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• W2078206917 endingPage "226" @default.
• W2078206917 startingPage "191" @default.
• W2078206917 abstract "This is a hypothesis that the sudden infant death syndrome (SIDS, crib death) results from a relative magnesium (Mg) deficiency in respect to calcium in a stressed, young infant. Multiparity in the very young, poor mother living under stressful urban conditions favors the development of maternal and fetal magnesium deficiency. The prematurely born infant has reduced magnesium stores and may have respiratory distress at birth, requiring diuretics and respiratory stimulants that provoke increased urinary loss of magnesium. The relative calcium excess in a stressed infant results in platelet aggregation chiefly in the pulmonary microvasculature with massive release of thromboxane A2 (TXA2), catecholamines and other mediators of shock. TXA2 causes apnea and sudden death by promoting constriction of pulmonary and coronary vessels, bronchoconstriction, and further platelet aggregation. These effects normally are counterbalanced by prostacyclin, PGI2, which is synthesized in the vascular endothelium. PGI2 production is curtailed by shock and by endothelial injury imposed by tobacco and cocaine smoke and polluted urban air. TXA2 is essentially unopposed. Death may be instantaneous or may follow a period of hyperventilation, resulting in well-expanded lungs. The infant's increased physical activity, increased permeability of blood vessels, relative thrombocytopenia, and a brief spike of hypertension from TXA2 and catecholamines released from platelets contribute to the development of intrathoracic petechiae. A coagulopathy develops, and blood remains fluid. Anaerobic metabolism and magnesium deficiency reduce ATP production. The exhausted infant dies. Death occurs between 2 and 4 months of age, when protection from magnesium, glucocorticoids, and PGI2 are reduced and when testosterone, which favors platelet aggregation, is increased in males. Biochemically proving magnesium deficiency is difficult in the infant postmortem. A prospective therapeutic trial of magnesium can be recommended." @default.
• W2078206917 created "2016-06-24" @default.
• W2078206917 creator A5038541729 @default.
• W2078206917 date "1991-01-01" @default.
• W2078206917 modified "2023-09-25" @default.
• W2078206917 title "Magnesium Deficiency in the Cause of the Sudden Infant Death Syndrome: An Updated Hypothesis" @default.
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