A recent report in The Lancet has concluded that blood pressure should be measured in both arms as the difference between left and right could indicate underlying health problems such as vascular disease.

Dr Christopher Clark and colleagues, from the Peninsula College of Medicine and Dentistry at the University of Exeter, reviewed 28 previous study papers on this subject.

According to the study, the difference between arms is important, although the arm with the higher pressure can vary between individuals. Most people in the study had an elevated blood pressure risk and about one-third had a normal level of risk.

The study concluded that a difference in systolic blood pressure of 10 millimetres of mercury (mm Hg) between arms could identify patients at high risk of asymptomatic peripheral vascular disease. A difference of 15 mm Hg would also indicate an increased risk of cerebrovascular disease, a 70% increased risk of cardiovascular mortality and 60% increased risk of death from all causes, the authors said.

Peripheral vascular disease (PVD) is the narrowing and hardening of the arteries that supply blood to the legs and feet. There are often no symptoms. Early detection of PVD is important because these patients could then benefit from stopping smoking, lowering their blood pressure or being offered statin therapy.

Writing in The Lancet, Prof Richard J McManus, department of primary care health sciences at the University of Oxford and Prof Jonathan Mant, from the department of public health and primary care at the University of Cambridge, said the review supports existing guidelines.

Prof Bryan Williams, from the Blood Pressure Association and the University of Leicester, said the study reinforced the message already in the guidelines from health watchdog NICE.

Among women with gestational diabetes mellitus, referral to a telephone-based nurse management program was associated with lower risk of high baby birth weight and increased postpartum glucose testing, according to Kaiser Permanente researchers.
Investigators for the Kaiser Permanente Northern California Division of Research examined the associations between referral to telephone-based nurse consultation and outcomes in 12 Kaiser Permanente medical centres with variation in the percent of patients referred to telephonic nurse management.
‘Compared with women from Kaiser Permanente medical centres where the annual proportions of referral to nurse management at the Kaiser Permanente Regional Perinatal Service Center was less than 30 percent, women who delivered in medical centres with an annual referral proportion of greater than 70 percent were less likely to have a high birth weight infant without increasing the risk or having a low birth weight infant,’ said Assiamira Ferrara, MD, PhD, a research scientist with the Kaiser Permanente Northern California Division of Research and the lead author of the study. ‘In addition, they were more likely to have postpartum glucose testing, which leads to earlier identification and management of postpartum glucose intolerance or diabetes.’
Investigators used data from the Kaiser Permanente Northern California GDM registry to identify women who had pregnancy complicated by GDM from 1997 through 2006. They restricted their cohort to women with GDM according to the National Diabetes Data Group criteria. During the study period, 96 percent of all pregnant women without pre-existing diabetes who delivered an infant were screened for GDM. Researchers excluded women who delivered multiple births due to their increased risk of perinatal complications. Overall, researchers identified 11,435 women with GDM at the 12 medical centres, of whom 44.5 percent were referred to the perinatal service centre.
‘The Kaiser Permanente Regional Perinatal Service Center is a nurse-based management program for women with GDM that offers supplemental care via telephone counselling to women with high-risk pregnancies, including those complicated by GDM,’ explained co-author Monique Hedderson, PhD, a research scientist with the Kaiser Permanente Northern California Division of Research.
The program includes a call center with 32 registered nurses and two registered dieticians who offer phone counselling seven days a week and address glucose monitoring and control, diet and physical activity. Nurses are available 24 hours a day, seven days a week, while dieticians are available to patients during the week from 8 a.m. to 5 p.m. In addition to care provided by obstetricians, women referred to the centre receive one to two counselling calls per week to help them manage their blood glucose levels during pregnancy. The centre also sends a laboratory slip for postpartum glucose testing and a reminder telephone call if the screening test was not performed. EurekAlert

Women undergoing treatment for breast cancer might fight off distressing side effects and improve psychological well-being by staying off the couch. According to the University of Miami (UM) study, women who are physically active during treatment have less depression and an enhanced quality of life and report less debilitating fatigue.
‘Women who are physically active may also have more confidence in their own ability to continue with family-related, household, work-related, or social activities, which bring meaning and satisfaction to their lives,’ says Jamie M. Stagl, M.S., doctoral student in Clinical Health Psychology in the College of Arts and Sciences at UM and lead author of the study. ‘This may lead to appraisals of lower fatigue, heightened quality of life, and less depression.’
UM researchers studied the reported physical activity of 240 women recently diagnosed with non-metastatic breast cancer and recruited from four to 10 weeks post-surgery. Participants attended a 10-week, group-based Cognitive Behavioral Stress Management (CBSM) intervention, or a one-day psychoeducation ‘self-help’ comparison group. In addition, researchers monitored the women’s reported physical activity levels.
While these researchers have previously shown that stress management improves breast cancer treatment, the current study reveals that there are additional benefits for women who are also physically active through treatment.
‘Women who increased the amount of time they spent being physically active between the weeks after surgery and their adjuvant therapy had less ‘fatigue disruption’

The market for electronic health technology or eHealth is growing fast in the European Union. This is largely due to the unstoppable demand for mobile health devices which help patients to monitor their health, communicate with their doctors and store medical records. Meanwhile, the EU institutions are trying to speed up legislation to boost growth in the sector.

The demand for such services is expected to grow exponentially as the ageing baby boomers put increasing pressure on healthcare systems. It is estimated that nearly 30% of Europeans will be over 65 by the year 2050.

Many phone and TV companies across Europe are currently developing technologies to check your blood pressure and sugar level, and will remind you to take your medicine. This information is relayed over cable and satellite networks to users. KPN offers its diabeticStation in the Netherlands, Telecom Italia has the MyDoctor@home service, and Orange has a medication reminder solution. These services help to reduce the cost and time patients spend in hospital or at the doctor. In Belgium, Belgacom is testing a project for people with heart conditions, while Portugal Telecom and Deutsche Telekom have services for disabled people.

The eHealth industry has a critical role to play in the European Union