Correlation of gestational age and age at death in sudden infant death syndrome: another pointer to the role of critical developmental period?

BACKGROUND: Filiano and Kinney proposed a triple-risk model for the sudden infant death syndrome (SIDS) that involves the intersection of three risks: (1) a vulnerable infant, (2) a critical developmental period in homeostatic control, and (3) an exogenous stressor(s). The primary evidence for the role of a critical developmental period in SIDS etiology is the peak of cases around the third month of life. Independently, several studies pointed to correlation between gestational age and age at death in SIDS, but used that to assess the SIDS risk for preterm infants, ignoring further ramifications. METHODS: We did a detailed analysis of CDC data spanning over two decades (1983-2011). We focused not only on the correlation between two age variables (gestational and age at death), but also on the possibility of misdiagnosis. Also, we attempted to account for potential biases in the data induced by the ICD-9/ICD-190 transition or the "Back to Sleep" campaign. RESULTS: The peak of deaths in the third month of life, that was the main argument for the role of the critical development period, wasn't unique to SIDS. However, we confirmed an almost linear and negative correlation between gestational age and the week of death due to SIDS. This pattern (slope of correlation < 0 and significance of correlation p < 0.05) is characteristic of SIDS among all diseases analyzed in the study. CONCLUSIONS: We interpret the results as the evidence of the role of the critical development period in SIDS etiology. Possibly more attention in the future research should be put to theories that are based on homeostatic control.

The relationship between EMG high frequency and low frequency band amplitude changes correlates with tissue inorganic phosphate levels.

Assessing inorganic phosphate levels seems crucial in deciphering the biochemical state of organisms or tissues. The concentration of inorganic phosphate in blood is an order of magnitude smaller than in tissues and, on top of that, it is dynamically used to fill temporary gaps in tissues. This is the reason blood inorganic phosphate level is considered a poor proxy for tissue levels. Therefore, tissue biopsy seems to be the dominant method when assessing inorganic phosphate levels for instance in muscles. In this study, we attempted to derive a non-invasive biomarker for phosphate tissue levels. We analyzed surface electromyography signals taken during 31P spectroscopy of leg muscles in five adult pigs. We induced hypophosphatemia via 20 minutes-long hyperventilation. It turned out that the proportion of the amplitude of the low frequency band and the high frequency band is significantly (p=0.002) correlated with the relative phosphate levels. The electromyographic signal did not correlate significantly with pCO2 levels in the blood, suggesting that the changes in the signal are a result of inorganic phosphate levels, not hyperventilation. The results might lead to the development of a real-time phosphate fluctuations measurement procedure.

Stress-Induced Phosphaturia in Weaned Piglets.

The weaning period in piglets draws significant attention from researchers, veterinarians, and breeders. A substantial change in diet accompanied by enormous stress has health and welfare implications (abnormal feeding intake, infections, umbilical lesions, etc.). While the parameters like optimal age or weight for the weaning have been studied extensively, relatively less attention has been devoted to the study of stress effects in the piglets' biochemistry. As one of the effects of stress is hyperventilation, a gasometric analysis supported by measurements of hypoxia biomarkers was conducted. Piglets blood and urine, one day and seven days before and one day and seven days after the weaning, were tested. There was no evidence of hyperventilation, but phosphaturia and hypophosphatemia were observed one and seven days postweaning, respectively. A statistical analysis across the population also pointed to minor tissue hypoxia. Our work contributes to an understanding of biochemical dynamics and helps in the interpretation of physiological changes observed in piglets in this critical period.