Dr. Howard Smith Oncall

Vidcast:  https://youtu.be/6Gp35HxNfKI   If you burn your candle at both ends during the week and think that you can catch up on sleep over the weekend, think again!  A study from the University of Colorado shows that you won’t catch up on sleep and that your irregular sleep pattern will torpedo your glucose metabolism and internal time clock.   The study assigned health young adults to one of three groups: a group with only 5 hours of sleep at night with no weekend catch-up; a group with only 5 hours of sleep for 5 nights followed by the chance to snooze forever on the weekend; and a control group who slept 9 hours each night.  The researchers studied the subjects’ sleep patterns via sleep studies, their weight gain, insulin sensitivity, and body circadian rhythms.   The results revealed that the sleep-deprived group only recaptured a little more than one hour of the more than 12 hours of lost sleep when they were able to sleep in over the weekend.  Of even more importance, they could never recapture all the

  Vidcast:  ttps://youtu.be/mJ67PSiq78Y   Mothers who smoke, vape, or use oral and patch nicotine products may be exposing their unborn children to the risk of attention deficit and hyperactivity issues,ADHD, later in life.  A study from Finland just published in the journal Pediatrics studied over 1,000 children and matched controls born 10 years ago.     The researchers studied serum samples from mothers collected during the first and second trimesters and measured the levels of cotinine, a biomarker for nicotine.  Then the mothers were divided into 3 groups according to serum nicotine levels during pregnancy.   Those mothers with the highest nicotine levels were more than 3 times more likely to have children suffering from ADHD.   Prior to this definitive study, there was no solid proof that the association was with nicotine.   If you love your children-to-be, don’t consume nicotine in any form by smoking tobacco, vaping, chewing nicotine gum, or placing patches during pregnancy.  Don’t expose your develop

Vidcast:  https://youtu.be/BnAb8oU9ZdY   Keeping your head, hands, and body busy in middle age pays off big later in life.  The latest pot of gold at the end of the rainbow is that your risk of dementia drops by nearly 35 to more than 50 percent.     This finding comes from Sweden’s University of Gothenburg’s study of 800 women who were followed from their mid-forties well into their nineties.   The physically active women were 34 % less likely to develop dementia than their inactive peers.  Their activities included intense exercise such as running and swimming but also lighter physical pursuits such as biking, walking, bowling, or gardening.   The more intellectually active women enjoyed a 46 percent lower incidence of Alzheimer’s disease and a 34% lower incidence of any dementia.  Their activities were reading writing, needlework, attending shows and concerts, singing in a choir, and painting.   I end each of my news reports with the suggestion that a smile on your face, an active mind, and your body in mo

Vidcast:  https://youtu.be/SCayESaafFI   Regularly eating breakfasts versus skipping them lifts a teen’s grade average from a C to an A.  The UK’s University of Leeds investigators tabulated the breakfasting habits of 294 16-18 year olds with their scores on standardized tests.  The test scores were converted to letter grades.   Of the participant group, 53% ate breakfasts regularly but 29% never ate them.  The participants grades on General Certificate of Secondary Education achievement tests, so-called GCSE exams, provided a measure of their academic prowess.   Far too many students at all grade levels in both the UK and the USA arrive at school deprived of a nourishing breakfast.  Families must make this meal a priority.   Katie Adolphus, Clare L. Lawton, Louise Dye. Associations Between Habitual School-Day Breakfast Consumption Frequency and Academic Performance in British Adolescents. Frontiers in Public Health, 2019; 7 DOI: 10.3389/fpubh.2019.00283   #Breakfast #grades #highschool #math #English #parent

Vidcast:  https://youtu.be/YYp0nHFGiSo   Omega-3 fatty acid fish oil supplements can significantly improve attention deficit symptoms for children who have deficiencies of this essential contributor to brain development.  This the conclusion of a collaborative British-Chinese double-blind, controlled study of 92 children and adolescents with ADHD.   The children given the EPA fatty acid supplements showed improvements in focused attention and hit reaction time.  Not surprisingly, only those subjects with the lowest baseline levels of fatty acids improved.     There is a clinical test for omega-3 fatty acid levels though its not perfect.  If you have a child with ADHD, consult your doctors about the test.  Do be certain though that your child’s diet includes fish, flaxseed, or fish oil supplements.    Chang, J.P., Su, K., Mondelli, V. et al. High-dose eicosapentaenoic acid (EPA) improves attention and vigilance in children and adolescents with attention deficit hyperactivity disorder (ADHD) and low endogenous

Vidcast:  https://youtu.be/mr_Zu297u7g   Forty-one weeks of gestation appears to be the safe upper limit for pregnancies.  This the conclusion of a Swedish multisite study of more than 2700 women with post-mature babies.   Half the group were randomized to be induced at 41 weeks,  The remainder were followed for up to another 7 days with mandatory induction at 42 weeks.  The study was abruptly ended when six babies in the watch and wait group died versus none in the 41 week-induced group.   A pregnancy is conventionally considered safe up to 42 weeks.  If you or a loved one is pregnant, insist on delivery by 41 weeks if the baby is large enough by ultrasound.   A.M. Jukic, D.D. Baird, C.R. Weinberg, D.R. McConnaughey, A.J. Wilcox. Length of human pregnancy and contributors to its natural variation. Human Reproduction, 2013 DOI: 10.1093/humrep/det297   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991404/   #Pregnancy #postterm #induction #csection

Vidcast:  ttps://youtu.be/r3cfXswib-I   Yoga instruction or individual physical therapy, PT, over a 12 week period leads to better sleep for those plagued by low back pain.  Boston University investigators report this conclusion following their study of  320 adults with back pain.   Those using yoga enjoyed a 12% improvement in sleep while those having physical therapy noted  9% better sleep.  The best news is that this sleep improvement is sustained for at least a year.   Previous work credits both yoga and PT with improving low back pain.  Now we know that yoga and PT can also help the nearly 60% of those with low back pain that also have sleep problems.     Eric J. Roseen, Hanna Gerlovin, Alexandra Femia, Jae Cho, Suzanne Bertisch, Susan Redline, Karen J. Sherman, Robert Saper. Yoga, Physical Therapy, and Back Pain Education for Sleep Quality in Low-Income Racially Diverse Adults with Chronic Low Back Pain: a Secondary Analysis of a Randomized Controlled Trial. Journal of General Internal Medicine, 2019; D

Vidcast:  https://youtu.be/lSGFWPkOSJY   American men in a hetero relationship experience the lowest level of stress and anxiety when their female partners contribute 40% to the couple’s combined income.  British psychologists report this finding from their study of just over 6,000 US households.   Male stress peaks when he is the sole income earner, it dips as his partner contributes up to 40%, and then increases again as the woman’s contribution becomes predominant.  In comparison, women experience the least stress when she earns the same as her partner.  The male stress pattern disappeared if the woman clearly earned more before the marriage.   Men can reduce their stress level by welcoming, not fearing, financial contributions from their wives.    Joanna Syrda. Spousal Relative Income and Male Psychological Distress. Personality and Social Psychology Bulletin, 2019; 014616721988361 DOI: 10.1177/0146167219883611   #marriage #gender, #stress #income

Vidcast:  https://youtu.be/kwJ05jen3Wc   Eating fruits and veggies and foregoing fatty, sugary foods will reduce chances of hearing loss by up to 30%.  Harvard investigators managing the Nurses’ Health Study looked more than 3100 womens’ hearing as a function of diet over a 20 year period.   Women closely following healthy diets including the DASH, the Mediterranean, and the Alternate Healthy Eating Index eating plans had a 29% lower risk of mid-frequency hearing loss.  Their high frequency loss risk also dropped by 25%.   Our world is louder, and our hearing abilities will crash even sooner than in the past.  Vegetables, fruit, lean meat, and fish can help maintain your hearing fidelity.  Noise cancelling earplugs and earphones also help.   Sharon G Curhan, Christopher Halpin, Molin Wang, Roland D Eavey, Gary C Curhan. Prospective Study of Dietary Patterns and Hearing Threshold Decline. American Journal of Epidemiology, 2019; DOI: 10.1093/aje/kwz223   #diet #hearing #noise

Vidcast:  https://youtu.be/YH4G3xa8_sM   Patients receiving chemotherapy, radiation, immunotherapy, and surgery face stresses similar to astronauts blasted into deep space.  Exercise physiologists at New York’s Memorial Sloan-Kettering Center now propose NASA-like physical counter measure programs (CMPs).   Cancer patients and astronauts both suffer decreases in muscle mass, cardiac functional changes, cognitive shifts, and bone demineralization during their respective journeys.  Many of the training programs used prior to space flights are now being adapted for patient use.   Exercise improves brain, cardiac, and bowel function, enhances the immune response, and strengthens bones.  Expect to see the lessons of space medicine applied as CMPs to help all of us through medical and surgical therapy for cancer and more.   Jessica M. Scott, Lianne B. Dolan, Larry Norton, John B. Charles, Lee W. Jones. Multisystem Toxicity in Cancer: Lessons from NASA’s Countermeasures Program. Cell, 2019; 179 (5): 1003 DOI: 10.101

Vidcast:  https://youtu.be/yIqurbhKfAw   That’s the bottom line of the ISCHEMIA study, an international effort coordinated by cardiologists at Stanford and New York Universities.  Presented last week at the American Heart Association’s meetings, the study had nearly 5200 participants in 37 countries.   Patients with stable coronary blockages do no better with invasive surgery, either angiographic stent placement or open chest arterial bypass grafts, than those treated conservatively using medications.  The one exception: patients with chest pain, angina, achieved more relief from surgery.   There are rare cases when surgery is absolutely necessary.  When an operation is recommended to you, ask if there is an alternative.  If you are told, “No,” get a second opinion.   https://med.stanford.edu/news/all-news/2019/11/invasive-heart-treatments-not-always-needed.html   #Coronaryarterydisease #stents #CABG #angina

Vidcast:   https://youtu.be/sKbA3LbiCVg   Parents tightly managing their kids’ academic and social paths produce offspring with faulty academic and social skills, poor self-control, and emotional problems.  Family studies researchers at West Virginia University draw these conclusions from surveys of 302 young adults.   The investigators add that the parents who herd their children into the right preschools, elite grade schools, the most selective colleges, and 6 and 7 figure jobs do so for bragging rights.  The study terms these manipulated kids “hothouse children” comparing them to orchids bred under carefully controlled conditions.   Parents who truly love their kids give them guidance and the skills to focus on their life targets.  Then, they step back and applaud their self-directed accomplishments.   Kristin L. Moilanen, Mary Lynn Manuel. Helicopter Parenting and Adjustment Outcomes in Young Adulthood: A Consideration of the Mediating Roles of Mastery and Self-Regulation. Journal of Child and Family Stud

Vidcast:  https://youtu.be/h0lSb9JaTLA   Cleaning products and disinfectants can increase your risk of developing handicapping chronic obstructive lung disease, COPD, by up to 38%.  Harvard and NIH researchers followed more than 73,000 US nurses occupationally exposed to such toxic chemicals over a 6 year period.   The nurses were using chemicals including bleach, hydrogen peroxide, alcohol, ammonia, and glutaraldehyde to clean both surfaces and medical instruments.  A history of smoking or asthma did not impact the recorded risks.   COPD is the 3td leading cause of death worldwide, and up to 20% of cases are linked to occupational toxins.  You probably use many products that crippled these nurses at home.  When you do, limit your exposure and ventilate well.   Orianne Dumas, PhD1,2; Raphaëlle Varraso, PhD1,2; Krislyn M. Boggs, MPH3,4; et al.  Association of Occupational Exposure to Disinfectants With Incidence of Chronic Obstructive Pulmonary Disease Among US Female Nurses.  JAMA Netw Open. 2019;2(10):e19

Vidcast:  https://youtu.be/aaIi2jdCaVU   The high fat, low carb diet that is keto triggers activation of special lung T lymphocytes that make mucus webs which sideline  influenza viruses.  This finding is now reported by Yale immunobiologists using a mouse model.   The keto diet facilitates influenza virus death and better experimental animal survival compared with a high carb diet.  A line of mice incapable to producing the mucus-generating T cells saw no benefit from the keto diet.   With the flu season upon us, do get the vaccine.  Add to its protection by going keto and increasing your intake of fatty fish, beef, full-fat milk and cheese, avocado, peanut and almond butters, and healthy fatty oils.   Emily L. Goldberg, Ryan D. Molony, Eriko Kudo, Sviatoslav Sidorov, Yong Kong, Vishwa Deep Dixit, Akiko Iwasaki. Ketogenic diet activates protective γδ T cell responses against influenza virus infection. Science Immunology, 2019; 4 (41): eaav2026 DOI: 10.1126/sciimmunol.aav2026   https://www.healthline.com/nutr

  Vidcast:  https://youtu.be/jTrtQsWO7y4   Next week’s bingeing on that pie with ice cream and whipped cream piled high could trigger inflammatory bowel disease or worsen the disease you already have.  A mouse study from Canada’s University of Alberta reports that sugar in the gut feeds renegade bacteria like E. coli that trigger inflammation and destructive immune responses.   It only took two days of the sugary diet to give the experimental animals a bellyache.  Patients with inflammatory bowel disorders like Crohn’s and ulcerative colitis report similar experiences.   The good news is that your holiday sugar gorge may be neutralized by downing high fiber fruits, veggies, whole grains, beans and nuts that produce short-chain fatty acids.   Michael Laffin, Robert Fedorak, Aiden Zalasky, Heekuk Park, Amanpreet Gill, Ambika Agrawal, Ammar Keshteli, Naomi Hotte, Karen L. Madsen. A high-sugar diet rapidly enhances susceptibility to colitis via depletion of luminal short-chain fatty acids in mice. Scientific Repo

  Vidcast:  https://youtu.be/zq8SI0miOgg   Manipulating your facial expression to show serious, focused determination, a game face, will actually improve your performance on intellectual challenges.  A University of Tennessee psychology study looked at 62 participants as they solved Mandala puzzles.   Putting on the game face that so many athletic coaches demand of their players did actually speed the subjects’ thought processes and puzzle solution by some 20%.  Skin conductance measurements showed that game face actually reduced the participants’ stress levels   Remember that game face depends on the game you’re playing.  When I walk in to treat my pediatric patients, it’s show time.  I adjust best crazy tie and put on a broad smile.   Matthew T. Richesin, Michael D. Oliver, Debora R. Baldwin, Lahai A.M. Wicks. Game Face Expressions and Performance on Competitive Tasks. Stress and Health, 2019; DOI: 10.1002/smi.2899   #Gameface #winning #puzzles #acting  

  Vidcast:  https://youtu.be/DSErGGTJmQI   Instrumental music insulates your body’s nervous system from pressures of traffic jams, nasty other drivers, and sudden stops.  This the result of a small Brazilian study just published in Complementary Therapies in Medicine.   The investigators measured the effects of driving an unfamiliar car during a nerve-racking urban rush hour on the hearts of young, relatively inexperienced drivers.  Driving with peaceful music eliminated stress on the drivers’ autonomic nervous system as measured by heart rate variability.   If driving, commuting on mass transit, school pressures, your boss, or virtually any noxious experiences are literally driving you crazy, try some jazz or classical music.  Those calming melodies will neutralize the toxins of life.   Myrela AleneAlvesaDavid M.GarnerabJoice A.T.do AmaralcFernando R.OliveiradVitor E.Valentia.  The effects of musical auditory stimulation on heart rate autonomic responses to driving: A prospective randomized case-control pilo

  Vidcast:  https://youtu.be/5JaCIuYeWaw   Taking extra testosterone can double a man’s risk of dangerous leg blood clots, and that risk is tripled if he is younger than 65.  A study just published in JAMA Internal Medicine studied use of the supplement in nearly 40,000 men over a 7 year period.   Leg blood clots can travel up into the lungs and trigger a pulmonary embolism.  This blockage of blood into the lungs that kills up to 100,000 Americans each year.   Men take testosterone to increase physical and sexual vitality despite good scientific proof.  On the other hand extra hormone can enlarge a man’s breasts, reduce his sperm production, enlarge his prostate, and trigger sleep apnea.   I wouldn’t recommend it guys!   Walker RF, Zakai NA, MacLehose RF, et al. Association of Testosterone Therapy With Risk of Venous Thromboembolism Among Men With and Without Hypogonadism. JAMA Intern Med. Published online November 11, 2019. doi:https://doi.org/10.1001/jamainternmed.2019.5135   https://www.mayoclinic.org/hea

Vidcast:  https://youtu.be/n287C8md9t0   It’s generally thought that background music stirs creativity.  Not so says a study from several universities in the UK and Sweden just published in the journal Applied Cognitive Psychology.   A total of 84 university students and staff were presented with tests of creative ability, so-called Compound Remote Associate Tasks or CRAT for short.  Subjects were exposed to instrumental music only, songs with completely unfamiliar foreign language lyrics, or hit songs with familiar lyrics.  The control sounds were library background buzz and absolute quiet.   The study results showed that the familiar songs with lyrics negatively impacted creativity the most followed by instrumentals and then foreign language songs.  Test performances were the same in absolute silence and in the low din of the library.   The researchers hypothesize that the changing state of sound is most responsible for reducing creativity as the music reduces the performance of verbal working memory.  I pe

Vidcast:  https://youtu.be/9_LxyguWH5U   Deep sleep, the slow wave, non-REM variety, is the best sleep for literally cleansing your brain according to a new study from the University of Rochester.  The scientists studied the effects of deep sleep in a mouse model inducing that state with the unique combination of general anesthetics ketamine and xylazine.   The combination of deep slow wave sleep and the low level cardiovascular activity that accompanies it triggers the so-called glymphatic system, the brain’s unique plumbing apparatus that flushes waste from our brain cells.  This essential purging fails to occur during sleep deprivation and is also less likely to occur as we age when it becomes more difficult to achieve deep sleep.      Other studies suggest that the onset of Alzheimer’s is associated with less deep sleep and this may be due to poor glymphatic system activity.   You can help yourself get deep sleep at any age with the following tips.  Before bedtime: no eating, caffeinated beverages, exerci