Dr. Howard Smith Reports

Vidcast:  https://youtu.be/Cx1EWDS3Cok

Most women are counseled to try a vaginal delivery following a previous Caesarian section (VBAC).  The latest evidence from the University of Oxford questions the wisdom of that recommendation.

More than 74,000 Scottish births over a 13 year period show that a VBAC is associated with a 7 fold higher risk of a uterine rupture, a 3 fold  higher risk of surgical injury, and a two-fold higher risk of sepsis and blood transfusion.  There is also a greater risk of stillbirth, a NICU admission, and a need for neonatal resuscitation.

If you’ve had a C-section and your OB is recommending a vaginal delivery, question carefully whether that choice is right for you.

Kathryn E. Fitzpatrick, Jennifer J. Kurinczuk, Sohinee Bhattacharya, Maria A. Quigley. Planned mode of delivery after previous cesarean section and short-term maternal and perinatal outcomes: A population-based record linkage cohort study in Scotland. PLOS Medicine, 2019; 16 (9): e1002913 DOI: 10.1371/journal.pmed.1002913

#Csection #VBAC #vaginaldelivery

Vidcast:  https://youtu.be/EjFQsAfXW2k

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:: 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.

#parenting #consistency #responsibility #distraction #humor

Vidcast: https://youtu.be/T4cdm4mMfgE

Deadly head and neck melanoma has increased by 51% for children and younger adults over the past 20 years.  St. Louis University oncologists raise this warning after reviewing nearly 12,500  confirmed melanoma cases documented in American and Canadian cancer registries.

Once predominately a cancer of older patients, it is now popping up increasingly often in children, adolescents, and  young adults.  White males 15 to 39 years of age are the prime targets.

We must teach out children from a young age to protect their skins.  Global warming will lead to more time outdoors and a greater need for UV radiation protection.  Stock up on your favorite sunscreen.

Bray HN, Simpson MC, Zahirsha ZS, et al. Head and Neck Melanoma Incidence Trends in the Pediatric, Adolescent, and Young Adult Population of the United States and Canada, 1995-2014. JAMA Otolaryngol Head Neck Surg. Published online October 03, 2019. doi:10.1001/gov/jobs

#melanoma #youngadults #sunburn

Vidcast:  https://youtu.be/JI5Z-3IfCwo

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: 10.18632/aging.102023

#Tea #brain #thinking #dementia

Vidcast:  https://youtu.be/YAsWf2Xaeh0

Only half of pregnant women receive the recommended flu and whooping cough vaccines say the latest CDC statistics.  The flu is a terrible risk for a pregnant woman, and pertussis is the same for her newborn.

Pregnancy makes the flu more severe, and increases the risk for hospitalization by 2.5 times.  Every year, pertussis lands up to 700 babies under the age of 2 months in the hospital struggling for their lives.

Each pregnant woman should receive the flu and the DTaP vaccines during each pregnancy.  The immunity conferred by both vaccines is passed to the developing fetus, and it is the greatest gift any mother can give to her developing child.

https://www.cdc.gov/mmwr/volumes/68/wr/pdfs/mm6840e1-h.pdf?deliveryName=USCDC_921-DM10321

#Influenza #pertussis #pregnancy #infants

Vidcast:  https://youtu.be/80u3lfBHQRk

When you dine socially, you consume 48% more food than when you eat alone.  This conclusion comes from a meta-analysis of some 42 studies of group versus solo food consumption just published in the American Journal of Clinical Nutrition.

On the other hand, eating with a group of strangers did not increase food consumption. The investigators conjecture that many of us feel we must eat modestly when doing so with those we don’t know or wish to impress.

With the food fests of Halloween, Thanksgiving, and Christmas/Chanukah on the horizon, be aware of what you’re putting in your mouth.  Maybe it’s best to have more coming out of your mouth in the form of stimulating conversation than going into your gut.

Helen K Ruddock, Jeffrey M Brunstrom, Lenny R Vartanian, Suzanne Higgs. A systematic review and meta-analysis of the social facilitation of eating. The American Journal of Clinical Nutrition, 2019; 110 (4): 842 DOI: 10.1093/ajcn/nqz155

#Socialeating #overeating

Vidcast:  https://youtu.be/p5LbkvtUu74

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:  https://youtu.be/ZYkfn_mauO8

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/EjFQsAfXW2k

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:: 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.

#parenting #consistency #responsibility #distraction #humor

Vidcast:  https://youtu.be/p5LbkvtUu74

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