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Blood pressure is the force of the blood pushing against the artery walls. Two numbers are recorded when measuring blood pressure:
Systolic pressure. This is the higher number. It refers to the highest pressure inside the artery. It occurs when the heart contracts and pumps blood to the body.
Diastolic pressure. This is the lower number. It refers to the lowest pressure inside the artery. It occurs when the heart relaxes and fills with blood.
For example, if a child's blood pressure is 110/70 mmHg, 110 is the systolic blood pressure and 70 is the diastolic blood pressure.
High blood pressure (hypertension) means that the pressure inside the arteries is too high. This higher pressure may harm the arteries and cause the heart to work harder.
If the pressure is high when the heart contracts, then the systolic pressure will be high.
If the pressure is high when the heart relaxes, then the diastolic pressure will be high.
The systolic or diastolic pressure, or both, may be high.
Many things affect blood pressure. These include:
Time of day. Blood pressure changes throughout the day.
Physical activity. Blood pressure is usually higher during and right after exercise.
Emotions. Feeling angry, afraid, or happy can affect blood pressure. Feeling anxious or nervous at the healthcare provider's office may also affect blood pressure.
Age, height, weight, and gender. Blood pressure is lower in infants compared with older children. Taller children usually have higher blood pressure than shorter children. Overweight or obese children are more likely to have high blood pressure. And boys usually have slightly higher blood pressure than girls.
Illness or medicines. This might be heart disease or kidney disease.
Diet. Salt, foods with high salt content (such as packaged meats), alcohol, and drinks with caffeine (such as coffee and soda) can all raise blood pressure.
One high blood pressure reading doesn't mean that your child has high blood pressure. Your child's healthcare provider will want to check your child's blood pressure over a period of days or weeks. When blood pressure stays high, it may be a problem.
When the cause of high blood pressure isn't known, it's called primary. Secondary high blood pressure happens with illness or certain lifestyle choices.
Secondary causes of high blood pressure in children and teens include:
Kidney disease and heart disease
Prescription medicine such as corticosteroids or birth control pills
Illegal drugs such as cocaine or methamphetamine
Endocrine disorders such as overactive thyroid (hyperthyroidism) and diabetes
Mental health causes such as mental stress and anxiety
Children and teens are more likely to have high blood pressure if they are:
Have a family history of high blood pressure or heart disease
Are boys
Have a mother who smoked during pregnancy
High blood pressure often doesn't cause any symptoms. This is why it's often referred to as the silent killer. It's often found during a routine visit to a healthcare provider.
Your child's healthcare provider will diagnose high blood pressure by checking your child's blood pressure. The provider will check blood pressure over several days or weeks before making the diagnosis. Your child's healthcare provider will also:
Review your child's health history, including diet, exercise, activities, and emotional health
Review your family history
Give your child a physical exam
Reliable blood pressure readings taken at home can be helpful in finding out if your child truly has high blood pressure. Ambulatory blood pressure monitoring uses a device that can be worn for 24 hours. It takes multiple blood pressure readings and can help get a more accurate reading of overall blood pressure.
Your child's provider may also order tests. These may include:
Electrocardiogram (ECG), to check your child's heart rhythm
Echocardiogram (echo), to check your child's heart anatomy and function as well as any narrowing of the aorta
Blood tests
Urine tests
Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is. If your child's healthcare provider has found a secondary cause, such as kidney disease, the disease will be treated. If the provider hasn't found a cause, treatment involves making lifestyle changes. These may include eating a heart-healthy diet that:
Has lots of fruits and vegetables, whole grains, and low-fat or nonfat dairy products
Is low in salt
Limits fatty and sweet foods
Other lifestyle changes may include:
Losing weight
Getting more exercise
Learning to manage emotions and stress
Quitting or staying away from smoking
Staying away from alcohol
Many children and teens are able to lower their blood pressure with lifestyle changes. But some children may need medicine.
High blood pressure may damage the blood vessels and heart. This increases the risk for heart attack and stroke later in life.
Not all high blood pressure can be prevented. But making heart-healthy lifestyle choices may lower the chance of developing high blood pressure. Help your child:
Keep a healthy weight
Eat a healthy diet
Be active every day
Stay away from smoking
The American Academy of Pediatrics (AAP) recommends children older than 3 years old have blood pressure screenings at their yearly well-child visit. It should be checked at every healthcare encounter if they are obese, are taking medicine known to increase blood pressure, have kidney disease, diabetes, or a history of aortic arch obstruction or coarctation. Normal blood pressure in kids depends on their gender, age, and height.
If you have a family history of high blood pressure or heart disease, make sure your child's provider knows. And if your child is overweight, make sure you talk with their provider about ways to lose weight.
High blood pressure means that the pressure inside the arteries is too high. This may harm the arteries and cause the heart to work harder.
High blood pressure often has no known cause. Some health conditions and medicines may cause high blood pressure.
Blood pressure changes. Your child's provider will check it over a period of days or weeks before making a diagnosis of high blood pressure.
Lifestyle changes like weight loss, exercise, and healthy eating can help to lower high blood pressure.
Tips to help you get the most from a visit to your child's healthcare provider:
Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
Ask if your child's condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your child's provider after office hours. This is important if your child becomes ill and you have questions or need advice.


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I just love this.
Friday, April 8, 2016
2 comments:
you are related to "SIDNEY WHIPLASH"?
Wildflower - April 8, 2016 at 6:15 PM
- Phil said...
That's Snidely Whiplash....
- April 8, 2016 at 6:47 PM
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Chronic CO poisoning usually involves lower levels of the gas in the air and lower blood CO (COHb) concentrations. Exposure usually continues for many days to months. The boundary limit between acute and chronic exposure is indistinct.
The word chronic should be reserved to describe the type of exposure, not the subsequent condition or effect! A damaging effect of CO poisoning, or in fact, any change which persists, should be referred to as a residual effect.
Chronic CO poisoning may not elicit the typical symptoms of (acute) CO poisoning such as headache, nausea, weakness, dizziness, etc. Mucous membranes of the body will almost never be cherry pink. Chronic CO poisoning is often misdiagnosed as chronic fatigue syndrome, a viral or bacterial pulmonary or gastrointestinal infection, a "run-down" condition, immune deficiency, etc. Patients may occasionally present with polycythemia, increased hematocrit, etc.
Chronic CO poisoning is, in fact, difficult to diagnose by those not skilled in its presentation. As stated above, it is often mistaken for chronic fatigue syndrome, viral or bacterial pulmonary or gastrointestinal infection, excessive heat, etc. Similar symptoms are seen simultaneously in more than one person, and which disappear upon removal from an environment are tip-offs that CO is involved. COHb is usually not excessively elevated. More often than not, by the time air CO or blood CO levels are measured, the presence of CO in the environment has been corrected, making measurement impossible. Computed tomography (CT) and magnetic resonance imaging (MRI) generally show no lesion, even when psychological/psychiatric and neurologic evaluations may detect functional deficits.
This is a subject about which many exciting new data have become available during the past 2 years. Summaries of some of these dates are seen on this website. A body of animal data is also available which is of some value in understanding and predicting human responses. See the very useful British study by CO Support and the other studies contained in the section called Chronic CO Poisoning.
Chronic CO Poisoning -
Chronic -
(Gk.) khronos = time | (Lat.) chronicus | (Fr.) chronique
Syn. continuing, lingering, persistent, prolonged, protracted
Webster's New College Dictionary, Houghton Mifflin Co., 1986.
The term chronic is sometimes used as in definition #2 - "A history of CO inhalation and an awareness of the typical distributions of lesions are important for recognition of the effects of CO poisoning, especially when patients are in the chronic stage." (Uchino et al., 1994, Neuroradiology, 36, 399-401)
Note: In this condition, ie. chronic CO poisoning, we are concerned with how long the insult (exposure) lasts, not how long the resulting effects last.
Pollutant | Concentration | Location / Condition |
Carbon Dioxide | 860 ppm | Lecture Hall |
Carbon Dioxide | 600 - 2500 ppm | Schoolroom |
Carbon Dioxide | 9000 ppm | Nuclear submarines |
Carbon Monoxide | 2.04 +/- 2.55 ppm | U.S. homes |
Carbon Monoxide | 2.5 - 28 ppm | Offices, restaurants, bars, arenas |
Carbon Monoxide | 3.1 - 7.8 ppm | Home kitchens with gas stoves |
Carbon Monoxide | 1 - 5 ppm | median outdoor concentration in cities, 1979 |
Carbon Monoxide | 0 - 3 -27 ppm | Max. 1 hr. average outdoor concentration |
Carbon Monoxide | 0 - 3 - 22 ppm | max. 1 hr. average indoor concentration |
Carbon Monoxide | 20 ppm | Room polluted with cigarette smoke |
Hydrogen Cyanide | 56 ppb | Room polluted with cigarette smoke |
Nitric Oxide | 1.05 ppm | Room polluted with cigarette smoke |
Nitrogen Dioxide | 5 - 110 ppb | U.S. homes with gas stoves |
Nitrogen Dioxide | 5 - 317 ppb | English homes with gas cookers |
Nitrogen Dioxide | 20 - 66 ppb | Median outdoor concentration in cities, 1979 |
Nitrogen Dioxide | 25 - 177 ppb | Homes, 48 hr. average |
Nitrogen Dioxide | 200 ppb | Room polluted with cigarette smoke |
Ozone | 2 - 68 ppb | Photocopying room |
Ozone | 2 - 18 ppb | Homes with electrostatic air cleaners |
Ozone | 7 - 60 ppb | Median outdoor concentration in cities, 1979 |
Ozone | 0 - 700 ppb | Using an electronic air cleaner |
Sulfur Dioxide | 8 - 37 ppb | Yearly averages in Chicago & NY |
Methane | 2 ppm | Atmospheric air |
Condition | Ratio |
All | 4.6 |
Vehicular | 3.0 |
Furnaces (non-vehicular) | 19 |
Thus, for every CO death due to a malfunctioning furnace, there are 20 non-fatal CO poisonings.
Thus, for every CO death, this suggests there are 39.25 people who present to the ER for CO poisoning. How many more people with CO poisoning don't go to the ER, and thus are not found in the record?
Occult - "hidden from view, secret, concealed". Most chronic CO poisoning is of this type, at least at first.
Paresthesias - "abnormal or morbid sensation, as with burning, prickling, etc., but without objective symptoms.
Symptom | Frequency % |
Fatigue | 92 |
Headache | 87 |
Dizziness | 69 |
Sleep Disturbances | 66 |
Cardiac Symptoms | 62 |
Apathy | 54 |
Nausea, vomiting | 42 |
Memory Disturbances | 40 |
Reduced Libido | 22 |
Loss of Appetite | 17 |
From: Jain, K.K. (1990) Carbon Monoxide Poisoning, Warren H. Green, Inc., St. Louis, MO
Chronic CO poisoning often masquerades as lethargy, listlessness, lack of motivation, sleepiness, etc. and is often characterized as chronic fatigue syndrome, clinical depression, or an endocrine disorder. The changes are frequently subtle and only recognized as being related to CO exposure after a period of time. Recognition of CO involvement often only occurs by accident or by happen-stance and documentation of abnormally elevated CO in the air and blood is frequently not possible.
Source: From Study A, Penney, D.G. Carbon Monoxide Toxicity, D.G. Penney, ed., CRC Press, 2000. Back to Top
Chronic carbon monoxide problems are potentially worse in the U.K. than in the USA, because of the many very old buildings and the past and present construction approach which consists of building solid walls, floors, and ceilings. This usually precludes the use of ducted forced air heating/cooling. Instead, buildings are fitted with "gas fires", ie. gas heaters that are usually located in old fireplaces, exhausting into the fireplace chimney.
Mrs. Betty Jones is a 35-year-old homemaker. She and her husband George, 37 years old, live in a city in the mid-west. She has an Associates degree in accounting, while her husband has a Masters degree in Business Administration. Neither of them are smokers.
In early 1995, they purchased a home in a suburban community through a real estate brokerage company. The home was built in 1958. It was inspected and major appliances in the home were guaranteed for 5 years. The home has three bedrooms, a living room, a family room, and a glassed-in back porch. It is heated by a forced-air, natural gas furnace in the basement. Hot water is provided by a gas-fired water heater, also in the basement.
Beginning in the autumn of 1995, Betty Jones began having headaches and feeling very tired. Her two children, John (12 years of age) and Cathy (9 years of age), and her husband George occasionally awoke in the morning with headaches, dizziness, and nausea. They believed that they all had a touch of "flu" or had eaten tainted food.
Mrs. Jones continued to feel "out of it" for the remainder of 1995 and into the spring of 1996. Her physician, Dr. Blackstone, gave her a "physical", obtaining chest X-rays, blood for complete CBC, and samples for a Pap smear test. He found nothing wrong, saying that "flu" has been going around. A furnace company that regularly serviced the heating system found "everything in good working order."
During the summer of 1996, Betty Jones and the whole family felt much better, although she and the children continued to have frequent headaches and to feel slightly fatigued. They felt better when they went away for vacation for two weeks.
In late October 1996, Betty Jones again began to have frequent severe headaches and to become extremely fatigued. She was becoming so lethargic that she could not accomplish her normal housework. She was forgetting tasks that needed doing, and finding it increasingly difficult to maintain the family checkbook. She was also feeling depressed and defeated in her daily life.
On several visits to Dr. Blackstone, she was told that there was nothing wrong with her. He said her perceived state was psychosomatic, and that she should seek counseling or schedule regular visits with a psychiatrist.
By spring 1997, the Jones' children John and Cathy, previously excellent students, were on academic probation at school. John, a 7th grader, was in danger of failing and being held back a year. Cathy was now getting C's and D's in her classes in elementary school and her teachers were concerned. Mr. Jones, who all his life had been an ambitious and successful employee at a national insurance company, believed he now was in danger of being fired.
To gain extra space in their modest 1300 square foot home, the Jones family contracted to have a fourth bedroom added during the summer of 1997. Because the old furnace in the home was the original unit and would not be adequate to heat the new larger house, the contractor installed a new one. In doing so, he discovered that the heat exchanger in the old furnace was badly rusted through, that the near horizontal run of flue pipe to the chimney was also rusted through, and that the old brick chimney was oversize, unlined, and partially blocked near the top.
Upon learning of these problems, Mr. Jones asked that the old furnace be fired up and measurements of CO made by the gas company. He had recently seen a program on TV about the dangers of CO and wanted to be sure. With the family safely outside, CO levels in the house were observed to attain 176 ppm after one hour. The whole family then went to see Dr. Blackstone, who drew blood for the measurement of carboxyhemoglobin. COHb levels came back at between 0.5% and 1.4%. The physician, not familiar with the effects of the gas, told them that since the CO was now out of their bodies, they would be well again.
Mrs. Jones continued to suffer from severe headaches, fatigue, depression, and irritability. She also continued to have cognitive and memory problems, and began to develop muscle and joint pain, to hear a buzzing sound in her head (Tinnitus), and to have various visual problems. Mr. Jones continued to find it difficult to do his job. He could not make decisions (loss of executive functioning) and lost track of details in his work. The children continued to struggle academically and socially - cognitive testing at school suggested recent significant declines in I.Q. in both children.
As of early 1999, the Jones family is attempting to recover from the health problems caused by their old, leaking furnace. They have been seen by a number of health professionals with varying results: neurologists, toxicologists, and neuropsychologists. To the Jones', it appears that few people in the medical community have much understanding of the long-term health effects of chronic CO exposure. They have retained legal counsel and are discussing options that might lead to compensation from responsible parties. Fortuitously, they have kept the old furnace, flue and other parts as evidence.
Back to Top Used with permission from the author David G. Penney, PH.D


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93% of Americans Believe a Home Is a Better Investment Than Stocks
93% of Americans Believe a Home Is a Better Investment Than Stocks
A recent Survey of Consumer Finances study released by the Federal Reserve reveals the net worth of homeowners is forty times greater than that of renters. If you're wondering if homeownership is a good investment, the study clearly answers that question, and the answer is yes.
Do Americans believe a home is a better investment than stocks?
In a post on the Liberty Street Economics blog, the Federal Reserve Bank of New York notes that 93.3% of Americans believe buying a home is definitely or probably a better investment than buying stocks.
Here's how the results break down:The survey also shows a wide range of reasons why Americans feel that way (respondents were able to pick more than one answer):
Bottom Line
The data show how strongly Americans believe in homeownership as an investment. That belief is warranted. The Liberty Street Economics blog put it best by saying:
"Housing represents the largest asset owned by most households and is a major means of wealth accumulation, particularly for the middle class."
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We offer a range of delivery services for our UK and International customers. UK Customers can select our FREE standard delivery option on most non bike orders over £20. Or if you're in a hurry you can upgrade to our Next Day, Saturday or Sunday delivery services. You can also use our free Click & Collect service, where you can collect your purchases from a choice of over 50 Evans Cycles stores. International customers can benefit from FREE delivery on most orders and save UK VAT if we are shipping outside of the EU.
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Using our Click & Collect service your order will be delivered to a choice of over 50 Evans Cycles stores nationwide for collection. This service is FREE of charge for all orders. To check store stock and collection times, use the "Check store stock" button above. Click here for more details
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I've been into tea, at some level, since college with a first tin of loose tea brought back by my parents from Oxford. My love of tea increased with a visit to Boston and a chance cup at Tealuxe. Since then I've only gotten more interested in tea and have developed more of an appreciation for it.
tea rating guide
(updated 12/2010)
100: a perfect cuppa. these are the teas I'll keep in my cupboard and tend to be one per type of tea.
90-99: will definitely get more of this tea
80-89: likely to get more and perhaps it will become a favorite with time
70-79: very good, depending on my mood or the season
60-69: wouldn't actively try to get this tea, but also wouldn't avoid it in a tea shop or restaurant
50-59: run-of-the-mill tea for me
40-49: decent, would hit the spot in some moods, but probably wouldn't purchase it for my cupboard
30-39: okay, will try again, maybe
20-29: meh. I'd try this tea again if no other were available
10-19: drinkable, but a forced cup
0-9: didn't even finish the cup
Seattle, WA


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The Bulgarian currency is called LEV (in plural LEVA) divided in 100 parts. 1/100 part of one LEV is called STOTINKA (in plural STOTINKI). Bulgarian LEV has a fixed exchange rate to the Euro: 1 EUR ≈ 2 LEVA. The exchange rates of Bulgarian LEV to the other currencies are not fixed and vary. For example, the exchange rate of the US Dollar for July 20 is 1 USD = 1.38 LEVA. Selling other currencies than Euro and US Dollar could be difficult.
Bulgarian notes and coins in circulation