About 10 to 20% of SIDS cases are believed to be due to channelopathies, which are inherited defects in the ion channels which play an important role in the contraction of the heart.Genetic evidence published in November 2020 concerning the case of Kathleen Folbigg, who is in prison over the death of four of her children, showed that at least two of the children had genetic mutations in the CALM2 gene that predisposed them to heart complications. Alcohol
Drinking of alcohol by parents is linked to SIDS. One study found a positive correlation between the two during New Years celebrations and weekends. Another found that alcohol use disorder was linked to a more than doubling of risk. Other
A 2022 study found that infants who died of SIDS exhibited significantly lower specific activity of butyrylcholinesterase, an enzyme involved in the brains arousal pathway, shortly after birth. This can serve as a biomarker to identify infants with a potential autonomic cholinergic dysfunction and elevated risk for SIDS.SIDS has been linked to cold weather, with this association believed to be due to over-bundling and thus, overheating. Premature babies are at four times the risk of SIDS, possibly related to an underdeveloped ability to automatically control the cardiovascular system.A 1998 report found that antimony- and phosphorus-containing compounds used as fire retardants in PVC and other cot mattress materials are not a cause of SIDS. The report also states that toxic gas cannot be generated from antimony in mattresses and that babies had SIDS on mattresses that did not contain the compound.
Precautions
Pioglitazone/metformin should not be used in people with type 1 diabetes or for the treatment of diabetic ketoacidosis and should be used with caution in people with edema. Serum ALT levels should be evaluated prior to the initiation of therapy with combination of pioglitazone and metformin and periodically thereafter per the clinical judgment of the health care professional. Side-effects
The most common side-effects are upper respiratory tract infection, diarrhea, combined edema/peripheral edema and headache, respectively. Most clinical adverse events were similar between groups treated with pioglitazone in combination with metformin and those treated with pioglitazone monotherapy. Contraindications
Pioglitazone/metformin is contraindicated in people with known hypersensitivity to any components of this combination. These combination also contraindicated in renal disease which may also result from conditions, e.g., acute myocardial infarction, sepsis, acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Drug interaction
Pioglitazone/metformin may interact with furosemide, nifedipine, cationic drugs (e.g., amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, and vancomycin) and certain drugs tend to produce hyperglycemia and may lead to loss of glycemic control (e.g., thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid). References
External links
"Metformin hydrochloride mixture with pioglitazone hydrochloride". Drug Information Portal. U.S. National Library of Medicine.