis of SIDS remains unclear. Epidemiological data on SIDS-related deaths have suggested genetic factors, and many studies have attempted to identify SIDS-associated genes. This has resulted in a large body of literature implicating various genes and their encoded proteins and signaling pathways in numerous cohorts of various sizes and ethnicities. This review has undertaken a systematic evaluation of these studies, identifying the pathways that have been implicated in these studies, including central nervous system pathways, cardiac channelopathies, immune dysfunction, metabolism/energy pathways, and nicotine response. This review also explores how new genomic techniques will aid in advancing our knowledge of the genomic risk factors associated with SIDS, including SNPs and copy number variation. Last, this review explores how the current information can be applied to aid in our assessment of the at risk infant population. PMID:21122164

  15. [Sudden death during performance of sport: forensic medicine elucidation].

    Science.gov (United States)

    La Harpe, R; Rostan, A; Fryc, O

    1992-06-01

    Our study deals with cases of sudden death (non-traumatic death) while playing sport which were examined at the Institute of Forensic Medicine at the University of Geneva, and covers the last ten years: 1980-1989. We discovered 19 cases, all men between the ages of 17 to 67. In the case of the younger sportsmen (under the age of 45-50) or when the causes of mortality were unclear, the police requested an autopsy, which totalled 8 cases. In the other 11 cases, we were asked to make an external examination of the bodies, in order to exclude any signs of violence. Seven sportsmen, aged 36-49, who used to play high-risk sports such as football, tennis, basketball and running were autopsied and presented a myocardial infarct. Its interesting that 2 of these cases had also an old scar of a myocardial infarct. The eighth case was a 17 year old boy who had an already known obstructive cardiomyopathy.

  16. Electrocardiographic features of sudden unexpected death in epilepsy.

    Science.gov (United States)

    Chyou, Janice Y; Friedman, Daniel; Cerrone, Marina; Slater, William; Guo, Yu; Taupin, Daniel; O'Rourke, Sean; Priori, Silvia G; Devinsky, Orrin

    2016-07-01

    Sudden unexpected death in epilepsy (SUDEP) is the most common cause of epilepsy-related mortality. We hypothesized that electrocardiography (ECG) features may distinguish SUDEP cases from living subjects with epilepsy. Using a matched case-control design, we compared ECG studies of 12 consecutive cases of SUDEP over 10 years and 22 epilepsy controls matched for age, sex, epilepsy type (focal, generalized, or unknown/mixed type), concomitant antiepileptic, and psychotropic drug classes. Conduction intervals and prevalence of abnormal ventricular conduction diagnosis (QRS ≥110 msec), abnormal ventricular conduction pattern (QRS <110 msec, morphology of incomplete right or left bundle branch block or intraventricular conduction delay), early repolarization, and features of inherited cardiac channelopathies were assessed. Abnormal ventricular conduction diagnosis and pattern distinguished SUDEP cases from matched controls. Abnormal ventricular conduction diagnosis was present in two cases and no controls. Abnormal ventricular conduction pattern was more common in cases than controls (58% vs. 18%, p = 0.04). Early repolarization was similarly prevalent in cases and controls, but the overall prevalence exceeded that of published community-based cohorts. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  17. Observations of stratospheric sudden warmings in Earth rotation variations

    Science.gov (United States)

    Neef, Lisa; Walther, Sophia; Matthes, Katja; Kodera, Kunihiko

    2014-08-01

    Stratospheric sudden warmings (SSWs) are extreme events in the polar stratosphere that are both caused by and have effects on the tropospheric flow. This means that SSWs are associated with changes in the angular momentum of the atmosphere, both before and after their onset. Because these angular momentum changes are transferred to the solid Earth, they can be observed in the rate of the Earth's rotation and the wobble of its rotational pole. By comparing observed Earth rotation variations to reanalysis data, we find that an anomaly in the orientation of the Earth's rotational pole, up to 4 times as large as the annual polar wobble, typically precedes SSWs by 20-40 days. The polar motion signal is due to pressure anomalies that are typically seen before SSW events and represents a new type of observable that may aid in the prediction of SSWs. A decline in the length of day is also seen, on average, near the time of the SSW wind reversal and is found to be due to anomalous easterly winds generated in the tropical troposphere around this time, though the structure and timing of this signal seems to vary widely from event to event.

  18. Role of risk stratification and genetics in sudden cardiac death.

    Science.gov (United States)

    Rai, Vikrant; Agrawal, Devendra K

    2017-03-01

    Sudden cardiac death (SCD) is a major public health issue due to its increasing incidence in the general population and the difficulty in identifying high-risk individuals. Nearly 300 000 - 350 000 patients in the United States and 4-5 million patients in the world die annually from SCD. Coronary artery disease and advanced heart failure are the main etiology for SCD. Ischemia of any cause precipitates lethal arrhythmias, and ventricular tachycardia and ventricular fibrillation are the most common lethal arrhythmias precipitating SCD. Pulseless electrical activity, bradyarrhythmia, and electromechanical dissociation also result in SCD. Most SCDs occur outside of the hospital setting, so it is difficult to estimate the public burden, which results in overestimating the incidence of SCD. The insufficiency and limited predictive value of various indicators and criteria for SCD result in the increasing incidence. As a result, there is a need to develop better risk stratification criteria and find modifiable variables to decrease the incidence. Primary and secondary prevention and treatment of SCD need further research. This critical review is focused on the etiology, risk factors, prognostic factors, and importance of risk stratification of SCD.

  19. Preferences of Patients for Discussing Sudden Unexpected Death in Epilepsy

    Directory of Open Access Journals (Sweden)

    Sūna Normunds

    2017-08-01

    Full Text Available People with epilepsy have increased mortality rates, which is partially attributed to sudden unexpected death in epilepsy syndrome (SUDEP. Poor seizure control appears to be the strongest SUDEP risk factor. Management of epilepsy and adherence to therapy is critical to seizure control. The belief by caregivers of negative influence caused by being informed about the syndrome is the main reason SUDEP is not disclosed. There are no clear recommendations when to disclose the risk of SUDEP and how much information should be provided. We addressed the preferences of Latvian epilepsy patients for discussing SUDEP as well as awareness of the syndrome. Our study involved 55 epilepsy patients. We found that, as in other studies, our patients were relatively well informed about SUDEP. We found that a considerable proportion of patients preferred to receive information about SUDEP from a general practitioner. We note the belief of patients that the disclosure of SUDEP would either improve or have no effect on the quality of life. We were able to identify groups of patients with a self-reported belief of more frequent expected anxiety and poor adherence to medical treatment. Our data improves the understanding of preferences of patient for discussing the negative aspects of epilepsy.

  20. Amplitude equation and long-range interactions in underwater sand ripples in one dimension

    DEFF Research Database (Denmark)

    Schnipper, Teis; Mertens, Keith; Ellegaard, Clive

    2008-01-01

    ) which, due to the first term, is neither completely local (it has long-range coupling through the average height (h) over bar) nor has local sand conservation. We argue that this is reasonable and show that the equation compares well with experimental observations in narrow channels. We focus...... in particular on the so-called doubling transition, a secondary instability caused by the sudden decrease in the amplitude of the water motion, leading to the appearance of a new ripple in each trough. This transition is well reproduced for sufficiently large delta (asymmetry between trough and crest). We...

  1. Strong, sudden cooling alleviates the inflammatory responses in heat-stressed dairy cows based on iTRAQ proteomic analysis

    Science.gov (United States)

    Cheng, Jianbo; Min, Li; Zheng, Nan; Fan, Caiyun; Zhao, Shengguo; Zhang, Yangdong; Wang, Jiaqi

    2017-09-01

    This study was designed to investigate the effects of sudden cooling on the physiological responses of 12 heat-stressed Holstein dairy cows using an isobaric tags for relative and absolute quantification (iTRAQ) labeling approach. Plasma samples were collected from these cows during heat stress (HS), and after strong, sudden cooling in the summer (16 days later). We compared plasma proteomic data before and after sudden cooling to identify the differentially abundant proteins. The results showed that sudden cooling in summer effectively alleviated the negative consequences of HS on body temperature and production variables. Expressions of plasma hemoglobin alpha and hemoglobin beta were upregulated, whereas lipopolysaccharide-binding protein (LBP) and haptoglobin were downregulated in this process. The increase of hemoglobin after cooling may improve oxygen transport and alleviate the rise in respiration rates in heat-stressed dairy cows. The decrease of LBP and haptoglobin suggests that the inflammatory responses caused by HS are relieved after cooling. Our findings provide new insight into the physiological changes that occur when heat-stressed dairy cows experience strong, sudden cooling.

  2. The quality and value of sudden infant death necropsy reporting in Ireland

    Science.gov (United States)

    Sheehan, K M; McDonnell, M; Doyle, E M; Matthews, T; Devaney, D M

    2003-01-01

    Background: Infant necropsies are important for identifying cause of death. Recently issued guidelines have recommended investigations to be performed following sudden unexpected death in infants. Aims: To evaluate the quality and value of infant postmortem reporting. Methods: Postmortem reports from 1994–1996 and 1998–2000 in Ireland were evaluated using the National Sudden Infant Death Register. Scoring was by a modification of the Rushton system based on the extent of the postmortem data. The finding of additional pathological information was also assessed. Results: Of the 274 cases registered during the selection period, reports were available for 245. Overall quality of necropsy reporting was below the minimum accepted standard in 55.5%; 47% of the necropsies were performed in regional paediatric pathology centres. The quality of necropsies performed in regional centres was significantly higher than those performed elsewhere. Although 86% of the cases were defined as sudden infant death syndrome (SIDS; no cause of death found), the finding of additional pathological information was significantly related to the extent of the necropsy. There was a significant improvement in the quality of necropsies after the postmortem guidelines were issued. Conclusions: The overall quality of sudden unexpected infant death necropsies in Ireland is less than adequate. A minimum accepted standard of necropsy is required before a diagnosis of SIDS can be made. Although standards have improved recently, this study highlights the need to adhere to published guidelines and the importance of auditing the effect of introducing practice guidelines on clinical practice to complete the audit loop. PMID:14514778

  3. Postmortem gastric perforation (gastromalacia) mimicking abusive injury in sudden unexplained infant death.

    Science.gov (United States)

    Laczniak, Andrew N; Sato, Yutaka; Nashelsky, Marcus

    2011-12-01

    Gastromalacia is a postmortem autolysis of gastric tissue that can culminate in gastric perforation. This entity is well-recognized by pathologists but is rarely encountered by diagnostic radiologists. We are reporting a case of sudden unexplained infant death (SUID) in which a boy was found to have pneumoperitoneum on postmortem radiographs, subsequently proved by autopsy to be caused by postmortem gastric perforation resulting from gastromalacia. It is important for radiologists to recognize this entity so as not to mistake it for bowel perforation caused by antemortem pathology, including inflicted trauma.

  4. Triggers for an episode of sudden onset low back pain: study protocol

    Directory of Open Access Journals (Sweden)

    Steffens Daniel

    2012-01-01

    Full Text Available Abstract Background Most research on risk factors for low back pain has focused on long term exposures rather than factors immediately preceding the onset of low back pain. The aim of this study is to quantify the transient increase in risk of a sudden episode of low back pain associated with acute exposure to a range of common physical and psychological factors. Methods/design This study uses a case-crossover design. One thousand adults with a sudden onset of low back pain presenting to primary care clinicians will be recruited. Basic demographic and clinical information including exposure to putative triggers will be collected using a questionnaire. These triggers include exposure to hazardous manual tasks, physical activity, a slip/trip or fall, consumption of alcohol, sexual activity, being distracted, and being fatigued or tired. Exposures in the case window (0-2 hours from the time when participants first notice their back pain will be compared to exposures in two control time-windows (one 24-26 hours and another 48-50 hours before the case window. Discussion The completion of this study will provide the first-research based estimates of the increase in risk of a sudden episode of acute low back pain associated with transient exposure to a range of common factors thought to trigger low back pain.

  5. Impact of Stratospheric Sudden Warming on East Asian Winter Monsoons

    Science.gov (United States)

    Chen, Quanliang

    2017-04-01

    Quanliang Chen, Luyang Xu, and Hongke Cai College of Atmospheric Science, Chengdu University of Information Technology and Plateau Atmospheric and Environment Laboratory of Sichuan Province, Chengdu 610225, China Fifty-two stratospheric sudden warming (SSW) events that occurred from 1957 to 2002 were analysed based on the 40-year European Centre for Medium-Range Weather Forecasts Reanalysis dataset. Those that could descent to the troposphere were composited to investigate their impacts on the East Asian winter monsoon (EAWM). It reveals that when the SSW occurs, the Arctic Oscillation (AO) and the North Pacific Oscillation (NPO) are both in the negative phase and that the tropospheric circulations quite wave-like. The Siberian high and the Aleutian low are both strengthened, leading to an increased gradient between the Asian continent and the North Pacific. Hence, strong EAWM is observed with widespread cooling over in land and coastal East Asia. After the peak of the SSW, in contrast, the tropospheric circulation is quite zonally symmetric with negative phases of AO and NPO. The mid-tropospheric East Asian trough deepens and shifts eastward. This configuration facilitates warming over the East AsianinlandandcoolingoverthecoastalEastAsiacenteredoverJapan.Theactivitiesofplanetarywavesduringthelifecycleofthe SSW were analysed. The anomalous propagation and the attendant altered amplitude of the planetary waves can well explain the observed circulation and the EAWM.

  6. A case of sudden death after Japanese encephalitis vaccination.

    Science.gov (United States)

    Bunai, Yasuo; Ishii, Akira; Akaza, Kayoko; Nagai, Atsushi; Nishida, Naoki; Yamaguchi, Seiji

    2015-07-01

    Japanese encephalitis (JE) virus is estimated to result in 3500-50,000 clinical cases every year, with mortality rates of up to 20-50% and a high percentage of neurological sequelae in survivors. Vaccination is the single most important measure in preventing this disease. Inactivated Vero cell culture-derived JE vaccines have not been linked to any fatalities, and few serious adverse events after vaccination have been reported. Here, we report a case of sudden death in which a 10-year-old boy experienced cardiopulmonary arrest 5 min after receiving a Japanese encephalitis vaccination. He had been receiving psychotropic drugs for the treatment of pervasive developmental disorders. Postmortem examinations were nonspecific, and no signs of dermatologic or mucosal lesions or an elevation of the serum tryptase level, which are characteristic of anaphylaxis, were observed. A toxicological examination revealed that the blood concentrations of the orally administered psychotropic drugs were within the therapeutic ranges. The patient was considered to have died of an arrhythmia that was not directly associated with the vaccination. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. 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)

  8. Familial Atrial Septal Defect and Sudden Cardiac Death

    DEFF Research Database (Denmark)

    Ellesøe, Sabrina Gade; Johansen, Morten Munk; Bjerre, Jesper Vandborg

    2016-01-01

    disturbances, cardiomyopathies, complex CHD, and sudden cardiac death as well. Here, we show that NKX2-5 mutations primarily occur in ASD patients with conduction disturbances and heritable ASD. Furthermore, these families are at increased risk of sudden cardiac death. RESULTS: We screened 39 probands.......1 × 10(-9) ). The majority of patients (74%) had ASD with conduction disturbance. Nineteen patients (15%) of 120 with familial ASD and conduction disturbance died from sudden cardiac death of which nine (8%) were confirmed mutation carriers, and 10 were possible carriers. CONCLUSIONS: NKX2-5 mutations...... mainly occur in familial CHD, the signature phenotype is ASD with conduction disturbances and mutation carriers are at increased risk of sudden cardiac death. We suggest that familial ASD patients should be screened for NKX2-5 mutations and, if they are mutation carriers, implantation of an implantable...

  9. QT Variability and Other Electrocardiographic Predictors of Sudden Cardiac Death

    NARCIS (Netherlands)

    M.E. van den Berg (Marten)

    2017-01-01

    markdownabstractThis thesis investigates sudden cardiac death, focusing of QT variability, heart-rate variability and other electrocardiographic markers. Topics include: - Normal values for heart-rate variability - Normal values for QT variability - The association of QT variability with

  10. Sudden insight is associated with shutting out visual inputs

    National Research Council Canada - National Science Library

    Salvi, Carola; Bricolo, Emanuela; Franconeri, Steven L; Kounios, John; Beeman, Mark

    2015-01-01

    ... window—all signs of shutting out distractions and turning attention inward. Prior research has demonstrated that attention-related brain areas are differently active when people solve problems with sudden insight (the Aha! phenomenon...

  11. The epidemiology of sudden oak death in Oregon forests

    Science.gov (United States)

    Ebba K. Peterson

    2011-01-01

    The phytopathogen Phytophthora ramorum (Werres, DeCock & Man in't Veld), causal agent of Sudden Oak Death (SOD) of oaks (Quercus spp.) and tanoaks (Notholithocarpus densiflorus syn. Lithocarpus densiflorus...

  12. Sudden shrinkage of free rectus abdominis musculocutaneous flap 15 years after maxilla reconstruction

    Directory of Open Access Journals (Sweden)

    Yasushi Mochizuki

    2018-03-01

    Full Text Available A 60-year-old male displayed sudden shrinkage of a left free rectus abdominis musculocutaneous flap, which had been grafted to his left maxilla 15 years previously. No post-reconstructive irradiation had been performed, and no late occlusion of the vascular anastomosis, local infection, recurrence of the maxillary cancer, or body weight loss was observed. However, the shrinkage amounted to approximately 50%. This is considerably more than previously reported cases of shrinkage of various free flaps, which ranged between 10% and 25%. The resultant depression was successfully augmented with a right free deep inferior epigastric artery perforator flap. The residual fat volume of the previously grafted shrunken flap was revealed to be compatible with that of the newly harvested contralateral perforator flap. Thus, the volume of the previously grafted flap may reflect the status of the intact contralateral donor site, although the mechanism of sudden flap shrinkage is unclear.

  13. Sudden infant death syndrome: methodological and patogenetical types of diagnosis

    Directory of Open Access Journals (Sweden)

    B.I. Glukhovets

    2011-01-01

    Full Text Available The review presents an analysis of literature data on pathogenesis of sudden infant death syndrome (SIDS in comparison with author’s experience of infants dead in home. Diagnostic significance of qualified autopsy examinations in analysis of infants’ death is shown. Frequent combination of morphogenetic cardiopathy and early signs of atrial myocarditis can be estimated as pathogenetic basis of SIDS.Key words: sudden infant death syndrome, morphogenetic cardiopathy, atrial myocarditis.

  14. Post-mortem toxicology in young sudden cardiac death victims

    DEFF Research Database (Denmark)

    Bjune, Thea; Risgaard, Bjarke; Kruckow, Line

    2017-01-01

    Aims: Several drugs increase the risk of ventricular fibrillation and sudden cardiac death (SCD). We aimed to investigate in detail the toxicological findings of all young SCD throughout Denmark. Methods and results: Deaths in persons aged 1-49 years were included over a 10-year period. Death...... death with positive toxicology had higher rates of sudden arrhythmic death syndrome (SADS), compared with SCD with negative toxicology (56% vs. 42%, P 

  15. Obesity paradox and risk of sudden death in heart failure results from the MUerte Subita en Insuficiencia cardiaca (MUSIC) study.

    Science.gov (United States)

    Gastelurrutia, Paloma; Pascual-Figal, Domingo; Vazquez, Rafael; Cygankiewicz, Iwona; Shamagian, Lillian Grigorian; Puig, Teresa; Ferrero, Andreu; Cinca, Juan; de Luna, Antoni Bayes; Bayes-Genis, Antoni

    2011-01-01

    among patients with heart failure (HF), body mass index (BMI) has been inversely associated with mortality, giving rise to the so-called obesity paradox. The aim of this study was to examine the relationship between BMI and two modes of cardiac death: pump failure death and sudden death. nine hundred seventy-nine patients with mild to moderate chronic symptomatic HF from the MUSIC (MUerte Subita en Insuficiencia Cardiaca) Study, a prospective, multicenter, and longitudinal study designed to assess risk predictors of cardiac mortality, were followed up during a median of 44 months. Independent predictors of death were identified by a multivariable Cox proportional hazards model. higher BMI emerged as an independent predictor of all-cause mortality (hazard ratio [HR] = 0.94, 95% confidence interval [CI] = 0.91-0.97, P = .0003) and pump failure death (HR = 0.93, 95% CI = 0.88-0.98, P = .004). Sudden death accounted for 45% of deaths in obese patients, 53% in overweight patients, and 37% in lean patients. No significant relationship between BMI and sudden death was observed (HR = 0.97, 95% CI = 0.92-1.02, P = .28). The only independent predictors of sudden death were prior history of myocardial infarction (HR = 1.89, 95% CI = 1.23-2.90, P = .004), hypertension (HR = 1.66, 95% CI = 1.05-2.63, P = .03), left ventricular ejection fraction (HR = 0.88, 95% CI = 0.79-0.96, P = .006), and N-terminal pro-B-type natriuretic peptide (HR = 1.01, 95% CI = 1.00-1.02, P = .048). the obesity paradox in HF affects all-cause mortality and pump failure death but not sudden death. The risk of dying suddenly was similar across BMI categories in this cohort of ambulatory patients with HF.

  16. Peripheral arterial chemoreceptors and sudden infant death syndrome.

    Science.gov (United States)

    Gauda, Estelle B; Cristofalo, Elizabeth; Nunez, Jeanne

    2007-07-01

    Sudden infant death syndrome (SIDS) is the major cause of death in infants between 1 month and 1 year of age. Two particular concerns are that (1) premature or low birth weight (peripheral arterial chemoreceptors (PACs) may be one biological mechanism that could help to explain the epidemiological association between the increased incidence of SIDS in formerly premature infants. Because premature infants are often exposed to the extremes of oxygen stress during early postnatal development, they are more likely to have a maladaptive response of PACs later in their lives. As the first line of defense that mediates an increase in ventilation to a hypoxic challenge during wakefulness and sleep, PACs also mediate arousal responses during sleep in response to an asphyxial event that is often associated with upper airway obstruction. In most mammalian species, PACs are not fully developed at birth and thus are vulnerable to plasticity-induced changes mediated by environmental exposures such as the extremes of oxygen tension. Hypoxic or hyperoxic exposure during early postnatal development can lead to hyposensitive or hypersensitive PAC responses later in life. Although baseline chemoreceptor activity may not be the cause of an initial hypoxic or asphyxial event, the level of peripheral chemoreceptor drive does modulate the (1) time to arousal, (2) resumption of airflow during airway obstruction, (3) escape behaviors during rebreathing, and (4) cardiorespiratory responses that result from activation of the laryngeal chemoreflex. The laryngeal chemoreflex can be stimulated by reflux of gastric contents above the upper esophageal sphincter, or an increase in nasopharyngeal secretions from upper respiratory tract infections--events that contribute to some cases of SIDS. In this review, evidence is presented that both hypo- and hypersensitivity of PACs may be disadvantageous to the premature infant who is placed in an at risk environment for the occurrence of hypoxemia

  17. 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......) in the MCAD gene has been characterized, thus rendering diagnosis easy in the majority of cases. Since the clinical spectrum of MCAD deficiency ranges from death in the first days of life to an asymptomatic life, there are probably other genetic factors--in addition to MCAD mutations......--involved in the expression of the disease. Thus, families who have experienced the death of a child from MCAD deficiency might have an increased risk of a seriously affected subsequent child. In such a family we have therefore performed a prenatal diagnosis on a chorionic villus sample by a highly specific and sensitive...

  18. Marked decline of sudden mass fatality events in New Zealand 1900 to 2015: the basic epidemiology.

    Science.gov (United States)

    Wilson, Nick; Morales, Adrienne; Guy, Nicola; Thomson, George

    2017-06-01

    To describe the basic epidemiology of sudden mass fatality events for the 1900 to 2015 period in New Zealand (NZ). Official lists and internet searches were used to identify the events. Events were categorised, rates calculated and time trends analysed. A total of 56 sudden mass fatality events with 10 or more fatalities between 1900 and 2015 in NZ were identified. There were 1,896 deaths in total, with the worst event being the Hawke's Bay earthquake (258 deaths). Events were classified as transportation-related (64%), natural causes (11%), industrial (9%), war (9%) and infrastructure (5%). There were marked declines in the rate of events per person-years of exposure and the associated mortality rate (both pevents. The occurrence and health burden of sudden mass fatality events have markedly declined in NZ over time. Implications for public health: There remains large scope for addressing the knowledge gaps in the basic epidemiology and societal responses to these events to guide primary prevention and appropriate disaster response. © 2017 The Authors.

  19. Molecular Autopsy for Sudden Death in the Young: Is Data Aggregation the Key?

    Directory of Open Access Journals (Sweden)

    Manuel Rueda

    2017-11-01

    Full Text Available The Scripps molecular autopsy study seeks to incorporate genetic testing into the postmortem examination of cases of sudden death in the young (<45 years old. Here, we describe the results from the first 2 years of the study, which consisted of whole exome sequencing (WES of a cohort of 50 cases predominantly from San Diego County. Apart from the individual description of cases, we analyzed the data at the cohort-level, which brought new perspectives on the genetic causes of sudden death. We investigated the advantages and disadvantages of using WES compared to a gene panel for cardiac disease (usually the first genetic test used by medical examiners. In an attempt to connect complex clinical phenotypes with genotypes, we classified samples by their genetic fingerprint. Finally, we studied the benefits of analyzing the mitochondrial DNA genome. In this regard, we found that half of the cases clinically diagnosed as sudden infant death syndrome had an increased ratio of heteroplasmic variants, and that the variants were also present in the mothers. We believe that community-based data aggregation and sharing will eventually lead to an improved classification of variants. Allele frequencies for the all cases can be accessed via our genomics browser at https://genomics.scripps.edu/browser.

  20. Numerical Investigation of magnetohydrodynamic flow through Sudden expansion pipes in Liquid Metal Blankets

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Jingchao; He, Qingyun; Chen, Hongli, E-mail: hlchen1@ustc.edu.cn; Ye, Minyou

    2016-11-01

    In fusion liquid metal blanket, sudden expansions and sudden contractions are very common geometries. Changing of the cross-section causes 3-D magnetohydrodynamic (MHD) effects, which will affect the flow pattern, current distribution and pressure drop. In this paper the numerical code based on OpenFOAM platform developed by University of Science and Technology of China was used to investigate and optimize the sudden expansion pipe. The code has been validated by the recommended benchmark cases including Shercliff, Hunt, ALEX experiments (rectangular duct and round pipe) and KIT experiment cases. The obtained numerical results agreed well with those of all the benchmark cases. Previous and valuable analytical and experimental works have been done by L. Buhler, et. el. Based on these works, in the present paper, further investigation of different expansion lengths between the upstream pipe and downstream pipe at high Hartmann number and Reynolds number were conducted. Besides, different expansion ratios with a specific expansion length were conducted. The numerical results showed that with the increasing of expansion length, the 3D MHD effects gradually weakened. Especially, the 3D pressure drop decreases with the increasing of expansion length. Whereas, the expansion ratio factor shows no obvious influences on the total MHD pressure drop but greatly influence the local pressure distribution. These numerical simulations can be used to evaluate the MHD flow inside the expansion and contraction pipes.

  1. Factors Affecting the Occurrence of Out-of-Hospital Sudden Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Izabella Uchmanowicz

    2015-01-01

    Full Text Available Objective. This paper aims to discover the risk factors for sudden cardiac arrest (out-of-hospital sudden cardiac arrest (OHSCA which significantly affect the decision about prioritizing emergency interventions before dispatching medical emergency teams, risk of deterioration of the patient’s condition at the scene, and emergency procedures. Methods. A retrospective study taking into account the international classification of diseases ICD-10 based on an analysis of medical records of Emergency Medical Service in Wroclaw (Poland. Results. The main risk factor of OHSCA is coexistence of external cause leading to illness or death (ICD Group V-10 as well as the occurrence of diseases from the group of endocrine disorders (group E, in particular diabetes. The increase in the risk of OHSCA incidence is affected by nervous system diseases (group G, especially epilepsy of various etiologies, respiratory diseases (group J, mainly COPD, and bronchial asthma or mental and behavioral disorders (group F, with particular emphasis on the drugs issue. The procedure for receiving calls for Emergency Notification Centre does not take into account clinical risk factors for sudden cardiac arrest (SCA. Conclusion. Having knowledge of OHSCA risk factors can increase the efficiency of rescue operations from rapid assessment and provision of appropriate medical team, through effective performance of medical emergency treatment and prevention of SCA or finally reducing the costs.

  2. Cytoarchitectural and functional abnormalities of the inferior colliculus in sudden unexplained perinatal death.

    Science.gov (United States)

    Lavezzi, Anna M; Pusiol, Teresa; Matturri, Luigi

    2015-02-01

    The inferior colliculus is a mesencephalic structure endowed with serotonergic fibers that plays an important role in the processing of acoustic information. The implication of the neuromodulator serotonin also in the aetiology of sudden unexplained fetal and infant death syndromes and the demonstration in these pathologies of developmental alterations of the superior olivary complex (SOC), a group of pontine nuclei likewise involved in hearing, prompted us to investigate whether the inferior colliculus may somehow contribute to the pathogenetic mechanism of unexplained perinatal death. Therefore, we performed in a wide set of fetuses and infants, aged from 33 gestational weeks to 7 postnatal months and died of both known and unknown cause, an in-depth anatomopathological analysis of the brainstem, particularly of the midbrain. Peculiar neuroanatomical and functional abnormalities of the inferior colliculus, such as hypoplasia/structural disarrangement and immunonegativity or poor positivity of serotonin, were exclusively found in sudden death victims, and not in controls. In addition, these alterations were frequently related to dysgenesis of connected structures, precisely the raphé nuclei and the superior olivary complex, and to nicotine absorption in pregnancy. We propose, on the basis of these results, the involvement of the inferior colliculus in more important functions than those related to hearing, as breathing and, more extensively, all the vital activities, and then in pathological conditions underlying a sudden death in vulnerable periods of the autonomic nervous system development, particularly associated to harmful risk factors as cigarette smoking.

  3. [Forensic Analysis of 6 Cases of Sudden Death due to Hyperthyroid Heart Disease].

    Science.gov (United States)

    Zhang, M Z; Li, B X; Zhao, R; Guan, D W; Zhang, G H; Wu, X; Zhu, B L; Li, R B

    2017-10-01

    To analyse the cases of sudden death due to hyperthyroid heart disease, and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases. Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine, China Medical University. The general information (gender and age), clinical manifestations, medical history, anatomical and histopathological findings, biochemical parameters and cause of death were analysed retrospectively. Most of the 6 patients had definite history of hyperthyroidism, and they all showed certain degrees of symptoms of cardiovascular disease; had obvious incentive factors of death; histopathological examination of thyroid conformed to the performances of diffuse toxic goiter; with increase of cardiac weight, dilatation of cardiac chambers, myocardial hypertrophy and focal necrosis; postmortem biochemical analyses of pericardial fluid could be used as an additional method for diagnostic of sudden death due to hyperthyroid heart disease. The identification of death due to hyperthyroid heart disease should be based on the clinical history and the results of autopsy, histopathological examination, postmortem toxicology tests. The postmortem biochemical detection of thyroid and cardiac function should be performed if necessary.

  4. Control of trunk motion following sudden stop perturbations during cart pushing.

    Science.gov (United States)

    Lee, Yun-Ju; Hoozemans, Marco J M; van Dieën, Jaap H

    2011-01-04

    External perturbations during pushing tasks have been suggested to be a risk factor for low-back symptoms. An experiment was designed to investigate whether self-induced and externally induced sudden stops while pushing a high inertia cart influence trunk motions, and how flexor and extensor muscles counteract these perturbations. Twelve healthy male participants pushed a 200 kg cart at shoulder height and hip height. Pushing while walking was compared to situations in which participants had to stop the cart suddenly (self-induced stop) or in which the wheels of the cart were unexpectedly blocked (externally induced stop). For the perturbed conditions, the peak values and the maximum changes from the reference condition (pushing while walking) of the external moment at L5/S1, trunk inclination and electromyographic amplitudes of trunk muscles were determined. In the self-induced stop, a voluntary trunk extension occurred. Initial responses in both stops consisted of flexor and extensor muscle cocontraction. In self-induced stops this was followed by sustained extensor activity. In the externally induced stops, an external extension moment caused a decrease in trunk inclination. The opposite directions of the internal moment and trunk motion in the externally induced stop while pushing at shoulder height may indicate insufficient active control of trunk posture. Consequently, sudden blocking of the wheels in pushing at shoulder height may put the low back at risk of mechanical injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Magnetic resonance imaging in sudden deafness; Ressonancia magnetica em surdez subita

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, Hugo Valter Lisboa; Barros, Flavia Alencar; Penido, Norma de Oliveira; Souza, Ana Claudia Valerio de; Yamaoka, Wellington Yugo [Sao Paulo Univ., SP (Brazil). Dept. de Otorinolaringologia e Cirurgia da Cabeca e Pescoco; Yamashita, Helio [Sao Paulo Univ., SP (Brazil). Dept. de Imagem e Diagnostico]. E-mail: hvlramos@gmail.com

    2005-07-15

    The etiology of sudden deafness can remain undetermined despite extensive investigation. This study addresses the value of magnetic resonance imaging in the analysis of sudden deafness patients.Study Design: transversal cohort.Material And Method: In a prospective study, 49 patients attended at otolaryngology emergency room of Federal University of Sao Paulo - Escola Paulista de Medicina, from April 2001 to May 2003, were submitted to magnetic resonance imaging.Results: Magnetic Resonance abnormalities were seen in 23 (46.9%) patients and revealed two tumors suggestive of meningioma, three vestibular schwannomas, thirteen microangiopathic changes of the brain and five (21.7%) pathological conditions of the labyrinth.Conclusion: Sudden deafness should be approached as a symptom common to different diseases. The presence of cerebellopontine angle tumors in 10.2% of our cases, among other treatable causes, justifies the recommendation of gadolinium-enhanced magnetic resonance use, not only to study the auditory peripheral pathway, but to study the whole auditory pathway including the brain. (author)

  6. Sudden cardiac death in adult congenital heart disease: can the unpredictable be foreseen?

    Science.gov (United States)

    Koyak, Zeliha; de Groot, Joris R; Bouma, Berto J; Zwinderman, Aeilko H; Silversides, Candice K; Oechslin, Erwin N; Budts, Werner; Van Gelder, Isabelle C; Mulder, Barbara J M; Harris, Louise

    2017-03-01

    Sudden cardiac death (SCD) is a major cause of mortality in adults with congenital heart disease (CHD). Several risk factors for SCD including conduction disturbances and ventricular dysfunction have been described previously. However, electrocardiogram (ECG) and echocardiographic parameters may change over time, and the predictive value of such temporal changes, rather than their point estimates, for SCD remains unknown. This was a retrospective case-control study in adults with CHD and proven or presumed SCD and matched controls. Data were obtained from three databases including 25 000 adults with CHD. Sequential measurements were performed on electrocardiograms and echocardiograms. Ventricular function was assessed by echocardiography and graded on a four-point ordinal scale: 1, normal [ejection fraction (EF) ≥50%]; 2, mildly impaired (EF 40-49%); 3, moderately impaired (EF 30-39%); and 4, severely impaired (EF < 30%). Overall, 131 SCDs (mean age 36 ± 14 years, 67% male) and 260 controls (mean age 37 ± 13 years, 63% male) were included. At baseline, median QRS duration was 108 ms (range 58-168 ms) in SCDs and 97 ms (range 50-168 ms) in controls and increased over time at a rate of 1.6 ± 0.5 vs. 0.5 ± 0.2 ms/year in SCDs and controls, respectively (P = 0.011). QT dispersion at baseline was 61 ms (range 31-168 ms) in SCDs and 50 ms (range 21-129 ms) in controls. QT dispersion increased at a rate of 1.1 ± 0.4 ms/year in SCD victims and decreased at a rate of 0.2 ± 0.2 ms/year in controls (P = 0.004). Increase of QRS duration ≥5 ms/year was associated with an increased risk of SCD [OR 1.9, 95% confidence interval (CI) 1.1-3.3, P = 0.013]. Change from any baseline systemic ventricular function (normal, mild, or moderately impaired) to severe ventricular dysfunction over time was associated with the highest risk of SCD (OR 16.9, 95% CI 1.8-120.1, P = 0.008). In adults with CHD, QRS duration and ventricular dysfunction progress over time. Progression of QRS

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

    Directory of Open Access Journals (Sweden)

    Deborah Carmen Mash

    2016-10-01

    Full Text Available Over the past decade, the excited delirium syndrome (ExDS has raised continuous controversy regarding the cause and manner of death of some highly agitated persons who die in police custody, during physical restraint or incapacitation by electrical devices. At autopsy, medical examiners have difficulty in identifying any 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 recognized at the beginning of the cocaine epidemic by medical examiners. The first neurochemical pathology examinations of brain tissues from these cases 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

  8. Application of a classification system focusing on potential asphyxia for cases of sudden unexpected infant death.

    Science.gov (United States)

    Randall, Brad; Donelan, Kent; Koponen, Mark; Sens, Mary Ann; Krous, Henry F

    2012-03-01

    Current classification schemes for sudden unexpected infant death (SUID) may not be optimal for capturing scene events that potentially predispose to asphyxia. (1) To compare causes of death in a group of SUID cases assigned by multiple reviewers using our recently published classification scheme for SUID that is based on asphyxial risk at the death scene, and (2) To compare these newly assigned causes of death to that originally assigned by the medical examiners of record who performed the autopsies. Five reviewers independently assigned causes of death for 117 cases of SUID, including 83 originally diagnosed as sudden infant death syndrome (SIDS), accessioned into the San Diego SIDS/SUDC Research Project from the San Diego County Medical Examiner's Office. The diagnostic categories are: A: SIDS; B: Unexplained-Potentially Asphyxia; C: Unexplained-Other Potential Causes of Death; D: Unclassified-Other; E: Unclassified; and F: Known Cause of Death. The reviewers collectively opined that conditions at the death scene contributed to or caused death in 32-50% of all of the 117 cases as well as in 40-59% of the 83 originally diagnosed SIDS cases. Another cause of death was considered plausible in 2-12% of the SIDS cases. Application of this new classification system resulted in 55-69% decrease in SIDS diagnoses. Asphyxia as a potential contributor to, or as the specific cause of death, appears to exist in a large percentage of cases designated as SIDS using other classification schemes. When certifiers use a classification system that focuses upon potential asphyxia in determining the cause of death the incidence of SIDS dramatically declines.

  9. Pneumonia and bacteremia in a golden-headed lion tamarin (Leontopithecus chrysomelas) caused by Klebsiella pneumoniae subsp. pneumoniae during a translocation program of free-ranging animals in Brazil.

    Science.gov (United States)

    Bueno, Marina G; Iovine, Renata O; Torres, Luciana N; Catão-Dias, José L; Pissinatti, Alcides; Kierulff, Maria C M; Carvalho, Vania M

    2015-05-01

    Klebsiella pneumoniae is an important emerging pathogen in humans, particularly the invasive hypermucoviscosity (HMV) phenotype. In addition, the organism is an important public health concern because of nosocomial infections and antimicrobial resistance. Nonhuman primates in captivity are susceptible to Klebsiella, particularly when a stress factor is involved. Infections vary depending on the species but can cause significant morbidity and mortality in these animals. The objective of this study was to describe a case of bronchopneumonia and bacteremia caused by Klebsiella pneumoniae in a free-ranging golden-headed lion tamarin (Leontopithecus chrysomelas) caught and maintained in quarantine during a translocation program for conservation purposes. An adult male, that had showed emaciation and apathy, was clinically examined and, despite being provided supportive therapy, died 2 days after onset of clinical signs. At postmortem examination, generalized bilateral pneumonia and pericarditis were observed. Tissue samples were fixed in 10% formalin for histology, and pulmonary tissues and cardiac blood were collected for microbiologic diagnostic procedures. Bacteria that were shown to be HMV K. pneumoniae subsp. pneumoniae strains were isolated from the pulmonary fluids and cardiac blood in pure cultures. Severe bronchopneumonia was the main pathological finding. The consequences of the confirmed presence of the HMV phenotype of K. pneumoniae subsp. pneumoniae in this wildlife species for human, animal, and ecosystem health should be determined. These results demonstrate the importance of quarantine and potential pathogen screening during wildlife translocation procedures. © 2015 The Author(s).

  10. Ambient Heat and Sudden Infant Death: A Case-Crossover Study Spanning 30 Years in Montreal, Canada.

    Science.gov (United States)

    Auger, Nathalie; Fraser, William D; Smargiassi, Audrey; Kosatsky, Tom

    2015-07-01

    Climate change may lead to more severe and extreme heat waves in the future, but its potential impact on sudden infant death-a leading cause of infant mortality-is unclear. We sought to determine whether risk of sudden infant death syndrome (SIDS) is elevated during hot weather. We undertook a case-crossover analysis of all sudden infant deaths during warm periods in metropolitan Montreal, Quebec, Canada, from 1981 through 2010. Our analysis included a total of 196 certified cases of SIDS, including 89 deaths at 1-2 months of age, and 94 at 3-12 months. We estimated associations between maximum outdoor temperatures and SIDS by comparing outdoor temperatures on the day of or day before a SIDS event with temperatures on control days during the same month, using cubic splines to model temperature and adjusting for relative humidity. Maximum daily temperatures of ≥ 29°C on the same day were associated with 2.78 times greater odds of sudden infant death relative to 20°C (95% CI: 1.64, 4.70). The likelihood of sudden death increased steadily with higher temperature. Associations were stronger for infants 3-12 months of age than for infants 1-2 months of age, with odds ratios of 3.90 (95% CI: 1.87, 8.13) and 1.73 (95% CI: 0.80, 3.73), respectively, for 29°C compared with 20°C on the day of the event. High ambient temperature may be a novel risk factor for SIDS, especially at ≥ 3 months of age. Climate change and the higher temperatures that result may account for a potentially greater proportion of sudden infant deaths in the future.

  11. Clinical and Genetic Diagnosis of Nonischemic Sudden Cardiac Death.

    Science.gov (United States)

    Jiménez-Jáimez, Juan; Alcalde Martínez, Vicente; Jiménez Fernández, Miriam; Bermúdez Jiménez, Francisco; Rodríguez Vázquez Del Rey, María Del Mar; Perin, Francesca; Oyonarte Ramírez, José Manuel; López Fernández, Silvia; de la Torre, Inmaculada; García Orta, Rocío; González Molina, Mercedes; Cabrerizo, Elisa María; Álvarez Abril, Beatriz; Álvarez, Miguel; Macías Ruiz, Rosa; Correa, Concepción; Tercedor, Luis

    2017-10-01

    Nonischemic sudden cardiac death (SCD) is predominantly caused by cardiomyopathies and channelopathies. There are many diagnostic tests, including some complex techniques. Our aim was to analyze the diagnostic yield of a systematic diagnostic protocol in a specialized unit. The study included 56 families with at least 1 index case of SCD (resuscitated or not). Survivors were studied with electrocardiogram, advanced cardiac imaging, exercise testing, familial study, genetic testing and, in some cases, pharmacological testing. Families with deceased probands were studied using the postmortem findings, familial evaluation, and molecular autopsy with next-generation sequencing (NGS). A positive diagnosis was obtained in 80.4% of the cases, with no differences between survivors and nonsurvivors (P=.53). Cardiac channelopathies were more prevalent among survivors than nonsurvivors (66.6% vs 40%, P=.03). Among the 30 deceased probands, the definitive diagnosis was given by autopsy in 7. A diagnosis of cardiomyopathy tended to be associated with a higher event rate in the family. Genetic testing with NGS was performed in 42 index cases, with a positive result in 28 (66.6%), with no differences between survivors and nonsurvivors (P=.21). There is a strong likelihood of reaching a diagnosis in SCD after a rigorous protocol, with a more prevalent diagnosis of channelopathy among survivors and a worse familial prognosis in cardiomyopathies. Genetic testing with NGS is useful and its value is increasing with respect to the Sanger method. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  12. The Etiological Relationship Between Migraine and Sudden Hearing Loss.

    Science.gov (United States)

    Arslan, Yildiz; Arslan, İlker Burak; Aydin, Huriye; Yağiz, Özlem; Tokuçoğlu, Figen; Çukurova, İbrahim

    2017-12-01

    To investigate the relationship between sudden sensorineural hearing loss (SSNHL) and migraine, assess the prevalence of migraine in patients with idiopathic SSNHL, and determine a possible common vascular etiopathogenesis for migraine and SSNHL. Prospective cohort study. Tertiary referral center. This study initially assessed 178 SSNHL cases obtained from the Head and Neck Surgery Clinic patient database at a tertiary hospital in Turkey between January 2011 and March 2016. Ultimately, a total of 61 idiopathic SSNHL patients participated in the present study. İNTERVENTIONS:: Diagnostic. Cases with inflammation in the middle or inner ear; a retro cochlear tumor; autoimmune, infectious, functional, metabolic, neoplastic, traumatic, toxic, or vascular causes; Meniere's disease; otosclerosis; multiple sclerosis; and/or cerebrovascular diseases were excluded. Of the 61 idiopathic SSHNL patients, 34 were women (55.74%); and 24 (39.34%) had migraine, according to the criteria of the International Headache Society (IHS). The mean age of the migraine patients (Group 1) was 43.83 ± 13.16 years, and that of those without migraine (Group 2) was 51.05 ± 16.49 years. The groups did not significantly differ in terms of age, sex, or SSNHL recovery rates according to the Siegel criteria (p > 0.05). Ten of the migraine patients experienced visual aura, and the recovery rates of this group were higher. Additionally, the rate of total hearing loss was lower in Group 1 (n = 3, 12.5%) than in Group 2 (n = 10, 27%). SSNHL patients had a higher prevalence of migraine. Although those with migraine had higher recovery rates, the differences were not statistically significant.

  13. A case of sudden, painless, and persistent urinary incontinence.

    Science.gov (United States)

    Delasobera, B Elizabeth; Rogers, William D

    2013-01-01

    Urinary incontinence is not a common emergency department (ED) complaint, and it is hard to imagine that a case involving this complaint could turn out to be interesting. We report the case of a patient who presented with the complaint of sudden onset of painless urinary incontinence for 1 day, who had an unexpected diagnosis. To describe a case of incontinence with an unexpected diagnosis and to review the various causes of incontinence. A 52-year-old woman with a history of kidney stones recently treated with lithotripsy, nephrostomy tubes, and ureteral stents, presented to the ED complaining of new-onset incontinence. The patient had awakened on the morning of presentation with urinary incontinence that persisted throughout the day. On examination she had normal vital signs, and other than a functioning nephrostomy tube, she had a normal examination. In addition to a urinalysis, a KUB (kidney, ureter, and bladder) X-ray study was performed, which showed that her recently placed right ureteral stent had migrated from its original location into the urethra. The stent was found by the urologist protruding from the urethral meatus and removed without difficulty. The patient's incontinence resolved immediately after the stent was removed. Emergency physicians frequently see patients with ureteral stents, but may not be aware of how frequently those stents can migrate or malfunction. Our experience suggests that radiologic determination of stent location may be helpful in patients who present with new-onset stress or overflow incontinence. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. A New Insight Into Sudden Cardiac Death in Young People

    Science.gov (United States)

    Wang, Yueyue; Xia, Lei; Shen, Xiaodong; Han, Guoxin; Feng, Dan; Xiao, Hongju; Zhai, Yongzhi; Chen, Xin; Miao, Yuanyuan; Zhao, Chunhong; Wang, Yingchan; Guo, Mingguang; Li, Tanshi; Zhu, Hai Yan

    2015-01-01

    Abstract Takotsubo cardiomyopathy (TTC) causes sudden cardiac death and has garnered increased attention worldwide in recent years. However, few studies have clearly classified the risk factors for this disease, including gender, race and morbidity, as well as the physical and mental stressors that can exacerbate the disease, particularly in young patients. To better analyze the characteristics of young TTC patients, we performed a systematic review of reported cases involving young patients. A computer-assisted search was performed using prominent electronic medical information sources to identify literature published between January 1965 and December 2013. Relevant studies containing clinical data of young TTC patients were included. Ninety-six records that included information about 104 cases were ultimately selected for our review. Several of the following results were noted: First, physical stress was more likely to exacerbate TTC than was mental stress in young patients. Second, more female than male TTC patients were noted among both young patients and the general population. Third, ethnicity appears to play no role in the disease, as no significant differences were noted among individuals of different races with respect to clinical characteristics, morbidity or stressors. Fourth, the clinical manifestations of TTC were similar to those of other cardiac diseases, including coronary heart disease. However, TTC may be detected using the combination of echocardiography and ventriculography. Clinicians should consider TTC if young patients present with symptoms similar to those of coronary heart disease so that harmful treatments such as coronary artery stent placement may be avoided. Moreover, the answers to questions regarding the clinical diagnostic criteria, etiology, pathophysiology, and the management of this syndrome in youth remain unclear; therefore, further research is needed. PMID:26266349

  15. An autopsy case of sudden unexpected death due to a glial cyst of the pineal gland.

    Science.gov (United States)

    Na, Joo-Young; Lee, Kyung-Hwa; Kim, Hyung-Seok; Park, Jong-Tae

    2014-09-01

    Pineal cysts are usually asymptomatic; however, they may rarely cause symptoms such as chronic headache, paroxysmal headache with gaze paresis, postural syncope, loss of consciousness, and sudden death. A 30-year-old woman with no specific medical history except chronic headache was found collapsed in a public toilet per se. Postmortem examination revealed no external injuries or internal diseases except a cystic lesion of the pineal gland. Histologic examination showed an internal cyst surrounded by glial tissues and pineal parenchyma that was diagnosed as a glial cyst of the pineal gland. Although the pineal cyst cannot be confirmed as the cause of death, it was considered, as no other cause was evident. Herein, we report a pineal cyst considered as an assumed cause of death.

  16. Infant sudden death: Mutations responsible for impaired Nav1.5 channel trafficking and function.

    Science.gov (United States)

    Gando, Ivan; Morganstein, Jace; Jana, Kundan; McDonald, Thomas V; Tang, Yingying; Coetzee, William A

    2017-06-01

    Two genetic variants in SCN5A, encoding the Nav1.5 Na+ channel α-subunit, were found in a 5-month-old girl who died suddenly in her sleep. The first variant is a missense mutation, resulting in an amino acid change (Q1832E), which has been described (but not characterized) in a patient with Brugada syndrome. The second is a nonsense mutation that produces a premature stop codon and a C-terminal truncation (R1944Δ). To investigate their functional relevance with patch clamp experiments in transfected HEK-293 cells. The Q1832E mutation drastically reduced Nav1.5 current density. The R1944Δ C-terminal truncation had negligible effects on Nav1.5 current density. Neither of the mutations affected the voltage dependence of steady activation and inactivation or influenced the late Na+ current or the recovery from inactivation. Biochemical and immunofluorescent approaches demonstrated that the Q1832E mutation caused severe trafficking defects. Polymerase chain reaction cloning and sequencing the victim's genomic DNA allowed us to determine that the two variants were in trans. We investigated the functional consequences by coexpressing Nav1.5(Q1832E) and Nav1.5(R1944Δ), which led to a significantly reduced current amplitude relative to wild-type. These sudden infant death syndrome (SIDS)-related variants caused a severely dysfunctional Nav1.5 channel, which was mainly due to trafficking defects caused by the Q1832E mutation. The decreased current density is likely to be a major contributing factor to arrhythmogenesis in Brugada syndrome and the sudden death of this SIDS victim. © 2017 Wiley Periodicals, Inc.

  17. Circumstances and toxicology of sudden or unnatural deaths involving alprazolam.

    Science.gov (United States)

    Darke, Shane; Torok, Michelle; Duflou, Johan

    2014-05-01

    There has been a great deal of clinical concern regarding alprazolam abuse. This paper reported on alprazolam positive cases of sudden or unnatural deaths presenting to the New South Wales Department of Forensic Medicine (DOFM), 1/1/1997-31/12/2012. Case series. 412 cases were identified. There was a large increase in the annual number of cases, from 3 in 1997 to 86 in 2012. By 2012, 4.5% of all DOFM case presentations involved alprazolam. The mean age was 41.3 years, and 66.5% were male. Circumstances of death were: accidental drug toxicity (57.0%), deliberate drug toxicity (10.4%), suicide by means other than drug overdose (12.6%), disease (10.0%), accident (5.1%), homicide (2.4%). The major factor driving the increase in cases was accidental drug toxicity involving alprazolam, rising from 0 in 1997 to 58 in 2012. A history of drug/alcohol problems was noted in 80.4%, and 56.6% were injecting drug users. The median alprazolam concentration was 0.08 mg/L (range 0.005-2.10mg/L), with 37.4% of cases having concentrations of ≥ 0.1 mg/L. In 94.9% of cases, drugs other than alprazolam and its metabolites were present, including all accidental overdoses. The most commonly detected drugs were opioids (64.6%), other benzodiazepines (44.4%) and alcohol (34.5%). A third (31.8%) of cases were HCV positive. Cases involving alprazolam increased markedly, driven mostly by toxicity deaths amongst people with known drug and alcohol problems. Caution in prescribing alprazolam would appear appropriate, particularly to those with known drug dependence. Copyright © 2014. Published by Elsevier Ireland Ltd.

  18. [Analyses of clinical features and efficacy of sudden deafness with vertigo and dizziness].

    Science.gov (United States)

    Liu, Bo; Han, Demin; Zhang, Yi; Li, Yongxin; Gong, Shusheng; Chen, Xiuwu; Meng, Xixi; Tang, Junxiang; Xiang, Jie; Jiang, Xuejun; Yang, Ning; Tian, Ying; Hui, Lian; Feng, Shuai

    2015-06-01

    To investigate the clinical characteristics and the effect of drug treatment for sudden hearing loss with vertigo or dizziness. In a prospective, randomized, single blinded randomized multicenter clinical study, patients with sudden deafness, ranging in age from 18 to 65 years old, with a duration less than 2 weeks, and with no any medical treatments were collected. In accordance with the hearing curve, those patients were divided into four types, i.e., low and intermediate frequency descent type; high frequency descent type; fall flat type; and total deafness type. Each type was treated by four different treatment options, according to the unified design of the random table, and randomly selected one of the options for treatment. The efficacy of the patients with sudden deafness with vertigo and dizziness was analyzed statistically after the follow-up for 4 weeks. SPSS 13.0 software was used to analyze the data. In August 2007 to October 2011, 33 hospitals in the country included 1 024 patients with sudden deafness in line with the inclusion criteria, of whom 296 (28.91%) were accompanied by vertigo/dizziness symptoms, 126 were males and 170 were females, with an average age of (41.2 ± 13.5) years old. types of the different audiometric curves of sudden deafness, the occurrence of complete deafness with vertigo/dizziness was the highest (44.93%), followed by flat down type (25.87%), high frequency descent type (21.28%) and low intermediate frequency descent type (18.54%). After the standard treatment, the vertigo and dizziness symptoms of the sudden deafness patients could disappear, and the hearing in each group was obviously improved. The hearing curative effect on patients accompanied by vertigo/dizziness of low frequency and intermediate frequency descent type was the best, and the total efficiency can reach up to 94.74%, with the cure rate of 68.42%; followed by flat type, in which the total effective rate was 80.76%, with the recovery rate of 22.12%; and

  19. Cardiac effects of anabolic steroids: hypertrophy, ischemia and electrical remodelling as potential triggers of sudden death.

    Science.gov (United States)

    Nascimento, J H M; Medei, E

    2011-05-01

    Anabolic-androgenic steroids (AAS) are synthetic testosterone derivatives developed to maximise anabolic activity and minimise androgenic activity. AAS abuse is widespread among both athletes and non-athletes at fitness centres and is becoming a public health issue. In addition to their atherogenic, thrombogenic and spastic effects, AAS have direct cardiotoxic effects by causing hypertrophy, electrical and structural remodelling, and contractile dysfunction and by increasing the susceptibility to ischemic injuries. All of these factors contribute to an increased risk of ventricular arrhythmias and sudden cardiac death.

  20. 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.)

  1. [SPORTS-RELATED SUDDEN DEATH: LESSONS FROM THE FRENCH REGISTRY].

    Science.gov (United States)

    Marijon, Eloi; Bougouin, Wulfran; Jouven, Xavier

    2015-09-01

    So far, sports-related sudden death has been mainly studied through young competitive athletes. The national sports-related sudden death French registry (2005-2010) is the first study evaluating sudden death during sports activities in the general population, estimating that approximately 1000 cases occur each year in France. The vast majority occurs among middle age men practicing recreational activities, with women presenting a very low risk (up to 30-fold lower) compared to men. Outcomes dramatically vary across districts with survival to hospital discharge from 0 to 50%. Those differences are mainly the result of major disparities between districts regarding cardiopulmonary resuscitation initiated by bystanders. Coronary artery disease remains the most frequent cardiovascular disease associated with such events.

  2. Coupled catastrophes: sudden shifts cascade and hop among interdependent systems

    CERN Document Server

    Brummitt, Charles D; D'Souza, Raissa M

    2014-01-01

    A profoundly important challenge in several disciplines today is to understand how sudden changes can propagate among coupled systems. Examples include the synchronization of business cycles, population collapse in patchy ecosystems, markets shifting to a new technology platform, collapses in prices and in confidence in financial markets, and protests erupting in multiple countries. We characterize these phenomena using a simple model grounded in the theory of fast--slow ordinary differential equations and in catastrophe theory. In the model, a system consists of multiple subsystems (e.g., countries in the global economy or patches of an ecosystem), each described by a scalar quantity (such as economic output or population) that undergoes sudden changes via saddle-node bifurcations. The subsystems are coupled via their scalar quantities (e.g., trade couples economic output, diffusion couples populations); that coupling moves their bifurcations. The model elucidates two ways in which sudden changes can propaga...

  3. 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.

  4. The role of Coxsackievirus A16 in a case of sudden unexplained death in an infant

    DEFF Research Database (Denmark)

    Astrup, B. S.; Johnsen, I. B. G.; Engsbro, Anne Line

    2016-01-01

    The Coxsackievirus A16 (CV-A16) is one of the main pathogens causing hand-foot-and-mouth disease in young children. It is a low-virulence virus rarely involved in serious illness. It is seen sporadically or in outbreaks all over the world. We report a case of sudden unexplained death in infancy......, SUDI, in a 3 and 1/2 months old infant, in which a thorough post mortem investigation pointed at a fatal infection with CV-A16 as the most likely cause of death. Only five cases of fatal CV-A16 infection have been published and none of these presented as sudden death. The fatal cases involved two...... infants, two young children and an elderly man. Post mortem, pre-autopsy CT-scan and C-reactive protein analysis allowed for an autopsy procedure targeted at a microbiological cause of death. The case illustrates the usefulness of supplementary testing during autopsy. © 2015 Elsevier Ireland Ltd....

  5. Sudden sensorineural hearing loss following intramuscular administration of penicillin.

    Science.gov (United States)

    Escada, Pedro Alberto; Capucho, Clara; Madeira da Silva, José Francisco

    2004-02-01

    We report a case of sudden hearing loss in a patient with acute exudative tonsillitis, occurring 15 minutes after the intramuscular administration of penicillin. Audiological evaluation documented a profound sensorineural hearing loss of the cochlear type. The mechanism of the hearing loss was probably an immediate hypersensitivity (type I) allergic drug reaction. Penicillin is used frequently for the treatment of several infections. Allergic reactions to penicillin are well known and include urticaria, maculopapular exanthems, angio-oedema, bronchospasm and anaphylaxis, but sudden hearing loss has never been recorded.

  6. Sudden bilateral sensorineural hearing loss associated with urticarial vasculitis.

    Science.gov (United States)

    Hall, A C; Leong, A C; Jiang, D; Fitzgerald-O'Connor, A

    2013-07-01

    Bilateral sensorineural hearing loss associated with recurrent urticarial skin lesions may be signs of underlying Muckle-Wells syndrome. Previous reports have described the hearing loss to be progressive in nature. To our knowledge, this paper presents the first published case of sudden onset, bilateral sensorineural hearing loss associated with urticarial vasculitis due to underlying Muckle-Wells syndrome. The patient underwent a cochlear implantation with a modest outcome. Cochlear implantation may help to rehabilitate sudden hearing loss associated with this condition, but early diagnosis may allow treatment with interleukin-1β inhibitors such as anakinra.

  7. Sudden death associated with QT interval prolongation and KCNQ1 gene mutation in a family of English Springer Spaniels.

    Science.gov (United States)

    Ware, W A; Reina-Doreste, Y; Stern, J A; Meurs, K M

    2015-01-01

    A 5-year-old, healthy English Springer Spaniel died suddenly 4 months after delivering a litter of 7 puppies. Within 4 months of the dam's death, 3 offspring also died suddenly. Abnormal cardiac repolarization, caused by an inherited long QT syndrome, is thought to be responsible for arrhythmias leading to sudden death in this family. Four remaining dogs from the affected litter and 11 related dogs. Physical examination and resting ECG were done on the littermates and 9 related dogs. Additional tests on some or all littermates included echocardiogram with Doppler, Holter monitoring, and routine serum biochemistry. Blood for DNA sequencing was obtained from all 15 dogs. Three of 4 littermates examined, but no other dogs, had prolonged QT intervals with unique T-wave morphology. DNA sequencing of the KCNQ1 gene identified a heterozygous single base pair mutation, unique to these 3 dogs, which changes a conserved amino acid from threonine to lysine and is predicted to change protein structure. This family represents the first documentation in dogs of spontaneous familial QT prolongation, which was associated with a KCNQ1 gene mutation and sudden death. Although the final rhythm could not be documented in these dogs, their phenotypic manifestations of QT interval prolongation and abnormal ECG restitution suggested increased risk for sudden arrhythmic death. The KCNQ1 gene mutation identified is speculated to impair the cardiac repolarizing current IKs, similar to KCNQ1 mutations causing long QT syndrome 1 in humans. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  8. Ion drift simulation of sudden appearance of sub-keV structured ions in the inner magnetosphere

    Directory of Open Access Journals (Sweden)

    M. Yamauchi

    2014-02-01

    Full Text Available Energy–latitude dispersed structured sub-keV ions in the inner magnetosphere often show significant development or intensification (by more than factor of 3 within 1–2 h near noon or afternoon where the azimuthal ion drift velocity at the sub-keV range is expected to be near zero. To examine whether such sudden appearances in the dayside can be explained by the drift motion of ions that are formed during substorm-related injections, we numerically simulated two such examples, one at noon and the other in the afternoon, based on the ion drift model. For both cases, the ion drift model with finite duration of proton source in the nightside can explain the observed large inbound–outbound differences in the sub-keV proton population without any new sources. Ion drift motion can thus cause rapid changes of complicated ion populations, at remote places from the source a long time after the substorm activities.

  9. Over-Representation of the Pro-Arrhythmic, Sudden Death Predisposing Sodium Channel Polymorphism, S1103Y, in a Population-Based Cohort of African American Sudden Infant Death Syndrome

    Science.gov (United States)

    Van Norstrand, David W.; Tester, David J.; Ackerman, Michael J.

    2008-01-01

    Background The S1103Y-SCN5A polymorphism has been implicated as a pro-arrhythmic, sudden death predisposing risk factor in African Americans including one postmortem investigation of African American infants with sudden infant death syndrome (SIDS). Objective This study sought to assess whether or not the relatively African American-specific common polymorphism, S1103Y, in the SCN5A-encoded cardiac sodium channel is overrepresented in SIDS in African Americans. Methods Seventy-one cases from a population-based cohort of unexplained infant deaths among African Americans (37 females, 34 males, average age = 3 ± 2 months, range from birth to 11 months) were submitted to the Mayo Clinic Windland Smith Rice Sudden Death Genomics Laboratory for postmortem genetic testing. Polymerase chain reaction and a restriction digest assay was performed to genotype this cohort for S1103Y. Results Targeted mutational analysis of exon 18 in SCN5A of the African American SIDS cohort (n = 71) revealed the S1103Y polymorphism in 16/71 African American cases of SIDS (22.5%) compared to 135/1161 (11.6%) ostensibly healthy adult African Americans (p = 0.01). Conclusion This study provides an independent assessment of the prevalence of S1103Y-SCN5A among African American infants with a sudden, unexpected and unexplained death prior to their first birthday. Further scrutiny and quantification of the risk apparently associated with S1103Y seems warranted. PMID:18452875

  10. [Maternal deaths due to sudden death. Results from the French confidential enquiry into maternal deaths, 2010-2012].

    Science.gov (United States)

    Morau, E; Beaumont, E; Verspyck, E

    2017-12-01

    Sudden death is defined as unexpected cardiac arrest occurring less than one hour after the onset of the first symptoms. Between 2010 and 2012, 23 maternal deaths were considered as unexplained sudden deaths and three of them were not evaluated due to a lack of clinical data. In addition, 13 maternal deaths with an identified cause occurred in a clinical context of sudden death (7 cases of pulmonary embolism, 2 cases of epilepsy, and 2 cases of cardiomyopathy). The first maneuvers of resuscitation in the presence of bystanders were attempted in 8 of 22 cases (36%). This emphasizes the importance of teaching the non-medical resuscitation modalities of cardiac arrest in pregnant women. Pregnant women must receive accurate resuscitation as the whole population. An autopsy was performed in 10 of 33 cases (30%) and was considered incomplete in 3 patients. This result emphasizes the necessity to perform a systematic and specialized autopsy in the context of sudden maternal death, which is mostly unexplained. Copyright © 2017. Published by Elsevier Masson SAS.

  11. Classification system for the Sudden Unexpected Infant Death Case Registry and its application.

    Science.gov (United States)

    Shapiro-Mendoza, Carrie K; Camperlengo, Lena; Ludvigsen, Rebecca; Cottengim, Carri; Anderson, Robert N; Andrew, Thomas; Covington, Theresa; Hauck, Fern R; Kemp, James; MacDorman, Marian

    2014-07-01

    Sudden unexpected infant deaths (SUID) accounted for 1 in 3 postneonatal deaths in 2010. Sudden infant death syndrome and accidental sleep-related suffocation are among the most frequently reported types of SUID. The causes of these SUID usually are not obvious before a medico-legal investigation and may remain unexplained even after investigation. Lack of consistent investigation practices and an autopsy marker make it difficult to distinguish sudden infant death syndrome from other SUID. Standardized categories might assist in differentiating SUID subtypes and allow for more accurate monitoring of the magnitude of SUID, as well as an enhanced ability to characterize the highest risk groups. To capture information about the extent to which cases are thoroughly investigated and how factors like unsafe sleep may contribute to deaths, CDC created a multistate SUID Case Registry in 2009. As part of the registry, the Centers for Disease Control and Prevention developed a classification system that recognizes the uncertainty about how suffocation or asphyxiation may contribute to death and that accounts for unknown and incomplete information about the death scene and autopsy. This report describes the classification system, including its definitions and decision-making algorithm, and applies the system to 436 US SUID cases that occurred in 2011 and were reported to the registry. These categories, although not replacing official cause-of-death determinations, allow local and state programs to track SUID subtypes, creating a valuable tool to identify gaps in investigation and inform SUID reduction strategies. Copyright © 2014 by the American Academy of Pediatrics.

  12. Sudden cardiac death in non-dialysis chronic kidney disease patients.

    Science.gov (United States)

    Caravaca, Francisco; Chávez, Edgar; Alvarado, Raúl; García-Pino, Guadalupe; Luna, Enrique

    2016-01-01

    A relatively high proportion of deaths in dialysis patients occur suddenly and unexpectedly. The incidence of sudden cardiac death (SCD) in non-dialysis advanced chronic kidney disease (CKD) stages has been less well investigated. This study aims to determine the incidence and predictors of SCD in a cohort of 1078 patients with CKD not yet on dialysis. Prospective observational cohort study, which included patients with advanced CKD not yet on dialysis (stage 4-5). The association between baseline variables and SCD was assessed using Cox and competing-risk (Fine and Grey) regression models. Demographic, clinical information, medication use, and baseline biochemical parameters of potential interest were included as covariates. During the study period (median follow-up time 12 months), 210 patients died (19%), and SCD occurred in 34 cases (16% of total deaths). All-cause mortality and SCD incidence rates were 113 (95% CI: 99-128), and 18 (95% CI: 13-26) events per 1000 patients/year, respectively. By Cox regression analysis, covariates significantly associated with SCD were: Age, comorbidity index, and treatment with antiplatelet drugs. This latter covariate showed a beneficial effect over the development of SCD. By competing-risk regression, in which the competing event was non-sudden death from any cause, only age and comorbidity index remained significantly associated with SCD. SCD is relatively common in non-dialysis advanced CKD patients. SCD was closely related to age and comorbidity, and some indirect data from this study suggest that unrecognised or undertreated cardiovascular disease may predispose to a higher risk of SCD. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  13. 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.

  14. Do antiepileptic drugs play a role in sudden unexpected death in epilepsy?

    Science.gov (United States)

    Walczak, Thaddeus

    2003-01-01

    Sudden unexpected death in epilepsy (SUDEP) accounts for approximately 2% of deaths in population-based cohorts of epilepsy, and up to 25% of deaths in cohorts of more severe epilepsy. When it occurs, SUDEP usually follows a generalised tonic-clonic seizure. Unresponsiveness, apnoea, and cardiac arrest occur in SUDEP, rather than the typical gradual recovery. The great majority of tonic-clonic seizures occur without difficulty and how the rare seizure associated with SUDEP differs from others is unknown.Three mechanisms have been proposed for SUDEP: cardiac arrhythmia, neurogenic pulmonary oedema, and postictal suppression of brainstem respiratory centres leading to central apnoea. Recent studies have found that the incidence of SUDEP increases with the severity of epilepsy in the population studied. The duration of epilepsy, number of tonic-clonic seizures, mental retardation, and simultaneous treatment with more than two antiepileptic drugs are independent risk factors for SUDEP. Some studies have reported that carbamazepine use, carbamazepine toxicity, and frequent, rapid changes in carbamazepine levels, may be associated with SUDEP. Other evidence indicates that carbamazepine could potentially increase the risk for SUDEP by causing arrhythmia or by altering cardiac autonomic function. However, this evidence is tenuous and most studies have not found an association between the use of carbamazepine or any other individual antiepileptic drug and SUDEP. There is little information regarding antiepileptic drugs other than phenytoin and carbamazepine. The incidence of SUDEP with gabapentin, tiagabine, and lamotrigine clinical development programmes is in the range found in other populations with refractory epilepsy. This suggests that these individual antiepileptic drugs are no more likely to cause SUDEP than antiepileptic drugs in general. Best current evidence indicates that the risk of SUDEP can be decreased by aggressive treatment of tonic-clonic seizures with as

  15. 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.

  16. Use of remotely sensed imagery to map Sudden Oak Death (Phytophthora ramorum) in the Santa Cruz Mountains

    Science.gov (United States)

    Gillis, Trinka

    This project sought a method to map Sudden Oak Death distribution in the Santa Cruz Mountains of California, a coastal mountain range and one of the locations where this disease was first observed. The project researched a method to identify forest affected by SOD using 30 m multi-spectral Landsat satellite imagery to classify tree mortality at the canopy-level throughout the study area, and applied that method to a time series of data to show pattern of spread. A successful methodology would be of interest to scientists trying to identify areas which escaped disease contagion, environmentalists attempting to quantify damage, and land managers evaluating the health of their forests. The more we can learn about the disease, the more chance we have to prevent further spread and damage to existing wild lands. The primary data source for this research was springtime Landsat Climate Data Record surface reflectance data. Non-forest areas were masked out using data produced by the National Land Cover Database and supplemental land cover classification from the Landsat 2011 Climate Data Record image. Areas with other known causes of tree death, as identified by Fire and Resource Assessment Program fire perimeter polygons, and US Department of Agriculture Forest Health Monitoring Program Aerial Detection Survey polygons, were also masked out. Within the remaining forested study area, manually-created points were classified based on the land cover contained by the corresponding Landsat 2011 pixel. These were used to extract value ranges from the Landsat bands and calculated vegetation indices. The range and index which best differentiated healthy from dead trees, SWIR/NIR, was applied to each Landsat scene in the time series to map tree mortality. Results Validation Points, classified using Google Earth high-resolution aerial imagery, were created to evaluate the accuracy of the mapping methodology for the 2011 data.

  17. Steroid Use in Idiopathic Sudden Sensorineural Hearing Loss: What ...

    African Journals Online (AJOL)

    Idiopathic sudden sensorineural hearing loss is a disease of unknown etiology. Controversy in the literature argues whether the condition should be treated by steroid therapy. In this case study, a Medline literature search was completed to find out if there is any evidence to support its use in this condition.

  18. Training Emergency Responders: Sudden Infant Death Syndrome. An Instructor's Manual.

    Science.gov (United States)

    Applied Science Associates, Inc., Reston, VA.

    This manual was developed to help instructors train police and emergency medical technicians, who often are the first persons to arrive at the scene of a death (first responders), to serve families who lose a child to Sudden Infant Death Syndrome (SIDS). The manual begins with an introduction that discusses the purpose of the training and…

  19. Sudden Infant Death Syndrome, FY 1983. Special Report to Congress.

    Science.gov (United States)

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    This report describes research programs focusing on the sudden infant death syndrome (SIDS) and indicates some presently available results. Specific attention is given to research on sleep apnea, respiratory control, and hypoxia, as well as to infectious disease processes and immunology. Findings of a large-scale multidisciplinary SIDS project are…

  20. Was message of sudden infant death study misleading?

    OpenAIRE

    Gornall, Jonathan

    2006-01-01

    An investigation by the BMJ has uncovered serious concerns about an important paper on sudden infant deaths recurring within a family. The paper has featured in the appeal case at several recent high profile murder appeals and has also influenced international practice

  1. On the Developmental Dynamics of Sudden Stratospheric Warmings

    Science.gov (United States)

    1990-07-31

    had to deal with sudden wind shift encounterd in a major warming but would still have to be able to withstand the stress imposed by the steep...Hemisphere, Mon. Wea. Rev., 106, 762-770. 1979: An Introduction to Dynamic Meteorology, Acedemic Press, 391pp. --- , 1981: The Amplification of Height Wave 1

  2. Sudden Cardiac Death in Nigeria: Pathophysiology and Evidence ...

    African Journals Online (AJOL)

    Sudden death is an emerging phenomenon in Nigeria, a country with a burden of preventable communicable and non communicable diseases. The rapid adoption of western lifestyle, the almost complete dependence on vehicular transport as well as stress that accompany infrastructural development and processes of ...

  3. Guidelines for autopsy investigation of sudden cardiac death

    NARCIS (Netherlands)

    Basso, Cristina; Burke, Margaret; Fornes, Paul; Gallagher, Patrick J.; de Gouveia, Rosa Henriques; Sheppard, Mary; Thiene, Gaetano; van der Wal, Allard

    2010-01-01

    Although sudden cardiac death is one of the most important mode of death in Western Countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed, and the accurate diagnosis of

  4. Guidelines for autopsy investigation of sudden cardiac death

    NARCIS (Netherlands)

    Basso, C.; Burke, M.; Fornes, P.; Gallagher, P. J.; de Gouveia, R. H.; Sheppard, M.; Thiene, G.; van der Wal, A.

    2010-01-01

    Although sudden cardiac death is one of the most important mode of death in Western Countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed and the accurate diagnosis of

  5. Guidelines for autopsy investigation of sudden cardiac death

    NARCIS (Netherlands)

    Basso, Cristina; Burke, Margaret; Fornes, Paul; Gallagher, Patrick J.; de Gouveia, Rosa Henriques; Sheppard, Mary; Thiene, Gaetano; van der Wal, Allard

    2008-01-01

    Although sudden cardiac death is one of the most important mode of death in Western Countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed, and the accurate diagnosis of

  6. Bidirectional infrasonic ducts associated with sudden stratospheric warming events

    NARCIS (Netherlands)

    Assink, J.D.; Waxler, R.; Smets, P.S.M.; Evers, L.G.

    2014-01-01

    In January 2011, the state of the polar vortex in the midlatitudes changed significantly due to a minor sudden stratospheric warming event. As a result, a bidirectional duct for infrasound propagation developed in the middle atmosphere that persisted for 2 weeks. The ducts were due to two zonal wind

  7. Prevention of sudden cardiac death in young athletes

    OpenAIRE

    Katja Ažman Juvan; Petra Zupet

    2010-01-01

    Sudden cardiac deaths in young athletes (less than 35 years old) are rare though highly publicized tragedies, occurring mainly in athletes with underlying cardiovascular diseases. Since these diseases often have a clinically silent course, they should be actively searched for by preparticipation screening. Preparticipation screening of athletes varies among different countries. However, a common European protocol has been proposed, which comprises a history, clinica...

  8. Survivor-Victim Status, Attachment, and Sudden Death Bereavement.

    Science.gov (United States)

    Reed, Mark D.; Greenwald, Jason Y.

    1991-01-01

    Examined significance of survivor-victim relationship in understanding grief following sudden death bereavement by suicide or accident. Results showed that survivor-victim attachment was more important than survivor status (parent versus sibling/child) in explaining grief reactions. Compared to accident survivors, suicide survivors experienced…

  9. Solar flare effects and storm sudden commencement even in ...

    African Journals Online (AJOL)

    1998-05-08

    Variations in the three components of geomagnetic field were observed at the twenty-two geomagnetic Euro-African Observatories during the solar flare that occurred on the 6 May, 1998 at 0080UT and storm sudden commencement that took place on May 8, 1998 at 15.00 UT. The geomagnetic field on 6 May, 1998 was ...

  10. Temporal epidemiology of sudden oak death in Oregon

    Science.gov (United States)

    Ebba K. Peterson; Everett M. Hansen; Alan Kanaskie

    2015-01-01

    An effort to eradicate Phytophthora ramorum, causal agent of sudden oak death, has been underway since its discovery in Oregon forests. Using an information-theoretical approach, we sought to model yearly variation in the size of newly infested areas and dispersal distance. Maximum dispersal distances were best modeled by spring and winter...

  11. Collaboratively managing sudden oak death using tangible geospatial modeling

    Science.gov (United States)

    Ross K. Meentemeyer; Francesco Tonini; Douglas Shoemaker; Richard C. Cobb; Brendan A. Harmon; Vaclav Petras; Anna Petrasova; Helena Mitasova

    2017-01-01

    Failure to build consensus amongst stakeholders has been a primary obstacle barring progress in developing and implementing strategies to manage sudden oak death (SOD). Consensus as to the goals of in situ management of SOD has rarely been reached, because stakeholders’ visions of success vary widely and often compete with each other...

  12. 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.…

  13. 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 variet...

  14. Social phobia with sudden onset-Post-panic social phobia?

    DEFF Research Database (Denmark)

    Kristensen, Ann Suhl; Mortensen, Erik Lykke; Mors, Ole

    2008-01-01

    Overlap between social phobia (SP) and panic disorder (PD) has been observed in epidemiological, family, and challenge studies. One possible explanation is that some cases of SP develop as a consequence of a panic attack in a social situation. By definition, these cases of SP have sudden onset...

  15. Sudden oak death in California: what is the potential?

    Science.gov (United States)

    Tara M. Barrett; Demetrios Gatziolis; Jeremy S. Fried; Karen L. Waddell

    2006-01-01

    Sudden oak death, a disease associated with the pathogen Phytophthora ramorum, has a large number of shrub and tree host species. Three of the tree species must susceptible to mortality from the disease, California black oak (Quercus kelloggii), coast live oak (Quercus agrifolia), and tanoak (...

  16. Systemic Analysis of Sudden Natural Deaths at Braithwaite ...

    African Journals Online (AJOL)

    Alasia Datonye

    30 Sempos C, Cooper R, Kover MG, McMillen M. Divergence of the recent trends in coronary mortality for the four major race- sex groups in the United States. Am J Public Health. 1988; 78:1422-1427. 31 Murai T, Baba M, Ro A, Murai N, Matsuo Y, Takada A,. Saito K. Sudden death due to cardiovascular disorders: a review ...

  17. Incidence of ventricular arrhythmias, brady-arrhythmias and sudden ...

    African Journals Online (AJOL)

    Ventricular arrhythmias (VAS), Including ventricular tachycardia (VT), ventricular fibrillation (VF) and Brady-arrhythmias, are life-threatening complications of acute myocardial infarction (MI). Objective: To study the incidence of ventricular arrhythmias, brady-arrhythmias and Sudden Cardiac Death (SCD) in Sudanese ...

  18. Myocardial infarction & sudden death in recreational master marathon runners.

    Science.gov (United States)

    Finn, Suzanne Elizabeth; Coviello, Jessica

    2011-02-01

    This review of the current literature on myocardial infarction and sudden death in recreational master marathon runners aims to help raise awareness of the scope of the problem to primary care providers, and to provide guidelines for educating and screening in recreational master marathon runners.

  19. a sudden total loss of vision after routine cataract surgery

    African Journals Online (AJOL)

    David Ofori-Adjei

    2013-06-01

    Jun 1, 2013 ... June 2013. Volume 47, Number 2. GHANA MEDICAL JOURNAL. 96. A SUDDEN TOTAL LOSS OF VISION AFTER ROUTINE CATARACT. SURGERY. S. LARTEY1, P. ... Cataract surgery has its complications. The most feared ... mm Hg on oral nifedipine 40 mg daily who presented with 6/36 vision in both ...

  20. Sudden Hearing Loss with Vertigo Portends Greater Stroke Risk Than Sudden Hearing Loss or Vertigo Alone.

    Science.gov (United States)

    Chang, Tzu-Pu; Wang, Zheyu; Winnick, Ariel A; Chuang, Hsun-Yang; Urrutia, Victor C; Carey, John P; Newman-Toker, David E

    2017-11-01

    Because it is unknown whether sudden hearing loss (SHL) in acute vertigo is a "benign" sign (reflecting ear disease) or a "dangerous" sign (reflecting stroke), we sought to compare long-term stroke risk among patients with (1) "SHL with vertigo," (2) "SHL alone," and (3) "vertigo alone" using a large national health-care database. Patients with first-incident SHL (International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-9-CM] 388.2) or vertigo (ICD-9-CM 386.x, 780.4) were identified from the National Health Insurance Research Database of Taiwan (2002-2009). We defined SHL with vertigo as a vertigo-related diagnosis ±30 days from the index SHL event. SHL without a temporally proximate vertigo diagnosis was considered SHL alone. The vertigo-alone group had no SHL diagnosis. All the patients were followed up until stroke, death, withdrawal from the database, or current end of the database (December 31, 2012) for a minimum period of 3 years. The hazards of stroke were compared across groups. We studied 218,656 patients (678 SHL with vertigo, 1998 with SHL alone, and 215,980 with vertigo alone). Stroke rates at study end were 5.5% (SHL with vertigo), 3.0% (SHL alone), and 3.9% (vertigo alone). Stroke hazards were higher in SHL with vertigo than in SHL alone (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.28-2.91) and in vertigo alone (HR, 1.63; 95% CI, 1.18-2.25). Defining a narrower window between SHL and vertigo (±3 days) increased the hazards. The combination of SHL plus vertigo in close temporal proximity is associated with increased subsequent stroke risk over SHL alone and vertigo alone. This suggests that SHL in patients with vertigo is not necessarily a benign peripheral vestibular sign. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.