Dr. Howard Smith Oncall

Vidcast:  https://youtu.be/ogsadES_aa4   Cancer survivors facing sleepless nights can be cured with basic sleep education.  Psychologists at Harvard’s Dana-Farber Cancer Institute, looking for a less resource-intense alternative to individual cognitive-behavioral-therapy, tested a simple 2 step program on some 51 participants.   It begins with a sleep-education class that makes that dry information about healthy sleep found in pamphlets come alive.  This session alone cured 41% of the group.   A second step for those with continuing problems is a short series of additional group meetings led by a psychologist or social worker.  This step brought the success rate up to 71%.   Healthy sleep is critical for all of us but particularly for cancer patients.  It stokes up the immune system and keeps the remainder of the body firing on all cylinders.   Dana-Farber Cancer Institute. "Chronic insomnia can be cured in cancer survivors with a basic sleep education class." ScienceDaily. ScienceDaily, 24 September 2019.  

Vidcast:  ttps://youtu.be/IC2HBiQBqf8   You’ll turboscharge your self-confidence by seeing yourself in the eyes of those outside your circle of peers.  A Brigham Young University study of 213 college students analyzed the phenomenon called the imposter syndrome in which even competent trainees feel they are faking it and will be embarrassingly exposed any minute.   The study shows that one in every 5 students suffers from imposter syndrome.  The most effective remedy for this self-defeating mindset is reaching out to parents and professors rather than peers for feedback on your work.   Even those suffering from imposter syndrome can perform well.  Eliminating the self-doubt just makes it easier and more pleasant for you to excel at school or work.   Richard G. Gardner, Jeffrey S. Bednar, Bryan W. Stewart, James B. Oldroyd, Joseph Moore. “I must have slipped through the cracks somehow”: An examination of coping with perceived impostorism and the role of social support. Journal of Vocational Behavior, 2019; 115

Vidcast:  https://youtu.be/Icbiaal4Abg   If you crack open that can of nuts and consume even half a serving each day, you’ll keep your weight in a healthy range and avoid obesity.  Harvard nutritional researchers conducted longitudinal studies on nearly 145,000 professional men and women for up to 24 years.   Subing in nuts for less healthy fare such as processed meats, refined grains, and sugary treats lowered the risk of gaining more than 10 pounds over a 4 year period by 23% and reduced the risk of obesity by 16%.  The investigators theorize that chewing nuts and digesting the fiber they contain tends to satisfy your appetite.   Eat those nuts, especially walnuts, instead of junk food each day.  You only need 7 walnut halves, 12 almonds, 8 cashews, 14 peanuts, or 23 pistachios.   Xiaoran Liu, Yanping Li, Marta Guasch-Ferré, Walter C Willett, Jean-Philippe Drouin-Chartier, Shilpa N Bhupathiraju, Deirdre K Tobias. Changes in nut consumption influence long-term weight change in US men and women. BMJ Nutrition

Vidcast:  https://youtu.be/SH6daqtuf0c   More than one in every 10 young persons with medical illness is currently using marijuana each day.  Public health researchers at the Universities of Nebraska and Kansas reviewed survey records from nearly 170,000 participants.   Frequency of use is highest in the youngest.  Twenty-five percent of young patients 18-24 use marijuana while only 2.4% of those over 65 do so.    The majority who use cannabis for medical purposes smoke it.   As more and more states pass medical marijuana laws, its use will continue to rise.  As that happens, standardization of available products and careful FDA oversight will help to assure safety and effectiveness.   If you are a user, be certain that your clinicians know it so that cannabis may be properly integrated into your care plan.   Dai H, Richter KP. A National Survey of Marijuana Use Among US Adults With Medical Conditions, 2016-2017. JAMA Netw Open. Published online September 20, 20192(9):e1911936. doi:10.1001/jamanetworkopen.201

Vidcast:  https://youtu.be/uwfSwkH0Hvk   At least once daily Sofrito, a sauce consisting of garlic and onions, reduces the risk of developing breast cancer by 50% or more.  Researchers at the Universities of Buffalo and Puerto Rico studied more than 300 breast cancer survivors and an equal number of healthy controls.   Those women consuming the most Sofrito showed the greatest benefit. The effect was dose-dependent, and those eating less had only a 40% cancer reduction.   Sofrito is a popular part of Latin, Spanish, Portuguese, and Italian cuisines.  This study confirms earlier ones that identified anti-cancer properties in so-called allium vegetables that include garlic and onions.  Ironically, their magic appears to be contained in the sulfur compounds that make them so smelly.   Gauri Desai, Michelle Schelske-Santos, Cruz M. Nazario, Rosa V. Rosario-Rosado, Imar Mansilla-Rivera, Farah Ramírez-Marrero, Jing Nie, Ajay A. Myneni, Zuo-Feng Zhang, Jo L. Freudenheim, Lina Mu. Onion and Garlic Intake and Breast C

Vidcast:  https://youtu.be/v4hLGckpOYI   Kids and teens who specialize in a single sport sustain more stress fractures, tendinitis, ligament tears, and musculoskeletal overuse damage.  Brown University epidemiologists and Boston Children Hospital orthopedists analyzed data from more than 10,000 youths over the past 22 years.   More serious injuries occur in those who exclusively play one sport, practice and play intensively, and in girls than in boys.  Girls bumped their injury risk by 30%.   For boys injury risk and severity rose when they played baseball or participated in gymnastics or cheerleading.   The investigators suggest that young athletes principally playing a single sport add a second one recreationally to spread physical stress over around their bodies.  They also recommend variations in practice workout exercises to achieve moderation in physical exertion.   Alison E. Field, Frances A. Tepolt, Daniel S. Yang, Mininder S. Kocher. Injury Risk Associated With Sports Specialization and Activity Volu

Vidcast:  https://youtu.be/2go_s2VQgnM   The pathologic love of yourself decreases almost 80% in most persons as they pass from their teen years into midlife.  Psychologists from the University of Illinois-Urbana-Champaign report this finding after studying some 237 participants over a 23 year period surveying them at 18 and 41 years of age.   Three key aspects of narcissism, vanity, entitlement, and leadership tendencies changed differently over time.   Vanity decreased the least and its persistence was associated with unsatisfactory relationships and broken marriages.  Entitlement decreased the most, and its demise was associated with greater life satisfaction. Leadership skills unexpectantly also decreased by 22%.   The decline of narcissism is a sign of overall psychologic maturity.  Those who gaze beyond themselves are happier and more beloved.   Eunike Wetzel Emily Grijalva Richard Robins Brent Roberts. You’re Still so Vain; Changes in Narcissism from Young Adulthood to Middle Age. Journal of Personalit

  Vidcast:  https://youtu.be/3grsczIEnEE   Regularly consuming green, oolong, or black tea at least 4 times weekly will improve your brain’s regional synchrony and your thinking skills.  A collaborative study recently published in the journal Aging looked at MRI brain imaging and neuropsychological test results as a function of tea drinking.   The imaging studies showed that regular tea drinkers had more efficient connections between various regions of their brains.  This speeds transfer of information and triggers enhanced performance on cognitive tests.   If you want to stay on the top of your intellectual game, tea makes an excellent beverage.  Previous studies have also shown that it improves your mood, reduces your risk of cardiovascular disease, and reduces your risk of age-related cognitive deterioration by some 50%.   Junhua Li, Rafael Romero-Garcia, John Suckling, Lei Feng. Habitual tea drinking modulates brain efficiency: evidence from brain connectivity evaluation. Aging, 2019; 11 (11): 3876 DOI: 1

Vidcast:  https://youtu.be/nzYmPzIEq-k   Sixty percent of adolescents ride with teen drivers who are distracted.  University of Michigan researchers report this information from their study of 877 surveyed families.   The most common distractions in the vehicle include deafeningly loud music in 46% of cases, cell phone use in 42%, and raucous teens in the back seat 39% of the time.  Even more concerning were data showing that the impaired teen driver was speeding in 45% of instances, sleepy 14% of the time, or intoxicated in 5% of cases.   Motor vehicle accidents kill more teens than any other cause.  Strongly encourage your kids to ride with peers who drive defensively and never allow them to drive with a teen who has had a license for less than 6 months.   Michigan Medicine - University of Michigan. "3 in 5 parents say their teen has been in a car with a distracted teen driver: Teens driving with teens: More than half of parents in a new national poll believe their teen has been in an unsafe situation ridin

Vidcast:  https://youtu.be/IbIaSEhMt7c   Growing cannabis plants give off biogenic volatile organic compounds, BVOC for short, that can poison those exposed.  Besides the BVOCs from the plants, the oil extraction process gives off another, butane.  Together, these organic compounds create highly toxic ground-level ozone.   Researchers from Nevada’s Desert Research Institute studied emissions from four growing facilities in both Nevada and California.   The large number of plants at each location produce large amounts of BVOCs and ozone.  Nevada and California already exceed acceptable levels of group level ozone,   If you are growing marijuana, be certain to protect yourself sand your community from the fumes.  If you’re growing it legally, consult with the EPA and seek out ways to protect yourself and your community.   Vera Samburova, Mark McDaniel, Dave Campbell, Michael Wolf, William R. Stockwell, Andrey Khlystov. Dominant volatile organic compounds (VOCs) measured at four Cannabis growing facilities: pilo

  idcast:  https://youtu.be/bILq94CbJoc   Give kids active toys like bikes, skates, scooters, slides, and swings that motivate them to physically exert themselves.  When you do, they will not be among the more than 80% of kids who never meet physical activity guidelines.   These specify at least one hour of vigorous activity each day.   Researchers at the University of Queensland studied more than 4000 children 5-17 years of age.  Predictably, those with more active toys and relatively fewer electronic toys more often met physical activity goals.   Fabricating your kids’ world to promote physical activity teaches them to care for their bodies. This educational gift is the most valuable they’ll ever receive.   Katrina M. Moss, Annette J. Dobson, Kimberley L. Edwards, Kylie D. Hesketh, Yung-Ting Chang, Gita D. Mishra. Not All Play Equipment Is Created Equal: Associations Between Equipment at Home and Children’s Physical Activity. Journal of Physical Activity and Health, 2019; 1 DOI: 10.1123/jpah.2019-0075   #Ex

Vidcast:  ttps://youtu.be/r6alvHymzwg   Simply rubbing your hands with Purell™ or  knock-offs will not kill the influenza virus.  A Japanese study just published by the American Society of Microbiology shows that the mucus that contains the virus protects it from alcohol-based hand sanitizers.   The typical 15-30 second sanitizer rub won’t kill the flu virus, or probably any virus, unless the secretions are dried.  The good news is that first washing your hands with an antiseptic soap for 30 seconds will kill virus.     You don’t have antibacterial soap but do have Purell?  I suggest quickly washing your hands with any soap to eliminate mucus and then use the hand sanitizer.    Ryohei Hirose, Takaaki Nakaya, Yuji Naito, Tomo Daidoji, Risa Bandou, Ken Inoue, Osamu Dohi, Naohisa Yoshida, Hideyuki Konishi, Yoshito Itoh. Situations Leading to Reduced Effectiveness of Current Hand Hygiene against Infectious Mucus from Influenza Virus-Infected Patients. mSphere, 2019; 4 (5) DOI: 10.1128/mSphere.00474-19   #Influenz

Vidcast:  https://youtu.be/GIM0xl8Rs10   Babies delivered by C-section rather than by a normal vaginal route develop a gastrointestinal bacterial population contaminated by bad bugs found around the hospital.  Their gut bacteria include antibiotic-resistant ones rather than the more benign species found in their mothers.   British researchers studied 600 healthy babies to identify their gut bacteria using DNA fingerprinting techniques.  The C-section babies had more than 800 potentially-dangerous bacteria, of the type that cause life-threatening, blood-borne infections in hospitalized patients.   These observations mandate that C-sections be avoided except for life-threatening situations.  Elective c-sections for convenience are foolish and unnecessarily risky.   Yan Shao et al. Stunted gut microbiota and increased pathogen colonisation associated with caesarean birth. Nature #2019 DOI: 10.1038/s41586-019-1560-1   #Caesariansection #microbiome #antibioticresistantbacteria

Vidcast:  https://youtu.be/bTWGLdnm90w   If you prefer more conservative medical therapy but must visit a surgeon for a consultation, pick an appointment at the end of day or just before lunch.  You’ll be half as likely to hear a recommendation for surgery.   A Swedish study of some 848 orthopedic appointments confirms that, when doctors are relatively fatigued, they avoid difficult or risky decisions.  Patients visited the orthopods during a total of 133 office sessions including morning, afternoon, or all-day.  The surgeons recommended operations more than 40% of the time earlier in the sessions but only 22% of the time at the end of any given session.   In general, if you can, see clinicians at the beginning of any given office session.  Their minds will be fresh and they will most likely be on time.   Emil Persson, Kinga Barrafrem, Andreas Meunier, Gustav Tinghög. The effect of decision fatigue on surgeons' clinical decision making. Health Economics, 2019; DOI: 10.1002/hec.3933   #Surgery #officevisits #c

Vidcast:  https://youtu.be/-81VImw-zEo   The prevalence of heart infections, bacterial infestations of the valves and cardiac linings known as endocarditis, have nearly doubled in drug abusers.  Cardiologists at the Cleveland Clinic studied nearly 1 million hospitalized patients with this disorder to understand the causes.   The drug users who developed bacterial endocarditis were predominately young, white men with incomes among the lowest 25%.  They had higher rates of concurrent hepatitis C, alcohol abuse, and HIV infection compared with non-drug abusing cardiac patients.  They were more likely to require heart surgery and had longer hospital stays and higher health care expenses.   Bacterial heart infections occur when germs enter the bloodstream, usually from reused and contaminated drug paraphernalia.  If you must use drugs, hopefully to withdraw from them, consume them by mouth.  If not, enlist help from clinicians to obtain sterile equipment.   Amer N. Kadri, Bryan Wilner, Adrian V. Hernandez, Georges

Vidcast:  https://youtu.be/BV1PEQG6hzk   WikiHow’s 3 step program to become extroverted.  It is excellent, and I will paraphrase it.   ONE: Have the mindset. TWO: Do the work. THREE: Engage with others.   Have the mindset:  Value Extroversion: make friends easily, comfortable in crowds, keep a party going. Envision yourself as a good extrovert: not phony or hurtful. Select a spot on the extrovert spectrum. Look forward to feeling better about yourself. Know transition is difficult.   Do the work:  Observe. Perform. Start small. Be around people. Know yourself Walk on the wild side.   Practice: Find the right group. Play your strengths Talk Assert yourself Interrupt politely Attract attention Make people laugh Keep the party going.     https://www.wikihow.com/Be-an-Extrovert   #Extroversion #introversion #acting

Vidcast:  https://youtu.be/eFtj42jop5Q   If you’re quiet and withdrawn by nature, you’ll be happier if you push yourself to be outgoing.  UC-Riverside psychologists studied 123 subjects classifying them as introverts or extroverts.   Investigators coached each participant to act, for one week, as quiet, reserved introverts or as talkative, outgoing, “life of the party” extroverts.   The participants reported greater feelings of well-being during their week spent as extroverts.   Those who were naturally quiet and had to work the hardest to be talkative and spontaneous showed no ill effects as the result of the charade.   We are all actors of sorts, and this study shows that it is healthy to get outside yourself.  Humans are naturally social animals, and the qualities associated with extroversion facilitate that tendency.   Seth Margolis, Sonja Lyubomirsky. Experimental manipulation of extraverted and introverted behavior and its effects on well-being.. Journal of Experimental Psychology: General, 2019; DOI: 1

Vidcast:  https://youtu.be/4V_LSBkMV5s   Four months on a plant-based, low fat diet can cleanse your gut and leave you with a healthier microbiome that helps you control your weight, improve your body composition, and avoid diabetes.  The Physician Committee for Responsible Medicine demonstrated this result after studying 147 subject half of whom followed the vegan program.   Those foregoing meat and fish showed significantly reduced body weights, a significantly lower fat mass, an increase in their insulin sensitivity, and a healthier gastrointestinal bacterial composition.  The investigators conclude that the fiber from the plant-based diet is the magic sauce that refines the gut microbiome.   If you’re looking for a healthy way to lose some weight and improve your metabolism, take a break and become a vegan for 12 weeks.   Diabetologia. "Short-term study suggests vegan diet can boost gut microbes related to body weight, body composition and blood sugar control." ScienceDaily. ScienceDaily, 16 September 201

Vidcast:  ttps://youtu.be/0PQgrkKSGSw   You’ll make poor choices and turn in awful intellectual performances on an empty stomach.  Psychologists at Scotland’s University of Dundee put 50 participants to the test either 2 hours after eating or following a 10 hour fast.   Test results revealed that hunger triggers impatience, impulsivity, and a need for immediate gratification .  The well-fed were willing to wait over a month for a substantial reward while the hungry could only manage 3 days.   If you want and need consistent mental performance, start with a good breakfast and eat regularly.  The researchers add, of course, that you shouldn’t food shop when you’re hungry.   Jordan Skrynka, Benjamin T. Vincent. Hunger increases delay discounting of food and non-food rewards. Psychonomic Bulletin & Review, 2019; DOI: 10.3758/s13423-019-01655-0     #Hunger #impulsivity #impatience

Vidcast:  https://youtu.be/OSjfU5mXNbI   Studies prove that oral exposure to peanut protein can tame deadly peanut allergies.   The FDA just approved a drug therapy program, Palforzia, to do just that.     A Stanford University study now shows that peanut reactivity will return unless therapeutic peanut exposures continue.   The researchers studied 120 peanut-allergic participants.    After nearly 3.5 months of ever increasing peanut protein, all were successfully desensitized and could safely consume the equivalent of 200 peanuts.  Stopping the 200 peanut treatments completely or continuing with daily exposures of only 15 peanuts a day failed to maintain peanut non-reactivity.   This result suggests that any desensitization program, including Palforzia, will require continuation of therapy for an extended period.  It would be dangerous to stop.    R Sharon Chinthrajah, MD ,Natasha Purington, MS, Sandra Andorf, PhD, etal.  Sustained outcomes in oral immunotherapy for peanut allergy (POISED study): a large, ra