Why and how should the patient perform a correct home blood pressure measurement?

Home blood pressure (BP) measurement is a medical prescription. The interpretation of the results must be left to the physician. This method is complementary to the classical office BP measurement and the 24 hour ambulatory blood pressure measurement. It must be proposed to some selected patients on the basis of their capacity of learning and understanding the place of the technique for the diagnosis and the treatment compliance. It allows a more active contribution of the patient to the management of her chronic disease and, this, may improve the prevention of cardiovascular complication. A normal blood pressure during self BP measurement is equal or lower to 135/85 mmHg or even lower in high cardiovascular risk patients. This new technique, already largely used by patients, needs adequate education and good advice for buying a validated device.L’automesure de la pression artérielle est un acte médical. Sa prescription et l’interprétation de ses données sont à réaliser par le médecin. Ce pré-requis étant dit, cette technique, complémentaire de la mesure au cabinet de consultation et de celle ambulatoire de la pression artérielle, apporte, chez les sujets sélectionnés, des informations pour la confirmation d’un diagnostic d’hypertension artérielle et pour l’appréciation de la qualité de son traitement. Elle permet de responsabiliser le patient dans sa prise en charge d’un problème souvent asymptomatique jusqu’à sa révélation lors d’une complication. La pression artérielle normale est, en automesure, inférieure à 135/85 mmHg, voire plus basse chez le patient à haut risque cardiovasculaire. Cette technique, fréquemment utilisée de nos jours par le patient, mérite qu’une éducation correcte de ce dernier soit faite après lui avoir conseillé d’acheter un appareil validé.Peer reviewe

The FRD Special programme on collaborative software research and development. Draft call for proposals

The foundation for Research Development (FRD) is evaluating the need for a new Special Programme in Computer Science. An initial meeting was held in August 1993 at the FRD to discuss the new programme. A Steering Committee was appointed with Professor A E Krzesinski of Stellenbosch as Chairperson. Several regional meetings were held in the Western Cape, Eastern Cape and the PWV to discuss the parameters of the proposed programme. The result of these meetings was a Draft Call for Proposals which was discussed by the Steering Committee in January 1994 and which was further refined during February 1994. The Steering Committee and the FRD have distributed the Draft Call to as wide and audience as possible. We hope that its publication in SACJ will facilitate the further spread of knowledge about the proposed programme. The FRD wishes the programme to be collaborative, goal-directed, inter-institutional, inter-disciplinary and definitive in the sense that it will set a direction in Computer Science in South Africa for the next 5 years. The goal of the programme is to link up research, development, industry and community organisations to develop expertise and manpower in order to establish a national capability for developing innovative world-class software

A population synthesis study of the luminosity function of hot white dwarfs

We present a coherent and detailed Monte Carlo simulation of the population of hot white dwarfs. We assess the statistical significance of the hot end of the white dwarf luminosity function and the role played by the bolometric corrections of hydrogen-rich white dwarfs at high effective temperatures. We use the most up-to-date stellar evolutionary models and implement a full description of the observational selection biases to obtain realistic simulations of the observed white dwarf population. Our theoretical results are compared with the luminosity function of hot white dwarfs obtained from the Sloan Digital Sky Survey (SDSS), for both DA and non-DA white dwarfs. We find that the theoretical results are in excellent agreement with the observational data for the population of white dwarfs with hydrogen deficient atmospheres (non-DA white dwarfs). For the population of white dwarfs with hydrogen-rich atmospheres (white dwarfs of the DA class), our simulations show some discrepancies with the observations for the brightest luminosity bins. These discrepancies can be attributed to the way in which the masses of the white dwarfs contributing to this luminosity bin have been computed, as most of them have masses smaller than the theoretical lower limit for carbon-oxygen white dwarfs. We conclude that the way in which the observational luminosity function of hot white dwarfs is obtained is very sensitive to the particular implementation of the method used to derive the masses of the sample. We also provide a revised luminosity function for hot white dwarfs with hydrogen-rich atmospheres.Comment: 6 pages, 5 figures, accepted for publication in A&

Hyperkalemia: The New Killer?

peer reviewedHyperkalemia is now commonly observed due to several associated factors such as old age, diabetes, congestive heart failure, renal insufficiency and drugs such as spironolactone used to improve cardiac function. Moreover, the easily prescribed new antiinflammatory drugs COX2 selective inhibitors in these patients lead to a very acute risk for vital hyperkalemia development. This review insists on the prevention of such potentially reversible disorder.L'hyperkaliémie devient un trouble ionique assez habituel suite à la conjonction du vieillissement de la population avec un fond d'insuffisance rénale, de l'épidémie de diabète, d'insuffisance cardiaque et des nouvelles stratégies thérapeutiques prônant notamment l'usage de spironolactone. Le recours aussi fréquent aux anti-inflammatoires expose ces patients à un risque aigu d'élévation de la kaliémie pouvant conduire au décès (surtout les nouveaux COX2 inhibiteurs sélectifs). Cette revue insiste sur la prévention de ce risque vital

The MVA Priority Approximation

A Mean Value Analysis (MVA) approximation is presented for computing the average performance measures of closed-, open-, and mixed-type multiclass queuing networks containing Preemptive Resume (PR) and nonpreemptive Head-Of-Line (HOL) priority service centers. The approximation has essentially the same storage and computational requirements as MVA, thus allowing computationally efficient solutions of large priority queuing networks. The accuracy of the MVA approximation is systematically investigated and presented. It is shown that the approximation can compute the average performance measures of priority networks to within an accuracy of 5 percent for a large range of network parameter values. Accuracy of the method is shown to be superior to that of Sevcik's shadow approximation

Polyomavirus Bk Infection in Renal Transplant Recipients

peer reviewedBeside acute rejection or immunosuppressive therapy toxicity, infection by Polyomavirus BK, usually not aggressive in immunoactive patients, has emerged as an important factor affecting graft function in renal transplant recipients. Indeed, one of the most important complications of BK infection is nephropathy. Viral replication in the urinary tract as assessed by the presence of "decoy cells", or by a positive PCR for BK virus has been detected in up to half of the recipients but only 5% will present nephropathy which is usually the only sign. The most common risk factors for this emerging new cause are new immunosuppressive drugs and rejection episodes. The gold standard to diagnose BK nephropathy is immunohistochemical staining for large T antigen in graft biopsy specimens. Urine cytology examination and DNA BK PCR are used as a screening test. The prognosis in BK nephropathy has been considered to be poor. The early reduction of immunosuppression can improve the prognosis and perhaps also cidofovir or leflunomide use

Reduction of non-regression time through Artificial Intelligence

Please help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected]

Loss probabilities for circuit-switched networks

Consider a circuit-switched network where several source switches are connected to a destination switch via a tandem switch. Circuit-switched networks traditionally employ a Blocked Calls Cleared ( BCC) admission rule: a call is rejected if all circuits from the originating switch to the tandem switch are busy, or if all circuits from the tandem switch to the destination switch are busy. This paper investigates a simple extension to the BCC rule. Rather than reject all blocked calls, the Blocked Calls Held (BCH) rule holds some blocked calls by storing their call signalling information in a buffer at the tandem switch. These calls will later be connected when circuits become available. The BCH system is modeled by a MSCCC loss queue. The stationary distribution for the MSCCC loss queue is presented and an efficient recursive calculation of the queue performance measures is derived . The model reveals that, under moderate overload conditions, the BCH rule achieves a substantially lower loss probability than the BCC rule, at the expense of a small increase in the connection delay