Dr. Howard Smith Reports

Vidcast:  https://youtu.be/coW1hyYs094

The death toll from E-cigarette use has now climbed to 12 in 10 states.  The CDC further reports that 805 mostly young persons in 46 states have fallen victim to severe lung injuries after vaping and 91% required hospitalization.

Those stricken after e-cigarette use have a distinct profile: most were young with a median age of 23 years, males in 69% of cases, 77% inhaled THC products, 57% smoked nicotine, and more deaths occurred in older smokers with a median age of 50 years.  There is evidence that the most severe illness occurs after vaping street products.

Protecting yourself is easy.  Don’t vape.  Putting an e-cigarette into your mouth is no different than swallowing slow-release cyanide.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6839e1.htm

#Vaping #ecigarettes #lungdisease #THC

Vaping, ecigarettes, lungdisease, THC

Vidcast:  https://youtu.be/coW1hyYs094

The death toll from E-cigarette use has now climbed to 12 in 10 states.  The CDC further reports that 805 mostly young persons in 46 states have fallen victim to severe lung injuries after vaping and 91% required hospitalization.

Those stricken after e-cigarette use have a distinct profile: most were young with a median age of 23 years, males in 69% of cases, 77% inhaled THC products, 57% smoked nicotine, and more deaths occurred in older smokers with a median age of 50 years.  There is evidence that the most severe illness occurs after vaping street products.

Protecting yourself is easy.  Don’t vape.  Putting an e-cigarette into your mouth is no different than swallowing slow-release cyanide.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6839e1.htm

#Vaping #ecigarettes #lungdisease #THC

Vaping, ecigarettes, lungdisease, THC

Vidcast:  https://youtu.be/oaJHcZmrrN8

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/TtWHs0_tqLI

Thyroid surgeons performing at least 40 yearly complete thyroid excisions have the fewest complications. Kaiser Permanente California now reports its review of 10,500 such operations over a 7 year period.

The chief complications of vocal cord paralysis and parathyroid hormone deficiency occur since the nerves to the larynx and the parathyroid glands must be carefully dissected out of the thyroid before its removal.  Although these complications begin to decrease when a surgeon performs 18 such procedures a year, they only hit bottom at more than twice that number.

When you have surgery, your surgeon’s experience with your prospective operator far outweigh his or her bedside manner.  If you can get both, all the better.

Meltzer C, Hull M, Sundang A, Adams JL. Association Between Annual Surgeon Total Thyroidectomy Volume and Transient and Permanent Complications. JAMA Otolaryngol Head Neck Surg. Published online July 25, 2019145(9):830–837. doi:10.1001/jamaoto.2019.1752

#Thyroidectomy #surgerycomplications #surgeryvolume

Vidcast:  https://youtu.be/_MoJEEKE4ik

Our cells and bodies work on internal biological clocks which are lubricated for better efficiency by good old fashioned stress.  University of Minnesota biologists now report  this phenomenon in the journal Neuron.

Using a mouse model and tissue cultures of cells, the scientists unraveled the complex blend of signaling proteins that control the clock. They found that stress accelerates the speed of signal processing and improves the robust nature of cellular biologic clocks.

The bottom line is that some stress may well be good for you.  It literally keeps your system on its toes and speeds your reaction time.

Salil Saurav Pathak, Dong Liu, Tianbao Li, Nuria de Zavalia, Lei Zhu, Jin Li, Ramanujam Karthikeyan, Tommy Alain, Andrew C. Liu, Kai-Florian Storch, Randal J. Kaufman, Victor X. Jin, Shimon Amir, Nahum Sonenberg, Ruifeng Cao. The eIF2α Kinase GCN2 Modulates Period and Rhythmicity of the Circadian Clock by Translational Control of Atf4. Neuron, 2019; DOI: 10.1016/j.neuron.2019.08.007

#Biologicalclocks #stress

Vidcast:  https://youtu.be/_MoJEEKE4ik

Our cells and bodies work on internal biological clocks which are lubricated for better efficiency by good old fashioned stress.  University of Minnesota biologists now report  this phenomenon in the journal Neuron.

Using a mouse model and tissue cultures of cells, the scientists unraveled the complex blend of signaling proteins that control the clock. They found that stress accelerates the speed of signal processing and improves the robust nature of cellular biologic clocks.

The bottom line is that some stress may well be good for you.  It literally keeps your system on its toes and speeds your reaction time.

Salil Saurav Pathak, Dong Liu, Tianbao Li, Nuria de Zavalia, Lei Zhu, Jin Li, Ramanujam Karthikeyan, Tommy Alain, Andrew C. Liu, Kai-Florian Storch, Randal J. Kaufman, Victor X. Jin, Shimon Amir, Nahum Sonenberg, Ruifeng Cao. The eIF2α Kinase GCN2 Modulates Period and Rhythmicity of the Circadian Clock by Translational Control of Atf4. Neuron, 2019; DOI: 10.1016/j.neuron.2019.08.007

#Biologicalclocks #stress

Vidcast:  https://youtu.be/VHVmpX5vX2E

The Apple Watch, Samsung Galaxy and FitBit wearables are credible exercise measuring devices that take clinical testing into the real world.  Pulmonologists from Utah’s Intermountain Medical Center now report that these devices can match a standard 6 minute walk distance test for estimating lung reserve.

The study tested 52 respiratory disease patients over a 12 week period.  Their results proved that step counters could accurately predict the results from the 6 minute walk test.  Because the wearables turn in data from outside the clinic, their information is likely be even more relevant.

If you have a smartwatch or Fitbit, embrace use of their exercise apps as a metronome to help you give your body the workout it deserves....and needs.

Intermountain Medical Center. "Wrist-worn step trackers accurate in predicting patient health outcomes." ScienceDaily. ScienceDaily, 29 September 2019. www.sciencedaily.com/releases/2019/09/190929123811.htm

#Stepcounters #AppleWatch #FitBit #lungdisease 

Vidcast:  https://youtu.be/VHVmpX5vX2E

The Apple Watch, Samsung Galaxy and FitBit wearables are credible exercise measuring devices that take clinical testing into the real world.  Pulmonologists from Utah’s Intermountain Medical Center now report that these devices can match a standard 6 minute walk distance test for estimating lung reserve.

The study tested 52 respiratory disease patients over a 12 week period.  Their results proved that step counters could accurately predict the results from the 6 minute walk test.  Because the wearables turn in data from outside the clinic, their information is likely be even more relevant.

If you have a smartwatch or Fitbit, embrace use of their exercise apps as a metronome to help you give your body the workout it deserves....and needs.

Intermountain Medical Center. "Wrist-worn step trackers accurate in predicting patient health outcomes." ScienceDaily. ScienceDaily, 29 September 2019. www.sciencedaily.com/releases/2019/09/190929123811.htm

#Stepcounters #AppleWatch #FitBit #lungdisease 

https://youtu.be/0_CdQ5xGbdA

To guide your headstrong teen, present your opinions as rational suggestions rather than imperial directives.  Psychologists at Cardiff University studied the responses of 1000 adolescents to pointed suggestions delivered in various tones of voice.

Each teen heard 30 directives voiced by actors in 3 ways: a controlling authoritarian tone, a autonomy-supportive tone, or a neutral tone.  The results: heavy-handed demands trigger resistance and negative responses while suggestions delivered in a respectful, positive manner backed by credible rationales led to acceptance.

As always, interpersonal relationships benefit more from honey than vinegar.  As children grow and mature, they demand from us, their parents, respect for their independence and ability to make sensible decisions.

Cardiff University. "Teenagers less likely to respond to mothers with controlling tone of voice: New study showed adolescents were less likely to want to engage with schoolwork when mothers spoke with a pressurising tone." ScienceDaily. ScienceDaily, 26 September 2019.

#Parenting #demands #suggestions #teens

https://youtu.be/0_CdQ5xGbdA

To guide your headstrong teen, present your opinions as rational suggestions rather than imperial directives.  Psychologists at Cardiff University studied the responses of 1000 adolescents to pointed suggestions delivered in various tones of voice.

Each teen heard 30 directives voiced by actors in 3 ways: a controlling authoritarian tone, a autonomy-supportive tone, or a neutral tone.  The results: heavy-handed demands trigger resistance and negative responses while suggestions delivered in a respectful, positive manner backed by credible rationales led to acceptance.

As always, interpersonal relationships benefit more from honey than vinegar.  As children grow and mature, they demand from us, their parents, respect for their independence and ability to make sensible decisions.

Cardiff University. "Teenagers less likely to respond to mothers with controlling tone of voice: New study showed adolescents were less likely to want to engage with schoolwork when mothers spoke with a pressurising tone." ScienceDaily. ScienceDaily, 26 September 2019.

#Parenting #demands #suggestions #teens