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The 2012 Canadian hypertension education program recommendations for the management of hypertension: blood pressure measurement, diagnosis, assessment of risk, and therapy.

https://arctichealth.org/en/permalink/ahliterature124290
Source
Can J Cardiol. 2012 May;28(3):270-87
Publication Type
Article
Date
May-2012
Author
Stella S Daskalopoulou
Nadia A Khan
Robert R Quinn
Marcel Ruzicka
Donald W McKay
Daniel G Hackam
Simon W Rabkin
Doreen M Rabi
Richard E Gilbert
Raj S Padwal
Martin Dawes
Rhian M Touyz
Tavis S Campbell
Lyne Cloutier
Steven Grover
George Honos
Robert J Herman
Ernesto L Schiffrin
Peter Bolli
Thomas Wilson
Ross D Feldman
M Patrice Lindsay
Brenda R Hemmelgarn
Michael D Hill
Mark Gelfer
Kevin D Burns
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Luc Trudeau
Simon L Bacon
Robert J Petrella
Alain Milot
James A Stone
Denis Drouin
Maxime Lamarre-Cliché
Marshall Godwin
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
Brian Penner
Robert A Hegele
Philip A McFarlane
Mukul Sharma
Norman R C Campbell
Debra Reid
Luc Poirier
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, McGill University, Montreal, Québec, Canada. stella.daskalopoulou@mcgill.ca
Source
Can J Cardiol. 2012 May;28(3):270-87
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - methods
Canada
Cardiovascular Diseases - etiology - prevention & control
Education, Medical, Continuing - standards
Evidence-Based Medicine - standards
Female
Health Education - standards
Humans
Hypertension - complications - diagnosis - therapy
Male
Middle Aged
Monitoring, Physiologic - methods
Practice Guidelines as Topic - standards
Prognosis
Risk assessment
Treatment Outcome
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2012. The new recommendations are: (1) use of home blood pressure monitoring to confirm a diagnosis of white coat syndrome; (2) mineralocorticoid receptor antagonists may be used in selected patients with hypertension and systolic heart failure; (3) a history of atrial fibrillation in patients with hypertension should not be a factor in deciding to prescribe an angiotensin-receptor blocker for the treatment of hypertension; and (4) the blood pressure target for patients with nondiabetic chronic kidney disease has now been changed to
PubMed ID
22595447 View in PubMed
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Accuracy of parents in measuring body temperature with a tympanic thermometer.

https://arctichealth.org/en/permalink/ahliterature176648
Source
BMC Fam Pract. 2005 Jan 11;6(1):3
Publication Type
Article
Date
Jan-11-2005
Author
Joan L Robinson
Hsing Jou
Donald W Spady
Author Affiliation
Department of Pediatrics and Stollery Children's Hospital, 2C3 Walter MacKenzie Centre, Edmonton, Alberta, T6G 2B7 Canada. jr3@ualberta.ca
Source
BMC Fam Pract. 2005 Jan 11;6(1):3
Date
Jan-11-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta
Body Temperature - physiology
Child
Child, Preschool
Confidence Intervals
Fever - diagnosis - nursing
Humans
Infant
Monitoring, Physiologic - instrumentation - nursing
Nursing Assessment
Parents
Predictive value of tests
Reference Standards
Sensitivity and specificity
Thermography - instrumentation - standards
Thermometers - standards
Tympanic Membrane - physiology
Abstract
It is now common for parents to measure tympanic temperatures in children. The objective of this study was to assess the diagnostic accuracy of these measurements.
Parents and then nurses measured the temperature of 60 children with a tympanic thermometer designed for home use (home thermometer). The reference standard was a temperature measured by a nurse with a model of tympanic thermometer commonly used in hospitals (hospital thermometer). A difference of >or= 0.5 degrees C was considered clinically significant. A fever was defined as a temperature >or= 38.5 degrees C.
The mean absolute difference between the readings done by the parent and the nurse with the home thermometer was 0.44 +/- 0.61 degrees C, and 33% of the readings differed by >or= 0.5 degrees C. The mean absolute difference between the readings done by the parent with the home thermometer and the nurse with the hospital thermometer was 0.51 +/- 0.63 degrees C, and 72 % of the readings differed by >or= 0.5 degrees C. Using the home thermometer, parents detected fever with a sensitivity of 76% (95% CI 50-93%), a specificity of 95% (95% CI 84-99%), a positive predictive value of 87% (95% CI 60-98%), and a negative predictive value of 91% (95% CI 79-98 %). In comparing the readings the nurse obtained from the two different tympanic thermometers, the mean absolute difference was 0.24 +/- 0.22 degrees C. Nurses detected fever with a sensitivity of 94% (95 % CI 71-100 %), a specificity of 88% (95% CI 75-96 %), a positive predictive value of 76% (95% CI 53-92%), and a negative predictive value of 97% (95%CI 87-100 %) using the home thermometer. The intraclass correlation coefficient for the three sets of readings was 0.80, and the consistency of readings was not affected by the body temperature.
The readings done by parents with a tympanic thermometer designed for home use differed a clinically significant amount from the reference standard (readings done by nurses with a model of tympanic thermometer commonly used in hospitals) the majority of the time, and parents failed to detect fever about one-quarter of the time. Tympanic readings reported by parents should be interpreted with great caution.
Notes
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PubMed ID
15644134 View in PubMed
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Accurate, reproducible measurement of blood pressure.

https://arctichealth.org/en/permalink/ahliterature228803
Source
CMAJ. 1990 Jul 1;143(1):19-24
Publication Type
Article
Date
Jul-1-1990
Author
N R Campbell
A. Chockalingam
J G Fodor
D W McKay
Author Affiliation
Division of Community Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's.
Source
CMAJ. 1990 Jul 1;143(1):19-24
Date
Jul-1-1990
Language
English
Publication Type
Article
Keywords
Adult
Ambulatory Care - methods - standards
Blood Pressure Determination - instrumentation - methods
Canada
Child
Heart Auscultation - instrumentation - standards
Humans
Hypertension - diagnosis
Monitoring, Physiologic
Patient Education as Topic
Abstract
The diagnosis of mild hypertension and the treatment of hypertension require accurate measurement of blood pressure. Blood pressure readings are altered by various factors that influence the patient, the techniques used and the accuracy of the sphygmomanometer. The variability of readings can be reduced if informed patients prepare in advance by emptying their bladder and bowel, by avoiding over-the-counter vasoactive drugs the day of measurement and by avoiding exposure to cold, caffeine consumption, smoking and physical exertion within half an hour before measurement. The use of standardized techniques to measure blood pressure will help to avoid large systematic errors. Poor technique can account for differences in readings of more than 15 mm Hg and ultimately misdiagnosis. Most of the recommended procedures are simple and, when routinely incorporated into clinical practice, require little additional time. The equipment must be appropriate and in good condition. Physicians should have a suitable selection of cuff sizes readily available; the use of the correct cuff size is essential to minimize systematic errors in blood pressure measurement. Semiannual calibration of aneroid sphygmomanometers and annual inspection of mercury sphygmomanometers and blood pressure cuffs are recommended. We review the methods recommended for measuring blood pressure and discuss the factors known to produce large differences in blood pressure readings.
Notes
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PubMed ID
2192791 View in PubMed
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Acidification of distal esophagus and sleep-related breathing disturbances.

https://arctichealth.org/en/permalink/ahliterature179752
Source
Chest. 2004 Jun;125(6):2101-6
Publication Type
Article
Date
Jun-2004
Author
Soren Berg
Victor Hoffstein
Thorarinn Gislason
Author Affiliation
Lund Sleep Study Group, Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University of Lund, Sweden.
Source
Chest. 2004 Jun;125(6):2101-6
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Comorbidity
Disorders of Excessive Somnolence - epidemiology - etiology
Esophagus - physiopathology
Follow-Up Studies
Gastroesophageal Reflux - diagnosis - epidemiology
Humans
Hydrogen-Ion Concentration
Male
Middle Aged
Monitoring, Physiologic - methods
Polysomnography - methods
Pressure
Probability
Risk assessment
Severity of Illness Index
Sleep Apnea, Obstructive - diagnosis - epidemiology
Sleep Stages
Abstract
To investigate whether distal esophageal acidification occurs during sleep in patients suspected of sleep-disordered breathing, and whether such acidification is related to respiratory abnormalities.
Fourteen middle-aged, snoring men all complaining of daytime sleepiness and suspected of having obstructive sleep apnea.
Sleep laboratory, Pulmonary Department, Landspitali University Hospital, Reykjavik, Iceland.
Each patient underwent full nocturnal polysomnography testing, which included continuous monitoring of esophageal pressure (Pes) and pH. We identified all pH events, which were defined as a reduction in esophageal pH of >/= 1.0. During each pH event, the respiratory recordings where examined for the presence of apneas or hypopneas, and Pes was recorded. The data were analyzed to determine the possible relationships between pH events and respiratory events, and between changes in pH and changes in Pes. We found that there were more respiratory events than pH events. The mean (+/- SD) number of apneas and hypopneas per hour of sleep was 33 +/- 22, whereas the mean number of pH events per hour of sleep was 7 +/- 6. Overall, 81% of all pH events were associated with respiratory events. Correlation analysis did not reveal any significant relationship between pH events and the magnitude of Pes or apnea-hypopnea index.
Episodes of esophageal acidification are common in patients with sleep apnea, and are usually associated with respiratory and pressure events. However, changes in pH were independent of the magnitude of the Pes.
PubMed ID
15189928 View in PubMed
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Actical accelerometer sedentary activity thresholds for adults.

https://arctichealth.org/en/permalink/ahliterature134337
Source
J Phys Act Health. 2011 May;8(4):587-91
Publication Type
Article
Date
May-2011
Author
Suzy Lai Wong
Rachel Colley
Sarah Connor Gorber
Mark Tremblay
Author Affiliation
Health Analysis Division, Statistics Canada, Ottawa, Canada.
Source
J Phys Act Health. 2011 May;8(4):587-91
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Child
Female
Humans
Male
Middle Aged
Monitoring, Physiologic - instrumentation - methods
Motor Activity
Sedentary lifestyle
Young Adult
Abstract
Actical accelerometer thresholds have been derived to enable objective measurement of time spent performing sedentary activity in children and adolescents, but not adults. Thus, the purpose of this study was to determine Actical accelerometer sedentary activity thresholds for adults.
Data were available from 3187 participants aged 6 to 79 years from a preliminary partial dataset of the Canadian Health Measures Survey, who wore an Actical for 7 days. Step count data were used to evaluate the use of 50, 100, and 800 counts per min (cpm) as sedentary activity thresholds. Minutes when no steps were recorded were considered minutes of sedentary activity.
The use of higher cpm thresholds resulted in a greater percentage of sedentary minutes being correctly classified as sedentary. The percentage of minutes that were incorrectly classified as sedentary was substantially higher when using a threshold of 800 cpm compared with 50 or 100 cpm. Results were similar for children, adolescents, and adults.
These findings suggest that a threshold of 100 cpm is appropriate for classifying sedentary activity of adults when using the Actical. As such, wear periods with minutes registering less than 100 cpm would be classified as time spent performing sedentary activity.
PubMed ID
21597132 View in PubMed
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The Actiheart in adolescents: a doubly labelled water validation.

https://arctichealth.org/en/permalink/ahliterature118532
Source
Pediatr Exerc Sci. 2012 Nov;24(4):589-602
Publication Type
Article
Date
Nov-2012
Author
Nerissa Campbell
Harry Prapavessis
Casey Gray
Erin McGowan
Elaine Rush
Ralph Maddison
Author Affiliation
School of Kinesiology, The University of Western Ontario, London, Ontario, Canada.
Source
Pediatr Exerc Sci. 2012 Nov;24(4):589-602
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anthropometry
Body Composition
Body mass index
Child
Cohort Studies
Energy Metabolism - physiology
Exercise Test - instrumentation - methods
Female
Heart Rate - physiology
Humans
Linear Models
Male
Monitoring, Physiologic - instrumentation
Motor Activity - physiology
Ontario
Water - diagnostic use
Abstract
This study investigated the validity of the Actiheart device for estimating free-living physical activity energy expenditure (PAEE) in adolescents.
Total energy expenditure (TEE) was measured in eighteen Canadian adolescents, aged 15-18 years, by DLW. Physical activity energy expenditure was calculated as 0.9 X TEE minus resting energy expenditure, assuming 10% for the thermic effect of feeding. Participants wore the chest mounted Actiheart device which records simultaneously minute-by-minute acceleration (ACC) and heart rate (HR). Using both children and adult branched equation modeling, derived from laboratory-based activity, PAEE was estimated from the ACC and HR data. Linear regression analyses examined the association between PAEE derived from the Actiheart and DLW method where DLW PAEE served as the dependent variable. Measurement of agreement between the two methods was analyzed using the Bland-Altman procedure.
A nonsignificant association was found between the children derived Actiheart and DLW PAEE values (R = .23, R(2) = .05, p = .36); whereas a significant association was found between the adult derived Actiheart and DLW PAEE values (R = .53, R(2) = .29, p
PubMed ID
23196766 View in PubMed
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Acute effects on heart rate variability when exposed to hand transmitted vibration and noise.

https://arctichealth.org/en/permalink/ahliterature163243
Source
Int Arch Occup Environ Health. 2007 Nov;81(2):193-9
Publication Type
Article
Date
Nov-2007
Author
Bodil Björ
Lage Burström
Marcus Karlsson
Tohr Nilsson
Ulf Näslund
Urban Wiklund
Author Affiliation
Department of Public Health and Clinical Medicine, Occupational Medicine, Umeå University, 901 87 Umeå, Sweden. bodil.bjor@envmed.umu.se
Source
Int Arch Occup Environ Health. 2007 Nov;81(2):193-9
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Electrocardiography
Female
Hand-Arm Vibration Syndrome - physiopathology
Heart Rate - physiology
Humans
Male
Monitoring, Physiologic
Noise - adverse effects
Sweden
Vibration - adverse effects
Abstract
This study investigates possible acute effects on heart rate variability (HRV) when people are exposed to hand transmitted vibration and noise individually and simultaneously.
Ten male and 10 female subjects were recruited by advertisement. Subjects completed a questionnaire concerning their work environment, general health, medication, hearing, and physical activity level. The test started with the subject resting for 15 min while sitting down. After resting, they were exposed to one of four exposure conditions: (1) only vibration; (2) only noise; (3) both noise and vibration; or (4) a control condition of exposure to the static load only. All four exposures lasted 15 min and the resting time between the exposures was 30 min. A continuous electrocardiogram (ECG) signal was recorded and the following HRV parameters were calculated: total spectral power (P(TOT)); the spectral power of the very low frequency component (P(VLF)); the low frequency component (P(LF)); the high frequency component (P(HF)); and the ratio LF/HF.
Exposure to only vibration resulted in a lower P(TOT) compared to static load, whereas exposure to only noise resulted in a higher P(TOT). The mean values of P(TOT), P(VLF), P(LF), and P(HF) were lowest during exposure to vibration and simultaneous exposure to vibration and noise.
Exposure to vibration and/or noise acutely affects HRV compared to standing without these exposures. Being exposed to vibration only and being exposed to noise only seem to generate opposite effects. Compared to no exposure, P(TOT) was reduced during vibration exposure and increased during noise exposure.
PubMed ID
17541625 View in PubMed
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Acute myocardial infarction patients' chest pain as monitored and evaluated by ambulance personnel.

https://arctichealth.org/en/permalink/ahliterature55133
Source
Intensive Crit Care Nurs. 1992 Jun;8(2):113-7
Publication Type
Article
Date
Jun-1992
Author
B. Fridlund
B. Carlsson
Source
Intensive Crit Care Nurs. 1992 Jun;8(2):113-7
Date
Jun-1992
Language
English
Publication Type
Article
Keywords
Allied Health Personnel - standards
Chest Pain - diagnosis - drug therapy - etiology
Evaluation Studies
Humans
Monitoring, Physiologic - methods - standards
Myocardial Infarction - complications - diagnosis - therapy
Outcome Assessment (Health Care)
Research Support, Non-U.S. Gov't
Sweden
Abstract
A delicate duty for ambulance personnel is to care for patients who suffer from chest pain, caused by acute myocardial infarction (AMI-patient). In Sweden pain-relieving drugs may be administered, such as: oxygen, entonox, or morphine according to the skill of the ambulance personnel. The aim of this study was to find out if AMI-patients' expressions of pain were monitored and evaluated, in which way the AMI-patients received pain-relief, and to which degree they were relieved of pain. Examinations of the records of the ambulance personnel's observations during transport of AMI-patients revealed that nine tenths of those who complained about chest pain received pain-relieving drugs. The results of the treatments varied, however, from a good rate of response to morphine to less responses to oxygen and entonox. In order to treat AMI-patients who are in need of pain-relief during their transit to hospital the ambulance personnel must possess thorough knowledge of both pain theory and communication theory. Furthermore, they need tools for assessment of pain and for administering adequate pain-relieving drugs in clinical practice. In the future it may be necessary to differentiate between ambulance personnel in routine service and those in emergency service according to their levels of education.
PubMed ID
1611285 View in PubMed
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[Acute pulmonary dysfunction in adults. Adult respiratory distress syndrome--ARDS].

https://arctichealth.org/en/permalink/ahliterature228393
Source
Tidsskr Nor Laegeforen. 1990 Sep 10;110(21):2752-6
Publication Type
Article
Date
Sep-10-1990
Author
J L Svennevig
J. Pillgram-Larsen
H. Moen
P. Halvorsen
A. Skulberg
Author Affiliation
Kirurgisk Avdeling, Ullevål sykehus, Oslo.
Source
Tidsskr Nor Laegeforen. 1990 Sep 10;110(21):2752-6
Date
Sep-10-1990
Language
Norwegian
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Female
Humans
Male
Middle Aged
Monitoring, Physiologic - methods
Norway
Postoperative Complications - diagnosis - physiopathology - therapy
Prognosis
Respiration, Artificial
Respiratory Distress Syndrome, Adult - diagnosis - physiopathology - therapy
Wounds and Injuries - complications
Abstract
During a 3-year period 0.1% of all patients undergoing surgery and 0.3% of the patients submitted for trauma developed ARDS. The diagnosis was based on strict criteria. Mortality among the 42 patients was 45.2%. Abdominal sepsis was associated with high mortality, trauma with a much better prognosis. Swan-Ganz catheters were used in 81% of the patients. The measurements were characterized by high pulmonary vascular resistance and increased intrapulmonary shunting. However, the initial recordings showed only small differences between survivors and fatal cases as regards haemodynamics and blood gas parameters. Mortality was associated with low diuresis, heart failure, need of inotropic support and on age of over 50 years. The significance of invasive central monitoring is discussed.
PubMed ID
2219047 View in PubMed
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Addressing challenges in future surveillance after surgery for early-stage cervical cancer.

https://arctichealth.org/en/permalink/ahliterature267055
Source
Int J Gynecol Cancer. 2015 Feb;25(2):309-14
Publication Type
Article
Date
Feb-2015
Author
Katrine Fuglsang
Lone Kjeld Petersen
Jan Blaakaer
Source
Int J Gynecol Cancer. 2015 Feb;25(2):309-14
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - mortality - pathology - surgery
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Middle Aged
Monitoring, Physiologic - methods
Neoplasm Staging
Recurrence
Retrospective Studies
Risk assessment
Survival Analysis
Uterine Cervical Neoplasms - mortality - pathology - surgery
Watchful Waiting
Young Adult
Abstract
This study examines surveillance after early-stage cervical cancer surgery. Since the 1980s, the value of surveillance has been discussed continuously. The main question explored is whether surveillance serves the purpose of ensuring early diagnosis of recurrence.
A retrospective cohort study included 389 women with cervical cancer who underwent surgery as the primary treatment modality at the Department of Obstetrics and Gynecology, Aarhus University Hospital, Denmark, from 1996 to 2011. We used data from patient files and the Danish National Pathology Data Bank. The cumulative risk was estimated by the Kaplan-Meier method and tested by the log-rank test.
Forty-three women (11%) had recurrence. Only 27% of the recurrent cases were diagnosed at a scheduled surveillance appointment, but they were often asymptomatic and seemed to have a better outcome after treatment compared with the recurrent cases diagnosed at self-referral.The 5-year survival was overall 91.3%, recurrence-free survival was 96%, and cancer-specific survival was 54%. The median recurrence-free interval was 23 months (range, 4-144) for the symptomatic patients and 14 months (range, 4-48) for the asymptomatic patients. The median survival after recurrence was 12 months (range, 2-132) for the symptomatic patients and 156 months (range, 40-180) for the asymptomatic patients.
At the moment, neither the value of surveillance nor the significance of self-referral related to survival after recurrence is known. In this study, those who are diagnosed with recurrence before symptom onset seem to fare better in terms of 5-year survival than those who are diagnosed after self-referral because of symptoms.
PubMed ID
25594142 View in PubMed
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435 records – page 1 of 44.