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Abnormal Heart Rhythm May Be Cause of Some SIDS Cases

June 15, 1998

A significant number of cases of sudden infant death syndrome may result from a heart rhythm abnormality, the biggest SIDS study ever conducted concludes. Many cases of SIDS are thought to be caused when babies sleeping on their stomachs are suffocated by their bedding. Other causes, however, are largely a mystery, though experts have speculated that some deaths are a result of heart problems, breathing difficulties, even murder.

The latest research, conducted in Italy, singles out a heart defect that can trigger cardiac arrest. It raises the possibility that screening with an ordinary electrocardiogram soon after birth might spot babies at risk so they can be treated to prevent deaths.

The study by Dr. Peter John Schwartz and colleagues from the University of Pavia involved 33,043 infants and took 19 years to complete. Doctors checked babies with electrocardiograms a few days after birth, then followed them for a year. They reported in the June 11 New England Journal of Medicine that babies with a heart rhythm defect called a prolonged QT interval were 41 times more likely than others to die of SIDS. Half of the 24 babies in the study who died of SIDS had this condition, compared with none of those who died of other causes.

The condition can be treated with drugs.

Hormone Shows Success in Weight-Loss Trial

Early results from the first clinical trial in humans using leptin, the so-called anti-obesity hormone, to reduce weight have shown some success, researchers reported Sunday at a Chicago meeting of the American Diabetes Assn. After six months of treatment, average weight loss for the people taking the highest dosage of leptin was nearly 16 pounds, said Dr. Andrew S. Greenberg of the USDA Human Nutrition Center at Tufts University in Boston.

The safety trial of the hormone in 123 people showed no significant adverse effects, the team reported. The most common side effects were redness, itching and / or swelling at the injection site. Phase 2 trials have begun with about 500 subjects enrolled.

Incidence of Type 2 Diabetes Shows Big Jump

The most common type of diabetes has shown a dramatic increase in incidence between 1987 and 1996, suggesting that a major public health crisis may be on the horizon, Texas researchers reported at the same meeting. The incidence of Type 2 diabetes, which affects an estimated 16 million older Americans, rose by 9% per year over the decade, according to Dr. Michael P. Stern of the University of Texas Health Science Center at San Antonio.

"Because diabetes and obesity are major risk factors for cardiovascular disease--and both are increasing--this escalation may well eventually blunt or reverse the decline in heart disease that has been underway in the United States since the 1960s," Stern said.

Childhood Epilepsy Can Lead to Adult Problems

People who had epilepsy as children are more likely than others to be unemployed, unmarried and childless as adults, a Finnish study suggests. The researchers studied 220 who were treated for seizures as children between 1961 and 1964. They found that two-thirds had been seizure-free for at least five years.

Among the patients were 99 who had no other neurological problems. The study found these people were twice as likely as others their age to have completed only six years of school. They were about three times more likely to be unemployed, unmarried and childless, the researchers reported in the June 11 New England Journal of Medicine.

Another study in the journal, conducted by Dr. Christopher M. Verity and others from Addenbrooke's Hospital in Cambridge, England, however, found no sign that youngsters who have convulsions resulting from high fevers suffer any long-term problems.

Babies Released Too Early at Risk for Jaundice?

Newborns who are discharged from the hospital less than 72 hours after birth are at increased risk for readmission for the treatment of hyperbilirubinemia, an elevated level of bilirubin in the blood that can cause jaundice, according to a study of 29,934 Michigan infants.

Dr. M. Jeffrey Maisels and Dr. Elizabeth Kring of the William Beaumont Hospital in Royal Oak, Mich., reviewed the records of all newborns discharged between December 1988 and November 1994. They then compared the 247 infants who were readmitted within two weeks of birth with a randomly selected group of babies with similar characteristics who were not readmitted.

Maisels and Kring reported in the June issue of Pediatrics that of the 247 infants readmitted, 127 had significant jaundice caused by elevated bilirubin levels.

While readmission in general was rare, babies who were discharged in less than 72 hours were more likely to be readmitted for jaundice than were those who stayed three days.

Mothers Who Smoke and Breast-Feed

Mothers who go into the next room to smoke a cigarette may not be doing enough to protect their babies because the chemicals in tobacco smoke also show up in breast milk.

A study in the June American Journal of Public Health found that even chemicals from secondhand smoke can show up in a mother's milk, and later in her baby's urine. In fact, babies may get more exposure to tobacco through breast milk than by breathing secondhand smoke, Dr. Maria Mascola at Massachusetts General Hospital in Boston found.

Mascola's team examined 330 mothers and babies who were already taking part in a study of smoking. The babies of women who smoked and breast-fed had 10 times the level of cotinine in their urine as did babies of mothers who smoked but who bottle-fed their infants.

Cotinine is one of the breakdown products of the nicotine in cigarette smoke that can be found in the body. Mascola's group also found that babies whose mothers did not smoke but who lived with someone who did had higher levels of cotinine than babies in nonsmoking homes.

--Compiled by THOMAS H. MAUGH II

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