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SIDS Research

San Diego SIDS/SUDC Research Project
Henry F. Krous, MD, Director

Rady Children's Hospital -San Diego
3020 Children’s Way, MC 5007
San Diego, CA 92123

Goals

  1. To elucidate causes and mechanisms of sudden death in infancy and childhood;
  2. Determine role of features of the medical history, death scene and postmortem examination to reduce the risk of sudden death;
  3. Provide a basis for legislation pertaining to sudden infant death syndrome (SIDS) and sudden unexplained death in childhood (SUDC) that encourages national use of standardized scene investigations and postmortem examination protocols;
  4. Provide a basis for legislation supported by medical examiners, coroners, and surviving parents that authorizes research utilizing the records and specimens from these cases;
  5. Provide an opportunity for surviving parents to obtain a “second opinion”;
  6. Motivate other investigators to investigate SIDS and SUDC.

Organization and Research Project Collaborators

Dr. Henry Krous is the Director and Principle Investigator of the San Diego SIDS/SUDC Research Project.  The research collaborators are:

  1. Dr. Hannah Kinney, Pediatric Neuropathologist, Harvard Medical School, Boston, MA.
  2. Dr. Claire Langston, Pediatric Pulmonary Pathologist, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX.
  3. Dr. David Gozal, Pediatric Pulmonologist, University of Louisville School of Medicine, Louisville, KY.
  4. Dr. Gary W. Perry, Florida Atlantic University.
  5. Dr. Michael J. Emery, University of Washington School of Medicine, Seattle, WA.
  6. Dr. Michael Ackerman, Pediatric Cardiologist, Mayo Clinic, Rochester, MN.
  7. Dr. Piero Rinaldo, Pediatric Metabolic Geneticist, Mayo Clinic, Rochester, MN.
  8. Dr. Thomas Keens, Pediatric Pulmonologist, Children’s Hospital-Los Angeles, Los Angeles, CA.
  9. Patricia Silva, MS, Biostatistician, Rady Children’s Hospital-San Diego, San Diego, CA.
  10. Dr. Christina Stanley, Chief Deputy Medical Examiner, County of San Diego Office of the Chief Medical Examiner, San Diego, CA.
  11. Laura Crandall, Director, SUDC Program, Upper Montclair, NJ.  National parent liaison.
  12. Chelsea Hilbert, Director of Outreach Services, SUDC Program, Corona, CA.  National parent liaison.
  13. Two full-time, on-site research associates.

Location

The San Diego SIDS/SUDC Research Project is located within the Department of pathology at Rady Children's Hospital.
The SUDC webpage is: www.sudc.org.

 San Diego SIDS/SUDC Research Project Databases

  1. Medical history, death scene and postmortem information on infants accessioned by SD-OCME beginning in 1991 to the present;
  2. Medical history, death scene and postmortem information on children dying after their first birthday that have been accessioned nationally;
  3. Hard copies of the medical records, scene investigation protocols and/or reports, postmortem protocols and/or reports, family surveys, records and emails are in the research offices of the San Diego SIDS/SUDC Research Project
  4. Laboratory data and postmortem findings from postmortem examinations performed by Dr. Henry Krous at Rady Children’s Hospital-San Diego

Funding

The Project receives grant funding from the CJ Foundation for SIDS and the National SIDS Alliance.  It is also the grateful recipient of numerous private contributions from survivors of infants and children dying suddenly and unexpectedly.

Confidentiality

Confidentiality as required by the Institutional Review Board of Rady Children's Hospital, HIPAA, and funding agencies is strictly maintained regarding all communications, information and records.

San Diego SIDS/SUDC Research Project Publications

  1. Krous HF, Chapman AJ, Altshuler G. Cardiac Hemangioma, A Rare (or possible) Cause of Sudden Death in Childhood. J Forensic Sci 1978; 23:375-378.
  2. Krous HF, Campbell GA, Fowler MA, Catron AC, Farber, JP. Maternal Nicotine Administration and Fetal Brainstem Damage: A Rat Model with Implications for Sudden Infant Death Syndrome. Am J Obstet Gynecol 1981; 140:743‑46.
  3. Farber JP, Catron AC, Krous HF. Pulmonary Petechiae: Ventilatory-Circulatory Interactions. Pediatr Res 1983; 7:230‑33.
  4. Krous HF. Microscopic Distribution of Intrathoracic Petechiae in Sudden Infant Death Syndrome. Arch Pathol Lab Med 1984; 108:77-79.
  5. Krous HF, Jordan J. A Necropsy Study of the Distribution of Petechiae in Non-Sudden Infant Death Syndrome. Arch Pathol Lab Med 1984; 108:75-76.
  6. Krous HF, Catron AC, Farber JP. Nonepinephrine Induced Pulmonary Petechiae in the Rat: An Experimental Model with Potential Implications for Sudden Infant Death Syndrome. Pediatr Pathol 1984; 2:115-122.
  7. Kaplan DW, Bauman A, Krous HF. The Epidemiology of Sudden Infant Death Syndrome in American Indians. Pediatrics, 1984; 74:1041-1046.
  8. Krous HF, Jordan J, Wen J, Farber JP. Developmental Morphometry of the Vagus Nerve in the Opossum. Dev Brain Research 1985; 20:155-159.
  9. Krous HF, Jordan J. A Comparison of the Distribution of Petechiae and Their Significance in Sudden Infant Death Syndrome (SIDS), Lethal Upper Airway Obstruction and Non-SIDS. In: Harper RM, Hoffman HJ, eds. Sudden Infant Death Syndrome. Risk Factors and Basic Mechanisms. PM Publishing Company, 1988:91-100.
  10. Krous, HF. Sudden Infant Death Syndrome and Infanticide: Diagnosis and Dilemma. Violence Update April, 1992; 2(8):1.
  11. Shimizu C, Rambaud C, Cheron G, Rouzioux C, Lozinski, GM, Rao A, Stanway G, Krous HF, Burns JC. Molecular identification of viruses in sudden infant death associated with myocarditis and pericarditis. Pediatr Infect Dis J 1995;14(7):584-588
  12. Wright WK, Krous HF, Griswold WR, Billman GF, Eichenfield LF, Lemire JM, Reznik VM. Pulmonary Vasculitis with Hemorrhage in Anaphylactoid Purpura. Pediatr Pulmonol 1994; 17:269-271.
  13. Krous HF. The Differential Diagnosis of Sudden, Unexpected Infant Death. In: Rognum, TO, Ed. Sudden Infant Death Syndrome: New Trends in the Nineties. Scandinavian University Press 1995; 16:74-80.
  14. Krous HF. International Standardized Autopsy Protocol for Sudden, Unexpected Infant Death. In: Rognum, TO, ed. Sudden Infant Death Syndrome. New Trends in the Nineties.  Scandinavian University Press 1995; 17:81-95.
  15. Shimizu C, Rambaud C, Cheron G, Rouzioux C, Lozinski GM, Rao A, Stanway G, Krous HF, Burns JC. Molecular Identification of Viruses in Sudden Infant Death Associated with Myocarditis and Pericarditis. Pediatr Infect Dis J 1995; 14:584‑588.
  16. Byard RW, Krous HF. Minor Inflammatory Lesions and Sudden Infant Death: Cause, Coincidence, or Epiphenomena? J Ped Pathol Lab Med 1995; 15(5):649-654.
  17. Panigraphy AB, Filiano JJ, Sleeper LA, Mandell F, Valdes-Dapena M, Krous HF, Rava LA, White WF, Kinney HC. Decreased Kainate Receptor Binding in the Arcuate Nucleus of the Sudden Infant Death Syndrome. J Neuropathol Exp Neurol 1997; 56:1253‑61.
  18. Kinney HC, Filiano JJ, Assmann SF, Mandell F, Valdes-Dapena M, Krous HF, O’Donnell T, Rava LA, White WF. Tritiated-naloxone binding to brainstem opioid receptors in the sudden infant death syndrome. J Auton Nerv Syst 1998; 69(2-3): 156-63.
  19. Nachmonoff DB, Panigrahy A, Filiano JJ, Mandell F, Sleeper LA, Valdes-Dapena M, Krous HF, White WF, Kinney HC. Brainstem 3H-nicotine receptor binding in the sudden infant death syndrome. J Neuropathol Exp Neurol 1998; 57:1018-1025
  20. Adams EJ, Chavez GF, Steen D, Shah R, Iyasu S, Krous HF. Changes in the Epidemiologic Profile of Sudden Infant Death Syndrome as Rates Decline Among California Infants: 1990-1995. Pediatrics 1998; 102:1445-1451.
  21. Krous HF, Hauck FR, Herman SM, Valdes-Dapena M, McClatchey KD, Filkins JA, Hoffman HJ. Laryngeal Basement Membrane Thickening Is Not A Reliable Postmortem Marker For SIDS; Results From The Chicago Infant Mortality Study. Am J Forensic Med Pathol 1999; 20:221-227
  22. Byard RW, Krous HF. Suffocation, Shaking or SIDS: Can We Tell The Difference J Paediatr Child Health 1999; 35:432-433.
  23. Byard RW, Krous HF. Petechial Hemorrhages and Unexpected Infant Death. Legal Medicine (Tokyo) 1999; 1(4):193-7
  24. Byard RW, Markopoulos D, Prasad D, Eitzen D, James RA, Blackbourne BD, Krous HF. Early Adolescent Suicide- A Comparative Study. J Clin Forensic Med, 2000; 7(1):6-9.
  25. Panigraphy A, Filiano J, Sleeper LA, Mandell F, Valdes-Dapena M, Krous HF, Rava L, Foley E, While WF, Kinney HC. Decreased Serotinergic Receptor Binding in Rhombic Lip-Derived Regions of the Medulla Oblongata in the Sudden Infant Death Syndrome. Neuropathology 2000; 59:377-384.
  26. Mitchell E. Krous HF, Donald T, Byard RW. Changing Trends in the Diagnosis of Sudden Infant Death. Am J Forens Med Pathol 2000; 21:311-314.
  27. Mitchell A, Krous HF, Donald T, Byard RW. An Analysis of the Usefulness of Specific Stages in the Pathologic Investigation of Sudden Infant Death. Am J Forens Med Pathol 2000; 21:395-400
  28. Krous HF, Nadeau JM, Silva PD, Blackbourne BD. Neck Extension and Rotation in Sudden Infant Death Syndrome. Pediatric Dev Path 2001; 4:154-159.
  29. Krous HF, Nadeau JM, Silva PD, Blackbourne BD. Intrathoracic Petechiae in Sudden Infant Death Syndrome: Relationship to Face Position When Found. Pediatric Develop Path 2001; 4:160-166.
  30. Byard RW, de Koning D, Blackbourne B, Nadeau JM, Krous HF. Shared Bathing and Drowning in Infants and Young Children. J Paediatr Child Health, 2001; 37:542-544.
  31. Krous HF, Nadeau JM, Byard, RW, Blackbourne B. Oronasal Blood in Sudden Infant Death. Am J Forensic Med Pathol 2001; 22:346-351.
  32. Byard RW, Beal S, Blackbourne B, Nadeau JM, Krous HF. Specific Dangers Associated with Infants Sleeping on Sofas. J Paediatr Child Health. 2001; 37:476-478.
  33. Krous HF, Nadeau JM, Byard RW, Fukomoto RI, Blackbourne BD. Environmental Hyperthermic Infant and Early Childhood Death. Am J Forensic Med Pathol, 2001; 22:374-382.
  34. Krous HF. Nadeau JM, Silva PD, Byard RW. Infanticide: Is Its Incidence Among Postneonatal Infant Deaths Increasing? An 18-year Population-Based Analysis in California. Am J Forensic Med Pathol 2002; 23(2):127-131.
  35. Krous HF, Floyd C, Nadeau JM, Silva PD, Blackbourne BD, Langston C. Medial Smooth Smooth Muscle Thickness in Small Pulmonary Arteries in Sudden Infant Death Syndrome Revisited. Pediatr Dev Pathol 2002; 5(4):375-385.
  36. Krous HF, Nadeau JM, Silva PD, Blackbourne BD. A Comparison of A Comparison of Respiratory Symptoms and Inflammation in Sudden Infant Death Syndrome And in Accidental or Inflicted Infant Death. Am J Forensic Med Pathol, 2003; 24(1):1-8.
  37. Jones KL, Krous HF, Nadeau JM, Zielke HR, Gozal D. Vascular Endothelial Growth Factor in the Cerebrospinal Fluid of SIDS Infants. Evidence for Antecedent Hypoxia. Pediatrics 2003; 111(2):358-363.
  38. Byard RW, Krous HF. Sudden Infant Death Syndrome: Overview and Update. Ped Develop Pathol 2003; 6:112-127
  39. Rognum TO, Arnestad M, Bajanowski T, Banner J, Blair P, Borthne A, Byard RW, Gaustad P, Gregersen M, Grogaard J, Holter E, Isaksen CV, Jorgensen JV, Krous HF, de Lange C, Moore I, Morland J, Opdal SH, Rasten-Almqvist P,m Schlaud M, Sidebotham P, Skullerud K, Stoltenburg-Didinger G, Stray-Pedersen A, Sveum L, Vege A. Consensus on Diagnostic Criteria for the Exclusion of SIDS. Nordisk Rettsmedisin NR 2003; 3/4:49-88
  40. Harding B, Risdon RA, Krous HF. Shaken Baby Syndrome. Pathological diagnosis rests on the combined triad, not on individual injuries. BMJ 2004; 328:720-1.
  41. Byard RW, Krous HF. Pediatric Forensic Pathology in Crisis. Pediatr Dev Pathol. 2004;7(3):212-213.
  42. Krous HF, Byard RW, Rognum TO. Pathology Research Into SIDS – Where Do We Go From Here? Pediatrics. Pediatrics 2004;114(2):492-494
  43. Krous HF, Beckwith JB, Byard RW, Rognum TO, Bajanowski T, Corey T, Cutz E, Hanzlick R, Keens TG, Mitchell EA.  Sudden Infant Death Syndrome (SIDS) And Unclassified Sudden Infant Deaths (USID): A Definitional And Diagnostic Approach. Pediatrics 2004;114(1):234-238.
  44. Byard RW, Krous HF. Research And Sudden Infant Death Syndrome – Definitions, Diagnostic Difficulties and Discrepancies. J Paediatr Child Health 2004 Aug;40(8):419-421.
  45. Krous HF, Chadwick AE, Isaacs H Jr. Tumors Associated with Sudden Infant and Childhood Death. Pediatr Dev Pathol 2005;8(1)20-25.
  46. Krous HF, Chadwick AE, Stanley C. Delayed infant death following catastrophic deterioration and breast-feeding. J Paediatr Child Health 2005;41(4):215-7.
  47. Wixom C, Chadwick AE, Krous HF. Sudden, Unexpected Death Associated with Meningioangiomatosis. A Case Report. Pediatr Dev Pathol, 2005;8:240-244.
  48. Krous HF, Byard RW. Controversies in Pediatric Forensic Pathology. Forensic Science, Medicine, and Pathology 2005;1:9-18.
  49. Krous HF, Byard RW. Sudden Infant Death Syndrome and Sudden Unexpected Infant Death. Illinois Child Welfare. 2004;1:51-66.
  50. Krous HF, Chadwick AE, Crandall L, Nadeau-Manning JM. Sudden Unexpected Death in Children: A Report of 50 Cases. Pediatr Dev Pathol 2005;8:307-319.
  51. Krous HF, Chadwick AE, Stanley C, Beckwith JB. Is SIDS Associated with Sleep? A Report of Six Cases Demonstrating Difficulty in This Determination. Forensic Science, Medicine, and Pathology 2005;1:179-185.
  52. Krous HF, Haas E, Chadwick AE, Wagner GN. Sudden Death in a Neonate with Idiopathic Eosinophilic Endomyocarditis. Ped Develop Path 2005;8(5):587-592.
  53. Emery M, Krous, HF, Nadeau, JM, Serum Testosterone and Estradiol Levels in Sudden Infant Death. J Pediatrics, J Pediatr 2005;147(5):586-591.
  54. Byard RW, Ranson D, Krous HF, et al. National Australian Workshop Consensus on the Definition of SIDS and Initiation of a Uniform autopsy Approach to Unexpected Infant and Early Childhood Death. Forensic Science, Medicine, and Pathology 2005;1(4):289-292.
  55. Krous HF, Wixom C, Chadwick AE, Haas EA, Silva PD, Stanley C. Pulmonary Intra-alveolar Siderophages in SIDS and Suffocation. Pediatr Dev Pathol 2006;9(2):103-114.
  56. Krous HF. Why is a postmortem examination important when an infant or child dies suddenly? Pediatr Dev Pathol 2006;9(2):168-9.
  57. Bajanowski T, Vege A, Byard RW, Krous HF, Arnestad M, Bachs L, Banner J, Blair PS, Borthne A, Dettmeyer R, Fleming P, Gaustad P, Gregersen M, Grogaard J, Holter E, Isaksen CV, Jorgensen JV, de Lange C, Madea B, Moore I, Morland J, Opdal SH, Rasten-Almqvist P, Schlaud M, Sidebotham P, Skullerud K, Stoltenburg-Didinger G, Stray-Pedersen A, Sveum L, Rognum TO. Sudden Infant Death Syndrome (SIDS) Sudden infant death syndrome (SIDS)-Standardised investigations and classification: Recommendations. Forensic Sci International. 2006;9(2):168-9.
  58. Krous HF, Haas EA, Manning JM, Deeds A, Silva PD, Chadwick AE, Stanley C. Child Protective Services Referrals in Cases of Sudden Infant Death: A 10-Year, Population-Based Analysis in San Diego County, California. Child Maltreat. 2006;11(3):247-256.
  59. Paterson DS, Thompson EG, Belliveau RA, Trachtenberg FL, Darnall RA, Chadwick AE, Krous HF, Kinney HC. Multiple Abnormalities in the Brainstem Serotonergic System in the Sudden Infant Death Syndrome (see editorial). JAMA 2006;296:2124-2132.
  60. Vargas SL, Ponce CA, Galvez P, Ibarra C, Haas EA, Chadwick AE, Krous HF. Pneumocystis carinii f. sp. Hominis Is Not A Direct Cause Of Sudden Infant Death Syndrome. The Pediatric Infectious Disease Journal 2007;26(1):81-83.
  61. Krous HF, Masoumi H, Haas EA, Chadwick AE, Thach BT. Aspiration of gastric contents in sudden infant death syndrome without cardiopulmonary resuscitation. J Pediatr. 2007;150(3):241-6.
  62. Masoumi H, H, Kinney HC, Chadwick AE, Rubio A, Krous HF. Sudden Unexpected Death in Childhood Associated With Cardiac Rhabdomyoma, Involuting Adrenal Ganglioneuroma, and Megalencephaly: Another Expression of Tuberous Sclerosis? Ped Develop Path 2007;10(2):129-33.
  63. Cutz E, Perrin DG, Pan J, Haas EA, Krous HF. Pulmonary Neuroendocrine Cells And Neuroepithelial Bodies In Sudden Infant Death Syndrome: Potential Markers Of Airway Chemoreceptor Dysfunction. Pediatr Dev Pathol. 2007;10(2):106-16.
  64. Kinney HC, Armstrong DL, Chadwick AE, Crandall LA, Hilbert C, Belliveau RA, Krous HF. Sudden Death in Toddlers Associated with Developmental Abnormalities of the Hippocampus. Ped Dev Path, 2007;10(3):208-23.
  65. Corey TS, Hanzlick R, Howard J, Nelson C, Krous HF. A Functional Approach to Sudden Unexplained Infant Deaths. Am J Forensic Med Pathol. 2007 Sep;28(3):271-277.
  66. Krous HF, Haas EA, Masoumi H, Chadwick AE, Stanley C. A Comparison of Pulmonary Intra-Alveolar Hemorrhage in Cases of Sudden Infant Death Caused by SIDS in a Safe Sleep Environment or by Suffocation. Forensic Science International, 2007;172(1):56-62.
  67. Byard RW, Blumbergs P, Rutty G, Sperhake J, Banner J, Krous HF. Lack of Evidence for a Causal Relationship Between Hypoxic-Ischemic Encephalopathy and Subdural Hemorrhage in Fetal Life, Infancy, and Early Childhood. Ped Dev Pathol 2007;10:348-350.
  68. Krous HF, Singh SB, Chadwick AE, Kinney HC. Viral Meningitis And Fatal Neurogenic Pulmonary Hemorrhagic Edema In A Toddler. Ped Dev Pathol. In Press.
  69. Mitchell E, Krous HF, Byard RW. Pathological Findings in Overlaying. J Clin Forensic Med. In Press.
  70. Krous HF, Haas EA, Chadwick AE, Silva PD, Stanley. Pulmonary Intra-Alveolar Hemorrhage in SIDS and Suffocation: A San Diego SIDS/SUDC Research Project Report. Journal of Forensic and Legal Medicine, In Press.
  71. Krous HF, et al. Hemoglobin F in Sudden Infant Death Syndrome. A San Diego SIDS/SUDC Research Report. Journal of Forensic and Legal Medicine, In Press.
  72. Krous HF, Haas EA, Chadwick AE, Masoumi H, Mhoyan A, Stanley C. Delayed Death In Sudden Infant Death Syndrome: A San Diego SIDS/SUDC Research Project 15-Year Population-Based Report . Forensic Science International. In Press.
  73. Chadwick DL, Bertocci G, Castillo E, Frasier L, Guenther E, Hansen K, Herman B, Krous HF. The Annual Risk of Death from Short Falls of Young Children: Less than One in a Million. Pediatrics. In Press.

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