Regional Guideline on the Use of Observation and Therapeutic Engagement in Adult Psychiatric Inpatient Facilities in Northern Ireland

Regional Guideline on the Use of Observation and Therapeutic Engagement in Adult Psychiatric Inpatient Facilities in Northern Ireland

Comparative vascular and renal tubular effects of angiotensin II receptor blockers combined with a thiazide diuretic in humans.

OBJECTIVE: The goal of this study was to investigate whether angiotensin II receptor blockers (ARBs) induce a comparable blockade of AT1 receptors in the vasculature and in the kidney when the renin-angiotensin system is activated by a thiazide diuretic. METHOD: Thirty individuals participated in this randomized, controlled, single-blind study. The blood pressure and renal hemodynamic and tubular responses to a 1-h infusion of exogenous angiotensin II (Ang II 3 ng/kg per min) were investigated before and 24 h after a 7-day administration of either irbesartan 300 mg alone or in association with 12.5 or 25 mg hydrochlorothiazide (HCTZ). Irbesartan 300/25 mg was also compared with losartan 100 mg, valsartan 160 mg, and olmesartan 20 mg all in association with 25 mg HCTZ. Each participant received two treatments with a 1-week washout period between treatments. RESULTS: The blood pressure response to Ang II was blocked by more than 90% with irbesartan alone or in association with HCTZ and with olmesartan/HCTZ and by nearly 60% with valsartan/HCTZ and losartan/HCTZ (P < 0.05). In the kidney, Ang II reduced renal plasma flow by 36% at baseline (P < 0.001). Irbesartan +/- HCTZ and olmesartan/HCTZ blocked the renal hemodynamic response to Ang II nearly completely, whereas valsartan/HCTZ and losartan/HCTZ only blunted this effect by 34 and 45%, respectively. At the tubular level, Ang II significantly reduced urinary volume (-84%) and urinary sodium excretion (-65%) (P < 0.01). These tubular effects of Ang II were only partially blunted by the administration of ARBs. CONCLUSION: These data demonstrate that ARBs prescribed at their recommended doses do not block renal tubular AT1 receptors as effectively as vascular receptors do. This observation may account for the need of higher doses of ARB for renal protection. Moreover, our results confirm that there are significant differences between ARBs in their capacity to induce a sustained vascular and tubular blockade of Ang II receptors.

Cicatrice hypertrophique de la conjonctive palpébrale ou chéloïde de la conjonctive tarsale. A propos d'une observation anatomo-clinique [Hypertrophic eyelid conjunctival scar. A tarsal keloid].

The clinicopathologic case of a 53-year-old female patient with an abnormal tumor growing on the mucous part of the superior right eyelid is reported. The patient was operated on for ten years ago and a whitish mass slowly developed on the conjunctival face of the eyelid disturbing the use of corneal lenses. It was hard, painless and had the shape of a flat mushroom. The removal was performed under local anesthesia and allowed us to resect a hard and fibrous lesion. Histopathology showed that the lesion was made of a fibrous tissue organized like a hypertrophic scar. Surgical treatment of chalazion is frequent and rarely gives rise to abnormal scarring.

Verbrachen, belge [coureur cycliste participant au meeting de la Toussaint, 1er novembre 1919] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 56708

[Gerardus Petrus dit Gerard] Leene [coureur cycliste néerlandais participant au meeting de la Toussaint, 1er novembre 1919] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 56715

[Ahmed] Djebelia, Français [participant au marathon modifié des Jeux interalliés, stade Pershing, le 4 juillet 1919] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 54701

[Piet] Moeskops [coureur cycliste néerlandais participant au meeting de la Toussaint, 1er novembre 1919] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 56698

[Pierre] Sergent [coureur cycliste participant au meeting de la Toussaint, 2 novembre 1919] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 56714

[Pierre] Sergent [coureur cycliste participant au meeting de la Toussaint, 2 novembre 1919] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 56713

[René] Chassot [coureur cycliste participant au meeting de la Toussaint, 1er novembre 1919] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 56709

[Gerardus Petrus, dit Gerard] Leene [coureur cycliste néerlandais participant au meeting de la Toussaint, 1er novembre 1919] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 56700

[Piet] Moeskops [coureur cycliste néerlandais participant au meeting de la Toussaint, 1er novembre 1919] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 56699