Dr. Howard Smith Oncall

Vidcast: https://www.instagram.com/p/C5WwxNsrj1h/ The next generation of Moderna’s mRNA CoVid vaccines will be directed against two key portions of the virus’ spike protein rather than the entire spike.  Creating mRNA that codes only for the spike’s N-terminal domain (NTD) and the receptor binding domain (RBD) generates blocking antibodies against these two spike regions that play the greatest roles in viral attachment to human cells.  As a result, this improved vaccine will be more active against variants and subvariants that pop up. The other good news about this new vaccine family, dubbed mRNA-1283 in contrast to the initial Moderna offering labeled mRNA 1273, is that it offers enhanced stability in the refrigerator vs. the freezer.  In addition, the new vaccine is effective at lower doses with fewer potential side effects. Look for this new Moderna offering in the fall. https://medicalxpress.com/news/2023-09-moderna-reveals-highly-covid-vaccine.html #moderna #CoVid #vaccine #mRNA #NTD #RBD #stability

Vidcast:  https://www.instagram.com/p/C5Wu4hYLn2O/ The FDA is now out with a warning about skin creams sold for use after tattooing, piercings, laser hair removal, and dermabrasion.  Most of these agents contain the local anesthetic lidocaine in concentrations that are dangerous. The FDA warns that using agents with lidocaine concentrations above 4% is dangerous. The agency has fired off cease and desist warning letters to 6 companies. The companies and their dangerous products include: TKTX Company: TKTX Numb Maximum Strength Pain Reliever, Mithra+ 10% Lidocaine, TKTX During Procedure Numbing Gel 40% and J-CAIN cream [LIDOCAINE] 29.9% SeeNext Venture, Ltd.: NumbSkin 5% Lidocaine Numbing Cream (15 grams), NumbSkin 5% Lidocaine Numbing Cream (30 grams) and NumbSkin 10.56% Lidocaine Numbing Cream Tattoo Numbing Cream Co.: Signature Tattoo Numbing Cream and Miracle Numb Spray Sky Bank Media, LLC, doing business as Painless Tattoo Co.: Painless Tattoo Numbing Cream and Painless Tattoo Numbing Spray

Vidcast:  https://www.instagram.com/p/C5WuKsELOVL/ Fire-inhibiting and disinfecting compounds, both of which are commonly found around our homes, damage the specialized cells that create the insulating coverings around nerves called myelin sheaths.  The absence of these sheaths is associated with multiple sclerosis. Case Western Reserve investigators have demonstrated that organophosphate flame retardants found in furniture and electronics stop the maturation of the sheath-generating oligodendrite cells while the quinaternary ammonium compounds found in disinfectants and in personal care products are frankly damaging to such cells.  Epidemiologic analyses indicate that these chemicals and the toxicity they induce are also associated with neurodevelopmental pathology including attention-deficit and autism spectrum disorders. The take away: pregnant women and young children should not be exposed to these agents.  Read product labels carefully. https://www.nature.com/articles/s41593-024-01599-2 #flameretar

Vidcast:  https://www.instagram.com/p/C5WtXOXLVfJ/ It may soon be possible to diagnose not only Parkinson’s but other degenerative neurologic disorders with simple skin biopsies.  This the promise suggested by a new study from Harvard-Beth Israel Hospital neurologists. Parkinson’s Disease, Lewy body dementia, multiple system atrophy, and pure autonomic failure are neurologic disorders with a distinctive deposit of the compound phosphorylated alpha-synuclein (P-synuclein) in tissues throughout the nervous system.  The Harvard study evaluated the practicality of detecting this telltale compound in simple skin biopsies. After evaluating leg, thigh and neck skin samples from 428 individuals with these neurologic disorders, the data demonstrated the presence of P-synuclein in 93% of those with Parkinson’s, 96% of those with Lewy body dementia, 98% of those with multiple system atrophy, and 100% of those with pure autonomic failure. New studies are underway to validate the usefulness of P-synuclein skin biopsi

Vidcast:  https://www.instagram.com/p/C5WshKLr39o/ Columbia University biomedical engineers have harnessed the method by which cells normally communicate with each other in order to deliver poison pill chemotherapy directly to lung cancer cells.  Knowing that structures called exosomes are cell-to-cell messengers, the researchers have engineered these so-called extracellular vehicles to convey messengerRNA capable of directing lung cancer cells to produce suicidal chemotherapy. Comparing their engineered exosomes to liposomes of the type successfully used to convey CoVid vaccine mRNA, they demonstrated the superiority of exosomes for chemotherapy delivery.  These exosomes, delivered by the latest inhalation devices, can transmit to ailing cells powerful immunotherapy including that driven by interleukins such as IL-12. These bioengineered exosomes or EVs for extracellular vesicles can also be employed to deliver other agents to a variety of cells in a variety of diseased organs.  Though not yet being test

Vidcast:  https://www.instagram.com/p/C5WrzUdr3Tr/ Those who religions’ dietary laws forbid the ingestion of any foods or proteins from pigs often use this prohibition as the reason for rejecting the use of vaccines including the measles vaccine for their children and themselves.  It is true that many vaccines do use porcine gelatin, but there is an alternative. The Priorix Measles, Mumps, and Rubella vaccine contains beef rather than pig gelatin.  Studies have shown that Priorix is as effective and safe a vaccine as those that contain pig gelatin. So…. If you adhere to kosher or Halal food laws, ask your child’s or your own medical team about Priorix.  You can protect your family and your community by preventing the spread of communicable disease and still be faithful to your religious beliefs. https://www.cdc.gov/vaccines/acip/recs/grade/mmr-PRIORIX-etr.html #mmr #vaccine #measles #pork #beef #gelatin #halal #kosher #muslim #judaism

Vidcast:  https://www.instagram.com/p/C5WrBg0rMGD/ Just as second hand smoke contains dangerous compounds that can induce lung disease and worse, the fumes from e-cigarettes are transmitting chemicals into the bodies of anyone in the vaper’s vicinity.  Nurse researchers from Emory University now report that metabolites of agents contained in vaping liquids have been detected in the blood and saliva of children whose parents use e-cigarettes. Worse still, half of parents were unaware that e-cigarette vapors posed any risk to children.  Specifically, 58% of vaping parents in a focus group thought that vapors from their own devices were creating very mild or no risk to their own children. The vapors from e-cigarettes contain addicting levels of nicotine as well as volatile organic compounds that have inflammatory and/or carcinogenic effects on the lungs.  If you must vape or smoke electronic cigarettes, don’t do it around your children or around any children. https://www.clinicaladvisor.com/reports/secondha

Vidcast:  https://www.instagram.com/p/C5WpotMrR0E/ Ninety-five percent of benzoyl peroxide-containing cosmetics contain detectable levels of the human carcinogen benzene.  Even more worrisome: 89% of these products will harbor significantly toxic benzene concentrations if heated to levels considered safe by pharmaceutical standards. These findings prompted the independent testing lab Valisure to seek a mandatory FDA recall of all acne medications that contain benzoyl peroxide or BP for short.  The tested products include Equate Beauty 2.5% BP cleansers, Neutrogena 10% BP cleanser, CVS Health 10% BP face wash, Walgreens 10% BP cream, Clean & Clear 10% cleanser, Equate Beauty 10% BP acne wash, and Proactiv 2.5% BP cleanser. Predictably, some of the companies manufacturing BP-containing products as well their national trade association took issue with some of the test procedures.  Others groups have validated the reliability of these tests. While more investigations are ongoing, the best advice is to av

Vidcast:  https://www.instagram.com/p/C5Woz9vLkT-/ With the astronomical success of the GLP-1 agonist drugs including semaglutide and tirzepatide, shortages of these drugs are driving a search for alternatives using artificial intelligence techniques.  In addition to finding more diet drugs, the search is on for new compounds with fewer side effects. Spanish researchers are due to tell this spring’s European Congress on Obesity that their AI search of more than 10,000 naturally occurring compounds has identified two compounds that stimulate GLP-1 receptors.  These agents, dubbed Compounds A and B, are non-peptides and, as such, can be administered orally eliminating the need for injection.   Once these agents were identified, the investigators have used computer models to predict how well they will work in the human body.  More to come. https://www.medscape.com/viewarticle/ai-identifies-two-natural-bioactive-glp-1-compounds-2024a10005ze?ecd=a2a #diet #glp1agonist #semaglutide #tirzepatide #AI  diet, gl

Vidcast:  https://www.instagram.com/p/C5Wn8VVry4R/ Hospitals and medical schools across the US opened up e-letters on April 1st from the Department of Health and Human Services, and it was no April Fool’s joke.  The letter heralded guidance rules and regulations regarding the new requirement for a patient’s written informed consent to any and all “sensitive and intimate examinations including pelvic, breast, prostate, and rectal” particularly those performed under anesthesia by all staff and trainees. The medical necessity for these exams should be explained to the patient before signing is requested whether the exam is planned for the immediate future or was conducted due to unforeseen circumstances while the patient was under anesthesia.  In all circumstances, you, as the patient, have the right to refuse consent for such examinations by licensed providers and/or by trainees including medical students, fellows, nurse practitioners, physician assistants, and student nurses. So expect to be asked to sign

Vidcast:  https://www.instagram.com/p/C5B_XR2LsjW/ The Food and Drug Administration and Wenders LLC are recalling Trader Joe’s 50% Less Salt Roasted & Salted Whole Cashews.  Lots  T12139, T12140, T12141, and T12142 have salmonella contamination. This bacterium can trigger serious and possibly fatal infections in the very young, elders, and in those with weak immune systems. The cashews were sold by Trader Joe’s in AL, AR, AZ, CA, CO, ID, KS, LA, NM, NV, OK, OR, TN, TX, UT, and WA state. Do not consume these nuts.  Return them to the place of purchase for a refund.  For more information, email Wenders LLC at foodsafety@wendersllc.com. https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/wenders-llc-recalls-trader-joes-nuts-50-less-sodium-roasted-salted-whole-cashews-because-possible #traderjoes #cashews #salmonella #infection #recall

Vidcast:  https://www.instagram.com/p/C5B-bYLraqu/ The Consumer Product Safety Commission and Twenty Four Six Foods now recall Happiness USA Liquid Rolling Candy.  The rolling ball on the liquid candy dispenser easily detaches and becomes a choking hazard. About 290,000 units were sold at kosher market stores nationwide. Immediately take these candy dispensers away from your . Contact Twenty Four Six Foods at 1-833-436-1200 or via  email at recall246foods@gmail.com to obtain a refund. https://www.cpsc.gov/Recalls/2024/Twenty-Four-Six-Foods-Recalls-Happiness-USA-Roller-Ball-Candy-Due-to-Choking-Hazards #twentyfoursixfoods #liquidcandy #rollingball #choking #recall

Vidcast:  https://www.instagram.com/p/C5B9eOlrZHE/ The Consumer Product Safety Commission and the Culture Kings company are recalling Culture King’s Magnetic Levitation Sneaker Displays.  The powerful magnets that permit the sneakers to float can attract each other leading to display breakage, plastic splintering, and even spark emissions leading to lacerations and other injuries.  Should the multiple magnets be swallowed, they can lead to bowel perforations, twisting, and obstruction with infections that can become deadly. About 4300 of these sneaker displays were sold online at culturekings.com. Immediately store these displays and contact Culture Kings at 1-888-520-1885 or via email at sneakerdisplays@realtimeresults.net for a refund and recalled product stickers.  When handling this display, keep the magnets at least 6 inches apart. Put the stickers on the metal side of each magnet, destroy the display by cutting the power cord, and upload a photo of the destroyed unit and the stickered magnets to rec

Vidcast:  https://www.instagram.com/p/C5B8h2Ir6T-/ The Consumer Product Safety Commission and Fisher-Price now recall Fisher-Price Little People Mickey and Friends Figures.  In particular, Donald and Daisy have heads that detach and create choking hazards for young children.  The other figures are said to be ok, but I’d check them to be certain. About 204,000 of these figure packs were sold in the US and about 11,000 were sold in Canada) at Walmart, Kohls, Meijer, HEB and Kroger stores nationwide, and online at Amazon.com and Walmart.com and other various eCommerce sites. Take the Donald and Daisy figures away from your kids.  Contact Fisher-Price at 1-855-853-6224 to receive a prepaid return shipping label to send back Donald and Daisy for a $10 refund.  https://www.cpsc.gov/Recalls/2024/Fisher-Price-Recalls-Little-People-Mickey-and-Friends-Figures-Due-to-Choking-Hazard #fisherprice #toy #figures #donald #daisy #disney #choking #recall

Vidcast:  https://www.instagram.com/p/C5B7yWBrMfP/ The Consumer Product Safety Commission and the Crown Boiler Company are recalling Crown Aruba IV (AWR Series) gas-fired hot water boilers.  The blocked vent switch fails to operate properly at altitudes above 2,000 feet leading to emission of poisonous carbon monoxide. About 1100 of these boilers were sold by heating and plumbing contractors and wholesale distributors nationwide. If you have one of these boilers, contact the Crown Boiler Company at 1-888-583-5624 or via the email  AKP@velocityboilerworks.com to check if your particular boiler model number is part of the recall.  If so, the company will arrange a free repair.  Meanwhile, if you must use the boiler, have a carbon monoxide monitor operating. https://www.cpsc.gov/Recalls/2024/Crown-Boiler-Recalls-Home-Heating-Boilers-Due-to-Carbon-Monoxide-Poisoning-Hazard #crown #boiler #gas #blockedventswitch #carbonmonoxide #poisoning #recall

Vidcast:  https://www.instagram.com/p/C5B7BParYFb/ The Consumer Product Safety Commission and Nestlé USA have recalled Metallic Mugs included in 2023 Holiday Starbucks-branded Gift Sets.  If these mugs are heated by microwave or by filling with with very hot liquids, they overheat and crack leading to burns and lacerations. About 440,500 of these gift sets with mugs were sold online and in-store nationwide at Target and Walmart and through Nexcom military retail outlets. Stop using these mugs.  For a refund, return them to the place of purchase or contact Nestlé USA at 1-800-681-1676. https://www.cpsc.gov/Recalls/2024/Nestle-USA-Recalls-Metallic-Mugs-Sold-with-Starbucks-Branded-Gift-Sets-Due-to-Burn-and-Laceration-Hazards #nestle #cups #metallic #overheating #cracking #burns #lacerations #recall

Vidcast:  https://www.instagram.com/p/C5B58KcLbMq/ The Consumer Product Safety Commission and Ravin Crossbows are recalling Ravin R500 Model Crossbows.  If the device is not fully cocked, it can suddenly discharge creating injuries to the user or bystanders. About 13,300 of these crossbows were sold in the US and about 425 were sold in Canada at Ravin, Bass Pro Shops, Cabela’s, Dick’s Sporting Goods stores and other stores nationwide, and online at ravincrossbows.com. Immediately stop using these crossbows and contact Ravin Crossbows at 1-888-298-6335 or via, email at R500recall@ravincrossbows.com in order to arrange a free repair. https://www.cpsc.gov/Recalls/2024/Ravin-Crossbows-Recalls-Ravin-R500-Series-Crossbows-Due-to-Injury-Hazard #ravin #crossbow #discharge #injuries #recall

Vidcast:  https://www.instagram.com/p/C48quhaLgwD/ Health insurance corporations are preventing patients from receiving the latest and most effective treatments for IBD, Crohn’s Disease and Ulcerative Colitis.  Over 80% of US health insurance companies refuse to authorize the most contemporary therapy for inflammatory bowel disease as initial therapy.  This the conclusion of a review by gastroenterologists at Harvard’s Beth Israel Deaconess Hospital. Over 90% of companies insist that any given patient first fail one of the decades-old therapeutic regimens for IBD before prescribing modern therapy.   Only after failing to respond to salicylates, steroids, or immunosuppressive drugs, are patients permitted to employ cutting edge biologics including anti-tumor necrosis factors and adhesion molecule antagonists. Studies have shown that the early use of these effective and contemporary approaches leads to enhanced bowel healing preventing hospitalizations, surgical procedures, and irreversible disease.  Of the

Vidcast:  https://www.instagram.com/p/C48pAtGLNIy/ The FDA has improved what is described as a new treatment for certain chronic nasal and sinus infections. This therapy for so-called chronic rhinosinusitis without nasal polyps employs the long-used steroid nasal spray fluticasone, branded as Flonase, but delivers this drug using a novel dispenser that employs a higher pressure exhalation delivery system called the Xhance, marketed by the Opinose company.  The device sports a blow hole into which the patient forces air under pressure.  This pressurized exhaled air carries the steroid mist up into the higher reaches of the nasal cavity.   Two company-sponsored so-called phase 3 studies demonstrated that the Xhance system with the topical steroid versus a comparable exhalation delivery system with placebo solution led to fewer nasal and sinus symptoms and improved sinus aeration on imaging.  It would seem that the controls are flawed.  An appropriate control would be the Xhance exhalation steroid delivery s

Vidcast:  https://www.instagram.com/p/C48oOcerTFL/ The FDA has fired off letters to the Chinese manufacturer of plastic syringes and the two American importers of these products due to persisting quality issues.   The FDA has directed Medline Industries and Sol-Millennium Medical Inc, the importers and distributors of these Chinese syringes, to immediately transition away from selling plastic syringes manufactured by Jiangsu Caina Medical Co. Ltd as this company’s syringes consistently leak, break, and fail to deliver reproducible liquid volumes. The FDA warns consumers, medical teams, and healthcare organizations to check the origin of the syringes they use and to use non-Chinese syringes if at all possible.  If they must be used, monitor them carefully for failures.  Glass syringes, syringes pre-filled with medications, and syringes used for topical and oral delivery of medications are not affected. https://www.fda.gov/medical-devices/safety-communications/update-evaluating-plastic-syringes-made-china-