Nasopharyngitis and the Sudden Infant Death Syndrome

PEDIATRICS ◽  
1977 ◽  
Vol 60 (4) ◽  
pp. 531-533
Author(s):  
ALFRED STEINSCHNEIDER
Keyword(s):  
Respiratory Tract ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Clinical Symptoms ◽  
Sudden Infant Death ◽  
Epidemiological Studies ◽  
Sudden Infant ◽  
Upper Respiratory Tract ◽  
Inflammatory Processes ◽  
Upper Respiratory

Epidemiological studies repeatedly have demonstrated the importance of a number of variables in affecting the incidence of the sudden infant death syndrome (SIDS).1.2 Characteristically, the peak risk of SIDS is within the second to third month of life, with relatively few cases in the first month of life or after the first year. Another consistent observation is the association between minor upper respiratory tract inflammatory processes(nasopharyngitis) and SIDS: relatively more SIDS victims than controls have had clinical symptoms referable to the upper respiratory tract one to two weeks prior to death. Furthermore, histologic examinations have revealed upper respiratory tract

Nasopharyngitis and Prolonged Sleep Apnea

PEDIATRICS ◽  
1975 ◽  
Vol 56 (6) ◽  
pp. 967-971
Author(s):  
Alfred Steinschneider
Keyword(s):  
Sleep Apnea ◽  
Respiratory Tract ◽  
Clinical Symptoms ◽  
Sudden Infant Death ◽  
Simultaneous Occurrence ◽  
Sudden Infant ◽  
Time Interval ◽  
Upper Respiratory Tract ◽  
Before And After ◽  
Upper Respiratory

The effect of nasopharyngitis on the simultaneous occurrence of prolonged sleep apnea (≥20 seconds in duration) was studied in 26 infants managed at home on an apnea monitor. During the observation period, these infants had a total of 69 illnesses which appeared to represent an upper respiratory tract inflammatory process. In general, the daily frequency of prolonged apneic episodes was significantly greater during nasopharyngitis when compared to comparable time intervals immediately prior to and following the illness. In addition, there was a decrease in the frequency of apneic episodes with increasing postnatal age until the episodes finally ceased to occur during the illnessreleted intervals. Apneic episodes ceased to occur at an earher age for the before- and after-illness intervals than for the time interval during which there were clinical symptoms. Thus, it would appear that infants go through an agerelated phase wherein prolonged apnea occurs during nasopharyngitis but not when free of illness. The implications of these results for the management of infants having prolonged sleep apnea are discussed. In view of the hypothesis that prolonged sleep apnea is part of the physiological process resulting in the sudden infant death syndrome, these results also provide for the prediction that infants who suddenly die in association with nasopharynqitis would do so, in general, at a later age than those who succumb when free of an upper respiratory tract inflammatory tory process.

Sudden Infant Death Syndrome (SIDS) in Denmark: Evaluation of the Increasing Incidence of Registered SIDS in the Period 1972 to 1983 and Results of a Prospective Study in 1987 through 1988

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 855-859
Author(s):  
Karin Helweg-Larsen ◽  
Lisbeth B. Knudsen ◽  
Markil Gregersen ◽  
Jørn Simonsen
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Respiratory Infections ◽  
Sudden Infant Death ◽  
Epidemiological Studies ◽  
Sudden Infant ◽  
Unexpected Death ◽  
National Board ◽  
Infant Deaths ◽  
Live Births

To investigate a reported increase, from 0.4 to 1.3 per thousand live births, in the Danish incidence of sudden infant death syndrome (SIDS), a retrospective analysis of SIDS in Denmark from 1972 to 1983 was carried out. Based on data registered with the National Board of Health, a notable regional difference in SIDS rate between the western and eastern parts of Denmark was found. This difference did not correlate with the overall postneonatal mortality by region. Danish law requires medicolegal investigation in all cases of sudden unexpected death. Medicolegal autopsies are performed only in the three forensic institutes which cover all of Denmark. Despite the law and a uniform organization of the forensic medical services, differing application of postmortem examinations and individual interpretation of the history and autopsy in cases of sudden infant death existed. Differences in reporting of respiratory infections, suffocation, and cardiac malformation were found to contribute to the increase and to regional disparities in SIDS incidence. The three Danish forensic institutes examined all cases of sudden infant deaths in Denmark 1987 and 1988. These cases were classified as explained cause of death, pure SIDS, and atypical SIDS; atypical cases were evaluated by consensus. The SIDS incidence (the number of classic SIDS and atypical SIDS per thousand live births) was 1.9 in 1987 and 1.3 in 1988, and it was identical in the eastern and western part of Denmark; however, a higher incidence both of overall postneonatal and SIDS mortality was found in the middle region of Denmark. The analysis stresses the importance of high autopsy rate and expert investigation in all cases of infant death in order to obtain reliable data for epidemiological studies. A prospective joint study of all postneonatal infant deaths in Finland, Iceland, Norway, Sweden, and Denmark will be carried out to analyze the reliability and the possible cause of reported differences in SIDS incidence in the five Nordic countries.

Enzyme-linked Immunoassay for Respiratory Syncytial Virus is Not Predictive of Bronchiolitis in Sudden Infant Death Syndrome

1998 ◽  
Vol 1 (5) ◽  
pp. 375-379 ◽  
Author(s):  
David M. Parham ◽  
Richard Cheng ◽  
Gordon E. Schutze ◽  
Bradley Dilday ◽  
Rebecca Nelson ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Predictive Value ◽  
Sudden Infant Death ◽  
Inflammatory Cell Infiltrate ◽  
Sudden Infant ◽  
Upper Respiratory Tract ◽  
Syncytial Virus ◽  
Chi Square Analysis

Although respiratory syncytial virus (RSV)-infected infants may present with apnea, the role that RSV plays in sudden infant death syndrome (SIDS) is speculative. To determine whether RSV is associated with bronchiolitis in these patients, we examined histologic sections of lungs from 41 apparent SIDS cases and compared the results with those of enzyme-linked immunofluorescent assay (EIA) from nasal washings. Bronchiolitis was defined by a bronchiolar inflammatory cell infiltrate plus epithelial necrosis. A positive EIA was associated with bronchiolitis in 8 instances, compared with 6 having a positive EIA and negative histology, 14 having a negative EIA and positive histology, and 13 having EIA and histology both negative. These results yield a predictive value of a positive test of 57% and a predictive value of a negative test of 48% ( P > .9 by chi square analysis). Although RSV of the upper respiratory tract may be related to SIDS, our results indicate that EIA of nasal washings is not predictive of bronchiolitis, and we recommend other means of verification of histologic results.

Influences from Upper Respiratory Tract on Caudal Brainstem Neurones of Cat

1974 ◽  
Vol 52 (4) ◽  
pp. 895-898 ◽  
Author(s):  
Barry J. Sessle ◽  
L. Frances Greenwood ◽  
David J. Kenny
Keyword(s):  
Respiratory Tract ◽  
Rhythmic Activity ◽  
Sudden Infant Death ◽  
Excitatory Input ◽  
Sudden Infant ◽  
Upper Respiratory Tract ◽  
Muscle Paralysis ◽  
Single Neurones ◽  
Upper Respiratory ◽  
Stimulation Of

During microelectrode penetrations of the solitary tract nucleus and adjacent reticular formation, single neurones were located that discharged in a rhythm that was linked with respiration but that persisted after muscle paralysis. Many of these neurones could be activated from the vagus or upper respiratory tract areas. Some had no demonstrated excitatory input, yet their rhythmic activity could be abolished only by stimulation of nerves innervating the upper respiratory tract. This stimulation also abolished respiration. Such findings emphasize the significance of upper respiratory tract feedback in normal respiratory function and possibly in abnormal conditions such as the 'sudden infant death syndrome.'

Apnea and Sleep State in Infants with Nasopharyngitis

PEDIATRICS ◽  
1980 ◽  
Vol 65 (4) ◽  
pp. 713-717
Author(s):  
Jeffrey B. Gould ◽  
Austin F. S. Lee ◽  
Peter Cook ◽  
Suzette Morelock
Keyword(s):  
Sleep Apnea ◽  
Eye Movement ◽  
Infant Death ◽  
Sleep Time ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Rapid Eye Movement ◽  
Upper Respiratory Tract ◽  
Sleep State ◽  
Upper Respiratory

Having a mild upper respiratory tract infection does not change the sleep state proportions or total sleep time of an infant. However, infants with colds exhibit some sleep state specific alterations in sleep apnea. At 40, 44, and 48 weeks postconception, the number of respiratory pauses of 2 to 4.9 seconds and of 5 to 9.9 seconds duration per 100 minutes of state, during rapid eye movement, and indeterminate sleep are decreased in infants with colds. The absence of this phenomenon at 52 weeks suggests that it is modified by maturation. We hypothesize that the reduction in rapid eye movement and indeterminate sleep apnea is a manifestation of an adaptive response in normal infants, but for infants at risk for the sudden infant death syndrome, this response may be overwhelmed, resulting in increased apnea and, in some instances, sudden infant death.

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