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P OSTER A BSTRACTS nal process can present as hip pain, though usually with neurological and systemic symptoms. CASE: An 80 year old Caucasian man with a history of sarcoidosis, pulmonary embolism, and atrial fibrillation on anticoagulation, was admitted to the hospital with progressive left hip pain. He had been treated initially with pain medications by his primary physician for presumed osteoarthritis. His pain worsened over several months and became associated with left lower extremity swelling, difficulty walking with left foot drop, and generalized weakness. His physical exam was remarkable for mildly distended abdomen with firmness in the left lower quadrant without hepatosplenomegaly, mild left lower extremity edema, decreased hip range of motion without pain, and mild weakness with left dorsiflexion. Digital rectal exam showed bright red blood. His labs revealed leukocytosis of 12,000, anemia with a hemoglobin of 11, normal platelet count, and supratherapeutic INR of 6.5. A lower extremity ultrasound revealed an acute proximal left lower extremity DVT. A large left retroperitoneal mass involving the iliopsoas muscle and surrounding vasculature was found on CAT scan of the abdomen and pelvis. He also had bowel wall thickening in the distal sigmoid colon and at the splenic flexure. A colonoscopy was performed and showed two separate masses involving the colon. Biopsies done via both ultrasound guidance and colonoscopy were positive for Burkitt lymphoma. He received chemotherapy and was discharged home under hospice care. DISCUSSION: Burkitt lymphoma is rare in older adults. It usually occurs in adults less than 35 years of age. It often presents with abdominal symptoms such as pain, ascites, or gastrointestinal bleeding. The left hip pain, swelling, and leg weakness in this patient was atypical and was due to the involvement of the left iliopsoas muscles and surrounding nerves and vasculature. CONCLUSION: In an elderly patient with chronic unilateral hip pain and atypical clinical signs and symptoms such as foot drop, leg swelling and focal weakness, consider an intra-abdominal or pelvic infiltrative process. C149 Pulse wave velocity varies within the cardiac cycle. A. K. Reddy, 1 C. J. Hartley, 1 G. E. Taffet. 1,2 1. Medicine (CVR), Baylor College of Medicine, Houston, TX; 2. Medicine (<strong>Geriatrics</strong>), Baylor College of Medicine, Houston, TX. Supported By: NIH Aortic pulse wave velocity (PWV), an index of arterial stiffness, is measured using the foot-to-foot (Ff) pulse transit time (PTT) of the flow velocity waveform at two aortic sites and the separation distance (Sd) between these sites (PWV=Sd/PTT). It has been shown that PWV is directly proportional to pressure (Kim et al., J Human Hypertens, 21:141-48, 2007), from a low at end-diastole to a high at endsystole within each cardiac cycle. But the velocity foot occurs at enddiastolic pressure and therefore Ff-PWV may underestimate the overall PWV (and stiffness). PWV can also be determined from aortic impedance (Imp) as PWV = Zc/ρ, where Zc = average of impedance moduli from 2nd-10th harmonics (see figure) (Reddy et al., Am J Physiol HCP, 285:H1464-70, 2003). Since Imp-PWV is determined from several harmonics we believe that it is a better representation of vessel stiffness than Ff-PWV. We determined Imp-PWV (figure) in 5 young (lower dashed line; 282±10) and 6 old (upper dotted line; 444±59) mice and Ff-PWV in 3 young (286±14) and 3 old (416±22) mice. PWV determined by both methods was not significantly different in the young mice because at young age lower overall PWV may be closer to Ff-PWV. In the old mice Imp-PWV was higher but was not significant perhaps due to large variability. Higher values Imp-PWV in old mice may represent the increase in the magnitude of the higher harmonics caused by stiffer arteries in old age. C148 Association of Vitamin D deficiency and In-Hospital Mortality in Elderly Patients with Heart Failure. A. Ali, N. Abi Rafeh, A. Abdo, J. Ross, V. Hak, D. P. Seminara, A. Szerszen. <strong>Geriatrics</strong>, Staten Island University Hospital, Staten Island, NY. Background: Vitamin D deficiency has been implicated in the pathogenesis of symptomatic heart failure. Low levels of 25-Hydroxyvitamin-D (25(OH)D) are associated with poor long term prognosis in heart failure. The relationship of low 25(OH)D levels and in-hospital mortality in elderly patients admitted with acute heart failure is not well studied. Objective: The study aims to assess the association of 25(OH)D deficiency and in-hospital mortality in elderly population admitted with heart failure and to determine the association between 25(OH)D levels and Ejection Fraction (EF), Brain Natriuretic Peptide (BNP), and New York Heart Association (NYHA) functional classification. Methods and Results: This was a cross-sectional observational pilot study. Twenty patients with acute heart failure were recruited in the study. The mean age of the patients was 84 (65-96) yrs. Subjects were divided into two groups based on their 25(OH)D levels of less than 20mg/dl or more than 20mg/dl. There was a trend towards higher BNP level in the 25(OH)D deficiency group (1946 ± 1531 pg/ml vs. 808 ± 302 pg/ml; p= 0.07). There was no correlation between 25(OH)D levels and EF or NYHA functional class. However, Sixty two percent of patients died in-hospital in 25(OH)D deficiency group as compared to none in normal 25(HO)D levels group (p=0.026). Conclusion: A low 25(OH)D level is associated with high inhospital mortality in elderly patients admitted with acute heart failure. The 25(OH)D level may be used as a prognostic maker for inhospital mortality in elderly patients with heart failure. C150 Antibiotic Utilization in ICU Patients Requiring Mechanical Ventilation. B. Chen, M. Restrepo. School of Medicine, UTHSCSA, San Antonio, TX. Supported By: MSTAR program through the National Institute of Aging PURPOSE: Infection is a major concern in health care but especially in the ICU and those on mechanical ventilation. There are limited data available regarding antibiotic utilization and the impact on clinical outcomes in the ICU setting, but particularly on patients requiring mechanical ventilation. We Assess antibiotic utilization and the impact on clinical outcomes in hospitalized ICU patients who required mechanical ventilation. S182 AGS 2012 ANNUAL MEETING
P OSTER A BSTRACTS METHODS: We conducted a retrospective observational cohort study of VA MICU patients in the year of 2007. We included patients who were on >18 years and on mechanical ventilators for >24 hrs. We looked into the antibiotic use and microbial culture to ultimately evaluate the clinical outcomes (length of stay and mortality) of these patients. [|11|] RESULTS: We identified 157 ICU patients who required mechanical ventilation. 95% of the patients received at least one dose of antibiotic therapy. The most common antibiotics were vancomycin and pip/tazo and tobramycin. The use of antibiotic was related to positive microbial cultures (p= 0.04). Adequate therapy is associated with positive cultures (p
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P OSTER A BSTRACTS Discussion: Angi
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P OSTER A BSTRACTS categories based
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P OSTER A BSTRACTS Design. CaMos is
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P OSTER A BSTRACTS A75 Geriatrics a
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P OSTER A BSTRACTS Design: Based on
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P OSTER A BSTRACTS death because
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P OSTER A BSTRACTS A158 Curved Path
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P OSTER A BSTRACTS compared to pati
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P OSTER A BSTRACTS Methods: We are
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P OSTER A BSTRACTS with only about
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P OSTER A BSTRACTS The aim of this
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P OSTER A BSTRACTS B27 Shared Decis
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P OSTER A BSTRACTS SES, adiposity a
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P OSTER A BSTRACTS care (OR 1.93, 9
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P OSTER A BSTRACTS B49 Prevalence a
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P OSTER A BSTRACTS frailty have inc
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P OSTER A BSTRACTS BMI=28.4, mean P
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P OSTER A BSTRACTS Each subject’s
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P OSTER A BSTRACTS There is growing
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P OSTER A BSTRACTS variation in uti
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P OSTER A BSTRACTS complex elders s
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P OSTER A BSTRACTS IgE antibodies i
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P OSTER A BSTRACTS The oldest old (
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P OSTER A BSTRACTS B159 Accuracy of
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P OSTER A BSTRACTS GDS and GDS apat
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P OSTER A BSTRACTS D144 The Use of
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P OSTER A BSTRACTS Methods: Cross-s
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P OSTER A BSTRACTS Aggressive treat
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A UTHOR I NDEX Azhar, G . . . . . .
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A UTHOR I NDEX Ceimo, J . . . . . .
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A UTHOR I NDEX Dunn, C M . . . . .
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A UTHOR I NDEX Griebling, T L . . .
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A UTHOR I NDEX Johnson, K . . . . .
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A UTHOR I NDEX Levine, M . . . . .
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A UTHOR I NDEX Mulsant, B . . . . .
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A UTHOR I NDEX Pschirer, J P . . .
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A UTHOR I NDEX Sheppard, K D . . .
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A UTHOR I NDEX Ukritchon, S . . . .
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K EYWORD 25-hydroxyvitamin D . . .
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K EYWORD I NDEX Colorectal cancer s
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K EYWORD I NDEX Geriatric curriculu
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K EYWORD I NDEX Medication discrepa
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K EYWORD I NDEX Race . . . . . . .
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