Dr. Howard Smith Oncall

  Vidcast:  https://youtu.be/P3pgy7NLv9w   So you have celiac disease, the most severe form of gluten sensitivity, and exposure to the wheat protein can make you terribly sick.  You avoid any wheat products at home, and you carefully choose restaurants that certify their food to be gluten-free.  Just how good is their certification.   Not very good say studies just published by gastroenterologists at Columbia med school and the NY Presbyterian Hospital.  Their data comes from users of the Nima Gluten Sensor that diners can use to self-test food labeled as gluten free.  In a review of more than 5600 tests by some 800 users over 18 months, gluten was detected in 53% of gluten-free pizza, 51% of gluten-free. pasta, 27% of breakfasts, 29% of lunches, and 34% of dinners.   Here’s the catch: the device is extremely sensitive detecting gluten levels as low as 5 to 10 parts per million (ppm).  In the US, food certified as gluten-free can contain up to 20 ppm, and less than that may not be clinically significant.   St

  Vidcast:  https://youtu.be/iRn033adAuY   The debate continues!  The latest multi-country study of nearly 18,000 kids in England, Ireland, and the US analyzed the effect of screen time on adolescent well-being.  When the data were tabulated, no negative effects could be found.   The University of Oxford investigators looked at the duration of screen time and its proximity to bedtime.  They scrutinized the impact of time with digital devices on adolescent overall well-being, self-esteem, psychosocial functioning, mood, and frank depressive symptoms.   Using best practice methodological and statistical techniques, the conclusion is that screen time is not harmful to teens.  Even this conclusion does not invalidate the universal advice that moderation is always the best policy.  Overwhelming numbers of screen time hours rob children of other opportunities in the real world, and they limit vital time for physical activity.    Amy Orben, Andrew K. Przybylski. Screens, Teens, and Psychological Well-Being: Evidence

  Vidcast:  https://youtu.be/9XGgeCUMD6s   Medical marijuana now legal  in 33 states and the District of Columbia, and many of you probably have questions about its uses.  I came cross this excellent article published this week in the British Medical Journal, and I want to pass it on.      The article reviews the available types of medicinal but also non-medicinal cannabis products and by-products, both natural and synthetic.  It reviews how these products may be helpful or harmful to you and for which illnesses they may be effective.   Just to give you a taste of the information, one table lists detailed information about the prescription medicinal products including the natural derivatives Sativex, Epidiolex, Bedrocan, Tilray, the synthetics Dronabinol, Nabilone, and the non-medicinals CBD oil, White Widow, and Spice.  Another table reviews the evidence for effectiveness of cannabinoids for the treatment of chronic pain, multiple sclerosis, epilepsy, and chemotherapy induced nausea and vomiting.   If you ha

  Vidcast:  https://youtu.be/ZuqDeXVraTM   Keeping your gums healthy may help you maintain a sharp mind as well as a full set of teeth throughout your life.  A study from the University of Louisville’s dental school shows that a bacterium that frequently causes gingivitis and periodontitis can travel to your brain and help to trigger your mental decline.   The nasty bug in question is Porphyromonas gingivalis.  The researchers demonstrated the genetic fingerprints of the bacterium and its characteristic toxin in the brains of deceased Alzheimer’s patients.  In a parallel mouse experiment, they showed that migration of this bacterium from gum to brain can be halted with agents that block the bacterium’s toxins.   When this blockage is successful, the rodents fail to develop mental deterioration.   The investigators start that studies are now underway to test such blocking drugs in Alzheimer’s patients to see if their disease progression may be stopped or slowed.  Even before such a drug is available, you can h

  Vidcast:  https://youtu.be/xZAKkqkiZlQ   Chugging those 6 packs and downing those jelly shots depresses the growth of the developing brain.  The skyrocketing alcohol consumption by teens and young adults may well be sapping the collective brainpower of our country.   Neuroscientists at the Oregon Health and Science University studied this phenomenon in 71 rhesus monkeys allowed to binge on alcoholic beverages and monitored for brain growth using MRI scans.  The study found that the equivalent of 4 beers per day on a consistent basis reduced brain growth and development by 0.25 milliliters per year.   This adverse effect of a young person’s brain development and likely their powers of thought and problem-solving can be added to the other dangers of alcohol abuse.  These are: liver rotting, stomach ulcers, and all those goes along with serious substance addiction.     If you find that your teen is drinking more than occasionally, and you will have to actively look, intervene to get them the help they need.  

Vidcast: https://youtu.be/LQaxn7d3DRs If you bicycle or walk home from work, go out of your way to use the side streets.  Urban scientists at England’s University of Surrey collaborated with colleagues in England, the Netherlands, and Brazil to measure air pollution during the morning and evening commutes.   The scientists studied black carbon levels in these 3 cities on both the most heavily trafficked routes and on alternative byways.  The data revealed twice has high pollution levels on the main routes in all three cities.  In London, the levels of toxic carbon were twice as high in the evening as they were in the morning.   If you don’t fancy sucking carbon monoxide and diesel dust during your commute, walk and cycle on the less-traveled routes.  Those streets are also safer for you overall.  If you do drive, keep your windows and sunroofs closed.   Veronika Sassen Brand, Prashant Kumar, Aline Santos Damascena, John P. Pritchard, Karst T. Geurs, Maria de Fatima Andrade. Impact of route choice and period

Vidcast: https://youtu.be/UB_dx6o4wAA Every year, more bystanders are saving lives by applying CPR.  The latest Swedish study emphasizes that pushing on the chest alone without also breathing for the patient using either mouth-to-mouth or a breathing tube can save just as many lives.   The Swedes reviewed more than 30,000 cardiac arrest patients and showed that those lucky 68% that received CPR of any type from bystanders were twice as likely to survive the first 30 days following the incident.  The statistics showed that chest compressions alone can be very effective.  There was no outstanding benefit for those who also received rescue breathing as well as chest compressions.   If you find someone on the ground without a pulse, call 911.  Then begin chest compressions at about two per second.    Check to see if you can remove any obstructing material from the victim’s mouth.  If you are capable of adding rescue breaths, do so.  If not, keep up the chest compressions until the EMTs arrive.   Gabriel Riva, Ma

  Vidcast:  https://youtu.be/L4Y8tMLdeFA   The scoop on lies comes to us from a British study published earlier this month.  Investigators surveyed 194 men and women, average age 39, about the lies they tell and hear.   The results: Men consider themselves good liars twice as often as women. Liars lie face-to-face followed by texts, phone calls, email, and social media. A few liars are responsible for most lies. Liars are articulate and weave stories that deviate only slightly from the truth. Most lies are told to family and friends; the least to employers and authorities. We only have a 50:50 chance of detecting a lie.   With that, look out for a barrage of lies in 2020.   Brianna L. Verigin, Ewout H. Meijer, Glynis Bogaard, Aldert Vrij. Lie prevalence, lie characteristics and strategies of self-reported good liars. PLOS ONE, 2019; 14 (12): e0225566 DOI: 10.1371/journal.pone.0225566   #Lies #liars #politicians #Republicans  

  Vidcast:  https://youtu.be/9dHxUTsaHmk   E-cigarettes create less lung and genetic damage than conventional cigarettes.  This according to an Ohio State study comparing 15 vapers with 16 cigarette smokers and 42 never smokers.   Participants’ lungs were evaluated by testing bronchial washings for inflammatory cells and chemical mediators as well as altered DNA.  The e-cig users showed evidence of general lung damage intermediate between cigarette smokers and never smokers. Their genetic changes were negligible and similar to never-smokers.   This data is reassuring for e-cig users but but fails to justify vaping.  High e-cigarette temperatures produce toxic chemicals and severe, sometimes fatal lung disease.  Best to quit nicotine use with gum or patches.   Min-Ae Song, Jo L. Freudenheim, Theodore M. Brasky, Ewy A. Mathé, Joseph P McElroy, Quentin A Nickerson, Sarah A. Reisinger, Dominic J. Smiraglia, Daniel Y Weng, Kevin L Ying, Mark D. Wewers and Peter G. Shields.  Biomarkers of Exposure and Effect in the

  Vidcast:  https://youtu.be/6bg_3Wlid2U   Common over-the-counter vitamins, iron, and other food supplements prevent cancer chemotherapy from saving womens’ lives.  A multi-center study just published in the Journal of Clinical Oncology reviewed 1134 women receiving cyclophosphamide, doxorubicin, and paclitaxel for their advanced breast cancers.   The antioxidants Vitamins A, C, E, carotenoids, and coenzymeQ increased the recurrence risk by 41% and the death risk by 40%.  The non-antioxidant Vitamin B12 bumped recurrence by 83% and doubled the death risk.  Iron increased the recurrence risk by 79%.   Human biochemistry is complicated and adding powerful anti-cancer drugs to the mix makes it more so.  Adding other chemicals into the mix is risky and may be fatal.   Christine B. Ambrosone, PhD1; Gary R. Zirpoli, PhD2; Alan D. Hutson, PhD1; William E. McCann1; Susan E. McCann, PhD, RD1; William E. Barlow, PhD3.  Dietary Supplement Use During Chemotherapy and Survival Outcomes of Patients With Breast Cancer Enro

  Vidcast:  https://youtu.be/uh1tXkoG61w   American health clubs may be contributing to a skin cancer epidemic among the Gen Ys and Zs.  The University of Connecticut now documents the availability of indoor tanning beds at 3 major health chains.   While self-standing indoor tanning salons that breed the deadly skin cancer melanoma are closing, this unhealthiest of practices is ironically springing up in health clubs.  Every Planet Fitness has tanning, 65% of Anytime Fitness center have it, and 41% of Gold’s Gyms can cook your skin.    Melanoma is the second most common cancer for those 15-29 years of age and the leading cause of cancer death in young women.  Don’t indoor tan and use sunscreen outdoors.   Sherry L. Pagoto, David E. Conroy, Kelsey Arroyo, Jared Goetz, Ashley B. West, Samantha Mulcahy, Molly E. Waring. Assessment of Tanning Beds in 3 Popular Gym Chains. JAMA Network Open, 2019; 2 (12): e1918058 DOI: 10.1001/jamanetworkopen.2019.18058   https://about.kaiserpermanente.org/total-health/health-top

  Vidcast:  https://youtu.be/klhYpLoZGrs   Caffeine in any beverage can neutralize the effects of a diet too rich in fat and carbs.  Food scientists at the University of Illinois-Urbana-Champaign now report this finding.   Rats on a 40% fat, 45% carb, and 15% protein diet for a month gained 16% fewer pounds and 22% less body fat if they drank the equivalent of 4 cups of coffee a day.  Cultured fat cells exposed to caffeine had up to 40% less lipid accumulation.   Even without regularly downing fried fish, chips, and donuts, all of us eat to many fats and sweets.  To maintain balance, enjoy coffee, tea, and sometimes cola every chance you get.   Fatima J. Zapata, Miguel Rebollo-Hernanz, Jan E. Novakofski, Manabu T. Nakamura, Elvira Gonzalez de Mejia. Caffeine, but not other phytochemicals, in mate tea (Ilex paraguariensis St. Hilaire) attenuates high-fat-high-sucrose-diet-driven lipogenesis and body fat accumulation. Journal of Functional Foods, 2019; 103646 DOI: 10.1016/j.jff.2019.103646   #Caffeine #fat #car

  Vidcast:  https://youtu.be/_i9HO1iJSYE   Stepping on your bathroom scale daily is the Jedi mind trick that painlessly stops weight gain over the holidays and these inactive winter months.  This battle plan comes from nutritionists at The University of Georgia.   Their study began before Thanksgiving and ended mid-January.  It involved 111 adults half of whom weighed themselves on a WiFi-enabled scale that graphically displayed their weights over time.  The others just ate without any numeric feedback.     The scale watchers gained no weight, and, if overweight, actually lost weight.  The controls gained up to 7 pounds on average.   If you want to look good in your swim suit come June, begin a daily weigh-in and chart it.   Sepideh Kaviani, Michelle vanDellen, Jamie A. Cooper. Daily Self‐Weighing to Prevent Holiday‐Associated Weight Gain in Adults. Obesity, 2019; 27 (6): 908 DOI: 10.1002/oby.22454   #Dieting #scale #winter #holidays #Mindtricks  

  Vidcast:  https://youtu.be/O8k52s6HoZs   Psychological counseling, known as cognitive behavioral therapy or CBT, neutralizes anxiety-induced cellula aging.  Neuropsychologists at Sweden’s Karolinska Institute studied 46 clinically anxious but untreated subjects measuring the psychologic effects and cellular improvement after talk therapy.   Those completing the CBT enjoyed a 46% reduction of anxiety symptoms.  Their protective oxidative enzymes increased, and the presence of these is associated with slower cellular aging.  Most interesting is the fact that the counseling was delivered online in virtual sessions.   If you suffer from anxiety disorders, do seek professional help.  You will feel happier and engage more effectively with family, friends and colleagues.  Your life will be better but also longer.   Kristoffer N. T. Månsson, Daniel Lindqvist, Liu L. Yang, Cecilia Svanborg, Josef Isung, Gustav Nilsonne, Lise Bergman-Nordgren, Samir El Alaoui, Erik Hedman-Lagerlöf, Martin Kraepelien, Jens Högström, G

  Vidcast:  https://youtu.be/SCgKVBviePU   There’s an epidemic of concussions among college students, and surprisingly most victims are not the football, rugby, and lacrosse players.   A new study from the University of Colorado at Boulder shows that the  $  highest concussion rates occur in non-athletes and in women.   Non-athletes were 57% more likely than athletes to sustain concussions and women were 11% more likely than men.  The college student concussion rate was more than 2.2 times higher than  that of the general population.  Most non-sports injuries were due to falls, fights, and car accidents. August was the most dangerous month.   Be careful out there students and protect your brains.  Otherwise, you’re throwing away your tuition.   John Breck, Adam Bohr, Sourav Poddar, Matthew B. McQueen, Tracy Casault. Characteristics and Incidence of Concussion Among a US Collegiate Undergraduate Population. JAMA Network Open, 2019; 2 (12): e1917626 DOI: 10.1001/jamanetworkopen.2019.17626   #Concussion #college

  Vidcast:  https://youtu.be/Ge7ktfyeQJ0   Accumulations of belly fat and love handles are associated with a reduction in our problem-solving powers.  This from an Iowa State University study of more than 4400 middle-aged men and women.   The researchers measured both belly and waist fat as well as lean muscle mass.  Participants with belly fat accumulations were the worst problem solvers followed by those with love handles.  Those with more lean muscle mass scored the highest.   To avoid a pear-shaped body and add lean body mass, exercise with resistance training and aerobics.  Then, eating right cutting out those saturated fatty doughnuts and carb-loaded beers.   Brandon S. Klinedinst, Colleen Pappas, Scott Le, Shan Yu, Qian Wang, Li Wang, Karin Allenspach-Jorn, Jonathan P. Mochel, Auriel A. Willette. Aging-related changes in fluid intelligence, muscle and adipose mass, and sex-specific immunologic mediation: A longitudinal UK Biobank study. Brain, Behavior, and Immunity, 2019; 82: 396 DOI: 10.1016/j.bbi.20

  Vidcast:  https://youtu.be/LKuMWAYkpEc   If you hope that a 23andMe test will predict health, don’t waste your money.  The largest meta-analysis of genetic testing, completed by the University of Alberta, shows that garden-variety mutations make only a 5 to 10% contribution to most disease.   These mutations, so called single nucleotide polymorphisms or SNPs, have a negligible impact on cancer, diabetes, dementia, and most other illnesses.  They do significantly affect a few including inflammatory bowel disease and macular degeneration.   This information empowers you to prolong your life and improve its quality by what you eat and how your exercise your body and brain.  These factors, not genes in your 23 pairs of chromosomes, control 90% of your health.   Jonas Patron, Arnau Serra-Cayuela, Beomsoo Han, Carin Li, David Scott Wishart. Assessing the performance of genome-wide association studies for predicting disease risk. PLOS ONE, 2019; 14 (12): e0220215 DOI: 10.1371/journal.pone.0220215   #Genetics #23an

  Vidcast:  https://youtu.be/wPMaVIrDLvM   Pink artificial sweetener, once wrongfully accused of triggering bladder cancer, may ironically help create new cancer chemotherapy drugs.  Data just published in the Journal of Medicinal Chemistry shows that saccharin prevents cancer cells from surviving in tumors’ typical low oxygen conditions.   Saccharin blocks the activity of tumor-specific carbonic anhydrase 9 while leaving unaffected the carbonic anhydrases 1 and 2 used by normal cells.  The researchers developed compounds with similar chemical structures to saccharin and found that many could kill lung, prostate, and colon cancer cells grown in tissue culture.   These new findings should make you more comfortable using the pink sweetener.  As with most foods and additives, moderation is the by-word.   Silvia Bua, Carrie Lomelino, Akilah B. Murray, Sameh M. Osman, Zeid A. ALOthman, Murat Bozdag, Hatem A. Abdel-Aziz, Wagdy M. Eldehna, Robert McKenna, Alessio Nocentini, Claudiu T. Supuran. “A Sweet Combination”:

  Vidcast:  https://youtu.be/OHxcJZNPSx8   Children reading digital books that provide animated feedback recall more of what they read.  Educational psychologists at Pittsburgh’s Carnegie Mellon University studied ninety 3 to 5 year olds comparing their comprehension of material read from board books, static digital books and animated digital books.   When a book’s illustrations move in response to a child‘s vocal delight, that child enjoys enhanced memory of the story.  The researchers developed the animated books to model responses of enthusiastic parents guiding their children’s early reading experiences.   Ok parents!  Skip the expense and batteries by releasing your own inner child actor as you read with your kids.  Truly make the material come alive with animated faces and sounds.   Cassondra M. Eng, Anthony S. Tomasic, Erik D. Thiessen. Contingent responsivity in E-books modeled from quality adult-child interactions: Effects on children’s learning and attention.. Developmental Psychology, 2019; DOI: 10

  Vidcast:  https://youtu.be/MvRPC47OMgE   If you’re pregnant and work two night shifts in any given week, you significantly increase your chances of suffering a miscarriage.  Danish occupational medicine specialists reviewed the data from nearly 23,000 pregnant women a for a study recently published online.   The data revealed that, after the 8th week of pregnancy, women who worked two or more night shifts in any given week had a 32% higher risk of miscarriage by the following week.  The risk of miscarriage escalated as the number of night shifts and the number of consecutive night shifts increased.   Again, this study only unearths an association, and the cause of this phenomenon is unproven.  The investigators do add that night work disrupts the body’s circadian rhythms and diminishes melatonin release.   Melatonin is known to be a factor in normal placental function.   If you are on the night shift and considering becoming pregnant, ask your managers if you can join the day crew.  This is crucial if you h