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...

  The New York Times had a long but intriguing article on the post-Covid syndrome (see   https://www.nytimes.com/2021/01/21/magazine/covid-aftereffects.html?referringSource=articleShare  ), making several strong points: -- many patients from diverse backgrounds (including doctors and nurses) develop long-standing symptoms after Covid infection (“long haulers”, or "long Covid"), with many individuals profiled in this article -- Mount Sinai Hospital in New York developed its Center for Post-Covid Care last May, now with more than 1600 patients -- patients experience a diverse set of symptoms including fatigue, pain, shortness of breath, light sensitivity, exercise intolerance, insomnia, tachyarrhythmias, diarrhea/cramping, and memory  problems/”brain fog”, with examples of people who cannot put a cogent sentence together, get trapped in their shower because they can’t remember how to get out, need to write themselves notes to remind themselves when to eat, unable to mu...

  The CDC just published an evaluation of the Abbott BinaxNOW rapid antigen test for SARS-CoV-2 infection at 2 community-based testing sites in Arizona (see  https://www.cdc.gov/mmwr/volumes/70/wr/mm7003e3.htm#T2_down  )   Details:  -- the BinaxNOW rapid antigen test received FDA Emergency Use Authorization      --it is advertised by Abbott as a "fast, $5, 15-minute, easy-to-use Covid-19 antigen test", and that with FDA EUA, is "ramping production to 50 million tests a month", and is the size of a credit card -- 3419 specimens were collected from people >10 yo, during November       -- age range 10-95yo, with median age 41, 7% age 10-17/55% aged 18-49/22% aged 50-64, and 16% >65yo      -- 38% male, 75% white/2% Black       -- asymptomatic 76%, symptomatic 24% with 19% having symptoms for <8 days: 11% 0-3 days, 8% 4-7 days  -- symptomatic people: 14% had a positive ...