Les antagonistes des récep- teurs de l'endothéline ont-ils une place dans le traitement de l'hyper- tension artérielle [Do endothelin receptors antagonists have a place in the treatment of arterial hypertension?].

The discovery in 1988 of endothelin, the most potent human endogenous vasoconstrictor, has opened the race to the discovery of a new weapon against arterial hypertension. The development of the endothelin receptors antagonists (ERAs) and the demonstration of their efficacy in preclinical models initially raised a wave of enthusiasm, which was however tempered due to their unfavorable side effect profile. In this article we will review the phases of the development ERAs, and their current and future place as therapeutic tool against arterial hypertension.

A comparison of the imaging characteristics of the new Kodak Hyper Speed G film with the current T-MAT G/RA film and the CR 9000 system.

Three standard radiation qualities (RQA 3, RQA 5 and RQA 9) and two screens, Kodak Lanex Regular and Insight Skeletal, were used to compare the imaging performance and dose requirements of the new Kodak Hyper Speed G and the current Kodak T-MAT G/RA medical x-ray films. The noise equivalent quanta (NEQ) and detective quantum efficiencies (DQE) of the four screen-film combinations were measured at three gross optical densities and compared with the characteristics for the Kodak CR 9000 system with GP (general purpose) and HR (high resolution) phosphor plates. The new Hyper Speed G film has double the intrinsic sensitivity of the T-MAT G/RA film and a higher contrast in the high optical density range for comparable exposure latitude. By providing both high sensitivity and high spatial resolution, the new film significantly improves the compromise between dose and image quality. As expected, the new film has a higher noise level and a lower signal-to-noise ratio than the standard film, although in the high frequency range this is compensated for by a better resolution, giving better DQE results--especially at high optical density. Both screen-film systems outperform the phosphor plates in terms of MTF and DQE for standard imaging conditions (Regular screen at RQA 5 and RQA 9 beam qualities). At low energy (RQA 3), the CR system has a comparable low-frequency DQE to screen-film systems when used with a fine screen at low and middle optical densities, and a superior low-frequency DQE at high optical density.

La prise en charge de l'hyper- tension artériette par des médecins en formation suit-elle les recommandations actuettes [Are the guidelines for the management of hypertensive patients followed by primary care residents and fellows?]

Numerous international guidelines are published which define how hypertensive patients should be managed. Are these guidelines followed and applicable? We have assessed the quality of management of 225 hypertensive ambulatory patients followed by young fellows in teaching for primary care medicine. The control rate defined by a blood pressure < 140/90 mmHg was 32,4%. In the last three visits, 60% of hypertensive patients had a blood pressure measurement. 79% of blood pressure readings ended with 0 or 5. Blood pressure control was identical whatever the comorbidities. In conclusion, the quality of management of hypertensive patients by in teaching fellow could potentially be improved. The actual recommendations are limited in their application. The control of high risk vascular patients is not better than those with a lower risk.

Simple Heuristics in a Social Game

Simple Heuristics in a Social World invites readers to discover the simple heuristics that people use to navigate the complexities and surprises of environments populated with others. The social world is a terrain where humans and other animals compete with conspecifics for myriad resources, including food, mates, and status, and where rivals grant the decision maker little time for deep thought, protracted information search, or complex calculations. Yet, the social world also encompasses domains where social animals such as humans can learn from one another and can forge alliances with one another to boost their chances of success. According to the book's thesis, the undeniable complexity of the social world does not dictate cognitive complexity as many scholars of rationality argue. Rather, it entails circumstances that render optimization impossible or computationally arduous: intractability, the existence of incommensurable considerations, and competing goals. With optimization beyond reach, less can be more. That is, heuristics--simple strategies for making decisions when time is pressing and careful deliberation an unaffordable luxury--become indispensible mental tools. As accurate as or even more accurate than complex methods when used in the appropriate social environments, these heuristics are good descriptive models of how people make many decisions and inferences, but their impressive performance also poses a normative challenge for optimization models. In short, the Homo socialis may prove to be a Homo heuristicus whose intelligence reflects ecological rather than logical rationality.