until next time, i hope you're learning to be more of a healthy you. i'm jamie. it is time now for "sunday house call." >> welcome to our program. joining us is dr. david samadi, chairman and professor of urology and chief of robotic surgery. >> and associate professor of medicine is marc siegel. unlocking the se cred code of sickness and health. i know so many people home sick right now watching us. this show is even for the healthy ones, too, right? >> absolutely. >> we'll take care of everybody today. >> one of the big issues has to do with the historic cold temperatures across the country.

that can mean really dangerous and possibly deadly conditions from hypothermia to frostbite. what do you do in the freezing temperatures? how can you protect yourself? dr. samadi, you know, you can wear mittens and glofgs and thermal underwear and hats -- >> hugs are very helpful. >> especially starting in 2014, we need a lot of hugs. this is serious. many of the temperatures in the midwest are minus 18 degrees. we haven't seen these kind of temperatures, even coming to the studio today. it's cold out there. you want to be really careful about this. now, hypothermia, normal temperature is about 98 degrees. when it comes to 95 degrees is when hypothermia or low heat kicks in. our body is very interesting, because when you get to this kind of temperature, your whole system is going to start to react. the heart is going to shut down the blood flow to all the extremities, so you don't get blood to your toes, your fingers, to the face. and try to preserve it to keep it heat. your central nervous system can slow down, so you can become

confused, delirious, lose memory in severe cases. and your respiratory system, you start having shallow breathing. that's really important. now, frostbite is something we see in this kind of temperature. that's the effect on the skin as a result of freezing. the first stage is when your skin gets really red, numb, itchy. the second phase is when it gets white. you want to be careful. this is a time you want to get inside and stay away from the cold, because that's when the vaso constriction or blood flow will not get there. the gangrene, black and blue, can lead to amputation. >> what if you're outside in the cold. how do you know if you've got hypothermia? do you get dizzy? does it come on silently and quickly and you don't even realize it? >> the problem is exactly that. because numbness is involved, you may not know it. people around you should be on the lookout for it. the body is trying to preserve blood flow to the vital organs.

what it does is cuts down on blood flow to the extremities, fingers, toes, chin. >> do you feel it? >> you may feel numb, and you may feel itchy, just like david just said. you look for redness, and look for then paleness. you have to get out of the cold right away. who's prone to this? people with circulatory problems have this problem. and then anybody that's out there for more than 30 minutes and is not properly covered. go indoors, get covered. you can use warm water to heat back up. you don't want to use electrical -- >> slowly? >> slowly. >> you want to jump in the hot shower. >> not too hot. and don't use electrical devices like heating pads or massage. that can actually cause more damage. frostbite can be term nepermane damage to the skin. we have a treatment we never had before. we're using cloth dissolvers in very bad cases. an activator that we use for heart attacks, we use for severe

frostbite. it's called tpa. we use it to prevent amputations. now the rate of amputations for severe frostbite is down to 10%. still terrible, but an improvement. >> big improvement i would imagine. if you're suffering from severe symptoms, like you mentioned, the confusion, should you go to the hospital? >> it's a medical emergency. you have to call 911. the fortunate thing it's ve reversible. put a warm pack on their armpits, warm drinks. you don't want to go into high temperature, because you don't have sensation, you can burn your skin. the patients that are in trouble are the diabetics that don't have the actual sensations, hypo thyroid. you want to be very careful. different people are different. you can have this type of hypothermia in five minutes. don't go out and say we have 30 minutes before we get in trouble. different people, different conditions, within five to ten minutes. >> children? >> children are very

susceptible. and drinking alcohol is not a solution. it causes vaseo dilation. so stay away from alcohol and coffee. >> any kind of medications or drugs. >> you think that's a big deal, too, both of you. drinking alcohol, thinking it's going to warm you up. that's not the way to go. >> that's right. you don't want to drink at this time. >> all di retices. >> smoking must be awful, too. top medical advances of the year, you mentioned a great one about frostbitten limbs can be saved. there's a scam, too, that's a break-through, that doctors say could transform the way people are treated with heart blockage. >> this was a british study. it it's revolutionizing how we look at heart attacks. we don't want to have to go to an angiogram or catheterization

all the time. c.a.t. scans, we have the angiogram, that shows what blockage you have. c.a.t. scans that tell you if your coronary arteries are getting calcified. we have stress tests. these are what we call noninvasive tests, jamie. now we have a new one still in the works but it's very exciting. they're usie ining p.e.t. scans technology. the imaging from p.e.t. tells you what area of the body is heating up. we want to know if the plaque is heating up in your coronary arteries. if the plaque ruptures, that's when you have a heart attack. this may be important in the next year or two, to tell us, hey, we know you have coronary artery disease, but you're getting ready to have a heart attack. you better get seen by your cardiologist now, you better get in now. >> or aneurysm? >> this is not meant for

aneurysm. you'll get a c.a.t. scan for this. this p.e.t. scan study is promising. but i'm not sure it will change the way we practice. it's only about 80 patients in the study. it was accurate in about 90%. we still have a long way to go for p.e.t. scan to come in this field. we use p.e.t. scan in our field for kidney cancers, and 50/50 can guess whether there's a cancer in the body. for bone imaging it would work. >> what does it show that a c.a.t. scan doesn't? >> they're seeing where the aggregate of the cells, sometimes with this kind of plaque formation you would have inflammation. it detects where the plaque ruptures. when the rupture happens is when the plaque starts to go and block the artery, heart attack and go to the brain and cause stroeblg. nobody knows the cause of plaque rupture. it's unknown. what we know is 60 million americans suffer from coronary artery disease. what i like is the test that

marc just mentioned, i just had mine about a year ago. it's a c.a.t. scan that looks how much calcium you have in the artery. if it's zero, which was mine, you're good to go. if it's over 100, you're in trouble and you want to see your cardiologist. >> do you ask for it? >> what you ask for is there's a lot of noninvasive tests out there now that you might be able to have before a cardiologist sends you for an angiogram. >> with needles and dyes. >> put that on the list. >> not for screening purposes, unless you have family history of heart disease, high blood pressure. >> skipping a flu shot, many people are squeakish. you can get the same protection without the shot. the doctors will fill us in on that. we always hear there's no cure for the common cold? but is there? there's a new blood test that could help fight that pesky

cough and stuffy nose that often comes with a cold. we'll be right back. [ me announcer ] this is the story of the dusty basement at 06 35th street the old dining table at 25th and hoffman. ...and the little room above the strip mall f roble avenue. ♪ this magic momt it is the story of where every great idea begins. and of those o believed they had the power to do more. dell is honored to be part of some of the world'great stories. that began much the same w ours did. in a little dorm room -- 2713. ♪ this magic moment ♪ ♪ legs, for crossing. ♪ et...splashing. better things than the joint pain and swelling of moderate to severe rheumatoid arthritis. if you're trying to manage your ra, now may be the time to ask about xeljanz xeljanz (tofacitinib) is a small pill,

not an injection or infusion, for adults with moderate to severe ra for whom methotrexate did not work well. xeljanz is an ra medicine that can enter cells and disrupt jak pathways, thought to play a role in the inflammation test. test. unless ok with your doctor. tears in the stomach or intestines, low blood cell counts and higher liver tests and cholestel levels have happened. your doctor hould perform blood tests before you start and while taking xeljanz, and routinely check certain liver tests. tell your doctor if you have been to a region where certain fungal infections are common, and if you have had tb, hepatitis b or c, or are prone to infections. tell your doctor about all the medicines y take, and if you are pregnant, or plan to be. taken twice daily, xeljanz can reduce the joint pain and swelling

of moderate to severe ra, even without methotrexate. ask if xeljanz is right for you.

back now with back on "sunday house call." get your flu shot yet? sometimes getting vaccinated can be a painful experience. we learned about cutting-edge research to look at ways to getting the shot without the use of needles. when can it start? >> she's ready to go. >> you see my sleeves are protecting me, so you guys coming after me with the flu shots. ready. >> we're not going to debate the benefit of flu shot. the problem with the flu shot is not just the needle itself, which can cause contamination, hiv, all those things we spoke about. it's intramuscular, it's painful. but the biggest news is the refrigeration. you have to keep it refrigerated

because the virus can die if you don't keep it that way. that's part of the reason getting the vaccine to a lot of poor countries where they may not have this kind of refrigeration can be devastating. the name of the company is vassax, a nano patch. a tiny little patch. almost the size of a dime. >> like a smoking patch thing. >> it's a tiny -- the size of a dime. it has 20,000 microprojections, that comes out of it. you put it on the skin, and it's not deep enough to get to the pain receptors. so you don't feel any pain. >> this is brilliant. for real? >> it's real. no, listen to this. at the tip of this microprojection, you already have the virus that's necessary for the vaccination, jamie. it gets into your system, and it can lead to a good vaccination. it's done in experiment, not

ready for a couple of years. it's important because it can be used for treatment of diabetes. it can work, so no more injections for them. for people who inject inflammatory, prednisone. >> even b-12 for vitamins and nutrition. i'm liking this technology. >> i think so, too. to answer eric's question, not ready for primetime. we're a couple of years away from being able to use it. in the doctor's office. but what i like about it is, one of the points david made, is you don't need to refrigerate it. a lot of problems with the live vaccines is you have to refrigerate them. that limits the usefulness. yes, a lot of kids are afraid of needles. i want everybody to get a flu shot. 50% of kids still don't get a flu shot. that's why we have the rampant flu epidemic we have every year. it's hard to get them to take the inhaled vaccine, too. maybe we can get them to use this. it's also useful for anti-aging

creams, diabetes. the idea it can get medication under your skin and absorbed into your body without a shot is key. it can be used for malaria vaccine which is in the works right now. it will have uses all across the board for using medications as well as vaccines. by the way, there's other vaccines out there that you can eat a strawberry and get a vaccine. all kinds of vaccines in the works. >> i have to get a question in here. eric, you had your suspected question. i'm not asking this to be silly. you said it's only done in wraps. >> the first stage of the clinical trial is so far the out yom, the result has been superb, in 90%. guess who's behind it, bill gates foundation is investing a lot of money in this. this has potential to revolutionize the way we treat diabetes in this country.

we've been talking about nano technology more and more every week. these are tiny, small, microscopic ways to really give this kind of vaccine. i think it has a tremendous potential. >> one of the biggest knocks on the flu vaccine is how an ti tw quated it is. you can eat a vaccine, have it put on your skin, you can inhale it. we're going to get a universal vaccine that lasts for ten years. this is going to be the future. that's what we're talking about here today. >> all these poor little mice. >> but it's brilliant. many needles that don't hit the pain receptor, wow, fantastic. thank you, doctors. we all are seeing a lot of people who have the cold, the common cold. it's always been uncommonly difficult for doctors to treat, even our doctors. but there's a new break-through they want you to know about that could change how all doctors are going to approach the illness, and they'll explain next.

>> some people basically are too polite to tell you when you've got bad breath. but you know that soon your smartphone, yeah, they say the smartphone can help you tell if you need to get a mint. how this would work, what it will mean, coming up. >> notice i'm not piping in, eric?er fifteen minutes could save you fifteen percent or more on car insurance. everybody knows that parker. well, did you know auctioneers make bad grocery store clerks? that'll be $23.50. now .75, 23.75, hold 'em. hey now do i hear 23.75? 24! hey 24 dollar, 24 and a quarter, quarter, now half, 24 and a half and .75! 25! now a quarter, hey 26 and a quarter, do you wanna pay now, you wanna do it, 25 and a quarter - sold to the man in the khaki jacket! geico. fifteen minutes could save you... well, you know. to prove to you that aleve is the better choice for him, he's agreed to give it up. that's today? [ male announcer ] we'll be with him all day as he goes back to taking tylenol. i was okay, but after lunch my knee started to hurt again.

and now i've got to take more pills. ♪ yup. another pill stop. can i get my aleve back yet? ♪ for my pain, i want my aleve. ♪ [ male announcer ] look for the easy-open red arthritis cap.

we have all had a economic cold and tried everything and nothing works. now there is a new breakthrough on how doctors can actually interpret if it is a cold and tell whether it is bacterial or viral by a blood test and know how to treat it. >> this is big.

this is not ready for rhyme time 102 people studied at duke university. but there are a couple of issues. first of all, we overprescribe antibiotics. two million people are getting resistant bacteria because we giving out 50 percent unnecessary antibiotics that lead to resistant bacteria because of mutation. it is great if we had a tool to help us say this is a bacteria. someone that is not making green mucous, you have muscle ache, it is probably a virus the i can tell the difference. if i could check a blood sample and that helps, this study came up with something called gene signature and they looked at 30 gene variations soldiered with virus and something call the flu shall factor, sounds like sciences fection. they could tell you had the flu in advance of you having

symptoms. the problem, it takes 12 hours to work. if someone comes to thes i give the test i have to make a decision on-the-spot, do i give out the z-pack? do i give an antibiotic? if i have to wait 12 hours, the game is over. with the flu you have more time because it is a while before they get the flu. >> if you diagnosis a patient and you pay attention to the physical exam, the symptoms and whether there is mucous, that is part of the art, who should get antibiotic. the issue is, a lot of kneejerk reaction is going on. the doctor says if why give the antibiotic i am sued and if i do there are issues. antibiotic resistant germs in our hospital, these are what we

are surrounded by. 23,000, up to possibly 100,000 people are dying from these because we, including myself, we are writing too many. the germs have become smart. theyer evolving and the gene signatures are being passed on. the 12 hours is actually a good situation for us better than the few days we have now. the clinical trial is going to bring it to one hour. that is a big deal. if you come in at 8:00 a.m. and by 10:30 or 11:00 i will know if it is bacterial or viral. it will reduce the number of antibiotics. >> and bad breath, you may not know you have it, but there is an app, yes, an app that can make sure your mouth is minty

fresh.

> doe >> tweet me and let me know if you know someone who has bad breath. how much better would this world be if people ask themselves, is my breath bad? we learned, this year, that there is a researcher working on an app that will detect whether you need to reach for mouthwash. i'm not pick on you, in particular, doctor, but you are on this. >> this machine, iphones are almost a human being. they can hear. they can see. now they with touch. they can use the smell. the company is coming up with an attachment which is a microprocessor that you attach to the phone and it has receptor

s almost like the receptor in a dog's nose. a human has 400 receptors and a dog has 2,000. it is very sensitive. had technology now exists with many in doctor's offices but they are not mobile. they are smaller. you can use your phone to do this. it is not so much for bad breath, that is easy, but, through this you can find and diagnosis diabetes, liver disease, a lot of the odors that come from other diseases you can diagnosis. the future of this is bright. a couple of years away from prime time. don't ask for it tomorrow. these are all on the way in apps. >> this is great. often bad breath is caused by a medical reason. >> we make fun of it and this is no way david has bad breath because you would not last in the o.r., so it must be great breath.

>> to the serious point, bad breath is a sign of stop action diseases. i am sure a breath test will be in a smartphone and you can know if you have a bacteria you should worry about or if you are on the verge of an ulcer. we talked about cancer, dog sniffing cancer and there are 2,000 sensors in the dog's nose h is a mechanical nose that can sense diabetes, possibly cancer, stomach disease and we import it and put it in a smartphone and you will be able to tell if you have this problem. >> can we do it now? >> when we can do it, do not diagnosis yourself. go see your doctor. see your doctor. >> it is like a personal breathalyzer. >> obviously, make sure you brush and scrape your tongue but sometimes there are areas in the

back of 9 throat that can cause bad breath. >> that does it for us. us. >> next up is house call. howard kurtz is coming up right now. >> have a grit day. >> this sunday, an msnbc host apologizes to mitt romney for mocking his adopted black grandchild. a family photo of romney holding the 3-month-old boy on his knee was just hysterical. >> any captions for this one? >> i think this picture is great. it's something for diversity in the republican party. >> the rnc. >> the baby is a symbol of the republican party? what on earth were they thinking? and what about harris-perry'sye. >> without reservation or qualification,