Dr. Howard Smith Reports

Vidcast: https://youtu.be/IUS_Wp0n4yk

CTE, chronic traumatic encephalopathy, the disease caused by repetitive head trauma is typically only diagnosable by autopsies.  It was discovered by post-mortem brain examinations of professional football and soccer players that sustained repetitive head trauma.  CTE may soon be routinely diagnosable in the living.  

Radiologists at Boston University’s med school, the Harvard Medical School, and the Mayo Clinic now report a study of  26 former NFL players using the latest PET scanning technique. These new positron emission tomography studies using unique injectable contrast agents can now detect depositions of tau proteins in the brain.

Compared with healthy controls who had not sustained head injuries, the NFL players with cognitive and neuropsychiatric symptoms had significantly higher deposits of tau protein on imaging.  The more years of tackle football a player had under his belt, the greater the accumulation of tau protein in the brain.

This study marks the beginning of testing for CTE in living patients.  The study authors caution that the technique is not yet ready for prime time as more and larger confirmatory studies must be completed.  

If you do know of a patient with a history of repeated head trauma who is evidencing symptoms of deteriorating brain function, it may be possible for that patient to join a study and receive imaging that could lead to treatment once that is available.

Robert A. Stern, Charles H. Adler, Kewei Chen, Michael Navitsky, Ji Luo, David W. Dodick, Michael L. Alosco, Yorghos Tripodis, Dhruman D. Goradia, Brett Martin, Diego Mastroeni, Nathan G. Fritts, Johnny Jarnagin, Michael D. Devous, Mark A. Mintun, Michael J. Pontecorvo, Martha E. Shenton, Eric M. Reiman. Tau Positron-Emission Tomography in Former National Football League Players. New England Journal of Medicine, 2019; DOI: 10.1056/NEJMoa1900757

#CTE #chronictraumaticencephalopathy #tau #dementia #football #soccer

Vidcast: https://youtu.be/IUS_Wp0n4yk

CTE, chronic traumatic encephalopathy, the disease caused by repetitive head trauma is typically only diagnosable by autopsies.  It was discovered by post-mortem brain examinations of professional football and soccer players that sustained repetitive head trauma.  CTE may soon be routinely diagnosable in the living.  

Radiologists at Boston University’s med school, the Harvard Medical School, and the Mayo Clinic now report a study of  26 former NFL players using the latest PET scanning technique. These new positron emission tomography studies using unique injectable contrast agents can now detect depositions of tau proteins in the brain.

Compared with healthy controls who had not sustained head injuries, the NFL players with cognitive and neuropsychiatric symptoms had significantly higher deposits of tau protein on imaging.  The more years of tackle football a player had under his belt, the greater the accumulation of tau protein in the brain.

This study marks the beginning of testing for CTE in living patients.  The study authors caution that the technique is not yet ready for prime time as more and larger confirmatory studies must be completed.  

If you do know of a patient with a history of repeated head trauma who is evidencing symptoms of deteriorating brain function, it may be possible for that patient to join a study and receive imaging that could lead to treatment once that is available.

Robert A. Stern, Charles H. Adler, Kewei Chen, Michael Navitsky, Ji Luo, David W. Dodick, Michael L. Alosco, Yorghos Tripodis, Dhruman D. Goradia, Brett Martin, Diego Mastroeni, Nathan G. Fritts, Johnny Jarnagin, Michael D. Devous, Mark A. Mintun, Michael J. Pontecorvo, Martha E. Shenton, Eric M. Reiman. Tau Positron-Emission Tomography in Former National Football League Players. New England Journal of Medicine, 2019; DOI: 10.1056/NEJMoa1900757

#CTE #chronictraumaticencephalopathy #tau #dementia #football #soccer

Vidcast: https://youtu.be/z99bXE9KVcI

The drugs in question are those that make men’s urine flow and their hair grow.  Many men take finasteride, better known as Proscar and Propecia, to shrink their prostates to improve urine flow and others take the same medicine help hair grow on their scalps.  

A new study from Scotland’s University of Edinburgh reveals that this drug and its cousin dutasteride (Avodart), technically known as 5-alpha-reductase inhibitors, can make the body less sensitive to insulin and induce type 2 diabetes.

The investigators reviewed health records from 55,000 men in the UK each of whom been taking these drugs over an 11 year period.  They discovered that this drug increases a man’s chances of developing diabetes by about 33%.

Finasteride and dutasteride are effective and popular.  Experts agree that these medications may be continued, but they add the sound medical advice that dictates close followup and surveillance of the users carbohydrate handling capabilities.  In simple terms, long term user’s docs should check them for diabetes periodically.

Li Wei, Edward Chia-Cheng Lai, Yea-Huei Kao-Yang, Brian R Walker, Thomas M MacDonald, Ruth Andrew. Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: population based cohort study. BMJ, 2019; l1204 DOI: 10.1136/bmj.l1204

#Finasteride #dutasteride #diabetes

Vidcast: https://youtu.be/z99bXE9KVcI

The drugs in question are those that make men’s urine flow and their hair grow.  Many men take finasteride, better known as Proscar and Propecia, to shrink their prostates to improve urine flow and others take the same medicine help hair grow on their scalps.  

A new study from Scotland’s University of Edinburgh reveals that this drug and its cousin dutasteride (Avodart), technically known as 5-alpha-reductase inhibitors, can make the body less sensitive to insulin and induce type 2 diabetes.

The investigators reviewed health records from 55,000 men in the UK each of whom been taking these drugs over an 11 year period.  They discovered that this drug increases a man’s chances of developing diabetes by about 33%.

Finasteride and dutasteride are effective and popular.  Experts agree that these medications may be continued, but they add the sound medical advice that dictates close followup and surveillance of the users carbohydrate handling capabilities.  In simple terms, long term user’s docs should check them for diabetes periodically.

Li Wei, Edward Chia-Cheng Lai, Yea-Huei Kao-Yang, Brian R Walker, Thomas M MacDonald, Ruth Andrew. Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: population based cohort study. BMJ, 2019; l1204 DOI: 10.1136/bmj.l1204

#Finasteride #dutasteride #diabetes

Vidcast: https://youtu.be/YuySgR0brbM

If you are trying to teach yourself new skills, either physical or mental, give your brain a short break during the learning process.  Neurophysiologists at the National Institutes of Health make this recommendation after analyzing the brain activity of volunteers as they master the task of reproducibly pressing a series of keys.

The scientists noted that brain wave activity which signals the cementing of behaviors into memory was more intense during short rest periods between skill practice sessions.  The subjects performed incrementally better when their initial mastery and practice sessions were interrupted by short rest periods compared with intense practice sessions followed by a night off and re-testing in the morning.

So, if you are trying to perfect a skill, learn it and practice it for awhile, then take a break, and the return to practice.  After several cycles, you should be able to optimize your performance and make it reproducible.

Marlene Bönstrup, Iñaki Iturrate, Ryan Thompson, Gabriel Cruciani, Nitzan Censor, Leonardo G. Cohen. A Rapid Form of Offline Consolidation in Skill Learning. Current Biology, 2019; DOI: 10.1016/j.cub.2019.02.049

#Learning #practice #rest #skillconsolidation

Vidcast: https://youtu.be/YuySgR0brbM

If you are trying to teach yourself new skills, either physical or mental, give your brain a short break during the learning process.  Neurophysiologists at the National Institutes of Health make this recommendation after analyzing the brain activity of volunteers as they master the task of reproducibly pressing a series of keys.

The scientists noted that brain wave activity which signals the cementing of behaviors into memory was more intense during short rest periods between skill practice sessions.  The subjects performed incrementally better when their initial mastery and practice sessions were interrupted by short rest periods compared with intense practice sessions followed by a night off and re-testing in the morning.

So, if you are trying to perfect a skill, learn it and practice it for awhile, then take a break, and the return to practice.  After several cycles, you should be able to optimize your performance and make it reproducible.

Marlene Bönstrup, Iñaki Iturrate, Ryan Thompson, Gabriel Cruciani, Nitzan Censor, Leonardo G. Cohen. A Rapid Form of Offline Consolidation in Skill Learning. Current Biology, 2019; DOI: 10.1016/j.cub.2019.02.049

#Learning #practice #rest #skillconsolidation

Vidcast: https://youtu.be/PVtH56EdCSQ

Nasty bacteria are everywhere, and petting zoos turn out to have some of the nastiest.  An Israeli study of some 8 randomly selected petting zoos in that country reveals that an alarming number of animals are carrying drug resistant E. coli that can and do spread to human visitors. These results were presented this week at a meeting of the European Society of Clinical Microbiology and Infectious Diseases.

The microbiologists collected some 380 samples from about 230 animals of varied species in the petting zoos and found that 12% of the animals were colonized with one or more strains of dangerous and antibiotic resistant E. coli.  These germs cause terrible diarrhea and urinary tract infections.

Most of the bacteria were predictably in feces, but nearly a quarter of the positive cultures came from the nimasls’ skin, fur, and feathers.

Most petting zoos I’ve visited in the US do have hand washing stations.  Even so, infants and toddlers who tend to lick and suck on their fingers before that can be cleansed should not touch any of the animals.  

Older children should be watched carefully, and parents should thoroughly wash everyone’s hands after the petting zoo visit.  One more thing: do not not consume any food near these animals.  The animals may be eating there but you shouldn’t since their germs could waft though the air into your lunch.

European Society of Clinical Microbiology and Infectious Diseases. "Petting zoos could potentially transmit highly virulent drug-resistant bacteria to visitors." ScienceDaily. ScienceDaily, 14 April 2019. www.sciencedaily.com/releases/2019/04/190414111457.htm.

#Pettingzoo #ecoli #antibioticresistantbacteria #parenting #children #gastroenteritis

Vidcast: https://youtu.be/PVtH56EdCSQ

Nasty bacteria are everywhere, and petting zoos turn out to have some of the nastiest.  An Israeli study of some 8 randomly selected petting zoos in that country reveals that an alarming number of animals are carrying drug resistant E. coli that can and do spread to human visitors. These results were presented this week at a meeting of the European Society of Clinical Microbiology and Infectious Diseases.

The microbiologists collected some 380 samples from about 230 animals of varied species in the petting zoos and found that 12% of the animals were colonized with one or more strains of dangerous and antibiotic resistant E. coli.  These germs cause terrible diarrhea and urinary tract infections.

Most of the bacteria were predictably in feces, but nearly a quarter of the positive cultures came from the nimasls’ skin, fur, and feathers.

Most petting zoos I’ve visited in the US do have hand washing stations.  Even so, infants and toddlers who tend to lick and suck on their fingers before that can be cleansed should not touch any of the animals.  

Older children should be watched carefully, and parents should thoroughly wash everyone’s hands after the petting zoo visit.  One more thing: do not not consume any food near these animals.  The animals may be eating there but you shouldn’t since their germs could waft though the air into your lunch.

European Society of Clinical Microbiology and Infectious Diseases. "Petting zoos could potentially transmit highly virulent drug-resistant bacteria to visitors." ScienceDaily. ScienceDaily, 14 April 2019. www.sciencedaily.com/releases/2019/04/190414111457.htm.

#Pettingzoo #ecoli #antibioticresistantbacteria #parenting #children #gastroenteritis

Vidcast: https://youtu.be/rBYdLg2PUlg

Patients admitted to an ICU for any medical problem, whether it directly affects the mind or not, is likely to be discharged with a thought disorder properly labeled a neuropathy.  Neuroscientists at Ontario’s Western University report this result after studying 20 patients who entered their hospital’s ICU with non-neurologic problems.

Each patient was assessed with psychometric tests upon discharge, and 100% of them demonstrated cognitive defects in two or more spheres including attention, decision-making, logical reasoning, and memory.  This is not surprising since any illness such as cardiovascular disease, infection, or traumatic injuries severe enough to land you in the ICU may certainly have secondary effects on your brain.

If you or a family member is in the ICU or has been there, a post-discharge visit to a neurologist should be considered.  Also be certain that the patient in question has proper supervision during the weeks following hospital discharge in order to detect an sudden and possibly life-threatening deterioration in status.

Kimia Honarmand, Sabhyata Malik, Conor Wild, Laura E. Gonzalez-Lara, Christopher W. McIntyre, Adrian M. Owen, Marat Slessarev. Feasibility of a web-based neurocognitive battery for assessing cognitive function in critical illness survivors. PLOS ONE, 2019; 14 (4): e0215203 DOI: 10.1371/journal.pone.0215203

#ICU #neuropathy #cognitivedeficit #memory #attention

Vidcast: https://youtu.be/rBYdLg2PUlg

Patients admitted to an ICU for any medical problem, whether it directly affects the mind or not, is likely to be discharged with a thought disorder properly labeled a neuropathy.  Neuroscientists at Ontario’s Western University report this result after studying 20 patients who entered their hospital’s ICU with non-neurologic problems.

Each patient was assessed with psychometric tests upon discharge, and 100% of them demonstrated cognitive defects in two or more spheres including attention, decision-making, logical reasoning, and memory.  This is not surprising since any illness such as cardiovascular disease, infection, or traumatic injuries severe enough to land you in the ICU may certainly have secondary effects on your brain.

If you or a family member is in the ICU or has been there, a post-discharge visit to a neurologist should be considered.  Also be certain that the patient in question has proper supervision during the weeks following hospital discharge in order to detect an sudden and possibly life-threatening deterioration in status.

Kimia Honarmand, Sabhyata Malik, Conor Wild, Laura E. Gonzalez-Lara, Christopher W. McIntyre, Adrian M. Owen, Marat Slessarev. Feasibility of a web-based neurocognitive battery for assessing cognitive function in critical illness survivors. PLOS ONE, 2019; 14 (4): e0215203 DOI: 10.1371/journal.pone.0215203

#ICU #neuropathy #cognitivedeficit #memory #attention