Orthostatic hypotension and associated conditions in geriatric inpatients.

Screening of orthostatic hypotension (OH) was performed in 285 patients aged 75  years. Current drugs, reasons for admission, geriatric syndromes, and confounding medical conditions were collected. Patients with OH (n = 116, 41%) as compared to those without OH (n = 169) more frequently (P < 0.01) presented falls in the last 6  months (62 vs. 40%, P < 0.001), a fall as the reason for the current admission (49 vs. 26%, P < 0.001), feeling of fainting (20 vs. 6%, P = 0.002), syncope (29 vs. 4%, P < 0.001) or functional decline (71 vs. 47%, P = 0.012). No difference was observed between the two groups in terms of age (85 ± 5 vs. 84 ± 4  years), gender (59 vs. 50% female), common geriatric conditions (e.g. malnutrition 46 vs. 58%, dementia 22 vs. 26%), comorbidity or confounding conditions (dehydration 28 vs. 30%, sepsis 2 vs. 6%). No difference was detected in the use of drugs with psychotropic cardiovascular or diuretic effect, or in their associations. Orthostatic hypotension is frequent upon hospital admission and should be screened, particularly in geriatric fallers. This absence of relation between OH and drugs use suggests that non-pharmacological interventions should be first attempted in older inpatients with OH before deciding to reduce or withdraw useful drugs.

Correlates of fractures in elderly, diabetic outpatients.

It is widely recognized that patients presenting diabetes are at increased risk for fractures. In a retrospective case-control study, 101 cases were selected from medical charts of outpatients older than 70 with diabetes mellitus and a fracture within the past 5 years. Glycosylated hemoglobin (HbA1c) had been measured within 4 months around the assessment. Each case was matched for sex and age with one control, diabetic patient with no fracture. HbA1c level was similar in both groups. Patients with fractures presented significantly lower BMIs than controls, and had a higher rate of declared osteoporosis and comorbidity. A small number of cases were using vitamin D supplements while more were treated with benzodiazepine, opiates and Selective serotonin reuptake inhibitors (SSRI). This study suggests that, rather than the tight control of blood glucose, other factors such as medication and comorbidity could be associated with fracture risk in elderly diabetics.

Epidemiology of bovine babesiosis and anaplasmosis in Zambia.

The serological prevalence of bovine babesiosis and anaplasmosis in the traditional farming sector of six provinces of Zambia was determined using the indirect fluorescent antibody test (IFAT) for babesiosis and the card agglutination test (CAT) for anaplasmosis. Antibodies to Babesia bigemina occurred throughout the country whereas the prevalence of B. bovis followed the distribution of its tick vector Boophilus microplus which is limited to the north-eastern part of the country. Low numbers of B. bovis serologically positive cattle were demonstrated in central and southern Province. Anaplasma spp. occurred throughout Zambia but the overall percentages of positive sera were low ranging between 14.7% and 38.6% using the CAT. Two hundred sera were retested for anaplasmosis using an enzyme-linked immunosorbent assay (ELISA). Sero-prevalence rates were 1.5 to 2.3-fold greater with the ELISA than with the card agglutination test.

Theileria taurotragi in Zambia.

Theileria sp. (Bwengwa) of low virulence was isolated by feeding R. appendiculatus ticks collected from the field on a susceptible calf and subsequently transmitted between cattle by R. appendiculatus ticks- Theileria sp. (Bwengwa) was shown to be T. taurotragi on parasitological, clinical and serological grounds. T. taurotragi is the fourth Theileria sp. shown to be present in Zambia.