BACKGROUND & AIMS: Hypertension (HTN) is a common health problem and a major cardiovascular risk factor. Accurate measurement of blood pressure (BP) is mandatory for proper diagnosis and follow-up. The aim of this study was to evaluate the accuracy of mercury sphygmomanometer BP-measuring devices in public hospitals in Cairo, Egypt. Fifty public hospitals were included, and 10% of all mercury sphygmomanometer devices in each hospital were tested. Assessment included physical condition (e.g., mercury status, lid of the device, state of the rubber tubes), leakage rate, and calibration accuracy (as compared with a reference device). Devices were approved as accurate when they could successfully pass all three assessment tests. The total number of sphygmomanometer devices was 465. The overall pass rate was 1.3% (six devices). Twenty-five (5.2%) devices passed all of the physical tests, 50 (10.8%) passed the leakage test, and 50 (16.5%) passed the calibration accuracy test. There were 162 (34.8%) devices that showed a high leakage rate (>80 mmHg) and thus were not tested for calibration accuracy. In conclusion, most of the mercury sphygmomanometer devices in hospitals are neglected and not checked regularly for any errors. A plan should be made to gradually replace those failed devices with new, validated, and well-calibrated devices, preferably devices that do not contain mercury.

背景与目标： 高血压（HTN）是常见的健康问题，也是心血管的主要危险因素。准确测量血压（BP）对于正确诊断和随访是必不可少的。这项研究的目的是评估埃及开罗公立医院水银血压计BP测量设备的准确性。其中包括50家公立医院，并且对每家医院中所有汞血压计设备的10％进行了测试。评估包括身体状况（例如，汞状态，设备的盖子，橡胶管的状态），泄漏率和校准精度（与参考设备相比）。当设备可以成功通过所有三个评估测试时，它们被认为是准确的。血压计设备总数为465。总合格率为1.3％（六个设备）。二十五（5.2％）的设备通过了所有物理测试，其中50（10.8％）通过了泄漏测试，还有50（16.5％）通过了校准精度测试。有162个（34.8％）的设备显示出高泄漏率（> 80 mmHg），因此没有经过校准精度测试。总之，医院中的大多数汞血压计设备都被忽略，没有定期检查是否有任何错误。应该制定计划，逐步用新的，经过验证且经过良好校准的设备（最好是不含汞的设备）替换那些发生故障的设备。

BACKGROUND & AIMS: :Mercury spilled from a mercurial sphygmomanometer on a hot carpet can vaporize and pollute the environment. We observed the vaporization of mercury in model experiments. Mercury (0.15g) was heated on a hot carpet and the near-by air was sampled with a midget impinger. The evaporated mercury levels were 5.0, 6.3, 8.1 and 10.0mg/m(3) at 20, 40, 60 and 80 minutes, respectively at a height of 30cm from carpet. The result indicated that even if a small quantity of mercury remained on the hot carpet, it could evaporate and pollute the indoor air. Little is known about the influence on human health of low mercury exposure, especially on children. In order not to pollute the air, we need to pay attention to mercury.

背景与目标： ：从水银血压计溢出的汞在热地毯上会蒸发并污染环境。我们在模型实验中观察到了汞的蒸发。将汞（0.15克）在热地毯上加热，并用小型撞击器取样附近的空气。在距地毯30cm的高度处，分别在20、40、60和80分钟时蒸发的汞含量分别为5.0、6.3、8.1和10.0mg / m（3）。结果表明，即使少量的汞残留在热毯上，也会蒸发并污染室内空气。关于低汞暴露对人类健康的影响知之甚少，尤其是对儿童而言。为了不污染空气，我们需要注意汞。

BACKGROUND & AIMS: :This study was designed to assess the accuracy of a modified sphygmomanometer, that measures pulse irregularity, to detect atrial fibrillation (AF). An irregularity index, defined as the standard deviation of the time intervals between beats divided by the mean of the time intervals, was used to analyze standard 12-lead ECGs from hospitalized patients. A threshold irregularity index was selected such that all ECGs with AF exceeded this irregularity index value. A modified automatic blood pressure monitor was designed to detect AF by calculating the irregularity index of the pulse. The device was used to calculate the irregularity index in an unselected group of outpatients during scheduled office visits in which a standard 12-lead ECG was performed. A total of 125 ECGs, 53 with AF, were analyzed. Using a threshold irregularity index of 0.066, the sensitivity for detecting AF was 100%, the specificity was 92% and diagnostic accuracy 95%. A modified sphygmomanometer was used to analyze the pulse of 450 outpatients, 54 of whom were documented by ECG to be in AF. When paired readings were analyzed, the rhythm was considered to be irregular if both readings were greater than the threshold index. Using a threshold index of 0.06, all the AF patients were correctly identified while 37 non-AF patients also exceeded the threshold irregularity index. In this analysis, the sensitivity was 100%, the specificity 91%, and the diagnostic accuracy 92% for detecting AF. The irregularity index determined using a modified sphygmomanometer can accurately identify AF.

背景与目标： ：本研究旨在评估改良的血压计的准确性，该血压计可测量脉搏不规则性，以检测房颤（AF）。不规则指数定义为心跳之间的时间间隔的标准偏差除以时间间隔的平均值，用于分析住院患者的标准12导联心电图。选择阈值不规则指数，以使所有具有AF的ECG都超过该不规则指数值。设计了一种改进的自动血压监视器，通过计算脉搏的不规则指数来检测房颤。该设备用于在计划的办公室就诊期间选择一组标准的12导联心电图来计算未选择门诊患者的违规指数。总共分析了125个ECG，其中53个伴有AF。使用0.066的阈值不规则指数，检测AF的灵敏度为100％，特异性为92％，诊断准确性为95％。使用改良的血压计分析了450名门诊病人的脉搏，其中54例被ECG记录为房颤。当分析配对读数时，如果两个读数均大于阈值指数，则认为节奏不规则。使用0.06的阈值指数，可以正确识别所有房颤患者，而37名非房颤患者也超过了阈值不规则指数。在该分析中，检测AF的敏感性为100％，特异性为91％，诊断准确性为92％。使用改进的血压计确定的不规则指数可以准确识别房颤。

BACKGROUND & AIMS: BACKGROUND:Auscultatory mercury sphygmomanometers to measure blood pressure (BP) have been banned from health services because of risk of pollution and environmental accidents with mercury. Aneroid appliances could be an alternative. OBJECTIVE:To validate the Missouri aneroid device for blood pressure measurement in cancer patients according to the protocol of the European Society of Hypertension (ESH). METHODS:33 patients hospitalized or under outpatient care at the Cancer Institute of the State of São Paulo, FMUSP, were evaluated. Three trained and blinded observers performed nine sequential blood pressure measurements interspersed with the mercury sphygmomanometers. The differences between the values of systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the test device with the mercury sphygmomanometer were classified according to the ESH protocol. RESULTS:The Missouri equipment underwent all three phases required by the ESH Protocol for SBP and DBP, and it was approved in all of the phases. The average difference between the test device and the mercury sphygmomanometer was 0.62 (SD = 4.53) and 0.06 (SD = 6.57) mmHg for SBP and DBP, respectively. No association was found between the differences in BP measurements with sex, age, body mass index and arm circumference and length. CONCLUSION:The results revealed that the aneroid Missouri device meets ESH accuracy recommendations for the measurement of SBP and DBP, and it can be used to replace the mercury sphygmomanometer.

背景与目标： 背景：由于汞污染的风险和环境事故的危险，已经禁止在医疗服务部门使用用于测量血压（BP）的听诊水银血压计。无液器具可以替代。
目的：根据欧洲高血压学会（ESH）的协议，验证用于癌症患者血压测量的密苏里州无液装置。
方法：对33名在圣保罗州癌症研究所FMUSP住院或接受门诊治疗的患者进行了评估。三名训练有素且不知情的观察员进行了九次连续的血压测量，并穿插了水银血压计。根据ESH协议对使用水银血压计的测试设备的收缩压（SBP）和舒张压（DBP）值之间的差异进行分类。
结果：密苏里州的设备经历了ESH协议针对SBP和DBP所要求的所有三个阶段，并且在所有阶段都得到了批准。对于SBP和DBP，测试设备与水银血压计之间的平均差分别为0.62（SD = 4.53）和0.06（SD = 6.57）mmHg。在血压测量与性别，年龄，体重指数以及臂围和长度之间的差异之间未发现关联。
结论：结果表明，密苏里州无液装置符合SSH和DBP测量的ESH精度建议，可用于替代水银血压计。

BACKGROUND & AIMS: :The aim of this report is to describe a new device that can validate, by automated auscultation, individual blood pressure (BP) readings taken by automated sphygmomanometers.The Accutension Stetho utilizes a smartphone application in conjunction with a specially designed stethoscope that interfaces directly into the smartphone via the earphone jack. The Korotkoff sounds are recorded by the application and are analyzed by the operator on the screen of the smartphone simultaneously with the images from the sphygmomanometer screen during BP estimation. Current auscultatory validation standards require at least 85 subjects and strict statistical criteria for passage. A device that passes can make no guarantee of accuracy on individual patients. The Accutension Stetho is an inexpensive smartphone/stethoscope kit combination that estimates precise BP values by auscultation to confirm the accuracy of an automated sphygmomanometer's readings on individual patients. This should be of great value for both professional and, in certain circumstances, self-measurement BP. Patients will avoid both unnecessary treatment and errors of underestimation of BP, in which the patient requires therapy. The Stetho's software has been validated in an independent ANSI/AAMI/ISO standard study. The Stetho has been shown to perform without difficulty in multiple deflation-based devices by many manufacturers.

背景与目标： ：本报告旨在描述一种新设备，该设备可通过自动听诊来验证自动血压计所采集的个人血压（BP）读数。Accutension Stetho利用智能手机应用程序与专门设计的听诊器结合使用，可直接与血压计连接通过耳机插孔的智能手机。应用程序会记录Korotkoff声音，并由操作员在BP估计期间与智能血压计屏幕上的图像同时在智能手机的屏幕上进行分析。当前的听诊验证标准至少需要85名受试者和严格的统计学标准才能通过。通过的设备不能保证每个患者的准确性。 Accutension Stetho是一种廉价的智能手机/听诊器套件组合，可通过听诊估算精确的BP值，以确认自动血压计对各个患者的读数的准确性。这对于专业人士以及在某些情况下的自我测量BP都将具有巨大的价值。患者将避免不必要的治疗和患者需要治疗的BP低估的错误。 Stetho的软件已通过独立ANSI / AAMI / ISO标准研究的验证。许多制造商已证明Stetho在基于多重排气的设备中可以毫不费力地运行。

BACKGROUND & AIMS: :The study objective was to compare blood pressure (BP) measurement by the Hawksley random-zero sphygmomanometer and the standard mercury sphygmomanometer. Comparison of simultaneous 'blind' BP measurements were made using the Hawksley random-zero sphygmomanometer and the standard mercury sphygmomanometer linked by a Y-connector to a single cuff, in the general practice and office environments. Sixty five healthy volunteers and general practice patients, aged between 20 and 50 years (SBP range 82-184 mm Hg, DBP range 38-112 mm Hg), were studied. Each had three blood pressure measurements taken. Mean BPs recorded by the Hawksley random-zero sphygmomanometer were lower than those recorded by the standard mercury sphygmomanometer. The Hawksley random-zero sphygmomanometer underestimated SBP by 1.3 mm Hg (95% CI 0.9-1.8 mm Hg) and DBP by 1.7 mm Hg (95% CI 1.1-2.3 mm Hg). These differences between instruments were independent of BP level both for systolic and diastolic measurements. An overview including this study and six other published reports describing nine studies examining the performance of the Hawksley random-zero sphygmomanometer suggested a similar degree of underestimation for SBP (mean difference 1.35 mm Hg, 95% CI 1.24-1.46 mm Hg). Underestimation of DBP appeared greater (mean difference 2.54 mm Hg, 95% CI 2.43-2.65 mm Hg) but was reduced when two outlying studies were removed from analysis (mean 1.97, 95% CI 1.85-2.09 mm Hg). We conclude that the Hawksley random-zero sphygmomanometer underestimates systolic and diastolic pressure, when compared with the standard mercury sphygmomanometer. However, the degree of underestimation is small and appears consistent across a wide range of blood pressure levels.(ABSTRACT TRUNCATED AT 250 WORDS)

背景与目标： ：研究目的是比较Hawksley随机零血压计和标准汞血压计的血压测量。在一般实践和办公环境中，使用Hawksley随机零血压计和通过Y型接头连接到单个袖带的标准汞血压计，对同时进行的“盲”血压测量进行了比较。研究对象是年龄在20至50岁（SBP范围为82-184 mm Hg，DBP范围为38-112 mm Hg）之间的六十五名健康志愿者和普通患者。每个人都进行了三个血压测量。 Hawksley随机零血压计记录的平均BP低于标准汞血压计记录的平均BP。 Hawksley随机零血压计低估了SBP 1.3 mm Hg（95％CI 0.9-1.8 mm Hg）和DBP 1.7 mm Hg（95％CI 1.1-2.3 mm Hg）。仪器之间的这些差异与收缩压和舒张压测量的BP水平无关。包括本研究在内的概述和其他六份已发表的报告，其中描述了九项研究霍克斯利随机零血压计性能的研究，表明对SBP的评估程度相近（平均差异1.35 mm Hg，95％CI 1.24-1.46 mm Hg）。 DBP的低估似乎更大（平均差异为2.54 mm Hg，95％CI为2.43-2.65 mm Hg），但是当从分析中移除两项外围研究时，DBP的低估有所降低（平均1.97，95％CI为1.85-2.09 mm Hg）。我们得出的结论是，与标准汞血压计相比，Hawksley随机零血压计低估了收缩压和舒张压。但是，低估的程度很小，并且在广泛的血压水平上似乎保持一致。（摘要截断为250个字）

BACKGROUND & AIMS: :We performed a randomized, single-visit, crossover study to compare the precision of a digital monitor and an aneroid monitor relative to a desktop mercury sphygmomanometer (DMS). Three blood pressure measurements per patient, one per device, were taken over 25 minutes. Of 99 patients, 95 had complete blood pressure data. Systolic blood pressures measured with the digital monitor were significantly different from those with the DMS (p<0.01). Thirty-four percent of systolic and 48% of diastolic pressures measured with the digital monitor were within +/- 5 mm Hg of the DMS. The aneroid monitor performed significantly better than the digital monitor, with 54% of systolic (p<0.01) and 58% of diastolic blood pressures within +/- 5 mm Hg of the DMS standard. Health care providers are encouraged to supervise patients' initial use of a home blood pressure monitor and calibrate readings against a standard mercury sphygmomanometer.

背景与目标： ：我们进行了一项随机，单次访问的交叉研究，以比较数字监测仪和无液监测仪相对于台式水银血压计（DMS）的精度。在25分钟内对每位患者进行三项血压测量，每台设备进行一次血压测量。在99位患者中，有95位具有完整的血压数据。用数字监视器测量的收缩压与用DMS测量的收缩压有显着差异（p <0.01）。用数字监护仪测得的收缩压的百分之三十四和舒张压的百分之四十八在DMS的-5 mm Hg之内。与DMS标准相比，无液监护仪的血压明显好于数字监护仪，其收缩压为54％（p <0.01），舒张压为58％。鼓励医疗保健提供者监督患者初次使用家用血压计，并根据标准的汞血压计校准读数。

BACKGROUND & AIMS: Purpose:(a) to investigate the test-retest and inter-rater reliabilities and the criterion-related validity of the modified sphygmomanometer test (MST) for the assessment of muscle strength in community-dwelling older adults, (b) to calculate the standard error of measurement (SEM) and the smallest real difference (SRD); (c) to verify whether the number of trials affect the results.

Methods:Bilateral strength of lower limbs (LL) and grip muscles were evaluated with the MST and with portable dynamometers in 50 older adults (69.92 ± 5.52 years). Intra-class Correlation Coefficients (ICC) was used to evaluate the inter-rater and test-retest reliabilities and Pearson Correlations was used to investigate the criterion-related validity of the MST. SEM and SRD were also calculated. Analysis of variance was used to investigate whether the number of trials affects the results.

Results:Significant correlations with high to very high magnitude were found for all muscle groups evaluated for test-retest and inter-rater reliabilities (0.80 ≤ ICC ≤ 0.99; p < 0.001) and validity (0.80 ≤ r ≤ 0.91; p < 0.001). Moreover, the values provided by different numbers of trials were similar. The SEM (3.66 ≤ SEM ≤ 20.46) and the SRD (10.15 ≤ SRD95% ≤ 56.70) were considered low for all outcome measures.

Conclusion:The MST showed adequate results for all the measurement properties evaluated for the assessment of the muscle strength of older adults.Implications for rehabilitationOlder adults often develop sarcopenia and dynapenia that are associated with an increased number of falls and fractures and loss of independence.Portable dynamometer is the standard instrument to evaluate isometric muscle strength, however this instrument is expensive and it is not readily available in the underdeveloped or in developed countries.The Modified Sphygmomanometer Test is an alternative method for the clinical measurement of muscle strength, is portable, has a low-cost and provides an objective measurement.In this study the Modified Sphygmomanometer Test showed adequate results for all the measurement properties evaluated for the assessment of the muscle strength in community-dwelling older adults and a single trial after test familiarization can be used to measure the muscle strength in this population.

背景与目标： 目的 ：( a）研究改良的血压计测试（MST）的重测信度和评定者间信度以及与标准相关的有效性，以评估社区居住的老年人的肌肉力量， （b）计算标准测量误差（SEM）和最小实际差（SRD）； （c）验证试验次数是否会影响结果。

方法：在MST和便携式测功机中评估了下肢（LL）和握肌的双向力量50个老年人（69.92岁±5.52岁）。类内相关系数（ICC）用于评估评分者之间和重测的可靠性，而Pearson Correlations相关用于研究MST与标准相关的有效性。还计算了SEM和SRD。方差分析用于研究试验次数是否影响结果。

结果：在所有进行了重新测试的肌肉组中，发现了从高到高幅度的显着相关性评分者间信度（0.80≤ICC≤0.99; p <0.001）和效度（0.80≤rr≤0.91; p <0.001）。此外，不同数量的试验提供的值是相似的。所有结果指标的SEM（3.66≤SEM≤20.46）和SRD（10.15≤SRD95％≤56.70）被认为低。

结论：MST对所有结果均显示出足够的结果为评估老年人的肌肉力量而评估的测量特性康复的意义老年人经常会出现肌肉减少症和运动障碍，与跌倒和骨折的次数增加以及失去独立性有关。便携式测功机是评估等长肌的标准工具强度，但是该仪器价格昂贵，并且在不发达国家或发达国家尚不可用。改良的血压计测试是临床上测量肌肉力量的另一种方法，具有便携性，低成本，可提供客观测量的优点在这项研究中，改良的血压计测试显示出针对评估肌肉力量评估的所有测量属性均具有足够的结果社区居住的老年人和测试熟悉后的一项单独试验可用于测量该人群的肌肉力量。