Dr. Howard Smith Oncall

Vidcast: https://youtu.be/U077ZmTUQiE Stocky, young athletes often experience disordered sleep snd breathing patterns that could predispose them to heart attack and sudden death.  Exercise scientists from Japan’s Showa University explored this situation by studying 42 male rugby players 18-19 years of age. After formal sleep studies were completed, 43% of the players experienced significant sleep disordered breathing with snoring, dangerous pauses in their breathing, higher than normal heart rates, and lower than normal oxygen levels.  Further studies of these athletes’ hearts revealed rhythm abnormalities suggesting they had potentially lethal cardiac damage already. If you have a teen or a spouse, male or female,  “sawing wood at night,” don’t ignore it.  Push for a formal sleep study to determine if the noisy breathing is accompanied by dangerous oxygen level dips and heart rate abnormalities. #Snoring #apnea #hypoxia #sleepdisorderedbreathing #teens #athletes Yoshitaka Iso, Hitomi Kitai, Etsushi Kyuno, Fu

Vidcast: https://youtu.be/eN_3h-Beq0E The FDA now announces approval of a new immunotherapy agent for treatment of so-called triple negative breast cancer that is either locally advanced or has already spread to other body organs.  Triple negative breast cancer, notoriously difficult to treat, has cells that lack any of the three cell receptors which facilitate the effectiveness of traditional hormonal- and chemo- therapy.   The drug is the checkpoint inhibitor atezolizmumab, branded as Tecentriq by Genentech.  It received an accelerated thumbs up by the FDA on a compassionate basis.  It must be used in conjunction with the chemotherapeutic agent paclitaxel. Preliminary studies of this combo therapy demonstrated that breast cancer patients whose tumors lack estrogen, progesterone, and growth factor receptors but do have the PD-L1 receptor and therefore were eligible for immunotherapy plus chemotherapy lived 60% longer than those treated with chemotherapy alone. As these results are only preliminary but very p

Vidcast: https://youtu.be/75kcONZby7w Music can keep groups of people engaged by synchronizing and pacing their brainwaves, but not all types of music have this effect.  Engineers at the City College of New York studied the neural responses of audiences in response to various forms of music. Their research shows that unfamiliar scores synchronize communal brains most effectively, and the positive effects recur even with repetition.  On the other hand, familiar pieces failed to drive audience brain synch even with repetition.   Music-induced brain synch does work best for those audiences with some pre-formed appreciation for music. Speaking as a surgeon, I’ve always found that music in the operating room helped to establish an efficient yet safe work pace.   Relying on my team to help choose the music reduced stress and optimized group satisfaction. #Music #audiences #engagement #brainsynchronization #musicappreciation Jens Madsen, Elizabeth Hellmuth Margulis, Rhimmon Simchy-Gross, Lucas C. Parra. Music synchr

Vidcast: https://youtu.be/SBQp1xuaQf4 Abusive bosses who rule with a heavy hand are managing their own failure.  This is the conclusion of a 427 study meta-analysis completed by researchers at Portland State University and published in the Journal of Management. Managers perceived as unfair, unhelpful, and impersonal trigger counterproductive and passive-aggressive work behaviors including work slow-downs, delayed arrivals in the morning,  extended breaks during the work day, calling-in sick, and frank workplace sabotage.  Obnoxious leaders create a toxic work environment, staff stress, and departures of valuable team members. The most successful managers walk around the workplaces to kindle personal work relationships with their staff.  Once bosses know their subordinates as people, they can better function as facilitators to help everyone on the team shine and in so doing burnish their own reputations. #Managers #bullies #sabotage #toxicenvironment #work Yucheng Zhang, Xin Liu, Shan Xu, Liu-Qin Yang, Timoth

Vidcast: https://youtu.be/Ba4CdsBjh4I E-cigarettes, touted as being safer than tobacco cigarettes, seem to trigger heart attacks and strokes.  This is the conclusion of research from the University of Kansas that studied nearly 100,000 Americans.  It was presented recently at this year’s meeting of the American College of Cardiology. Those who vape are 56% more likely to suffer a heart attack, 30% more likely to have a stroke, and 55% more likely to be depressed or at least anxious.   E-cigarettes also expose users to as much or more of the highly addictive drug nicotine compared with conventional cigarettes. Proponents of vaping claim that e-cigarette users can avoid tobacco’s carcinogenic tars.  Studies are now showing that the flavorings added to the liquid nicotine are themselves toxic and carcinogenic.   Worse yet, manufacturers of the nearly 500 brands of e-cigarettes are following the tobacco companies’ evil playbook and marketing these devices to children and adolescents.  The bottom line is that anyt

Vidcast: https://youtu.be/oThU1o302_w Children of mothers who suffered a serious infection during pregnancy have a higher risk of autism and depression.  This is the result of a study looking at some 1.8 million Swedish children that was just published in JAMA Psychiatry. For those mothers who required inpatient therapy for infection during their pregnancies,  their children had a 79% higher risk of autism and a 24% higher risk of depression.  There was no higher risk of other psychiatric problems including bipolar disorder or schizophrenia. This study only demonstrates an association without explaining why it happens.  It is a powerful reminder that women and their partners during the childbearing years should be fully vaccinated against all infections.  It is ironic that anti-vaxxer pregnant women may be giving birth to children at higher risk for autism. #Maternalinfection #vaccination #autism #depression Benjamin J. S. al-Haddad, Bo Jacobsson, Shilpi Chabra, Dominika Modzelewska, Erin M. Olson, Raphael Be

Vidcast: https://youtu.be/tiqLuSu8Rw8 Obstetricians at Israel’s Ben Gurion University now proclaim that “50 is the new 40 when it comes to childbirth!”  They studied more than 8,000 pregnant women 40 years and above. The data revealed that complications such as premature birth, gestational diabetes, high blood pressure, and a need for c-section were no higher for those in their 50s compared with mothers in their 40s.  They do however consider all pregnancies in women 40 or older to be high risk with a need for careful followup of blood sugars and blood pressures. This is all well and good, but just because it’s possible for parents to have a child when they are over 50 doesn’t mean that it’s a good idea.  Raising children requires lots of energy and lots of money.   Couples in their 50s may have both, but they don’t have the 30 to 40 years that couples in their 20s and 30s have before they reach an age when their bodies and minds are entering the relaxation mode.   Children need guidance throughout their and

Vidcast: https://youtu.be/vkno1b7LI28 Nearly eighty percent of young women have never had a check of their cholesterol and other lipid levels.  This is the finding of a study by University of Pennsylvania cardiologists after reviewing the records of more than 5,000 women admitted to the UPenn hospital for childbirth. The current American College of Cardiology and American Heart Association guidelines recommend that all adults 20 years or older have regular lipid screening.  Furthermore, they suggest a spot check once around age 10 and another around age 18.  If there is a family history of a lipid disorder, even younger children should also have a cholesterol check between the ages of 2 and 10 years. One in every three American adults does have elevated cholesterol, a condition that lacks any symptoms until it may be too late.  To catch and treat this condition before the inevitable heart attack or stroke, the UPenn cardiologists recommend that every woman should have a lipid test as she enters her prenatal c

Vidcast: https://youtu.be/ns4WPEqWzG0 Want to boost your long distance running performance in only 4 days?  Get yourself on the Mediterranean Diet says investigators from St. Louis University. They studied 11 male and female 5K runners giving each 4 days of the Mediterranean Diet or 4 days of the typical Western Diet before they ran the 5K on a treadmill.  Consuming the Mediterranean Diet with its fruits, veggies, nuts, olive oil and whole grains pumped the runners performance up by a consistent 6 percent compared with their times after consuming the Western Diet’s red meats, processed meats, dairy, refined sugar, and fats.   The researchers attribute the performance boost to the Mediterranean Diet’s anti-inflammatory and antioxidant properties.  Just be aware that these advantages are quickly lost after stopping the diet. If you want top performance from your body in so many challenging situations, not just in running, eat the fruits and vegetables that your body craves and treat the offerings of the typical

Vidcast: https://youtu.be/iLaBRwQvVhI Raw dog food is becoming quite the rage.  A study just published in the British Medical Journal’s Veterinary Record reveals that raw dog food from 10 different sources contains dangerous levels of E.coli and other fecal bacteria, Salmonella, Campylobacter, and Clostridia. Raw pet food is prepared from miscellaneous body parts and organs that are a byproduct of slaughtering cattle, chickens, sheep, turkeys, pigs, ducks, salmon, and even reindeer.  The raw meat is not heat treated or freeze-dried to kill bacterial contaminants but rather only packaged and fresh frozen.  This type of simple freezing fails to kill many bacteria. The bacteria in these products can easily pass to you and to your children.  If you choose to feed it to your poor dog and risk making the animal sick, keep the raw dog food frozen until just before using it, keep it far away from your own food,, and handle it with separate kitchen equipment while you wear gloves. If you really want to give your doggi

Listen up men.  Two chemicals that can damage your sperm and your ability to father a normal child are lurking in and around your home.   A study just published by England’s University of Nottingham shows that the plasticizer DEHP and the industrial chemical PCB153 both reduce the motility and increase the level of DNA damage of sperm exposed to them in the test tube.   DEHP is found in carpets, linoleum flooring, upholstery, clothing, and even children’s toys.  Although PCB use was banned in the US more than 40 years ago, these chemicals degrade so slowly that they remain in many structures and in the soil on which we all walk and play. Vidcast: https://youtu.be/ccMiRss_ygk Male fertility is on the decline, and sperm samples from around the world demonstrate a 50% reduction in quality over the past 80 years.  If you are trying to father a child, avoid drinking from plastic containers or wearing plastic clogs that contain the organic compounds DEHP, PCBs, or BPAs.   To maintain your reproductive health, drink

Vidcast:  https://youtu.be/vJAm-_EAjsQ From the “spoonful of sugar makes the medicine go down” department, Johns Hopkins School of Education reports that the fusion of contemporary arts such as dancing, singing, rapping, and drawing into traditional science lessons increases student interest and retention of the subject matter.  The educators studied some 350 5th grade students in 6 Baltimore schools. In this crossover study design, one group of students received the arts-enriched science class and the other group the straight science curriculum.  In the second part of the investigation, the groups were reversed. The data demonstrated that the art-science combo lessons covering chemistry-environmental science and life science-astronomy were retained three times better than straight science instruction by those students at a basic reading level.  Those students with more advanced reading skills and academic performance derived no benefit.  I’ll bet they did have more fun. Breathing life into potentially dry ed

Vidcast: https://youtu.be/lbn-vkUlfL8 The earlier a deaf child regains sensitivity to sounds, the greater are the chances for that child to master spoken language.  Ear surgeons and audiologists at Chicago’s Lurie Children’s Hospital report their experience with 219 severely hearing-challenged children undergoing implantation of so-called bionic ears before 3 years of age. Of the group, some 39 infants received their cochlear implants before the age of 12 months.  These early implanted babies as a group tolerated the surgery well and showed spectacular progress with their language acquisition.   They developed the ability to understand spoken words one year earlier than children implanted after 18 to 24 months of age.  In contrast, children implanted after 2 years of age were less likely to completely master verbal language and required gestural or sign language. Every state now has universal hearing screening to promptly identify the 1 plus kids in 1000 with significant hearing loss.  The earlier a child’s h

Vidcast: https://youtu.be/bLgAUHPUvnk Using popular mouthwashes may cause your blood pressure to jump up significantly.  Dentists and cardiologists at the University of Texas report that the antibacterial agent in mouthwash, chlorhexidine, prevents the normal oral bacteria from metabolizing ingested nitrates into the nitric oxide that plays a key role in normalizing blood pressure. The investigators recruited subjects from the faculty, staff, and student populations in order to study their oral bacteria, oral nitrites, and blood pressures before, during, and after their use of mouthwash.  The subjects used Peridex mouthwash twice daily for 7 days. Use of the mouthwash and tongue cleaning significantly elevated both the systolic and the diastolic blood pressures as it depressed counts of oral bacteria and the concentration of nitric oxide.  Parameters returned to baseline 3 days following mouthwash discontinuation. This study is an additional reason why so-called therapeutic mouthwashes containing anti-bacteri

Vidcast: https://youtu.be/aIKf40gEBrc There’s a national campaign to stop children from smoking or vaping, and the FDA now announces that many, MANY retail outlets are simply not doing their part.  The federal watchdog agency regularly inspects these establishments, issues warnings to violators, and eventually triggers the prosecution of scofflaws. Let’s look at the perp list.  In terms of percentage of stores in violation, the petroleum company stores including Exxon-Mobil, Citgo, Sunoco, BP, and Marathon top the list at about 40% unlawfully selling these dangerous and addictive products to our kids.  The largest drug store chain illegally selling is Walgreen’s-Duane Reade, and 22% of their outlets were caught.  About 20% of Walmart, Family Dollar, Kroger, and Circle K stores were selling to kids and violating the law. We the public can stop these national companies from preying on our children.  Go on social media and barrage these companies’ accounts with your anger.  Also, complain about company policies

Vidcast: https://youtu.be/EWIAn6hx8D8 Ok anti-vaxxers, listen up!  The MMR vaccine that protects your children against the ravages of measles, mumps, and rubella does not, let me repeat, DOES NOT not increase your child’s risk of autism. A huge study of more than 600,000 Danish children and more than 5 million person-years of surveillance revealed that vaccinated children were actually 7% less likely to develop autism compared with unvaccinated kids. What more can I say.  There is no compelling evidence than this or any other vaccine currently available and recommended by public health officials can do anything but protect your child and protect your community by preventing the transmission of disease to others whose immunity may be impaired due to illness or age. #autism #vaccine #MMR, measles #mumps #rubella #vaccinesafety #healthnews Anders Hviid, Jørgen Vinsløv Hansen, Morten Frisch, Mads Melbye. Measles, Mumps, Rubella Vaccination and Autism. Annals of Internal Medicine, 2019; DOI: 10.7326/M18-2101 Saad

Vidcast: https://youtu.be/PTaQhgCWsPw If you burn your candle at both ends during the week and think that you can catch up on sleep over the weekend, think again!  A study from the University of Colorado shows that you won’t catch up on sleep and that your irregular sleep pattern will torpedo your glucose metabolism and internal time clock. The study assigned health young adults to one of three groups: a group with only 5 hours of sleep at night with no weekend catch-up; a group with only 5 hours of sleep for 5 nights followed by the chance to snooze forever on the weekend; and a control group who slept 9 hours each night.  The researchers studied the subjects’ sleep patterns via sleep studies, their weight gain, insulin sensitivity, and body circadian rhythms. The results revealed that the sleep-deprived group only recaptured a little more than one hour of the more than 12 hours of lost sleep when they were able to sleep in over the weekend.  Of even more importance, they could never recapture all the lost c

Vidcast: https://youtu.be/pRc6Gy_ICQE Don’t have the time or money for commercial weight loss schemes with their complicated diet plans, pre-packaged food, and embarrassing group weight-ins?   Downloading any one of a number of free apps for your smartphone will help you lose weight and keep it off simply and cheaply. Psychologists at Duke studied one hundred plus eager young and middle-aged adults.  They showed them how to use their phones and a free app called MyFitnessPal to track their food intake and weight on a daily basis for a three month period.  The app kept the participants engaged by prompting them to record their data and to read transmitted emails detailing tips for healthy eating. Those who were diligent lost about a half pound a week over the 12 weeks.  The best part is that they were able to keep the weight off.   Although the half pound a week is only half the maximum recommended maximal rate of weight loss, the method is easy, free, and effective. If you let your phone be your Jiminy Cricke

Vidcast: https://youtu.be/KHm3dFfwBBc You and I have talked many times about the fact that exercise, almost any exercise other than reaching for a donut, will help you live longer.  Now a study from Denmark published in the Mayo Clinic Proceedings pinpoints just which forms of exercise will add extra years to your life. The investigators reviewed data from more than 8500 participants in the Copenhagen City Heart Study.  Although 12% of that group were total couch potatoes, 75% of those remaining participated in at least one form of physical activity. When the data was tallied, it turns out that playing tennis seems to add the most extra years to your life at nearly 10 years.  Following that we have badminton at 6 years, soccer at nearly 5 years, cycling at nearly 4 years, swimming, jogging, and calisthenics at 3 years.   Bringing up the rear was health club exercise at 1.5 years.  Remember that this study merely reports an association between longer life and different types of recreational activity. It appear

Vidcast: https://youtu.be/DZstc_1Yoaw It’s generally thought that background music stirs creativity.  Not so says a study from several universities in the UK and Sweden just published in the journal Applied Cognitive Psychology. A total of 84 university students and staff were presented with tests of creative ability, so-called Compound Remote Associate Tasks or CRAT for short.  Subjects were exposed to instrumental music only, songs with completely unfamiliar foreign language lyrics, or hit songs with familiar lyrics.  The control sounds were library background buzz and absolute quiet. The study results showed that the familiar songs with lyrics negatively impacted creativity the most followed by instrumentals and then foreign language songs.  Test performances were the same in absolute silence and in the low din of the library. The researchers hypothesize that the changing state of sound is most responsible for reducing creativity as the music reduces the performance of verbal working memory.  I personally