Apparent life-threatening event in infancy

Choi, Hee Joung; Kim, Yeo Hyang

doi:10.3345/kjp.2016.59.9.347

Cited by 9 publications

(10 citation statements)

References 55 publications

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“…Brief apneic spells are common within the first few minutes after birth, later on more prolonged episodes of apnea are observed. These apneic episodes (breath holding) are associated with prematurity, laryngeal chemoreflex activity or bradycardia, and loss of muscle tone (“near-miss SIDS” or apparent life-threatening events) ( 32 ). Episodic apnea and bradycardia have been observed in the infants who died of SIDS ( 33 ).…”

Section: Brainstem Control Of Respiration During the Transition From mentioning

confidence: 99%

Towards Better Understanding of the Pathogenesis of Neuronal Respiratory Network in Sudden Perinatal Death

et al. 2017

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Sudden perinatal death that includes the victims of sudden infant death syndrome, sudden intrauterine death syndrome, and stillbirth are heartbreaking events in the life of parents. Most of the studies about sudden perinatal death were reported from Italy, highlighting two main etiological factors: prone sleeping position and smoking. Other probable contributory factors are prematurity, male gender, lack of breastfeeding, respiratory tract infections, use of pacifiers, infant botulism, extensive use of pesticides and insecticides, etc. However, extensive studies across the world are required to establish the role of these factors in a different subset of populations. Previous studies confirmed the widely accepted hypothesis that neuropathology of the brainstem is one of the main cause of sudden perinatal death. This study is an effort to summarize the neuropathological evaluation of the brainstems and their association to sudden perinatal death. Brainstem nuclei in vulnerable infants undergo certain changes that may alter the sleep arousal cycle, cardiorespiratory control, and ultimately culminate in death. This review focuses on the roles of different brainstem nuclei, their pathologies, and the established facts in this regard in terms of it’s link to such deaths. This study will also help to understand the role of brainstem nuclei in controlling the cardiorespiratory cycles in sudden perinatal death and may provide a better understanding to resolve the mystery of these deaths in future. It is also found that a global initiative to deal with perinatal death is required to facilitate the diagnosis and prevention in developed and as well as developing countries.

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Section: Brainstem Control Of Respiration During the Transition From mentioning

confidence: 99%

Towards Better Understanding of the Pathogenesis of Neuronal Respiratory Network in Sudden Perinatal Death

et al. 2017

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“…The natural course seems to be benign and its outcome generally depends on the underlying disease, where detectable. 13 There is no available evidence about a relationship between intrauterine exposure to anticancer treatments and apparent life-threatening event.…”

Section: Discussionmentioning

confidence: 99%

Management of HER2-positive breast cancer during pregnancy: a case report

Berwart

Buonomo

Peccatori

et al. 2020

Tumori

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Introduction: Breast cancer is one of the most common malignancies diagnosed during pregnancy, with an incidence of 1:3000 pregnancies. Its rising incidence is related to the trend to postpone childbearing during the last 30 years. Breast cancer during pregnancy should not be managed differently from the nonpregnant setting. Chemotherapy is reported to be safe after the first trimester, whereas trastuzumab and tamoxifen are contraindicated regardless of the trimester. Case description: A patient diagnosed with breast cancer recurrence during pregnancy was exposed to both tamoxifen and trastuzumab during the first two trimesters of pregnancy. In addition, docetaxel was administered during the second and third trimesters, without subsequent fetal malformations or obstetric complications. Conclusions: When conception occurs inadvertently during assumption of tamoxifen or anti-HER2 agents, their effects on the fetus and on the course of pregnancy are not completely understood. Further studies are needed in this setting, highlighting the importance to share clinical experiences.

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“…This difference is likely because BRUE is a diagnosis of exclusion. ALTE has previously been associated with nonaccidental trauma, [3][4][5] seizures, 6,7 infections, 27 metabolic disease, 28 and cardiac disease. 8 The association of these and other diagnoses with BRUE remains unexplored.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Management of Children With Brief Resolved Unexplained Events (BRUEs)

et al. 2019

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BACKGROUND: In May 2016, the American Academy of Pediatrics published a clinical practice guideline for brief resolved unexplained events (BRUEs). We evaluated for changes in the management of BRUE after guideline publication. METHODS: Using a pediatric multicenter administrative database, we compared rates of admission, testing, revisits, and diagnoses in patients diagnosed with a BRUE or apparent lifethreatening event (ALTE) during 2017 with rates of admission, testing, revisits, and diagnoses in patients diagnosed with ALTE during 2015. We used interrupted time series analysis to test if the guideline was associated with changes in admission rate for all patients with ALTE or BRUE between 2015 and 2017. We stratified analyses by age (0-60 and 61-365 days). RESULTS: A total of 9501 patients were included (5608 in 2015 and 3893 in 2017). The admission rate decreased by 5.7% (95% confidence interval, 3.8% to 7.5%) for infants 0 to 60 days and by 18.0% (95% confidence interval, 15.3% to 20.7%) for infants 61 to 365 days from 2015 to 2017. Patients in 2017 had lower rates of EEG, brain MRI, chest radiography, laboratory testing, and urinalyses compared with patients in 2015. In the interrupted time series analysis model (n = 13 977), guideline publication was associated with decreasing admission rates (0.2% per week) for infants 61 to 365 days (P , .001). CONCLUSIONS: Compared with patients evaluated in 2015, patients with BRUE or ALTE in 2017 have lower rate of admissions and testing. Findings may be due to changes in the definition of BRUE and guideline recommendations. WHAT'S KNOWN ON THIS SUBJECT: In 2016, the American Academy of Pediatrics published a clinical practice guideline in which the name of apparent lifethreatening events was changed to brief resolved unexplained events (BRUEs). This guideline allowed for risk stratification and provided guidance for lowrisk BRUE. WHAT THIS STUDY ADDS: In this review of a pediatric multicenter administrative database, BRUE admissions decreased after guideline implementation without an increase in revisits or high-acuity diagnoses. These findings reveal that changes in practice have not resulted in worse outcomes.

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Apparent life-threatening event in infancy

Cited by 9 publications

References 55 publications

Towards Better Understanding of the Pathogenesis of Neuronal Respiratory Network in Sudden Perinatal Death

Towards Better Understanding of the Pathogenesis of Neuronal Respiratory Network in Sudden Perinatal Death

Management of HER2-positive breast cancer during pregnancy: a case report

Changes in the Management of Children With Brief Resolved Unexplained Events (BRUEs)

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