The more tense a woman who has to undergo an elective cesarean section is, the
more her blood pressure drops after she undergoes a spinal or epidural
anesthesia procedure prior to the operation, according to experts at the Rabin
Medical Center-Beilinson Campus.
In an article in the latest issue of
Hebrew language Rabin Hamagazine, hospital anesthesiologist Dr. Sharon Orbach
reports that half of all pregnant women who undergo such a spinal injection
suffer an immediate drop in blood pressure that causes the patient to feel
unwell, faint and/or nauseous.
Since the phenomenon is common but does
not occur in all women in this situation, Orbach and Beilinson colleagues
conducted research to find out what caused the reaction and whether there was a
way to prevent it. They observed 100 women who had a planned, rather than
emergency cesarean section at their hospital and found that the more stressed
the woman was, the more likely a blood pressure drop after the injection of
anesthesia to eliminate pain below the waist. Each physician rated the amount of
stress shown by the patient on a scale of one to 10.
The team reached the
conclusion that women should be prepared mentally and emotionally for the
“Childbirth preparation courses are routine in every hospital,”
said Orbach, but women are not prepared for the eventuality of a c-section.
Anxiety, she concluded, results from lack of information and expectation that
the experience would be a negative one. Among the ways to calm women down, in
addition to explaining the procedure, are music, meditation and positive
thinking. Going into such surgery with a feeling of safety and a calm atmosphere
can minimize the need for additional medications, said Orbach.
& CHILD ABUSE LINK FOUND
Searchers have long suspected some kind of link
between childhood abuse and smoking. But in an interesting twist, a new study
from the University of Washington finds a connection not between whether or not
an abused child will ever begin smoking, but to how much they smoke once they
“In other words, people are as likely to smoke whether or not they
were sexually or physically abused, but they’re inclined to smoke more if they
were abused and have a history of smoking,” said social work Prof. Todd
Herrenkohl, who published an article in the Journal of Adolescent
Herrenkohl and co-authors probed the Lehigh Longitudinal Study,
which began in the mid-1970s. Participants were recruited from child-welfare
abuse and protective service programs, as well as day-care programs, private
nursery programs and Head Start classrooms in eastern Pennsylvania.
researchers looked specifically for any connection between physical or sexual
abuse and adolescent and adult smoking.
They found that boys who had
experienced either type of abuse and were smokers, smoked more than those who
hadn’t been abused as a child. For girls who smoked, only those who had been
sexually abused smoked more as adolescents.
That frequency of adolescent
smoking by both girls and boys, in turn, led to increased smoking in adulthood,
especially among women.
Lead author Allison Kristman-Valente, a doctoral
candidate in social work, found the difference between boys and girls to be one
that requires more study. “There may be other factors at work that we need to
disentangle,” she said. “I think the big ‘aha’ finding is the one on gender
Hopefully this will encourage other researchers to look at
gender differences in smoking among teens and adults.”
In the Lehigh
study, slightly more than 50 percent of the participants said they had smoked in
adolescence – about five times the national average for children aged 12 to 17.
Fifty-seven percent of males and 44% of females reported smoking in adolescence.
Researchers said they don’t know why the smoking rate was so high in this study.
Herrenkohl theorizes that the reasons could have been socioeconomic,
geographical or the fact that participants in this study were already at
relatively high risk. When study participants were evaluated as adults, 49%
reported smoking in the past year (at nearly equal rates for men and
Kristman-Valente said what is of great concern is the fact that
so many women who were abused as children were smoking while raising children,
and that women who smoke frequently also are less successful in smoking
cessation programs. Since tobacco use often begins in adolescence, researchers
say it’s important that public policies are in place to try to prevent kids from
lighting up a cigarette in the first place.
“Early adversity can persist
throughout a person’s life, so early intervention or prevention of child abuse
can potentially lead to long-term public health benefits,” Kristman- Valente
said. “I hope our findings encourage more focus on the connection between child
maltreatment and smoking in particular.
Not many people look at this
consequence, even though smoking is the number one cause of preventable death in
BE CAREFUL LETTING OFF STEAM
Home nebulizers that produce cold
or hot steam to open up clogged nostrils or bronchi can be dangerous if not
maintained properly, the Health Ministry warned recently. Legionnaire’s disease,
a potentially fatal pneumonia most often caused by Legionella pneumophila –
aerobic bacteria carried by amoeba that thrive in stagnant water – is the main
The bacteria were first identified in 1976 at an American Legion
convention in Philadelphia where infected air conditioning pipes caused 221 to
become ill, and 34 of those died. There are as many as 18,000 cases of
Legionnaire’s disease annually in the US alone.
The ministry said that
Legionella can multiply in water systems with warm or hot water, especially in
places where limescale and other deposits are. If nebulizers are used at home,
one should empty the device out, wipe it with a towel and dry it. Water for
filling it should be boiled and cooled before use, even if taken from mineral
bottles or drips from air conditioners.
Once a week, the devices should
be cleaned carefully and dried according to the manufacturer’s instructions. At
the beginning of the season when it is used, the nebulizer should be washed
carefully and dried before use, as well as at the end of the season, before
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