Abstract:
OBJECTIVES:To determine whether histamine2-receptor antagonist (H2RA) dose modified for renal impairment affects gastrointestinal (GI) disease control. DESIGN:Concurrent medical record review. SETTING:One hundred forty-six nursing facilities throughout the United States. PARTICIPANTS:Three hundred thirty-six patients aged 65 and older receiving H2RAs for GI disorders. INTERVENTION:H2RA dose modified for renal impairment or no dose change. MEASUREMENTS:Disease control (no H2RA dose increase for 6 months or longer, additional GI medication, hospitalizations, emergency room visits, and unscheduled physician visits for GI symptoms) was evaluated using chart review at 3, 6, 9, and 12 months in nursing home patients aged 65 and older with H2RA dose modified for decreased creatinine clearance (ClCr) according to manufacturer. RESULTS:Three hundred thirty-six patients, mean age +/- standard deviation 85.9 +/- 7.9, with mean ClCr of 33.6 +/- 10.4 mL/min, were recommended to receive lower H2RA doses based upon estimated renal function. Patients were analyzed in two groups: H2RA dose reduced (Group 1) and dose reduction not adopted or implemented (Group 2). There was no difference in baseline characteristics (age, weight, ClCr, or starting H2RA dose and indication) between the two groups. One hundred ninety-eight patients in Group 1 were taking 195.5 +/- 71.0 mg per day of nizatidine or equivalent, compared with 183.7 +/- 66.6 mg for 138 patients in Group 2. For patients with 90 days of follow-up, the mean H2RA dose in Group 1 was 100.2 +/- 44.3 mg, compared with 187.8 +/- 69.9 for Group 2 (P <.0001) The mean decrease in daily dose for Groups 1 and 2 after 365 days were 98.9 +/- 72.9 mg and 22.2 +/- 68.2 mg, respectively (P <.0001). Except for more physician visits in Group 2, disease control was similar for all groups. Major and minor GI bleeding events were similar across both groups and over time. The 12-month mortality rate was 12.1% and 21.7% for Groups 1 and 2, respectively. This difference was statistically significant (P =.02). CONCLUSION:The findings suggest that the dose of H2RAs may be decreased based upon renal function in frail elderly patients without compromising GI disease control.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Lackner TE,Heard T,Glunz S,Gann N,Babington M,Malone DCdoi
10.1034/j.1600-0579.2003.00209.xsubject
Has Abstractpub_date
2003-05-01 00:00:00pages
650-6issue
5eissn
0002-8614issn
1532-5415journal_volume
51pub_type
杂志文章abstract:OBJECTIVES:To compare falls and fall-related injuries that a fall evaluator or hospital incident report identified with injuries identified according to discharge International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for the same set of inpatient episodes of care. DESIGN:Pros...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12539
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVES:To determine the extent of muscle weakness in older female hip fracture patients compared with healthy older and young women; to determine the extent to which this weakness is caused by a decline of the force produced per unit area of muscle rather than by a decline in muscle bulk; and to investigate the mec...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb02756.x
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Social media platforms are promising sources for large quantities of participant-driven research data and circumvent some common challenges when conducting dementia research. This study provides a summary of key considerations and recommendations about using these platforms as research tools for d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16790
更新日期:2020-12-01 00:00:00
abstract::In view of some controversies still existing about the real efficacy of ergot derivatives in the management of dementia, a double-blind, randomized, parallel group trial extending up to 6 months was carried out to compare the effects of nicergoline, 60 mg daily, and placebo in 315 patients suffering from mild to moder...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.1989.tb05494.x
更新日期:1989-04-01 00:00:00
abstract:OBJECTIVES:Patients undergoing hip fracture surgery have a 10 times increased risk of stroke compared with the general population. We aimed to evaluate the association between the CHA2 DS2 -VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, previous stroke/TIA [transient ischemic attack]/systemic em...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16452
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence and outcomes of breathlessness in older Americans. SETTING:Community-dwelling older adults. PARTICIPANTS:Individuals aged 70 and older in the nationally representative Health and Retirement Study (2008, follow-up through 2012) (N = 3,671; mean age 78). MEASUREMENTS:Breathlessne...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14313
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To describe the types of continence aids that older adults hospitalized in acute medical units use and to test the association between use of continence aids and development of new urinary incontinence (UI) at discharge. DESIGN:Prospective cohort study. SETTING:A 900-bed teaching hospital in Israel. PARTI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03413.x
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:To develop and evaluate the psychometric properties of two new urge incontinence-specific instruments that measure quality of life and symptom annoyance. DESIGN:New instruments were developed and validated in racially, ethnically, and age-diverse community-dwelling women with urge or mixed incontinence with...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb01294.x
更新日期:1999-08-01 00:00:00
abstract::Familial achalasia most often has been recorded in siblings, and only rarely (twice previously) in a parent and offspring. This report concerns a third case of achalasia in a parent and offspring (mother and son). Clinical and radiographic features of the esophageal achalasia are presented. The possibility that geneti...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb01741.x
更新日期:1979-11-01 00:00:00
abstract:OBJECTIVES:To determine how many individual patient data (IPD) reviews that included older people were available in MEDLINE and whether the effectiveness of treatments differed between older and younger individuals. DESIGN:Overview of IPD reviews. SETTING:A MEDLINE search was conducted for IPD reviews of randomized c...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.12830
更新日期:2014-06-01 00:00:00
abstract::Osteoporosis and sarcopenia are degenerative diseases frequently associated with aging. The loss of bone and muscle results in significant morbidity, so preventing or attenuating osteoporosis and sarcopenia is an important public health goal. Dietary protein is crucial for development of bone and muscle, and recent ev...
journal_title:Journal of the American Geriatrics Society
pub_type: 历史文章,杂志文章
doi:10.1111/j.1532-5415.2009.02285.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the attitudes of first- and fourth-year medical students toward older people and the relationship between these attitudes and possible career choice. To examine the effects of an intensive geriatric medicine (GM) teaching program on these attitudes and career aspirations. DESIGN:Observational st...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01552.x
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:To determine the effect of home-based primary care (HBPC) on Medicare costs and mortality in frail elders. DESIGN:Case-control concurrent study using Medicare administrative data. SETTING:HBPC practice in Washington, District of Columbia. PARTICIPANTS:HBPC cases (n = 722) and controls (n = 2,161) matched ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12974
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:To determine the effect of milk and dairy intake on the development of all-cause dementia and its subtypes in an elderly Japanese population. DESIGN:Prospective cohort study. SETTING:The Hisayama Study, Japan. PARTICIPANTS:Individuals aged 60 and older without dementia (N = 1,081). MEASUREMENTS:Milk and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12887
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To identify a set of geriatric conditions as optimal targets for quality improvement to be used in a quality measurement system for vulnerable older adults. DESIGN:Discussion and two rounds of ranking of conditions by a panel of geriatric clinical experts informed by literature reviews. METHODS:A list of 78...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb04691.x
更新日期:2000-04-01 00:00:00
abstract::Innovative methods are needed to incorporate effective geriatric education into internal medicine residency programs. The purpose of this report is to describe the development and use of clinical decision-support (CDS) tools to facilitate geriatric education and improve the care delivered to older adults in an academi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.03960.x
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:To explore changes in care goals and treatment orders around the occurrence of pneumonia and intake problems, and whether hospitalization is in line with earlier agreed-upon do-not-hospitalize orders. DESIGN:Data were collected as part of the Dutch End of Life in Dementia study (2007-2011), a longitudinal o...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14667
更新日期:2017-04-01 00:00:00
abstract::The coming decades will see a dramatic rise in the number of homebound adults. These individuals will have multiple medical conditions requiring a team of caregivers to provide adequate care. Home-based primary care (HBPC) programs can coordinate and provide such multidisciplinary care. Traditionally, though, HBPC pro...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2006.00835.x
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVES:To explore associations between serum 25-hydroxyvitamin D (25(OH)D) levels and a wide range of health conditions, physical performance measures, disability, and mortality in a large epidemiological study to identify an optimum range for 25(OH)D concentrations. DESIGN:Cross-sectional study, with additional p...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:To evaluate the association between pressure-redistributing support surface (PRSS) use and incident pressure ulcers in older adults with hip fracture. DESIGN:Secondary analysis of data from prospective cohort with assessments performed as soon as possible after hospital admission and on alternating days for...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03446.x
更新日期:2011-06-01 00:00:00
abstract::(-)Deprenyl (Selegiline, Jumex, Eldepryl, Movergan), a close structural relative to phenylethylamine (PEA), is a drug with a unique pharmacological spectrum. (1) It is a highly potent and selective, irreversible inhibitor of B-type monoamine oxidase (MAO), a predominantly glial enzyme in the brain. The activity of thi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1992.tb01860.x
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVES:Gastrointestinal (GI) complications are the most-common serious adverse reactions associated with nonsteroidal anti-inflammatory drugs (NSAIDs). We quantified the effect of specific NSAIDs on the rate of GI hospitalizations among older people living in long-term care. DESIGN:Retrospective cohort study. SET...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49117.x
更新日期:2001-05-01 00:00:00
abstract::Patients with dementia often manifest troublesome and disruptive behaviors in addition to intellectual impairments. This study evaluated behavioral disturbances in 126 demented patients examined sequentially, using questionnaires administered to primary caregivers to quantify the types and severity of behavioral distu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb04260.x
更新日期:1988-09-01 00:00:00
abstract::The characteristic morphologic changes frequently observed in the brain of an old adult include a decrease in weight and volume, a change in the pattern of cerebral cortical convolutions, and an increase in ventricular size. Cell loss varies from region to region in the brain, and may be intensified in Alzheimer's dis...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1976.tb03246.x
更新日期:1976-01-01 00:00:00
abstract::Despite recent gains in establishing academic sections, divisions, and departments of geriatrics in medical schools, much remains to be done to meet the medical needs of an aging population. To better understand how medical schools are educating students in geriatric-related topics, all U.S. allopathic and osteopathic...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53023.x
更新日期:2005-01-01 00:00:00
abstract::Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14902
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:To study the effects of comprehensive geriatric assessment (CGA) and multidisciplinary intervention on elderly patients sent home from the emergency department (ED). DESIGN:Prospective, randomized, controlled trial with 18 months of follow-up. SETTING:Large medical school-affiliated public hospital in an u...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2004.52401.x
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:To assess colonization and infection with methicillin-resistant Staphylococcus aureus (MRSA), high-level gentamicin-resistant enterococci (R-ENT) and gentamicin and/or ceftriaxone-resistant Gram-negative bacilli (R-GNB) and the factors that are associated with colonization and infection with these organisms. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06210.x
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVES:To examine whether the total burden of comorbidity and pattern of co-occurring conditions varies in individuals with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HF-P) or HF with reduced LVEF (HF-R). DESIGN:Cross-sectional cohort study. SETTING:Four participating health plan...
journal_title:Journal of the American Geriatrics Society
pub_type: 历史文章,杂志文章,多中心研究
doi:10.1111/jgs.12062
更新日期:2013-01-01 00:00:00
abstract::This article provides a comprehensive review of aromatase inhibitors (AIs) for geriatricians, because it appears that more elderly women will be using these drugs in the near future. Computerized literature searches of Medline were conducted through May 2003. Key words/phrases included in the literature searches were ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2004.52171.x
更新日期:2004-04-01 00:00:00