Background Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem detecting white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM, reporting sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-h ABPM as the reference standard, were 74% (95% CI: 65–82%), 79% (95% CI: 69%, 87%), and 11.11 (95% CI: 6.82, 14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI 0.19, 0.29) and 0.29 (95% CI 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71% (95% CI 61%, 80%), 82% (95% CI 77%, 87%), and 11.60 (95% CI 8.98, 15.13), respectively. Conclusions Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-h ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

Background: Currently, clinic blood pressure measurement(CBPM) is most commonly used for screening hypertension, but it is facing with white coat hypertension(WCHT) and masked hypertension(MHT). Home blood pressure measurement(HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline and Scopus databases were searched up to 23 rd January 2020. Studies having diagnostic test as CBPM or HBPM, reference standard as ABPM, and reported sensitivity and specificity of either or both tests and/or proportion of white coat or masked hypertension were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio of CBPM were 70%(95%CI:63%-76%), 81%(95%CI:73%-81%), and 9.84(95%CI:6.82-14.20), respectively. Pooled prevalence of WCHT and MHT were 28%(95%CI:25%-32%) and 27%(95%CI:22%-31%). Pooled sensitivity, specificity, and diagnostic odds ratio of HBPM were 74%(95%CI:66%-80%), 83%(95%CI:76%-89%), and 13.73(95%CI:8.55.0-22.03), respectively. Pooled WCHT and MHT were 17%(95%CI:11%-22%) and 30%(95%CI:19%-42%), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than performance of CBPM. However, prevalence of MHT was high in both negative CBPM and HBPM. Therefore, ABPM is still necessary for hypertension diagnosis, especially in people suspected with masked hypertension.

Background: Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem of white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM which reported sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-hour ABPM as the reference standard, were 74%(95%CI:65%-82%), 79%(95%CI:61%-87%), and 11.11(95%CI:6.82-14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI: 0.19, 0.29) and 0.29 (95% CI: 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71%(95%CI:61%-80%), 82%(95%CI:77%-87%), and 11.60(95%CI:8.55.0-22.03), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-hour ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

During 9-20 Nov 2011, four prisoners in the national prison died with unknown cause and many prisoners developed diarrhea and neuropathy. The Bureau of Epidemiology launched an investigation to identify etiology and source of outbreak, and implement control measures. A case was defined as a prisoner or guard who developed gastrointestinal (GI) symptoms or neurological symptoms during 1 Sep to 31 Dec 2011. Foods, water, blood and urine samples were tested for heavy metals, vitamins B1 and B12. The prison had 33 guards, 3,668 male prisoners and 555 female prisoners. Among 475 prisoners who met the case definition, 307 (64.6%) GI cases, 49 (10.3%) neurological cases and 119 (25.1%) cases with both GI and neurological symptoms were identified. No case was found among the guards. Attack rates among male and female prisoners were 12.6% (462/3,668) and 2.3% (13/555) respectively. No female prisoners developed neuropathy. Eleven male prisoners had severe distal symmetrical peripheral neuropathy. Four men aged 26-47 years died after developing acute dyspnea. The cases rapidly increased after pipeline of the prison damaged on 2 Nov 2011. Blood and urine samples illustrated vitamin B1 deficiency and high arsenic concentration respectively. This outbreak of peripheral neuropathy possibly resulted from arsenic contaminated drinking water. After providing clean water on 24 Nov 2011, the outbreak subsided within 10 days.

Cholangiocarcinoma (CCA) is a common cancer in Thailand. This study aimed to describe epidemiological characteristics and survival outcomes of patients diagnosed with CCA at Roi-et Cancer Center during January and December 2010. Cox proportional hazard regression analysis was used to analyze data from 119 patients diagnosed with imaging techniques. The median survival time was found to be 4.4 months and the 2-year survival rate was 14.5%. From multivariate analysis by Cox proportional hazard regression, carcinoembryonic antigen (CEA) level >5 µg/l and alkaline phosphatase (ALP) >150 IU/l were found to be indicators of decreased survival time while having surgery led to longer survival time. To improve survival outcome, early detection through screening program and early diagnosis must be organized. Prognostic values of CEA and ALP should be considered.