Dr. Howard Smith Oncall

  Vidcast:  https://youtu.be/iQk7i516CCE   A medical crystal ball suggests that CoVid19, like common influenza, may return each winter to test our resolve.  Dutch and Michigan epidemiologists analyzed data covering over 13,0000 persons infected by multiple coronaviruses over 3-8 years.   Four of the seven coronaviruses implicated in these infections tend to reappear seasonally between December and May with a peak in January to February.  Most cases were mild with the severe infections occurring in those under 5 years or over 50.    CoVid19, though, appears to be more vicious than these previous coronaviruses.  We’d better be prepared for a long, seasonally-recurrent fight and pray for effective testing, vaccines, and therapy.   https://jcm.asm.org/content/48/8/2940   https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiaa161/5815743   #covid19 #coronavirus #seasonal #influenza

  Vidcast:  https://youtu.be/1YsBXJhgE4w   Cotton and even surgical masks can’t filter live virus from a CoVid-laden cough.  A small South Korean study had 4 CoVid patients cough into a petri dish wearing a 3 layer surgical mask, a 2 layer cotton mask, or no mask at all.   Ninety-five percent of the virus went through the surgical mask and 72% went through the cotton mask.  The outer surfaces of both types of mask were flush with live virus.   Masks will not keep an infected person’s virus from the air you breathe and from settling on the surfaces you touch.  Wear your own mask and stay far away from everyone not in your family.    https://annals.org/aim/fullarticle/2764367/effectiveness-surgical-cotton-masks-blocking-sars-cov-2-controlled-comparison   #covid19 #coronavirus #mask  

  Vidcast:  https://youtu.be/YuYpoIHu81c   Wearing masks reduces a healthcare worker’s risk of infection by 80% and the general public’s risk by 55%.  This from a Chinese meta-analysis of 21 eligible studies.   A deeper dive into the numbers reveals that no health care worker wearing an N95 mask contracted the virus.  At the other extreme, family of an infected loved one at home have a 60% chance of infection since mask wearing turns out to be inconsistent.   This study screams, “ Wear a mask outside your home and religiously if you have virus in your home!”  Even so, you must physically distance to reduce your infection chances from 55% to a bare minimum.   https://www.medrxiv.org/content/10.1101/2020.04.03.20051649v1.full.pdf   #covid19 #coronavirus #mask  

  Vidcast:  https://youtu.be/Uj_TiSZN1v4   Cold brew coffee is the latest fad but it contains fewer of the antioxidants that help us prevent heart disease, stroke, cancer, respiratory ills, and neurologic deterioration.  Researchers at Philadelphias Thomas Jefferson University studied hot and cold brews of light and dark coffee roasts.   Their studies show that hot brewing dark roasted coffee extracts the most antioxidants from coffee.  Cold brewing dark roast or brewing light roasted coffee hot or cold fails to deliver these desirable compounds but yields more caffeine.   So you can enjoy coffee brewed hot or cold.  If you drink coffee with your health in mind, go ahead and brew it in the old-fashioned way with boiling hot water.   https://www.sciencedaily.com/releases/2020/04/200402134618.htm   #coffee #antioxidants #coldbrew #hotbrew  

Vidcast:   https://youtu.be/pnIqIxyUzA8   Those infected with CoVid19 but asymptomatic could spew virus as they speak.  Aerosol engineers at UCDavis raise this possibility as the result of their studies of respiratory particles generated by speech.   Their studies reveal that particles spring from lung fluids, waft up airways, and spew out the mouth as you speak.  Louder speech generates more particles.  Droplets spread farther as they dry.   The droplets generated would be stopped by N95 masks but many go right through simple cloth masks.  There’s no proof yet that such droplets have virus, but chances are.....   The bottom line: stay up to 30 feet from non-family.  A mask or bandana helps but won’t completely protect you.   Sima Asadi, Nicole Bouvier, Anthony S. Wexler, William D. Ristenpart. The coronavirus pandemic and aerosols: Does COVID-19 transmit via expiratory particles? Aerosol Science and Technology, 2020; 1 DOI: 10.1080/02786826.2020.1749229   Sima Asadi, Anthony S. Wexler, Christopher D. Cappa,

  Vidcast:  https://youtu.be/LYEluacRGEI   Cellex of North Carolina has developed the first rapid test for CoVid19 antibodies circulating in the bloodstream.  This test is 95% accurate, delivers a result in 15-20 minutes, and has won FDA emergency use authorization. The Mayo Clinic developed its own antibody test.   These antibody tests, unlike the CoVid19 RT-PCR virus RNA tests, determine if the virus has stimulated a patients immune system.  It may not become positive as quickly as the viral test, but it could predict if a given person has become immune to CoVid19.   Such information will help us determine when we can safely relax lockdown and which newly-protected persons may return to work.    https://www.fda.gov/media/136622/download   https://www.medscape.com/viewarticle/928150    #covid19 #coronavirus #antibody #testing

  Vidcast:  https://youtu.be/KEvEg0yTHgk   Hydroxychloroquine and azithromycin or Zithromax, currently being tested as both prophylaxis and therapy for CoVid19 infections, work together to induce dangerous electrocardiographic changes.  This the conclusion of NYU cardiac electrophysiologists studying 84 CoVid19 patients treated at their hospital.   After 3-4 days of therapy with this drug cocktail, 11% of CoVid19 patients developed a prolonged QT interval of greater than 500 milliseconds.  This EKG change is associated with sudden cardiac death due to severe arrhythmias.   These drugs may turn out to be lifesaving but they are not for do-it-yourselfers.  Their use requires careful and repeated cardiac monitoring.  Using hydroxychloroquin and Zithromax yourself may prevent CoVid19 but only because you die first.    https://www.medrxiv.org/content/10.1101/2020.04.02.20047050v1.full.pdf    #covid19 #coronavirus #hydroxychloroquine #zithromax #azithromycin #arrhythmia #qtinterval  

  Vidcast:  https://youtu.be/wEDQ78_nlZU   Hydroxychloroquine with added azithromycin (Zithromax) eradicates CoVid19 virus in the blood of infected patients even better than hydroxychlorquine alone.  A pre-published preliminary French study followed 36 CoVid19 patients hospitalized for treatment in Marseilles.   14 patients received hydroxychloroquine 600 mg/d alone and 6 of them also received treatment with a Z-pack. The data revealed a significant drop in nasal virus over a 5 day period.  By that time, only 50% of hydroxychloroquine-treated patients had virus and none of those treated with both drugs had it.   This news is exciting but not established fact.  These drugs each have side effects, some deadly, and must be careful monitored.   https://doi.org/10.1016/j.ijantimicag.2020.105949   #covid19 #coronavirus #hydroxychloroquine #azithromycin #zithromax  

  Vidcast:  https://youtu.be/Pi8bv4AhqMk   Hydroxychloroquine definitely helps eradicate severe novel coronavirus infections.  This is the conclusion of a randomized Wuhan University study looking at 62 hospitalized CoVid19 patients that was just pre-published online.   Those in the experimental group received hydroxychloroquine 400 mg/day in additional to conventional medical and respiratory therapy.  Those receiving the med were 47% more likely to clear their pneumonia and enjoy faster temperature normalization.  The only 4 patients who deteriorated during the study did not receive hydroxychloroquine.   Preliminary studies like this give us hope that there are weapons we can use against this virus.  The drug may help in desperate cases and further study may support more widespread use.   https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v2.full.pdf   #covid19 #coronavirus #hydroxychloroquine  

  Vidcast:  https://youtu.be/lPZiZXc-JNA   Angiotensin receptor blockers and Ace inhibitor anti-hypertensive medications may actually help coronavirus victims fighting for their lives.  Several weeks ago I reported studies that questioned the safety of such drugs since the virus appears to interact with the angiotensin system.      A pre-published Chinese study looked at 126  CoVid19 patients treated with angiotensin drugs versus other blood pressure medications.  The new data reveals that those patients treated with angiotensin-type drugs demonstrate 42% less harmful inflammation, tend to suffer critical disease progression 41% less often, and have a 35% lower death rate.   As we learn more about this brand new coronavirus, treatment guidance changes.  That’s medical science for you.   https://www.medrxiv.org/content/10.1101/2020.03.31.20038935v1.full.pdf    #covid19 #covid19 #hypertension #angiotensin #arb #aceinhibitor

  Vidcast:  https://youtu.be/y3gQk50l2eA   An extra 3-400 calories a day restores predictable periods for exercising women.  A study from Penn State to be presented to the Endocrine Society’s annual meeting studied 62 fitness enthusiasts with sporadic menstrual periods.   Half of the group increased their daily calories.  They and the control group continued their vigorous exercise and the remainder of their usual diet over the 12 month study duration.  Those women who added calories were twice as likely to achieve menstrual regularity.   Women with eating disorders such as anorexia-bulemia suffer radically altered menstrual cycles with their weight loss.  Now we know that even those with regular diets may benefit from a few more calories.   https://www.sciencedaily.com/releases/2020/03/200331093259.htm   #calories #dysmenorrhea #exercise  

  Vidcast:  https://youtu.be/VcVf5kR2QAA   Some good news to brighten your day.  A new cancer screening test from Harvard’s Dana-Farber Cancer Institute and the Mayo Clinic can detect the presence of more than 50 cancer types including the tough ones to diagnose like ovarian and pancreatic cancer.   The test detects cancer DNA in the blood and differentiates it from normal DNA by patterns of methylation.  It can pinpoint the source of the cancer organ-wise in more than 90% of cases.   More work must be done since, currently, the test can only detect cancer 43% of the time.  If a cancer is detected, the test is correct 99% of the time.   Very exciting.  Stay tuned.   M.C. Liu, G.R. Oxnard, E.A. Klein, etal. Sensitive and specific multi-cancer detection and localization using methylation signatures in cell-free DNA. Annals of Oncology, 2020; DOI: 10.1016/j.annonc.2020.02.011   #cancer #ovarian #pancreatic #cancertest #dna

  Vidcast:  https://youtu.be/BBKKOZvf0yg   Seventy percent of Italians killed by coronavirus are male, and two-thirds of those hospitalized with the virus in China were men.  Israeli immunologists, experts on gender differences in immune function, explain why.   Men are more susceptible to viruses than women due to less effective and less-well prepared immune systems.  Men have fewer immune scavenger macrophages than women and fewer pre-activated macrophages ready to do battle.  Macrophage control is on the X chromosome and men have only one of those.    Then too, men have less healthy lifestyles.  They smoke more, eat unhealthy foods, and wash their hands in public restrooms half as often as women. C’mon guys.   https://aabgu.org/male-corona-mortality/#   #immunity #macrophage #covid19 #coronavirus #male    

  Vidcast:  https://youtu.be/gFePQvC1YsU   If you’re taking either over-the-counter or prescription Zantac or ranitidine, get rid of it.  The FDA has been investigating this drug for contamination with a likely carcinogen N-Nitrosodimethylamine or NDMA and now orders it off the market.  Ranitidine decomposes over time when its stored at higher than room temperature, and  the levels of NDMA become unsafe.   Stop taking this medication, and dispose of it properly.  Know that drugs with a similar function including Pepcid, Tagamet, Nexium, Prevacid, and Prilosec are not contaminated with NDMA.  Check with your doctor to be certain that using one of these will be safe for you before buying them over the counter.   https://www.fda.gov/safety/medical-product-safety-information/all-ranitidine-products-zantac-press-release-fda-requests-removal   #recall #zantac #ranitidine #ndma

  Vidcast:  https://youtu.be/G8h5b5NbJ_A   The answer is YES!  If you’re younger, it protects others.    It may also protect you as an elder or one with diabetes, lung disease, or immunosuppression.   Virologists tell us that safe physical distancing is 6 feet or lately 10 feet.  A new study from MIT shows that aerosols with live virus may spew 27 feet or further.   Can’t buy a mask?  A 2 layer neck warmer or a lighter decorative face mask will cover your nose and mouth.     Want added protection?  Attach a layer of HEPA vacuum cleaner bag material and an inner, comfortable liner inside.  It’s almost as good as an N95 mask. The real ones are for first responders and healthcare professionals.   Spread of aerosols: https://jamanetwork.com/journals/jama/fullarticle/2763852   CDC PPE specifications: https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirator-use-faq.html   #covid19 #coronavirus #mask #aerosols

Vidcast:  https://youtu.be/8eMXEqLnWOc   Our lethargic US government is finally moving on coronavirus vaccines to the tune of $1 billion.  BARDA, the Biomedical Advances Research and Development Authority, part of the Health and Human Services agency, has signed contracts to develop and manufacture a vaccine.    Moderna, a biotech company that has a vaccine candidate, has begun testing it.  BARDA is also talking about alternative vaccines with Pfizer, Sanofi, and Johnson and Johnson’s own labs.    J&J will use the government grant to ramp up manufacturing capacity to produce at least 1 billion doses of the vaccine. Even so,  safe and effective vaccine will not be available until late 2021, but it will come.   https://www.reuters.com/article/us-health-coronavirus-johnson-johnson/jj-u-s-government-plan-1-billion-doses-of-coronavirus-vaccine-idUSKBN21H1OY?il=0   https://www.fiercebiotech.com/biotech/j-j-barda-commit-1b-to-covid-19-vaccine-r-d   #covid19 #coronavirus #vaccine 

Vidcast:  https://youtu.be/oEI5jizWH1A   Simmering in a daily hot bath may reduce your risk of all cardiovascular disease by 28% and of stroke by 26%.  A study of some 30,000 adults over a 30 year period was just published in the British Medical Journal.   The data revealed the benefit of hot water versus warm water for cardiovascular disease but not for strokes.  We know from other studies that tub baths do have a beneficial effect on high blood pressure.   Be warned, though, that this study only shows an association and not a cause-effect relationship.  Furthermore, hot water baths could be dangerous for elders as baths may cause confusion and occasional drowning.    Andrew Felix Burden. Tub bathing and heart disease. Heart, 2020; heartjnl-2019-316187 DOI: 10.1136/heartjnl-2019-316187   #bath #cardiovasculardisease #stroke #hypertension  

  Vidcast:  https://youtu.be/b-CoCrm9xfg   Winter Gardens Quality Foods is recalling its Whole Foods Market Vodka Sauce due to undeclared milk in the product.  The affected lot is 20057.   Those with milk allergies could develop a severe or life-threatening allergic reaction to the product.  This sauce was sold in AZ, CA, CT, FL, HI, ME, MA. NV, NH, NJ, NY, and RI.  Return this product to the store for a full refund.   https://bit.ly/2Jppu75   #recall #vodkasauce #milk  

  Vidcast:  https://youtu.be/YzPJIV_573Q   The numbers from China, the only country that has begun to emerge from their CoVid19 epidemic, show that a plague resurgence seems unlikely.  The risk depends on population size and  density for any given area as well as the rigor of personal protection measures.   Mathematicians analyzed numbers of new cases in 13 cities or provinces and calculated probabilities of new cases going forward. In half the jurisdictions, there was a ZERO calculated probability more cases.  In the most populous areas, the risk was between 3 and 7%, but strict personal protection reduced the risk by 67%.   We can control this virus with hand washing, physical distancing, testing, and quarantine of active cases.   https://www.medrxiv.org/content/10.1101/2020.03.26.20044271v1.full.pdf   #coronavirus #covid19 #resurgence #economy

  Vidcast:  https://youtu.be/fT3x9m-CuSo   For every 1 degree Fahrenheit temperature increase, there appears to be a 7% reduction in CoVid19 transmissibility.  This from a University of Chicago and UC Santa Barbara study of nearly 167,000 coronavirus cases from 134 countries.   There appear to be no affects on viral spread of changes in humidity or levels of precipitation.  Based on this data, the investigators predict that temperature changes between March and July of this year will result in a 43% drop in CoVid19 spread in the Northern hemisphere and a 71% rise in the Southern hemisphere.   This info challenges us here in North America to get our epidemic under control before temperatures begin to drop next fall.    https://www.medrxiv.org/content/10.1101/2020.03.26.20044420v1.full.pdf   #coronavirus #covid19 #temperature #seasons #transmissibility