Dr. Howard Smith Oncall

Vidcast:  https://youtu.be/Wuw8pTzG7KA   Men and women infected with HIV should avoid drinking to excess.  This recommendation comes from immunologic studies completed at the Boston University School of Medicine.   The researchers there tested a group of HIV-positive subjects and determined their immune competence by assessing 3 individual processes: systemic inflammation, monocyte activation, and atypical coagulation..  Their levels of alcohol consumption were quantitated by a phosphatidyl-ethanol determination that quantitates alcohol consumption episodes for 21 days afterwards.   Those men and women with more alcohol in their blood showed more significantly altered immune function.  The drinking upper limit for women was 3/drinks a day and for men was 3-4 drinks a day.  Keep in mind also that a 2015 Yale study did show that HIV-infected men are more sensitive to the negative effects of alcohol than the uninflected.   These and other studies indicate the need for those with HIV to be ultra-careful about the

Vidcast:  https://youtu.be/fRevpx6l9UQ   In the search for pain control in light of the current opioid epidemic, you need look no further than your significant other.  A small study just published in the Scandinavian Journal of Pain shows that even the passive presence of your partner will help you better cope with pain.   The researchers studied 48 heterosexual couples and assessed the response of each partner to a painful pressure stimulus when alone or in the presence of the other.  The data reveals that both men and women demonstrated higher pain thresholds, better pain tolerance, and lower pain perception when in the presence of their partners than when alone.  This was true even in the absence of physical contact or verbal communication.   The next time you’re about to reach for that Tylenol, Advil, or aspirin, instead try reaching for your lover’s hand.   Stefan Duschek, Lena Nassauer, Casandra I. Montoro, Angela Bair, Pedro Montoya. Dispositional empathy is associated with experimental pain reduction

Vidcast:  https://youtu.be/Fo8xdLfLWwE   Moving your body regularly, even slowly and casually, will double your chances of avoiding early death.  This good news comes from a Norwegian meta-analysis of 8 studies covering more than 36,000 subjects.   Compared with those who reported negligible extra physical activity, those with some, say routine walking enjoyed a mortality reduction of 52%,  those with more activity, say regular brisk walking, a reduction of 66%, and those following a more vigorous exercise routine a reduction of 73%.  In contrast, the confirmed sedentary couch potatoes more than doubled their risk of premature death.   Once again, we see proof that exercise is THE best medicine for your body.  It keeps your weight in line without starving yourself, it tones your muscles, it strengthens your bones, and it increases blood flow to your vital organs in turn improving your brain, heart, and digestive functions.   Ulf Ekelund, Jakob Tarp, Jostein Steene-Johannessen, Bjørge H Hansen, etal. Dose-resp

Vidcast:  https://youtu.be/bGmAxYkLFr4   In the largest study of its kind just published in The New England Journal of Medicine, multinational public health researchers prove that even short term exposures to inhaled pollutants is associated with higher mortality rates.   The study looked some 652 urban areas in 24 countries and regions evaluating their air quality data and 30 year death rates due to cardiovascular disease, respiratory problems, and all-causes.  The results conclusively prove that higher concentrations of air pollutants is associated with elevated death rates in all categories.     How can you use this information?  When you look at the weather info on your phone, watch, or computer, focus on the air quality as well as the temperatures and rain probability.  On days where air quality is poor,  do avoid spending time outdoors. Spending more time in clean country air won’t kill you either.   Cong Liu, Renjie Chen, Francesco Sera, Ana M. Vicedo-Cabrera, etal. Ambient Particulate Air Pollution an

Vidcast:  https://youtu.be/ypwilC6A8ec   A number of studies indict smartphone use for triggering an adolescent mental health decline.  Not so fast say a group of university psychologists in a study just published by the journal Clinical Psychological Science.   The investigators closely followed a group of 388 kids 10-15 years of age, both socioeconomically and racially diverse, who attended North Carolina public schools.  They collected data on mental health symptoms as well as personal tech usage at baseline and over a 2 week period.  Their data set included more than 13,000 total observations over nearly 5300 study days.   The tabulated results demonstrated no short-term correlation between intensity of smartphone use and feelings of isolation or depression.  Even those with a greater risk for mental health issues did not experience them on days of higher phone use.   The psychologists conclude that parents should stop trying to limit smartphone or tablet use and instead support their teens online and off

Vidcast: https://youtu.be/VT_6z3ohyks   Dog owners are more likely than owners of other pets or non-pet owners to have a healthy heart and to keep it that way.  This conclusion comes from a study just published by the Mayo Clinic’s Division Of Preventive Cardiology.   Looking at nearly 1800 subjects without a history of heart problems, the investigators tabulated their cardiac risk factors including physical activity, body mass index, diet, blood pressure, cholesterol, and smoking status.  Those with the best overall cardiovascular health profiles were dog owners though owners of other pets scored higher than non-pet owners.   Dog owners scored highest in large part due to their greater level of physical activity walking and playing with their pets.  The exercise tends to keep their weight and other factors in line.  Other studies have shown that dog ownership is associated with less social isolation and optimal mental health.   So, if you can, add a dog to your life.  That life may just be longer and more fu

Vidcast:  https://youtu.be/nXAsJvs5q4k   You’ll absorb just as much information from listening to a book as reading it.  This is the conclusion from a UC-Berkeley in which researchers used MRI scans of participants to create so-called 3D semantic maps that represented the brain’s processing of word-based information.   When the captured data was decoded, the investigators were surprised to find that the semantic maps of those listening to stories were almost identical to the maps generated by the brains of those reading the same story.  Those of you who love audio books and podcasts will now have some scientific evidence to back up your intuition.   Semantic mapping techniques will soon be used to study those with dyslexia and auditory processing impairment.  Hopefully the data will lead to more effective therapy for these problems as well as for victims of stroke, epilepsy, and traumatic brain injury.   Ana F. Palenciano, Carlos González-García, Juan E. Arco, Luiz Pessoa and María Ruz.  Representational orga

Vidcast: https://youtu.be/Lpgg9Nl5I10   I’m Dr. Howard Smith, PENTA Medical Network, reporting from NYC with the Health News Roundup for the 3rd week of AUGUST, 2019.   This is Health News You Should Use, the latest medical discoveries that you can use to keep yourself and your family healthy.   Here are this weeks stories : Medicate Mildly Asthmatic Kids Only When Needed Those With Sleepless Nights May Suffer Heart Attacks and Strokes Binge Drinking More Dangerous To Females A Cellphone Break Is No Break At All Does Bossing Around Alexa and Siri Makes Us Rude To Each Other? Virtual Reality Can Curb Pain American Stroke Care Is Substandard Nordic Walking Aids Breast Cancer Surgery Rehab Obesity-Related Cancers Strike Younger People Marijuana Legalization Drives More Poisonings Bullying Is Deadly Surgery May Impair Your Thinking Half Of Patients Lie To Their Doctors Kids Having Tonsillectomies Are Prescribed Unnecessary Narcotics Marijuana Use Contributes To Alcoholism For show notes and references to for the

Vidcast:  https://youtu.be/LNri2WQPAnQ   Cannabis users who also use alcohol are more likely to drink heavily and more frequently.  This is the conclusion from Penn State researchers who surveyed more than 1,000 subjects between the ages of 18 and 25 years about their use of alcohol, marijuana, and the two together.   Those who used the two drugs simultaneously, so-called SAM users, consumed nearly 3.5 times more alcohol, drank 2.4 times more often, drank for 1.7 times more hours, and consumed twice as many drinks on days when they were drinking.  SAM users were predominately younger, male, White, college students past or present, and not living at home.  Nearly two-thirds of SAM users drank and used 2-4 times a week.   One of the chief rationales for legalizing recreational marijuana is that it is safer than alcohol.  It may be safer but not healthier according to some recent studies I’ve reported.  In any event, overusing both together is a recipe for disaster and a premature descent into addictive multi-su

Vidcast:  https://youtu.be/7PXOk2UMWz0   Sixty percent of children having their tonsils removed are prescribed opioids for 6 to 10 days following the surgery.  This fact comes from study by University of Michigan of nearly 16,000 children ages 1 to 18 years who underwent surgery from 2016 until 2018.   This prescribing pattern flies in the face of American Academy of Otolaryngology guidelines that suggest using NSAIDS such as ibuprofen in place of narcotics.  The study confirms that use of these addicting pain killers does not reduce post-operative hospital visits for pain or dehydration.  The data instead show that narcotics do cause painful constipation and sometimes tragic overdoses.   Having performed thousands of tonsillectomies myself during my 40 years practicing pediatric otolaryngology, I know that narcotic pain medicine can be avoided with the appropriate use of  the T&T plan: Tylenol and Twinkies, a sugar and carb-laden postoperative diet.  I also reject the use of blood-thinning NSAIDs which s

Vidcast:  https://youtu.be/M8KGl6VRPSk   A whopping 48% of persons who are victims of the big four, domestic violence, sexual assault, depression, or suicidal thoughts refuse to reveal this fact and ask for help.  A collaborative study of some 4500 subjects questioned in two online surveys was just published in JAMA Open Network.   Digging deeper into the data, the investigators showed that 70% of those concealing these vital pieces of information did so due to embarrassment and fear of being judged.  Then, about half of those avoiding disclosure did so because they didn’t want to commit to follow-up therapy such as counseling sessions or anti-depression medications or they fearing having such information in their medical records.   These findings show the need for better sensitivity and communication skill training for clinicians so that patients feel comfortable sharing their intimate secrets.  Beyond that, there must be iron-clad guarantees of confidentiality.  The clinician-patient privilege must become a

Vidcast:  https://youtu.be/j0AMNiPTals   One in every 14 persons over the age of 65 who undergoes even seemingly risk-free elective surgery may suffer a silent or covert stroke that can permanently impair their cognitive powers or worse.  This warning comes from a Canadian study just published in The Lancet.   Covert strokes are those without obvious symptoms including paralysis, weakness, speech degradation, or visual problems.   Population health scientists at McMaster University studied more than 1100 patients treated in the Americas, Europe, Asia, and New Zealand.  All patients underwent brain MRI scanning within 9 days of their surgery and were followed for a year to determine their cognitive abilities.  Of the 7% of patients that sustained silent strokes, 42% demonstrated a cognitive decline.  Even worse, 29% of those who didn’t suffer a stroke also developed impaired brain function.   Adding it all up, nearly 30% of the elders undergoing elective surgery developed post-operative mental decline.  If you

Vidcast:  https://youtu.be/MatgZ2Jd0-U   Teens who have been bullied are 3 times more likely to have attempted suicide than those who have not be victimized.  This fact is true for adolescents around the world according to a recently published data analysis culled from more than 130,000 adolescents 12 through 15 years by the World Health Organizations Student Health Survey.   The risk of suicide increases with the numbers of bullying incidents a child has sustained.  In the most extreme cases, being bullied on the majority of school days drives up the suicide risk more than 5 times.   This study shows that bullying can be a death sentence for the victims.  Its findings will serve as a basis for convicting bullies of felony murder thereby ruining the lives of at least two teens and their families.    If you are aware that your child is a bully, put an immediate stop to their behavior before they too become victim of their own bad acts.   Ai Koyanagi, Hans Oh, Andre F. Carvalho, Lee Smith, Josep Maria Haro, Dav

Vidcast:  https://youtu.be/sSbGUgcsl68   As medical and recreational cannabis are increasingly legalized, poison control centers are fielding more calls from emergency rooms and desperate parents.  A report from UMass-Amherst just published in JAMA looks at the rise in calls following legalization of medical marijuana in Massachusetts.    Legalization of medicinal weed was followed by a 140% increase in poisoning calls with nearly 20% of the calls involving children infancy through 4 years of age.  Calls regarding edible marijuana increased for all age groups reflecting the misconception that edible versus smokable marijuana is less potent and dangerous.   Now remember that Massachusetts only legalized marijuana for medical purposes.  Recreational marijuana remains restricted, yet carelessness is permitting this drug to get into the hands of young children and abused by teens.     You cannot legislate morality or common sense so cannabis will soon be as available as alcohol.  We as parents must be certain to

Vidcast:  https://youtu.be/ByXQXvIfwRg   The obesity epidemic is triggering cancer in ever-younger Americans.  Epidemiologists from Case Western Reserve University studied cancers, both obesity-related and non-related, that were documented in the worldwide SEER18 database over the first 16 years of the 21st century.  They focused on the age of the cancers at diagnosis.   The data included some 6 million cancers.  While the incidence of cancer either remained the same or diminished in the 20 to 49 year and the 65 or older age groups, it increased for those in the 50 to 64 year age group.  In this group, the occurrence of obesity-related cancers was significantly higher than that for non-obesity related cancers.   The obesity-related cancers are gastrointestinal at all sites, breast, ovarian, kidney, thyroid, and myeloma.   Avoidance of these devastating cancers as well as heart disease, diabetes, and stroke is the reward for keeping your weight in a healthy range by moderation in eating and exercise.   Korouki

Vidcast:  https://youtu.be/WaX8zsaB2Xg   Recovery from breast cancer surgery is challenging, and much work is needed to regain arm strength, shoulder mobility, and freedom from arm swelling.  A Spanish meta-analysis, just published in the European Journal of Cancer Care, shows that Nordic walking has a significant, positive impact on arm edema, physical fitness, disability, and patient optimism.   The investigators reviewed 4 randomized, controlled studies and 5 before-after studies.  Although the duration of Nordic walking exercise varied widely between studies, this type of exercise reduced arm circumference and extracellular edema fluid, improved upper body strength, increased shoulder range of motion, and improved quality of life.   Although many of the study methodologies could have been better, the overall conclusion is that Nordic walking withworld-wide  ski-type poles is a valuable addition to rehabilitation therapy after breast cancer surgery.     Miguel A. Sánchez‐Lastra Jorge Torres Iván Martíne

Vidcast:  https://youtu.be/WRdLs2fhXtY Nearly 90% of American stroke victims with large blood vessel blockages receive less than optimal care.  That statistic is even worse for minority populations suggesting healthcare racism.   Mayo Clinic neurology researchers reviewed more than 200,000 admissions to some 173 medical centers over the most recent 2 year period.  Despite widespread professional acknowledgement that large vessel clot removal is the most effective therapy for acute ischemic strokes, this so-called mechanical thrombectomy occurred in only 8.4% of patients overall.  Only 7% of minority patients were so treated compared with nearly 10% of white and non-Hispanic patients.   More than 800,000 strokes occur in the US every year.  Studies have shown that prompt, aggressive therapy with clot dissolving medications and/or mechanical clot removal leads to the best outcomes.     That care only occurs if a stroke is recognized.  To spot a stroke, remember FAST.  Face drooping, Arm weakness, Speech difficu

Vidcast:  https://youtu.be/4VSFYpvclCQ   A VR trip to far-off lands or a challenging VR adventure game may curb pain without the risks of medicine.  UCLA researchers proved that point by quantitating the pain of 120 hospital patients half of whom were randomized to use virtual reality headsets three times a day for a two day study period.   Those treated to the VR sessions recorded nearly 4 times less pain than controls.  Those with the most severe pain recorded a 3 fold reduction in their discomfort.  The VR helped a broad range of surgical pain including gastrointestinal, musculoskeletal, and neurologic.   Virtual reality is being employed in an ever broader group of medical applications.  I’ve reported its use for treating phobias, but it is also in current use teaching medical students and nurses, training surgeons, interpreting xrays and scans, planning radiation therapy and surgery, speeding rehabilitation, and enhancing telemedicine.   PLoS ONE, online August 14, 2019. https://doi.org/10.1371/journal.p

Vidcast: https://youtu.be/V3eQcWkwLWY   Information technologists from Utah’s Brigham Young University have a simple answer: NOT YET!  They studied 274 adult subjects to determine how they interact with digital assistants versus humans.   The researchers conclude that adults consistently code switch adding please and thank you to their requests of other human beings despite their tendencies to bark commands at their Amazon ECHOs and Apple iPhones.  Although they did not study children as yet, they suspect that kids may pick up bad habits from speaking to machines.     Apparently parents, Amazon, and Google have the same fears, and the tech giants have now added features that request and compliment polite orders from our children.  We as parents should mimic the machines and teach our kids that verbal honey always works better than vinegar.   Brigham Young University. "Are Siri and Alexa making us ruder? Study of 274 adults finds the answer -- for now." ScienceDaily. ScienceDaily, 15 August 2019. www.scienceda

Vidcast:  https://youtu.be/oPpEHSrCrLs   Ok...be honest.  How often during the day do you take a break from report writing or tedious calculations by picking up your cellphone?  Management scientists at New Jersey’s Rutgers Business School are just out with new data that shows such cellphone breaks do not refresh your brain but just the opposite.   The investigators presented each of  more than 400 study participants with multiple word puzzles to solve.  Midway through the timed exercise, a break was offered during which they could use either their phones, a computer, or some paper.  Some took no break at all.   Those who used to break to play with their cellphones took 19% longer to complete the puzzles and solved 22% fewer puzzles than non-phone users who skipped the break entirely.  These “phone users” post break efficiency and cognitive power was only slightly better than those who passed up the break opportunity.   The lesson learned is that, when you want to give your brain a recharge during a particula