In obesity, accurate perioperative blood pressure measurement using upper arm, non-invasive blood pressure (NIBP) is technically challenging. Proximal forearm NIBP may be an acceptable substitute. Mean arterial blood pressures (MAP) estimated by proximal forearm NIBP were compared with direct intra-arterial measurements. It was hypothesised that the measurement techniques would be interchangeable if between-technique MAP differed ≤ 20% and MAP ratios were < 1.2 and > 0.8. Method: A total of 30 adults with body mass index ≥ 30 kg/m 2 in whom perioperative intra-arterial blood pressure measurement was considered mandatory were enrolled. MAP measurements using the two techniques were obtained at three random intervals in each patient. Bland-Altman analyses were employed. Results: Forearm mean NIBP MAP overestimated mean intra-arterial MAP by 2.2 (SD 8.1; range from 23.8 to -19.4 mmHg; p = 0.011, 95% CI 3.9 to 0.5). However, Bland-Altman analyses revealed a wide dispersion with several MAP differences and MAP ratios exceeding the pre-specified bounds for interchangeability. Conclusion: Forearm NIBP could not be considered interchangeable with direct intra-arterial MAP measurements in obese patients.
<div style="left: 155.087px; top: 577.926px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.856878);" data-canvas-width="318.63"><strong>Background:</strong> Depression can have far-reaching effects on the</div><div style="left: 80.9418px; top: 601.256px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.92316);" data-canvas-width="392.82000000000005">functioning and adjustment of young people. Among both</div><div style="left: 80.9418px; top: 624.585px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.910571);" data-canvas-width="392.775">children and adolescents depression confers an increased risk</div><div style="left: 80.9418px; top: 647.915px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.898096);" data-canvas-width="325.38">for illness, interpersonal and psychosocial difficulties.</div><div style="left: 80.9418px; top: 647.915px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.898096);" data-canvas-width="325.38"> </div><div style="left: 141.257px; top: 685.427px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.906132);" data-canvas-width="332.50499999999994"><strong>Objective:</strong>The aim of this study was to determine the profile of</div><div style="left: 80.9418px; top: 708.757px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.914105);" data-canvas-width="392.7450000000001">children (birth - 12 years) and adolescents (13 - 18 years) with</div><div style="left: 80.9418px; top: 732.086px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.896099);" data-canvas-width="392.76000000000005">major depression referred to the Child Mental Health Unit at the</div><div style="left: 80.9418px; top: 755.416px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.893043);" data-canvas-width="392.77500000000015">Free State Psychiatric Complex (FSPC) from 1 January 2004 to</div><div style="left: 80.9418px; top: 778.745px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.976556);" data-canvas-width="132.6">31 December 2004.</div><div style="left: 80.9418px; top: 778.745px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.976556);" data-canvas-width="132.6"> </div><div style="left: 129.137px; top: 816.258px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.917412);" data-canvas-width="344.5799999999999"><strong>Method:</strong> A total of 904 children and adolescents were referred</div><div style="left: 80.9418px; top: 839.587px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.919419);" data-canvas-width="392.745">to the Unit during 2004. From these referrals 100 children and</div><div style="left: 80.9418px; top: 862.917px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.933475);" data-canvas-width="392.775">adolescents (11.06%) were diagnosed with major depression</div><div style="left: 80.9418px; top: 886.246px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.910612);" data-canvas-width="193.06499999999997">and were included in the study.</div><div style="left: 80.9418px; top: 886.246px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.910612);" data-canvas-width="193.06499999999997"> </div><div style="left: 180.887px; top: 923.759px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.870766);" data-canvas-width="312.75000000000006"><strong>Data analysis:</strong> The data were summarised using frequencies</div><div style="left: 80.9418px; top: 947.088px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.925438);" data-canvas-width="392.91000000000014">and percentages (categorical variables) and means of</div><div style="left: 80.9418px; top: 970.418px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.885185);" data-canvas-width="200.76000000000002">percentiles (numerical variables).</div><div style="left: 80.9418px; top: 970.418px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.885185);" data-canvas-width="200.76000000000002"> </div><div style="left: 120.362px; top: 1007.93px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.905652);" data-canvas-width="353.31000000000006"><strong>Results:</strong> The majority (74%) of the cases were in the adolescent</div><div style="left: 80.9418px; top: 1031.26px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.904977);" data-canvas-width="392.74499999999995">age group and 61% were girls. The main complaints presented</div><div style="left: 80.9418px; top: 1054.59px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.882313);" data-canvas-width="392.8350000000001">by the parents or in the referral letter by the general practitioners</div><div style="left: 80.9418px; top: 1077.92px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.903519);" data-canvas-width="392.83500000000004">were behavioural problems (37%) such as stealing, aggression</div><div style="left: 80.9418px; top: 1101.25px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.936476);" data-canvas-width="392.80500000000006">and attention-seeking behaviour, followed by decrease in</div><div style="left: 80.9418px; top: 1124.58px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.898045);" data-canvas-width="392.7899999999999">school performance (25%), suspected depression (21%),</div><div style="left: 80.9418px; top: 1147.91px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.8945);" data-canvas-width="392.74499999999983">suicidal tendencies (17%), and school refusal (8%). Twelve per</div><div style="left: 80.9418px; top: 1171.24px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.880596);" data-canvas-width="392.775">cent of the group had lost a family member. The main presenting</div><div style="left: 80.9418px; top: 1194.57px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.912615);" data-canvas-width="392.81999999999994">clinical symptoms of major depression in the study group were</div><div style="left: 80.9418px; top: 1217.9px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.870739);" data-canvas-width="392.805">sleep disturbance (59%), dysphoric (depressed) mood (57%),</div><div style="left: 80.9418px; top: 1241.23px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.92694);" data-canvas-width="392.7599999999999">disturbance in appetite (49%), constant fatigue/loss of energy</div><div style="left: 80.9418px; top: 1264.56px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.908711);" data-canvas-width="392.76">(43%), inability to enjoy activities that would normally give</div><div style="left: 80.9418px; top: 1287.88px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.892772);" data-canvas-width="392.80500000000006">pleasure (37%), and impaired concentration (36%). Somatic</div><div style="left: 80.9418px; top: 1311.21px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.909585);" data-canvas-width="325.965">complaints occurred in 42% of the study population.</div>
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