Dr. Howard Smith Oncall

  Vidcast:  https://youtu.be/Y26LDEEM0Kg   Coronavirus infected individuals do not shed live virus in their tears.  Researchers at Singapore’s National University Hospital studied 17 patients with the virus.   Their tears were disease free by both viral cultures and RP-PCR genetic tests.  At the same time, their noses and throats were swarming with infectious CoVid19.   While you can’t spread virus via your eyes, you can contract disease via this route.   If viral-laden droplets from an infected person’s nose or throat get into your eyes, your tears will transport live virus into your nose, throat, and respiratory tract.  Then the game is lost.   Keep your hands spotless and away from your nose, mouth, and eyes.    Ivan Seah Yu Jun, Danielle E. Anderson, Adrian Eng Zheng Kang, Lin-Fa Wang, Pooja Rao, Barnaby Edward Young, David Chien Lye, Rupesh Agrawal. Assessing Viral Shedding and Infectivity of Tears in Coronavirus Disease 2019 (COVID-19) Patients. Ophthalmology, 2020; DOI: 10.1016/j.ophtha.2020.03.026   #

  Vidcast:  https://youtu.be/NQxpwpddiYs   Those pretzels, chips, and pasta sauce may weaken your immune defenses against bacteria and viruses including CoVid19.  Immunologists at Germany’s University of Bonn trace the effects of your liberal self-shaking on your host defenses.   When you eat abundant salt, your kidneys seek to flush it out to maintain a safe concentration around your cells.  In so doing, glucocorticoid steroid levels in your body rise, and these steroids suppress your immunity.  Their studies in both mice and men confirm this effect.   Given our current coronavirus epidemic, you can’t afford to given an advantage to invading viruses or bacteria.  Cut out the salty foods and gorge on fruits and vegetables as you social distance.    Katarzyna Jobin, Natascha E. Stumpf, Sebastian Schwab, etal. A high-salt diet compromises antibacterial neutrophil responses through hormonal perturbation. Science Translational Medicine, 2020 DOI: 10.1126/scitranslmed.aay3850   #covid19 #coronavirus #salt #immunit

  Vidcast:  https://youtu.be/98zOq9ZpG9M   TPA, the clot busting tissue plasminogen activator that rescues heart attack and stroke patients, may help ventilator-dependent CoVid19 patients in respiratory failure.  Researchers at MIT, Harvard teaching hospitals, and the University of Colorado believe that TPA can prevent extensive blood clotting that exacerbates CoVid19 patients’ respiratory failure.   Clinicians on the front lines of the coronavirus battle in New York and Europe report that infected patients clot too easily and have damaging clots not only in their lungs but also in their hearts and kidneys as part of multi-organ failure.   A federally-funded clinical trial of TPA will deliver the drug intravenously and via direct airway instillation.  Genentech is donating the drug.    Hunter B. Moore, Christopher D. Barrett, Ernest E. Moore, Robert C. McIntyre, Peter K. Moore, Daniel S. Talmor, Frederick A. Moore, Michael B. Yaffe. Is There a Role for Tissue Plasminogen Activator (tPA) as a Novel Treatment f

  Vidcast:  https://youtu.be/q66mLjoY-r4   Tocilizumab, a Genentech-Roche drug marketed as Actemra for autoimmune arthritis and cytokine storms induced by CAR-T cell cancer therapy, did successfully squelch CoVid19 immune storm in a preliminary Chinese study.  Researchers there treated 20 patients with severe and critical disease in risk of dying.   The patients received a 9 day course of the drug along with vent therapy.  75% showed improved oxygenation and one patient came off oxygen and 90% showed improved lung CTs. 90% of patients with discharged well.    A worldwide clinical trial coded as COVACTA will begin recruiting 330 patients in April.  The drug, potentially lifesaving, does have serious side effects including gastrointestinal tears, liver toxicity, and cancer   http://chinaxiv.org/abs/202003.00026 https://www.cancernetwork.com/news/fda-approves-phase-iii-clinical-trial-tocilizumab-covid-19-pneumonia   #covid19 #coronavirus #cytokinestorm #covacta #actemra #tocilizumab  

Lindt Excellence 85% Cocoa Chocolate Recalled Vidcast:  https://youtu.be/SlUff4Zowzs   Lindt and Sprüngli USA is voluntarily recalling its Lindt Excellence 85% Cocoa chocolate bars due to improper packaging and labeling.  The product in the wrapper is actually Lindt Excellent Dark Carmel Sea Salt bars.  This contains milk and soy.  Those who have allergies to either may develop and allergic reaction that could be life-threatening.  The Lot is Code L5539 with a best before date of 11/30/2020.  If you have this product, return it to any Lindt store for a replacement.   https://bit.ly/2J6nTmH   #recall #lindt #chocolate #milk #soy  

  Vidcast:  https://youtu.be/Qh5-66RULws   Mountain Rose Herbs is voluntarily recalling its Organic Kudzu Root Herbal Supplement.  This product may have Salmonella contamination.  This bacterium can product a severe gastroenteritis or get into the bloodstream and induce sepsis with heart valve infection, blood vessel infection, or septic arthritis.  The Lots involved are #24247-X and #24247.  This product has been sold in nearly every state and in Canada.  If you have this item, return it to the place of purchase for a full refund.  Info from the company at 1-800-879-3337.   https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/mountain-rose-herbs-recalls-organic-kudzu-root-herbal-supplement-due-possible-health-risk   #recall #kudzuroot #supplement #salmonella  

  Vidcast:  https://youtu.be/9esH8xR_GNA   Elevators: Space on larger elevators and face the wall but don’t lean against it.  If you’re the third on a smaller residential elevator, wait for the next one.  Families count as one if they fit on one wall.  Knuckles, elbows or probes on the buttons please.   Out and about:  In a line? Space 6-10 feet away and get off the line if someone is coughing or sneezing.  Breath shallowly in line or passing people on the street.   When returning:  Immediately wash with soap and water or use hand sanitizer.  Wipe off surfaces of purchased items with soapy sponge or Clorox wipe.   #covid19 #coronavirus #soap #elevator #purell #clorox  

  Vidcast:  https://youtu.be/gBCsEskhjLE   Soap, any kind of soap, disintegrates coronavirus by pulverizing its outer lipid-protein envelope.  It’s fast, and 20-30 seconds in contact with soapy water should do it.   My routine: rubbing with bar or soft soap and water for 20 seconds (2 happy birthday songs) and then leave the soapy water for another 20 seconds.  Don't forget to use soapy water on your phone, your smartwatch or fitness wearable, and let it sit for 20-30 seconds.  Remember, virus lives on surfaces: cardboard 24 hrs, stainless steel 48 hrs, and plastic 72 hrs. so rewash hands if you touch them or coat them down with soapy water for 30 seconds.   https://www.theguardian.com/commentisfree/2020/mar/12/science-soap-kills-coronavirus-alcohol-based-disinfectants   https://www.nejm.org/doi/full/10.1056/NEJMc2004973     #covid19 #coronavirus #soap #cardboard #plastic #stainless

  Vidcast:  https://youtu.be/eL_nvp4v6IY   Why is a ventilator, or a vent as we docs call it, so complicated and expensive.  Isn’t just a pump to drive oxygenated air into a patient’s lungs?   Its pump is electronically controlled to control the numbers of respirations per minute, the volume of air in each respiration, and the percentage of added oxygen.  The ventilator can assist natural breaths or control respirations completely.  For patients with severe lung infections and damage, the vent maintains some residual airway pressure between breaths.    These machines cost as much as $50, 000 each.  A clever Canadian anesthetist has created plumbing so that up to 9 patients with similar respiratory requirements may be serviced by one vent.     https://www.dailymail.co.uk/news/article-8136299/Doctors-turns-one-ventilator-nine-genius-DIY-mechanics.html   #covid19 #coronavirus #ventilator  

  Vidcast:  https://youtu.be/0WNk_nLAHOA   London’s Smiths Group, a major ventilator manufacturer, is ramping up its own production to make an additional 30,000 over the coming months.  The company is helping other companies across the globe so that other nations may ramp up ventilator manufacturing.     How about in the US?  A Washington state ventilator manufacturer VENTEC will partner with GM to streamline its supply chain and multiply its manufacturing capabilities from 150/month to 10s of thousands/month..   Ford has also indicated a willingness to help.  They will make not only ventilators but face masks with tiny fans to generate positive pressures within the mask to keep the virus out of the respiratory tract and eyes.   #covid19 #coronavirus #ventilator  

  Vidcast:  https://youtu.be/AMGmbjdWo-o   The CoVid19 virus uses the angiotensin converting enzyme 2 or ACE2 as a binding site to human cells in the lungs, heart, and kidneys.  The angiotensin receptor blockers (ARBs) used to lower blood pressure increase ACE2 levels and may be able to diminish the damage the virus creates in vital organs.   Clinicians from China and India observe that the ARB drugs losartan and telmisartan bind strongest to the angiotensin receptors and would be most effective against CoVid19.  Since these drugs are already FDA-approved, drug trials using them for treating CoVid19 may be launched.   If you are on an ARB, stay on it as such studies unfold but don’t switch to it yet!   https://onlinelibrary.wiley.com/doi/pdf/10.1002/ddr.21656   https://www.bmj.com/content/368/bmj.m406/rr-2   #covid19 #coronavirus #angiotensin #arb

  Vidcast:  https://youtu.be/5E2waVcfjJg   The pain killer Ibuprofen, Advil and Motrin, along with angiotensin blood pressure lowering drugs may allow CoVid19 to more easily infect and possibly kill you.    Ibuprofen and other NSAIDS are anti-inflammatory drugs that increase the angiotensin enzyme that facilitates virus binding to human respiratory lining cells.  Patients with severe CoVid infections frequently have high blood pressure and diabetes.  Diabetes itself and the blood pressure drugs ACE inhibitors and angiotensin receptor blockers also increase this same angiotensin viral latching enzyme.   Researchers recommend using acetaminophen and not ibuprofen or NSAIDS for pain and fever.  They suggest switching blood pressure medications to the calcium channel blockers than don’t aid viral invasion.   https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext   https://www.sciencealert.com/who-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms   #covid19 #coronavirus #ang

  Vidcast:  https://youtu.be/IHwvx_cgwDQ   Genetic analysis of the novel coronavirus CoVid19 conclusively shows it was not genetically engineered to become a biological agent in a political or economic war.  The evidence just published in the journal Nature is compelling enough to convince all but the most stubborn science deniers.   Studying longitudinal samples of the virus, the virus’ overall structure and outer coat spike protein are not compatible with genetic manipulation of a known dangerous coronavirus such as those that caused the previous SARS and MERS epidemics.  CoVid19 evolved from a bat virus, and the previous coronaviruses originated in civets and camels.     Unwarranted conspiracy theories are divisive and block our efforts to live through  CoVid19.   Kristian G. Andersen, Andrew Rambaut, W. Ian Lipkin, Edward C. Holmes, Robert F. Garry. The proximal origin of SARS-CoV-2. Nature Medicine, 2020; DOI: 10.1038/s41591-020-0820-9   #covid19 #coronavirus #sars #mers #geneticengineering #biowarfare  

  Vidcast:  https://youtu.be/3Gtw86u2CcY   We must band together to flatten the CoVid19 curve, and most of us will be working from home if work is possible.  My son Dave, Business Insider’s Front Page Editor, offers these 5 tips to his BI colleagues and through me to you.  His credentials: he has been working remotely and successfully for 3 years.   Don’t forget to eat.  At the office, you have a set lunchtime.  At home, you can eat whenever, but you won’t.  Carve out a fixed lunch time.  Better yet, also plan morning and afternoon snack breaks. Over-communicate.  Let your managers and colleagues know that you are working and turning out product.  These connections will make you and others happier.  Your ‘over-communicating” is still likely less than what you’d do at the office. Move your body.  Stand, stretch, and walk periodically.  Listen to your smart wearable’s  nagging.  Ask Alexa to play dance music and embarrass yourself. Use distractions strategically.  When you’re on deadline, avoid them by turning

  Vidcast:  https://youtu.be/WtD2ata8B7k   American Honda is recalling its Portable Generators.  The inverter assembly may short circuit if salt water leaks in.  Should that happen, the unit will smoke and may catch fire.   About 340,000 units were sold in the US.   Immediately stop using those generator.  Contact a local authorized Honda Power Equipment service center to schedule a free repair.  For more information, call 1-888-888-3139.   https://www.cpsc.gov/Recalls/2020/American-Honda-Recall-of-Portable-Generators-Due-to-Fire-and-Burn-Hazards   #honda #generator #firehazard  

  Vidcast:  https://youtu.be/Pe8zlg-Y_sc   Once infected with the coronavirus, a patient could shed live and infectious virus for nearly 3 weeks.  Vietnamese researchers studied a 73 year old man admitted with a dry cough and difficulty breathing and diagnosed with a CoVid19 pneumonia.   Over an 8 day period, he improved clinically with what turned out to be a mild case.  Even so, longitudinal testing of his throat and gastrointestinal tract revealed persistently positive CoVid19 RT-PCR tests.  His throat tests finally turned negative by hospital day 11- illness day 16.  His rectal swabs remained positive until hospital day 18 - illness day 23.   Many of us will become infected.  Be prepared for a long quarantine.    https://www.medrxiv.org/content/10.1101/2020.03.07.20032052v1.full.pdf   #covid19 #coronavirus #shedding #quarantine

  Vidcast:  https://youtu.be/qocFgfKcPIc   If you’re one of the 44% with type O blood, you are significantly less likely to become seriously infected with coronavirus.  If you have type A blood, you are much more likely to contract it.   Chinese investigators studied infected persons in Wuhan and in Shenzhen.  Type O persons had a 33% lower infection risk.   Type A persons had a 21% higher infection risk. The AB group fared a bit worse than the A group, but the B group had no greater risk or benefit.   You can’t change your blood group, but you can avoid infection.  Those with A or AB groups should be even more obsessive about avoiding exposures.   https://www.medrxiv.org/content/10.1101/2020.03.11.20031096v1.full.pdf   #covid19 #coronavirus #abogroups #bloodgroups

  Vidcast:  https://youtu.be/-cTZbHQgBfI   CoVid19 remains viable in contaminated spray for up to 3 hours.  It can live on surfaces for up to 3 days.  This data, just reported in the New England Journal, comes from the NIH infectious disease unit in Montana.   The researchers tested the virus in 10 experimental scenarios.  The virus lived longest on plastics, 72 hours, and stainless steel, 48 hours.  No significant virus lived on cardboard after 24 hours or on copper after only 4 hours.   Keep this information in mind as you protect yourself from the virus.  Clean all surfaces frequently, including your phone.  Soap is an excellent virus killer  destroying its outer shell protein coat.   https://www.nejm.org/doi/full/10.1056/NEJMc2004973?query=RP   #covid19 #coronavirus #aerosols #plastic #steel #cardboard #copper  

  Vidcast:  https://youtu.be/8FGEP8dTIAY   AFC Distribution Corp. of Rancho Dominguez, California is voluntary recalling Cooked Butterfly Tail-On Whiteleg Shrimp, Lot #2019.10.02.  This shrimp may be found in various prepared sushi and other foods with sell-by dates ranging from 02/19/2020 to 03/13/2020.  The shrimp may be contaminated with Vibrio parahaemolyticus. This organism causes a severe gastroenteritis with nausea, vomiting, diarrhea, fever and chills.   The shrimp have been sold in products prepared at retail AFC sushi counters and distributed in some 40 states.  If you have a product containing these shrimp, discard it or return it to the point of purchase for a refund.  For more information, contact the AFC Recall Team at 1-866-467-8744.    https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/cooked-butterfly-tail-whiteleg-shrimp-sushi-ebi-lot-20191002   #recall #afc #shrimp #sushi #vibrio

Vidcast:  https://youtu.be/y45ok4Y3Lig   The good ole nausea drug, Compazine or prochlorperazine, prevents tumor cells from hiding surface receptors that immunotherapy drugs require for the kill.  Oncologists at Australia’s University of Queenland studied this receptor hiding process called endocytosis in both human cells and a mouse model.   Studying human squamous cell carcinoma cells, they observed less endocytosis and more antibody binding sites in cells from patients responding better to cetuximab, an anticancer antibody to skin growth factor.  The endocytosis inhibitor Compazine demonstrably helped cancer immunotherapy in mice.  The drug turbocharged tumor cell killing by both the anti-tumor antibody cetuximab and the check point inhibitor avelumab.   Compazine may well be an effective antidote to immunotherapy failures.    Hui Yi Chew, Priscila O. De Lima, Jazmina L. Gonzalez Cruz, etal. Endocytosis Inhibition in Humans to Improve Responses to ADCC-Mediating Antibodies. Cell, 2020; 180 (5): 895 DOI: 10