An Unexpected Finding in SUDEP Involving a Child: Focal Myocardial Infarct Adjacent to Bundle of His

Sudden unexpected death in epilepsy (SUDEP) is a nontraumatic, nondrowning death of an individual with epilepsy in which an autopsy with appropriate ancillary studies does not identify a cause of death. The mechanism of death in SUDEP is unknown, but is thought to involve cardiac and/or respiratory mechanisms. Research in SUDEP is hindered by a lack of consensus regarding required components of a death investigation before a cause of death may be certified as SUDEP. Histopathologic examination of the cardiac conduction system is not routinely performed in SUDEP death investigations. We present a case of SUDEP where histopathologic examination of the cardiac conduction system revealed a focal myocardial infarct of the summit of the ventricular septum abutting the bundle of His, which potentially provides insight into the mechanism of SUDEP for this particular case, and suggests that routine examination of the cardiac conduction system in SUDEP may be beneficial.     

Congress and the political expansion of the U.S. districts courts

Expanding the number of U.S. district judgeships is often justifiedas a response to expanding caseloads. Increasing judgeshipsduring unified government, however, allows Congress and thePresident to engage in political (patronage and ideological)control of the federal district courts. This paper examinesempirically the relative importance of caseload pressure andpolitical motives for Congress to expand the number of federaldistrict judgeships. We demonstrate that politics dominatesthe timing of judgeship expansion in the U.S. District Courts.We also show that both politics and caseload affect the actualsize of those timed expansions. In particular, we find thatbefore 1970, Congress seemed to have strong political motivationsfor the size of an expansion. After 1970, Congress became muchmore attentive to caseload considerations.     

PARENTAL CONFLICT RESOLUTION

Six-, 12-, and 15-month follow-up data are presented evaluating a program for high-conflict parents. Funded by a grant from Health and Human Services, the program's content reflects an extensive review of research literature, including the relevant literature on personality disorders. Introduced in Phoenix, Arizona in October 1999, the program has served more than 1,000 families in several jurisdictions. Whereas other programs for entrenched, high-conflict cases are typically time intensive, involving 2 to 6 months, this is a one-time 4-hour program. As such, the authors are heartened to report a suprisingly positive—and enduring—response from the parents.