During the past two decades tremendous efforts have been made by the medical community, especially in the fields of forensic medicine and pediatrics, to better understand the etiology, epidemiology and pathophysiology of SIDS. There have been many SIDS reports from developed countries, but few from developing Asian countries. Despite a recent significant decrease in the incidence of SIDS in many developed countries, SIDS continues to be the most common cause of post-neonatal infant death in these countries. This article analyzes the SIDS data (1990-2006) from the Office of the Chief Medical Examiner for the State of Maryland, USA, along with review of the literature with regard to the history, epidemiological and pathophysiological characteristics of SIDS, as well as the recent advances in SIDS research. The changing trends in the diagnosis of SIDS and current challenges to its forensic investigation are also discussed.
Arrhythmias, Cardiac/complications* ; Forensic Medicine ; Humans ; Infant ; Risk Factors ; Sleep Apnea Syndromes/complications* ; Sudden Infant Death/etiology* ; United States/epidemiology*

OBJECTIVETo assess the relationship between diurnal temperature range (DTR) and sudden infant death (SID) between 2001 and 2004 in Shanghai, China.

METHODSWe 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.

RESULTSDTR 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.

CONCLUSIONAn 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.

Air Pollutants ; analysis ; China ; epidemiology ; Death Certificates ; Humans ; Humidity ; Infant ; Infant, Newborn ; Nitrogen Dioxide ; analysis ; Ozone ; analysis ; Particulate Matter ; analysis ; Risk Factors ; Sudden Infant Death ; epidemiology ; etiology ; Sulfur Dioxide ; analysis ; Temperature

Complement C4 ; genetics ; Environmental Pollution ; adverse effects ; HLA-DR Antigens ; genetics ; Humans ; Hypoxia ; complications ; Infant ; Infant, Newborn ; Infection ; complications ; Interleukin-10 ; genetics ; Mutation ; Polymorphism, Genetic ; Risk Factors ; Sudden Infant Death ; classification ; diagnosis ; etiology ; prevention & control

Amino Acid Metabolism, Inborn Errors ; diagnosis ; genetics ; therapy ; Death, Sudden ; etiology ; Hereditary Central Nervous System Demyelinating Diseases ; diagnosis ; etiology ; Humans ; Hydroxymethylglutaryl-CoA Synthase ; deficiency ; Infant, Newborn ; Male ; Mutation ; Oxo-Acid-Lyases ; genetics ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heart muscle disease of unknown etiology characterized by fatty or fibrofatty infiltration of the right ventricular myocardium. It is well known that ARVC is one of the important causes of sudden death in young individuals. The significant pathological change of ARVC is atrophy and fibrofatty myocardial replacement of the right ventricular free wall. According to the histopathological substrate ARVC could be divided into 2 types: fatty and fibrofatty myocardial replacement. Possible etiology including: (1) apoptosis or programmed cell death; (2) inflammatory; (3) myocardium dysplasia and (4) myocyte transdifferentiation theory.
Adipose Tissue/pathology* ; Adolescent ; Adult ; Apoptosis ; Arrhythmias, Cardiac/etiology* ; Arrhythmogenic Right Ventricular Dysplasia/pathology* ; Child ; Child, Preschool ; Death, Sudden, Cardiac/etiology* ; Female ; Forensic Medicine ; Humans ; Infant ; Male ; Middle Aged

Arrhythmias, Cardiac ; diagnosis ; genetics ; pathology ; Brugada Syndrome ; diagnosis ; genetics ; pathology ; Channelopathies ; diagnosis ; genetics ; pathology ; DNA Mutational Analysis ; Electrocardiography ; Genetic Testing ; Heart Conduction System ; physiopathology ; Humans ; Infant ; Long QT Syndrome ; diagnosis ; genetics ; pathology ; Muscle Proteins ; genetics ; Mutation ; NAV1.5 Voltage-Gated Sodium Channel ; genetics ; Sodium Channels ; genetics ; Sudden Infant Death ; etiology

Timothy syndrome, long QT syndrome type 8, is highly malignant with ventricular tachyarrhythmia. A 30-month-old boy had sudden cardiac arrest during anesthesia induction before plastic surgery for bilateral cutaneous syndactyly. After successful resuscitation, prolonged QT interval (QTc, 0.58-0.60 sec) and T-wave alternans were found in his electrocardiogram. Starting beta-blocker to prevent further tachycardia and collapse event, then there were no more arrhythmic events. The genes KCNQ1, KCNH2, KCNE1 and 2, and SCN5A were negative for long QT syndrome. The mutation p.Gly406Arg was confirmed in CACNA1C, which maintains L-type calcium channel depolarization in the heart and other systems.
Anesthesia/*adverse effects ; Calcium Channels, L-Type/*genetics ; Death, Sudden, Cardiac/*etiology ; Electroencephalography ; Humans ; Infant ; Long QT Syndrome/*genetics ; Magnetic Resonance Imaging ; Male ; Methyl Ethers/adverse effects ; Nitric Oxide/adverse effects ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA ; Surgery, Plastic ; Syndactyly/diagnosis/*genetics/surgery