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Best Of - 2nd - Week of Apr 2023



The Morning After Pill Less Effective For The Obese: Best Of: 0822



Even a double dose of Plan B, levonorgestrel, the most common morning after pill, fails to significantly reduce the chances of ovulation and therefore pregnancy in obese women.  Oregon Health and Science University investigators studied 70 women with a mean age of 28, a mean body mass index of 38, and a body weight of greater than 175 pounds.


The group of participants receiving the standard 1.5 mg dose of the progesterone levonorgestrel experienced only a 51% incidence of ovulation prevention while the group receiving the 3 mg double dose had only a 69% ovulation prevention.  Not every effective.  While the higher dose did inhibit egg release somewhat, the extra protection it afforded was not statistically significant and did not provide reliable emergency contraceptions.


The OBGYN clinicians participating in the study recommend that obese women requiring emergency contraception consider asking their medical teams for ulipristal, marketed as Ella and EllaOne.  This drug is a selective progesterone receptor modulator and does work effectively in heavier women.


#morningafterpill #obesity #ovulation #planB #levonorgestrel #Ella #ulipristal

morningafterpill, obesity, ovulation, planB, levonorgestrel, Ella, ulipristal



Coffee Triggers Excessive Shopping: Best Of: 0622



Those drinking coffee prior to shopping in stores spend 50% more money and purchases 30% more items than non-coffee drinkers.  Academic marketing investigators at the University of South Florida studied 300 subjects shopping in stores in France and in Spain.


One-half of the shoppers were provided a free cup of coffee containing 100 mg of caffeine.  The others were offered either decaf coffee or water.  Those drinking caffeine not only bought more items in total but the extra items were non-essential or impulse items.  Un-caffeinated shoppers bought the same numbers of essential items as those drinking caffeine.


In a side experiment looking at online shopping, the researchers followed 200 business school students who, by habit, drank caffeinated beverages or didn’t.  Analysis of their purchases revealed that the caffeinated shoppers bought more impulse than essential items.


#shopping #caffeine #impulse

shopping, caffeine, impulse



Walking Faster Makes Aging Slower: Best Of: 0522



Those who consistently walk at a brisk pace have cells that are measurably 53% younger compared with those who walk at an average pace.  British researchers studied data from nearly 406 middle-aged persons with data in the UK Biobank and correlated self-reported walking speeds with a quantitative measure of cellular aging, the white cell telomere length.  The longer the telomere, the younger the cell.


Of the entire group, 52.3% reported walking at average speeds, 41.1% at brisk speeds, and 6.6% at slow walking paces.  Compared with slow walkers, those walking at an average speed had telomeres 66 units longer and the brisk walkers had telomeres that were 101 units longer.


The investigators emphasize that habitual brisk walking not only keeps your cells younger but makes your body as a whole less susceptible to all diseases.


#aging #telomerelength #walkingpace #exercise

aging, telomerelength, walkingpace, exercise



Speed Bumps A Danger For Pregnancies: Best Of: 0421



Hitting speed bumps at speeds exceeding 28 mph may cause brain injuries to a 3rd trimester fetus and uterine stress for the mother.  This warning comes from engineers at the University of British Columbia.


The investigators derived their conclusions from models that calculate the effects of speed bump shear on the fetal brain as well as the uterus after a vehicle hits the bump.  Variables include the vehicle speed and the speed bump size.


Crunching the numbers leads to the conclusion that vehicles with women in their late pregnancy stages should go over speed bumps at 15 mph or less.  They similarly caution care and suggest slower speeds when traversing bumpy terrain.


#speedbumps #pregnancy #fetus #uterus

speedbumps, pregnancy, fetus, uterus



Keeping Teens Off Tanning Beds Saves Lives and Dollars: Best Of: 0421



Barring US teens 14 to 17 years of age from using indoor tanning facilities would prevent more than 18,401 melanoma cases and save $205 million healthcare dollars.  This from a microsimulation study just published in the journal Cancer.


Banning tanning bed use for the 17.1 million US minors would prevent 15,101 primary melanoma cases and 3,299 potentially deadly recurrences over their lifetimes.  Exposure to UV radiation is most dangerous for the young, and a 2009 survey showed that 32% of high school students used a tanning bed at least once in the preceding year.


Seven European countries ban teen tanning altogether.  American teens should avoid it themselves.


#tanning #melanoma #teens #tanningbeds

tanning, melanoma, teens, tanningbeds



Physical Activity Out Of Work Most Beneficial: Best Of: 0421



Exercising during your off-hours can reduce your chances of death by as much as 40%.  Ironically, though, high physical exertion at work actually increases your death risk by 27%.  Danish researchers present these conclusions after studying the mortality data from a cohort of 104,046 Danes and tabulating it with self-reported physical activity during leisure time and at work.


Compared with those reporting little leisure activity, those with moderate and high or very high physical exertion experienced 26% and 40% reduced risks of death from coronary events and stroke.  Work activity was unhelpful, and those with high and very high exertion at work were 13% and 27% more likely to die.


#exercise #leisuretime #work #mortality 

exercise, leisuretime, work, mortality



Better Sleep Heals Post-Traumatic and Other Brain Disease: Best Of: 0321



Concussion, dementia, and sleep deprivation produce similar changes to your brain’s architecture as determined by a novel MRI imaging analysis.  Oregon investigators now present data from their study of 56 Afghanistan war vets and suggest possible therapeutic approaches to TBI and dementia.


Their imaging data shows a correlation between battle brain trauma and enlargement of perivascular spaces that fill with metabolic waste as the result of brain cell damage.  This same material collects with advancing age and dementia, but sound sleep helps flush it away.


The researchers propose that their imaging technique provides a diagnostic and monitoring tool for brain injuries and a method for documenting improvement driven by improved sleep.


#tbi #concussion #dementia #sleep #mri

tbi, concussion, dementia, sleep, mri



NSAIDs Increase Bleeding After Tonsillectomy: Best Of: 1120



If your child has a tonsillectomy, don’t use ibuprofen, Motrin or Advil, to control post-operative pain.  A study from Harvard’s Boston Children’s Hospital shows that these drugs increase the risk of bleeding following tonsillectomy by 36%.


The study analyzed more than one-half million children under 18 years who underwent tonsil removal between 2004 and 2015.  Another NSAID, ketoralac, a non-steroidal anti-inflammatory drug often used in the recovery room, increased the bleeding risk by nearly 40%.


How do you then help your kid get through recovery.  Use acetaminophen, Tylenol, every 4 hours and give them plenty of sugar.  I put my tonsillectomy patients on the Twinkie diet since sugar does damp pain.


#bleeding #tonsillectomy #ibuprofen #nsaids

bleeding, tonsillectomy, ibuprofen, nsaids



Menopausal Hot Flushes And Sweats Predict Cardiovascular Trouble: Best Of: 0720



Women with these vasomotor symptoms or VMS are 70% more likely to suffer heart attacks or strokes over time.  Epidemiologists at Australia’s University of Queenland just published this warning after their meta-analysis of 23,365 women.


The risk of adverse cardiovascular consequences rises with severity of hot flushes and night sweats but not with how often they occur.  Women with severe vasomotor symptoms are more than twice as likely to have a cardiovascular issue compared with those without such symptoms.  Even pre-menopausal flushes and sweats raise the risk 40%.


If you are a woman experiencing these vasomotor phenomena, speak with your doctors to establish comprehensive cardiovascular monitoring.


#menopause #hotflashes #vasomotor #cardiovascular #heartattack #stroke

menopause, hotflashes, vasomotor, cardiovascular, heartattack, stroke


Nervous Neds and Nellies May Stay Safer: Best Of: 0619



Those who tend to be anxious have a 6th sense superpower that effectively protects them from danger.  A new study from Caltech’s cognitive neuroscience department shows that anxious individuals more effectively flee from subtle dangers.


The study participants were challenged with a series of virtual reality threats characterized as slow that are impending or fast that are immediate.  Brain activity was assessed by real time MRI.  


The most anxious individuals did a better job of dodging slow threats while all participants performed about the same with fast threats.  If you tend to be anxious and take a lot of ribbing about your risk aversion from your friends and family, just tell them that you have a very special sense that someday may save you and also them from disaster.


Bowen J. Fung, Song Qi, Demis Hassabis, Nathaniel Daw & Dean Mobbs. Slow escape decisions are swayed by trait anxiety.  Nature Human Behaviour (2019) .


#Anxiety #danger #risk #superpower

Anxiety, danger, risk, superpower



Weight Yourself Down To Lose Weight: Best Of: 0520



Wearing a weighted vest for just 3 weeks could help you lose 5 times more weight.  A new study from Sweden’s University of Gothenberg studied weight loss in 69 mildly obese subjects.


The experimental group wore 24 pound vests while the control group wore 2 lb vests over the study period.  The weigh-in at the end clocked a 3.5 pound average weight loss for the heavy vest group versus a .7 pound loss for controls.  The weight lost was in fat and not muscle.


The investigators attribute the effect to a natural “gravitostat.”  Animal experiments suggest it controls appetite.  Of course, moving about with a weighted vest does expend more energy.


#obesity #dieting #weightedvest #fat

obesity, dieting, weightedvest, fat



Snoring And Sleep Apnea May Lead to Young Athletes’ Sudden Death: Best Of: 0319



Stocky, young athletes often experience disordered sleep snd breathing patterns that could predispose them to heart attack and sudden death.  Exercise scientists from Japan’s Showa University explored this situation by studying 42 male rugby players 18-19 years of age.


After formal sleep studies were completed, 43% of the players experienced significant sleep disordered breathing with snoring, dangerous pauses in their breathing, higher than normal heart rates, and lower than normal oxygen levels.  Further studies of these athletes’ hearts revealed rhythm abnormalities suggesting they had potentially lethal cardiac damage already.


If you have a teen or a spouse, male or female,  “sawing wood at night,” don’t ignore it.  Push for a formal sleep study to determine if the noisy breathing is accompanied by dangerous oxygen level dips and heart rate abnormalities.


Yoshitaka Iso, Hitomi Kitai, Etsushi Kyuno, Fumiyoshi Tsunoda, Naoya Nishinaka, Masahiko Funato, Eiichi Nishimura, Shuichi Akihiro, Hiroyuki Tanuma, Toru Yonechi, Eiichi Geshi, Takeyuki Sambe, Hiroshi Suzuki. Prevalence and significance of sleep disordered breathing in adolescent athletes. ERJ Open Research, 2019; 5 (1): 00029-2019 DOI: 10.1183/23120541.00029-2019


#Snoring #apnea #hypoxia #sleepdisorderedbreathing #teens #athletes

Snoring, apnea, hypoxia, sleepdisorderedbreathing, teens, athletes



It’s Lyme Time Again: Best Of: WBZ Radio: 0391



The Lyme Disease season begins in April and peaks in the summer.  On his WBZ Radio program Dr. Howard Smith OnCall he provides an Early Bird Special about Lyme disease and what you need to know to protect yourself.  Get the excellent online CDC Lyme disease pamphlet at:


#lyme #ticks #rash #arthritis #cardiac #wbznewsradio

lyme, ticks, rash, arthritis, cardiac, wbznewsradio




A Child With Persistent Ear Fluid: Best Of: WBZ Radio: 0190



Dr. Smith takes a WBZ Radio on-air call from the mother of a 6 year old with recurrent ear infections and persistent middle ear fluid.  They discuss a medical approach than can prevent the need for tube surgery.


#earinfections #earfluid #otitis #serousotitis #eartubes #wbznewsradio

earinfections, earfluid, otitis, serousotitis, eartubes, wbznewsradio



The Deadly Toothpick: Best Of: WBZ Radio: 0191



Lead-in by WBZ’s Gary LaPierre

Dr. Smith reports on his WBZ Medical Minute the sad New England Journal posting about a young man who swallowed a toothpick with ultimately fatal consequences.


#toothpick #bowels #eyes #perforation #wbznewsradio

toothpick, bowels, eyes, perforation, wbznewsradio




Rescuing Yourself From Fatal Choking: Best Of: WBZ Radio: 0891



Dr. Smith gives his WBZ Radio listeners a tip regarding the do-it-yourself Heimlich-type maneuver that actually preceded Heimlich’s report.  The Flake Maneuver was developed by Boston Children's Hospital ENT specialist Carlyle Flake MD.


#choking #flakemaneuver #heimlichmaneuver #foreignbody #asphyxiation #wbznewsradio

choking, flakemaneuver, heimlichmaneuver, foreignbody, asphyxiation, wbznewsradio

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