phenylephrine-hydrochloride and Death--Sudden

This is an investigation of anatomical and sleep history risk factors that were associated with abrupt sleep-associated death in seven children with good pre-mortem history. Seven young children with abrupt deaths and information on health status, sleep history, death scene report, and autopsy performed in a specialized unit dedicated to investigation of abrupt death in young children were investigated Seven age and gender matched living children with obstructive-sleep-apnea (OSA) were compared to the findings obtained from the dead children. Two deaths results from accidents determined by the death scene and five were unexplained at the death scene. History revealed presence of chronic indicators of abnormal sleep in all cases prior death and history of an acute, often mild, rhinitis just preceding death in several. Four children, including three infants, were usually sleeping in a prone position. Autopsy demonstrated variable enlargement of upper airway soft tissues in all cases, and in all cases, there were features consistent with a narrow, small nasomaxillary complex, with or without mandibular retroposition. All children were concluded to have died of hypoxia during sleep. Our OSA children presented similar complaints and similar facial features. Anatomic risk factors for a narrow upper airway can be determined early in life, and these traits are often familial. Their presence should lead to greater attention to sleep-related complaints that may be present very early in life and indicate impairment of well been and presence of sleep disruption. Further investigation should be performed to understand the role of upper airway infection in the setting of anatomically small airway in apparently abrupt death of infants and toddlers.

Topics: Child, Preschool; Death, Sudden; Female; Humans; Hypoxia; Infant; Male; Maxilla; Nose; Palate, Hard; Retrospective Studies; Risk Factors; Sleep Apnea, Obstructive

In March 2009, a new strain of influenza A/H1N1 virus was identified in Mexico, responsible for a pandemic. Worldwide, more than 13,500 patients died, most often from acute respiratory distress syndrome. Because sudden death cases were rare, involving mostly young apparently healthy persons, influenza A/H1N1 (2009)-related deaths may be misdiagnosed, which can raise medico-legal issues.. we report on an unexpected out-of-hospital death involving a young male with no past medical history and no vaccination. Fever was his only symptom. Laboratory tests: histology showed patchy necrotic foci with mononuclear inflammation in the lungs. The heart was histologically normal, but virological analyses using molecular biology on frozen myocardial samples showed high virus load. In conclusion, this case report shows that influenza A/H1N1 (2009) virus can be a cause of sudden cardiac death in the young and demonstrates the importance of quantitative virological analyses for the diagnosis of myocarditis.

Topics: Death, Sudden; DNA, Viral; Heart; Humans; Inflammation; Influenza A Virus, H1N1 Subtype; Influenza, Human; Lung; Male; Myocardium; Necrosis; Nose; Real-Time Polymerase Chain Reaction; Viral Load; Young Adult

Topics: Animals; Death, Sudden; Gasoline; Humans; Nose; Petroleum; Reflex; Substance-Related Disorders

Topics: Airway Obstruction; Apnea; Death, Sudden; Humans; Infant; Infant, Newborn; Nose; Reflex; Respiration; Sleep, REM

Topics: Apnea; Asphyxia Neonatorum; Death, Sudden; Female; Humans; Infant, Newborn; Labor Presentation; Nose; Pregnancy; Reflex

Topics: Asphyxia; Death, Sudden; Humans; Infant; Infant, Newborn; Mouth; Nose; Respiration; Respiratory System; Respiratory Tract Infections; Skull

Topics: Apnea; Asphyxia; Death, Sudden; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Nose; Respiration; Respiratory Insufficiency; Seasons

Topics: Child; Choanal Atresia; Death; Death, Sudden; Humans; Infant; Nose