Dr. Howard Smith Oncall

Swimming Too Hard Triggers “Swimmer’s Shoulder”Vidcast:  https://youtu.be/blWE7iLH_Mc   Overzealous coaches and a winning obsession may be damaging high school swimmers’ shoulders.  Data from 150 such athletes was just presented to the American Academy of Pediatrics.   Nearly 77% report pain, 66% just suck it up hoping to become better swimmers, and 51% know a peer regularly using pain medicine.  Pain with possible joint damage is related to practice intensity: little or no pain from swimming 1600-3500 yards but definite pain swimming 2,000 to 6300 yards.   Swimming is a terrific sport, but developing bodies are vulnerable to repetitive trauma and overuse damage.  If your kid is a swimmer complaining of shoulder pain after and between practices, have a word with the coach.   American Academy of Pediatrics. "'Swimmer's shoulder,' common in more than three-quarters of swimmers: Research shows that painful swimmer's shoulder may be due to heavy training load and a 'no pain, no gain' work ethic." ScienceDaily. Sc

Vidcast:  https://youtu.be/h0U1Gf37Yl0   Nearly 4 extra years of education cuts a risk of alcohol dependence by 50%.  National Institutes of Health investigators draw this conclusion from their study of 780,000 participants.   The genetic markers linked to more education were not associated with less alcohol consumption but rather with less binge drinking, fewer memory gaps due to drinking, fewer drinks on average per drinking day, and a lower weekly intake of beer or hard cider.  Added education did link to more alcohol with meals and more wine consumption.   Our politicians now talk about extending public education to include 4 years of college or vocational training.  One benefit of these additional years after high school may be fewer Americans with alcohol addiction.   Rosoff et al. Educational attainment impacts drinking behaviors and risk for alcohol dependence: results from a two-sample Mendelian randomization study with ~780,000 participants. Molecular Psychiatry, 2019 DOI: 10.1038/s41380-019-0535-9

Vidcast:  https://youtu.be/BvpOnQHfbeg   If you are having a baby, try to do it during the day on a weekday.  A new study from the Colorado State University reviews data from more than 2 million Texas births over a 5 year period and pinpoints the riskiest times to give birth.   Obstetric complications are nearly 30% higher on holidays, about 20% higher during night shifts,  and 9% higher on weekends.  If you deliver in a teaching hospital in July when the new residents first arrive, the complication risk is an average of 28% higher.    Hospitals are sites where medical miracles occur, but, given the nature of human frailty and exhaustion, so too can medical mishaps.  When you or a family member is hospitalized, keep your eyes open and advocate for your own best interests in a friendly way.  Then, if you can, try to avoid those holidays, nights, and weekends.   Sammy Zahran, David Mushinski, Hsueh-Hsiang Li, Ian Breunig, Sophie Mckee. Clinical Capital and the Risk of Maternal Labor and Delivery Complications:

Vidcast:  https://youtu.be/3lQomJHLMWE   Soccer playing seems to increase the risk of developing ALS or amyotrophic lateral sclerosis. This is the conclusion of an Italian study that reviewed the medical records of all professional soccer players in the Italian leagues between 1959 and 2000.   Players were followed for at least 16 years after their playing days ended.   The data showed that nearly twice as many soccer players as expected  developed ALS, and nearly 5 times as many younger players 45 years or less fell ill.  The average age at ALS diagnosis in the general population is just over 62 years but the average age at which soccer players developed the disease is age 40.   Since ALS development is associated with a history of head injury, soccer heading is the likely culprit.  Parents, please listen up!  If your child is playing soccer at any age, insist that they not do any heading.  Ask their coaches to enforce a strict no-heading rule.     Soccer is called football in Europe and for good reason.  Ba

Vidcast:  https://youtu.be/V_o6df79H60   Teen hypertension doubles the risk of end stage renal failure later in life.  A study just published in JAMA Internal Medicine looked at more than 1.5 million candidates for Israeli military service.  Of this group, nearly 8000 were found to have elevated blood pressures.   Those with hypertension were predominately male and half were overweight or obese.  They were followed for nearly 20 years.  Teen hypertension doubled the risk of eventual kidney failure, a need for dialysis, and a possible kidney transplant even for those who were not overweight.   Elevated blood pressures in children have become more common as the rate of childhood and adolescent obesity skyrockets.  Pediatricians now recommend that every child over the age of 3 years should have their blood pressures checked annually.     If their pressures are elevated, they should be measured at every visit and treated aggressively initially with lifestyle changes such as weight reduction, dietary modification,

Vidcast:  https://youtu.be/zYZvlJq3Il4   Want a mental boost in 20 short minutes?  It’s a simple as getting off your couch and visiting a nearby park.  If you prefer, you don’t even need to exercise to get the benefit.   Researchers at the University of Alabama-Birmingham’s Department of Occupational Therapy document a significant improvement in emotional well-being for those who choose to visit one of three local parks.  They tabulated the results and found that the benefits would accrue even to those unable to pursue physical activities due to disability.   If you think about it, you’ll be surprised to find just how close a green space is to your home or work.  Get over there, clear your mind, and take a 20 minute or longer mental vacation.   Hon K. Yuen, Gavin R. Jenkins. Factors associated with changes in subjective well-being immediately after urban park visit. International Journal of Environmental Health Research, 2019; 1 DOI: 10.1080/09603123.2019.1577368   #greenspace #urbanpark #relaxation

Vidcast:  https://youtu.be/85jJpOtXbxQ   Food with lots of sugar and fat is associated with significant psychologic distress.  This conclusion comes from a study of nearly quarter million Californians participating in the California Health Interview Survey.   The study showed that nearly 17 percent of Californians had psychological distress associated with frequently consuming unhealthy foods.  Other factors such as gender, age, and socioeconomic status were less important.   This represents more proof that “you are what you eat.”  To maintain your weight and your health, stick with clean foods: fruits and vegetables with the addition of chicken and fish as protein sources.   Jim E. Banta, Gina Segovia-Siapco, Christine Betty Crocker, Danielle Montoya, Noara Alhusseini. Mental health status and dietary intake among California adults: a population-based survey. International Journal of Food Sciences and Nutrition, 2019; 1 DOI: 10.1080/09637486.2019.1570085   #junkfood #fats #sugars #neurosis #psychologicdistre

xvid https://youtu.be/ToiYYvmAGmQ   Our cells, like our homes, fill up with garbage very fast.  The latest research from Harvard Medical School reveals that vigorous exercise and even some fasting will help our cells with their housekeeping duties of removing damaged, toxic, and unnecessary proteins.   Previous studies have shown that the signal for flushing your cells is the messenger molecule cyclic-AMP.  This new discovery that exercise triggers the dumping junk proteins from the cell is almost certainly explained by that fact that exercise bumps up your adrenalin and that, in turn, triggers a burst of cyclic-AMP.   Since cell garbage plays a key role in neurodegenerative diseases such as Alzheimer’s and Parkinson’s as well as storage diseases like amyloidosis, it may well be that prevention of these dread diseases can be added to the list of exercise’s benefits.   #exercise #cellcleansing #cAMP #Alzheimers #Parkinsons   Jordan J. S. VerPlank, Sudarsanareddy Lokireddy, Jinghui Zhao, Alfred L. Goldberg. 26S

Vidcast:  https://youtu.be/5C8p2QDuUm4   Our shoulders take a lot of abuse, and the latest statistics reveal a 6-fold increase in shoulder replacement surgery over the past 20 years.  You’re probably thinking...so what.  We can replace any joint at will, and there is already a good track record for hip and knee replacements.   The problem is that joint replacements don’t last.  They wear out, like any mechanical device.   The latest study from the University of Oxford’s orthopedic surgeons reveals that nearly one in four young men will require ultimately a revision of their shoulder surgery, and the artificial shoulders fail most often during the first 5 years after placement.  Trying to revise shoulder replacements can be complicated and risky.  Living bone and metal replacement parts don’t always play nice with each other.   Shoulder replacements aren’t the only artificial joints that fail or wear out.  Hip and knee replacements each only last about 10-20 years.     The overwhelming driver of replacement jo

Vidcast:  https://youtu.be/XaMm0m4v-NQ   Regularly smoking more than one pack a day may reduce your ability to see colors.  A study from New Jersey’s Rutgers University compared the visual prowess of more than 60 regular smokers with a similar number of controls who smoked fewer than 15 cigarettes in their whole lives.   Those smoking 20 plus cigarettes a day, every day, reported significant degradation in their red-green and blue-yellow color vision and could not easily see contrasting images.  The researchers have not yet pinpointed which chemical toxins in cigarettes damage the retina, but they also point out that a cigarette smoking habit yellows your eye lenses and doubles the risk of age-related macular degeneration.   Here is yet more proof that smoking is bad for your body.  If it doesn’t kill you, and it will, it may suffocate and blind you.   Thiago P. Fernandes, Steven M. Silverstein, Natalia L. Almeida, Natanael A. Santos. Visual impairments in tobacco use disorder. Psychiatry Research, 2019; 271:

https://youtu.be/jO3AfALckJE A Danish study published in BMJ Open reports that short, standard acupuncture sessions will significantly reduce moderate to severe menopausal symptoms.   Investigators at the University of Copenhagen using a crossover protocol administered weekly acupuncture therapy for 5 consecutive weeks to a treatment group while the controls received no treatment.  Then, the controls received the acupuncture and the initially treated subjects were merely observed.     The assessors who questioned participants about their symptoms were unaware of the treatment received.  The tabulated results showed that the acupuncture therapy significantly diminished hot flashes, sweats day and night, sleep issues, emotional symptoms, skin, and hair complaints.   If you are suffering from menopause-related symptoms and are unable to get relief from conventional Western medicine, do seek out a qualified acupuncture specialist.  Complementary and alternative therapy can be very effective.   Lund KS, Siersma V,

Vidcast:  https://youtu.be/VgrYfoKJD6I   As our families add children, we parents turn to our older children and encourage them to be the new arrival’s big brother or sister.  The latest intelligence from psychologists at Britain’s University of Warwick reveals the worrisome intelligence that the older siblings instead tend to bully the younger ones.   The researchers tabulated data from nearly 6900 British children who were studied at ages 5, 7 and 12 years.  A total of 28% of the children were involved in sibling bullying, and many were both bullies and victims.  Bullying occurred more often in families with 3 or more children, and the eldest child or older brothers were most often the bullies.   Bullying tends to be rampant in any situation where humans live in close proximity, know which buttons to push, and compete for parental attention and other limited resources.  Older children often resent the younger ones who came along to rob them of their only child privilege.     Parents must guard against sibli

Vidcast:  https://youtu.be/3V6fqO7M0sg   Capuchin and Rhesus monkeys think outside the box better than people when it comes to problem solving.  Psychologists at Georgia State University pitted 29 monkeys against 60 college students in a computer game contest.   The monkeys figured out shortcuts to victory faster and used them more often than the students.  Other experiments show that chimpanzees and baboons also perform better than humans, who tend to rely more on familiar strategies demonstrating less so-called cognitive flexibility.   We humans are often victims of our learned biases about vaccines, climate change, race, and politics.  Be a monkey’s uncle, and make the most of your innate brainpower by opening your mind and unleashing your imagination.   Julia Watzek, Sarah M. Pope, Sarah F. Brosnan. Capuchin and rhesus monkeys but not humans show cognitive flexibility in an optional-switch task. Scientific Reports, 2019; 9 (1) DOI: 10.1038/s41598-019-49658-0   Monkeys, problemsolving, creativity

Vidcast:  https://youtu.be/HmUUF6hRgGw   A pregnant woman under emotional or physical stress is more likely to give birth to a male.  Epidemiologists and obstetricians at New York’s Columbia University report this association after analyzing data from 187 women.    In a general population, the chance of birthing a boy is 51%.  For women suffering emotional stress, marked anxiety, and depression, that percentage drops to 40%.  Physical stress including blood pressure and weight problems, drops the chance to 31%.  Stress also diminishes normal fetal heart rate changes and triggers birth complications.    The antidote to all this stress is love, social support, and professional care.   If you’re pregnant, see that you get it.  If you care for those who are pregnant, give it!   Kate Walsh, Clare A. McCormack, Rachel Webster, Anita Pinto, Seonjoo Lee, Tianshu Feng, H. Sloan Krakovsky, Sinclaire M. O’Grady, Benjamin Tycko, Frances A. Champagne, Elizabeth A. Werner, Grace Liu, Catherine Monk. Maternal prenatal stres

Vidcast:  https://youtu.be/guaG2awiXAM   Intense focus on the here and now that is at the heart of mindfulness techniques will help control cravings for pain killers as well as the pain that necessitates their use.  Rutgers University investigators studied 30 patients with opioid addiction due to chronic pain who were participating in a methadone withdrawal program.   The addition of mindfulness exercises led to a 30% reduction in the participants narcotic cravings as well as their nagging pain.  Their stress levels declined while their positive thoughts escalated.   Complete, lasting withdrawal from narcotics using methadone maintenance is only about 50% successful.   Mindfulness therapy might just be the secret sauce to drive that statistic toward 100%.   Eric L. Garland, Adam W. Hanley, Anna Kline, Nina A. Cooperman. Mindfulness-Oriented Recovery Enhancement reduces opioid craving among individuals with opioid use disorder and chronic pain in medication assisted treatment: Ecological momentary assessments

Vidcast:  https://youtu.be/Sjxtdv7Pix0   I’m attending the National Assn. of Broadcasters Meeting this week.  Here is some evergreen “Health News You Can Always Use.”   We’ve all heard about the narcotic epidemic.  The real news is that there are potent weapons to combat opioid use as close as our medicine cabinets.     Ibuprofen, generic or branded Advil or Motrin, either alone or with acetaminophen, generic or Tylenol, significantly reduced the need for postoperative morphine in a study of more than 550 patients undergoing hip surgery.     The subjects started their oral pain meds one hour before surgery and continued to receive them every 6 hours for the first day after surgery.  The patients were able to obtain any additional pain relief they needed by pushing a button to self-administer IV morphine.   The finding that 400 mg of ibuprofen, that’s two adult pills, taken every 6 hours kills pain exceedingly well and eliminates the need for more powerful drugs should be useful information to you.  If you are

Vidcast:  https://youtu.be/lCgarvg7Y1M   I’m attending the National Assn. of Broadcasters Meeting this week.  Here is some evergreen “Health News You Can Always Use.”   Marijuana use is spreading like wildfire, and the prevailing opinion is that its components are harmless.  Another of this weeks stories highlights its potential danger for those with heart problems.  Now a study from Britain’s University of Oxford and Canada’s McGill University shows that regular cannabis use in adolescence can trigger adult depression and suicidal ideas.   The researchers reviews 11 international studies covering more than 23,000 young persons.  Regular weed use by an individual bumped his or her risk of serious depression and suicide up by a factor of about 7%.  The number isn’t huge, but the consequences are tragic for that person so affected.  Then when you amplify the individual effect over a population, it translates into more than 400,000 cases of deadly depression in the U.S., 60,000 case in the U.K., and 25, 000 case

Vidcast:   https://youtu.be/oit_IwHdblE   I’m attending the National Assn. of Broadcasters Meeting this week.  Here is some evergreen “Health News You Can Always Use.”   One study after another heralds the advantages of breastfeeding.  Some mothers turn to pumping their breast milk when their flow is sporadic or when they develop conflicts with sib childcare or the demands of work.  Do babies enjoy the same advantages from ingesting pumped breast milk?   The short answer is an emphatic NO.  Researchers from Canada’s University of Manitoba studied the breast milk of almost 400 healthy mothers 3 to 4 months following delivery.  Using sophisticated genetic probes, they showed that the milk the babies actually ingested was healthier when it came directly from the mother’s breast.     The natural breast milk contained good bacteria from both the mother and from the mouth of the infant.  The pumped breast milk contained those bugs but also an abundance of bad bacteria, opportunistic types that are capable of causin

Vidcast:  https://youtu.be/CmwdpRQqV_0   I’m attending the National Assn. of Broadcasters Meeting this week.  Here is some evergreen “Health News You Can Always Use.”   Exercise not only strengthens your heart, tones your muscles, and drives more blood flow to your brain, it also trains your fat cells to release healthy proteins into your blood that help keep your body humming.  New research from Harvard’s Joslin Diabetes Center just published in Nature Metabolism demonstrate that exercise-primed fat releases a healthy so-called adipokine that improves glucose metabolism.   This magic protein, Transforming Growth Factor Beta 2 or TGFbeta2, appears in both humans and mice as the result of exercise.  It controls blood sugar levels and neutralizes the effect of a high fat diet which in mice and in many humans induces diabetes.   Your muscles do play a role in the process too.  The lactic acid they produce as you exercise appears to be the trigger that leads to TGFbeta2 release from fat.  The investigators specul

Vidcast:  https://youtu.be/vOcrGIm3oYQ   I’m attending the National Assn. of Broadcasters Meeting this week.  Here is some evergreen “Health News You Can Always Use.”   Take out meals, just like sit-down restaurant offerings, are way too large with way too many calories.  A British fish n’ chip wholesale supplier cooperated with academic nutritionists at Newcastle University to design what they call the Lite-BITE® box carry out box as part of a UK national campaign to fight obesity.   The usual fish and chip take out meal clocks in at over 1600 calories which is almost an entire day’s caloric tally.  The Lite-BITE® box holds 5 ounces of fish and 5 ounces of chips for a more moderate 650 calories.   Fried fish and fried potatoes are hardly healthy choices, but at least the smaller take-out box keeps the calorie count down.   If a you as a  diner need a more filling meal, a side salad should complete your order.   Right-sizing portion size is a powerful tool in maintaining a healthy weight.  Smaller takeout box