Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized...Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized elderly patients. Methods Out of 1852 patients admit- ted between 31/12/1999 and 31/12/2000 to an acute geriatric ward, 474 patients （48% males） with a mean age of 81.5 ±6.8 years were en- rolled in this study. Blood pressure （BP） was measured three times during the day in a supine and standing position. Patients with at least one increase in systolic or diastolic BP levels upon standing were diagnosed with OHT. Medical history, physical examination and laboratory parameters were retrieved from the medical records. Mortality data until 18th June 2014 were retrieved from the computerized system of the Ministry of the Interior. Results Four hundred and seven patients （86%） were diagnosed with OHT. Those without OHT had a lowerbody mass index and were more likely males, smokers, had a higher rate of Parkinson＇s disease and less congestive heart failure compared with those with OHT. Patients with OHT had a better survival rate than those without OHT （P = 0.024）. Hazard ratios （HRs） for mortality in those with OHT adjusted to age and multiple risk factors were： 0.67 [95% confidence interval （CI）： 0.51-0.87] and 0.73 （95% CI： 0.55-0.97）, respectively; a similar tendency was noticed in a sensitivity analysis by gender. Conclusion Hospitalized elderly patients with OHT had a better survival rate than those without OHT.展开更多
Background: Medical screening for Special Forces (SF) has significant implications on operational competency of the soldiers. Two lumbar spine defects, spondylolysis and spondylolisthesis, are currently disqualifying ...Background: Medical screening for Special Forces (SF) has significant implications on operational competency of the soldiers. Two lumbar spine defects, spondylolysis and spondylolisthesis, are currently disqualifying from joining the SF in the Israeli Defense Force. Purpose: To evaluate the yield of four lumbar x-ray compared with two lumbar x-ray for the diagnosis of spondylolysis and spondylolisthesis. Design: Retrospective comparison of the diagnostic yield of the two modalities. Patient sample: Special forces unit candidates undergoing routine x-ray for the diagnosis of spinal defects. Outcome measures: The rate of diagnosis of spondylolysis and spondylolisthesis between the two groups. Methods: We retrospectively compared two lumbar spine radiographic screening protocols regarding the rate of diagnosis for disqualifying spinal defects in asymptomatic candidates for SF. All radiographs were obtained as part of a routine medical evaluation for SF. Results: 1026 candidates were examined with two lumbar spine radiographs (Anteroposterior (AP) and lateral). 338 candidates were examined with four lumbar radiographs (AP, lateral and oblique radiographs). Spondylolysis and spondylolisthesis were diagnosed at a significantly higher rate in the four-radiograph group than in the two-radiograph group (2.66%, 1.77% vs. 1.26%, 0.39% respectively, P = 0.003). Conclusions: Adding two oblique radiographs to the screening process of elite units candidates significantly increases the rate of diagnosis of spondylolysis and spondylolisthesis.展开更多
文摘Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized elderly patients. Methods Out of 1852 patients admit- ted between 31/12/1999 and 31/12/2000 to an acute geriatric ward, 474 patients （48% males） with a mean age of 81.5 ±6.8 years were en- rolled in this study. Blood pressure （BP） was measured three times during the day in a supine and standing position. Patients with at least one increase in systolic or diastolic BP levels upon standing were diagnosed with OHT. Medical history, physical examination and laboratory parameters were retrieved from the medical records. Mortality data until 18th June 2014 were retrieved from the computerized system of the Ministry of the Interior. Results Four hundred and seven patients （86%） were diagnosed with OHT. Those without OHT had a lowerbody mass index and were more likely males, smokers, had a higher rate of Parkinson＇s disease and less congestive heart failure compared with those with OHT. Patients with OHT had a better survival rate than those without OHT （P = 0.024）. Hazard ratios （HRs） for mortality in those with OHT adjusted to age and multiple risk factors were： 0.67 [95% confidence interval （CI）： 0.51-0.87] and 0.73 （95% CI： 0.55-0.97）, respectively; a similar tendency was noticed in a sensitivity analysis by gender. Conclusion Hospitalized elderly patients with OHT had a better survival rate than those without OHT.
文摘Background: Medical screening for Special Forces (SF) has significant implications on operational competency of the soldiers. Two lumbar spine defects, spondylolysis and spondylolisthesis, are currently disqualifying from joining the SF in the Israeli Defense Force. Purpose: To evaluate the yield of four lumbar x-ray compared with two lumbar x-ray for the diagnosis of spondylolysis and spondylolisthesis. Design: Retrospective comparison of the diagnostic yield of the two modalities. Patient sample: Special forces unit candidates undergoing routine x-ray for the diagnosis of spinal defects. Outcome measures: The rate of diagnosis of spondylolysis and spondylolisthesis between the two groups. Methods: We retrospectively compared two lumbar spine radiographic screening protocols regarding the rate of diagnosis for disqualifying spinal defects in asymptomatic candidates for SF. All radiographs were obtained as part of a routine medical evaluation for SF. Results: 1026 candidates were examined with two lumbar spine radiographs (Anteroposterior (AP) and lateral). 338 candidates were examined with four lumbar radiographs (AP, lateral and oblique radiographs). Spondylolysis and spondylolisthesis were diagnosed at a significantly higher rate in the four-radiograph group than in the two-radiograph group (2.66%, 1.77% vs. 1.26%, 0.39% respectively, P = 0.003). Conclusions: Adding two oblique radiographs to the screening process of elite units candidates significantly increases the rate of diagnosis of spondylolysis and spondylolisthesis.
