Dr. Howard Smith Oncall

Vidcast:  https://youtu.be/n-VPKjhnrRU If a child swallows a button battery that has passed into the stomach, a study to be presented to the Digestive Disease Week annual meeting concludes that the ingested object must be removed quickly to prevent damage to the gastrointestinal tract linings.  Current recommendations suggest wait and see to allow the battery to pass through the gastrointestinal system.  These tiny coin-shaped batteries are found in small electronic devices including toys, key fobs, talking greeting cards, watches, and hearing aids. A study by the Children’s Hospital Colorado that presents data from 68 kids treated at children’s hospitals in that state, Florida, and Ohio.  The findings indicate that acid released by these ingested batteries leads to corrosive stomach lining injuries 60% of the time. Because of this damage, the authors’ recommendation for immediate removal of the coin battery is far more aggressive and proactive than the current wait and see guidelines issued by the North Amer

Vidcast:  https://youtu.be/ZIK07yBWRcA A study just published online by the New England Journal of Medicine is challenging the way we manage asthma.   For decades, inhalation of the short-acting bronchodilator albuterol, sold as Proventil and Ventolin, has been the recommended treatment for attacks with the addition of an inhaled steroid for maintenance of easy breathing. A collaborative group from New Zealand, Australia, and Britain now demonstrates that the inhaled steroid+long acting bronchodilator combo budesonide-formoterol, marketed as Symbicort, and only used when needed not only works effectively to stop asthma attacks but also prevents them with less steroid exposure for the patient. The study included 688 adult asthma patients in 3 treatment groups who randomly received either as-needed albuterol, as-needed budesonide-formoterol, or daily budesonide with the addition of albuterol as needed.  The results showed that as-needed steroid+long-acting bronchodilator reduced the incidence of severe asthma a

Vidcast: https://youtu.be/MtNakRwjYu0 Health News You Should Use, the latest medical discoveries and commonsense advice that you can use in a practical way to keep yourself and your family healthy.   Here are this weeks stories and a selections of news from the past several weeks: Prophylactic Antibiotic Dose Improves Instrumented Vaginal Deliveries  How Much Coffee Is Too Much Sunscreens Won’t Lower Your Vitamin D But May Be Toxic Meditation Could Backfire Losing Your Appendix May Bump Up Your Parkinson’s Risk Recreational Sports Improve Grades Avocado Kills Hunger Skin-sparing Mastectomy A Safe Alternative Cialis Helps Heart Failure Nuts to High Blood Pressure An Early Diagnosis of Autism Is Possible Morning Workouts Drive Better Thinking E-Cigarettes Are Contaminated With Bacteria and Fungi A Simple Test Predicts Lasting Concussion Effects Late Pregnancy Ultrasound Benefits Mother, Baby, and Bottomline Children’s Author Roald Dahl Speaks About Measles For more information, you’ll find all the references fo

Vidcast:  https://youtu.be/9DzvBHZ9CzU The author of “Charlie and the Chocolate Factory” and “Matilda,” Roald Dahl, wrote in 1988 about his experience when his daughter developed measles.  "Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything. 'Are you feeling all right?' I asked her. 'I feel all sleepy,' she said. In an hour, she was unconscious. In twelve hours she was dead.” Dahl went on: “The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her. That was...in 1962, but even now, if a child wit

Vidcast:  https://youtu.be/CU2WZFt3CZ8 A planned ultrasound at 36 weeks will detect undiagnosed breech presentations in time to allow intervention and prevention of dangerous fetal distress and emergency c-sections.  This recommendation springs from a study by public health specialists at Britain’s University of Cambridge. The investigators screened nearly 3900 women during their first pregnancies with a 36 week ultrasound.  The screening detected a 4.6% incidence of breech presentation more than half of which were unsuspected.  The women were given the choice of attempting to turn the baby, so-called external cephalic version, or a an elective c-section. Those whose babies would not reposition underwent the elective c-section. In the UK, the 36 week ultrasound that costs about 13 pounds or US$17, would prevent about 15,000 undetected breech presentations, more than 4,000 emergency c-sections and 8 baby deaths a year.  The effects are even more dramatic when extrapolated to the US population. If you are pregn

Vidcast:  https://youtu.be/RvII1BZlmOU Pediatric sports medicine specialists at the University of Colorado report that a simple test, the Romberg test, can predict which children will suffer lasting effects from a concussion and would benefit from proactive therapy.  Their study was just published in the Journal of Neurosurgery;Pediatrics. The data from more than 350 children and adolescents with a mean age of nearly 15 years showed that an abnormal Romberg balance test was the best predictor of prolonged symptoms after the traumatic brain injury.  This test was more predictive than other variables including self-reported headache severity, headache frequency, confusion, forgetfulness,  inattention, memory lapses, fatigue, and dizziness failed to correlate with the duration of issues post-concussion. The Romberg test is simple to perform.  The subject stands with feet together and eyes closed.  The test is deemed positive if the individual cannot maintain balance with minimal movement. This finding is importa

Vidcast:  https://youtu.be/PqKyUnQe-Mc Need more reasons not to use e-cigarettes and to convince your children to avoid them?  Besides the fact that they spew addicting nicotine and toxic flavoring chemicals?   A study from the Harvard School of Public Health now finds bacterial endotoxins and fungal cell wall remnants in 75 popular e-cigarette products from 10 top-selling US brands. The investigators studied 37 e-cigarette cartridges and 38 e-liquid products that are used to refill cartridges.  They demonstrated that 23% of the products contained significant concentrations of gram-negative bacterial endotoxins and a whopping 81% of the products were contaminated with fungal by-products.   Other studies have confirmed that these bacterial endotoxins and fungal glucans trigger acute and chronic respiratory problems.  Asthmatics or those with pre-existing lung disease would be particularly vulnerable. This study joins so many others that underscore what is just common sense: don’t inhale poisons unless you have

Vidcast:  https://youtu.be/Xvpv230Tovc Starting the day with a moderate-intensity walking exercise session does help your mind function better.  The latest Australian study just published in the British Journal of Sports Medicine, looked at more than 65 subjects of all genders and 55 to 80 years of age. The morning workout was associated with improved attention, concentration, executive function, visual learning, and working memory.  The study also revealed that periodic 3 minute walking breaks during the day further improved test results when compared with those clocked by those who had no additional exercise after the morning session. This study is additional proof that the extra exercise-driven blood flow to your brain and the exercise-induced chemical agents such as endorphins that flow in that blood fine-tune your brain to perform optimally.  Although the study was completed in middle-aged and older persons, the exercise would likely also benefit anyone of any age. Michael J Wheeler1,2, Daniel J Green1,

Vidcast:  https://youtu.be/v1aLm03-Ujg Neuroscientists at the University of California-San Diego’s Autism Center of Excellence now report that autism may be reliably diagnosed in babies as young as 14 months thereby permitting effective, early intervention.  The researchers studied more than 1200 toddlers who were first evaluated between their first and third birthdays and were then followed with at least one additional thorough assessment later in childhood. The ability to reliably diagnose autism or autism spectrum diagnosis occurs by 14 months of age.  Diagnostic reliability is only 50% at 12 months, rises to 79% by 14 months, and is 83% by 16 months.  Only 2% of those first diagnosed with autism during infancy later had that diagnosis dropped. The mean age at diagnosis for autism is currently between 3 and 4 years.  Research studies suggest that autism in its many shades develops in utero during the first or second trimesters, and this new information confirms that a reliable, earlier diagnosis is definit

Vidcast:  https://youtu.be/KgQBWuFn7SM Eating walnuts instead of other sources of fat in a diet can lower your blood pressure.  This conclusion comes from a study of 45 overweight or obese subjects by nutritionists at Penn State just published in the Journal of the American Heart Association. The investigation found that eating walnuts to replace at least 5 percent of the typical 12 percent saturated fat that most Americans consume significantly lowered the body’s central diastolic or resting blood pressure. A normal diastolic pressure level is key for preventing heart disease and stroke.  The walnuts did not lower either systolic blood pressure or arterial stiffness. The next time you’re looking for a heart healthy snack, skip the potato chips and reach instead for the can of walnuts.  For an even greater effect, replace those french fries you know you always order with walnuts and green beans.  Your heart and circulation will be glad you did. Alyssa M. Tindall, Kristina S. Petersen, Ann C. Skulas‐Ray, Chesn

Vidcast:  https://youtu.be/axAxR1HvtK8 Tadalafil, marketed as Cialis, is one of the popular drugs used for erectile disfunction (ED).  Now a study at Britain’s University of Manchester shows that cialis slows or reverses the progression of congestive heart failure. The study, just published in the journal Scientific Reports, was carried out in sheep since their hearts are physiologically similar to the human heart.  Heart failure was induced in the sheep using pacemakers to overdrive and exhaust their hearts. When the sheep were given Cialis at a dose equivalent to that taken by humans for ED, their heart function improved and their hearts were again capable of responding to adrenaline, a key signaling agent in both sheep and humans.  Cialis and drugs like it including Viagra work in part by dilating blood vessels, and this effect may reduce the resistance against which the heart must pump, the so-called after load, permitting it to function better. More studies are needed to explain the exact mechanism of ac

Vidcast:  https://youtu.be/2ldqpbInV8s A new Mayo Clinic study shows that many breast cancers may be safely and completely removed without sacrificing the overlying skin and nipple.  This study is being presented to the American Society of Breast Surgeons annual meeting this month. The study looked at skin and nipple-sparing mastectomies in 769 women undergoing a total of 1300 surgeries.  At one year following surgery, the technique was considered a success in 97% of cases both in terms of cancer eradication and breast reconstruction. Longer-term followup data will be necessary to determine whether or not skin- and nipple- sparing will become the norm.  Even at this point, though, this information from Mayo suggests that such conservative surgery should be considered an option for many women. Mayo Clinic. "Less-invasive mastectomy safe for more breast cancer patients." ScienceDaily. ScienceDaily, 2 May 2019. . #mastectomy #skinsparing #nipplesparing

Vidcast: https://youtu.be/9719lEJfRc8 If you’re looking to suppress your hunger without “pigging out” and bumping up your daily calorie count, try substituting avocados for carbs in your diet.  Nutrition scientists at the Illinois Institute of Technology studied some 31 overweight and obese subjects and modified their diets. They replaced carbohydrate calories with fat calories from avocados on a calorie-for-calorie basis.  They used either whole avocados or half avocados to create dose-response data. The final results demonstrated that avocados can suppress hunger and increase the hormones typically released when a person feels full.  The fats and fiber contained in avocados are healthy additions to anyone's diet, and this soft fruit is a useful weapon in the battle against obesity and diabetes. Lanjun Zhu, Yancui Huang, Indika Edirisinghe, Eunyoung Park, Britt Burton-Freeman. Using the Avocado to Test the Satiety Effects of a Fat-Fiber Combination in Place of Carbohydrate Energy in a Breakfast Meal in Overw

Vidcast:  https://youtu.be/uZ8R9XqIQPA Ok college students!  Looking to bump up your GPA?  Get yourself signed up for intramural sports ASAP! A study of some 1800 Michigan State University freshmen revealed that those playing intramural sports earned a GPA average of 3.25 compared with the 3.07 GPA earned by the couch potatoes.  In addition, the data revealed that the athletes were less likely to drop of fail a course and were 40% more likely to advance and become sophomores during their second year at MSU.  The students in each group were matched by high school GPA, gender, race, socioeconomic status, and legacy status. Lest you think that more extracurriculars were better, the study reported that between 4 to 6 was the ideal number. Kerri L. Vasold, Lauren E. Kosowski, James M. Pivarnik. Academic Success and 1 Year of Intramural Sports Participation by Freshmen Students. Journal of College Student Retention: Research, Theory & Practice, 2019; 152102511983300 DOI: 10.1177/1521025119833000 #Intramuralspor

Vidcast:  https://youtu.be/yiNPfnT5xXA A study of 62 million persons in 26 US health systems shows that those who had an appendectomy for any reason were three times more likely to develop Parkinson’s Disease.  These results are being presented at the Digestive Disease Week 2019 meeting this month. This study represents yet another link between the gastrointestinal tract and the brain.  This is only an association, and further investigations must reveal the how and why appendectomy could affect the development of Parkinson’s Disease.  This data is ammunition for those who recommend a conservative approach to appendicitis using antibiotics and dietary modification.  It is also food for thought before undergoing a prophylactic appendectomy if you are having other abdominal surgery.  Until we know more, if you can, hold on to your appendix. Digestive Disease Week. "Appendix removal associated with development of Parkinson's disease: Data from 62 million records explores relationship between the gut and the nervo

Vidcast:  https://youtu.be/ZSuPJ8F3dls Meditation is designed to relax you, but a new study from University College London finds that one in every four persons who regularly meditates experiences a decidedly unpleasant experience on a regular basis. The investigators surveyed more than 1200 persons who had regularly meditated for at least 2 months. The unpleasant experiences included anxiety, fear, distorted emotions or thoughts, and an altered sense of self or the world.  Those most likely to have negative meditation experiences were those subjects who had been at a meditation retreat, those practicing deconstructive meditation, and those without deep religious beliefs.  Bad meditation trips were slightly more likely for men than women. Meditation can have very positive effects.  Just be aware, though, that it may trigger negative sensations so buyer beware! Marco Schlosser, Terje Sparby, Sebastjan Vörös, Rebecca Jones, Natalie L. Marchant. Unpleasant meditation-related experiences in regular meditators: Pre

Vidcast:  https://youtu.be/DeihdcN1XFk With the rates of skin cancer including the deadly melanoma escalating, sunscreen is a must for beach goers and particularly vital for those with light complexions.  Since sunlight is a driver for Vitamin D synthesis in our bodies, some worry that sunscreen use will create a Vitamin D shortfall. A study just published in the British Journal of Dermatology shows that sunscreen use does not prevent Vitamin D synthesis despite protecting against sunburn and cancerous skin cell mutations.   Those sunscreen formulations with a high UVA protection factor allowed more Vitamin D production. Sunscreen overuse can be harmful, however, as application and reapplication can drive absorption of sun-blocking chemicals into the body.  A study from the FDA shows that 4 daily applications of sunscreen by spray, lotion, or cream drives absorption of the most common sunscreen chemicals, oxybenzone, octocrylene, and ecamsule to levels deemed possibly toxic. The bottom line is that you should

Vidcast:  https://youtu.be/R0U3fzU6TIw More than 6 cups of coffee a day drives blood pressure to dangerous levels and bumps up the risk of heart disease by 22%.   A new study from the University of South Australia derives this conclusion from a review of data from 347,000 Aussies between the ages of 37 and 73 years. Coffee has many beneficial effects including waking us up boosting our energy, and focusing our thinking, but, as is the case with many things in our lives, more is less.  An estimated 3 billion cups of coffee are consumed daily worldwide.  Do make sure that your consumption reflects the principle of moderation and amounts to fewer than 6 cups a day. Ang Zhou, Elina Hyppönen. Long-term coffee consumption, caffeine metabolism genetics, and risk of cardiovascular disease: a prospective analysis of up to 347,077 individuals and 8368 cases. The American Journal of Clinical Nutrition, 2019; 109 (3): 509 DOI: 10.1093/ajcn/nqy297 #Coffee #hypertension

Vidcast:  https://youtu.be/RnDteFmdD5o Women who give birth via a vaginal delivery that requires an instrumental assist using either forceps or a gentle vacuum benefit from a single dose of a common antibiotic.  A just published study from the University of Oxford in The Lancet journal shows a significant reduction in post-partum infection after one intravenous dose of amoxicillin-clavulanic acid, better known as Augmentin. The randomized, blinded study looked at nearly 3500 women who gave birth in 27 British obstetric units.  The group that received a single dose of antibiotic enjoyed a 42% reduction in postpartum infection.  The antibiotic advantage was somewhat greater for those women requiring forceps versus vacuum assist.  There also appeared to be an antibiotic advantage for those women requiring an episiotomy despite the lack of need for instrumentation.  Prophylactic antibiotics are currently recommended by the World Health Organization for all women delivering by c-section.  This study suggests the s

Vidcast: https://youtu.be/OI5pnCcaYbc Health News You Should Use, the latest medical discoveries and commonsense advice that you can use in a practical way to keep yourself and your family healthy.   Here’s a run down of this weeks stories: The Healthiest Breakfast For Diabetics Kids’ Foreign Body Ingestions Double Over 20 Years Muscle Power Versus Muscle Strength Associated With Longer Life Smiling Does Make You Feel Happier An ICU Stay Can Disrupt Brain Function Petting Zoos Harbor Bad Germs Taking A Break From Learning New Skills Hastens Success Flow And Grow Drugs Are Associated with Diabetes New Imaging Detects CTE Brain Damage In The Living Dental Whitening Could Destroy Your Teeth Fecal Transplants May Help Autism A Five Minute Exercise Works Wonders Glimpses Of Coffee Mimic Caffeine Effect Fruits and Vegetables Keep Your Vision Clear MEDICAL MAILBAG: Farxiga For Weight Loss? For more information, you’ll find all the references for the stories and a copy of show notes on my website at: https://www.drho