Dr. Howard Smith Reports

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.

Koroukian SM, Dong W, Berger NA. Changes in Age Distribution of Obesity-Associated Cancers. JAMA Netw Open. Published online August 14, 20192(8):e199261. doi:10.1001/jamanetworkopen.2019.9261.

#Obesity #cancer #middleage 

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.

Koroukian SM, Dong W, Berger NA. Changes in Age Distribution of Obesity-Associated Cancers. JAMA Netw Open. Published online August 14, 20192(8):e199261. doi:10.1001/jamanetworkopen.2019.9261.

#Obesity #cancer #middleage 

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 Martínez‐Lemos Carlos Ayán.

Nordic walking for women with breast cancer: A systematic review.  European Journal of Cancer Care. 06 August 2019.  https://doi.org/10.1111/ecc.13130

#Breastcancer #Nordicwalking #lymphedema #rehabilitation

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 Martínez‐Lemos Carlos Ayán.

Nordic walking for women with breast cancer: A systematic review.  European Journal of Cancer Care. 06 August 2019.  https://doi.org/10.1111/ecc.13130

#Breastcancer #Nordicwalking #lymphedema #rehabilitation

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 difficulty, and Time to call 911.

If you or a member of your family is prone to stroke due to age, high blood pressure, or cholesterol problems, do a little online research and find which local hospitals offer the best stroke care.  This includes a specialized stroke ambulance service, since stroke care can never begin soon enough.

Lorenzo Rinaldo, MD, PhD; Alejandro A. Rabinstein, MD; Harry Cloft, MD, PhD; John M. Knudsen, MD; Leonardo Rangel Castilla, MD; Waleed Brinjikji, MD.  Racial and Ethnic Disparities in the Utilization of Thrombectomy for Acute Stroke: Analysis of Data From 2016 to 2018.  Stroke. 2019;50:00-00. DOI: 10.1161/STROKEAHA.118.024651.

#Stroke #thrombectomy

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 difficulty, and Time to call 911.

If you or a member of your family is prone to stroke due to age, high blood pressure, or cholesterol problems, do a little online research and find which local hospitals offer the best stroke care.  This includes a specialized stroke ambulance service, since stroke care can never begin soon enough.

Lorenzo Rinaldo, MD, PhD; Alejandro A. Rabinstein, MD; Harry Cloft, MD, PhD; John M. Knudsen, MD; Leonardo Rangel Castilla, MD; Waleed Brinjikji, MD.  Racial and Ethnic Disparities in the Utilization of Thrombectomy for Acute Stroke: Analysis of Data From 2016 to 2018.  Stroke. 2019;50:00-00. DOI: 10.1161/STROKEAHA.118.024651.

#Stroke #thrombectomy

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.pone.0167523

https://medicalfuturist.com/category/virtual-reality

#VR #virtualreality #pain

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.pone.0167523

https://medicalfuturist.com/category/virtual-reality

#VR #virtualreality #pain

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.sciencedaily.com/releases/2019/08.

#Alexa #Siri #rudeness #parenting

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.sciencedaily.com/releases/2019/08.

#Alexa #Siri #rudeness #parenting