ACUTE FOREIGN BODY LARYNGO-TRACHEAL OBSTRUCTION: A CAUSE FOR SUDDEN AND UNEXPECTED DEATH IN CHILDREN

PEDIATRICS ◽  
1971 ◽  
Vol 48 (2) ◽  
pp. 281-285
Author(s):  
Felicien M. Steichen ◽  
Andrew Fellini ◽  
Arnold H. Einhorn
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Sudden Death ◽  
Clinical Picture ◽  
Sudden Unexpected Death ◽  
Cerebral Damage ◽  
Unexpected Death ◽  
Unexplained Death ◽  
Tracheal Obstruction ◽  
Foreign Body Obstruction

Sudden unexpected death in three well children beyond crib age due to laryngo-tracheal obstruction by a foreign body is described. The clinical picture is characterized by a paucity of clues in, very often, the absence of reliable witnesses and of any preexisting causes for sudden death. Because of this and on suspicion only, immediate laryngoscopy and bronchoscopy are indicated in all children above crib age with sudden unexpected and unexplained death, after initial respiratory and cardiac resuscitation have taken place. It is hoped that mouth to mouth breathing by the nonprofessional bystander as well as expertise with respiratory resuscitation by ambulance crews, will deliver the occasional child suffering from potentionally fatal foreign body obstruction of the airways to the emergency department before irreversible anoxic cerebral damage has occurred. Children treated in this optimal fashion may thus be given an opportunity to survive.

scholarly journals Differential Methylation in the GSTT1 Regulatory Region in Sudden Unexplained Death and Sudden Unexpected Death in Epilepsy

2021 ◽  
Vol 22 (6) ◽  
pp. 2790
Author(s):  
Steffan Noe Christiansen ◽  
Stine Bøttcher Jacobsen ◽  
Jeppe Dyrberg Andersen ◽  
Marie-Louise Kampmann ◽  
Linea Christine Trudsø ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Cardiac Tissue ◽  
Heart Diseases ◽  
Regulatory Region ◽  
Differential Methylation ◽  
Sudden Unexpected Death ◽  
Diagnostic Challenge ◽  
Unexpected Death ◽  
Sudden Unexplained Death ◽  
Unexplained Death

Sudden cardiac death (SCD) is a diagnostic challenge in forensic medicine. In a relatively large proportion of the SCDs, the deaths remain unexplained after autopsy. This challenge is likely caused by unknown disease mechanisms. Changes in DNA methylation have been associated with several heart diseases, but the role of DNA methylation in SCD is unknown. In this study, we investigated DNA methylation in two SCD subtypes, sudden unexplained death (SUD) and sudden unexpected death in epilepsy (SUDEP). We assessed DNA methylation of more than 850,000 positions in cardiac tissue from nine SUD and 14 SUDEP cases using the Illumina Infinium MethylationEPIC BeadChip. In total, six differently methylated regions (DMRs) between the SUD and SUDEP cases were identified. The DMRs were located in proximity to or overlapping genes encoding proteins that are a part of the glutathione S-transferase (GST) superfamily. Whole genome sequencing (WGS) showed that the DNA methylation alterations were not caused by genetic changes, while whole transcriptome sequencing (WTS) showed that DNA methylation was associated with expression levels of the GSTT1 gene. In conclusion, our results indicate that cardiac DNA methylation is similar in SUD and SUDEP, but with regional differential methylation in proximity to GST genes.

scholarly journals Pneumococcal sepsis associated with adrenal apoplexy in a young woman with anorexia nervosa

2013 ◽  
pp. 25-29
Author(s):  
Nicola Maria Vitola ◽  
Dante Lo Pardo ◽  
Romualdo Cirillo ◽  
Matteo De Roberto ◽  
Pier Giovanni Crocco ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Emergency Department ◽  
Anorexia Nervosa ◽  
Sudden Death ◽  
Clinical Picture ◽  
Causes Of Death ◽  
Critical Conditions ◽  
Crude Rate ◽  
Treatment Practices ◽  
Pneumococcal Sepsis

BACKGROUND A crude rate of mortality of 5% has been quoted for anorexia nervosa in recent studies. Nowadays the mechanism of death is unclear and various authors recommend that any anorexia nervosa death be reported and that, where possible, an autopsy be performed. METHODS In this work we present a case of sudden death in anorexia nervosa with unexpected autopsy findings. A 21-years-old woman with long-standing anorexia nervosa, severely underweight with a body mass index of 14.47 kg/m2, has been taken to the Emergency Department in very critical conditions. Despite the attempts of resuscitation, she died shortly afterwards. Therefore an autopsy has been requested in order to clarify the causes of death. RESULTS The clinical picture, laboratory parameters, histology and microbiological investigations were consistent with pneumococcal sepsis associated adrenal apoplexy. CONCLUSIONS The cause of death in anorexia nervosa cannot reliably be established from antemortem clinical features. All anorexia nervosa deaths should be reported together with description of necropsy. This may lead to advances in the knowledge and treatment practices.

Medication Use in Women and Men With Sudden Unexpected Death

2018 ◽  
Vol 52 (9) ◽  
pp. 868-875 ◽  
Author(s):  
Sonalie Patel ◽  
Mitchell M. Conover ◽  
Golsa Joodi ◽  
Sarah Chen ◽  
Ross J. Simpson ◽  
...  
Keyword(s):  
Sudden Death ◽  
Anatomical Therapeutic Chemical ◽  
Angiotensin Receptor Blockers ◽  
Sudden Unexpected Death ◽  
Medical Examiner ◽  
Evidence Based ◽  
Unexpected Death ◽  
Converting Enzyme Inhibitors ◽  
Β Blockers ◽  
Wake County

Background: In Wake County, NC, sudden unexpected death accounts for 10% to 15% of all natural deaths in individuals 18 to 64 years old. Medications such as aspirin, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, statins, and β-blockers are recommended in guidelines to reduce cardiovascular events and even sudden death (β-blockers). However, guidelines are often underpracticed, even in high-risk patients, with noted disparities in women. Objective: We assessed the relation between prescription of evidence-based medications and sudden unexpected death in Wake County, NC. Methods: We analyzed 399 cases of sudden unexpected death for the time period March 1, 2013 to February 28, 2015 in Wake County, NC. Medications were assessed from available medical examiner reports and medical records and grouped using the third level of the Anatomical Therapeutic Chemical Classification System (ATC) codes. This study was reviewed and exempt by the University of North Carolina’s institutional review board. Results: Among 126 female and 273 male victims, women were prescribed more medications overall than men (6.5 vs 4.3, P = 0.001); however, the use of guideline-directed therapies was not different between genders in the chronic conditions associated with sudden death. Overall, there was remarkably low use of evidence-based medications. Conclusions: Our findings highlight the need to improve prescribing of evidence-based medications and to further explore the relationship between undertreatment and sudden unexpected death.

scholarly journals Sudden death in a child with epilepsy: potential cerebellar mechanisms?

2011 ◽  
Vol 69 (4) ◽  
pp. 707-710 ◽  
Author(s):  
Fulvio A. Scorza ◽  
Vera C. Terra ◽  
Ricardo M. Arida ◽  
Américo C. Sakamoto ◽  
Ronald M. Harper
Keyword(s):  
Basal Ganglia ◽  
Sudden Death ◽  
Neurological Disorder ◽  
Brain Structures ◽  
Sudden Unexpected Death ◽  
Cardiac Rate ◽  
Unexpected Death ◽  
Rate Regulation ◽  
Related Category

Epilepsy is the most common neurological disorder in humans. People with epilepsy are more likely to die prematurely than those without epilepsy, with the most common epilepsy-related category of death being sudden unexpected death in epilepsy (SUDEP). The central mechanisms underlying the fatal process remain unclear, but cardiac and respiratory mechanisms appear to be involved. Recently, cerebellar, thalamic, basal ganglia and limbic brain structures have been shown to be implicated in respiratory and cardiac rate regulation. We discuss here the potential mechanisms underlying the fatal process, with a description of cerebellar actions likely failing in that SUDEP process.

Could sudden death syndrome (SDS) in chickens (Gallus gallus) be a valid animal model for sudden unexpected death in epilepsy (SUDEP)?

2009 ◽  
Vol 73 (1) ◽  
pp. 67-69 ◽  
Author(s):  
F.A. Scorza ◽  
R. de Albuquerque ◽  
R.M. Arida ◽  
B. Schmidt ◽  
Antonio-Carlos G. de Almeida ◽  
...  
Keyword(s):  
Animal Model ◽  
Sudden Death ◽  
Gallus Gallus ◽  
Sudden Death Syndrome ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Valid Animal Model

Sudden unexpected death in children presenting to the emergency department

1994 ◽  
Vol 23 (3) ◽  
pp. 634-635
Author(s):  
B. Bentley ◽  
J.S. Jones ◽  
G. Hoffman ◽  
B. Fletter
Keyword(s):  
Emergency Department ◽  
Sudden Unexpected Death ◽  
Unexpected Death

scholarly journals Sudden death in children

2018 ◽  
Vol 146 (1-2) ◽  
pp. 55-62
Author(s):  
Aleksandra Doronjski ◽  
Milena Bjelica ◽  
Slobodan Spasojevic ◽  
Tanja Radovanovic ◽  
Jelena Culafic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Sudden Death ◽  
Causes Of Death ◽  
Carbon Monoxide Poisoning ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Unexpected Death ◽  
Common Cause ◽  
Number Of Patients

Introduction/Objective. Sudden death in children may occur as a result of many diseases and accidents, while the cause often remains unknown. There are different terms in the literature that represent the causes of sudden death in children. The aim of our study was to determine the most common cause of sudden death in children admitted to the Clinic of Pediatrics. Methods. The retrospective study was conducted in the period from January 1, 1995 to December 31, 2015 and included 49 patients, aged from 10 days to 17 years, in whom death occurred in the Emergency Department and in the first 48 hours of hospitalization. Results. In 23 patients (47%) the cause of death was infection, in 10 patients (20%) heart failure, four patients (8%) died due to status epilepticus, the same number of patients (8%) died due to aspiration of a foreign body, while the rest of the patients died due to diabetic ketoacidosis (2%), rickets (2%), carbon monoxide poisoning (2%), hemolytic anemia (2%), suicide by hanging (2%), drowning (2%), sudden infant death syndrome (2%), and sudden unexpected death in epilepsy (2%). Most of the patients in our study were infants (43%). Conclusion. Our study shows that infants are at the highest risk of sudden death, while the most frequent causes of death are infections and cardiovascular diseases.

scholarly journals Confirmation of Cause of Death Via Comprehensive Autopsy and Whole Exome Molecular Sequencing in People With Epilepsy and Sudden Unexpected Death

2021 ◽  
Author(s):  
C. Anwar A. Chahal ◽  
David J. Tester ◽  
Ahmed U. Fayyaz ◽  
Keerthi Jaliparthy ◽  
Nadeem A. Khan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Sudden Death ◽  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Cause Of Death ◽  
Sudden Cardiac Arrest ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Pathogenic Variants ◽  
Whole Exome

Background Sudden cardiac arrest is the leading mode of death in the United States. Epilepsy affects 1% of Americans; yet epidemiological data show a prevalence of 4% in cases of sudden cardiac arrest. Sudden unexpected death in epilepsy (SUDEP) may share features with sudden cardiac arrest. The objective of this study was to report autopsy and genomic findings in a large cohort of SUDEP cases. Methods and Results Mayo Clinic Sudden Death Registry containing cases (ages 0–90 years) of sudden unexpected and unexplained deaths 1960 to present was queried. Exome sequencing performed on decedent cases. From 13 687 cases of sudden death, 656 (4.8%) had a history of seizures, including 368 confirmed by electroencephalography, 96 classified as SUDEP, 58 as non‐SUDEP, and 214 as unknown (insufficient records). Mean age of death in SUDEP was 37 (±19.7) years; 56 (58.3%) were male; 65% of deaths occurred at night; 54% were found in bed; and 80.6% were prone. Autopsies were obtained in 83 cases; bystander coronary artery disease was frequently reported as cause of death; nonspecific fibrosis was seen in 32.6% of cases, in structurally normal hearts. There were 4 cases of Dravet syndrome with pathogenic variants in SCN1A gene. Using whole exome sequencing in 11 cases, 18 ultrarare nonsynonymous variants were identified in 6 cases including CACNB2, RYR2, CLNB, CACNA1H, and CLCN2 . Conclusions This study examined one of the largest single‐center US series of SUDEP cases. Several cases were reclassified as SUDEP, 15% had an ECG when alive, and 11 (11.4%) had blood for whole exome sequencing analysis. The most frequent antemortem genetic finding was pathogenic variants in SCN1A ; postmortem whole exome sequencing identified 18 ultrarare variants.

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