[The validity and reliability of arterial pressure measurement in a health center]. / Validez y fiabilidad de la medición de la tensión arterial en un centro de salud.

OBJECTIVE: To evaluate the validity of blood pressure measurement by studying the presence of preference bias in last digits and also of the bias which tends to situate measurements below the established limit. To evaluate the interobserver (doctor-nurse) reliability of the measurements. DESIGN: A cross-sectional [correction of crossover] observation study with descriptive and analytic components. SETTING: A nursing station in the Health Centre. PATIENTS: The patients who attended the nursing station by appointment during the months of September and October 1993. MEASUREMENTS AND MAIN RESULTS: The patients who attended the nursing station by appointment had their blood pressure measured by a doctor or nurse in a random fashion. We detected a preference in last digits, which was very significant for both systolic and diastolic pressure (p < 0.0001). The tendency to reduce diastolic figures to below the preestablished limit of pressure was also very significant (p < 0.05). The nurse found lower figures than the doctor, with a very significant difference for diastolic pressure (p < 0.001). The index of kappa concordance between nurse and doctor on evaluating whether pressure was high or not was 0.4864, with a C.I. of 95%, from 0.3530 to 0.6198. CONCLUSIONS: The existence of two important biases in the measurements of pressure questions their validity. Additionally the significant difference between the pressure averages and the low concordance poses a serious question over the interobserver reliability and should make us restate blood pressure measurement and the treatment of patients suffering Hypertension.

[Efficacy of antimicrobial prevention with single-dose ceftriaxone in urologic surgery]. / Eficacia de la profilaxis antimicrobiana con dosis única de ceftriaxona en cirugía urológica.

One gm ceftriaxone was administered i.m. to 266 patients 1 h before urologic surgery. The antimicrobial spectrum and long half life of this beta-lactam make it potentially useful for prophylaxis. Its efficacy was determined by the incidence of infections and antibiotics required postoperatively. Postoperative bacteriuria was determined by two urine cultures: one at discharge from hospital or after catheter removal and another 4 weeks postoperatively. The overall postoperative infection rate was 9.7% and bacteriuria was 11.2%; most of these were asymptomatic. Antibiotics were administered postoperatively in 13.9% of the patients. The foregoing results corroborate the efficacy of this agent given in a single dose for prophylaxis against infection in urologic surgery.