geoffrey modest medical blogs

  Long-term potent topical corticosteroid use may be associated with increased risk of osteoporosis and fractures (see  osteoporosis topical steroids jamaderm2021  in dropbox, or  doi:10.1001/jamadermatol.2020.4968 )   Details: -- 723,251 Danish adults who were treated with potent or very potent topical corticosteroids (TCSs), from 2003-2018 -- mean age 53, 53% women, 20% from each of 5 defined SES groups, few comorbidities (cancer and diabetes 3% each, no comment on others) -- meds used: psych meds 11%, thiazides 9%, statins 8%, PPIs 7%, contraceptives 7% -- inhaled steroids 3%, systemic steroids 8% -- topical steroid doses were translated into equipotent doses of mometasone 1 mg/g -- all patients had used at least 200 g of mometasone cumulatively, based on filled prescriptions -- Main outcomes: diagnosis of osteoporosis (as inpatient or outpatient diagnosis) or major osteoporotic fracture (fracture the hip, distal forearm, vertebrae, or humerus)   Results...

from a dermatologist in Rhode Island, who circulated this within their health center system geoff If you would like to be on the regular email list for upcoming blogs, please contact me at  gmodest@uphams.org For access to the dropbox, go to link:  https://www.dropbox.com/sh/0bmvtita8mzms11/XDTwHySFFg Then go to "clinic", then to "clinical stuff" for articles, or go to  https://www.dropbox.com/sh/nyle22q1fn6lkpk/AAB9B2hBj5Kw4gtrJAkI-UF8a?dl=0  for the powerpoint presentations to get access to all of the blogs: 1. go to  http://gmodestmedblogs.blogspot.com/  to see them in reverse chronological order 2. click on 3 parallel lines top left, if you want to see blogs by category, then click on "labels" and choose a category​ 3. or you can just click on the magnifying glass on top right, then  type in a name in the search box and get all the blogs with that name in them please feel free to circ...

​ Two recent articles found relationships between the gut microbiome and hypertension (see doi:10.1038/nature24628 );​ and between the skin microbiome and atopic dermatitis ( see  DOI: 10.1126/scitranslmed.aah4680 ). -------------------------- Gut microbiome and hypertension. Details: --in mice:     --high salt diet led to increased blood pressure as well as gut microbiome changes: eg, depletion of Lactobacillus murinus within one day of the high salt diet     ​--concomitant high salt diet and repletion of L. murinus led to a decrease in systolic and normalization of diastolic blood pressures     ​--other studies suggest that high salt diet leads to induction of T H 17 cells (T helper 17 cells), which depends on the gut microbiota     ​--in this study high salt diet led to led to pretty specific increases in the mouse T H 17 cells, and these lev...