June 2017 - SIDS?

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Year: 2017
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Language: English
Publication Date: June 1, 2017
Product Code: AFPj_Volume_7_Issue_2
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June 2017 - SIDS?

The theme of the second issue of 2017 is “SIDS?” and the Special Guest Editor is Dr. Melissa Pasquale-Styles. The theme is meant to be provocative, as was the paper that was published in the inaugural issue of Academic Forensic Pathology over six years ago (1). I think it is fair to say that the use of the term “SIDS” is falling out of favor with forensic pathologists. The number of cases of infant deaths certified as SIDS has been falling; this is likely due at least in part to a diagnostic shift amongst forensic pathologists to the diagnosis of “undetermined.” Although SIDS essentially means undetermined, the SIDS term had taken on a life of its own, and inadvertently became thought of as an actual, singular entity—a real thing—rather than a descriptive term of classification for research purposes.

Other examples of the unintended consequence of using such descriptive acronyms are sudden unexplained infant death (SUID) and sudden unexpected death in infancy (SUDI). Both of these terms have been used by forensic pathologists to imply an undetermined cause of death in infants where no cause of death is found. However, the term SUID is defined quite differently by the Centers for Disease Control and Prevention (CDC). They define the term SUID to mean the “death of an infant less than 1 year of age that occurs suddenly and unexpectedly, and whose cause of death is not immediately obvious before investigation” [bold emphasis mine] (2). This definition includes cases that are ultimately certified as SIDS, undetermined (even though SIDS means undetermined as well), and accidental suffocation and strangulation in bed. This is a drastically different definition from the meaning that a forensic pathologist is trying to convey, which is an “undetermined” cause of death after completion of the entire investigation. The reason that the CDC groups SIDS, undetermined, and asphyxial deaths of infants together is ostensibly to track all “unexpected” deaths in the infant population, understanding the inconsistency of certification amongst forensic pathologists. Imagine the confusion parents would feel if they were to see the diagnosis of SUID on a death certificate or autopsy report (where the forensic pathologist was implying an undetermined cause of death) and then they read the CDC literature and believe that the diagnosis is either undetermined or SIDS or asphyxia!

The issue begins with a historical paper about the history of SIDS. Another paper challenges the often-taught maxim that 10% of SIDS cases are actually undiscovered homicides. While there are several papers discussing “complete” autopsies in adults, there are far fewer in the infant population, and we feature an article describing the approach to autopsying an infant who has died suddenly and unexpectedly. This is followed by papers discussing recommendations for neuropathologic examination in pediatric cases and the assessment and classification of apparent asphyxial deaths in the infant population. Finally, we feature a paper discussing the perceived unintended consequences of the diversion away from the “SIDS” diagnosis. We also feature several unsolicited articles.

 

 

ACADEMIC FORENSIC PATHOLOGY:

The Official Publication of the National Association of Medical Examiners

 

June 2017 • Volume Seven • Issue Two • SIDS

 

EDITORIALS

Letter from the Editor-In-Chief........................................................................................................................vi

J. Keith Pinckard

Letter from the NAME President.................................................................................................................. viii

Brian L. Peterson

Letter from the Guest Editor............................................................................................................................x

Melissa A. Pasquale-Styles

 

BIOGRAPHIES

Biography for the Editor-In-Chief...................................................................................................................xii

Biography for the Associate Editor-In-Chief..................................................................................................xiii

Biographies for the Editorial Board...............................................................................................................xiv

 

SPECIAL CONTENT

Inexplicable Child Deaths: Medicolegal Death Investigation Resources from the SUDC
Foundation and the SUDC Registry and Research Collaborative
..............................................................xxiv

Laura Gould Crandall

 

INVITED REVIEWS

A Fresh Look at the History of SIDS............................................................................................................146

James R. Wright Jr.

Ten Percent of SIDS Cases Are Murder — Or Are They?...........................................................................163

Christopher M. Milroy, Charis Kepron

Recommendations for the Autopsy of an Infant Who Has Died Suddenly and Unexpectedly.....................171

Kathryn Pinneri, Evan W. Matshes

Neuropathologic Examination in Sudden Unexpected Deaths in Infancy and Childhood: Recommendations for Highest Diagnostic Yield and Cost-Effectiveness in Forensic Settings.........................................................182

Rebecca D. Folkerth, Jacqueline Nunez, Zhanna Georgievskaya, Declan McGuone

An Approach to the Classification of Apparent Asphyxial Infant Deaths.......................................................200

Evan W. Matshes, Emma O. Lew

The Diagnostic Shift of SIDS to Undetermined: Are There Unintended Consequences?.............................212

Laura Gould Crandall, Laura Reno, Barbara Himes, Deborah Robinson

 

REVIEW ARTICLES

Medicolegal Death Scene Investigations After Natural Disaster- and Weather-Related Events:
A Review of the Literature
.............................................................................................................................221

Luciana A. Rocha, Catharine Q. Fromknecht, Sarah Davis Redman, Joanne E. Brady, Sarah E. Hodge, Rebecca S. Noe

Rickets: Historical, Epidemiological, Pathophysiological, and Pathological Perspectives............................240

Alfredo Walker, Dina el Demellawy, Jorge Davila

 

 

ORIGINAL ARTICLES

Analysis of the Medical Assistance In Dying Cases In Ontario: Understanding the Patient Demographics of Case Uptake In Ontario Since the Royal Assent and Amendments of Bill C-14 In Canada..................................263

Alexandra E. Rosso, Dirk Huyer, Alfredo Walker

 

 

CASE OF THE MONTH

A Case of Granulomatosis with Polyangiitis Diagnosed at Autopsy............................................................288

J. Keith Pinckard

Ruptured Dural Arteriovenous Fistula/Malformation...................................................................................299

Vivian S. Snyder, James Y. Chen, Lawrence A. Hansen

 

IMAGES IN FORENSIC PATHOLOGY

Acute Esophageal Necrosis........................................................................................................................312

Daniel C. Butler, Nicholas I. Batalis

 

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