Dr. Howard Smith Oncall

Vidcast: https://youtu.be/iasDGPN5naM The FDA has just issued a special warning that some e-cigarette users have developed seizures.  Nicotine toxicity can lower a persons seizure threshold. Seizures have previously only been reported in cases of accidental e-cigarette liquid ingestion.  Now case reports are coming in where seizures are occurring in those vaping for the first time but also in more experienced users.  Convulsions may occur after only a few puffs but may also be delayed up to one day. If you or someone you know has experienced a seizure in association with e-cigarette use, report the details immediately to both your doctor and to the FDA through their safety reporting portal: safetyreporting.hhs.gov.  https://www.fda.gov/TobaccoProducts/NewsEvents/ucm635133.htm #Vaping #ecigarettes #seizure #nicotine

Vidcast: https://youtu.be/nu3KJdwFFJw Nearly 20% of fatal strokes occurring in younger persons are due to illicit drug use and abuse.  This is the conclusion of a new study from Australia’s National Drug and Alcohol Research Center. The investigators studied 279 persons aged 15 to 44 years who died of stroke.  The most frequent drug implicated was methamphetamine.  None of the stroke victims were taking the typical psychostimulants prescribed for attention deficits. Notable was the fact that the levels of circulating methamphetamine in the stroke victims were less than half of that found in those dying from methamphetamine overdoses indicating that even lower doses of methamphetamine may be deadly by triggering a hyper-metabolic state and intracranial bleeding. Psychostimulant drug use, both legal and illicit, is on the rise, and about 76 million people are now using them.  Given this fact, it is not surprising that the only group in which the incidence of stroke is markedly increasing is the 25 to 44 year ol

Vidcast: https://youtu.be/_EiQgYiu9d0 Since we just learned that sugar will not sweeten your mood, we look to psychologists from the Iowa State University to provide an alternative to a Hershey bar or a glass of sangria.  They just published a study in the Journal of Happiness Studies that suggests a very good alternative. The researchers had groups of college students test 3 potentially mood-elevating techniques as they walked around campus eyeballing passersby for 12 minute sessions.  A loving-kindness group made wishes to themselves that the people they saw would be happy.  A second interconnectedness group looked at others and tried to imaging how they might be interconnected in some way.  The third group made downward social comparisons thinking how much better off they were than those they saw.  A control group merely looked at the passersby objectively noting what they were wearing. Twelve minutes of thinking kind thoughts about people had a therapeutic effect, even on those with narcissistic tendencie

Vidcast: https://youtu.be/ZNIoRMpE1Po Does sugar really turbocharge you and improve your mood?  A study by British and German psychologists just published in Neuroscience and Behavioral Reviews says absolutely not. The researchers performed a meta-analysis of 31 studies covering nearly 1300 adults.  The investigations looked at how the quantity and type of sugar ingested affected alertness, fatigue, mood, anger, and depression. When the numbers were crunched, the conclusions reached were: Sugar does not elevate your mood. Sugar makes most people less alert. Sugar makes you more tired and fatigued. So if you are looking for a way to energize yourself in order to complete that project, thesis, term paper, or your review for that exam, forget about sugaring up.  Instead, you might try that cocoa-caffeine cocktail I described awhile back. Konstantinos Mantantzis, Friederike Schlaghecken, Sandra I. Sünram-Lea, Elizabeth A. Maylor. Sugar Rush or Sugar Crash? A Meta-Analysis of Carbohydrate Effects on Mood. Neuros

Vidcast: https://youtu.be/CXEY8458XWQ Kids whose parents read 5 books a day to them enter school with exposure to 1.4 million more words more than those children who parents did not read to them.  Even reading one book a day to your child will give them almost 300,000 more words as they begin kindergarten. This data comes from Ohio State’s Center For Early Childhood Research and Policy.  With the info that board books contain about 140 words and picture books an average of 228 words, they calculated that kids never read to would be exposed to 4662 words, those read to 1-2 times a week 63,570 words, 3-5 times a week 169,520 words, one book a day 296,660 words, and 5 books a day 1,483,300 words. The researchers emphasize that these extra words translate into faster development of better reading skills.  They also add that the words in books tend to be more complex than conversational words, especially since our society’s verbal discourse has begun to deteriorate into a chain of “likes” and run-on sentences. Rea

Vidcast: https://youtu.be/5GktQvHI9Lc It’s no secret that the USA has the most expensive healthcare in the world, but a new commentary by clinicians at Cornell and the University of Texas-San Antonio suggests our specialty-driven clinical practice guidelines may be at fault.  This perspective comes from a panel of doctors who have practiced in other wealthy countries before coming to the US to live.   When they moved to the US, they were surprised to find that the recommendations for bowel cancer screening here differed so radically from those in their native countries.  Then, they looked at the panels making the recommendations.   In the US, the American College of Gastroenterology panel, composed entirely of, guess who, gastroenterologists, universally recommends colonoscopies.  In Europe, the European Society of Medical Oncology panel with six medical oncologists, one gastrointestinal surgeon, and no gastroenterologists states that colonoscopy has a limited role and recommends stool biochemical screening i

Vidcast: https://youtu.be/tVWdIgOWwEs 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. Still, the da

Vidcast: https://youtu.be/CbOcuLIEkkw 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 From Three

Vidcast: https://youtu.be/C3A3taMtQIg Medical marijuana now legalized 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 have an in

Vidcast: https://youtu.be/MCs-vrn_2io 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 help yours

Vidcast: https://youtu.be/GF0b2eu17dM Young people and adults with Post Traumatic Stress Disorder suffer from flashback-induced anxiety attacks that send the entire body into orbit.  Controlling the breathing rate using an electronic device helps those with PTSD relax, suppress anxiety, and better manage their symptoms. Clinical researchers from Atlanta’s Emory University reported their success with just such a gadget to the American Physiological Society’s spring meeting this week.  A stand-alone device called the RESPeRATE was used in a group of subjects with verified PTSD, and control subjects were given sham devices to use.  The working device produces tones to help the user pace the breathing to ever slower rates while the sham device maintained a normal rate of 14 breaths per minute. The PSTD subjects with most severe symptoms showed significant improvements in their heart rates, blood pressures, and sympathetic nervous system activity when they used the device.  This translates into relief from the eff

Vidcast: https://youtu.be/6n6RFpV2k1w Babies are dying in these infant rocker-sleepers when they roll over or twist their airways and suffocate.  The death count is a reported 32 infants, but that count likely under estimates the number.   The device all over the news is the Fisher-Price Rock ’n Play Sleeper but amazon.com alone lists more than 40 similar products made by Fisher-Price, a division of Mattel Toys, but also Graco, 4Moms, Ingenuity, Disney, Tiny Love, Bright Start, Born Free, and more.  Any of these devices that cuddle a baby in an inclined or even a level position can be deadly for an infant capable of twisting and turning. Infants should sleep flat in a crib devoid of any blankets, bumpers, pillows, or loose sheets.  If you are a parent, grandparent, nanny, sitter, or daycare staff member, do not put an infant into one of these sleeper-rocker devices.   Efforts by the American Academy of Pediatrics and Consumer Reports are now underway to have them recalled.  That all takes time, and you need t

Vidcast: https://youtu.be/SW0ORYzGoY4 This is Health News You Should Use, the latest medical discoveries and commonsense advice from me that you can use in a practical way to keep yourself and your family healthy.   Here are this weeks stories: You CAN Prevent Childhood Drownings Pregnancy Illness Triggers Preventable Childhood Brain Ills ACL Repair Improved By Reducing Blood Flow Gut Bacteria Wreck Your Arteries Traffic Lights Halt Poor Food Choices 3D Mammography Eliminates Breast Biopsies Smart Toilet Seat Diagnoses Heart Disease Childhood Team Sports Prevent Later Depression For Men Creative Productivity Soars When Dollars Drive Brainstorming Followed By Reflection Losing Weight May Stop Migraines Working Nights Triggers Miscarriage Virtual Reality Cures Fear of Heights Compression-Only CPR Can Save Lives Dirtiest Air During Evening Commute Heavy Drinking Stops Brain Growth #Drowning #parenting #Choline #neuropathy #ADHD #pregnancy #ACL #sportsmedicine #Atherosclerosis #microbiome #TMAO #yogurt #oliveoil

Vidcast: https://youtu.be/z8IdZ7-cD-w 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. Tatiana A. Sh

Vidcast: https://youtu.be/s44du_Y3pjo 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 of the

Vidcast: https://youtu.be/8OMzNy8ABzA Do you cringe at the thought of looking down from bridge or tall building, going up in a balloon, or parasailing?  Are you afraid of falling even if you are only up on a chair?  Some caution makes sense, but if you have a pathologic fear that limits your life choices then you probably suffer from acrophobia or the extreme, irrational phobia about height.    From 2 to 5% of us have acrophobia, and twice as many women as men suffer from it.  It can be extremely dangerous if an affected person develops a panic attack and becomes so agitated that she or he cannot safely get down. Dutch researchers developed a VR app to help acrophobics control their fears using cognitive behavioral therapy without the use of formal psychotherapy.  The app called ZeroPhobia, available on the iOS and Google Play app stores for $14, works with your smartphone and cardboard goggles. The neuroscientists studied this app in a trial involving nearly 200 subjects.  Half were treated with 6 animated m

Vidcast: https://youtu.be/KDuBlo4yEKs 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 have a histo

Vidcast: https://youtu.be/CginQ3SSplk If you’re overweight and suffering from migraine headaches, dropping those extra pounds will literally take a load off your mind.  This conclusion comes from a new study by Italy’s University of Padova recently presented to the annual meeting of the Endocrine Society. Researchers there conducted a meta-analysis of 10 studies covering more 473 migraine sufferers.  They found that any weight loss in obese subjects led to significant improvement including fewer migraines, shorter and less intense headache spells, and less disability. The improvement did not depend upon the degree of obesity, the numbers of pounds lost, or how subjects achieved the weight reduction.  Dieting and surgery both worked, and the effects were similar in adults and children. If you’re popping pills, getting shots, having psychotherapy, using biofeedback, enjoying therapeutic massages, getting acupunctured, or wolfing down exotic herbs all to prevent or control your migraines and you are overweight,

Vidcast: ttps://youtu.be/C0sWcaWvpTY Paying creatives for every idea they churn out led to optimal results.  The alternatives, paying for idea quality or offering no motivational reward at all, fell flat according to studies by business school researchers at The University of Texas-Austin and the University of Illinois-Urbana-Champaign. Their data also demonstrated the most interesting finding that true creativity has an incubation period.  The greatest creative productivity occurred when the idea kids spewed out rough ideas, took at least a 20 minute break, and then returned to their initial thoughts and refined them into very practical plans. The bottom line?  When you need creative solutions throw as many ideas up on the board as you can, and don’t be cheap about paying the brainstormers or yourself.  Then go out for a walk and return to fine-tune the initial ideas many minutes or days later. Steven J. Kachelmeier, Laura W. Wang and Michael G. Williamson. Incentivizing the Creative Process: From Initial Qu

Vidcast: https://youtu.be/k3ZHb9CeRFs Playing organized team sports grows the hippocampus, the brain’s emotion and memory center, while reducing the incidence of adult depression.  This is the finding by neuroscientists at the Washington University-St. Louis.   They studied a nationwide sample over over 4000 children 9 to 11 years of age using questionnaires to determine their participation in sports and their emotional outlook.  Each underwent MRI brain imaging to measure their hippocampal volumes.  Participation in regular, organized team sports but not casual pickup games or non-sport activities such as music or art triggers hippocampal growth in both boys and girls.  The sports-playing boys but not the girls showed a notably reduced incidence of clinical depression later in life. The authors caution that this observation is merely an association and not proof of cause and effect.  Even so, it underscores the value of participation in after-school athletics as long as they don’t trigger head injuries. Lisa