Tuesday, January 21, 2020

To Protect Against Congenital Heart Defects, Fathers-to-Be Should Avoid Alcohol Six Months Before Conception

Aspiring parents should both avoid drinking alcohol prior to conception to protect against congenital heart defects, according to research published today (October 2, 2019) in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

Drinking alcohol three months before pregnancy or during the first trimester was associated with a 44% raised risk of congenital heart disease for fathers and 16% for mothers, compared to not drinking. Binge drinking, defined as five or more drinks per sitting, was related to a 52% higher likelihood of these birth defects for men and 16% for women.

‘Binge drinking by would-be parents is a high risk and dangerous behavior that not only may increase the chance of their baby being born with a heart defect, but also greatly damages their own health,’ said study author Dr Jiabi Qin, of Xiangya School of Public Health, Central South University, Changsha, China.

Dr Qin said the results suggest that when couples are trying for a baby, men should not consume alcohol for at least six months before fertilization while women should stop alcohol one year before and avoid it while pregnant.

Congenital heart diseases are the most common birth defects, with approximately 1.35 million babies affected every year. These conditions can increase the likelihood of cardiovascular disease later life, even after surgical treatment, and are the main cause of perinatal death. Alcohol is a known teratogen and has been connected with fetal alcohol spectrum disorder (FASD). Around one in four children with FASD have congenital heart disease, indicating that alcohol might also be implicated in these disorders.

Previous studies investigating the link between alcohol and congenital heart disease have focused on prospective mothers, with inconclusive results. This is the first meta-analysis to examine the role of paternal alcohol drinking.

The researchers compiled the best data published between 1991 and 2019, which amounted to 55 studies including 41,747 babies with congenital heart disease and 297,587 without. The analysis showed a nonlinear dose-response relationship between parental alcohol drinking and congenital heart diseases.

Dr Qin said: ‘We observed a gradually rising risk of congenital heart diseases as parental alcohol consumption increased. The relationship was not statistically significant at the lower quantities.’

Regarding specific defects, the study found that compared to abstinence, maternal drinking was correlated to a 20% greater risk of tetralogy of Fallot, a combination of four abnormalities in the heart’s structure.

The authors noted that this was an observational study and does not prove a causal effect, nor does it prove that paternal drinking is more harmful to the fetal heart than maternal drinking. The data cannot be used to define a cut-off of alcohol consumption that might be considered safe.

Dr Qin said: ‘The underlying mechanisms connecting parental alcohol and congenital heart diseases are uncertain and warrant further research. Although our analysis has limitations — for example the type of alcohol was not recorded — it does indicate that men and women planning a family should give up alcohol.’


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Monday, July 22, 2019

Music can help reduce anxiety before anesthesia

Music is a viable alternative to sedative medications in reducing anxiety prior to a peripheral nerve block procedure, claim researchers.

Patients commonly take sedative medications, like midazolam, prior to the procedure to reduce anxiety. In this study, researchers found relaxing music to be similarly effective to the intravenous form of midazolam in reducing a patient's anxiety prior to the nerve block procedure.


A peripheral nerve block procedure is a type of regional anesthesia done in the preoperative area under ultrasound guidance that blocks sensations of pain from a specific area of the body. The procedure is routinely performed for a variety of outpatient orthopaedic surgeries, such as hip and knee arthroscopy and elbow or hand surgeries.


Our findings show that there are drug-free alternatives to help calm a patient before certain procedures, like nerve blocks. We've rolled out a new process at our ambulatory surgical center to provide patients who want to listen to music with access to disposable headphones. Ultimately, our goal is to offer music as an alternative to help patients relax during their perioperative period, said the study's lead author.


While research has shown music can help reduce a patient\s anxiety prior to surgery, previous studies have primarily focused on music versus an oral form of sedative medications, which are not routinely used in the preoperative setting.


In this study, the first to compare music medicine with an intravenous form of sedative medication researchers aimed to measure the efficacy of music in lowering a patient's anxiety prior to conducting a peripheral nerve block.


The team randonly assigned 157 adults to receive one of 2 options 3 minutes prior to the peripheral nerve block- either an injection of 1-2 mg of midazolam, or a pair of noise-cancelling headphones playing Marconi Union's " Weightless", an 8 minute song, created in collaboration with sound therapists, with carefully arranged harmonies, rhythms and bass lines designed specifically to calm listeners down. Researchers evaluated levels of anxiety before and after the use of each method and found similar changes in the levels of anxiety in both groups.


However, the team noted that patients who received midazolam reported higher levels of satisfaction with their overall experience and fewer issues with communication. Researchers attributed these findings to a number of factors, including  the fact they used-noise-canceling headphones, didn't standardise the volume of music and didn't allow patients to select the music.


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