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Total Intravenous Anesthesia
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
In most field anesthesia environments, minimal monitoring equipment is available to the anesthetist. The anesthetist should be diligent in monitoring subjective visual indications of patient status. One can easily monitor heart rate, pulse quality, respiratory rate and depth, mucous membrane color, and capillary refill time without the aid of an electronic monitor. These simple observations can provide a wealth of information in regard to the physiologic status of the patient. Hand-held pulse oximetry units are available and helpful to the anesthetist in monitoring heart rate and saturation of hemoglobin with oxygen (Figure 5.13).Most ECG units are cumbersome and expensive, making them unlikely to be available in the field. Smaller, inexpensive units that attach to smart phones have been developed and work well in a variety of species (Figure 5.14). This ECG design is much more conducive to field anesthesia use.Small oscillometric blood pressure monitors are also available for field anesthesia monitoring (Figure 5.15). These units are fairly expensive, and accuracy in equine patients is variable.
New Concepts in Coronary Heart Disease (CHD)
Published in Mark C Houston, The Truth About Heart Disease, 2023
There are many possible reasons for these findings:Genetics. Genetics are important in predicting the risk for CHD. These are often not measured by your doctor (Chapters 9 and 10).Proper testing. We must measure more sensitive indicators for CHD and measure them earlier. For example, it is important to measure endothelial dysfunction and conduct other noninvasive tests on the vascular system and heart to determine if there is early CHD. If so, then an aggressive, early prevention, and treatment program is warranted.CHD risk factors. The standard or top five CHD risk factors, as they are often touted, do not adequately identify individuals at risk for CHD. In addition, there are over 400 CHD risk factors. These are not measured, not known by many doctors, or they are ignored. For example, blood pressure should be measured in the office, at home, and by using a 24-hour ambulatory blood pressure monitor. The blood cholesterol and other lipids should be measured using an advanced blood lipid testing method that measures not just total cholesterol, LDL, HDL, and triglycerides but also measures each of these related to particle numbers and size for LDL, HDL, and triglycerides. In addition, the HDL function should be measured.
Prenatal Care
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Gabriele Saccone, Kerri Sendek
In developed countries, prenatal care usually consists of 7–12 visits per pregnancy, with a prenatal visit ideally at 10–14 weeks for aneuploidy screening (see Chaps. 5 and 6), followed by visits about every 4 weeks approximately at 16, 20, 24, and 28 weeks, about every 2 weeks from 32 to 36 weeks, and then weekly until delivery (Table 2.1). Uncomplicated multiparous women may need fewer visits than uncomplicated nulliparous ones. Individual patient needs and risk factors should be assessed at the first prenatal visit and reassessed at each appointment thereafter. Telemedicine can be considered for some visits. The patient should be encouraged to obtain a home blood pressure monitor and a weight scale to track important vital signs.
Usefulness of Triglyceride-glucose index for detecting prevalent atrial fibrillation in a type 2 diabetic population
Published in Postgraduate Medicine, 2022
Wenrui Shi, Mu Qin, Shaohui Wu, Kai Xu, Qidong Zheng, Xu Liu
Clinical examinations were also conducted at MMC during the first visit. Patients were asked to take off their shoes and only wear light-weight clothes before measuring height and weight. When holding in a standing position, the patient’s standard height was recorded to the nearest 0.1 cm by a calibrated stadiometer, and the standard weight was recorded to the nearest 0.1 kg by a calibrated digital scale. A calibrated electronic blood pressure monitor was used for blood pressure measurement after the patients complete a five-minute resting. For every patient, one specified physician performed three consecutive measurements with a two-minute interval between every two measurements, and the mean value of these recordings was brought into statistical analysis. Standard twelve-leads ECG was conducted when the patient holding in a supine position. A specialized cardiologist was employed to read the ECG results and give the final report; the conclusion of the ECG report was then imputed into the MMC-specialized electronic medical record system manually.
Vaping behaviour patterns and daily blood pressure and heart rate variation: a brief report
Published in Annals of Human Biology, 2021
Susan D. Mueller, Geraldine R. Britton, Gary D. James, Pamela Stewart Fahs
Therefore, we evaluated the relationship between ad libitum vaping versus smoking behaviour on cardiovascular response. Data were from a larger pilot study conducted to assess the impact of the use of ambulatory blood pressure monitoring (ABPM) to influence smoking behaviour in a campus community. We analysed the immediate effect of vaping on blood pressure, mean arterial pressure, and heart rate as compared to combustible cigarettes. To do so, ambulatory blood pressure monitoring (ABPM), a well-validated method of measuring cardiovascular responses to stimuli (James 2013) was used. This method previously demonstrated the association between nicotine consumption and acute changes in blood pressure (Gerhardt et al. 1999). When using the ambulatory blood pressure monitor, participants continuously wear an inflatable arm cuff while an oscillometric device records measurements at pre-set intervals. Simultaneous with measurements, the individual records contextual information on a log, or behaviour diary. The resulting physiologic data are analysed and compared to the behaviour diary data to interpret the impact of context on blood pressure (James 2013).
Sex-specific cardiac and vascular responses to hypertension in Chinese populations without overt cardiovascular diseases
Published in Postgraduate Medicine, 2021
Zhiming Li, Jingguang Liu, Jian Shen, Yumin Chen, Lizhen He, Menghao Li, Xiongwei Xie
BP measurement was performed in accordance to guideline recommendation [22]. Patients sit quietly for at least 5 minutes with back supported and both legs on the floor. Standard cuff was used, and the arm was placed at the desk at the same level of the heart. Two BP readings, with 1-minute interval, were recorded and the average value was used for current analyses (Omron HEM-7121 Automatic Blood Pressure Monitor). PP was calculated as follow: PP = SBP – DBP. Serum creatinine was used to calculate estimated glomerular filtration rate (eGFR) using the formula of Modification of Diet in Renal Disease [23]. Body mass index (BMI) was calculated by weight in kilograms divided by height in squared meters, and BMI ≥ 28 kg/m2 was defined as obesity based on the WHO recommendation for Asian populations [24]. Body surface area (BSA) was calculated as follow: BSA = (Weight 0.425 * Height 0.725) * 0.007184. Waist circumference ≥ 90 cm in men and ≥ 80 cm in women were defined as abdominal obesity [24].