Dr. Howard Smith Oncall

  Vidcast:  https://youtu.be/X86AIAevYRc   Abusive bosses who rule with a heavy hand are managing their own failure.  This is the conclusion of a 427 study meta-analysis completed by researchers at Portland State University and published in the Journal of Management.   Managers perceived as unfair, unhelpful, and impersonal trigger counterproductive and passive-aggressive work behaviors including work slow-downs, delayed arrivals in the morning,  extended breaks during the work day, calling-in sick, and frank workplace sabotage.  Obnoxious leaders create a toxic work environment, staff stress, and departures of valuable team members.   The most successful managers walk around the workplaces to kindle personal work relationships with their staff.  Once bosses know their subordinates as people, they can better function as facilitators to help everyone on the team shine and in so doing burnish their own reputations.   Yucheng Zhang, Xin Liu, Shan Xu, Liu-Qin Yang, Timothy C. Bednall. Why Abusive Supervision Impa

  Vidcast:  https://youtu.be/5R8o82HKzOo   Music can keep groups of people engaged by synchronizing and pacing their brainwaves, but not all types of music have this effect.  Engineers at the City College of New York studied the neural responses of audiences in response to various forms of music.   Their research shows that unfamiliar scores synchronize communal brains most effectively, and the positive effects recur even with repetition.  On the other hand, familiar pieces failed to drive audience brain synch even with repetition.   Music-induced brain synch does work best for those audiences with some pre-formed appreciation for music.   Speaking as a surgeon, I’ve always found that music in the operating room helped to establish an efficient yet safe work pace.   Relying on my team to help choose the music reduced stress and optimized group satisfaction.     Jens Madsen, Elizabeth Hellmuth Margulis, Rhimmon Simchy-Gross, Lucas C. Parra. Music synchronizes brainwaves across listeners with strong effects of

  Vidcast:  https://youtu.be/NGDyl9OUX7k   E-cigarettes, touted as being safer than tobacco cigarettes, seem to trigger heart attacks and strokes.  This is the conclusion of research from the University of Kansas that studied nearly 100,000 Americans.  It was presented recently at this year’s meeting of the American College of Cardiology.   Those who vape are 56% more likely to suffer a heart attack, 30% more likely to have a stroke, and 55% more likely to be depressed or at least anxious.   E-cigarettes also expose users to as much or more of the highly addictive drug nicotine compared with conventional cigarettes.   Proponents of vaping claim that e-cigarette users can avoid tobacco’s carcinogenic tars.  Studies are now showing that the flavorings added to the liquid nicotine are themselves toxic and carcinogenic.     Worse yet, manufacturers of the nearly 500 brands of e-cigarettes are following the tobacco companies’ evil playbook and marketing these devices to children and adolescents.  The bottom line i

  Vidcast:  https://youtu.be/6YkO3qoOn-M   Obstetricians at Israel’s Ben Gurion University now proclaim that “50 is the new 40 when it comes to childbirth!”  They studied more than 8,000 pregnant women 40 years and above.   The data revealed that complications such as premature birth, gestational diabetes, high blood pressure, and a need for c-section were no higher for those in their 50s compared with mothers in their 40s.  They do however consider all pregnancies in women 40 or older to be high risk with a need for careful followup of blood sugars and blood pressures.   This is all well and good, but just because it’s possible for parents to have a child when they are over 50 doesn’t mean that it’s a good idea.  Raising children requires lots of energy and lots of money.     Couples in their 50s may have both, but they don’t have the 30 to 40 years that couples in their 20s and 30s have before they reach an age when their bodies and minds are entering the relaxation mode.     Children need guidance througho

    Vidcast:  https://youtu.be/rLcHzGnCbCw   Want to boost your long distance running performance in only 4 days?  Get yourself on the Mediterranean Diet says investigators from St. Louis University.   They studied 11 male and female 5K runners giving each 4 days of the Mediterranean Diet or 4 days of the typical Western Diet before they ran the 5K on a treadmill.  Consuming the Mediterranean Diet with its fruits, veggies, nuts, olive oil and whole grains pumped the runners performance up by a consistent 6 percent compared with their times after consuming the Western Diet’s red meats, processed meats, dairy, refined sugar, and fats.     The researchers attribute the performance boost to the Mediterranean Diet’s anti-inflammatory and antioxidant properties.  Just be aware that these advantages are quickly lost after stopping the diet.   If you want top performance from your body in so many challenging situations, not just in running, eat the fruits and vegetables that your body craves and treat the offerings o

  Vidcast:  https://youtu.be/6YdaC5YgAuQ   Raw dog food is becoming quite the rage.  A study just published in the British Medical Journal’s Veterinary Record reveals that raw dog food from 10 different sources contains dangerous levels of E.coli and other fecal bacteria, Salmonella, Campylobacter, and Clostridia.   Raw pet food is prepared from miscellaneous body parts and organs that are a byproduct of slaughtering cattle, chickens, sheep, turkeys, pigs, ducks, salmon, and even reindeer.  The raw meat is not heat treated or freeze-dried to kill bacterial contaminants but rather only packaged and fresh frozen.  This type of simple freezing fails to kill many bacteria.   The bacteria in these products can easily pass to you and to your children.  If you choose to feed it to your poor dog and risk making the animal sick, keep the raw dog food frozen until just before using it, keep it far away from your own food,, and handle it with separate kitchen equipment while you wear gloves.   If you really want to give

  Vidcast:  https://youtu.be/SL6hU7sJnWQ   Listen up men.  Two chemicals that can damage your sperm and your ability to father a normal child are lurking in and around your home.   A study just published by England’s University of Nottingham shows that the plasticizer DEHP and the industrial chemical PCB153 both reduce the motility and increase the level of DNA damage of sperm exposed to them in the test tube.   DEHP is found in carpets, linoleum flooring, upholstery, clothing, and even children’s toys.  Although PCB use was banned in the US more than 40 years ago, these chemicals degrade so slowly that they remain in many structures and in the soil on which we all walk and play.   Male fertility is on the decline, and sperm samples from around the world demonstrate a 50% reduction in quality over the past 80 years.  If you are trying to father a child, avoid drinking from plastic containers or wearing plastic clogs that contain the organic compounds DEHP, PCBs, or BPAs.   To maintain your reproductive health

  Vidcast:   https://youtu.be/Krls1Vigp3E   Using popular mouthwashes may cause your blood pressure to jump up significantly.  Dentists and cardiologists at the University of Texas report that the antibacterial agent in mouthwash, chlorhexidine, prevents the normal oral bacteria from metabolizing ingested nitrates into the nitric oxide that plays a key role in normalizing blood pressure.   The investigators recruited subjects from the faculty, staff, and student populations in order to study their oral bacteria, oral nitrites, and blood pressures before, during, and after their use of mouthwash.  The subjects used Peridex mouthwash twice daily for 7 days.   Use of the mouthwash and tongue cleaning significantly elevated both the systolic and the diastolic blood pressures as it depressed counts of oral bacteria and the concentration of nitric oxide.  Parameters returned to baseline 3 days following mouthwash discontinuation.   This study is an additional reason why so-called therapeutic mouthwashes containing

  Vidcast:  https://youtu.be/_DFUFfgGHsc   If a parent constantly corrects an infant, that child’s brain becomes more sensitive to angry vocalizations.  Investigators at Britain’s University of Manchester studied 40 six month old infants and their mothers utilizing the novel neuroimaging technique of Near Infrared Spectroscopy.  This permits the study of a baby’s brain activation by maternal vocalizations without the noise of MRI.   Infants as young as 6 months can differentiate happy and unhappy vocal rhythms.  The researchers found that those babies whose mothers repeatedly corrected them developed nerve networks that preferentially respond to angry vocalizations.   This study underscores the exquisite sensitivity of infant humans.  Parents need to monitor their own and each other’s interactions with their children and realize how much their behavior imprints their offspring in both negative as well as positive ways.     Good parenting is creating a safe, happy environment for your child by constructing bou

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