QotD: The Real You

You are presumed to be showing us your real self when you are on deadline, have a headache, are facing a customer service meltdown, haven't had a good night's sleep, are facing an ethical dilemma, are momentarily in power, are caught doing something when you thought no one else was looking, are irritable, have the opportunity to extract revenge, are losing a competition or are truly overwhelmed.
--Seth Godin

Opiate Painkillers Increase Birth Defects

opioid analgesic use and abuse on the rise
types: codeine, hydrocodone, meperidine, oxycodone, propoxyphene, morphine, tramadol, methadone, hydromorphone, fentanyl, pentazocine

therapeutic opioid use reported by 2.6% of 17,449 case mothers
2.0% of 6701 control mothers
mc: codeine (34.5%), hydrocodone (34.5%), oxycodone (14.4%), meperidine (12.9%)

time window studied: 1 mo before conception to 3 mo after

2-3x risk of infant defects:
conoventricular septal defects = opening btw ventricles not assoc w/ other congenital CV defect
atrioventricular septal defects = hole in upper vent septum assoc w/ atrial septal defect, incr lung circ
hypoplastic left heart syndrome = bad prognosis, rare, incomplete development of mitral valve, left ventricle, aortic valve, and/or aorta
spina bifida = embryonic neural tube not closed
gastroschisis = abd wall defect, hole near umbilicus thru which intestines and mb other organs develop outside, aka paraomphalocele, laparoschisis, abdominoschisis, abdominal hernia

SOURCE
medscape: http://www.medscape.com/viewarticle/738236?src=mpnews&spon=12