ABSTRACT
AIMS: To determine whether exposure to fluoridated water supplies prenatally or postnatally at the time of death increases the risk of sudden infant death syndrome (SIDS). METHODS: A nationwide, case-control study, with infant's water fluoridation status determined from census area unit information for mother's usual address at the time of the infant's birth, infant's usual address at the time of death / nominated sleep and address where infant died / was at nominated sleep. SIDS risk associated with fluoride exposure postnatally was assessed according to method of infant feeding (breast or reconstituted formula), for the two days prior to infant's death / nominated sleep. RESULTS: Infants exposed to fluoridated water supplies during pregnancy were not at increased risk for SIDS, adjusted odds ratio (OR) 1.19 (95% confidence interval (CI) 0.82, 1.74). For breast-fed infants at the time of death / nominated sleep, fluoridated water exposure was not associated with an increased risk for SIDS, adjusted OR 1.09 (95% CI 0.66, 1.79). Similarly, 'fluoridated' formula feeding, when compared with 'unfluoridated' formula feeding, showed no increased risk of SIDS, adjusted OR 1.25 (95% CI 0.73, 2.13). There was no evidence of an interaction between fluoridation and infant feeding for the last two days (chi2 = 0.171, df = 1, p = 0.68). CONCLUSION: Exposure to a fluoridated water supply prenatally or postnatally at the time of death did not affect the relative risk for SIDS.
Subject(s)
Fluoridation/adverse effects , Prenatal Exposure Delayed Effects , Sudden Infant Death/etiology , Analysis of Variance , Bottle Feeding , Breast Feeding , Case-Control Studies , Confounding Factors, Epidemiologic , Female , Fluoridation/statistics & numerical data , Humans , Infant , Infant Food , Infant, Newborn , Logistic Models , New Zealand/epidemiology , Pregnancy , Residence Characteristics , Risk Factors , Sudden Infant Death/epidemiologyABSTRACT
A patient was found to have a large mobile right atrial mass by two-dimensional echocardiography after developing sepsis due to prolonged central hyperalimentation. Contrast echocardiography was helpful in localizing the origin of the mass. A large infected thrombus emanating from the superior vena cava was removed at operation. The discussion includes a review of the literature on the echocardiography of right atrial masses.
Subject(s)
Echocardiography , Heart Diseases/etiology , Staphylococcal Infections/diagnosis , Thrombosis/diagnosis , Vena Cava, Superior , Catheterization, Central Venous/adverse effects , Diagnosis, Differential , Heart Atria , Humans , Male , Middle Aged , Staphylococcal Infections/etiology , Thrombosis/etiologyABSTRACT
Secondary drowning is a respiratory distress syndrome which develops after a latent period following apparently successful resuscitation from near-drowning. Eighteen cases of near-drowning have been reviewed and one case history is presented in detail to illustrate the importance of anticipating the development of this syndrome. Successful management of these patients involves ventilatory support and careful monitoring of the neurological and cardiovascular status. Because many doctors are unaware of the syndrome and because it has a good prognosis if recognized and treated early, a review of the clinical features and treatment is warranted.
