DEATHS FROM SUDDEN INFANT DEATH SYNDROME ON PUBLIC HOLIDAYS AND WEEKENDS

Deaths from sudden infant death syndrome (SIDS) between 1979 and 1984 were tabulated by month for weekdays, weekends and public holidays. Examination of deaths by day of the week showed the weekend had more deaths than the weekdays (χ₂= 26.3, df = 6, p = 0.0002) and that this pattern occurred in both the under three months and three-11 months age group. There were 40 deaths on the 78 public holidays in the six years under study. Modelling the data showed that there was no difference between the number of deaths on holidays compared to weekends.     

Cytomegalie der Kopfspeicheldrüsen bei SIDS

Zusammenfassung Es erfolgte eine retrospektive mikromorphologische Analyse der Glandula parotis und/oder der Glandula submandibularis von 180 plötzlichen Kindstodesfällen in Berlin und 75 Fällen in Hamburg. Erfaßt wurden Fälle der letzten 10 Jahre mit einem Alter zwischen 2 Wochen und einem Lebensjahr. — Typische CMV-Einschlußkörper wurden im Berliner Material in 18 Fällen (10%; Mädchen mehr als Jungen) und im Hamburger Material in 6 Fällen (7%; Jungen mehr als Mädchen) diagnostiziert. Während die meisten SIDS-Fälle sich im zweiten und dritten Lebensmonat ereigneten, war bei den CMV-Infektionen kein Altersgipfel festzustellen. Virusmaterial war mit immunhistochemischen Unterschungen sowie in-situ-Hybridisierung auch in histologisch unauffälligen Zellen nachzuweisen. — Unter Berücksichtigung der bekannten klinischen und epidemiologischen Daten zur Cytomegalie stellt die Diagnose einer lokalisierten Infektion der Kopf-speicheldrüsen keine befriedigende Erklärung für den plötzlichen Tod der Säuglinge dar; diese Befunde sind jedoch besonders beachtenswert als Hinweis auf eine Schwäche des Immunsystems.     

A sleep disturbance in high risk for SIDS infants

A developmentally immature sleep pattern has been identified in infants with a recent history of an unexplained life-threatening episode of sleep apnoea who are considered at risk for SIDS. In these infants there is a persistence of Sleep Onset REM Periods (SOREMPS) after prolonged wakefulness when compared to controls matched for age, sex, birthweight and race. This sleep characteristic has not been previously reported.     

The potential role of bacterial toxins in Sudden Infant Death Syndrome (SIDS)

Summary Toxigenic bacteria have been implicated in some cases of Sudden Infant Death Syndrome (SIDS). Although there is not much evidence thatClostridia spp. are associated with SIDS in Britain, strains ofStaphylococcus aureus producing pyrogenic toxins have been isolated from significant numbers of these infants at autopsy. The pyrogenic toxins, produced by some strains of group AStreptococcus pyogenes as well as staphylococci, are powerful superantigens that have significant physiological effects including induction of fever > 38°C. In this article, interactions between genetic and environmental factors that might enhance colonization of epithelial surfaces by toxigenic staphylococci are analyzed: infant's expression of Lewis^a antigen which acts as a receptor for some microorganisms; viral infections; the effect of mother's smoking on susceptibility to respiratory infection. Based on epidemiological findings and laboratory investigations, a hypothesis is proposed to explain how bacteria producing pyrogenic toxins might contribute to some cot deaths.     

Blutverteilungsmuster in der Lunge beim plötzlichen Säuglingstod

Zusammenfassung Bei 67 Fällen von plötzlichem Säuglingstod (SIDS) wurde die Blutverteilung in den Lungen mit Hilfe der Benzidin-Färbung an 50 dicken histologischen Schnitten untersucht. Es besteht ein fokales, akutes Emphysem und häufig ein diffuses, alveoläres und auch interstitielles Emphysem. In allen Lungenabschnitten finden sich z.T. ausgedehnte Atelektasen und Dystelektasen. Die Atelektasen und Dystelektasen zeigen eine hochgradige Hyperämie bei weitgestellten Alveolarkapillaren, während der Blutgehalt in den von Emphysem betroffenen Bezirken vermindert ist. Die mögliche funktionelle Bedeutung der gestörten Blutverteilung in der Lunge für eine zunehmende Hypoxie und den Todesmechanismus wird diskutiert.Als Vortrag auf der 56. Tagung der Deutschen Gesellschaft für Rechtsmedizin gehalten. Graz 17.–20.9.1977     

Exposure to prenatal carbon monoxide and postnatal hyperthermia: short and long-term effects on neurochemicals and neuroglia in the developing brain

The effects of prenatal exposure to carbon monoxide (CO), a major component of cigarette smoke, was studied alone or in combination with postnatal hyperthermia, on the structural and neurochemical development of the postnatal brain at 1 and 8 weeks. Pregnant guinea pigs (n = 11) were exposed to 200 p.p.m CO for 10 h/day from midgestation until term (68 days), whereas control mothers (n = 10) breathed room air. On postnatal day 4, neonates from the control and CO-exposed pregnancies were exposed to hyperthermia (35 degrees C) for 75 min or remained at ambient (23 degrees C) temperature. Using semiquantitative immunohistochemical techniques the following neurotransmitter alterations were found in the medulla at 1 week: a decrease in met-enkephalin-immunoreactivity (IR) following postnatal hyperthermia and an increase in 5-hydroxytryptamine-IR following a combination of CO and hyperthermia. No alterations were observed in substance P- or tyrosine-hydroxylase-IR in any paradigm. At 8 weeks of age the combination of prenatal CO exposure followed by a brief hyperthermic stress postnatally resulted in lesions throughout the brain and an increase in glial fibrillary acidic protein-IR in the medulla. Such effects on brain development could be of relevance in cardiorespiratory control in the neonate and could have implications for the etiology of Sudden Infant Death Syndrome, where smoking and hyperthermia are major risk factors.     

Bed‐sharing among six‐month‐old infants in western Sweden

Aim: In spite of several reports of an increased risk of sudden infant death syndrome (SIDS) in connection with bed‐sharing, it is not an uncommon practice. The aim of this study was to examine bed‐sharing at 6 months of age and the factors that are associated with bed‐sharing. Methods: Our cohort comprised 8176 randomly chosen families. At 6 month of age, the families received an invitation to the study, with a questionnaire, which was completed by 5605 families (response rate 68.5%). Results: Of the families, 19.8% bed‐shared. In the multivariate analysis, we found a correlation between breast‐feeding and bed‐sharing (breast‐feeding at 6 months: OR 1.94; 95% CI 1.56, 2.41). Moreover, we found an association with 3+ nightly awakenings at 6 months (2.70; 2.20, 3.32). It was more common to share a bed if the parent was single (2.04; 1.19, 3.51) and less common if the infant was bottle‐fed in the first week (0.70; 0.54, 0.90). Never using a pacifier was associated with a higher frequency of bed‐sharing. Conclusion: We found a correlation between breast‐feeding and bed‐sharing as well as between sleeping problems and a single parent. A lower percentage of infants sleeping in the parental bed were seen in association with formula feeding in the first week after birth.     

Cardiac Genetic Predisposition in Sudden Infant Death Syndrome

Background

Sudden infant death syndrome (SIDS) is a leading cause of postneonatal mortality. Genetic heart diseases (GHDs) underlie some cases of SIDS.