Gastrointestinal bleeding and blood transfusion in the elderly in Japan.

BACKGROUND/AIMS: The incidence of gastrointestinal bleeding (GIB) increases with age and blood transfusion is frequently given for the management of GIB. In this report, we summarized our data of the patients with GIB and discussed the relationship between blood transfusion and age in patients with GIB. METHODOLOGY: The patients were divided into two groups according to age, following elderly (≥75 years old) and younger (<75 years old) group. The causes and clinical outcome (blood transfusions, management) of each group were compared. RESULTS: One-hundred and twenty patients with GIB were hospitalized (59 men, 61 women) with a mean age of 72.0±15.8 years (range 16-96 years old). Thirty-one patients (25.8%) received blood transfusion. The mean pre-transfusion hemoglobin was 6.4±1.2g/dL (elderly 6.3±1.4, younger 6.6±1.0g/dL) and the mean amount of blood transfusion was 2.8±1.6U (elderly 3.2±1.8, younger 2.3±0.9U). The elderly patients using antithrombotic drugs need greater amounts of blood transfusion than younger patients using antithrombotic drugs. The hemoglobin level of the elder patients without antithrombotic drugs was significantly lower than that of younger patients without antithrombotic drugs. CONCLUSIONS: Our data suggest that our blood transfusion strategy seems to be in tolerance level with restrictive blood transfusion strategy.

Gastrointestinal bleeding associated with antithrombotic therapy in the elderly in Japan.

BACKGROUND/AIMS: We summarize data of patients with gastrointestinal bleeding (GIB) and discuss the relationship between antithrombotic drug use and age in patients with GIB. METHODOLOGY: One-hundred and twenty patients with GIB were divided into two groups according to age (=75 years old and <75 years old). The causes and clinical outcome of each group were compared. RESULTS: Forty-two patients received antithrombotic therapy. The main antithrombotic drugs were low dose aspirin (38 patients), ticlopidine (5 patients) and warfarin (3 patients). Compared with younger GIB patients, elderly patients had more coexisting illness and antithrombotic drugs. In patients taking antithrombotic drugs, upper GIB is more frequent than those not taking antithrombotic drugs (p<0.05) and antithrombotic drugs were the risk for GIB from erosive lesions of the esophagus or stomach. In the lower gastrointestinal tract, there was no difference of incidence related to antithrombotic use. The initial endoscopic hemostasis was performed in 14 patients. Eight varices patients received endoscopic vanding and 6 of 43 gastroduodenal ulcer patients had mechanical clip hemostasis. CONCLUSIONS: From our findings, antithrombotic drugs were considered to be a risk for GIB. It might be important to prevent or minimize GIB in elderly patients prescribed antithrombotic drugs.

Double-blind, placebo-controlled trial of zinc picolinate for taste disorders.

A total of 73 patients with an idiopathic zinc-deficiency taste disorder completed a double-blind, placebo-controlled trial of the efficacy of zinc picolinate. Patients in the zinc treatment group (n = 37) received 29 mg of zinc picolinate orally by capsule 3 times a day for 3 months. No significant difference was noted between the treatment and placebo groups in terms of improvement in subjective symptoms or whole-mouth taste sensation. However, assessment of taste using the filter paper disk method showed significantly better improvement for the group given zinc, and the serum zinc level was also significantly higher in this group than in the placebo control group.

A new whole-mouth gustatory test procedure. 1. Thresholds and principal components analysis in healthy men and women.

Gustatory testing using the whole-mouth method was performed in 123 healthy young male and female subjects. The average thresholds for detection and recognition of the four basic tastes were not greatly different from the normal thresholds previously reported in Japan: a 0.0165 M solution of sucrose for sweet taste, a 0.0316 M solution of table salt for salty taste, a 0.000743 M solution of tartaric acid for sour taste and a 0.0000203 M solution of quinine hydrochloride for bitter taste. These results indicate that the whole-mouth gustatory test procedure employed in this study may be useful for evaluating gustatory function clinically. Principal components analysis confirmed that sweet, salty, sour and bitter are indeed the four basic tastes and revealed that the sensation of taste is detected before the specific taste is recognized, regardless of the specific taste tested.