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AMDA Long Term Care Medicine - 2012


A04 - The Use of Micronutrients in Long Term Care


Mar 8, 2012 8:00am ‐ Mar 8, 2012 11:30am

Standard: $24.00

Description

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of clinical 3.5 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
Malnutrition is common in the older population; with nutritional deficiencies being a critical issue in the long term care setting. In nursing home residents, an increase in morbidity and mortality is evident in those with malnutrition and weight loss. Although composite nutritional assessment instruments have been developed, the recognition of micronutrient deficiencies in nursing home patients often falls short of optimum. This session will provide a comprehensive account of the prevalence, manifestations, prevention and management of a select group of micronutrients including the B vitamin group, vitamin E, iron, magnesium, zinc, selenium, and copper. The session will conclude with an audience question and answer period.

Learning Objectives(s):


  • Describe the prevalence and clinical manifestations of nutrient deficiencies in the long term care setting.
  • Discuss the approach to diagnosis, prevention and management of micronutrient deficiencies.
  • Recognize the adverse effects of inappropriate and excessive of micronutrients.


Speakers(s):
Meenakshi Patel, MD, CMD; Naushira Pandya, MD; T S Dharmarajan, MD

Disclosure(s):
Meenakshi Patel, MD, CMD has no financial disclosures to report. Naushira Pandya, MD has no financial disclosures to report. T S Dharmarajan, MD has no financial disclosures to report.

References(s):
1. Rude RK. Magnesium deficiency: A cause of heterogeneous disease in humans. J Bone Miner Res 1998;13:749-58. [PubMed abstract] 2. Wester PO. Magnesium. Am J Clin Nutr 1987;45:1305-12. [PubMed abstract] 3. Saris NE, Mervaala E, Karppanen H, Khawaja JA, Lewenstam A. Magnesium: an update on physiological, clinical, and analytical aspects. Clinica Chimica Acta 2000;294:1-26. 4. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy Press. Washington, DC, 1999. 5. U.S. Department of Agriculture, Agricultural Research Service. 2003. USDA National Nutrient Database for Standard Reference, Release 16. Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp. 6. Ford ES and Mokdad AH. Dietary magnesium intake in a national sample of U.S. adults. J Nutr. 2003;133:2879-82. 7. Vormann J. Magnesium: nutrition and metabolism. Molecular Aspects of Medicine 2003:24:27-37. 8. Feillet-Coudray C, Coudray C, Tressol JC, Pepin D, Mazur A, Abrams SA. Exchangeable magnesium pool masses in healthy women: effects of magnesium supplementation. Am J Clin Nutr 2002;75:72-8. 9. Ladefoged K, Hessov I, Jarnum S. Nutrition in short-bowel syndrome. Scand J Gastroenterol Suppl 1996;216:122-31. [PubMed abstract] 10. Rude KR. Magnesium metabolism and deficiency. Endocrinol Metab Clin North Am 1993;22:377-95. 11. Kelepouris E and Agus ZS. Hypomagnesemia: Renal magnesium handling. Semin Nephrol 1998;18:58-73. [PubMed abstract] 12. Ramsay LE, Yeo WW, Jackson PR. Metabolic effects of diuretics. Cardiology 1994;84 Suppl 2:48-56. [PubMed abstract] 13. Kobrin SM and Goldfarb S. Magnesium Deficiency. Semin Nephrol 1990;10:525-35. [PubMed abstract] 14. Lajer H and Daugaard G. Cisplatin and hypomagnesemia. Ca Treat Rev 1999;25:47-58. [PubMed abstract] 15. Tosiello L. Hypomagnesemia and diabetes mellitus. A review of clinical implications. Arch Intern Med 1996;156:1143-8. [PubMed abstract] 16. Paolisso G, Scheen A, D'Onofrio F, Lefebvre P. Magnesium and glucose homeostasis. Diabetologia 1990;33:511-4. [PubMed abstract] 17. Elisaf M, Bairaktari E, Kalaitzidis R, Siamopoulos K. Hypomagnesemia in alcoholic patients. Alcohol Clin Exp Res 1998;22:244-6. [PubMed abstract] 18. Abbott L, Nadler J, Rude RK. Magnesium deficiency in alcoholism: Possible contribution to osteoporosis and cardiovascular disease in alcoholics. Alcohol Clin Exp Res 1994;18:1076-82. [PubMed abstract] 19. Shils ME. Magnesium. In Modern Nutrition in Health and Disease, 9th Edition. (edited by Shils, ME, Olson, JA, Shike, M, and Ross, AC.) New York: Lippincott Williams and Wilkins, 1999, p. 169-92. 20. Elisaf M, Milionis H, Siamopoulos K. Hypomagnesemic hypokalemia and hypocalcemia: Clinical and laboratory characteristics. Mineral Electrolyte Metab 1997;23:105-12. [PubMed abstract] 21. American Diabetes Association. Nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care 1999;22:542-5. [PubMed abstract] 22. Rude RK and Olerich M. Magnesium deficiency: Possible role in osteoporosis associated with gluten-sensitive enteropathy. Osteoporos Int 1996;6:453-61. [PubMed abstract] 23. Bialostosky K, Wright JD, Kennedy-Stephenson J, McDowell M, Johnson CL. Dietary intake of macronutrients, micronutrients and other dietary constituents: United States 1988-94. Vital Heath Stat. 11(245) ed: National Center for Health Statistics, 2002:168. 24. Takahashi M, Degenkolb J, Hillen W. Determination of the equilibrium association constant between Tet repressor and tetracycline at limiting Mg2+ concentrations: a generally applicable method for effector-dependent high-affinity complexes. Anal Biochem 1991;199:197-202. 25. Xing JH and Soffer EE. Adverse effects of laxatives. Dis Colon Rectum 2001;44:1201-9. 26. Qureshi T and Melonakos TK. Acute hypermagnesemia after laxative use. Ann Emerg Med 1996;28:552-5. [PubMed abstract] 27. DePalma J. Magnesium Replacement Therapy. Am Fam Phys 1990;42:173-6. 28. Klasco RK (Ed): USP DI

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