Lecture Notes on Rheumatology

This concise text focuses on the Oxford Record Linkage Studies of factors associated with sudden infant death and the Foundation for the Study of Infant Death surveys of psychosocial stress experienced by bereaved parents. Its focus is on sudden infant deaths in Britain, but the authors make frequent reference to North American studies as well. The book begins with a brief history of sudden infant death syndrome and several case reports, followed by reviews of epidemiological studies with a table of the incidence of sudden infant death throughout the world, citing specific studies, their defined populations, the methods by which the cases were identified, and the direction of any bias associated with the study. The part dealing with epidemiology includes sections on time, place, and age of the infant, the characteristics of the parents, the pregnancy and the delivery, the differing characteristics of young and older victims of the syndrome, and the medical history of the infant's mother and siblings. There are numerous charts and graphs, which are clear, uncluttered, and neatly illustrate points made in the text. One puzzling omission is the possible role of latitude on the incidence of sudden infant death syndrome. Studies of longitude are mentioned and dismissed by the authors as failing to provide a convincing hypothesis. Some mention of latitude should have been included to complete the discussion of variation within areas. Part III covers the possible etiologies of sudden infant death syndrome, including nutrient excesses and deficiencies, sleeping and breathing, and immunodeficiencies. This section also provides a brief review of the appropriate methodology for epidemiological studies of this kind. At this point, the book suddenly changes gears and provides the detailed results of a survey of parents who contacted the Foundation for the Study of Infant Deaths, a British organization. This section relies heavily on anecdotal information from bereaved parents. Much of the information is specific to Great Britain, such as the medico-legal system, the state-provided death grant, and support provided by the Health Visitor. Despite its limited survey, this section may be useful reading for medical examiners, primary care physicians, public health nurses, medical social workers, chaplains, and others who come in contact with the families of SIDS victims. The final section of the volume provides two scoring systems for assessing risks of sudden infant death and information on primary and secondary prevention of SIDS. This information is useful for those counseling parents and developing diseaseprevention campaigns. This small book belongs on many bookshelves, although few readers may have an interest in more than a portion of it.