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Pesto baked chicken with carrot mash & tenderstem
924 g
We've just entered wild garlic season and we couldn't wait to use it to make our own homemade pesto, mixed with a little olive oil and pine nuts... We coat chicken with this delicious wild garlic pesto and serve it on a bed of carrot mash, a lighter alternative to potato mash!
- Coconut oil / olive oil
- Sea salt & black pepperCoconut oil / olive oil
- 1/2 lemon
- 180 g free-range chicken breast
- 20 g wild garlic
- 30 g pine nuts (nuts)
- 400 g carrots
- 160 g cherry tomatoes
- 200 g tenderstem
- Preheat the oven to 200C and boil a kettle.
- To make the wild garlic pesto; finely chop the wild garlic and half of the pine nuts. Place in a bowl and mix in 1 tbsp olive oil, and the lemon juice. Season with sea salt and black pepper.
- Place the chicken breasts into an ovenproof dish, and cover with a layer of the wild garlic pesto. Place in the oven for 25 mins or until cooked through.
- Peel and chop the carrot into 1cm pieces and place in a saucepan. Cover with boiling water and simmer for 20 mins until soft.
- Trim the tenderstem. Place the tenderstem, tomatoes and remaining pine nuts on a baking tray, drizzle over 1/2 tbsp oil and place in the oven for 10 mins.
- Drain the carrots and mash with a potato masher. Season with sea salt and black pepper.
- To serve, spoon the carrot mash onto a plate. Cut the wild garlic pesto chicken breast into slices. Place the sliced chicken on top of the carrot mash and serve alongside the tenderstem, tomatoes and pine nuts.
gluten free
dairy free
protein rich
gluten free
high protein


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Simply choose your size and colour of Vest (Pink or Black) from the dropdown menus. 4 Sizes – Small(size 10), Medium(size 12), Large(size 14), X Large(size 16) Feminine fit Racer back style High performance sports wear Moisture management finish Curved back hem for added comfort NeotericTM texture fabric with inherent wickability. Self fabric bound neck and armholes. Professionally Printed Worldwide Responsible Accredited Production (WRAP) certified production. Fabric:100% Polyester Weight:140gsm
Product Features
- New with tags: A brand-new, unused, unworn and undamaged item in the original packaging (such as the original box or bag) and/or with the original tags attached.
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- Moisture management finish


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Part of the "The Mask in the Iron Man" story arc
Iron Man Vol 3 #28
Chief Creative Officer
Previous Issue
Next Issue
Appearing in "The Mask in the Iron Man - Part Three - His Own Worst Enemy"
Featured Characters:
- Iron Man (Tony Stark) (Main story and recap)
Supporting Characters:
- Jocasta
- Iron Man (Sentient Armor)
- Stark Solutions
- Stark-Fujikawa
- Whiplash (Mark Scarlotti) (Death)
Other Characters:
- James Rhodes (Photo)
- Trevor Donahue (Behind the scenes)
- Baintronics, Inc. (Mentioned)
- Sunset Bain (Mentioned)
- God (Yahweh) (Invoked)
- Avengers (Mentioned)
- Solomon (Rumiko's friend) (First appearance)
- Michael Scarlotti (Mentioned)
- Ultron (Behind the scenes)
Races and Species:
- Earth (Main story and recap)
- United States of America (Main story and recap)
- Washington
- Seattle
- Lake Washington
- Stark Solutions Building (First appearance)
- Baintronics, Inc. Facility (Mentioned)
- Seattle
- Florida (Main story and recap)
- Miami (Main story and recap)
- Miami Beach (Mentioned)
- Stark-Fujikawa Facility (First appearance)
- Miami (Main story and recap)
- Washington
- Pacific Ocean
- United States of America (Main story and recap)
- Safe Armor (Main story and recap)
Synopsis for "The Mask in the Iron Man - Part Three - His Own Worst Enemy"
Tony figures the lightning mixed with the sophistication of his systems and lack of protection against the Y2K bug caused his armor to come alive. Regardless, he feels it must be deactivated, but the armor tries to talk him out of it and into becoming one; a perfect Iron Man. Meanwhile, Pepper and Happy consider working for Tony might not be a good idea, while Rumiko receives some advice to just follow her heart, and Tony decides to accept the armor's proposal. Whiplash ends up finding Iron Man and the armor takes over despite Tony's wishes; it beats Whiplash into naming his employer as Trevor Donahue, then as the mercenary begs for his life, pleading that he was only doing what he needed to in order to get his son back, the armor kills him, and drops his corpse into the sea.
See Also
- Write your own review of this comic!
- Discuss Iron Man Vol 3 28 on the forums
- 2 Images from Iron Man Vol 3 28
|Like this? Let us know!


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Quick And Easy Ways To Make Coffee
Coffee is one of the world's most popular drinks, and millions of people enjoy a cup of coffee every day. Brewing your own coffee right at home can be very satisfying while saving you money. If you want to brew a great cup of coffee in your own kitchen, keep reading for some great tips.
If you want coffee that is unrivaled in richness and flavor, buy a French press. Paper filters tend to absorb coffee's flavorful oils. A French press uses a plunger for steeping the beans. This increases the amount of flavorful oils in your container.
No matter how attached you are to your favorite blend, don't be afraid to try a new variety. You don't need to invest in a large bag to try out something new. Almost all brands will offer a single pot or sampler size to allow you to try out new flavors.
When you buy coffee beans, never keep them in the bag they came in after you have opened them. Get them into an airtight container, and place them out of direct light. They will stay fresh for awhile this way.
If you like iced coffee, brew coffee in the evening, and chill it in your fridge overnight. In this way, you can have cold coffee that has not been watered down after being poured over ice. You may want to sweeten and cream it up beforehand. This will provide you with great iced coffee when you wake up.
For the best results from an older coffee maker, first brew some hot water before you make any coffee. After you have run a full pot of water through the machine, add your coffee grounds and pour the heated water back into your coffee maker. This techniques help you attain a hot, flavorful pot of coffee.
If you are planning to store coffee beans, keep them in a place that is close to room temperature. This will help to extend the longevity of the beans, so that no flavor is lost providing great-tasting coffee for a very long time. Storing coffee beans in temperatures too hot or cold can cause them to go stale faster.
The purity of your coffee depends on the purity of the water used to make it. All things you put in the coffee will affect the taste. You should use purified, spring, or bottled water to make a great cup of joe.
After purchasing coffee it is important to properly store it for it to retain its freshness. If you will be using your coffee within a week, store it in an airtight plastic or glass container out of direct sunlight and away from heat. If it will be longer than a week before you will use it up, consider placing the coffee in the freezer.
Invest in a good-quality coffee grinder. A good grinder grinds coffee beans efficiently and consistently to ensure even extraction. The reason for efficiency is to ensure that not much heat is generated during grinding. Too much heat being generated during the grinding process can negatively affect the taste of the coffee. .
Keep your coffee press from getting corroded. Regardless of how great your coffee and filtration are, repeated water passing through the press leaves a residue. The mineral buildup might start ruining the taste of your coffee. The simplest fix is run hot water with some white vinegar included every few weeks to keep your coffee tasting fresh.
When you get some coffee beans, put most of them away in an airtight container. Place the container in your freezer if you do not have a cool place to keep it. You should grind small quantities of beans, for instance enough to last you for a week. Experience with different grinding techniques if you want different flavors.
Consider purchasing a coffee grinder that has conical or flat grinding burrs. These grinders reduce heat generation. This will keep the coffee unadulterated. Grinders that have simple blade mechanisms grind inconsistently. They can generate a lot of heat and burn your beans.
If you are used to an independent coffee house, then be careful when ordering in Starbucks. They have a very different language for their products, as part of their distinct branding. The Caramel Macchiato you love back home is not going to taste at all the same in a Starbucks while on the road.
Avoid using pre-flavored and packaged coffee beans. These beans are sprayed with extra oils that are very difficult to clean out of grinders and coffee machines. That oil stays in the machines and mixes with later batches causing strange-tasting coffee. They also tend to make the coffee smell better than it tastes.
The more you know about coffee, the better able you will be to brew a delicious cup right in your own kitchen. It is not that hard to turn out pot after pot of amazing coffee once you know the secrets. Just remember the tips from this article and soon you will enjoy quality coffee every time!


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Phil Exports to Austria rose by 40%
Philippine Exports to Austria rose by almost 40% from January-May 2007 while Austrian Exports to the Philippines remain sluggish.
According to a report from Aussenwirtschaft Österreich, exports from the Philippines to Austria increased by 39.5% during the first 5 months of the year. From EUR 41.581.439, the export figure is now at EUR 57.997.70. On the other hand, Austrian exports to the Philippines has decreased by 3%. It stands at EUR 30.587.858 from 31.554.748 of same period last year.


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A practical Modern English grammar book
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Preparation and Practice Tests for the TOEIC® (REVISED FORMAT)
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GRAMMAR, VOCABULARY & READING SKILLS for the Michigan ECCE will provide students with extensive practice in the format of the examination, developing their grammatical and lexical skills to the level required for success in the Michigan ECCE.


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Tuesday, November 24, 2009
Pork Cheeks braised in Absinthe
New favourite. Still learning how to make this properly.
- 4 trimmed pig's cheeks;
- 50 ml Absinthe;
- 30 ml Good quality white wine vinegar;
- 5 tbsp olive oil;
- 1 leek, finely sliced;
- 2 carrots cubed;
- 2-3 sticks celery, chopped;
- 1 onion, chopped;
- 2 cloves garlic, chopped;
- 1 bay leaf;
- 2 sprigs thyme;
- 1 tbsp tomato purée;
- 2 tbsp honey
- 750ml chicken stock
- 125ml white wine;
- Freshly ground salt and pepper
- Marinate the meat in 2 tbsp olive oil, the Absinthe, vinegar and salt and pepper for at least 4 hours before cooking. The Absinthe gives a very distinct taste that may not be to everyone's liking and could be replaced with e.g. vermouth or some other liquor;
- Preheat the oven to 170C;
- Heat the oil in a casserole with a tight-fitting lid. Add the leek, celery, carrot, onion and garlic and cook for 5 minutes, then add the bay leaf, thyme, and tomato purée. Cook for 2-3 minutes. Add the honey and cook for a further 5 minutes to caramelise;
- Add pig's cheeks, stir well and cook for 3-4 minutes to coat and colour. Add the stock and wine. Bring to the boil, season, then cover and transfer to the preheated oven. Cook for 2 ½ - 3 hours;Remove from the oven, lift the cheeks from the stock and reserve. Strain the stock and place in a medium-sized saucepan. Bring to the boil and allow the mixture to reduce in volume by half;
- For an extra savoury sauce wiz the strained vegetables (less herbs) in a food processor until smooth and add back to sauce until desired consistency is achieved;
Skate Knobs with Crab Potatoes & Beurre Blance
I got the recipe for the crab potatoes from Santino Busciglio the chef at Mennula in
Ingredients (for a starter for 4 triple everything for a main):
- 300 gr mealy potatoes e.g. King Edwards;
- Fresh preferably white crab meat;
- 2 spring onions;
- 3 tbsp best quality EVOO;
- 1 tbsp white wine balsamic;
- S&P to taste;
- 1 large skate knob per person;
- Beurre Blanc.
- Bake the potatoes in their skins on a bed of coarse sea salt at about 160 to 180 depending on their size;
- When potatoes are cooked through slice the potato in half and scoop out the flesh into a bowl;
- Crush the potatoes with a fork (crush don't mash you want the texture of potato) and the olive oil, sweet white balsamic vinegar, chopped spring onions, season with salt and finally the fresh crab meat. Do not over mix as it will turn in to crab glue.
- Fry skate knobs in oil on a hot pan for about 1 min per side;
- Form crab potatoes into a circular pile by pressing them through cake cutters, add skate knob on top, add about a table spoon of the beurre blance. Serve immediately.
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The Most Dangerous Game of Pool You'll Ever See
The most dangerous game of pool you'll ever see has just been played by Demolition Ranch.
Demolition Ranch is known for having some fun while testing out guns and doing a range of trick shots, but today you get to take a look at one of the funnest looking shooting games we've seen in a while. Take a look as they play the most dangerous game of pool you've ever seen.
While this does look like a great way to spend an afternoon, we strongly recommend that you don't try this at home.
If you should decide to circumvent our warning, please take every possible safety precaution to ensure that you play your game of shooting pool and are able to complete the game with no injuries to those involved.
Follow me @ChrisBucknerOA and at Chris Buckner Outdoor Adventures
NEXT: Here's What It Should Look Like When A Raccoon Attacks Your Dog


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Of course I´m not "overdoing" anything... these gfx are, gasp cough, very important to the gameplay mood.
Lightwave 3d.Blender ?
You mean 3d to cut corners on 2d?I must admit, I really like the way you've built this up. I'm wondering if I should try that approach, and see if that helps me get any further into finishing a game
No, I mean taking an old game published in a book (I have a Commodore 64 Games book), and bringing it to a modern platformYou mean 3d to cut corners on 2d?


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Own the City with your Friends! Convert civilians to your crowd, eat up smaller crowds than you and avoid the bigger ones! It's a Crowdy Crowd City!
Help Rocketman save his girlfriend from the evil robot's clutches.
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Disney Showcase celebrates the confidence, glamour, and inspiring stories of your favourite Disney Princess in a unique and empowering collection that reminds us all, dreams really do come true. The figurine is made from resin. Each piece is hand painted and slight colour variations are to be expected which makes each piece unique. Supplied in branded gift box. Not a toy or children's product. Intended for adults only.
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Write a review to be in with a chance of winning a £100 voucher.


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Marianne Cuhaci
Registered Social Worker Specializing in Adolescent and Family Issues
Marianne Cuhaci, MSW, RSW, AccFM, FDRP Med Arb PC, brings 30 years of varied social work to her practice. The majority of her experience has been with adolescents and families, and Marianne offers:
Individual Counselling.
Family Therapy
Parenting Mediation
Parenting Coordination
Parenting Capacity Assessment
If you or someone you know could benefit from her knowledge, compassion and experience, contact Marianne to discuss how she can help.
Conflict within a family is a rarely discussed, painful experience that Marianne will help you take the first steps to resolving.


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I've heard good things said about the TV show "Mr Selfridge" so last night we watched the show. I don't think I'll be watching any more. It just didn't hold my attention. As the TV drivelled on my phone rang; it was work. Would I do the early shift tomorrow? I agreed; I'd rather have an early or a late start. Mind you I'd rather do the longer night and weekend shifts if possible because there are less of those and I get more whole days off. What with the vagaries of my shift system I've now got to work for the next four days. Four consecutive days(!)
I was just about to go to kip when the door crashed open. "My Boy TM" and his new beard were visiting after a heavy day's drinking. He talked rubbish for a few minutes then staggered off into the distance.
Unusually for me I took a while to get to sleep. And then I had a rather restless night. I think I saw every hour on the clock. I blame our new mattress. This "memory-foam" doesn't mould itself to the shape of your body at all. It just has a crater where I sleep, and I can't get comfortable because I'm just rolling into that crater all the time. I suppose this is the disadvantage of buying a hooky mattress from a dodgy bloke I met by chance in the street.
I got up a little while before the alarm was about to go off, and had all of my toast as "Furry Face TM" was still asleep. And so to work. As I drove I listened to the news. An election in Greece has seen a victory for the "Stick It Up Your Bum, Europe Party". They've come to power by promising an end to austerity. So either they really will tell the EU to "stick it up their bum" and the Greek economy will collapse, or they will (like every other politician) moderate their promises in the light of reality. Either way it's not going to be good for Greece. And consequently the rest of Europe.
he Prime Minister had a phone call. Some chap, in a moment of drunken bravado, phoned Downing Street and after a little to-ing and fro-ing got put through to the Prime Minister. Personally I can't see what the fuss is about, but the pundits were all a-twitter on the matter.
And after nine years of travelling, the New Horizons probe in about to start taking photographs of the planet Pluto.
I got to work; I've got used to lone working at night over the last few weeks. It was odd to have the place filled with people. I did my bit; at lunch I went out to the car park and did sax practice. My Mexican Hat isn't too shabby at all.
An early start made for an early finish. I came home, turned on my PC, got shirty on social media and defriended someone. Defriending on Facebook is a serious thing to do (!) but I'm afraid sometimes I take offence. Because I'm a scruffy noisy messy tattoed thug-looking ruffian people tend to overlook the fact I have more letters after my name than sense.
I do get miffed when someone dismisses something I say about a subject on which I have years of professional experience and extensive post-graduate qualification in favour of uninformed opinion... and then tries to tell me I know nothing
Perhaps I'm just too full of my own importance...?
I'm going to eat my penis-cake now...


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Awards and Achievements
Over the last year at Elite Academy of Dance our dancers have had many achievements to celebrate. We are very proud of each and everyone of you, keep up the good work!
Individual Successes
A huge well done to Hollie Whiley who has gained a place with Tap Attack on their mini associates program. She danced fantastically when she performed alongside them in their 10th Annual Gala Show. Hollie has also been accepted onto the Ballet and Modern Pre-Associate Program at Chantry School of Contemporary and Balletic Arts.
Jessie Stubbs, Hannah Bonner and Katy Bates have also been accepted onto Pre-Associate ballet and modern programs at Chantry School of Contemporary and Balletic Arts. Well done girls we hope you gain a lot from this fantastic experience.
Congratulations to our musical theatre stars Molly Carter and Eloise Hopkinson. Molly has gained a place with Stagebox and is throughly enjoying attended her sessions there, and Eloise is attending the Denman Theatre in Hull to develop her studies.
South Lincolnshire Dance Festival 2018
During the October half term a number of students represented Elite at the South Lincolnshire Dance Festival for a 3rd year. They danced fantastically and were a joy to watch and a credit to the school. Well done to all the dancers that performed and a special well done to the dancers who placed.
1st Place Winners
- Poppy Whiley – Baby Classical
- Hollie Whiley – Open Tap
- Georgina Roberts – Novice Tap
- Hannah Bonner – Novice Lyrical
- Molly Carter – Novice Song & Dance
- Eloise Hopkinson – Novice Song & Dance
- Katy Bates – Novice Ballet
- Immy Cooper – Baby Cabaret
- Little Boxes Ballet Group
2nd Place Winners
- Molly Cook & Kirsten Richardson – Juvenile Cabaret Duet
- Esme Jaines & Eloise Bates – Baby Cabaret Duet
- Ava Wells – Novice Modern
- Penny Cooper – Novice Tap
3rd Place Winners
- Elyssa Arnold & Cadence Sellars – Juvenile Cabaret Duet
- Immy Cooper – Baby Classical
- Kara Scott – Novice Lyrical
- Georgina Roberts – Novice Song & Dance
- Alana Marper – Novice Acro
Dancer of the Year
Well done to Hollie Whiley who is the Elite Dancer of the Year 2019-2020. Your enthusiasm, passion, dedication and hard-work is setting a fantastic example to all our dancers. You really are an amazing role model to everyone at Elite!


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Background: Salt-sensitive (SS) hypertension affects >30 million Americans and is often associated with low plasma renin activity. We tested the diagnostic validity of several candidate genes for SS and low-renin hypertension.
Methods: In Japanese patients with newly diagnosed, untreated hypertension (n = 184), we studied polymorphisms in 10 genes, including G protein–coupled receptor kinase type 4 (GRK4), some variations of which are associated with hypertension and impair D1 receptor (D1R)-inhibited renal sodium transport. We used the multifactor dimensionality reduction method to determine the genotype associated with salt sensitivity (≥10% increase in blood pressure with high sodium intake) or low renin. To determine whether the GRK4 genotype is associated with impaired D1R function, we tested the natriuretic effect of docarpamine, a dopamine prodrug, in normotensive individuals with or without GRK4 polymorphisms (n = 18).
Results: A genetic model based on GRK4 R65L, GRK4 A142V, and GRK4 A486V was 94.4% predictive of SS hypertension, whereas the single-locus model with only GRK4 A142V was 78.4% predictive, and a 2-locus model of GRK4 A142V and CYP11B2 C-344T was 77.8% predictive of low-renin hypertension. Sodium excretion was inversely related to the number of GRK4 variants in hypertensive persons, and the natriuretic response to dopaminergic stimulation was impaired in normotensive persons having ≥3 GRK4 gene variants.
Conclusions: GRK4 gene variants are associated with SS and low-renin hypertension. However, the genetic model predicting SS hypertension is different from the model for low renin, suggesting genetic differences in these 2 phenotypes. Like low-renin testing, screening for GRK4 variants may be a useful diagnostic adjunct for detection of SS hypertension.
Hypertension (blood pressure ≥140/90 mmHg) affects more than 65 million adult Americans, and prehypertension (blood pressure between 120/80 mmHg and 139/89 mmHg) affects millions more (1). Salt sensitivity, defined as a 10% increase in mean arterial blood pressure after consumption of a diet high in salt (2)(3)(4)(5)(6)(7)(8)(9), affects 58 million Americans without hypertension and can lead to morbidity and mortality rates similar to those of hypertension. New methods for patient identification and risk stratification should be developed for these chronic disease risk factors (10). Low plasma renin activity (PRA) 1 is used as a diagnostic adjunct for determining salt sensitivity despite the fact that salt sensitivity and low PRA do not correlate well (11)(12). The discovery of single-nucleotide polymorphisms (SNPs) in genes that encode proteins involved in sodium regulatory pathways could lead to new diagnostic tools for salt sensitivity with or without hypertension.
Renal dopamine receptors are responsible for more than 50% of sodium excretion during moderate sodium surfeit (13). Renal paracrine inhibition of sodium transport by dopamine is impaired in genetically hypertensive rats and humans with essential hypertension (13)(14)(15) because of decreased dopamine D1 receptor (D1R) function not related to a primary defect of the D1R but rather to its uncoupling from second messengers. This uncoupling is caused by activating variants of the G protein–coupled receptor kinase type 4 (GRK4) (13)(16), a gene involved in the desensitization of the D1R (16)(17)(18)(19). Three variants of GRK4 (R65L, A142V, and A486V) impair D1R stimulation of renal cAMP production (16). Preventing renal GRK4 expression normalizes D1R function in renal proximal tubule cells from hypertensive persons (16) and ameliorates hypertension in spontaneously hypertensive rats (20). In mice, overexpression of human GRK4 142V but not wild-type GRK4 impairs the natriuretic response to D1R stimulation and produces hypertension (16).
To determine whether certain genotypes are predictive of salt sensitivity and/or low-renin hypertension, we studied the association between polymorphisms in the genes GRK4 (16)(21)(22), D1R (23), α-adducin (ADD) (24)(25)(26), G-protein β3 subunit (GNB3) (27), CYP11B2 (aldosterone synthase) (28), angiotensin-converting enzyme (ACE) (26)(29), angiotensinogen (AGT) (21)(25)(30), angiotensin II type 1 receptor (AT1R) (31), and 11β-hydroxysteroid dehydrogenase 2 (11βHSD2)(32), all of which have been reported to be associated with low-renin and/or salt-sensitive (SS) hypertension. Because plasma plasminogen activator inhibitor-1 (PAI-1) concentrations also correlate with low-renin hypertension (33), we also examined variants of this gene in newly diagnosed, untreated hypertensive Japanese patients.
Our analyses included investigation of multilocus genetic models for these 2 phenotypes. As a physiologic correlate to our genetic studies, we measured the renal responses to docarpamine, a dopamine prodrug (34), in normotensive Japanese persons with or without GRK4 variants to test the hypothesis that GRK4 variants are related to the impairment of sodium excretion in response to D1R stimulation even in the absence of expression of the hypertensive phenotype.
The selection of cohorts for genetic studies can have a profound effect on study outcomes (35). We therefore selected a cohort of Japanese persons with a relatively homogeneous genetic background (30).
Patients and Methods
All protocols were carried out at the Fukushima Medical University with the approval of its Institutional Review Board (IRB).
hypertensive patients
Study participants were randomly selected Japanese patients with newly diagnosed, untreated essential hypertension who were referred to the hospital by office or outpatient-clinic physicians. We verified blood pressure with a mercury sphygmomanometer at least twice before enrollment. After providing informed consent, patients with systolic blood pressures ≥140 mmHg and/or diastolic blood pressures ≥90 mmHg were admitted to the study unit for physical examination, routine urine and plasma laboratory tests, electrocardiography, and a chest x-ray. Patients with diabetes mellitus, renal dysfunction (serum creatinine >11 mg/L; creatinine clearance <70 mL/min; microalbuminuria >30 mg/g of creatinine; and/or abnormal urinalysis), or secondary hypertension were excluded from the study. A total of 184 patients [104 females, 80 males; mean (SE) age, 54.8 (0.8) years; mean (SE) body mass index (BMI), 23.1 (0.2) kg/m2] were admitted into the study. After the diagnosis of essential hypertension was established, the study patients were admitted to the hospital for 5 weeks. After completion of the study of salt sensitivity and before evaluation of the relationship between genotype and phenotype, each patient was started on antihypertensive medication in accordance with the IRB.
Salt sensitivity.
We assessed salt sensitivity of blood pressure by determining the blood pressure responses to changes in dietary sodium (36)(37) in 83 study patients who were willing to comply with the dietary protocol to assess salt sensitivity in the hospital. Patients received a normal-sodium diet (153 mmol/day) and 50 mmol potassium/day for 2 weeks, followed by a published dietary protocol (2)(9)(36)(37) consisting of 2 weeks of normal sodium intake followed by a low-sodium diet (51 mmol/day) for 5 days, a high-sodium diet (340 mmol/day) for 5 days, and a normal sodium diet (153 mmol/day) for another 5 days. Adherence to the diet was evident because sodium balance was achieved and sodium intake was matched by sodium excretion (Fig. 1⇓ ). As expected, during the periods of high salt intake the sodium excretion in the SS patients did not match the sodium intake, but sodium balance was restored when normal sodium intake was reinstituted. On the final day of each regimen, we monitored ambulatory blood pressure (Nippon Colin ABPM-630). Patients were considered to be SS if mean arterial pressure increased (≥10%) after the change in sodium intake from low to high; otherwise they were considered to be salt resistant (SR) (2)(9)(11)(37) (see Fig. 1 in the Data Supplement that accompanies the online version of this article at http://www.clinchem.org/content/vol52/issue3/ ). Mean arterial pressure was calculated as: diastolic blood pressure + 1/3 (systolic blood pressure − diastolic blood pressure).
Heart rates were not different between SS and SR individuals and were not affected by sodium intake. Therefore, heart rate was not taken into consideration in the calculation of mean arterial pressure.
We measured PRA in 2 groups of patients: 101 patients who remained on a normal sodium diet and 75 of the 83 patients studied for salt sensitivity (43 SR and 32 SS). In both groups, PRA was measured while patients were on a normal sodium diet.
normotensive persons
Response to dopaminergic stimulation.
We tested the effect of GRK4 variants on the natriuretic effect of docarpamine (34) in normotensive persons homozygous for the wild-type GRK4 polymorphisms [n = 8; mean (SE) age, 38.0 (2.7) years; BMI, 25.0 (1.1) kg/m2] and those heterozygous for each of the GRK4 polymorphisms [n = 10; age, 32 (1.8) years; BMI, 23.9 (0.8) kg/m2]. These persons had serum creatinine and blood urea nitrogen (BUN) concentrations within the reference intervals, as did the hypertensive patients, but had higher BMIs than the hypertensive patients. Each participant rested in the study unit for 30 min and then ingested 500 mL of distilled water, after which blood pressure and heart rate monitoring were begun. Urine was collected each hour. A total of 5 samples were obtained: 1 before and 4 after the oral ingestion of 750 mg of docarpamine.
genotyping and blood analyses
Variants of GRK4 R65L, GRK4 A142V, GRK4 V247I, GRK4 A253T, GRK4 A486V, GRK4 G562D, AGT M235T, AT1R A1166C, CYP11B2 C-344T, PAI-1 4/5G, GNβ3 C825T, and 11βHSD2 G534A were detected by fluorescence probe melting curves (38). AGT A-6G, ACE I/D, ADD, and D1R were genotyped as reported (23)(26)(39)(40). No variations for 11βHSD2 G534A, GRK4 V247I, GRK4 A253T, or GRK4 G562D were detected; thus, these variants were not included in subsequent analyses.
Patient samples for fasting PRA and plasma aldosterone (determined by RIA) were obtained at 0830 after patients had rested 30 min in the recumbent position. PRA <1 g · L−1 · h−1 was designated as low renin (24). Catechols were analyzed by reversed-phase ion-pair HPLC with electrochemical detection. Routine laboratory analytes were measured with an automated method (Hitachi 7600-120).
statistical analysis
Data are reported as the mean (SE). The effects of different sodium diets in SS and SR patients were evaluated by repeated-measures ANOVA. The linear contrast low/normal/high sodium was tested separately within each group and as a first-order interactive contrast in a two-way (factorial by repeated measures) ANOVA. No adjustments for multiple comparisons were applied to P values in Table 1⇓ (also see Table 1 in the online Data Supplement). In survey tables such as Table 1⇓ and Table 1 in the online Data Supplement, P values are descriptive rather than inferential. Thus, P values should be interpreted in light of the possibility of type 1 errors. Nevertheless, significance with Bonferroni correction for multiple comparisons was also noted (Table 1⇓ and Table 1 in the online Data Supplement). We determined differences between groups by t-test or χ2 test. Statistical analyses were performed with SPSS, Release 11.0.1 (SPSS Inc.), or SigmaPlot.
Allele frequency differences between SS and SR individuals and deviations from Hardy–Weinberg equilibrium were determined by TFPGA (http://bioweb.usu.edu/mpmbio/) (41). Associations of multilocus genotypes with salt sensitivity and PRA concentrations were assessed by multifactor dimensionality reduction (MDR). MDR assesses all possible genetic models and provides the best genetic model for differentiating salt sensitivity from salt resistance or low PRA from normal PRA based on both cross-validation consistency and prediction error (42)(43). The best genetic model for salt sensitivity was determined by the highest classification success and the lowest prediction error (42)(43). To determine the single best genetic model, we repeated the MDR analysis with all sets of loci with significant findings in the original analyses. Significance of the models was determined by permutation testing. Classic diagnostic measures of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic odds ratio were also calculated.
Age [SS group, 59.3 (2.1) years; SR group, 57.1 (1.7) years], sex distribution (SS group, 26 females and 22 males; SR group, 21 females and 14 males), height [SS group, 158.4 (1.5) cm; SR group, 160.1 (1.5) cm], BMI [SS group, 22.7 (0.4) kg/m2; SR group, 22.6 (0.4) kg/m2], weight, and blood pressures (normal sodium diet, 153 mmol/day; see Table 1 in the online Data Supplement) did not differ between SS and SR hypertensive individuals. Increasing sodium intake from low to high increased blood pressures >10% in SS [criterion for salt sensitivity (2)(9)(11)(37)] but not in SR patients (See Table 1 and Fig. 2 in the online Data Supplement). Decreasing sodium intake from high to normal decreased blood pressure in SS but not in SR patients (Fig. 2⇓ ).
The small increase in diastolic blood pressure after the increase in sodium intake in SR patients did not meet the criterion for salt sensitivity; it was also not significant with the Bonferroni correction [a P value of 0.0014 is significant for 36 comparisons (27 comparisons per group and 9 intergroup comparisons)]. In both groups, body weight increased with the high-sodium diet, but the increase was greater in SS patients [1.66 (0.14) kg; 3.02 (0.26)%] than in SR patients [0.24 (0.09) kg; 0.38 (0.16)%]. A high-sodium diet decreased the hematocrit in both groups, but the decrease was greater in SS patients [2.04 (0.36); 5.58 (0.96)%] than in SR patients [0.55 (0.18); 1.55 (0.52)%]. Creatinine clearances were normal and similar in both groups and unaffected by sodium intake (Table 1 in the online Data Supplement). The change in sodium intake from low to high decreased PRA and aldosterone concentrations to a similar degree in both groups (Table 1 in the online Data Supplement).
A low-sodium diet decreased and a high-sodium diet increased sodium excretion in both the SR and SS groups (Fig. 1⇑ ). However, the increase in sodium excretion was more immediate and greater in SR than in SS patients, and when they returned to a normal-sodium intake, sodium excretion decreased more quickly in SR than in SS patients. Sodium excretion converged in the 2 groups 5 days after the decrease in sodium intake, from 340 to 153 mmol/day, but more sodium (81.9 mmol) was still retained in SS patients than in SR patients.
Urinary potassium excretion and the urinary sodium-to-potassium ratios were similar in both groups and positively correlated with sodium intake (data not shown). When evaluated with all the other variables listed in Table 1 in the online Data Supplement, urinary norepinephrine concentrations in both groups were found to be unaffected by sodium intake. However, when we examined the effect of dietary change on urinary norepinephrine separately from the other variables (Table 1 in the online Data Supplement), we found that urinary norepinephrine decreased with high sodium intake in the SR group but not in the SS group, in agreement with other reports (44)(45)(46). In contrast, urinary dopamine increased with sodium intake in both the SR and SS groups (Table 1 in the online Data Supplement), suggesting that decreased renal production of dopamine is not involved in the hypertension of our study participants (13).
The allele and genotype frequencies of ACE, AGT, AT1R, PAI-1, CYP11B2, D1R, GNβ3, and ADD did not differ between SR and SS patients (Table 1⇑ shows variants giving significant differences. The full data are shown in Table 2 in the online Data Supplement). In contrast, in SS patients, variant alleles at all 3 polymorphic GRK4 sites were more common and genotype frequencies differed between groups (P <10−4 for all comparisons; Table 1⇑ ; also see Table 2 in the online Data Supplement). Most sites were in Hardy–Weinberg equilibrium except for AT1R genotypes, which had deficiencies of heterozygotes in both SS and SR patients (P <10−4 and P = 0.0003 for SR and SS patients, respectively), GRK4 A486V in the SS group (P = 0.006), and ACE I/D in the SR group (P = 0.04). The GRK4 A486V deviation is the result of a deficiency in the number of wild-type homozygotes and the ACE I/D deviation is attributable to a deficiency of heterozygotes.
The multisite genetic model that best predicted salt sensitivity included only the GRK4 variants R65L, A142V, and A486V and predicted SS status correctly 94.4% of the time (P <0.001), based on the MDR analysis. The model using the 3 GRK4 variants for Japanese patients with SS hypertension had a sensitivity of 83% and a specificity of 100% with an infinite positive likelihood ratio, a 17% negative likelihood ratio, and an infinite diagnostic odds ratio. Although the presence of 3 or more variants was always associated with high risk for SS status (Fig. 3⇓ ), one should use caution in interpreting the accuracy of the risk assignment in genotypes with small numbers (n = 1). The model including all 3 GRK4 variants was significantly better than any of the models using individual GRK4 variants alone. This model is in agreement with the finding that the presence of 3 GRK4 variants was always associated with salt sensitivity, based on the actual increase in blood pressure with increased sodium intake (Fig. 4⇓ ). Indeed, the number of GRK4 alleles varied inversely with the increase in sodium excretion after the increase in sodium intake (r2 = 0.99; P <0.001; Fig. 4⇓ ).
The findings for allele and genotype frequency distributions between low-renin [mean (SE) age, 54.7 (1.2) years; BMI, 23.2 (0.3) kg/m2; 35 males and 59 females] and normal-renin [age, 53.6 (1.2) years; BMI, 23.1 (0.3) kg/m2; 42 males and 40 females] phenotypes were similar, but not identical, to those for salt sensitivity. All 3 GRK4 sites differed between low- and high-renin individuals (P <10−4 in all cases). However, there were also differences in ADD allele and genotype frequencies between the low- and high-renin groups (P = 0. 006 and 0.01, respectively). A few of the loci were out of Hardy–Weinberg equilibrium, including GRK4 A142V (P = 0.04) and GNB3 (P = 0.04) in the low-renin population and PAI-1 (P = 0.01) and ADD (P = 0.05) in the normal-renin population. However, the single best genetic model for low-renin hypertension included only GRK4 A142V, with an estimated prediction success of 78.4% (P <0.001). All variants that show single-site association, except GRK4 A142V, were not found in the best genetic model, indicating that the strongest effects are for this site. As opposed to the SS model, the GRK4 variants do not interact to increase disease predisposition. A 2-locus model that included both GRK4 A142V and CYP11B2 was also highly statistically significant (P <0.001) with prediction success at 77.8%, indistinguishable from the GRK4 A142V model.
Because salt sensitivity was always found in hypertensive patients with 3 or more GRK4 gene variants (Fig. 4⇑ ), we studied the effect of docarpamine on electrolyte excretion in normotensive patients without any or with all 3 GRK4 gene variants (Fig. 5⇓ ; also see Table 3 in the online Data Supplement). One oral dose of docarpamine (750 mg), which minimally affected blood pressure, induced natriuresis, kaliuresis, and calciuresis in patients without GRK4 gene variants but not in those with all 3 GRK4 gene variants (Fig. 5⇓ ; also see Table 3 in the online Data Supplement).
We report several novel findings. First, 3 of the 6 GRK4 variants (R65L, A142V, and A486V, but not the variants V247I, A253T, and G562D) were more frequent in SS than in SR hypertensive Japanese patients and predicted salt sensitivity 94.4% of the time. Second, there were no differences in the allele frequencies of other genes previously thought to be important in the etiology of salt sensitivity. Third, hypertensive Japanese patients with 3 or more GRK4 gene variant alleles at any of the 3 sites (R65L, A142V, and A486V) were always sensitive to salt, although some patients with <3 GRK4 variants were also salt sensitive. Fourth, the ability to excrete a salt load was inversely related to the number of GRK4 variant alleles (R65L, A142V, and A486V), and the natriuretic effect of a dopaminergic drug was abrogated when 3 GRK4 gene variants were expressed, even in normotensive Japanese persons. Fifth, the same 3 GRK4 gene variants were individually associated with low-renin hypertension, but in addition low- and normal-renin participants showed differences in ADD allele and genotype frequencies. Sixth, the underlying genetic models for salt sensitivity and low-renin hypertension were different, indicating that they have different etiologies and are not clinically equivalent among Japanese. These findings support the notion that even in the event of a single gene being critical in the development of a phenotype, multiple polymorphic sites should be considered in detection of at-risk persons.
Patients with essential hypertension and low PRA are presumed to have SS hypertension. Our SS hypertensive patients had low PRA and aldosterone concentrations, similar to those described for SS hypertensive patients in other populations (25). This profile in SS patients is in keeping with decreased D1R-mediated inhibition of renal sodium transport and sodium and fluid retention in SS hypertension (13)(15). However, our findings and those of others indicate that low specificity precludes the use of PRA concentrations as an effective way to distinguish SS from SR individuals (2)(11)(12).
The usefulness of blood pressure sensitivity to salt intake as an intermediate phenotype has been reported to be reduced by the variability in blood pressure response to increased sodium intake (47), but GRK4 variants were not investigated in that study. In our study, GRK4 variants were not only more frequent in SS than in SR hypertensive Japanese patients, but homozygous gene variants for GRK4 R65L and A142V were seen only in SS hypertensive Japanese patients. Among our hypertensive patients, only SS hypertensive patients had at least 3 GRK4 variant alleles (65L, 142V, and 486V).
Three GRK4 gene variants (R65L, A142V, and A486V; allele and genotype frequencies), but not the other 3 GRK4 gene variants (V247I, A253T, and G562D), were associated with low-renin hypertension in our hypertensive Japanese patients. ADD G460W was also associated with low-renin essential hypertension, in agreement with other reports (24)(25)(26)(48)(49). However, the single best genetic model for low-renin hypertension was GRK4 A142V, with 78.4% prediction accuracy in hypertensive Japanese, a result that differed from that for salt sensitivity. A 2-locus model including both GRK4 A142V and CYP11B2 was also highly statistically significant (P <0.001) with a prediction success of 77.8%, which was indistinguishable from the GRK4 A142V model. These analyses support the conclusion that salt sensitivity and low-renin hypertension are not of identical in genetic makeup or physiologic origins.
Gene–gene interactions are important in the development of hypertension (50). We have reported that in Ghanaian hypertensive patients, GRK4 variants (termed FJ) were in nonrandom association with the variants of ACE, AGT, and AT1R in hypertensive but not in normotensive individuals and that ACE and GRK4 2-locus genotypes were significantly predictive of essential hypertension (not characterized for salt sensitivity or PRA status) (22)(51)(52). SS hypertensive Italians also have increased frequency of GRK4 A486V compared with normotensive Italians (21), and the haplotype combination of GRK4 R65, 142V, and 486V was associated with essential hypertension in another group of Caucasians (53). The latter study also demonstrated a gene dosing effect (i.e., a positive correlation between the number of GRK4 alleles and blood pressure) in hypertensive patients, similar to our findings. Mice overexpressing human GRK4γ A486V on a C57BL/6 background developed hypertension only after sodium chloride intake was increased from 0.4% to 0.8% (54). In contrast, GRK4γ A142V transgenic mice on a C57BL/6 background were hypertensive regardless of salt intake (16)(55). Thus, different variants in the same gene can cause SS or salt-independent hypertension, depending on the gene variant, and may be influenced by the genetic background.
We found that a few of the studied genes were out of Hardy–Weinberg equilibrium, such as AT1R genotypes, which had deficiencies of heterozygotes in both SS and SR patients, GRK4 A486V, which had deficiencies in the number of homozygotes in the SS group, and ACE, which had deficiencies in the number of heterozygotes in the SR group. Deviations from Hardy–Weinberg equilibrium may be caused by several factors, including systematic genotyping error, random chance, and true biological causes. These are not easy to differentiate, but if genotyping errors are systematic, deviations should appear in both cases and controls. Because this was not the case for all deviations, excepting AT1R, we draw no strong conclusions regarding the causation of deviations from Hardy–Weinberg equilibrium among the other variants. Because AT1R did not appear to associate significantly with disease in any analysis, this does not pose a problem in our final interpretations. That GRK4 A486V in the SS group is out of Hardy–Weinberg equilibrium may be of interest because this is one of the variants that strongly associates with the SS phenotype. The deficiency in the number of wild-type GRK4 A486 homozygotes is what would be expected if variation at this site is functional. In addition, ACE I/D, although not associated in the present study with the phenotype, has been previously reported to be associated with essential hypertension in an epistatic model with GRK4 (51). Our current findings may reflect this previously described interaction. Additional testing for Hardy–Weinberg equilibrium in the samples for low-renin hypertension reinforces the conclusion that deviations from Hardy–Weinberg equilibrium are not attributable to genotyping error, because the deviating markers are different from those for SS and SR patients. This difference is unexpected if the deviations were attributable to experimental error. The positive association between certain variants (GRK4 and ADD) for at least one of the phenotypes of interest (salt sensitivity or low renin) indicates that our sample size had enough power to detect certain genes associated with SS and low-renin hypertension.
The high degree of correlation between the number of GRK4 gene variants and the reduced ability to excrete a sodium load may underlie the correlation between the loss of dopaminergic function and hypertension described previously (13)(14)(15)(16). Even normotensive persons with 3 GRK4 variants did not respond to the natriuretic effect of docarpamine. Because these normotensive persons were much younger (32 years) than the hypertensive patients (54.8 years), it is very possible that they will develop salt sensitivity and hypertension later in life, as has been reported for SS Americans (56). Indeed, our SS hypertensive patients tended to be older than the hypertensive patients with low PRA (P = 0.057). To conclusively relate the dopaminergic defect found in hypertensive rodents and humans to the studies presented here, we will have to determine the natriuretic effect of dopaminergic drugs in SS hypertensive patients with ≥3 GRK4 variant alleles. Nevertheless, in SS hypertensive white Americans, the D1-like agonist fenoldopam failed to decrease proximal tubular sodium reabsorption (15); however, the genotypes of these patients were not determined.
Although the number of individuals studied is sufficiently high to warrant confidence in the predictive value of GRK4 for salt sensitivity in the Japanese population, it may not be sufficiently high to rule out the possible association between the other polymorphisms we tested and SS hypertension. This can be determined only by increasing the number of patients analyzed. In addition, the ability to generalize these findings will require 2 steps. First, we will need to replicate the results in another Japanese cohort. Second, the role of GRK4 variation will have to be studied in another population. This would demonstrate that the GRK4 variants underlie the physiologic bases of salt sensitivity. Fortunately, Speirs et al. (53) have studied GRK4 polymorphisms and their role in hypertension with similar results in a cohort of hypertensive Caucasians.
In summary, the genotype and allele frequencies of variants of GRK4 (R65L, A142V, and A486V) are higher in SS than in SR patients, and variations at all 3 sites predict salt sensitivity in hypertensive Japanese. We did not detect any differences in allele frequencies of variants of ACE, AGT, AT1R, PAI-I, CYP11B2, D1R, GNβ3, and ADD genes between SS and SR patients. In contrast, low-renin hypertension was associated not only with GRK4 variants but also with ADD variants, and the genetic model for low-renin hypertension is different and does not include all of the sites detected in single-site association analyses. Therefore, salt sensitivity and low-renin hypertension do not have the same underlying genetic architecture. Moreover, the presence of 3 GRK4 gene variants can impair renal dopamine-induced natriuresis, even in the absence of hypertension. Determining the SNP genotype for selected loci might be considered a model molecular diagnostic screening test for salt sensitivity and hypertension.
This work was supported in part by grants from the National Institutes of Health (DK39308, HL23081, DK52612, HL68686, HL074940, and RR13297), a grant from the Fukushima Society for the Promotion of Medicine (No. 18), and a grant from the Salt Science Research Foundation (No. 05C6). In addition, this work was supported by a Small Technology Transfer Research Award from the NIH (1-R41 HL074526-01).
1 Genotype frequency comparisons are significant for SS vs SR (and low- vs normal-renin) classes at all GRK4 sites in all cases (P <0.001).
2 Allele frequency comparisons are significant for SS vs SR (and low- vs normal-renin) classes at all GRK4 sites in all cases (P <0.001).
↵1 Nonstandard abbreviations: PRA, plasma renin activity; SNP, single-nucleotide polymorphism; D1R, D1-dopamine receptor; GRK, G protein–coupled receptor kinase; ADD, α-adducin; GNβ3, G-protein β3 subunit; CYP11B2, aldosterone synthase; ACE, angiotensin-converting enzyme; AGT, angiotensinogen; AT1R, angiotensin II type 1 receptor; 11βHSD2, 11β-hydroxysteroid dehydrogenase 2; SS, salt sensitive; PAI-1, plasminogen activator inhibitor-1; IRB, Institutional Review Board; BMI, body mass index; SR, salt resistant; BUN, blood urea nitrogen; and MDR, multifactor dimensionality reduction.
- © 2006 The American Association for Clinical Chemistry


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TACOMA, Wash. – The University of Puget Sound track and field teams opened their outdoor seasons with a Quad Meet on Shotwell Track on Saturday. The Logger women placed fourth and the men placed third as they combined 16 NWC qualifying marks.
Joe Cerne was one of six Logger men to ean an NWC qualifying mark in the meet. He also vaulted to No. 4 on the Loggers all-time list with a throw of 173'-10'' as well as finishing second in the event.
Another freshman, Robin Harkins, made his outdoor debut and did not disappoint with a third-place finish and an NWC qualifying time of 32.41.53 in the 10k race. Matt Klein also posted an NWC qualifying time of 33:26.07.
Sean Tyree earned an NWC qualifying time with a 51.52 in the 400m dash and placed second in the event. Emerson Sample was the men's final NWC qualifier with a time of 59.81 in the 400m hurdles.
Michael Haas took home the Loggers only individual title with a mark of 20'-2.5" in the long jump.
On the women's side, Andrea Leiken captured two of the Loggers 16 NWC qualifying times. Her time of 26.58 in the 200m dash and 59.88 in the 400m dash achieved the benchmark. She finished second in the 200 and third in the 400.
Marnie Hazlehurst and Brooke Peaden also recorded NWC qualifying times in the 10k. Hazlehurst finished at 39:17 while Brooke Peaden came across the finish line at 42:43.70.
Carrie Keith finished first in the 3000m steeplechase and hit an NWC qualifying mark with a time of 11:56.46. Cara Gillespie also ran an NWC qualifying time of 12:34.47.
The women also saw several NWC qualifying marks in the field events. Kari Hanson (5'-0.25") and Maggie Rowe (4'10.25") hit the benchmarks in the high jump as did Maya Heck (9'-6.25") in the pole vault. Sarah Stillman's triple jump of 31'-10.25" also was an NWC qualifying mark, followed by Maggie Klee's javelin mark of 125'-9".
Stillman, Gilbertson, Alicia Burns and Andrea Leiken captured another Logger victory in the women's 4x100m relay.
The Loggers head to the PLU Invitational on Saturday for their next outdoor meet.


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Toms River, NJ
I have been in the hospitably field for many years and to bring joy and happiness to people is such a feel good emotion that keeps me energized. Allowing me to create your dream vacation for you, your family, and your friends is MY dream come true. Disney offers the most highest of standards in hospitality and across all their vacation brands and I am thrilled to bring those standards to you!! Through my travel service it allows you to continue to focus on your everyday busy lives by working and spending more quality time with your family and friends while I coordinate all the details of your exciting vacation.
It is my pleasure and honor to be working for you, I look forward to booking your next Disney destination vacation!!!


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Adenoidectomy and tonsillectomy in childhood might increase long-term risks for respiratory and infectious diseases, according to a study recently published in JAMA Otolaryngology-Head & Neck Surgery.
Tonsillectomy and adenoidectomy are surgical procedures performed to remove the tonsils and adenoids. The tonsils and adenoids are masses of lymphoid tissue located behind the nasal passages.
Adenoids and tonsils are commonly removed in childhood which are parts of the immune system and has known roles in pathogen detection and defense and is usually removed at ages when the development of the immune system is sensitive. Though tonsillectomy and adenoidectomy are common pediatric procedures to treat obstructed breathing or recurrent middle-ear infections, little is known about their long-term health consequences.
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Sean G. Byars and his associates conducted a study to assess the long-term disease risks associated with adenoidectomy, tonsillectomy, and adenotonsillectomy during the first nine years of life as a child.
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The population-based cohort study included 1,189,061 children born between 1979 and 1999 and incidence of disease was examined up to age 30 years.
Key findings of the study:
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- Tonsillectomy was associated with an absolute risk increase of 19% for upper respiratory tract diseases; with adenoidectomy, the absolute risk increase was 11%.
- Adenotonsillectomy was associated with an absolute risk increase of 2% for infectious diseases.
- The long-term benefits of these surgeries, meanwhile, were deemed "minor."
The authors concluded that this was the first study to estimate long-term disease associations with early-life tonsillectomies and adenoidectomies for a broad range of diseases. Risks were significant for many diseases.
The study suggested that absolute risks and the number of patients needed to treat before enhanced health risks later in life become apparent were more consistent and widespread than the immediate population-wide benefits of childhood surgery for subsequent health within the first 30 years of life.
For more reference log on to
Author Details
Vinay Singh joined Medical Dialogue as Desk Editor in 2018. He covers the medical speciality news in different medical categories including Medical guidelines, updates from Medical Journals and Case Reports. He completed his graduation in Biotechnology from AAIDU and did his MBA from IILM Gurgaon. He can be contacted at email@example.com . Contact no. 011-43720751
Of course, those who are allergic would have chronic tonsillitis..selection bias is a major demerit of these types of studies
This is a biased study.
Considering the fact that tonsillectomy is performed in patients who are already prone to upper respiratory tract infections and allergies compared to those who did not undergo that procedure, The later life increase in incidence of Upper respiratory tract disease has to be expected due to selection bias.
You are right. Also, adenoids and tonsils that cause obstructive sleep apnea cannot be left untreated. Not operating will mean stunted growth, ADHD, obesity, and left heart failure.
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Some 50 Cent Hairstyle pictures.
Mixed 50 Cent Hairstyle photos
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We can help. You can overcome drug addiction and have a better life than you ever thought possible!
There are several alcohol and drug treatment facilities options available to individuals living in the Franktown region. It is very important understand each one of the types of rehab choices that are offered in Franktown, AB., to be able to select the ideal rehab option for yourself or a family member. Selecting the most appropriate drug rehab program in Franktown is a vital element in the treatment of drug abuse, drug addiction and alcoholism. The following info will help you to understand your various treatment choices allowing you to have the best possibility of an ideal end result.
Let's take a look at the different drug and alcohol rehabilitation facilities in Franktown, Colorado choices that correlate with the circumstances of the person looking for rehab.
Inpatient drug treatment in Franktown, AB. is really a rehab possibility best for many who will need health-related intervention during treatment or individuals with substantial substance abuse histories. Men and women can develop both mental and physical dependence to alcohol and drugs even after a short time period, so inpatient drug and alcohol rehab in Franktown is among the most beneficial rehabilitation option in nearly all cases. As a result of dependence and addiction, men and women will most likely struggle to make a full recovery using the limited services provided by outpatient treatment facilities in Franktown, Colorado where alcohol and drugs continue to be easily accessible when they depart the outpatient program. In addition, individuals in rehabilitation who receive outpatient rehabilitation as an alternative to inpatient drug and alcohol rehabilitation in Franktown are still prone to damaging influences and conditions which may cut across their process of recovery. If someone lives with an abusive companion or continues to maintain relationships which involve drug abuse, any rehab endeavours in outpatient rehab will be in vain. For this reason in-patient drug rehab in Franktown, AB. will most certainly result in more fruitful results which will prove lasting unlike an outpatient drug and alcohol rehabilitation program where benefits could be very minimal and short-lived.
In Franktown there's both short-term and long-term inpatient alcohol and drug rehab. Short-term is often a 30-day facility, while long-term inpatient drug and alcohol rehabilitation in Franktown, Colorado is more in depth and rehabilitation lasts 90-120 days on average. It becomes an excellent setting for clients since it is a completely drug-free environment where they can recover both physically and mentally without distraction. Preferably, men and women will continue in the long-term in-patient drug and alcohol rehab program in Franktown for the maximum period of time allowed, in order to handle anything which can cut across their sobriety once they leave treatment. Due to the fact detoxing and becoming physically stable can take 2-3 weeks by itself, the three to six months in long-term in-patient drug rehab in Franktown is going to be time well spent and much more efficient than short-term programs.
The key factor of all if you or someone you love is struggling with a drug abuse or addiction concern is to get it resolved right away, call someone and talk to experienced addiction professionals and have an assessment and treatment possibilities to guarantee the best opportunity for a full recovery.
Drug Rehab Exact Match:
We can help! You can overcome addiction and have a better life than you ever thought possible.
757 Maleta Lane
Castle Rock, CO. 80108
22422 East Main Street
Parker, CO. 80134
18801 East Main Street
Parker, CO. 80134
10292 South Progress Way
Parker, CO. 80134
10099 Ridgegate Parkway
Lone Tree, CO. 80124
443 South Highway 105
Palmer Lake, CO. 80133
Counselors available 24 hours a day, 7 days a week.1-800-405-8409
We have addiction treatment specialists available 24/7, ready to help you find the right treatment choice that meets your financial ability.addictionca.com


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Turbinia Gallery
Ideal for evening drink receptions
The Turbinia Gallery is home to Turbinia, once the fastest steam ship in the world. The Turbina gallery is licenced to hold ceremonies for up to 100 guests. Alternatively you can dine alongside Turbinia or hold your drinks reception here whilst having photographs around the museum before a wedding breakfast in the Great Hall.
Back to Discovery Museum weddings page
Room capacity
|Wedding breakfast
|Evening reception
|Drinks reception
|Turbinia Gallery
|100 (4pm ceremony)
Contact us
To find out more about hiring Discovery Museum please contact us on:
Telephone: (0844) 856 1074 or Email: firstname.lastname@example.com and state that you're interested in hiring a space at Discovery Museum.
Your event enquiry will go directly to our catering and events concession Sodexo Prestige.
Wedding photograph by Laurence Sweeney Photography. Wedding dress from Mia Sposa Bridal.


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Viruses CD-ROM
Discovery Education
Format: CD-ROM
Grade Level:
Copyright: 2002
Format: CD-ROM
Grade Level:
Copyright: 2002
Alt Formats:
Free Resources
Marc Record
Free Resources
Marc Record
How do you get students involved in something they can't even see? Let this interactive CD-ROM help with 25 minutes of stunning video clips and amazing footage. Visit the Laboratory and create a Venn diagram about different viral properties, go to the Studio to create a multimedia presentation with music and sound effects, and watch and learn about the nature of viruses at the Discovery Theater.
Includes a Teacher's Guide. Simulations include Bacterial/Viral Growth, Cell Division, and Scientific Inquiry.
Each v2.0 CD-ROM features
- Science Simulations: NEW! Now your students can perform hundreds of simulated lab experiments in a virtual lab.
- Discovery Channel Theater: Five fast-paced fact-filled video voyages in both English and Spanish.
- Library: Updated World Book Encyclopedia features extensive reference and research materials.
- Laboratory: New Assessment Component! Interactive activities focus on building critical learning skills.
- Multimedia Studio: Creative tool complete with slides, text and cool sound effects allows students to create their own multimedia presentation. Updated with Lesson Launchers—,ready-made slide shows to start teaching your next science topic.


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Robbery and snatching incidents in broad daylight have been on the rise, calling into question the police presence and performance.
The dacoits continue depriving people of valuables with such impunity, as if, are enjoying a free-hand by the police.
As per details, a senior Army Officer of Rahwali Cantt (Gujranwala) and his family was deprived of cash, gold ornaments and cellphones worth hundreds of thousands of rupees by three armed bandits in broad daylight on busiest Hafizabad-Kot Sarwar Interchange Road, on Monday.
According to FIR registered Under Section 392/324 PPC at the Hafizabad Saddr Police Station on the report of Brig Imran Munawar, son of Munawar Hussain, along with his family was on the way to his native village Chak 224 Behlool, district Faisalabad in his car. When they reached near the new grain market on Hafizabad-Kot Sarwar Interchange Road, three armed dacoits intercepted the car. They held them at gunpoint and snatched cash amounting to Rs75,000, three cellphones and gold ornaments, hundreds of thousands of rupees. The police have failed to trace any clue to the perpetrators.
In another incident, the police wireless system mechanic was deprived of gold ornaments, currency notes and prize bonds worth hundreds of thousands of rupees while four villagers were deprived of their motorcycles, cash and cellphones worth about one million rupees at four different places during the past 24 hours.
Imam Masjid Qari Khalil Ahmad of Kot Herkarn was going to his village on a bike when two dacoits, who had set up a picket near Police-Post Muradian, allegedly snatched his bike and Rs5,000. At the same point, the dacoits intercepted another Muhammad Sabir and robbed him of his bike and Rs12,000.
Another Ali Raza, son of Muhammad Javed Chohan was on the way to Mohallah Misri Khan Hafizabad when three armed bandits intercepted him. The culprits snatched bike and Rs5,000 from him.
The police have registered cases, with no arrest or clue, so far.
In another incident, two dacoits deprived Adnan Hussain of Thatha Gahra of Rs90,000 while a spare part dealer Sheikh Wajid of Jalalpur Bhattian was deprived of Rs65,000 by the bandits.
Moreover, a women Bilqees Bibi of Railway Road was deprived of Rs50,000 and gold ornaments worth hundreds of thousands of rupees by two accused.
Aamir Farooq, son of Zafar Iqbal of Mohallah Jilanipura was deprived of his "Applied For" bike by unknown bike-lifters. He had parked his bike outside a clinical libratory on Post Office Road and when he returned outside he was astonished to know that someone had lifted away his bike.
On Band Road locality, two bandits tortured a villager Shoukat Ali of Jalalpur Bhattian when he put up resistance. However, the dacoits succeeded in snatching Rs8,000 and a cellphone from him.
Similarly, unidentified bandits stormed into the house of Cable Operator Tahir Abbas in Rasulpur Tarar and attempted to rob him. The bandits tortured him severely when he put up resistance and fled the scene empty handed. The police, as usual, are investigation with no results.
Of late, dacoities, robberies, bike snatchings and other crimes have become order of the day for the past about one month. However, the police have miserably failed to arrest any of the accused involved in numerous dacoities and robberies despite the fact that the traders had staged protest rally about a week back against the police.
In this connection, Federal Minister of State for Health Services, Regulations and Coordination Saira Afzal Tarar had also expressed her concern over the rising incidents of dacoities. She had asked the Provincial Home Minister to order for stringent measures to prevent such incidents to provide sense of security to the local population.
According to citizens, the looting of a high-ranking Army Officer in broad daylight has proved beyond an iota of doubt that 'DAKOO RAJ' was prevailed in the district.


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The urban world is full of noise-generating electronics ranging from cell phones to WiFi routers. This fact is especially troubling for the telecommunications industry, which needs its own...
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Clontarf Live: Music Review
Irish singer and keyboard player Claire Young stopped by the Irish Wheelchair Association recent youth disco to do a cover set.
I didn't really know what to expect at first but when she started her set I was pleasantly surprised.
Young's vocals and musical ablity were very impressive, I liked how she did a range of different genres but still managed to make each song work with the range in her voice. For example she did lovely stripped back covers of Justin Bieber's "Love Yourself" and James Bay's "Hold Back The River"
For me it was covers of Bob Dylan's "Make You Feel My Love" and Adele's "Hello" that were the most enjoyable, these songs showed off the tones in her voice very well and she made these performances seem effortless.
It was performance of Rihanna's "We Found Love" and Ed Sheeran's "Photograph" which seemed to connect with the crowd, they sang along to every lyric.
I really enjoyed Claire Young's set on the night. Personally I think that she has the potential to have a successful music career.


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Bathroom Home Decor
Bathroom Home Decor
Following many of us understand a lot of the details in addition to expertise regarding exactly how inside as well as outside pattern perform, most of us undoubtedly can certainly use it to our household indoor as well as external surfaces. A few of that knowledge will give people simpler time in decorating your home your family room, Bathroom Home Decor and even your backyard for being something that we dream of.
With this knowledge we can likewise produce a well designed residence that will not experience too congested and really feel well balanced. As a result, eventually hopefully that our information as well as expertise about house layout can assist you throughout accomplishing your individual fantasy residence, so great luck inside sprucing up the house either along with Bathroom Home Decor or perhaps traditional design.


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It's Valentine's Day today, and once again it will be just me and Netflix. But in many ways we have the perfect relationship….
It's always there for me (unless the broadband goes down).
It knows what I like, but doesn't tell me what to do.
It isn't grossed out if I don't shave my legs (or anything else).
It's easy to turn on, but just as easy to turn off.
I can interrupt it at any time, but it can't do the same to me.
And just when I thought our relationship couldn't get any better, this arrived. My first Valentine's Day gift for many many years.
Read more here


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|Declan suffered some (setbacks) wrote in rooms,
@ 2015-05-26 17:01:00
|Entry tags:
|*journal, alexander murphy, clementine murphy, declan murphy
alexander m, clementine m
[Locked to Alexander M.]
Doing the big brother thing. Are you alright?
[Locked to Clementine M.]
Taking a couple days vacation time, getting out of the city.


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Here's one more example of The Dread Pro-Se Kimberlin's ineptitude in the courtroom. During the District Court hearing for the peace order petition he filed against me in 2015, he tried to use tweets sent by someone else with my name attached to them as evidence that I had commented on a post about Tetyana Kimberlin's elder daughter. I didn't authenticate the tweets during the District Court trial, and he tried to recycle them during the Walker v. Kimberlin, et al. trial last year.
MR. KIMBERLIN: I'm going to show you Exhibit 31.
MR. HOGE: Oh, yeah, these are the forged comments that you tried to introduce in the peace order hearing back in March of 2015.
MR. KIMBERLIN: Do you recognize that one?
THE COURT: He just said that they're forged, so he can't authenticate them.
MR. HOGE: I cannot authenticate it; they're forged.
THE COURT: Give them to the clerk, please, they've been marked.
Failing failures gotta fail.
T-minus 6 days and counting.


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Friday, 18 January 2013
A cosy play day
3 comments:
RIP punches then lol Its very pretty and lush with colour in the centre.ReplyDelete
Those strips could make lovely paper chains, like the old trad ones I made as a kid!
Michele at 'Michele Made Me' blog hung her junk mail paper chains from her ceiling light so it looked like a chandeleir......as an idea.
I like the strips from the punches and you've made me glad I didn't throw out the waste dye from my snow dyeing. Looks like we'll be snowed in this weekend so I may have a play with the dye bath and paper. I hope your heating is back on.ReplyDelete
Hi - where are you? Still in Scotland?ReplyDelete
I like the punched strips. They are rather lovely! Procion dyes do make good inks don't they.
It snowed here big time today, so I might try Julies snow dyeing malarky (if I have all the ingredients). Could do with a bit of a play.


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I love when it's 12:34. I love when there are 3 of something. I love avocados and mountain dew.
I love the sound fancy keyboards make. I love flipping through a new book. I love leaving for work and seeing squirrels and birds in my tree.
I love hearing great songs on the radio. I love having an "ah ha!" moment in school. I love the freedom of eating something and not knowing the calorie content.
I love the smell of clean laundry. I love buying office supplies. I love having fun at work.
I love coffee with whipped cream. I love getting to be green when we play board games. I love when people get my bad jokes.
I love my heated blanket. I love when I wake up thinking I'm late for work but it's actually my day off. I love breakfast food.
I love when my cat follows me in the house. I love when I have time to watch Doctor Who on Netflix. I love remembering a whole night's worth of dreams.
I love getting gumballs out of the $0.25 machine. I love swingsets. I love meeting new pets.
I love seeing the Northern Lights in Nebraska. I love coupons. I love decorating my living space for the respective season or holiday.
I love the feeling of taking out my contacts at night. I love writing big on chalkboards and dry erase boards. I love new textbooks.
I love studying with candy. I love back scratches. I love camping.
I love getting excited about things. I love making things for people. I love fuzzy pants and fluffy socks.
I love the feel of a room after deep cleaning it. I love getting butterflies every time I see my engagement ring. I love remembering a lot of little things starting from when I was 3.
I love when people are nice to me. I love when people notice how nice I am. I love art supplies.
I love the comfort of my Grandma's house. I love riding bikes. I love to pretend I have conversations with animals.
Everyone has down days. I'm in a bit of a depression, and have been for a couple weeks. I like to remind myself that there are so many little things (besides people and financial issues) that make my day brighter. What do you love?


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Courtyard Santiago Las Condes
- Free WiFi and free parking
- Collect nights
Courtyard Santiago Las Condesfrom €64
- Room, 2 Double Beds, City View
- Room, 1 King Bed, City View
- Suite, 1 Bedroom, City View
- Room, 1 King Bed, Mountain View
- Room, 2 Double Beds, Mountain View
More great choices
What's around Courtyard Santiago Las Condes
Top spots nearby
Recommended by this property
- Parque Arauco Mall (3-minute walk)
- KidZania Santiago (3-minute walk)
- Clinica Alemana (9-minute walk)
- CasaPiedra Event and Conference Center (20-minute walk)
- Bicentennial Park (23-minute walk)
- Valle Nevado Ski Resort (19.1 mi / 30.8 km)
Getting around
- Santiago (SCL-Arturo Merino Benitez) - 22 min drive
- Santiago Central Station - 20 min drive
- Manquehue Station - 19 min walk
- Military Academy Station - 29 min walk
- Airport drop-off service
At a glance
Key facts
Hotel size
- This hotel has 205 rooms
- This hotel is arranged over 10 floors
- Check-in time starts at 3 PM
- Check-out time is noon
- Express check-in/out
Required at check-in
- Credit card or cash deposit required
- Government-issued photo ID required
Travelling with others
- Pets not allowed (service animals welcome)
- Free WiFi in public areas
- Free WiFi in rooms
- Airport drop off (available 24 hours) *
- Free self parking
Payment types at the property
Other information
- Smoke-free property
In the hotel
- Buffet breakfast daily (surcharge)
- Restaurant
- Bar/lounge
- Coffee shop/café
- Snack bar/deli
- Room service (during limited hours)
- Bicycle rentals nearby
- Ecotours nearby
- Hiking/biking trails nearby
- Mountain biking nearby
- Ski lessons available nearby
- Ski equipment rental shops nearby
- Snowboarding nearby
- Snowmobiling nearby
- Business center
- Meeting rooms
- Computer station
- 24-hour front desk
- Concierge services
- Tours/ticket assistance
- Dry cleaning/laundry service
- Laundry facilities
- Free newspapers in lobby
- Luggage storage
- Multilingual staff
- Year Built - 2015
- Elevator
- Safe-deposit box at front desk
- Rooftop terrace
- Television in common areas
- Accessible bathroom
- In-room accessibility
- Roll-in shower
- Wheelchair-accessible path of travel
- Wheelchair-accessible parking
- Wheelchair-accessible public bathroom
- Assistive listening devices in meeting rooms
- Wheelchair-accessible van parking
- Wheelchair-accessible registration desk
- Wheelchair-accessible pool
- Wheelchair-accessible fitness centre
- Wheelchair-accessible meeting spaces/business centre
- Wheelchair-accessible on-site restaurant
- Visual alarms in hallways
- Closed captioned TV
- English
- Portuguese
- Spanish
In the room
- In-room climate control (air conditioning)
- Air conditioning
- Minibar
- Coffee/tea maker
- Iron/ironing board
- Private bathroom
- Shower/tub combination
- Free toiletries
- Hair dryer
- 42-inch LCD TV
- Cable TV channels
- IPod docking station
- Desk
- Free WiFi
- Phone
- Daily housekeeping
- In-room safe
- Access via exterior corridors
Recommended hotels
Special features
On Site
- Fitness facilities
- Bicycle rentals nearby
- Ecotours nearby
- Hiking/biking trails nearby
- Mountain biking nearby
- Ski lessons available nearby
- Ski equipment rental shops nearby
- Snowboarding nearby
- Snowmobiling nearby
Courtyard Santiago Las Condes's small print
Also known as
- Courtyard Santiago Las Condes Hotel
- Courtyard Santiago Las Condes
- Courtyard Santiago Las Condes Hotel
- Courtyard Santiago Las Condes Santiago
- Courtyard Santiago Las Condes Hotel Santiago
Parking height restrictions apply.
For transfers, guests must contact the property before arrival at the number on the booking confirmation.
Mandatory fees
You'll be asked to pay the following charges at check-in or check-out:
- The national sales tax (19%) is charged upon check-out to citizens of Chile regardless of length of stay and to foreigners staying in the country for 60 consecutive days or more. To qualify for a tax exemption, foreigners must pay for their stay in foreign currency (not in Chilean pesos) and present a valid passport along with the migration card they received upon arrival in the country at check-in. Furthermore, the tax may apply per room when the room is shared by a taxable and a nontaxable guest.
Optional extras
Rollaway beds are available for CLP 40000.0 per night
Buffet breakfast is offered for an extra charge of CLP 13000 per person (approximately)
Airport shuttle service is offered for an extra charge of CLP 31000 per vehicle
We have included all charges provided to us by this property. However, charges can vary, for example, based on length of stay or the unit you book.
Recent reviews
Exceptional 9.4 From 352 reviews
The staff are very friendly and helpful! Special thank you for Andrea, front desk!
When I arrived I asked if my reservation had free breakfast and it didn't but the lady was so kind to add free breakfast for all the days at the hotel and I also asked if everyday my room would get free water bottles and the lady did tell say, YES, you will get free water everyday in your room, well when I check out at 2:00 am all the breakfast were charged to my room and of course I did not get any free water bottles in my room (only the day I arrived), so, please, if you promise something, keep your work, with this in mind, I don't know if I'll return or not.
It was simply good
Amazing service with such kind staff. Thank you! The breakfast was delightful with a good range of different food. Great breads and fruits. The bedrooms are comfortable, clean and safe. The rooms were quiet in the evening. Thank you for the help I. Arranging tours.
Great service, room service options were limited and found a cockroach in the linens.
Is the description of this hotel not correct? Tell us


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Aliso Summit Trail is a 8.8 mile moderately trafficked out and back trail located near Laguna Niguel, California that features beautiful wild flowers and is good for all skill levels. The trail offers a number of activity options and is accessible year-round. Dogs are also able to use this trail.
dog friendly
kid friendly
mountain biking
wild flowers
This hike along the southern ridge of the Aliso and Wood Canyons Regional Park is fairly easy, with only a short moderate hill at the end. As you walk you'll find the park to your right and suburbs and homes to your left, so you don't really get an out in nature feel to the hike. At the end you get a really nice view of the ocean and Aliso Beach County Park. Plenty of room for bikers, hikers, dog walkers and runners.
Fun trail. Like other reviews say, the trail is certainly harder than it looks- I just finished a much longer hike with more elevation gain last weekend with no issues, and this one kicked my butt on the way back from the peak. Lots of flies today, but can't beat the views.
Not only did I get to see the ocean view, but I also got to see many other cities in the east of Laguna Niguel. Both views were pretty! However, you will have to walk on a street called Pacific Island Drive for a little bit.
David Carlson recorded Aliso Summit Trail
Bulk of trail has decent views, but is fairly boring. Really nice view of the coast at the end.
Great views! Easy walk or run. Great for family and pets.
Great views of the valley and then the ocean. Fun also to see the back sides of lots of beautiful houses. Busy on a Saturday, but wide enough trail and not so busy to be a negative.
Dino Katsiametis recorded Aliso Summit Trail
Super easy and family friendly. Lots of dogs too.
Small trail but it was fun. I love the elevation!
Karen T.
Pretty easy trail. The cons, you know and feel you are in a neighborhood. People walking dogs off leash. Pros, views, views, views.
A beautiful and easy hike. May come here again and again. It's such a pleasure to have a walk up the hills and enjoy the views.
Great views, but double-back instead of looping on Pacific.
This is a nice walk, not a hike. Wide trail but a steep drop on one side so keep kids close. Houses on one side and the canyon with ocean views on the other.
Watch out for the targeting doves they will poop on you !!!!!
It's a decent walk but wouldn't consider much of a hike. On one side you have a beautiful view of the canyon and ocean but on the other side are houses. Also the fairy houses are no longer on this trail. Once you reach the end of this path it ends on a street but take a right and continue up the hill to the first street you can make a right on. you will see a nice little area to rest but continue further to Sea View park where you can see a large panorama view of the ocean. Please note there are NO bathrooms on this path. Plenty of foot traffic but not to busy when we went. It's was a nice outing fun for a one time but probably won't do this one again.
We parked on Ridgeview and started at the trailhead on Highlands. The first 3/4 of the trail is uphill and can be a little rough for those who are just getting in to hiking or are a little out of shape. I know I caught myself needing to catch a breather! The rest of the trail is easy and it is wide to accommodate walking and cycling in both directions. The trail ended at pacific island drive. We turned right and continued up to Talavera Dr turned right and continued a little way to a park that had a few benches where we ate lunch and enjoyed the ocean view. We then continued up Talavera Dr to Seaview Park where we followed the dirt path to its end and were met with a full panoramic ocean view. If you are heading to the Aliso Summit Trail to see the fairy villages.... they are no longer there. As of August 2017 the fairies went back to Ireland lol!
Great hiking trail from Aliso Summit Trail all the way downhill where you can take Valido Trail just shortly before the final stretch up the Peak if you want to go down to the beach. Doggie bags were provided near the trail entrance but unfortunately many inconsiderate dog owners are simply too lazy to pick after their pooch. Great panoramic views all the way in many places ocean can be seen. Not too many people and no bikes which is a plus for hikers. Really easy for the 1st 2 miles or so on a wide path except for the last 1/2 mile is a bit of an incline and Valido Trail down to the beach area is narrow and steep but not too bad. About 1.5 hrs one way down on a leisurely pace.
Great trail, great views, easy trail!
This is a beautiful hike in Laguna Niguel. It's not hard at all. The scenery is just gorgeous. Most of the hike you do have homes that run along the trail but they are beautiful.
Good for running. Flat terrain, gorgeous view of the ocean, no rocks. Plus, I don't really like people watching me run and it wasn't too busy.
We started the hike at Ridgeview & Highland (free street parking = positive). The first 1.5 miles or so stays right next to the houses (definite negative). We then had to walk on Pacific Island Dr. when the trail ended and go south to Talavera Dr. to reconnect to another trail that took us south to the summit vista of the Pacific. The view and the trail for the last mile or so is away from the houses and scenic (positive). The trail is not a loop so the trip back to where we parked included the same boring 1.5 miles (negative). RT was 6.5 miles for us and just under 2.5 hrs. FYI... the trail was rather busy and there were many dog owners with their dogs off leash which doesn't bother me but might bother some people. All the people we encountered were polite.
Trailhead closed, so started in the middle walking on the sidewalk & thru neighborhood toward the summit, then back to car and onto the 'closed' section. Went almost to original entrance & unclear why it was closed. Not from the area so kinda fun to see the houses on one side and the valley on the other. Glad we did it, don't need to do it again.
Lovely hike at sunset
Boring. Unless you like looking into rich people's back yards
Nice hike with great views! don't miss out!
Rather easy trail. A bit of a hassle to get to the entrance, but well worth the trip. Don't text and bike as there are no guard rails!!!
Love the fairy houses
Great place to run!