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Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 1, February 2010, Pages 47-62

Horatio B., Fung , Maricelle O., Monteagudo-Chu

Background: Community-acquired pneumonia (CAP) is a frequent cause of hospitalization and death among the elderly.Objective: This article reviews information on CAP among the elderly, including age-related changes, predisposing risk factors, causes, treatment strategies, and prevention.Methods: Searches of MEDLINE (January 1990-November 2009), International Pharmaceutical Abstracts (January 1990-November 2009), and Google Scholar were conducted using the terms community-acquired pneumonia, pneumonia, treatment guidelines, and elderly. Additional publications were found by searching the reference lists of the identified articles. Studies that reported diagnostic criteria as well as the treatment outcomes achieved in adult patients with CAP were selected for this review.Results: Three practice guidelines,…

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Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 1, February 2010, Pages 63-72

Lisa L., Dwyer , Beth, Han , David A., Woodwell , Elizabeth A., Rechtsteiner

Background: Despite the need for and benefits of medications, polypharmacy (defined here as concurrent use of ≥9 medications) in nursing home residents is a concern. As the number of medications taken increases, so does the risk for adverse events. Monitoring polypharmacy in this population is important and can improve the quality of nursing home care.Objectives: The aims of this article were to estimate the use of polypharmacy in residents of nursing homes in the United States, to examine the associations between select resident and facility characteristics and polypharmacy, and to determine the leading therapeutic subclasses included in the polypharmacy received…

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Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 1, February 2010, Pages 73-76

Robi, Goswami , David, Van De Car , Kenneth E., Schmader , Thomas M., Bashore , Michael H., Sketch Jr

Background: Ranolazine is increasingly being prescribed for the treatment of chronic stable angina. This report describes an adverse effect that may be related to ranolazine.Case summary: A 77-year-old white man with chronic renal insufficiency was evaluated for moderate dyspnea on exertion (DOE). Cardiac and pulmonary workup revealed nonobstructive coronary artery disease and mild obstructive lung disease. The patient had been taking ranolazine 500 mg daily for possible angina for the past 2 months. Given the temporal association of his symptoms with drug initiation, ranolazine was discontinued during the hospitalization. One month after discontinuing ranolazine, the patient’s DOE had completely resolved;…

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Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 1, February 2010, Pages 77-83

Zachary A., Marcum , Steven M., Handler , Richard, Boyce , Walid, Gellad , Joseph T., Hanlon

Objective: This paper reviews recent articles examining medication misadventures that can be defined as medication errors and adverse drug events in the elderly.Methods: MEDLINE and International Pharmaceutical Abstracts were searched for articles published in English in 2009 using a combination of the terms medication errors, medication adherence, suboptimal prescribing, monitoring, adverse drug events, adverse drug withdrawal events, therapeutic failure, and aged. A manual search of the reference lists of the identified articles and the authors’ article files, book chapters, and recent reviews was conducted to identify additional publications. Those studies that described unique approaches to evaluating medication misadventures in the…

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Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 1, February 2010, Pages 84-85

[No author name available]

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Publication year: 2010
Source: The American Journal of Geriatric Pharmacotherapy, Volume 8, Issue 1, February 2010, Pages 86-96

David R.P., Guay

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2009 Marian Chace Lecture Introduction

• Content Type Journal Article
• DOI 10.1007/s10465-010-9085-z
• Authors
  • Patrizia Pallaro, Moving the Self Psychotherapy Center Bowie USA

• Journal American Journal of Dance Therapy
• Online ISSN 1573-3262
• Print ISSN 0146-3721

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Is protein intake associated with bone mineral density in young women?

Am J Clin Nutr. 2010 Mar 10;

Authors: Beasley JM, Ichikawa LE, Ange BA, Spangler L, Lacroix AZ, Ott SM, Scholes D

BACKGROUND: The range of protein intakes for optimizing bone health among premenopausal women is unclear. Protein is a major constituent of bone, but acidic amino acids may promote bone resorption. OBJECTIVE: The objective was to examine cross-sectional and longitudinal associations between baseline dietary protein and bone mineral density (BMD) among 560 females aged 14-40 y at baseline enrolled in a Pacific Northwest managed-care organization. The role of protein source (animal or vegetable) and participant characteristics were considered. DESIGN: Dietary protein intake was assessed by using a semiquantitative food-frequency questionnaire in participants enrolled in a study investigating associations between hormonal contraceptive use and bone health. Annual changes in hip, spine, and whole-body BMD were measured by using dual-energy X-ray absorptiometry. Cross-sectional and longitudinal associations between baseline protein intake (% of energy) and BMD were examined by using linear regression analysis and generalized estimating equations adjusted for confounders. RESULTS: The mean (+/-SD) protein intake at baseline was 15.5 +/- 3.2%. After multivariable adjustment, the mean BMD was similar across each tertile of protein intake. In cross-sectional analyses, low vegetable protein intake was associated with a lower BMD (P = 0.03 for hip, P = 0.10 for spine, and P = 0.04 for whole body). For every percentage increase in the percentage of energy from protein, no significant longitudinal changes in BMD were observed at any anatomic site over the follow-up period. CONCLUSIONS: Data from this longitudinal study suggest that a higher protein intake does not have an adverse effect on bone in premenopausal women. Cross-sectional analyses suggest that low vegetable protein intake is associated with lower BMD.

PMID: 20219968 [PubMed - as supplied by publisher]

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Are dietary choline and betaine intakes determinants of total homocysteine concentration?

Am J Clin Nutr. 2010 Mar 10;

Authors: Lee JE, Jacques PF, Dougherty L, Selhub J, Giovannucci E, Zeisel SH, Cho E

BACKGROUND: Elevated homocysteine concentrations are associated with an increased risk of cardiovascular disease and a decline in cognitive function. Intakes of choline and betaine, as methyl donors, may affect homocysteine concentrations. OBJECTIVE: The objective was to examine whether choline and betaine intakes, assessed from food-frequency questionnaires, are associated with total plasma homocysteine concentrations under both fasting and post-methionine-load conditions in both pre- and post-folic acid fortification periods in the United States. DESIGN: We assessed the association between choline and betaine intakes and fasting and post-methionine-load homocysteine concentrations using the US Department of Agriculture revised food-composition tables and evaluated whether the associations varied by folic acid fortification periods in 1325 male and 1407 female participants in the sixth examination (1995-1998) of the Framingham Offspring Study. RESULTS: A higher choline-plus-betaine intake was associated with lower concentrations of post-methionine-load homocysteine; the multivariate geometric means were 24.1 mumol/L (95% CI: 23.4, 24.9 mumol/L) in the top quintile of intake and 25.0 mumol/L (95% CI: 24.2, 25.7 mumol/L) in the bottom quintile (P for trend = 0.01). We found an inverse association between choline-plus-betaine intake and fasting homocysteine concentrations; the multivariate geometric mean fasting homocysteine concentrations were 9.6 mumol/L (95% CI: 9.3, 9.9 mumol/L) in the top quintile and 10.1 mumol/L (95% CI: 9.8, 10.4 mumol/L) in the bottom quintile (P for trend < 0.001). When we stratified by plasma folate and vitamin B-12 concentrations, the inverse association was limited to participants with low plasma folate or vitamin B-12 concentrations. In the postfortification period, the inverse association between choline-plus-betaine intake and either fasting or post-methionine-load homocysteine was no longer present. CONCLUSIONS: Choline and betaine intakes were associated with both fasting and post-methionine-load total homocysteine concentrations, especially in participants with low folate and vitamin B-12 status. The inverse association between choline and betaine intakes and homocysteine concentrations was no longer present in the postfortification period.

PMID: 20219967 [PubMed - as supplied by publisher]

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Food sources of individual plasma phospholipid trans fatty acid isomers: the Cardiovascular Health Study.

Am J Clin Nutr. 2010 Mar 10;

Authors: Micha R, King IB, Lemaitre RN, Rimm EB, Sacks F, Song X, Siscovick DS, Mozaffarian D

BACKGROUND: The overall consumption of trans fatty acids (TFAs) increases the risk of coronary artery disease. However, multiple TFA isomers exist, each with potentially different health effects. Different food sources of these specific TFA isomers are not well established. OBJECTIVE: Our objective was to determine the major independent food sources of specific TFA isomers. DESIGN: We investigated relations of major potential food sources of TFAs, as assessed by serial food-frequency questionnaires, with 10 plasma phospholipid TFA isomers [5 trans (t-) 18:1, 3 t-18:2, and 2 t-16:1] in 3330 older adults in the Cardiovascular Health Study, a community-based multicenter cohort. Stepwise regression was used to identify independent major food sources of individual plasma phospholipid TFA isomers, which were adjusted for demographic, lifestyle, and dietary factors. RESULTS: All 5 t-18:1 isomers were similarly associated with foods commonly made with partially hydrogenated vegetable oils (PHVOs), including biscuits (0.51 higher SD of total 18:1 fatty acid concentrations per serving/d, P < 0.01), chips and/or popcorn (0.33 higher SD per serving/d, P = 0.02), margarine (0.32 higher SD per serving/d, P < 0.001), fried foods (0.32 higher SD per serving/d, P = 0.04), and bakery foods (0.23 higher SD per serving/d, P = 0.02). Each of the t-18:2 isomers were associated only with bakery foods (0.50 higher SD of total 18:2 fatty acid concentrations per serving/d, P < 0.001). Ruminant foods were major correlates of t-16:1n-7, including red meats (0.72 higher SD per serving/d, P < 0.001), butter (0.43 higher SD per serving/d, P < 0.001), and higher-fat dairy (0.37 higher SD per serving/d, P < 0.001). In contrast, t-16:1n-9 were derived mainly from margarine (0.31 higher SD per serving/d, P < 0.001). CONCLUSIONS: t-18:1 Isomers are similarly derived from multiple PHVO-containing foods. In contrast, t-18:2 and t-16:1n-9 isomers are derived from more-specific types of PHVO-containing foods. Ruminant foods are major sources of t-16:1n-7. Different TFA isomers and dietary sources should be considered when investigating health effects and interventions to lower TFAs.

PMID: 20219966 [PubMed - as supplied by publisher]

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