Dr. Howard Smith Oncall

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

Vidcast:  https://youtu.be/UUTcZc0Izxs   The harder you think, the more sleep you require.  Neuroscientists at University College London report this finding after studying sleeping patterns in zebrafish.  These marine animals are a good model since, like humans, require a daily sleep session to rejuvenate their brains.   Experimental animals were driven to continuous brain activity by drugs such as caffeine or by forced, non-stop, swimming.  When an opportunity for them to rest occurred, they demonstrated a greater need for sleep.   Now that school and work are back in full swing, we all must be certain to permit our brains sufficient time for a recharge.  That necessary rejuvenation only comes from restful, deep, and uninterrupted sleep.   Sabine Reichert, Oriol Pavón Arocas, Jason Rihel. The Neuropeptide Galanin Is Required for Homeostatic Rebound Sleep following Increased Neuronal Activity. Neuron, 2019; DOI: 10.1016/j.neuron.2019.08.010   #Thought #sleep  

Vidcast:  ttps://youtu.be/YZQ4NNpfZ1Y   After my years as a camp counselor, raising 4 kids, and caring for children and their parents as a pediatric otolaryngologist for 40 years, here are my go-to principles for effective parenting.   ONE. Consistency.  Establish reasonable boundaries that create security.  Offer praise and rewards for remaining within them.  Use a carrot versus a stick.  Announce consequences for violations.  Say what you’ll do and do what you say.   TWO: TWO: Responsibility.  Allow progressive decision-making within limited choice boundaries even for infants and toddlers.  Child refuses food.  You say, “Do you want apples or peaches?” Have a balky, uncooperative teen?  “Do you want garbage or yard duty?”   THREE: Distraction.   When the inevitable poor behaviors and disagreements arise, distract using redirection to a different activity or location and…..   FOUR: Humor.  Laughter and smiles are powerful parenting tools.  Don’t be afraid to clown around and show love in a offbeat ways.   #p

Vidcast:  https://youtu.be/X36J-0nZ-rk   The common child discipline, the good old time out, is safe and effective.  University of Michigan pediatric psychologists report this conclusion after studying a large group of children in Early Had State Research study at 3 points in their early development: around 3, 4 and 10 years of age.   Despite the statements found on 30% of parental advice websites, time outs are recommended by the Academy of Pediatrics and not associated with anxiety, depression, aggressive behavior, or loss of self-control.     Time outs are part of my 4 commandments of good parenting that I’ll review in another report.   Rachel M. Knight, Jeremy Albright, Lindsay Deling, Dawn Dore-Stites, Amy K. Drayton. Longitudinal Relationship Between Time-Out and Child Emotional and Behavioral Functioning. Journal of Developmental & Behavioral Pediatrics, 2019; 1 DOI: 10.1097/DBP.0000000000000725   #Timeouts #parenting #discipline

Vidcast:  https://youtu.be/ia2-rZBk8yo   Sleep quality impaired by breathing disruptions accelerates the aging process.  So said sleep scientists from Harvard’s Brigham and Women’s Hospital earlier this summer at the Associated Professional Sleep Societies annual meeting.    A group of 622 adults underwent sleep analysis via polysomnography and quantitative aging determination by epigenetic DNA methylation.  Each standard deviation increase in apnea ages you 215 days. Each standard deviation increase in sleep disruption ages you 321 days.  Women were more susceptible than men.   Poor sleep quality negatively impacts every body organ leading to a shortened life.  This study puts it on a disease severity on par with diabetes.   https://www.medscape.com/viewarticle/914374   #Apnea #aging #sleepdisorderedbreathing  

Vidcast:  ttps://youtu.be/4O6kaDUCs-4   Children born even as little as 3 weeks prematurely during the summer months may be inappropriately placed a grade ahead.   Then they go through their elementary education at a profound disadvantage and are twice as likely to underperform.     The researchers at Britain’s University of Leeds do not recommend arbitrarily holding back a premie. Instead they suggest special educational services for such kids when they stumble and require them.     I suggest that, for educational placement purposes, the child’s date of birth be considered to be their expected due date, the date on which they should have been born.  Then, again, if the child needs help, it may be provided.     University of Leeds. "Early education setback for summer premature births." ScienceDaily. ScienceDaily, 13 August 2019. to be published in the Archives of Disease in Childhood.   #Premies #schoolplacement #duedate