Worsening dyspnea in a man with 2 hearts.

We report a case of dyspnea in a 71-year-old man who underwent heterotopic heart transplantation in 2003. At presentation, electrocardiography showed ventricular fibrillation of the native heart and then a progression to both donor and recipient hearts. Synchronized electrical cardioversion restored sinus rhythm and relieved the patient from his symptoms.

Validation of the SAA-102 home blood pressure monitor according to the protocols of the European Society of Hypertension, the Association for the Advancement of Medical Instrumentation and the British Society of Hypertension.

OBJECTIVE: To determine the accuracy of a new oscillometric home blood pressure (BP) monitor for arm BP measurement, the SAA-102, developed by the Sensacare Company. DESIGN: Evaluation of the SAA-102 was performed using validation protocols of the European Society of Hypertension (ESH), the Association for the Advancement of Medical Instrumentation (AAMI), and the British Hypertension Society (BHS). METHODS: The SAA-102 monitor was assessed on 33 participants according to ESH requirements, which are based on four zones of accuracy differing from the mercury standard by 5, 10, 15 mmHg or more. Then the oscillometric monitor was tested on 85 participants according to AAMI criteria which require a mean device-observers discrepancy within 5+/-8 mmHg. Finally, the electronic device was evaluated on 93 participants according to BHS requirements, which are based on five phases: before-use calibration, in-use assessment, after-use calibration, static device validation and report of the results. RESULTS: The SAA-102 passed all phases of the ESH international protocol for both systolic and diastolic blood pressure (SBP and DBP). The SAA-102 passed also AAMI criteria for SBP and DBP. The mean discrepancy between the SAA-102 and observers was 0.1+/-4.6 and -2.7+/-5.2 mmHg, for SBP and DBP, respectively. According to BHS protocol, the oscillometric monitor achieved final grading of A/A for SBP and DBP, respectively. CONCLUSION: These data show that the SAA-102 device satisfies ESH, AAMI, and BHS protocols for both SBP and DBP and may be recommended for everyday use for BP monitoring at home and in clinical practice.

Validation of the SAW-102 wrist home blood pressure monitor according to the protocols of the British Hypertension Society, the Association for the Advancement of Medical Instrumentation, and the European Society of Hypertension.

OBJECTIVE: To determine the accuracy of the SAW-102 wrist oscillometric blood pressure monitor developed by the Sensacare Company according to the protocols of the European Society of Hypertension (ESH), the Association for the Advancement of Medical Instrumentation (AAMI), and the British Hypertension Society (BHS). METHODS: SAW-102 was assessed on 33 participants according to ESH requirements, based on four zones of accuracy differing from the mercury standard by 5, 10, 15 mmHg or more. Then SAW-102 was tested on 85 participants according to AAMI criteria requiring mean device-observers discrepancy within 5+/-8 mmHg. Subsequently, SAW-102 was evaluated on 88 participants according to BHS requirements. Finally, 15 participants with wrist circumference greater than the manufacturer's recommendation (19.5 cm) were studied (large wrist group). Efforts were made to secure a stable position of wrist and arm at the heart level. RESULTS: SAW-102 passed all phases of ESH international protocol for both systolic blood pressure (SBP) and diastolic blood pressure (DBP). SAW-102 passed AAMI criteria with mean differences between SAW-102 and observers of 3.8+/-7.5 and 1.5+/-6.0 mmHg, SBP and DPB, respectively. According to BHS protocol, the device achieved final grading of B/B for SBP and DBP, respectively. Large wrist group did not pass the first phase of ESH protocol. CONCLUSION: This study demonstrated that SAW-102 meets the BHS, ESH, and AAMI standards when measurements are done at the heart level and when the manufacturer's specifications, regarding wrist circumference, are respected. Our data also indicate that exceeding 19.5 cm wrist circumference is accompanied by dramatic decrease of the accuracy of the device.

Chiari I malformation with syrinx: an unexpected diagnosis in the emergency department.

The authors describe a case of syringomyelia associated with Chiari I malformation in a patient in whom acute symptomatic exacerbation occurred after cervical spine trauma. The authors review the various factors in the pathogenesis of this unusual sequence of events.