Dr. Howard Smith Oncall

  Vidcast:  https://youtu.be/1YUDCkhva2g   If you tend to sleep poorly and are prone to migraine headaches, beware that a doozie may strike you two days later.  This warning comes from a Harvard study of 98 young persons 35 yrs on average who wore wrist devices to quantitate their sleep and kept headache diaries.     The data shows that a night with 6 and a half hours or less of fragmented sleep triggers a 39% chance of a migraine the second day after.  Ironically, the chance of a next day migraine is lower.     Migraine sufferers should do all they can to assure a good nights sleep every night including avoiding caffeine, late night meals, and agitation.    Suzanne M. Bertisch, Wenyuan Li, Catherine Buettner, Elizabeth Mostofsky, Michael Rueschman, Emily R. Kaplan, Jacqueline Fung, Shaelah Huntington, Tess Murphy, Courtney Stead, Rami Burstein, Susan Redline, Murray A. Mittleman Neurology Dec 2019, 10.1212/WNL.0000000000008740; DOI: 10.1212/WNL.0000000000008740   #Migraines #insomnia #fragmentedsleep  

  Vidcast:  https://youtu.be/TdNB8BS7RGY   More than 2 million teens 15 through 19 years underwent uncomfortable bi-manual pelvic exams and Pap tests over a recent 6 year period.  More than half the pelvics and nearly two-thirds of Paps were unnecessary according to a just published CDC/UC-San Francisco study.     FYI: A routine pelvic is not recommended for young women unless pregnant or symptomatic.  Pap tests for cervical cancer screening are not suggested for those under 21.     Ok young ladies and mothers of same, listen up.  You have a right to question and refuse these procedures if inappropriate.  Unnecessary procedures can be painful, add to your costs, and can lead to complications and other unnecessary testing.     Jin Qin, ScD1; Mona Saraiya, MD, MPH1; Gladys Martinez, PhD2; et al. Prevalence of Potentially Unnecessary Bimanual Pelvic Examinations and Papanicolaou Tests Among Young Women Aged 15-20 Years In The United States.  JAMA Network.   https://ja.ma/37IYWYx   #Teens #gynecology #cervical

  Vidcast:  https://youtu.be/rFJpY1FDVCQ   The polyphenols and fiber in just two apples a day can lower cholesterol and normalize other lipids and vascular function.  This conclusion comes from a British and Italian Study just published in The American Journal of Clinical Nutrition.   Study participants were 40 overweight men and women with mildly elevated cholesterol who consumed 2 Renetta apples a day for 8 weeks.  The apple supplement significantly lowered total cholesterol, LDL “bad” cholesterol, and triglycerides.  Beneficial vascular relaxation was better after downing the apples.   The Italian-grown Renetta apples are particularly rich in the very bioactive polyphenol proanthrocyanidins.  The researchers don’t know if these polyphenols or fiber do the trick.  Either way, don’t pass up apples.   Athanasios Koutsos et al. Two apples a day lower serum cholesterol and improve cardiometabolic biomarkers in mildly hypercholesterolemic adults: a randomized, controlled, crossover trial, The American Journal of

    Vidcast:  https://youtu.be/tak9_VV6Yuc   Pre-teens viewing healthy food prep on TV are nearly 3 times more likely to make healthy food choices for themselves.     A Dutch study focused on 125 participants 10 to 12 years of age who viewed a 10 minute TV clip before choosing a snack.  The snack choices included healthy apple and cucumber pieces versus unhealthy chips and min-pretzels   Those pre-teens viewing the clip showing fruit and vegetable prep were 2.7 times more likely to choose a healthy snack compared with those who viewed the clip of burgers and fries being readied.   I suggest your kids view one of the kid cooking shows such as Chopped Junior.   Frans Folkvord, Doeschka Anschütz, Marieke Geurts. Watching TV Cooking Programs: Effects on Actual Food Intake Among Children. Journal of Nutrition Education and Behavior, 2019; DOI: 10.1016/j.jneb.2019.09.016   https://coolmomeats.com/2017/09/26/food-tv-shows-for-kids/    #TVcookingshows #healthyeating #parenting #kidcookingshows TVcookingshows, health

  Vidcast:  https://youtu.be/EAor3z2zmXE   Kindness to others can reduce your feelings of pain.  This the conclusion of Chinese experiments just published in the Proceedings of the National Academy of Sciences.   In one experiment, the needle jab to donate blood hurt less when volunteers were giving to earthquake victims rather than making a routine donation.  In another, subjects were exposed to extreme cold but those working on a project to help migrant children complained less about the temperature.  In a third experiment, cancer patients helping to care for others noticed their own pain less.   Previous studies have shown that giving will bring you and others happiness.  Now, we know that charitable deeds also have therapeutic benefits for you.   Yilu Wang et al. Altruistic behaviors relieve physical pain, Proceedings of the National Academy of Sciences (2019). DOI: 10.1073/pnas.1911861117   #Charity #pain #altruism  

  Vidcast:  https://youtu.be/_Usci1VDUaA   A large, multicenter study of  222 breastfeeding babies and their mother shows that insignificant amounts of most anti-seizure drugs pass from mom to babe through breast milk.  The one drug that did pass was lamotrigine marketed as Lamictal.   Nearly 50% of babies had undetectable levels of drug in their blood, and the remainder had insignificant quantities.  Lamictal did pass through more readily into breast milk than the others, and its concentration in the baby depended upon the mother’s dosing.   This study concludes that mothers, taking most drugs for their seizure disorders, can safely breastfeed.  As always, you should consult with your own doctors before proceeding.   Birnbaum AK, Meador KJ, Karanam A, et al. Antiepileptic Drug Exposure in Infants of Breastfeeding Mothers With Epilepsy. JAMA Neurol. Published online December 30, 2019. doi:https://doi.org/10.1001/jamaneurol.2019.4443   #Breastfeeding #antiseizuredrugs #antiepileptics #lamotrigine #Lamictal  

  Vidcast:  https://youtu.be/iMqDLWIj6Rk   Confining food consumption to 10 hours produces significant weight reduction, better overall health and sounder sleep.  Researchers at UC-SanDiego studied 19 unhealthy subjects with so-called metabolic syndrome before and after 3 months of time-restricted eating (TRE). Metabolic syndrome includes a number of issues including obesity, high blood pressure, and diabetes..   Time restricted feeding during any 10 hour timeframe led to a significant loss of abdominal fat, some blood pressure and cholesterol reductions, and, for 70% of subjects, better sleep.  Many participants tended to eat breakfast later and dinner earlier.   This plan involves no ca lorie counting but suggests healthy eating.  Try it!   M.J. Wilkinson, E. N.C. Manoogian, A. Zadouri, S. Navlakh, S. Panda, P.R. Taub. Ten-Hour Time-Restricted Eating Reduces Weight, Blood Pressure, and Atherogenic Lipids in Patients with Metabolic Syndrome.  CellPress,:December 05, 2019DOI:https://doi.org/10.1016/j.cmet.201

  Vidcast:   https://youtu.be/qaShibFU3hU   Men and women under 45 who cut their levels of bad cholesterol by half have a 4 times lower risk of cardiovascular disease later in life.  This conclusion comes from an international collaborative study of  nearly 400,000 individuals published in The Lancet.   This population and computer-modeling study shows that the effect of lowering non-HDL cholesterol on later life-threatening disease is greatest for millennials and younger.  Those over 60 cutting their damaging cholesterol by half only cut their risk by half.   It’s never too soon to speak with your personal doc about regular lipid screens.  Keep your levels normal by cutting out saturated fats, consuming fiber, and exercising.    Brunner, Fabian JZeller, Tanja et al.  Application of non-HDL cholesterol for population-based cardiovascular risk stratification: results from the Multinational Cardiovascular Risk Consortium.  The Lancet, Volume 394, Issue 10215, 2173 - 2183   #Cholesterol #HDL #cardiovasculardisea

  Vidcast:   https://youtu.be/x96mfKzKFDo   Children given whole milk have a 39% lower risk of becoming overweight or obese.  Canadian researchers publishing in The American Journal of Clinical Nutrition report this conclusion from their meta-analysis of 28 studies and nearly 21,000 children 1-8 years of age.   This finding flies in the face of current pediatric recommendations to switch from whole milk with 3% fat to reduced fat milk ranging from

  Vidcast:  https://youtu.be/ufXT9FHoXAs   Thinking of fathering a child or having problems doing just that.  A new Swedish study shows that only 2 weeks of healthy eating including a lots of sugar the second week might boost your odds.   The investigators checked sperm quality for 15 healthy young men before and at the end of two weeks of controlled healthy eating.  During the second week, the healthy offerings were joined by sugary soda and pastries.   At the beginning, one-third of the men had low sperm motility.  At the end, all had vigorous swimmers!  We don’t know yet whether the healthy diet or the sugar did the trick.  For best results, use both.   Daniel Nätt, Unn Kugelberg, Eduard Casas, Elizabeth Nedstrand, Stefan Zalavary, Pontus Henriksson, Carola Nijm, Julia Jäderquist, Johanna Sandborg, Eva Flinke, Rashmi Ramesh, Lovisa Örkenby, Filip Appelkvist, Thomas Lingg, Nicola Guzzi, Cristian Bellodi, Marie Löf, Tanya Vavouri, Anita Öst. Human sperm displays rapid responses to diet. PLOS Biology, 2019; 1

  Vidcast:  https://youtu.be/10NdkjxKigc   If you rang in the New Year enjoying some weed and noticed ringing in your ear, so-called tinnitus, it isn’t a coincidence.  Ear researchers from Stanford now show that annoying tinnitus is associated with marijuana use.   The study looked at 2160 adults tabulating use of marijuana, alcohol, and more dangerous, addicting drugs.  Marijuana use, even once a month, was a significant risk for distracting ear ringing.  No other drugs had this effect, and the frequency and quantity of weed used did not impact the severity of ringing.   If you already notice tinnitus, an early sign of inner ear hearing loss, you might want to skip marijuana smokinq or eating.   Z.J. Qian, J.C. Alyono. An association between marijuana use and tinnitus.  Am. J. Otolaryngology 41: 1-2/2020.  https://doi.org/10.1016/j.amjoto.2019.102314   #Tinnitus #ringing #marijuana  

  Vidcast:  https://youtu.be/2rDWQ_5Cen8   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 M

  Vidcast:  https://youtu.be/CGVcV0EKQpw   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

  Vidcast:  https://youtu.be/VLMP7UqntR8   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/P3pgy7NLv9w   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.   St

  Vidcast:  https://youtu.be/iRn033adAuY   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

  Vidcast:  https://youtu.be/9XGgeCUMD6s   Medical marijuana now legal  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 ha

  Vidcast:  https://youtu.be/ZuqDeXVraTM   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 h

  Vidcast:  https://youtu.be/xZAKkqkiZlQ   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.  

Vidcast: https://youtu.be/LQaxn7d3DRs 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