BACKGROUND & AIMS: PURPOSE:The main objective of this study was to determine the reliability and concurrent validity of using Modified Sphygmomanometer (sphyg) and body weighing scale to determine the magnitude of pressure and body weight change during digital spinal examination. SUBJECTS:One hundred and twenty apparently healthy subjects were recruited. METHODS:Weighing scale was used to measure the body weight of the investigator while Mercury sphygmomanometer was used to measure the pressure exerted. There was test re-test interval of 2 weeks. Data were analysed by descriptive statistic and Pearson product moment correlation. RESULTS:The result showed that there was significant correlation between the weight change (WC) values obtained on the weighing scale on day 1 and 2 (r=0.91). Also, there was significant correlation between Pressure obtained in the sphygmomanometer on day 1 and 2 (r=0.94). Similarly, there was significant correlation between the WC and Pressure Change (PC), (r=-0.49). The participant's age, height, weight and BMI contributed significantly as predictors for both BWC and PC change respectively. CONCLUSION:This study concluded that weighing scale and Mercury sphygmomanometer are reliable and valid to determine the magnitude of pressure applied during DPAP.

背景与目标： 目的：本研究的主要目的是确定使用改良血压计和体重计确定数字化脊柱检查过程中压力和体重变化幅度的可靠性和同时有效性。
受试者：招募了一百二十名看起来健康的受试者。
方法：用体重计测量研究者的体重，用水银血压计测量施加的压力。重新测试间隔为2周。通过描述性统计和皮尔逊乘积矩相关性分析数据。
结果：结果表明，第1天和第2天在体重秤上获得的体重变化（WC）值之间存在显着相关性（r = 0.91）。同样，第1天和第2天在血压计中获得的压力之间也存在显着相关性（r = 0.94）。同样，WC和压力变化（PC）之间也存在显着相关性（r = -0.49）。参与者的年龄，身高，体重和BMI分别是BWC和PC改变的预测指标。
结论：本研究得出结论，称重秤和水银血压计对于确定DPAP期间施加的压力大小是可靠且有效的。

BACKGROUND & AIMS: BACKGROUND:Central arterial pressure is a better predictor of adverse cardiovascular outcomes than brachial blood pressure, but noninvasive measurement by applanation tonometry is technically demanding. METHOD:Pulsecor R6.5 is a novel device adapted from a standard sphygmomanometer which estimates the central aortic pressure from analysis of low-frequency suprasystolic waveforms at the occluded brachial artery. A physics-based model, which simulates the arterial system using elastic, thin-walled tube elements and Navier-Stokes equations, is used to calculate arterial pressure and flow propagation. To determine the reliability of the device, we compared 94 central systolic pressures estimated by Pulsecor to the simultaneous directly measured central aortic pressures at the time of coronary angiography in 37 individuals. RESULTS:There was good correlation in central SBP between catheter measurements and Pulsecor estimates by either invasive or noninvasive calibration methods (r = 0.99, P < 0.0001 and r = 0.95, P < 0.0001, respectively). The mean difference in central systolic pressure was 2.78 (SD 3.90) mmHg and coefficient of variation was 0.03 when the invasive calibration method was used.When the noninvasive calibration method was used, the mean difference in central systolic pressure was 0.25 (SD 6.31) mmHg and coefficient of variation was 0.05. CONCLUSION:We concluded that Pulsecor R6.5 provides a simple and easy method to noninvasively estimate central SBP, which has highly acceptable accuracy.

背景与目标： 背景：与肱动脉血压相比，中央动脉压是心血管不良预后的更好预测指标，但是压平眼压计的无创测量在技术上要求很高。
方法：Pulsecor R6.5是一种采用标准血压计的新型装置，该血压计通过分析闭塞的肱动脉的超搏动上的波形来估计中心主动脉压。基于物理的模型使用弹性薄壁管元件和Navier-Stokes方程模拟动脉系统，用于计算动脉压力和流量传播。为了确定设备的可靠性，我们比较了Pulsecor估计的94例中心收缩压与37例冠状动脉造影时同时直接测量的中心主动脉压。
结果：通过有创或无创校准方法，导管测量值与Pulsecor估计之间的中央SBP均具有良好的相关性（分别为r = 0.99，P <0.0001和r = 0.95，P <0.0001）。使用有创校准方法时，收缩压的中心平均差异为2.78（SD 3.90）mmHg，使用无创校准法时的变异系数为0.03;使用无创校准方法时，收缩压的平均差异为0.25（SD 6.31）mmHg。变异系数为0.05。
结论：我们得出结论，Pulsecor R6.5提供了一种简单且简便的方法来无创地估计中心性SBP，其准确度非常高。

BACKGROUND & AIMS: Use of an automated electronic sphygmomanometer will allow us to minimize the errors inherent in mercury sphygmomanometry. We conducted this validation according to the 1990 protocol of the British Hypertensive Society. We recruited 87 subjects from the antenatal population of Kandang Kerbau Hospital and took three sequential readings using simultaneously both manual and electronic sphygmomanometry. A total of 261 readings from either method were thus collected and the results analyzed to compare the accuracy of electronically read blood pressure with that assessed manually. We found that 89.9% of the electronically read pressures differed from the manually read pressures by 5 mm Hg or less and 98.9% of the electronic readings differed from manual readings by 10 mm Hg or less; only 0.4% of readings had a difference of more than 15 mm Hg. The accuracy of the device was not affected either by the blood pressure or the arm circumference.

背景与目标： 使用自动电子血压计将使我们能够最大程度地减少汞血压计固有的误差。我们根据1990年英国高血压学会的协议进行了验证。我们从Kandang Kerbau医院的产前人群中招募了87名受试者，并同时使用手动和电子血压计进行了三个顺序的读数。因此，从这两种方法中总共收集了261个读数，并对结果进行了分析，以比较电子读取血压与手动评估血压的准确性。我们发现89.9％的电子读数压力与手动读数压力相差5毫米汞柱或更少，而98.9％的电子读数压力与手动读数相差10 mm Hg或更少。只有0.4％的读数相差超过15毫米汞柱。该设备的精度不受血压或手臂圆周的影响。

BACKGROUND & AIMS: OBJECTIVE:To estimate the contribution of inadequate sphygmomanometer calibration to over- and under-detection of hypertension. DESIGN:Monte Carlo simulation of the measurement of blood pressure (BP) of a population with calibrated and uncalibrated sphygmomanometers. Simulated BP measurements included systematic sphygmomanometer error and random variability. MAIN OUTCOME MEASURES:The percentage of hypertensive adults (BP > 140/90 mmHg) not detected and the percentage of adults incorrectly classified hypertensive due to sphygmomanometer error. The percentage of the false positives and false negatives attributable to sphygmomanometer error. The number of additional visits patients need to make to obtain the same improvement in hypertension detection as is obtained by sphygmomanometer calibration. RESULTS:After three visits, uncalibrated sphygmomanometer error causes 20 and 28% of all undetected adult systolic and diastolic hypertension, respectively, and 15 and 31% of all falsely detected adult systolic and diastolic hypertension. In some groups, under-detection is worse; for example, sphygmomanometer error causes 27% of all missed systolic hypertension in 35-44-year-old females. In some age groups, over-detection is worse; for example, after three visits, sphygmomanometer error causes 63 and 50% of falsely detected systolic and diastolic hypertension in 18-24-year-old females, respectively. In-service sphygmomanometer calibration achieves the same or greater improvement in hypertension detection as an additional two visits. CONCLUSIONS:Uncalibrated sphygmomanometers are a preventable cause of clinically significant over- and under-detection of hypertension. Sphygmomanometers should be calibrated regularly by accredited organizations or technicians. Standards and guidelines governing sphygmomanometers in service should be revised. Sphygmomanometer calibration is a cost-effective way of improving hypertension detection.

背景与目标： 目的：评估血压计校准不足对高血压检测过度和检测不足的影响。
设计：蒙特卡洛模拟使用校准和未校准的血压计测量人群的血压（BP）。模拟的BP测量包括系统血压计误差和随机变异性。
主要观察指标：未检测到高血压成年人（BP> 140/90 mmHg）的百分比，以及由于血压计误差而错误归为高血压的成年人百分比。归因于血压计误差的误报和误报的百分比。为了获得与血压计校准获得的高血压检测相同的改善，患者需要进行的其他就诊次数。
结果：三次就诊后，未经校准的血压计误差分别导致所有未检测到的成人收缩压和舒张压高血压分别占20％和28％，以及所有错误检测到的成人收缩压和舒张压高血压分别占15％和31％。在某些人群中，检测不足的情况更加严重。例如，血压计误差导致35-44岁女性的所有收缩压漏诊占27％。在某些年龄段，过度检测的情况更严重；例如，在3次就诊后，血压计误差分别导致18-24岁女性的63％和50％错误检测出的收缩压和舒张压高血压。使用中的血压计校准与另外两次就诊相比，在高血压检测中达到了相同或更大的改善。
结论：未经校准的血压计是可预防的临床上显着过高和过低检测到高血压的原因。血压计应由经认可的组织或技术人员定期校准。应修订有关使用中的血压计的标准和指南。血压计校准是改善高血压检测的一种经济有效的方法。

BACKGROUND & AIMS: :The history of the blood pressure (BP) concept and measurements is described. Many scientists were involved. Among them, major triumphs were achieved by William Harvey during the early 1600s who announced that there is a finite amount of blood that circulated the body in one direction only. In the mid-1700s, Reverend Stephen Hales reported the first invasive measurement in horses and smaller animals. Poiseuille introduced in the early 1800s the mercury hydrodynometer and the mmHg units. Karl von-Vierordt described in 1855 that with enough pressure, the arterial pulse could be obliterated. He also created the sphygmograph, a pulse recorder usable for routine non-invasive monitoring on humans. In 1881, von Basch created the sphygmomanometer and the first non-invasive BP measurements. However, in 1896, Scipione Riva-Rocci developed further the mercury sphygmomanometer, almost as we know it today. The sphygmomanometer could only be used to determine the systolic BP. Observing the pulse disappearance via palpitation would only allow the measuring physician to observe the point when the artery was fully constricted. Nikolai Korotkoff was the first to observe the sounds made by the constriction of the artery in 1905.

背景与目标： ：描述了血压（BP）概念和测量的历史。许多科学家参与其中。其中，威廉·哈维（William Harvey）在1600年代初期取得了重大胜利，他宣布只有有限量的血液在一个方向上循环。 1700年代中期，斯蒂芬·海尔斯牧师报告了首次对马和较小动物进行的侵入性测量。 Poiseuille在1800年代初推出了汞水力计和mmHg单位。卡尔·冯·维尔多特（Karl von-Vierordt）在1855年描述过，只要压力足够大，动脉脉搏就会被消除。他还创建了血压计，这是一种脉搏记录仪，可用于对人类进行常规无创监测。 1881年，冯·巴什（von Basch）创建了血压计和首个非侵入性BP测量仪。但是，在1896年，Scipione Riva-Rocci进一步开发了水银血压计，几乎就是我们今天所知道的。血压计只能用于确定收缩压。通过心跳观察脉搏消失只会让测量医师观察到动脉完全收缩的时间点。尼古拉·科罗特科夫（Nikolai Korotkoff）最早在1905年观察到动脉收缩产生的声音。

BACKGROUND & AIMS: OBJECTIVE:To identify possible causes of inaccuracy in the use of the Hawksley random-zero sphygmomanometer and methods that could reduce this.

METHODS:Four Hawksley random-zero sphygmomanometers were compared with a standard sphygmomanometer under static conditions. Two methods (standard and rapid) were used to release pressure from the inflated cuff with pressures recorded by independent blinded observers. The rate at which the hand valve released pressure was analysed. The effects of varying filling times and pressures on the size of the final zero correction were investigated.

RESULTS:The Hawksley devices all under-recorded pressure compared with that measured by using a standard machine. A rapid means of pressure release approximately halved this error in each case. Pressure release through the hand valve was shown to have a characteristic and prolonged exponential decay. Using low filling times and pressures reduced the observed range of zeros seen, with the production of a correlation between the size of the zero and the inflation pressure used.

CONCLUSION:These findings suggest that overestimation of the final zero correction is a common and major source of error in the use of the Hawksley sphygmomanometer. A simple change in the design of the final pressure release would improve the machine's reliability in clinical usage. The machine's zero mechanism is susceptible to unintentional misuse. Such misuse could occur when the machine is used in accordance with current sphygmomanometry guidelines.

背景与目标： 目标：确定使用Hawksley随机零血压计的可能原因以及可以减少这种误差的方法。

方法：四个Hawksley随机在静态条件下，将零血压计与标准血压计进行了比较。两种方法（标准方法和快速方法）用于释放充气袖带中的压力，并由独立的盲人观察员记录压力。分析手动阀释放压力的速率。研究了不同的填充时间和压力对最终零校正量的影响。

结果：与采用标准方法测得的压力相比，Hawksley设备的压力均低于记录值机器。在每种情况下，快速的压力释放方式几乎都会使这一误差减半。已显示通过手动阀释放压力具有特征性和长时间的指数衰减。使用较低的填充时间和压力会减小观察到的零位范围，并在零位大小和所用充气压力之间产生相关性。

结论：这些发现表明最终零校正的高估是使用Hawksley血压计的常见且主要的误差来源。最终压力释放设计的简单更改将提高机器在临床使用中的可靠性。机器的调零机构容易被误用。按照当前的血压计指南使用机器时，可能会发生这种误用。