Survey of 23 Nordic university hospitals showed that 77% lacked written procedures for measuring and interpreting blood pressure in infants.

AIM: This study determined the use of standardised procedures for infant noninvasive blood pressure (NIBP) measurements in the Nordic countries and aimed to identify factors included in the standardisation and interpretation of NIBP measurements in infants. METHODS: A cross-sectional electronic questionnaire survey was sent to 84 physicians in all 23 university hospitals in Sweden, Norway, Denmark, Finland and Iceland and was completed from February to March 2017. The survey contained respondent characteristics, the presence and description of standardised procedures for NIBP measurements, daily practice of NIBP measurements and methodological considerations and interpretation of NIBP measurements in a healthy six-month-old child. RESULTS: We received responses from 55 of 84 physicians working in all 23 Nordic university hospitals, in paediatric cardiology (n = 22), general paediatrics (n = 16), paediatric nephrology (n = 14) and other fields (n = 3). Less than a quarter (23%) said their hospital issued specific NIBP procedures relating to infants and they referred to 19 different sources of information. The factors that were most commonly assessed for interpretation were age (100%), arousal state (78%) and cuff size (76%). CONCLUSION: Most of the university hospital units treating children lacked age-specific written procedures for measuring and interpreting infant NIBP, and there is a strong need for common Nordic guidelines.

Associations among total and food additive phosphorus intake and carotid intima-media thickness--a cross-sectional study in a middle-aged population in Southern Finland.

BACKGROUND: Dietary phosphorus (P) intake in Western countries is 2- to 3-fold higher than recommended, and phosphate is widely used as a food additive in eg. cola beverages and processed meat products. Elevated serum phosphate concentrations have been associated with cardiovascular disease (CVD) risk factors and CVD itself in several studies in patients with renal dysfunction and in a few studies in the general population. Carotid intima-media thickness (IMT) is a CVD risk factor, thus the aim of the study was to determine if an association between dietary P, especially food additive phosphate (FAP), intake, and IMT exists. METHODS: Associations among total phosphorus (TP) and FAP intake and carotid IMT were investigated in a cross-sectional study of 37- to 47-year-old females (n = 370) and males (n = 176) in Finland. Associations among TP intake, FAP intake, and IMT were tested by analysis of covariance (ANCOVA) in quintiles (TP) and sextiles (FAP) using sex, age, low-density/high-density lipoprotein cholesterol ratio, smoking status, and IMT sonographer as covariates. RESULTS: No significant associations were present between TP or FAP intake and IMT (p > 0.05, ANCOVA), but in between-group comparisons some differences were found indicating higher IMT among subjects with higher P intake. When testing for a significant linear trend with contrast analysis, a positive trend was observed between energy-adjusted TP intake and IMT among all subjects (p = 0.039), and among females a tendency for a trend existed (p = 0.067). Among all subjects, a significant positive linear trend was also present between FAP intake and IMT (p = 0.022); this trend was also seen in females (p = 0.045). In males, no significant associations or trends were noted between TP or FAP intake and IMT (p > 0.05). CONCLUSIONS: Our results indicate that a significant linear trend exists between energy-adjusted TP intake and FAP intake, and IMT among all subjects. Based on these results, high dietary P intake should be further investigated due to its potential association with adverse cardiovascular health effects in the general population.

Time-related arterial changes after allogeneic hematopoietic stem cell transplantation in children.

BACKGROUND: Metabolic syndrome is a frequent late effect in young adults after hematopoietic stem cell transplantation (HSCT) performed in childhood. METHODS: To further study the signs of cardiovascular changes in HSCT patients, we performed noninvasive vascular ultrasonic measurements of arterial stiffness and endothelial function in 25 children (median age: 11.2 y) and in 22 healthy matched controls. RESULTS: The distensibility of the common carotid artery (CCA) was significantly lower in the patients than in the controls (mean = 0.48, SD = 0.19 vs. mean = 0.64 mm Hg(-1) × 10(-2), SD = 0.28; P = 0.024). The distensibility decreased with time passed after HSCT (P = 0.009). The compliance of the CCA was decreased (mean = 0.10, SD = 0.04 vs. mean = 0.13 mm(2) × mm Hg(-1), SD = 0.05; P = 0.041), and the incremental elastic modulus (E inc) was higher in the patients than in the controls (mean = 2.05, SD = 0.7 vs. mean = 1.6 mm × 10(3), SD = 0.6; P = 0.019). E inc was associated with time passed after HSCT (P = 0.036). The size of the brachial artery and flow-mediated dilation did not differ between the groups. CONCLUSION: Early mechanical changes of the arterial wall were found at young age after HSCT. Ultrasonography may offer a noninvasive method to find early alterations of the vascular bed and to optimize prevention of atherosclerosis in HSCT patients.