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PubMed1996

Auditory alarms during anesthesia monitoring with an integrated monitoring system.

Alarms in the operating room remain a major source of annoyance and confusion. A previous study by Kestin et al. utilized a specific combination of distinct, separate monitors in 50 pediatric patients. He reported a mean of 10 alarms per case with a mean frequency of one alarm every 4.5 minutes. The alarms were classified as spurious (75%), change outside the alarm limits (22%), or patient risk (3%). We performed a similar study with 50 adult patients under general anesthesia with default alarm settings on an integrated monitor, (Cardiocap, Datex, Helsinki). In our study, the number of alarms averaged 3 per case with a mean frequency of one every 34 minutes. Spurious alarms (those caused by electrocautery, accidental patient movement, or other non-physiological reasons) represented only 24% of all alarms. Those alarms sounding that were outside the limits occurred at a rate of 53%, and those that were considered patient risks occurred at a rate of 23%. Of the alarms, 67% occurred during the beginning and end of anesthesia. The end-tidal carbon dioxide accounted for 42% of the alarms, mostly during intubation and extubation. Suggestions are made for further improvement in alarm systems.

Adult↗
PubMed2001

The Narcotrend--a new EEG monitor designed to measure the depth of anaesthesia. A comparison with bispectral index monitoring during propofol-remifentanil-anaesthesia.

INTRODUCTION: The Narcotrend is a new EEG monitor designed to measure the depth of anaesthesia based on a 6-letter classification from A (awake) to F (general anaesthesia with increasing burst suppression) and divided into 14 substages (A, B0-2, C0-2, D0-2, E0,1, F0,1). This study was designed to investigate the assessment of the depth of anaesthesia as measured by the Narcotrend in comparison with bispectral index monitoring (BIS). METHODS: Both BIS and Narcotrend EEG electrodes were positioned on the patient's forehead as recommended by the manufacturers. All patients were premedicated with diazepam 0.15 mg/kg orally in the evening and on the morning before surgery. Induction of anaesthesia was started with a remifentanil infusion at 0.4 microgram/kg/min; 5 min later propofol was given for hypnosis using a target-controlled infusion initially started at 3.5 micrograms/ml. After loss of consciousness patients received 1.2 mg/kg of suxamethonium. Immediately after intubation, remifentanil was reduced to 0.2 microgram/kg/min, and the depth of anaesthesia was adjusted according to clinical needs by regulating the propofol target-controlled-infusion. BIS values and Narcotrend stages were recorded as data pairs in intervals of 1 min during anaesthetic induction and emergence, and in intervals of 5 min during maintenance of anaesthesia. RESULTS: Fifty patients undergoing orthopaedic surgery were studied and 2031 data pairs were obtained. An increasing depth of anaesthesia as indicated by the Narcotrend was associated with significantly lower mean BIS values. With BIS values between 100 and 85 (representing awake patients), 95.5% of all data pairs indicated a Narcotrend stage A or B. In case the BIS was found to be 65-40 (representing general anaesthesia) the corresponding Narcotrend stages were measured as D (52.4%) or E (41.1%). No patient complained of intraoperative recall when interviewed on the 1st and 3rd postoperative day. CONCLUSIONS: We could demonstrate that an increase of the hypnotic component of anaesthesia as indicated by BIS is accompanied by corresponding effects as displayed by the Narcotrend during propofol-remifentanil anaesthesia. The Narcotrend stages D or E are assumed equivalent to BIS values between 64 and 40 indicating general anaesthesia.

Anesthesia, General↗
PubMed2006

Transcranial motor-evoked potentials monitoring can detect spinal cord ischemia more rapidly than spinal cord-evoked potentials monitoring during aortic occlusion in rats.

In this study, we evaluated the efficacy of transcranial motor-evoked potentials (tc-MEPs), compared with segmental spinal cord-evoked potentials (SCEPs), for detecting spinal cord ischemia (SCI) and assessed the relationship between neurological outcome and tc-MEPs or SCEPs in the rat aortic occlusion model. In the rats, SCI was induced by aortic occlusion for 10 min with a balloon catheter. At first, tc-MEPs (Group A: n = 6) or segmental SCEPs (Group B: n = 6) was recorded during SCI. Second, in using the quantal bioassay for the relationship between an interval of aortic occlusion and the probability of positive response in tc-MEPs or segmental SCEPs, the P50(MEP) and P50(SCEP) which represent the interval of aortic occlusion associated with 50% probability of assessment of ischemic spinal cord dysfunction by tc-MEP and SCEP were analyzed. The amplitude of tc-MEPs decreased significantly at 30 s and disappeared completely at 2 min after aortic occlusion. In Group B, it took about 6 min after aortic occlusion to diminish SCEP signal amplitude by approximately 50%. P50(MEP) obtained in the quantal analysis was 0.3 +/- 0.1 min. P50(SCEP) was calculated as 6.2 +/- 0.5 min that was significantly (P < 0.01) longer than P50(MEP). Our data indicated that tc-MEP monitoring could detect the onset of SCI so rapidly in comparison with segmental SCEP monitoring, which could provide therapeutic windows in a surgical approach that includes spinal cord protection.

Animals↗
PubMed2005

Monitoring health care workers after smallpox vaccination: findings from the Hospital Smallpox Vaccination-Monitoring System.

BACKGROUND: The Advisory Committee on Immunization Practices and the Healthcare Infection Control Practices Advisory Committee recommended that hospitals establish on-site, daily assessments of health care workers vaccinated with smallpox vaccine. The Hospital Smallpox Vaccination Monitoring System (HSVMS) was 1 component of the smallpox vaccination plan to monitor adverse events on-site in hospitals. This report presents findings from February to August 2003. METHODS: All US institutions participating in the smallpox vaccination program were eligible to enroll in and use HSVMS through the Internet-based Centers for Disease Control Secure Data Network. RESULTS: Of the 730 enrolled vaccinees, 341 (47%) were nurses; 122 (17%) physicians; 75 (10%) laboratory, patient care, radiology, or other technicians; 39 (5%) administrators; 22 (3%) housekeepers; 21 (3%) physical or respiratory therapists; 20 (3%) infection control professionals; 19 (3%) safety or security staff; and 17 (2%) epidemiologists; and 54 (7%) were workers in other job categories. Most (86%) vaccinees had been previously vaccinated. Postvaccination signs and symptoms were frequent: itching (75.2%), pain at the vaccination site (31.6%), swollen or tender lymph nodes (26.4%), fatigue (26.2%), and headache (20.8%). Symptoms were highest during the first week after vaccination; symptoms were more frequently reported among vaccinees without previous vaccination. Adherence to recommended vaccination site care was reported in 2732 of 3091 (88.4%) follow-up visits among workers with patient contact. Of the 4379 days workers planned to work, during 31 (0.7 per 100) days, workers performed restricted activities, and, in 60 (1.4 per 100) days, workers were absent. CONCLUSIONS: Findings from HSVMS indicate that adherence to post-smallpox vaccination site care was high and that the number of days of work affected was low.

Health Personnel↗
PubMed2006

New "plasma referenced" POCT glucose monitoring systems--are they suitable for glucose monitoring and diagnosis of diabetes?

BACKGROUND: Results from portable glucose meters should be reported as plasma values as recommended by IFCC. Three new "plasma calibrated" blood glucose meters (Abbott Precision Xcceed, Bayer Ascensia Contour and Roche Accu-Chek Aviva) were compared against laboratory venous plasma glucose measurements to determine their suitability for patient monitoring and diabetes diagnosis. METHODS: 115 capillary blood samples were analyzed on each of the three meters and compared to venous plasma measurements on the Dade Behring RXL analyzer (Hexokinase method). RESULTS: We found a significant positive bias of all meters compared to the laboratory reference method. Deviations of more than 10% were seen in more than a third of all glucose values in all three devices. 13%, 8.7% and 10.4%, respectively, of the values from the Abbott, Bayer and Roche devices fell in zone B or C of the Parkes' error grid. CONCLUSIONS: Neither glucose meter met the ADA or the NACB goals and should therefore not be used as screening tests to diagnose diabetes but are well suitable for patient monitoring.

Adult↗
PubMed2005

Bio-effect monitoring using a [(15)N]methacetin test as diagnostic tool to monitor remediation effects in an industrially polluted region.

The classical way to demonstrate the efficiency of remediation is measuring the reduction of toxic compounds in the environment. Nevertheless, more important is the risk reduction in human health. To determine changing health effects, exposure and bio-effects have to be monitored at time of and during remediation. Kindergarten children from a heavily polluted industrial (n=23) and a control area (n=12) were investigated. The region-specific outdoor and indoor exposure [27 volatile organic compounds (VOC), emphasis on tri- and tetrachloroethylene (TRI, TETRA)], the internal load [(trichloroacetic acid-TCA-as urine metabolites of TRI and TETRA and S-phenyl- and S-benzylmercapturic acid (SPMA and SBMA) as metabolites of benzene and toluene], and biological effect assessment ([(15)N]methacetin test-a non-invasive stable isotope test to determine the unspecific liver detoxification capacity of an individual) were measured twice a year during 2 years of remediation (1997/1998). It could be shown that in- and outdoor levels of TRI and TETRA decreased by 47% in the heavily polluted village, Greppin, while the levels remained much the same in the control village, Roitzsch. This trend was reflected in the decreasing elimination of TCA in the urine (41%) by the Greppin children, with no differences in the TCA elimination in Roitzsch probands. As the remediation efforts decreased the burden of exposure, the children's liver detoxification capacity improved as well. Combining different methods, such as exposure-effect (external and internal loads) and bio-effect monitoring, proved to be useful to assess remediation successes including the improvement in human health.

Acetamides↗
PubMed1999

An automatic monitor of formaldehyde in air by a monitoring tape method.

An automatic monitor has been developed for measuring formaldehyde in air using a sensitive tape for formaldehyde. It is based on the color change of the tape on reaction with formaldehyde. The porous cellulose tape, containing silica gel as an absorbent and impregnated with the processing solution containing hydroxylamine sulfate, Methyl Yellow (pH indicator; pH 2.9-4.0, red-yellow), glycerin and methanol, was found to be a highly sensitive means of detecting formaldehyde and maintains a stable sensitivity. When the tape was exposed to a sample of air containing formaldehyde, the color of the tape changed from yellow to red. The degree of color change was proportional to the concentration of formaldehyde at a constant sampling time and flow rate, and it could be recorded by measuring the intensity of reflected light (555 nm). The tape could be used to detect down to 0.08 ppm (World Health Organization standard) of formaldehyde with a sampling time of 30 min and a flow rate of 100 mL min-1. Reproducibility tests showed that the relative standard deviation of response (n = 10) was 3.8% for 0.1 ppm formaldehyde. The monitor is simple, specific, capable of unattended operation and is recommended for both laboratory and field operation.

Air Pollution, Indoor↗
PubMed1983

Tissue pH monitoring in microsurgery: a preliminary evaluation of continuous tissue pH monitoring as an indicator of perfusion disturbances in microvascular free flaps.

In an experiment using a continuous tissue pH monitoring system, selective occlusion of the vessels supplying lower abdominal island flaps in Sprague-Dawley rats resulted in predictable tissue pH changes. Arterial occlusion resulted in a rapid fall in pH. In all three experimental groups, the steepest rate of pH drop occurred during the first 30 minutes postocclusion. In a series of 9 patients who underwent microvascular free flap surgery the continuous pH monitor was employed postoperatively. Tissue pH was (and remained) normal in well-perfused free flaps. Tissue pH fell almost immediately with anastomotic failures. These findings demonstrate that pH measurement offers the microvascular surgeon a new, simple, and reliable approach to perfusion assessment in free flaps. Perhaps improved survival rates will result from earlier anastomotic exploration in compromised free flaps that exhibit falling pH values.

Adult↗
PubMed1988

Problems in therapeutic drug monitoring: free drug level monitoring.

Historically, it has been assumed that only free drug concentration is the pharmacologically active species. This article reviews the theoretical pharmacological and pharmacokinetic justifications for monitoring free drug levels. The determinants likely to influence plasma protein binding and the free concentrations of drugs are delineated. The different methods which can be used for determining free drug level are presented. Their advantages and drawbacks as well as their reliability and suitability for routine clinical practice are discussed. Currently, antiepileptic drugs such as valproic acid, phenytoin, carbamazepine and a few antiarrhythmic drugs meet the theoretical criteria justifying free drug level monitoring. Conditions causing alteration in free concentrations of these drugs are reported. But, for all these drugs, there is a considerable lack of data establishing the correlations between therapeutic or toxic response and free concentration. Presently, our capability to interpret correctly the free drug level data is still limited. In the future, much more effort must be devoted in order to provide sufficient information on the clinical relevance of free drug concentration.

Anti-Arrhythmia Agents↗
PubMed2000

Sialyl Lewis(x) (CD15s) monitoring as a means to select antirejection therapy in patients with rejection after renal transplantation: CD15s monitoring for treatment and diagnosis in patients with acute rejection after renal transplantation.

BACKGROUND: Sialyl Lewis(x) (CD15s), which is known to serve as a ligand for the cell adhesion molecules E-selectin and P-selectin, is expressed on peripheral lymphocytes in renal transplant patients with rejection. In this study, we examined whether CD15s monitoring could differentiate the patients with rejection in whom steroids were effective from those in whom steroids were not effective. METHODS: To investigate CD15s expression on peripheral lymphocytes, flow cytometry was performed before and after steroid pulse therapy in 20 recipients with rejection after renal transplantation, including 5 recipients resistant to steroid therapy. We also compared CD15s expression with pathological findings before and after steroid pulse therapy. RESULTS: CD15s expression was stronger before steroid pulse therapy in the 5 patients resistant to steroids than in the 15 patients responsive to steroid treatment. In addition, CD15s expression remained high without any pathological improvement in the 5 patients resistant to steroids after steroid treatment, although CD15s recovered to normal levels with remarkable improvement of pathological findings in the other 15 patients. Five patients in whom steroids were not effective, had full recovery of serum creatinine levels as well as CD15s expression after muromonab (OKT3) therapy. CONCLUSIONS: CD15s monitoring might help clinicians to select antirejection therapy.

Adult↗
PubMed1999

Task force IV: Clinical use of ambulatory blood pressure monitoring. Participants of the 1999 Consensus Conference on Ambulatory Blood Pressure Monitoring.

OBJECTIVE: To reach a consensus on the clinical use of ambulatory blood pressure monitoring (ABPM). METHODS: A task force on the clinical use of ABPM wrote this overview in preparation for the Seventh International Consensus Conference (23-25 September 1999, Leuven, Belgium). This article was amended to account for opinions aired at the conference and to reflect the common ground reached in the discussions. POINTS OF CONSENSUS: The Riva Rocci/Korotkoff technique, although it is prone to error, is easy and cheap to perform and remains worldwide the standard procedure for measuring blood pressure. ABPM should be performed only with properly validated devices as an accessory to conventional measurement of blood pressure. Ambulatory recording of blood pressure requires considerable investment in equipment and training and its use for screening purposes cannot be recommended. ABPM is most useful for identifying patients with white-coat hypertension (WCH), also known as isolated clinic hypertension, which is arbitrarily defined as a clinic blood pressure of more than 140 mmHg systolic or 90 mmHg diastolic in a patient with daytime ambulatory blood pressure below 135 mmHg systolic and 85 mmHg diastolic. Some experts consider a daytime blood pressure below 130 mmHg systolic and 80 mmHg diastolic optimal. Whether WCH predisposes subjects to sustained hypertension remains debated. However, outcome is better correlated to the ambulatory blood pressure than it is to the conventional blood pressure. Antihypertensive drugs lower the clinic blood pressure in patients with WCH but not the ambulatory blood pressure, and also do not improve prognosis. Nevertheless, WCH should not be left unattended. If no previous cardiovascular complications are present, treatment could be limited to follow-up and hygienic measures, which should also account for risk factors other than hypertension. ABPM is superior to conventional measurement of blood pressure not only for selecting patients for antihypertensive drug treatment but also for assessing the effects both of non-pharmacological and of pharmacological therapy. The ambulatory blood pressure should be reduced by treatment to below the thresholds applied for diagnosing sustained hypertension. ABPM makes the diagnosis and treatment of nocturnal hypertension possible and is especially indicated for patients with borderline hypertension, the elderly, pregnant women, patients with treatment-resistant hypertension and patients with symptoms suggestive of hypotension. In centres with sufficient financial resources, ABPM could become part of the routine assessment of patients with clinic hypertension. For patients with WCH, it should be repeated at annual or 6-monthly intervals. Variation of blood pressure throughout the day can be monitored only by ABPM, but several advantages of the latter technique can also be obtained by self-measurement of blood pressure, a less expensive method that is probably better suited to primary practice and use in developing countries. CONCLUSIONS: ABPM or equivalent methods for tracing the white-coat effect should become part of the routine diagnostic and therapeutic procedures applied to treated and untreated patients with elevated clinic blood pressures. Results of long-term outcome trials should better establish the advantage of further integrating ABPM as an accessory to conventional sphygmomanometry into the routine care of hypertensive patients and should provide more definite information on the long-term cost-effectiveness. Because such trials are not likely to be funded by the pharmaceutical industry, governments and health insurance companies should take responsibility in this regard.

Antihypertensive Agents↗
PubMed2004

Results of lis2t, a multicenter, randomized study comparing cyclosporine microemulsion with C2 monitoring and tacrolimus with C0 monitoring in de novo liver transplantation.

This is the first multicenter, randomized, open-label study to compare the efficacy and safety of cyclosporine A microemulsion (CsA-ME) (Neoral, Novartis, Basel, Switzerland ) with C2 monitoring versus tacrolimus in de novo liver transplant recipients. Patients were stratified according to hepatitis C virus status and randomized to receive CsA-ME (n= 250) or tacrolimus (n= 245) with steroids, with or without azathioprine. The primary endpoint was the incidence of biopsy-proven acute rejection (BPAR) at 3 months. Secondary endpoints included death or graft loss and safety evaluations at 6 months. The incidence of BPAR at 3 months was 26% in the CsA-ME group and 24% in the tacrolimus group (not significant). At 6 months, 89% of patients receiving CsA-ME and 88% of patients receiving tacrolimus were alive with a functioning graft. Among the hepatitis C virus-positive patients, there was no difference in BPAR, but death or graft loss was more frequent in those receiving tacrolimus (15% vs. 6%, P <0.05). Diabetes mellitus (14% vs. 7%, P <0.02) and diarrhea (29% vs. 14%, P <0.001) were significantly more often reported in patients receiving tacrolimus. The incidence of hypertension was similar in both groups. At 6 months, the median total cholesterol was 4.7 mmol/L (2.9-7.4 mmol/L) in the CsA-ME arm versus 4.3 mmol/L (2.5-6.4 mmol/L) in the tacrolimus arm; the median serum creatinine was 106 micromol/L (52-238 micromol/L) in the CsA-ME arm versus 103 micromol/L (44-477 micromol/L) in the tacrolimus arm. Efficacy is equivalent with CsA-ME using C2 monitoring or tacrolimus in liver transplant recipients. The incidence of adverse events is comparable except for a significantly higher incidence of diabetes mellitus and diarrhea in the tacrolimus group. Both agents are effective primary immunosuppressants in liver transplant recipients.

Adult↗
PubMed1993

EEG monitoring during carotid surgery: who should do the monitoring?

EEG monitoring was carried out by an EEG technician during 100 consecutive carotid endarterectomies in a community hospital. The technician's rating of the EEGs correlated with an inhouse electroencephalographer's interpretation and with historical published data. We conclude that intraoperative EEG monitoring during carotid endarterectomies can adequately be carried out by a competent EEG technician provided adequate physician backup and supervision are available.

Aged↗
PubMed1998

Agreement among raters in assessment of physiologic waveforms recorded by a cardiorespiratory monitor for home use. Collaborative Home Infant Monitoring Evaluation (CHIME) Study Group.

There are numerous reports of cardiorespiratory patterns in infants on home monitors, but no data to determine whether "experts" agree on the description of these patterns. Therefore, we evaluated agreement among four experienced investigators and five trained technicians who assessed independently the same sample of physiologic waveforms recorded from infants enrolled in a multicenter study. The monitor used respiratory inductance plethysmography and recorded waveforms for apnea > or = 16 s or a heart rate < 80 beats/min for > or = 5 s. The investigators and technicians initially assessed 88 waveforms. After additional training, the technicians assessed another 113 additional waveforms. In categorizing waveforms as apnea present or absent, agreement among technicians improved considerably with additional training (kappa 0.65 to 0.85). For categorizing waveforms as having bradycardia present versus absent, the trends were the same. Agreement in measurement of apnea duration also improved considerably with additional training (intraclass correlation 0.33-0.83). Agreement in measurement of bradycardia duration was consistently excellent (intraclass correlation 0.86-0.99). Total agreement was achieved among technicians with additional training for measurement of the lowest heart rate during a bradycardia. When classifying apnea as including > or = 1, > or = 2, > or = 3, or > or = 4 out-of-phase breaths, agreement was initially low, but after additional training it improved, especially in categorization of apneas with > or = 3 or > or = 4 out-of-phase breaths (kappa 0.67 and 0.94, respectively). Although researchers and clinicians commonly describe events based on cardiorespiratory recordings, agreement amongst experienced individuals may be poor, which can confound interpretation. With clear guidelines and sufficient training raters can attain a high level of agreement in describing cardiorespiratory events.

Female↗
PubMed2004

Simple fiber-optic-based sensors for process monitoring: an application in wine quality control monitoring.

The goal of this research was to develop a simple and economical fiber-optic sensor technology for agrifood process monitoring. Toward this end, two fiber-optic sensors were developed to be used in combination: a single reflection V-bend sensor and a single fiber air-gap probe. The former is designed to be sensitive toward refractive index and the latter towards absorption. Experiments indicate that the micromachined V-bend fiber refractometer is most sensitive when the bend angle is centered around 140 degrees, at which angle the sensor may resolve changes in refractive index as small as 0.00015. Additionally, the V-bend sensor was found to be non-responsive toward sample absorption even in extremely absorbing solutions. The air-gap design absorption sensor, most commonly used for measurements in highly colored media, was found to be slightly sensitive towards refractive index. When the two sensors are used together, the response of the absorption sensor may be corrected for. This sensor combination is able to provide accurate measurements in situations where Beer's law is not obeyed. Results are presented that show that the sensor pair was successfully used to monitor wine sugar content (Brix), and color density and hue, parameters related to the age of the wine.

Absorption↗
PubMed2004

The Blood Glucose Monitoring Communication questionnaire: an instrument to measure affect specific to blood glucose monitoring.

OBJECTIVE: The aim of this study was to present the psychometric properties of a new tool for evaluating affective response to blood glucose monitoring (BGM) in youths with type 1 diabetes and their parents. RESEARCH DESIGN AND METHODS: Study participants included 153 youths with type 1 diabetes and their parents. Each youth and parent completed the Blood Glucose Monitoring Communication (BGMC) questionnaire, Diabetes Family Conflict Scale, and Pediatric Quality of Life Inventory. Statistical analyses evaluated the psychometric properties of the BGMC questionnaires and their association with glycemic outcomes. RESULTS: Youth and parent BGMC questionnaires had acceptable internal consistency (youth, alpha = 0.77; parent, alpha = 0.82) and 1-year test-retest reliability (youth, r = 0.60; parent, r = 0.80). Higher BGMC questionnaire scores (indicating more negative affect) showed a strong association with higher levels of diabetes-specific family conflict (youth, r = 0.33; parent, r = 0.44) and poorer health-related psychosocial quality of life (youth, r = -0.50; parent, r = -0.42). Higher BGMC questionnaire scores were also associated with poorer glycemic control (youth, r = 0.28; parent, r = 0.20), even when the effects of diabetes-specific family conflict and psychosocial quality of life were controlled. Youths with BGMC questionnaire scores in the upper quartile had A1c values 1 percentage point higher (9.1%) than youths with scores in the lowest quartile (8.0%). CONCLUSIONS: The BGMC questionnaires have strong psychometric properties and are convenient measures of affect specific to BGM. Further, BGM affect is associated with glycemic outcomes and may provide a unique contribution to factors associated with glycemic control in youths.

Adolescent↗
PubMed1993

Evaluation of the reproducibility and accuracy of ambulatory blood pressure monitoring using the Takeda TM-2420 automated blood pressure monitor.

The reproducibility of ambulatory blood pressure measurements was assessed in eight normotensive subjects who underwent three separate days of recording, using Takeda Medical TM-2420 (TM-2420) blood pressure monitors. The coefficients of variation of mean 24 hour systolic and diastolic blood pressure were 2.1% and 2.8% respectively. The corresponding values for systolic and diastolic blood pressure variability, were 19% and 14% respectively. Measurement intervals of greater than 30 minutes significantly reduced the reproducibility of mean day interval systolic measurements. The bias of the TM-2420 systolic and diastolic blood pressure measurements compared to standard sphygmomanometer measurement were 0 +/- 7 mmHg and 1 +/- 6 mmHg respectively. Ambulatory blood pressure monitoring provides reproducible estimates of mean systolic and diastolic blood pressure, however, blood pressure variability is poorly reproducible.

Adaptation, Physiological↗
PubMed1993

The Canadian National Calibration Reference Centre for In-Vivo Monitoring: thyroid monitoring. Part I: The national inter-comparison programme.

This article is the first part of a five-part series covering various aspects of occupational thyroid monitoring. The Canadian National Calibration Reference Centre for In-Vivo Monitoring conducts a thyroid inter-comparison programme that now includes more than 100 facilities. The scope of the programme, begun in 1988, has greatly expanded in the last two years following a considerable effort to locate and inform facilities. This article presents the details of the programme, its results, and the lessons learned. Subsequent articles will discuss sources of errors, methodology, instrumental configuration, and counting geometry optimization.

Calibration↗