The Experts below are selected from a list of 14148 Experts worldwide ranked by ideXlab platform
Henry F Krous - One of the best experts on this subject based on the ideXlab platform.
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myocardial inflammation cellular death and viral detection in sudden infant death caused by sids Suffocation or myocarditis
Pediatric Research, 2009Co-Authors: Henry F Krous, Elisabeth A Haas, Homeyra Masoumi, Christina Stanley, Christine Ferandos, John H Arnold, Paul GrossfeldAbstract:The significance of minor myocardial inflammatory infiltrates and viral detection in SIDS is controversial. We retrospectively compared the demographic profiles, myocardial inflammation, cardiomyocyte necrosis, and myocardial virus detection in infants who died of SIDS in a safe sleep environment, accidental Suffocation, or myocarditis. Formalin-fixed, paraffin-embedded myocardial sections were semiquantitatively assessed for CD3 lymphocytes and CD68 macrophages using immunohistochemistry and for cardiomyocyte cell death in H&E-stained sections. Enteroviruses and adenoviruses were searched for using PCR technology. The means of lymphocytes, macrophages, and necrotic cardiomyocytes were not statistically different in SIDS and Suffocation cases. Enterovirus, not otherwise specified, was detected in one Suffocation case and was the only virus detected in the three groups. Very mild myocardial lymphocyte and macrophage infiltration and scattered necrotic cardiomyocytes in SIDS are not pathologic, but may occur after the developing heart is exposed to environmental pathogens, including viruses.
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a comparison of pulmonary intra alveolar hemorrhage in cases of sudden infant death due to sids in a safe sleep environment or to Suffocation
Forensic Science International, 2007Co-Authors: Henry F Krous, Elisabeth A Haas, Homeyra Masoumi, Amy E Chadwick, Christina StanleyAbstract:The differentiation of SIDS from accidental or inflicted Suffocation may be impossible without corroborating findings from the death scene or autopsy or in the absence of a confession from a perpetrator. Pulmonary intra-alveolar hemorrhage (PH) has been proposed as a potential clue to Suffocation, but none of the previous studies on this topic have limited SIDS cases to those who were in a safe sleep environment, in which all were found supine and alone on a firm surface with their heads uncovered. Our aims are to: (1) compare PH in SIDS cases found in a safe sleep environment to a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation and (2) assess the effect of age, CPR, and postmortem interval (PMI), with regard to the severity of PH in this subset of safe-sleeping SIDS cases. We conducted a retrospective study of all postneonatal cases accessioned by the Office of the Medical Examiner in San Diego County, California who died of SIDS or Suffocation between 1999 and 2004. A total of 74 cases of sudden infant death caused by SIDS (34 cases as defined above, comprising 8% of the total SIDS cases), accidental Suffocation (37), and inflicted Suffocation (3) from the San Diego SIDS/SUDC Research Project database were compared using a semiquantitative measure of pulmonary intra-alveolar hemorrhage. The most severe (grade 3 or 4) PH occurred in 35% of deaths attributed to Suffocation, but in only 9% of the SIDS cases. Age, duration of CPR attempts and PMI had no effect on the severity of PH in SIDS. Our results indicate that the severity of PH cannot be used independently to differentiate SIDS from Suffocation deaths. Each case must be evaluated on its own merits after thorough review of the medical history, circumstances of death, and postmortem findings.
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Pulmonary intra-alveolar hemorrhage in SIDS and Suffocation.
Journal of Forensic and Legal Medicine, 2007Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christina StanleyAbstract:The differentiation of SIDS from accidental or inflicted Suffocation may be impossible in some cases. Severe pulmonary intra-alveolar hemorrhage has been suggested as a potential marker for such differentiation. Our aims are to: (1) Compare pulmonary hemorrhage in SIDS and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation. (2) Review individual cases with the most severe pulmonary hemorrhage regardless of the cause of death, and (3) Assess the effect of age, bedsharing, cardiopulmonary resuscitation, and postmortem interval, with regard to the severity of pulmonary hemorrhage in SIDS cases. We conducted a retrospective study of all postneonatal cases accessioned by the Office of the Medical Examiner in San Diego County, California who died of SIDS or Suffocation between 1999 and 2004. A total of 444 cases of sudden infant death caused by SIDS (405), accidental Suffocation (36), and inflicted Suffocation (3) from the San Diego SIDS/SUDC Research Project database were compared using a semiquantitative measure of pulmonary intra-alveolar hemorrhage [absent (0) to severe (4)]. Grades 3 or 4 pulmonary hemorrhage occurred in 33% of deaths attributed to Suffocation, but in only 11% of the SIDS cases, however, all grades of pulmonary hemorrhage occurred in both groups. Therefore, our results indicate that the severity of pulmonary hemorrhage cannot be used in isolation to determine the cause or manner of sudden infant death. Among SIDS cases, those with a higher pulmonary hemorrhage grade (3 or 4) were more likely to bedshare, and with more than one co-sleeper, than those with a lower pulmonary hemorrhage grade (0 or 1). We conclude that each case must be evaluated on its own merits after thorough review of the medical history, circumstances of death, and postmortem findings.
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Pulmonary intra-alveolar siderophages in SIDS and Suffocation: a San Diego SIDS/SUDC Research Project report.
Pediatric and Developmental Pathology, 2006Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christopher Wixom, Patricia D. Silva, Christina StanleyAbstract:Pulmonary intra-alveolar siderophages (PS) have been suggested as a marker of previous attempts at imposed Suffocation in infants dying suddenly and unexpectedly. The aims of this study were to (1) compare PS counts between cases of sudden infant death syndrome (SIDS) and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation, (2) compare clinical variables in SIDS and control Suffocation cases, and (3) review individual cases irrespective of the cause and manner of death with an average PS count greater than 200 per 20 high-power fields (hpf) per lung lobe. Retrospective assessment of siderophages in available iron-stained lung sections was undertaken in 91 SIDS cases and 29 cases of death due to Suffocation (27 accidents and 2 homicides) from the San Diego SIDS and Sudden Unexplained Death in Childhood (SUDC) Research Project (SDSSRP) database. Neither the means of the log-transformed PS counts nor the medians of the raw PS counts were significantly different between the SIDS and control Suffocation groups. The distributions of the PS data were different, however-the range was wider in the SIDS group. Only 6% of each group had a history of prior apparent life-threatening events. Approximately three fourths of the families from both groups had no prior referral to Child Protective Services. The number of PS varies widely in cases of sudden infant death caused by SIDS and accidental or inflicted Suffocation and cannot be used as an independent variable to ascertain past attempts at Suffocation.
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pulmonary intra alveolar siderophages in sids and Suffocation a san diego sids sudc research project report
Pediatric and Developmental Pathology, 2006Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christopher Wixom, Patricia D. Silva, Christina StanleyAbstract:Pulmonary intra-alveolar siderophages (PS) have been suggested as a marker of previous attempts at imposed Suffocation in infants dying suddenly and unexpectedly. The aims of this study were to (1) compare PS counts between cases of sudden infant death syndrome (SIDS) and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation, (2) compare clinical variables in SIDS and control Suffocation cases, and (3) review individual cases irrespective of the cause and manner of death with an average PS count greater than 200 per 20 high-power fields (hpf) per lung lobe. Retrospective assessment of siderophages in available iron-stained lung sections was undertaken in 91 SIDS cases and 29 cases of death due to Suffocation (27 accidents and 2 homicides) from the San Diego SIDS and Sudden Unexplained Death in Childhood (SUDC) Research Project (SDSSRP) database. Neither the means of the log-transformed PS counts nor the medians of the raw PS counts were significantly different between the SIDS and control Suffocation groups. The distributions of the PS data were different, however-the range was wider in the SIDS group. Only 6% of each group had a history of prior apparent life-threatening events. Approximately three fourths of the families from both groups had no prior referral to Child Protective Services. The number of PS varies widely in cases of sudden infant death caused by SIDS and accidental or inflicted Suffocation and cannot be used as an independent variable to ascertain past attempts at Suffocation.
Christina Stanley - One of the best experts on this subject based on the ideXlab platform.
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myocardial inflammation cellular death and viral detection in sudden infant death caused by sids Suffocation or myocarditis
Pediatric Research, 2009Co-Authors: Henry F Krous, Elisabeth A Haas, Homeyra Masoumi, Christina Stanley, Christine Ferandos, John H Arnold, Paul GrossfeldAbstract:The significance of minor myocardial inflammatory infiltrates and viral detection in SIDS is controversial. We retrospectively compared the demographic profiles, myocardial inflammation, cardiomyocyte necrosis, and myocardial virus detection in infants who died of SIDS in a safe sleep environment, accidental Suffocation, or myocarditis. Formalin-fixed, paraffin-embedded myocardial sections were semiquantitatively assessed for CD3 lymphocytes and CD68 macrophages using immunohistochemistry and for cardiomyocyte cell death in H&E-stained sections. Enteroviruses and adenoviruses were searched for using PCR technology. The means of lymphocytes, macrophages, and necrotic cardiomyocytes were not statistically different in SIDS and Suffocation cases. Enterovirus, not otherwise specified, was detected in one Suffocation case and was the only virus detected in the three groups. Very mild myocardial lymphocyte and macrophage infiltration and scattered necrotic cardiomyocytes in SIDS are not pathologic, but may occur after the developing heart is exposed to environmental pathogens, including viruses.
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a comparison of pulmonary intra alveolar hemorrhage in cases of sudden infant death due to sids in a safe sleep environment or to Suffocation
Forensic Science International, 2007Co-Authors: Henry F Krous, Elisabeth A Haas, Homeyra Masoumi, Amy E Chadwick, Christina StanleyAbstract:The differentiation of SIDS from accidental or inflicted Suffocation may be impossible without corroborating findings from the death scene or autopsy or in the absence of a confession from a perpetrator. Pulmonary intra-alveolar hemorrhage (PH) has been proposed as a potential clue to Suffocation, but none of the previous studies on this topic have limited SIDS cases to those who were in a safe sleep environment, in which all were found supine and alone on a firm surface with their heads uncovered. Our aims are to: (1) compare PH in SIDS cases found in a safe sleep environment to a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation and (2) assess the effect of age, CPR, and postmortem interval (PMI), with regard to the severity of PH in this subset of safe-sleeping SIDS cases. We conducted a retrospective study of all postneonatal cases accessioned by the Office of the Medical Examiner in San Diego County, California who died of SIDS or Suffocation between 1999 and 2004. A total of 74 cases of sudden infant death caused by SIDS (34 cases as defined above, comprising 8% of the total SIDS cases), accidental Suffocation (37), and inflicted Suffocation (3) from the San Diego SIDS/SUDC Research Project database were compared using a semiquantitative measure of pulmonary intra-alveolar hemorrhage. The most severe (grade 3 or 4) PH occurred in 35% of deaths attributed to Suffocation, but in only 9% of the SIDS cases. Age, duration of CPR attempts and PMI had no effect on the severity of PH in SIDS. Our results indicate that the severity of PH cannot be used independently to differentiate SIDS from Suffocation deaths. Each case must be evaluated on its own merits after thorough review of the medical history, circumstances of death, and postmortem findings.
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Pulmonary intra-alveolar hemorrhage in SIDS and Suffocation.
Journal of Forensic and Legal Medicine, 2007Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christina StanleyAbstract:The differentiation of SIDS from accidental or inflicted Suffocation may be impossible in some cases. Severe pulmonary intra-alveolar hemorrhage has been suggested as a potential marker for such differentiation. Our aims are to: (1) Compare pulmonary hemorrhage in SIDS and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation. (2) Review individual cases with the most severe pulmonary hemorrhage regardless of the cause of death, and (3) Assess the effect of age, bedsharing, cardiopulmonary resuscitation, and postmortem interval, with regard to the severity of pulmonary hemorrhage in SIDS cases. We conducted a retrospective study of all postneonatal cases accessioned by the Office of the Medical Examiner in San Diego County, California who died of SIDS or Suffocation between 1999 and 2004. A total of 444 cases of sudden infant death caused by SIDS (405), accidental Suffocation (36), and inflicted Suffocation (3) from the San Diego SIDS/SUDC Research Project database were compared using a semiquantitative measure of pulmonary intra-alveolar hemorrhage [absent (0) to severe (4)]. Grades 3 or 4 pulmonary hemorrhage occurred in 33% of deaths attributed to Suffocation, but in only 11% of the SIDS cases, however, all grades of pulmonary hemorrhage occurred in both groups. Therefore, our results indicate that the severity of pulmonary hemorrhage cannot be used in isolation to determine the cause or manner of sudden infant death. Among SIDS cases, those with a higher pulmonary hemorrhage grade (3 or 4) were more likely to bedshare, and with more than one co-sleeper, than those with a lower pulmonary hemorrhage grade (0 or 1). We conclude that each case must be evaluated on its own merits after thorough review of the medical history, circumstances of death, and postmortem findings.
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Pulmonary intra-alveolar siderophages in SIDS and Suffocation: a San Diego SIDS/SUDC Research Project report.
Pediatric and Developmental Pathology, 2006Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christopher Wixom, Patricia D. Silva, Christina StanleyAbstract:Pulmonary intra-alveolar siderophages (PS) have been suggested as a marker of previous attempts at imposed Suffocation in infants dying suddenly and unexpectedly. The aims of this study were to (1) compare PS counts between cases of sudden infant death syndrome (SIDS) and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation, (2) compare clinical variables in SIDS and control Suffocation cases, and (3) review individual cases irrespective of the cause and manner of death with an average PS count greater than 200 per 20 high-power fields (hpf) per lung lobe. Retrospective assessment of siderophages in available iron-stained lung sections was undertaken in 91 SIDS cases and 29 cases of death due to Suffocation (27 accidents and 2 homicides) from the San Diego SIDS and Sudden Unexplained Death in Childhood (SUDC) Research Project (SDSSRP) database. Neither the means of the log-transformed PS counts nor the medians of the raw PS counts were significantly different between the SIDS and control Suffocation groups. The distributions of the PS data were different, however-the range was wider in the SIDS group. Only 6% of each group had a history of prior apparent life-threatening events. Approximately three fourths of the families from both groups had no prior referral to Child Protective Services. The number of PS varies widely in cases of sudden infant death caused by SIDS and accidental or inflicted Suffocation and cannot be used as an independent variable to ascertain past attempts at Suffocation.
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pulmonary intra alveolar siderophages in sids and Suffocation a san diego sids sudc research project report
Pediatric and Developmental Pathology, 2006Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christopher Wixom, Patricia D. Silva, Christina StanleyAbstract:Pulmonary intra-alveolar siderophages (PS) have been suggested as a marker of previous attempts at imposed Suffocation in infants dying suddenly and unexpectedly. The aims of this study were to (1) compare PS counts between cases of sudden infant death syndrome (SIDS) and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation, (2) compare clinical variables in SIDS and control Suffocation cases, and (3) review individual cases irrespective of the cause and manner of death with an average PS count greater than 200 per 20 high-power fields (hpf) per lung lobe. Retrospective assessment of siderophages in available iron-stained lung sections was undertaken in 91 SIDS cases and 29 cases of death due to Suffocation (27 accidents and 2 homicides) from the San Diego SIDS and Sudden Unexplained Death in Childhood (SUDC) Research Project (SDSSRP) database. Neither the means of the log-transformed PS counts nor the medians of the raw PS counts were significantly different between the SIDS and control Suffocation groups. The distributions of the PS data were different, however-the range was wider in the SIDS group. Only 6% of each group had a history of prior apparent life-threatening events. Approximately three fourths of the families from both groups had no prior referral to Child Protective Services. The number of PS varies widely in cases of sudden infant death caused by SIDS and accidental or inflicted Suffocation and cannot be used as an independent variable to ascertain past attempts at Suffocation.
Elisabeth A Haas - One of the best experts on this subject based on the ideXlab platform.
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myocardial inflammation cellular death and viral detection in sudden infant death caused by sids Suffocation or myocarditis
Pediatric Research, 2009Co-Authors: Henry F Krous, Elisabeth A Haas, Homeyra Masoumi, Christina Stanley, Christine Ferandos, John H Arnold, Paul GrossfeldAbstract:The significance of minor myocardial inflammatory infiltrates and viral detection in SIDS is controversial. We retrospectively compared the demographic profiles, myocardial inflammation, cardiomyocyte necrosis, and myocardial virus detection in infants who died of SIDS in a safe sleep environment, accidental Suffocation, or myocarditis. Formalin-fixed, paraffin-embedded myocardial sections were semiquantitatively assessed for CD3 lymphocytes and CD68 macrophages using immunohistochemistry and for cardiomyocyte cell death in H&E-stained sections. Enteroviruses and adenoviruses were searched for using PCR technology. The means of lymphocytes, macrophages, and necrotic cardiomyocytes were not statistically different in SIDS and Suffocation cases. Enterovirus, not otherwise specified, was detected in one Suffocation case and was the only virus detected in the three groups. Very mild myocardial lymphocyte and macrophage infiltration and scattered necrotic cardiomyocytes in SIDS are not pathologic, but may occur after the developing heart is exposed to environmental pathogens, including viruses.
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a comparison of pulmonary intra alveolar hemorrhage in cases of sudden infant death due to sids in a safe sleep environment or to Suffocation
Forensic Science International, 2007Co-Authors: Henry F Krous, Elisabeth A Haas, Homeyra Masoumi, Amy E Chadwick, Christina StanleyAbstract:The differentiation of SIDS from accidental or inflicted Suffocation may be impossible without corroborating findings from the death scene or autopsy or in the absence of a confession from a perpetrator. Pulmonary intra-alveolar hemorrhage (PH) has been proposed as a potential clue to Suffocation, but none of the previous studies on this topic have limited SIDS cases to those who were in a safe sleep environment, in which all were found supine and alone on a firm surface with their heads uncovered. Our aims are to: (1) compare PH in SIDS cases found in a safe sleep environment to a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation and (2) assess the effect of age, CPR, and postmortem interval (PMI), with regard to the severity of PH in this subset of safe-sleeping SIDS cases. We conducted a retrospective study of all postneonatal cases accessioned by the Office of the Medical Examiner in San Diego County, California who died of SIDS or Suffocation between 1999 and 2004. A total of 74 cases of sudden infant death caused by SIDS (34 cases as defined above, comprising 8% of the total SIDS cases), accidental Suffocation (37), and inflicted Suffocation (3) from the San Diego SIDS/SUDC Research Project database were compared using a semiquantitative measure of pulmonary intra-alveolar hemorrhage. The most severe (grade 3 or 4) PH occurred in 35% of deaths attributed to Suffocation, but in only 9% of the SIDS cases. Age, duration of CPR attempts and PMI had no effect on the severity of PH in SIDS. Our results indicate that the severity of PH cannot be used independently to differentiate SIDS from Suffocation deaths. Each case must be evaluated on its own merits after thorough review of the medical history, circumstances of death, and postmortem findings.
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Pulmonary intra-alveolar hemorrhage in SIDS and Suffocation.
Journal of Forensic and Legal Medicine, 2007Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christina StanleyAbstract:The differentiation of SIDS from accidental or inflicted Suffocation may be impossible in some cases. Severe pulmonary intra-alveolar hemorrhage has been suggested as a potential marker for such differentiation. Our aims are to: (1) Compare pulmonary hemorrhage in SIDS and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation. (2) Review individual cases with the most severe pulmonary hemorrhage regardless of the cause of death, and (3) Assess the effect of age, bedsharing, cardiopulmonary resuscitation, and postmortem interval, with regard to the severity of pulmonary hemorrhage in SIDS cases. We conducted a retrospective study of all postneonatal cases accessioned by the Office of the Medical Examiner in San Diego County, California who died of SIDS or Suffocation between 1999 and 2004. A total of 444 cases of sudden infant death caused by SIDS (405), accidental Suffocation (36), and inflicted Suffocation (3) from the San Diego SIDS/SUDC Research Project database were compared using a semiquantitative measure of pulmonary intra-alveolar hemorrhage [absent (0) to severe (4)]. Grades 3 or 4 pulmonary hemorrhage occurred in 33% of deaths attributed to Suffocation, but in only 11% of the SIDS cases, however, all grades of pulmonary hemorrhage occurred in both groups. Therefore, our results indicate that the severity of pulmonary hemorrhage cannot be used in isolation to determine the cause or manner of sudden infant death. Among SIDS cases, those with a higher pulmonary hemorrhage grade (3 or 4) were more likely to bedshare, and with more than one co-sleeper, than those with a lower pulmonary hemorrhage grade (0 or 1). We conclude that each case must be evaluated on its own merits after thorough review of the medical history, circumstances of death, and postmortem findings.
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Pulmonary intra-alveolar siderophages in SIDS and Suffocation: a San Diego SIDS/SUDC Research Project report.
Pediatric and Developmental Pathology, 2006Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christopher Wixom, Patricia D. Silva, Christina StanleyAbstract:Pulmonary intra-alveolar siderophages (PS) have been suggested as a marker of previous attempts at imposed Suffocation in infants dying suddenly and unexpectedly. The aims of this study were to (1) compare PS counts between cases of sudden infant death syndrome (SIDS) and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation, (2) compare clinical variables in SIDS and control Suffocation cases, and (3) review individual cases irrespective of the cause and manner of death with an average PS count greater than 200 per 20 high-power fields (hpf) per lung lobe. Retrospective assessment of siderophages in available iron-stained lung sections was undertaken in 91 SIDS cases and 29 cases of death due to Suffocation (27 accidents and 2 homicides) from the San Diego SIDS and Sudden Unexplained Death in Childhood (SUDC) Research Project (SDSSRP) database. Neither the means of the log-transformed PS counts nor the medians of the raw PS counts were significantly different between the SIDS and control Suffocation groups. The distributions of the PS data were different, however-the range was wider in the SIDS group. Only 6% of each group had a history of prior apparent life-threatening events. Approximately three fourths of the families from both groups had no prior referral to Child Protective Services. The number of PS varies widely in cases of sudden infant death caused by SIDS and accidental or inflicted Suffocation and cannot be used as an independent variable to ascertain past attempts at Suffocation.
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pulmonary intra alveolar siderophages in sids and Suffocation a san diego sids sudc research project report
Pediatric and Developmental Pathology, 2006Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christopher Wixom, Patricia D. Silva, Christina StanleyAbstract:Pulmonary intra-alveolar siderophages (PS) have been suggested as a marker of previous attempts at imposed Suffocation in infants dying suddenly and unexpectedly. The aims of this study were to (1) compare PS counts between cases of sudden infant death syndrome (SIDS) and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation, (2) compare clinical variables in SIDS and control Suffocation cases, and (3) review individual cases irrespective of the cause and manner of death with an average PS count greater than 200 per 20 high-power fields (hpf) per lung lobe. Retrospective assessment of siderophages in available iron-stained lung sections was undertaken in 91 SIDS cases and 29 cases of death due to Suffocation (27 accidents and 2 homicides) from the San Diego SIDS and Sudden Unexplained Death in Childhood (SUDC) Research Project (SDSSRP) database. Neither the means of the log-transformed PS counts nor the medians of the raw PS counts were significantly different between the SIDS and control Suffocation groups. The distributions of the PS data were different, however-the range was wider in the SIDS group. Only 6% of each group had a history of prior apparent life-threatening events. Approximately three fourths of the families from both groups had no prior referral to Child Protective Services. The number of PS varies widely in cases of sudden infant death caused by SIDS and accidental or inflicted Suffocation and cannot be used as an independent variable to ascertain past attempts at Suffocation.
Amy E Chadwick - One of the best experts on this subject based on the ideXlab platform.
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a comparison of pulmonary intra alveolar hemorrhage in cases of sudden infant death due to sids in a safe sleep environment or to Suffocation
Forensic Science International, 2007Co-Authors: Henry F Krous, Elisabeth A Haas, Homeyra Masoumi, Amy E Chadwick, Christina StanleyAbstract:The differentiation of SIDS from accidental or inflicted Suffocation may be impossible without corroborating findings from the death scene or autopsy or in the absence of a confession from a perpetrator. Pulmonary intra-alveolar hemorrhage (PH) has been proposed as a potential clue to Suffocation, but none of the previous studies on this topic have limited SIDS cases to those who were in a safe sleep environment, in which all were found supine and alone on a firm surface with their heads uncovered. Our aims are to: (1) compare PH in SIDS cases found in a safe sleep environment to a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation and (2) assess the effect of age, CPR, and postmortem interval (PMI), with regard to the severity of PH in this subset of safe-sleeping SIDS cases. We conducted a retrospective study of all postneonatal cases accessioned by the Office of the Medical Examiner in San Diego County, California who died of SIDS or Suffocation between 1999 and 2004. A total of 74 cases of sudden infant death caused by SIDS (34 cases as defined above, comprising 8% of the total SIDS cases), accidental Suffocation (37), and inflicted Suffocation (3) from the San Diego SIDS/SUDC Research Project database were compared using a semiquantitative measure of pulmonary intra-alveolar hemorrhage. The most severe (grade 3 or 4) PH occurred in 35% of deaths attributed to Suffocation, but in only 9% of the SIDS cases. Age, duration of CPR attempts and PMI had no effect on the severity of PH in SIDS. Our results indicate that the severity of PH cannot be used independently to differentiate SIDS from Suffocation deaths. Each case must be evaluated on its own merits after thorough review of the medical history, circumstances of death, and postmortem findings.
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Pulmonary intra-alveolar hemorrhage in SIDS and Suffocation.
Journal of Forensic and Legal Medicine, 2007Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christina StanleyAbstract:The differentiation of SIDS from accidental or inflicted Suffocation may be impossible in some cases. Severe pulmonary intra-alveolar hemorrhage has been suggested as a potential marker for such differentiation. Our aims are to: (1) Compare pulmonary hemorrhage in SIDS and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation. (2) Review individual cases with the most severe pulmonary hemorrhage regardless of the cause of death, and (3) Assess the effect of age, bedsharing, cardiopulmonary resuscitation, and postmortem interval, with regard to the severity of pulmonary hemorrhage in SIDS cases. We conducted a retrospective study of all postneonatal cases accessioned by the Office of the Medical Examiner in San Diego County, California who died of SIDS or Suffocation between 1999 and 2004. A total of 444 cases of sudden infant death caused by SIDS (405), accidental Suffocation (36), and inflicted Suffocation (3) from the San Diego SIDS/SUDC Research Project database were compared using a semiquantitative measure of pulmonary intra-alveolar hemorrhage [absent (0) to severe (4)]. Grades 3 or 4 pulmonary hemorrhage occurred in 33% of deaths attributed to Suffocation, but in only 11% of the SIDS cases, however, all grades of pulmonary hemorrhage occurred in both groups. Therefore, our results indicate that the severity of pulmonary hemorrhage cannot be used in isolation to determine the cause or manner of sudden infant death. Among SIDS cases, those with a higher pulmonary hemorrhage grade (3 or 4) were more likely to bedshare, and with more than one co-sleeper, than those with a lower pulmonary hemorrhage grade (0 or 1). We conclude that each case must be evaluated on its own merits after thorough review of the medical history, circumstances of death, and postmortem findings.
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Pulmonary intra-alveolar siderophages in SIDS and Suffocation: a San Diego SIDS/SUDC Research Project report.
Pediatric and Developmental Pathology, 2006Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christopher Wixom, Patricia D. Silva, Christina StanleyAbstract:Pulmonary intra-alveolar siderophages (PS) have been suggested as a marker of previous attempts at imposed Suffocation in infants dying suddenly and unexpectedly. The aims of this study were to (1) compare PS counts between cases of sudden infant death syndrome (SIDS) and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation, (2) compare clinical variables in SIDS and control Suffocation cases, and (3) review individual cases irrespective of the cause and manner of death with an average PS count greater than 200 per 20 high-power fields (hpf) per lung lobe. Retrospective assessment of siderophages in available iron-stained lung sections was undertaken in 91 SIDS cases and 29 cases of death due to Suffocation (27 accidents and 2 homicides) from the San Diego SIDS and Sudden Unexplained Death in Childhood (SUDC) Research Project (SDSSRP) database. Neither the means of the log-transformed PS counts nor the medians of the raw PS counts were significantly different between the SIDS and control Suffocation groups. The distributions of the PS data were different, however-the range was wider in the SIDS group. Only 6% of each group had a history of prior apparent life-threatening events. Approximately three fourths of the families from both groups had no prior referral to Child Protective Services. The number of PS varies widely in cases of sudden infant death caused by SIDS and accidental or inflicted Suffocation and cannot be used as an independent variable to ascertain past attempts at Suffocation.
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pulmonary intra alveolar siderophages in sids and Suffocation a san diego sids sudc research project report
Pediatric and Developmental Pathology, 2006Co-Authors: Henry F Krous, Elisabeth A Haas, Amy E Chadwick, Christopher Wixom, Patricia D. Silva, Christina StanleyAbstract:Pulmonary intra-alveolar siderophages (PS) have been suggested as a marker of previous attempts at imposed Suffocation in infants dying suddenly and unexpectedly. The aims of this study were to (1) compare PS counts between cases of sudden infant death syndrome (SIDS) and a control group comprised of infants whose deaths were attributed to accidental or inflicted Suffocation, (2) compare clinical variables in SIDS and control Suffocation cases, and (3) review individual cases irrespective of the cause and manner of death with an average PS count greater than 200 per 20 high-power fields (hpf) per lung lobe. Retrospective assessment of siderophages in available iron-stained lung sections was undertaken in 91 SIDS cases and 29 cases of death due to Suffocation (27 accidents and 2 homicides) from the San Diego SIDS and Sudden Unexplained Death in Childhood (SUDC) Research Project (SDSSRP) database. Neither the means of the log-transformed PS counts nor the medians of the raw PS counts were significantly different between the SIDS and control Suffocation groups. The distributions of the PS data were different, however-the range was wider in the SIDS group. Only 6% of each group had a history of prior apparent life-threatening events. Approximately three fourths of the families from both groups had no prior referral to Child Protective Services. The number of PS varies widely in cases of sudden infant death caused by SIDS and accidental or inflicted Suffocation and cannot be used as an independent variable to ascertain past attempts at Suffocation.
Ronald Ley - One of the best experts on this subject based on the ideXlab platform.
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Respiration and the Emotion of Dyspnea/Suffocation Fear
Respiration and Emotion, 2001Co-Authors: Ronald LeyAbstract:The thesis of this paper is that the experience of acute severe dyspnea accompanied by dyspnea/Suffocation fear are prerequisites for the classic primary panic attack (1, 2). The probability that the occurrence of a single panic attack leads to panic disorder depends on the intensity and duration of the initial attack and whether or not the accompanying environmental cues (endogenous and/or exogenous) facilitate generalization of dyspnea/Suffocation fear to a relatively broad range of stimuli. Thus, an initial classic panic attack is less likely to lead to subsequent secondary panic attacks (attacks of dyspnea/Suffocation fear in the absence of severe dyspna) or to tertiary attacks (relatively mild anxiety/apprehension elicited by anticipatory thoughts, and their antecedents, of prior primary or secondary attacks) if the initial primary attack occurs in a relatively unique environment.
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Pulmonary function and dyspnea/Suffocation theory of panic
Journal of Behavior Therapy and Experimental Psychiatry, 1998Co-Authors: Ronald LeyAbstract:This article presents a brief discussion of pulmonary function and panic attacks in the context of respiratory psychophysiology. Ley’s (Behaviour Research and Therapy, 27, 549–554, 1989) earlier dyspnea/Suffocation theory of panic is contrasted with Klein’s (Archives of General Psychiatry, 50, 306–316, 1993) later false Suffocation alarm theory. The distinction between “dyspnea” (the sensation of difficulty in breathing) and “Suffocation” (a condition that sometimes gives rise to dyspnea) is emphasized. The brief discussion is followed by a critical comparison of two recent studies on pulmonary function and panic. Asmundson and Stein (Journal of Anxiety Disorders, 8, 63–69, 1994) reported an association between forced expiratory flow rate (a measure of pulmonary function) in panic disorder patients and the severity of panic-related symptoms. They interpreted their findings as support for the dyspnea/Suffocation theory of panic since severity of dyspnea is a consequence of pulmonary function. Spinhoven et al. (Behaviour Research and Therapy, 33, 457–460, 1995) failed to replicate the findings of Asmundson and Stein. The present paper provides a critical analysis of the study by Spinhoven et al. and concludes that the failed attempt to replicate may have been a consequence of a flawed methodology (the subjects of the two studies are not comparable on a crucial pulmonary test) and a statistical anomaly (disproportionately small differences between means that exceed predictions based on sampling error). A recommendation is made that future attempts to replicate should pay special care to avoid the possibility of experimenter-demand effects.
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The Ondine Curse, False Suffocation Alarms, Trait-State Suffocation Fear, and Dyspnea-Suffocation Fear in Panic Attacks
Archives of General Psychiatry, 1997Co-Authors: Ronald LeyAbstract:Ley 1 still inexplicably and evasively ignores my point that patients with the Ondine curse do not feel distressed while actually suffocating. He simply confuses the matter by gratuitously suggesting that an alarm system has to be either off or maximally on. Clearly many physiological alarm systems produce mounting discomfort and activation but do not lead to a full-fledged maximum reaction unless adaptive action has failed to be effective. Ley obscures the issue by a physiologically unwarranted dictum about how alarm systems work. Central sleep apnea is a pathological feature of the breathing control mechanism; patients with central sleep apnea breathe insufficiently except during full wakefulness. Such patients are quite similar to patients with the Ondine curse, so this does not contradict my views. In obstructive sleep apnea, obesity or upper airway narrowing may result in hypoxia and hypercapnia, which may induce central apnea. During sleep apnea, the usual response
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Panic Attacks: Klein's False Suffocation Alarm, Taylor and Rachman's Data, and Ley's Dyspneic-Fear Theory
Archives of General Psychiatry, 1996Co-Authors: Ronald LeyAbstract:In a recent letter on Klein's 1 false Suffocation alarm theory of panic attacks, Taylor and Rachman 2 reported two sets of data that purportedly support predictions derived from the theory. One set supports the validity of their measure of Suffocation fear 3 as an index of the sensitivity of the putative Suffocation alarm: "As predicted, subjects with high Suffocation fear reported significantly more panic attacks than subjects with low Suffocation fear... " 2 The other set gave the results of a brief structured interview, 2 in which subjects with high Suffocation fears reported a significantly greater incidence of panic in enclosed spaces and in other situations and a greater incidence of spontaneous panic than did subjects with low Suffocation fears. The primary point to be made here is that Taylor and Rachman's results also support Ley's 4 theory of panic, a theory predicated on the assumption that the classic "panic
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The “Suffocation alarm” theory of panic attacks: A critical commentary
Journal of Behavior Therapy and Experimental Psychiatry, 1994Co-Authors: Ronald LeyAbstract:In 1993 Klein proposed a “false Suffocation alarm” theory of panic attacks, claiming that many spontaneous panic attacks are due to a “Suffocation monitor” in the brain erroneously signaling a lack of useful air, and triggering an evolved “Suffocation alarm system”. He proposed that carbon dioxide acts as a panic stimulus because rising arterial CO2 suggests Suffocation may be imminent. The present paper provides a critical analysis of Klein's theory and concludes that there is neither empirical evidence nor compelling argument to support the assumptions or the proposed neurological mechanism of a “Suffocation alarm”, true or false, or a CO2 “Suffocation monitor”. Data relevant to the role of breathing in the phenomenon of panic can be parsimoniously subsumed within the domain of dyspnea.
