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Rheology and the release of aldosterone in healthy elderly people.
Fluctuations in plasma aldosterone levels are often observed in healthy elderly people. They may be related to circadian variations in plasma renin activity. To investigate this hypothesis, we studied the variation in plasma aldosterone and plasma renin activity in 26 healthy elderly people on 5 different days and compared the data with those of 16 young subjects. Mean plasma aldosterone and plasma renin activity was higher in the elderly than in the young, and higher in the morning than in the afternoon. The percentage changes in plasma aldosterone after placebo were similar in the two groups. However, the rate of increase in plasma renin activity after placebo was significantly greater in the elderly than in the young. Mean plasma aldosterone correlated with plasma renin activity in the young, but not in the elderly. These findings suggest that increased sensitivity of the renin-angiotensin-aldosterone system to exogenous angiotensin may be a contributing factor in the circadian fluctuations of plasma aldosterone in healthy elderly people.Treatment of seborrheic dermatitis: can you guess which medical providers' prescribing behaviors align with accepted medical guidelines?
Seborrheic dermatitis (SD) is the most common skin condition in dermatology practice. In contrast to acne vulgaris, there is no FDA-approved systemic treatment for SD. Despite this, the most common form of treatment is topical medications (i.e., moisturizers, antifungals, and topical steroids). The relationship between prescribing decisions and formal evidence-based guidelines has not been evaluated in SD. To evaluate the adherence to available evidence-based SD guidelines and to identify potential barriers to guideline adherence. A retrospective chart review was conducted of consecutive new patients evaluated for SD from October 1, 2011 to October 1, 2013 at a single dermatology practice. Medical providers' prescribing behaviors in response to the treatment guidelines for SD were assessed. Multivariate logistic regression was performed to assess the association of physician and practice characteristics with prescribing guidelines. Of the 105 patients who were evaluated, 62.2% were prescribed topical steroids, 28.6% were prescribed antibiotic therapy, and 12.4% were prescribed topical antifungals. Of those who received topical steroids, 70.0% were prescribed a topical steroid with a topical steroid application site agreement, and 89.7% were prescribed a topical steroid without a topical steroid application site agreement. A topical steroid application site agreement was
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