text: Medical Management of Vestibular Disorders and Vestibular Rehabilitation Kevin Katzenmeyer, MD Jeffery Vrabec, MD April 12, 2000 Patients with vestibular disorders have a variety of symptoms. The complaint of dizziness can be caused by a variety of disorders including presyncopal faintness, loss of balance, light-headedness, or psychologic disorders and must be differentiated from vertigo or dysequilibrium of vestibular origin. These patients commonly describe a sensation of spinning and may have associated visual or vegetative complaints, especially during acute attacks. The differential diagnosis of vertigo has remained stable over the past several decades but diagnosis and management has improved. With improved understanding of the pathologic processes behind the disorders and renewed interest in vestibular rehabilitation many patients return to fully active lifestyles. With this improvement in medical management, the need to proceed with more agressive surgical procedures has become a less frequent event. Pathophysiology The vestibular labyrinth is responsible for detecting both linear and angular head movements. Each is composed of three semicircular canals and two otolithic organs. The semicircular canals - lateral, superior, and posterior - are oriented at right angles to each other and detect rotational movement. The otolithic organs - the utricle and saccule - detect linear acceleration. Stereocilia function as the mechanotransducers of these stimuli and are termed hair cells. In the semicircular canals, the hair cells are organized under a gelatin film called the cupula. Angular acceleration causes deflection of the cupula and hair cells and subsequent hyper or depolarization depending on the direction of movement. In the otolithic organs, the hair cells are attached to a layer of otoconia on the macula. The otoconia remain stationary relative to the head with linear acceleration, which causes deflection and stimulation of the underlying hair cells. In addition to a normally functioning vestibular system, balance requires input from the visual (vestibulo- ocular) and proprioceptive (vestibulospinal) systems. Vestibular input is balanced and compared to this input. Any insult that disrupts the calibration or balance between the two peripheral vestibular systems, or between the vestibular system and its visual and proprioceptive input leads to the sensation of vertigo or loss of balance. If this process is acute, vertigo usually results. If it is more chronic, dysequilibrium may be the manifest symptom. Therefore the goal of treatment is to restore balance between the input systems. In addition, there is intimate linkage of brainstem pathways that process vestibular and visceral inputs. There is evidence of convergance of the two systems in the nucleus of the solitary tract, the parabrachial nucleus, and the rostral ventrolateral medullary reticular formation. Since the parabrachial nucleus is connected with brainstem sympathetic output pathways, neuroendocrine regions of the hypothalamus, and limbic regions of the forebrain, these findings provide a potential neurologic basis for affective, autonomic, and neuroendocrine manifestations in vestibular dysfunction. Medical Treatment Treatment of acute vertigo has two components. First, one must control the acute episode, and secondly, speed the recovery and prevent future episodes. There does not appear to be an ideal drug in the treatment of vertigo. Existing drugs were essentially found during clinical use rather than developed specifically for the treatment of vertigo. Vertigo can be treated symptomatically or specifically. Symptomatic treatment involves controlling the acute symptoms and autonomic complaints. Specific treatment involves targetting the underlying cause of the vertigo. Some common types of vertigo have either established or postulated pathophysiology and lend themselves to specific treatment, others are still unknown and symptomatic control is the only option. Symptomatic Pharmacotherapy Vertigo is primarily due to an imbalance between the two vestibular labyrinths whose activity is modulated by the central vestibular system. There are several transmitters in the vestibular nuclei but cholinergic and H1 histaminergic receptors are the main types. Takeda has summarized a model to explain the neurophysiological mechanisms of vertigo. Sensory information from various sources is processed, integrated, and stored, and then compared to sensory information which the programmed system would expect to receive under normal circumstances. With this model a cholinergic system modulates the neural store, and a histaminergic system is used by the "comparator" to stimulate the vomiting center. In addition, GABA neurotransmitters are used as inhibitory signals from cerebellar purkinje cells. An adrenergic system projects from the brainstem to the vestibular nuclei to inhibit vestibular activity. Stimuli from the gastrointestinal tract act on the vomiting center via a serotonergic pathway. The chemoreceptor trigger zone in the area postrema acts on the vomiting center and can be blocked with dopamine (D2) agonists. Lastly, the vestibular nuclei act on the vomiting center via a histaminergic (H1) system. One can clearly see that many pathways and neurotransmitters are involved in causing the vertigo and autonomic complaints. This explains why so many classes of drugs are used in the management of this disorder. Four general classes of drugs are useful in the treatment of vertigo and its associated autonomic symptoms - anticholinergics, antihistamines, antidopaminergics, and monaminergics. The most effective single drug for the prophylaxis and treatment of motion sickness is the anticholinergic scopolamine. It was removed from the market because of questions about the delivery system but has now reappeared. Side effects include dry mouth, drowsiness, and blurred vision. Antihistamines include meclizine, dimenhydrinate, and promethazine. They usually last for 4-6 hours except for meclizine which is supposed to remain in the system for 24 hours. They generally have less side effects than the anticholinergics with drowsiness being the most prominent. Some of these agents have some anticholinergic activity with the corresponding side effects of dry mouth and blurry vision. The newer nonsedating antihistamines do not enter the CNS and have no value in the treatment of vertigo and motion sickness. Antidopaminergics such as prochlorperazine and chlorpromazine act at the chemoreceptor trigger zone, reducing neural inpulses to the vomiting center. These drugs do not prevent vertigo and motion sickness but may be useful in treating the nausea and vomiting caused by these disorders. Side effects include sedation and the possibility of extrapyramidal symptoms. Monoaminergic drugs include amphetamines and ephedrine. They appear to potentiate the effects of scopolamine and may be used in combination with one of the antihistamines for intense symptoms or in those who do not respond adequately to single-drug therapy. Lastly, the benzodiazepine diazepam act as a vestibular suppressant through the GABAergic system and can also minimize the associated anxiety and panic that occurs with vertigo. Specific Pharmacotherapy Otosyphilis Penicillin has been the established treatment of otosyphilis. Intramuscular and intravenous routes are both acceptable. 2.4 million units of benzathine penicillin IM weekly for three consecutive weeks is considered minimal treatment and others would argue that treatment should be extended to one year. If the IV route is chosen, 10 million units of penicillin G per day is administered in divided doses for ten days followed by 2.4 million units of IM benzathine penicillin per week for two additional weeks. Probenicid increases the half life and CSF penetration of penicillin and may improve these regimens. Penallergic patients may be dosed with 500 mg of tetracycline or erythromycin qid for 30 days. Steroids in addition to the penicillin has been shown to improve treatment. Prednisone 40 to 60 mg per day for two to four weeks with a taper is considered adequate. Vertebrobasilar insufficiency (VBI) VBI is manifested as vertigo, diplopia, dysarthria, gait ataxia, and bilateral sensory and motor disturbance. The symptoms of transient ischemia are alarming but generally benign as there is rich collateral blood supply and a relatively low incidence of stroke. Antiplatelet therapy is warranted usually with aspirin. Ticlid has also been used as a platelet aggregate inhibitor in patients suffering from VBI. There is some evidence that it is more effective than aspirin but because of the risk of life-threatening neutropenia it is only warranted in patients unable to tolerate aspirin. Migraine This diagnosis is controversial partly because there is not consensus as to the defining criteria. Nevertheless, many patients who suffer from migraine have concomitant vertigo and disequilibrium and if their headaches are controlled they are often asymptomatic from their vertigo. Diagnostic criteria include personal or family history of migraines, motion intolerance, and vestibular symptoms that do not fit other vestibular disorders. Treatment is threefold and includes modifying risk factors, abortive medical therapy, and prophylactic medical therapy. Patients suffering from migraine should avoid nicotine products, exogenous estrogens, and foods known to exacerbate symptoms (red wine, sharp cheese, chococate, MSG, etc.). Exercise programs and stress reduction are also important. Ergots, sumatriptin, and midrin are helpful in aborting acute attacks. When migraine occurs several times a month, prophylactic daily medical therapy should be used. Aspirin, ibuprofen, lithium, calcium channel blockers, amitryptiline, and beta blockers have all been found to be effective in reducing the frequency and severity of attack. Vestibular Neuritis Vestibular neuritis is characterized by sudden onset vertigo lasting several days and usually no hearing loss. Onset is often preceded by a viral infection of the respiratory or gastrointestinal systems and epidemics are not uncommon. Just as in herpetic lesions of the facial nerve, there are temporal bone studies consistent with viral infection of Scarpa's ganglion in patients with well documented histories of viral neuritis. Ariyasu et al treated patients with methylprednisolone and had relief of vertigo with normalization of the ENG at one month in his treatment group. Meniere's Disease The treatment of Meniere's disease or endolymphatic hydrops remains an enigma because the precise etiology of the disease is unknown. Temporal bone studies initially described the finding of hydrops and it was theorized that this was the cause of the subsequent symptoms. Unfortunately, investigators have induced histologic hydrops in animal models without evidence that vestibular symptoms resulted. Despite this, it is still considered the working model and is the basis for most treatment regimens. Diuretics and dietary salt restriction have been considered the mainstay of treatment for years. It is believed that diuretics can alter the fluid balance in the inner ear leading to a decrease in endolymph and resolution of the hydrops. Thiazide diuretics are traditionally used and lead to decreased sodium absorption in the distal tubule of the nephron. Side affects are many and include hypokalemia, hyperglycemia, hyperuricemia, hypotension, and hyperlipoproteinemia. A potassium sparing diuretic such as triamterene can be used in combination (Maxzide or Dyazide) to decrease the side effects. Carbonic anhydrase inhibitors are used by ophthalmologists to decrease intraocular pressure in treating glaucoma. An analogy drawn between this disease and hydrops led to their use by otolaryngologists. These agents decrease sodium-hydrogen exchange in the renal tubule leading to a diuresis. In addition they decrease the production of CSF. IV therapy can exacerbate symptoms but there is some evidence that oral therapy can reduce hydrops in the short term. Unfortunately again, significant side effects occur in as high as 50% of patients including metabolic acidosis and renal calculi. Vasodilators are used based on the hypothesis that ischemia of the stria vascularis causes Meniere's. The rationale is to improve the metabolic function of a diseased ear. IV histamine, isosorbide dinitrate, cinnarizine (a calcium antagonist), and betahistine (an oral histamine analogue) have been used with purported success. Betahistine has been extensively studied and used in Europe and has been found to produce vasodilation of the capillaries, arterioles, and arterial-venous arcades in the stria vascularis and spiral ligament and lower endolymphatic pressure. There has been some short-term relief of vertigo with this agent but no proof exists that any long-term management can be obtained with this drug. Fifty percent of subjects with clinical evidence of Meniere's disease were found to have antibodies to a 70-kd heat-shock protein in a study by Gottschlich et al. This antibody has been previously associated with autoimmune sensorineural hearing loss and treatment with immunosuppressive agents has gained favor. Systemic and intratympanic glucocorticoids, cyclophosphamide, and methotrexate have all been used by clinicians but this treatment is controversial at best currently. Despite all of these treatment regimens, it has been well shown that the placebo effect exists in the management of Meniere's disease. Torok performed a retrospective analysis and found that all therapies produced a 60-80% remission rate. Silverstein offered surgery to medical failures and studied the patients that declined more aggressive treatment. 59% had complete control of vertigo at 2 years and 70% at 8 years. He concluded that this was the natural course of the disease. Because of these confounding conditions it has been difficult to determine which treatment regimens alter the course of the disease. Ruckenstein did a retrospective analysis of the literature that was published following Torok's study and concluded that none of the above treatments provided relief of the symptoms of Meniere's disease. He concluded that all of these therapies were nonspecific and no better than placebo. He did not disparage the use of these agents but instead cautioned that the most benign form of treatment should be utilized in order not to harm the patient. The vestibular suppressants were the only class that were proven to alleviate acute attacks of vertigo in his analysis. Chemical labyrinthectomy has recently become popular in the treatment of patients with disabling vertigo that is persistent and refractory to medical management. Intramuscular streptomycin was initially used recognizing that it is more vestibulotoxic than cochleotoxic but the diseased ear in unilateral Meniere's cannot be targeted with systemic therapy. Intratympanic gentamicin allows treatment of unilateral Meniere's disease without producing systemic toxicity or effects on the opposite ear. The round window membrane serves as the primary route of entry into the inner ear with the annular ligament of the stapes serving as a secondary route. The solution may be used as a stock solution of 40 mg/cc at a pH of 5.4 or buffered to a pH of 6.4 to improve patient comfort. With the patient supine and the head turned away from the treatment ear the tympanic membrane is anesthetized and about 0.5 cc of solution injected into the middle ear. The patient remains in this position for 30 minutes and is instructed not to swallow. Many treatment protocols exist. At UTMB, we routinely schedule the injections weekly until effect has occurred. An audiogram is obtained prior to each injection to ensure that auditory toxicity is not occurring. Patients should report symptoms of acute unilateral vestibular insult with vertigo (usually described as different from that with Meniere's), imbalance, and a tendency to fall toward the affected ear. These symptoms occur at variable times after the procedure. Clinical signs of vestibular hypofunction such as spontaneous nystagmus or head-shake nystagmus are monitored in followup visits and considered the endpoint of therapy. Cold water calorics can be performed prior to the next injection if there is uncertainty of effect from the prior treatments. Generally, patients are offered the procedure up to six times before concluding failure. Minor was able to control vertigo in 91% of his treatment group with a 3% rate of profound SNHL. There was a recurrence rate of 22% with control of their symptoms in all but one by further ITAG treatments. These numbers are very similar to the results obtained with vestibular neurectomy with far fewer risks. Benign Paroxysmal Positional Vertigo (BPPV) BPPV is the most common cause of vertigo. In the past it was explained as cupulolithiasis: calcific deposits became embedded on the cupula, rendering the semicircular canal dependent on gravity. A substantial amount of evidence now exists that the disorder results from canalolithiasis: calcific debris (presumably displaced otoconia) in the semicircular canal but not adherent to the cupula. Head movements, particularly looking up, lying down, or rolling over onto the affected ear, result in displacement of this canal sludge and moverment of endolymph away from the cupula exerting a plunger-like effect and pulling of the cupula. Several approaches have been developed to treat BPPV including particle repositioning maneuvers and habituation exercises. Semont developed the liberatory maneuver as a single treatment alternative. Once the side of involvement is found the patient is quickly moved into the plane of the posterior canal and is kept in that position for 2-3 minutes. The patient is then rapidly moved up through the sitting position and down into the opposite side-lying position with the therapist maintaining the alignment of the neck and head of the body. The patient stays in this position for 5 minutes and then slowly returned to the seated position. They must then remain in a vertical position for 48 hours and avoid the provoking position for one week. Reportedly, it works by floating the debris through the canal and into the common crus and requires only one treatment. Semont reported cure in 84% after one treatment and 93% after two treatments. Epley proposed a canalith repositioning procedure where the patient is taken rapidly into the Dix-Hallpike position that provokes the symptoms and is kept in that position for 3-4 minutes. The head is then slowly taken through extension and turned to the opposite Dix-Hallpike position. The patient is rolled over onto their side so that the head is turned toward the floor and remains in that position for 3-4 minutes. They are then slowly sat up. Epley premedicated his patients and used a mastoid vibrator during the treatment which is not considered to be necessary by most clinicians currently. Again the patient is instructed to remain in an upright position for 48 hours and told not to lie on the effected side for 5 days. Epley reported 100% improvement or cure with multiple maneuvers in one patient treatment. This was repeated by Herdmann et al who found 90% were asymptomatic or significantly improved after one treatment. Brandt and Daroff designed habitation exercises that require the patient to move into the provoking position repeatedly, several times a day. The patient first sits and then moves rapidly into the position causing vertigo. A torsional nystagmus occurs with the vertigo. They stay in this position until the vertigo stops and then they sit up again. They remain in this position for 30 seconds and then move rapidly into the mirror-image position on the opposite side staying there for 30 seconds and then sitting back up. This is repeated until the vertigo diminishes. This is then repeated every 3 hours until the vertigo resolves for 2 consecutive days. Explanations for the success of this maneuver include dislodging of debris in the posterior canal and/or central adaptation reducing the CNS response from the posterior canal. They reported that 98% were asymptomatic after 3-14 days of exercises. Norre designed habituation exercises that were specific for each patient and were not limited to modifications of the Dix-Hallpike maneuver. These exercises have been advocated for patients who exhibit symptoms of BPPV in planes that are not consistent with the posterior canal and in patients who may have other vestibular disorders overlapping with BPPV. Their results included 32% asymptomatic at one week and 100% asymptomatic at 6 weeks. Not all researchers have found success in the same percentage of patients as the above authors but there is consistent data showing that the patients treated with any of the methods do better than control groups. In addition, the procedures are relatively quick, easy, and cost-effective to perform. Comparison will show that there is similar success with all approaches but not all are suitable for all patients. Patients who have more anxiety about the treatment and the sensation of vertigo may respond better to the longer term habituation exercises, whereas patients wanting more immediate relief will be better suited for the repositioning procedures. Patients with arthritic diseases and limited mobility also deserve special consideration when planning therapy. In determining immediate "cure", you must remember that this vertigo is fatiguable and some of these patients may recur in the future. Vestibular Rehabilitation Therapy (VRT) The use of exercise in the rehabilitation of patients with vestibular disorders is aimed at promoting vestibular compensation. Many treatment approaches have been designed to promote compensation through habituation. Other approaches are designed to enhance the adaptation of the vestibulo-ocular and vestibulospinal relex so that less input is required from the vestibular system. The program is usually begun on an outpatient basis but may be instituted while the patient is still hospitalized. Many of the exercises may initially exacerbate the patient's symptoms, so the patients should be thoroughly counselled to allay any feelings of mistrust. In cases with severe symptoms the patient's exercise protocol may have to be readjusted temporarily. Cawthorne-Cooksey exercises were developed in the 1940s and include movements of the head, tasks requiring coordination of eyes with the head, total body movements, and balance tasks. They recommended performing these exercises at various speeds, in different positions, and with the eyes open and closed. In addition they had the patients perform these exercises in loud and noisy environments which may be more difficult in the vestibular patient. There are many different VRT protocols in use but the treatment philosophy is remarkably similar to this approach established 60 years ago. The current common techniques of VRT still include habituation of pathologic responses, postural control exercises, visual-vestibular interaction, and conditioning activities. The therapist must first identify the pathologic movement that causes the symptoms and develop a list of activities that reproduce the movements. These movements can be incorporated into normal daily activities so that they are performed reliably and remain interesting to the patient. They are performed twice daily unless limited by severe nausea and vomiting. If they can stick with the program, many patients report improvement within 4 to 6 weeks. If postural control is found to be a culprit, this can be added to the exercise program. For example, if a patient is found to depend on somatosensory input despite the availability of visual input, the program may involve exercises that require balancing on thick foam. This can be performed initially with the eyes open and then progress to eyes closed. With visual-vestibular mismatch or bilateral vestibular disorders, exercises may optimize the use of the visual system. Many patients have adopted a sedentary lifestyle in order to avoid their symptoms. In turn, they become deconditioned which may exacerbate their disorder. These patients are designed an appropriate fitness program to match their age and lifestyle. This can incorporate sports that require hand-eye coordination to further improve their condition. One particular activity which may be poorly tolerated in the vestibular patient is swimming because of the relative weightlessness encountered. A particularly important use of VRT is in the elderly who may have multifactorial balance difficulties. With the impact of complications of falls in the elderly, VRT which may decrease the functional impact of disequilibrium, balance, or gait problems is highly desirable. No studies have shown that the outcome measures of VRT in the elderly are poorer. The only significant difference has been an increased amount of time required to maximize the benefit. It is important to remember though that input from two sensory systems is required for adequate postural stability. If there are losses from the visual or somatosensory systems there is a poorer response to VRT. VRT has been consistently shown to be an important part of the manangement of vestibular patients but it is not a cure-all. Most studies show that patients improve on the order of 70-80% but this does not mean to the point of being symptom-free. Cowand et al found that 28% of their patients showed complete resolution of symptoms within one year and 54% improved even if only marginally. Not all patients are ideally suited for VRT. Patients with stable or slowly progressive vestibular disease are the best candidates. Inappropriate candidates for VRT include those who have fluctuating nonstable vestibular lesions such as with Meniere's disease. If no provocative maneuvers and no postural control abnormalities are found on examination, the patient may not respond favorably as there will not be a treatable component by VRT, these patients may be better managed with other medical or surgical strategies. Conclusion Presentation of patients with vestibular complaints is a common occurence in the otolaryngology clinic. It is often a frustrating encounter as many patients are either poor historians or don't fit squarely into one of the common diagnostic categories. Nevertheless, it is imperative that a thorough evaluation take place so that diagnosis can be established. Many patients have been treated by other physicians with chronic use of vestibular suppressants and no form of rehabilitation. These patients often cling to these prescriptions as they fear the consequences of stopping therapy. After diagnosis and treatment of the acute symptoms, it is now clear that weaning of vestibular suppressants and institution of vestibular rehabilitation is crucial to prevent a chronically uncompensated vestibular patient. Bibliography Monsell EM, Cass SP, Ryback LP. Chemical Labyrinthectomy: Methods and Results. In Otologic Surgery by Brackmann et al. Pages 509-518. Herdmann SJ. Vestibular Rehabilitation. Wackym PA and Balaban CD. Medical Management of Vestibular Disorders and Vestibular Rehabilitation. In Head & Neck Surgery-Otolaryngology by Bailey. 2nd edition. Pages 2287-2307. Timmerman H. Pharmacotherapy of Vertigo: Any News to be Expected?. Acta Otolaryngol. 1994; Supplement 513: 28-32. Brookes GB. The Pharmacological Treatment of Meniere's Disease. Clinical Otolaryngology. 1996. 21: 3-11. Robertson D and Ireland D. Evaluation and Treatment of Uncompensated Unilateral Vestibular Disease. Otolaryngology Clinics of North America. Vol 30. Number 5. Pages 745-757. Luxon LM. The Medical Management of Vertigo. Journal of Laryngology and Otology. Dec 97. Vol. 111, pp. 1114- 1121. Steenerson RL and Cronin GW. Comparison of the Canalith Repositioning Procedure and Vestibular Habituation Training in Forty Patients with Benign Paroxysmal Positional Vertigo. Oto-HNS. Jan 1996. Vol 114, Number 1. Pages 61-64. Telian SA and Shepard NT. Update of Vestibular Rehabilitation Therapy. Oto Clinics of North America. Vol 29, Number 2, pages 359-371. Antonelli PJ. Update on Vertigo Management. Comprehensive Therapy. 1999; 25(1): 5-12. Ruckenstein MJ, Rutka JA, and Hawke M. The Treatment of Meniere's Disease: Torok Revisited. Laryngoscope 101: Feb 1991. Number 2. Pages 211-218. Baloh RW et al. Vestibular Neuritis: Clinical-Pathologic Correlation. Oto-HNS. Vol 114, Number 4. Pages 586- 592. Ariyasu L et al. The Beneficial Effect of Methylprednisolone in Acute Vestibular Vertigo. Archives of Oto-HNS. Vol 116, June 1990. Pp 700-703. Drugs Used for Vertigo and Vomiting. American Medical Association Drug Evaluations Annual 1994. Pages 439- 464. Minor LB. Intratympanic Gentamicin for Control of Vertigo in Meniere's Disease: Vestibular Signs that Specify Completion of Therapy. American J of Otology. Vol 20. Number 2, 1999. Pages 209-219. Vrabec JT. Benign Paroxysmal Positional Vertigo and Otolith Repositioning. Archives of Otolaryngology-HNS. 124(2): 223-225. Cowand JL et al. Efficacy of Vestibuar Rehabilitation Oto-HNS. Vol 118. Number 1. Pages 49-54.


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Nightwish meet & greet in Trondheim, NorwayPublished on 18.9.2012 12:07
Battery Energy Drink is the official energy drink of Nightwish on the Imaginaerum World Tour in 2012. In celebration of the Nighwish tour hitting Norway, Battery Energy Drink offered Norwegian Nightwish fans the chance to win tickets to see Nightwish in Trondheim on August 25th. The prize also included the unique opportunity to meet & greet Nightwish.
Over a dozen Nightwish fans were made happy when they got to meet their idols before the concert. The lucky winners got their pictures taken with the band and received their autographs.
Thank you for participating in the competition, guys. Furthermore, a big thank you goes to Nightwish for making this happen.

subset: commoncrawl


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Just select a County below to view the state approved alcohol education classes available in that county:
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The University of Miami School of Law Legal Corps, an award-winning, postgraduate fellowship program, places recent law graduates in public sector organizations. Economic conditions have decreased funding for public sector agencies while the demand for legal services has dramatically increased. In response, Legal Corps seeks to help fill the gaps at understaffed public agencies by providing them with prepared, skilled, and diverse attorneys.
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All Legal Corps Fellowships are subject to final approval by Miami Law.
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Click here to go to UM's central giving website. From there, you can select Legal Corps as your gift designation for the School of Law.
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Southwest Details Denver Plan
Southwest Airlines (LUV) Thursday unveiled the details of its plans to fly out of Denver.
The Dallas-based low-cost airline, which last week announced it would enter the Denver market, will begin service from the Mile High City on Jan. 3, with a total of 13 daily flights to these cities: Chicago, Las Vegas and Phoenix. One-way fares will start at $59.
Southwest initially will occupy two gates in the C Concourse of the Denver airport and will have about 40 local employees.
The airline expects over time to beef up its presence in Denver, where Frontier Airlines (FRNT) and UAL's (UALAQ) United Airlines maintain hubs."These destinations are just the beginning for Southwest in Denver. We look forward to growing with the demand here," said Gary Kelly, Southwest's CEO. "Denver is a market that has been a significant gap in Southwest's system for many years, and we can now connect Denver customers into our coast-to-coast operations." Southwest shares were up a penny to $15.59.
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Hi All, I'm wondering how one could define the length of time a resource has been, or was, in existence. I can see how a single client or intermediary could figure this out by auditing HTTP Messages (from 201 following POST or PUT through to a successful DELETE) - but I was looking for a way to indicate this to any client. This leads me to two questions: 1: Is there scope for a Created response header? 2: Can/could 410 Gone response include a Last-Modified header? Cheers, NathanReceived on Thursday, 20 January 2011 12:36:15 GMT
This archive was generated by hypermail 2.2.0+W3C-0.50 : Friday, 27 April 2012 06:51:36 GMT


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Post A Photo
This Is What A 24K Gold iPad Air 2 Looks Like
Quick! If you had to guess what an iPad Air 2 decked out in 24K gold looked like, what would you say? If your answer was "ridiculously kitschy" — congratulations! You're correct. (We'd also accept "kind of like grandpa's wristwatch")
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WD® To Demonstrate Solid State Hybrid Drive And 5 Mm Technologies In Tablet, Thin And Light Devices At COMPUTEX TAIPEI 2013
IRVINE, Calif., May 22, 2013 /PRNewswire/ -- WD ®, a Western Digital (NASDAQ: WDC) company and world leader in storage and connected-life products, today announced that it will demonstrate its solid state hybrid drives (SSHD) and 5 mm ultra-slim hard drive technologies in tablet and other thin-and-light devices at the COMPUTEX TAIPEI 2013 trade event, held in Taiwan from June 4 to June 8, 2013. The innovations will be a part of WD's exhibit showcasing its latest storage technologies and solutions addressing thin-and-light mobile devices, cloud datacenter computing and the connected lifestyle.
At Taipei World Trade Center Nangang Exhibition Hall, booth number L0810, WD will demonstrate:
- The world's first ultra-slim 2.5-inch, 5 mm hard drives and SSHDs, which are designed for integration into the slimmest devices and space-constrained computing environments;
- 7 mm form factor drive designs for high-capacity mobile storage;
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|Hi everyone,
I was cleaning out my cat's litter tray and when I lifted the liner there was a watery droplet of blood on the plastic. Somehow the urine had got through the liner into the tray as well, and it looked darker than usual so I dabbed it with a paper towel and it had a red tinge to it so I'm pretty certain my cat has a bit of blood in her urine but it's not really obvious or clots or anything.
She is very old (approx 17 yrs old) and I guess I'm expecting the worse that it might be cancer? I don't think she is blocked up by looking at the amount of urine in her tray (she pees big puddles). she is also on Carbimazole for hyperthyroid and we recently upped her dose a bit but when she was diagnosed with hypert her kidneys results came back fine.
I guess I'm wondering what tests need to be done to explain the blood and find the cause?
Follow-Up Postings:
|I imagine the vet would first do a regular urinalysis to check for white and red cells. Could be just a UTI which is cured with antibiotics.
Any chance you can get a urine sample to take in? If not, the vet should be able to express her bladder and get a sample.
|Is she euthyroid (normal thyroid levels) with her current dose of Carbimazole? If so, you should have bloodwork run to check her kidney function now. You can't necessarily trust normal kidney results at the time of her hyperT diagnosis, This is because uncontrolled hyperT can mask renal problems by forcing sick kidneys to work harder than they would work without the stimulating effects of the hyperT. Blood tests can't tell the difference between kidneys being forced to work hard by uncontrolled hyperT (and therefore returning "normal" test results), and kidneys that really are healthy. The only way to evaluate the health of your cat's kidneys is to have a blood chemistry run AFTER she has achieved euthyroid on carbimazole.
If it turns out that she does have kidney disease (which is likely, given her age), then it's also likely that the blood in her urine points to a urinary tract infection. Kidney cats are prone to UTI's because of their dilute urine. Dilute urine is less acidic and more easily populated by bacteria. The "big puddles" your cat produces makes me think that she is diluting her urine with extra water intake (common in both kidney and hyperT cats).
The only way to definitively diagnose UTI is by having a STERILE urine sample tested either by urinalysis or by urinary culture (culture is best). This means that the sample needs to be collected by cystocentesis (drawing urine directly from the bladder with a long, thin needle inserted through the abdomen). Any urine that is collected after being peed out (free catch) is subject to contamination that may return a false positive lab result, so that's just a waste of time and money.
If a culture run on a sterile urine sample comes back negative for bacteria and/or urinary crystals, then your cat most likely has simple cystitis. This is often caused by stress.
- Posted by spedigrees (firstname.lastname@example.com) on Wed, Jul 31, 13 at 10:59
|Urinary infections are fairly common in pets of any age, and can be easily cured by a course of antibiotics. I would look at that possibility first.
- Posted by trancegemini_wa (My Page) on Wed, Jul 31, 13 at 12:31
|thanks so much for the replies. I have to admit I've been pretty stressed about this today and I'm feeling more relieved to read these.
Laurie thanks for the detailed post. I remember when her kidney results came back normal I questioned it with the vet, because it just didn't seem logical for her age to have perfect kidney function, and I remember the vet assured me the results were reliable but it sounds like they probably weren't anyway.
Her hyperT has been pretty well controlled but she did need a dosage adjustment recently, so I'll get the vet to do another check on her kidneys. I would say her urine must be very dilute because there is a lot of it when she goes.
she's booked in at the vets tomorrow morning and hopefully it is just a uti or cystitis. I'll let you know how it turns out
|If your vet is basing the assessment of your cat's kidneys on a blood sample tested while your cat had uncontrolled hyperT, those results can NOT be relied upon to be accurate.
Here's what I'd do in your position. Have the vet take a urine sample by cystocentesis tomorrow, then have a CULTURE run on the sample (not just a urinalysis). A culture will tell if infection is present, and more importantly, it will identify the specific bacteria present so that your vet can prescribe a targeted antibiotic known to be effective against that specific bacteria.
As far as hyperT and kidneys are concerned, I recommend you take her to your vet for a followup T4 and renal panel THREE WEEKS after her most recent med dose adjustment. That will give the med time to stabilize her T4. Assuming that the new med dose was properly adjusted and that she is euthyroid on the retest, then the results of the renal panel will be valid.
I strongly recommend you keep a file at home with copies of ALL of your cat's past and present lab results, in case you're not doing so already. You will find it soooo helpful to be able to compare lab results over time so that you'll know exactly what to discuss with your vet during appointments. Vets rarely (if ever) have time to go over the complete lab history of a patient during every exam, so it's up to us as primary caretakers to become acquainted with this history ourselves to make sure that nothing gets overlooked. If you don't have them, ask your vet for copies of all of her past and current lab reports when you go for your appointment tomorrow. Better yet, call today and let them know you want those reports so that they have time to photocopy them for you to pick up tomorrow.
|"I remember when her kidney results came back normal I questioned it with the vet, because it just didn't seem logical for her age to have perfect kidney function, and I remember the vet assured me the results were reliable but it sounds like they probably weren't anyway."
This concerns me. HT is known to mask kidney problems. You might want to take your kitty to a cat specialist, who treats feline geriatric problems, rather than a general practice vet.
- Posted by trancegemini_wa (My Page) on Thu, Aug 1, 13 at 0:19
|Thanks laurie, ok I'll do that and hold off on the kidney test for now. I might get the thyroid tested again in a few weeks first just to make sure she's back in range before doing the kidney test.
The vet she is seeing tomorrow is not the same one who did the kidney test (I just wasn't too impressed with them anyway but they were close to my house and it made it a bit easier getting my cat there), and I have changed vets again not long ago
snookums I don't think there are cat specialist vets where i live, it's hard to find a halfway decent vet locally since my old vet retired and I've been to just about all of them since then I think
|I think that's a good plan. There's no reason to waste money ... or your cat's blood ... on a renal panel until you know that the results will be accurate.
- Posted by trancegemini_wa 10b (My Page) on Sat, Oct 12, 13 at 7:16
|I just thought I'd post an update to this. After many tests my cat was finally diagnosed a few weeks ago with advanced kidney disease (less than 10%) and non regenerative anaemia. Today she took a turn for the worse and was very weak and I took to her to the vet to be euthanized. I stayed with her and kept her comforted, and she passed very quickly and peacefully.
Right now my heart is broken and my dear little kitten is gone, but I know it was for the best. she was ready and as much as I didn't want to let her go, I knew it was time so that she didn't suffer. I prayed that she would go peacefully, and my prayers were answered, and she is now in kitty heaven and not suffering, even though it has left a huge hole in my heart.
This post was edited by trancegemini_wa on Sat, Oct 12, 13 at 7:35
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Bonney Kapp
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Pool Report: Karen Leigh's Going Away to Cambodia Party - Posted August 21, 2009
In case you haven't already heard, Bloomberg's Karen Leigh is ditching DC and the White House for Phnom Penh. Press corps friends gathered at Stetson's last night to send her off to Cambodia... Bonney Kapp... [FishbowlDC]
Sasha's Send Off From Print To Glossy - Posted April 29, 2009
Last night at Poste, friends of Sasha Issenberg gathered to celebrate his move from The Boston Globe to the magazine Monocle. He starts today as a Washington correspondent. We, unfortunately, weren't able to make it, but hear these folks did: Peter Canellos, ... [FishbowlDC]
FNC Embeds in Seventeen - Posted September 5, 2008
Seventeen magazine profiles two of Fox News Channel's young political reporters. Embed producers Bonney Kapp (with the Sen. ... [TVNewser]
Obama Picks His Hannity Representative - Posted August 7, 2008
Sen. Barack Obama hasn't appeared on Hannity & Colmes yet, but apparently he's found someone he'd like to send on in his place. Fox News embed producer Bonney Kapp writes on the ... [TVNewser]
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Home → News Display
Turn Around, Don't Drown
March 17, 2009
AUGUSTA, MAINE -- Springtime in Maine brings crocuses and robins, but also an increased risk of flooding. The Maine Emergency Management Agency is joining with the National Weather Service with one simple message this spring: "Turn Around, Don't Drown."
Each year more deaths occur due to flooding than from any other severe weather related hazard. "People underestimate the force and power of water," MEMA Director Rob McAleer says. "More than half of all flood related deaths result from vehicles being driven into flooded areas and then swept away. These deaths are preventable."
According to the National Weather Service, all vehicles are at risk when entering flood waters. Even pickups and sports utility vehicles can float in very little water. "Even if you think the water looks shallow, there may not be a road there anymore," McAleer says. "Rapidly flowing water can scour a roadbed away and leave a weakened road surface or a large hole that could easily swallow a vehicle."
"If you encounter a flooded road, it isn't about getting home on time, it's about getting home at all," McAleer says, "The message is pretty simple. Turn around. Don't drown."
MEMA and the National Weather Service suggest these safety rules:
- Monitor the NOAA weather radio or your favorite news source for vital weather related information.
- Track flood potential thoughout the spring at our Riverwatch page
- If flooding occurs, get to higher ground. Get out of areas subject to flooding.
- Obey local officials and road signs placed by road crews. They are there for your safety.
- Avoid areas already flooded...especially if the water is flowing fast. Don't attempt to cross flowing streams. Turn around, don't drown!
- Road beds may be washed out under flood waters. Never drive through flooded roadways. Turn around, don't drown!
- Do not camp or park your vehicle along streams and washes...particularly during threatening weather conditions.
- Be especially cautious at night when it is harder to recognize flood dangers.
- After the flood, be aware that bridges, culverts or the road surface may have sustained damage. Obey all road closure signs even after the flood waters have receded.
- Learn more about flood preparedness and safety at Maine Prepares
Contact:Lynette Miller


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I have this morning received a very helpful email from QCA/RM:
I have again checked the APS this morning and the test packages were downloaded on the 7th December (just like they were last time I checked). Surely the fact that I have access to the aforementioned familiarisation materials now means that my server is (and always has been) talking to their server?Quote:
Originally Posted by Qwalificashun & Curricuelum Orfority/Researching Monkeys
I'm really quite narked now because QCA/RM send that email to every listed contact at my school so I can now expect a queue of teachers running around my office with their heads on fire asking why haven't done it yet. Advice please?


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MYsql replication questions.
Have a question about replication. I read this statement on MYsql's website:
"•Data security - because data is replicated to the slave, and the slave can pause the replication process, it is possible to run backup services on the slave without corrupting the corresponding master data. "
Question 1: Does this mean everytime a backup script is run in ispconfig 2 there is a chance I could corrupt my databases? Is it a minute possiblity or is it fairly common?
Question 2: I found a few different replication tutorials on HowToForge, one covering master-slave and one covering master-master. Is a master-master vulnerable to the same corruption? Is a master-slave scenario safer all the way around?
Question 3: In falko's tutorial "http://www.howtoforge.com/mysql5_master_master_replication_debian_etch" he mentions:
"The advantages of master-master replication over the traditional master-slave replication are that you don't have to modify your applications to make write accesses only to the master"
Does this mean if I use a master-slave replication I have to tell ISPConfig 2 to only wrtite to the master or something like that?
Thanks as always folks,
now you tell your applications to shoot inserts, deletes, updates etc to the master, and selects to the slave .. or use your master for everything, and just keep your slave solely for backing up your data.
Thanks alot for the answers Mark,
I think I will start off with just a slave for backups only. Then as I get better with Linux, I will try the whole splitting commands between the master and slave thing lol
You could write a mysql class like i did .. what it does it checks if the query starts with SELECT or something else, depending on what it runs the query on the correct server.
good luck!
A few more questions if I could.
Hello all,
I encountered an error on my slave. A few questions I would ask if possible:
1. Error was this:
Aug 31 12:11:16 server2 mysqld[1933]: 100831 12:11:16 [ERROR] Slave: Error 'Duplicate entry 'random data' for key 1' on query. Default database: 'web4db1'. Query: 'INSERT INTO `jos_session` ( `session_id`,`time`,`username`,`gid`,`guest`,`clie nt_id` ) VALUES ( 'random data','random data','','0','1','0' )', Error_code: 1062
Aug 31 12:11:16 server2 mysqld[1933]: 100831 12:11:16 [ERROR] Error running query, slave SQL thread aborted. Fix the problem, and restart the slave SQL thread with "SLAVE START". We stopped at log 'mysql-bin.000001' position 8683
I several sites installed on ISPConfig some playing around with Drupal, some with joomla etc etc. For instance web1db1 and web4db1 both are Joomla so both have a table "jos_session" since they are completely different databases that shouldn't be a problem correct? What usually causes this error and where should I investigate first?
2. While researching this error some sites have said to insert "slave-skip-errors = 1062" into config file for slave. Is this wise or just mearly a bandaid type of thing?
Thanks as always for the help folks,
skipping slave errors should only be used if you know the problem that occured won't be of any problem for the rest of the replication .. the error tells you that there is already a record in that table with the same key ..
1. Do you have "read only" in your slave config?
2. Remember that a SUPER user is exempt for "read only" (they can always edit data on a read only server)
3. if you're sure you can continue do:
and check if the "Seconds Behind master" field is decreasing..
good luck.
Man this is sad.
Well I think I must have horrid mysql karma or something lol
So I followed your instructions, all seemed well. I then saw a new tutorial by falko of setting up master slave replication with ssl. Now I'm just on a private network playing around and stuff so I don't NEED security lol but figured what the hell lets play around with it.
Now I get this error in syslog:
Sep 2 05:00:05 server2 mysqld[4567]: 100902 5:00:05 [ERROR] Slave I/O thread: error connecting to master 'email@example.com:3306': Error: 'Access denied for user 'slave_user'@'10.1.10.124' (using password: YES)' errno: 1045 retry-time: 60 retries: 86400
After searching the forums I found a post where it was possibly a firewall problem. Now before the ssl the slave was working just fine until it hit that duplication error, so I wouldn't think it is a firewall issue. I found this command as well:
mysql -u firstname.lastname@example.com -pmypassword
This returns with this error:
ERROR 1045 <28000>: Access denied for user 'firstname.lastname@example.com.'@'localhost' <using password: YES>
It cuts off the host after 5 digits, don't know if that is normal either?
So any ideas folks?
Thanks as always for your time,
lol alls well that ends well.
Well when I followed the tutorial I copied and pasted falko's commands into notepad then made my changes to db names, ip's etc and saved the file. I went back through it and there were no typos.
I went through both master and slave and reversed all changes I had made. then opened up notepad and repasted the commands from the tutorial, the error went away lol
I'm thinking maybe I grabbed an extra space or something copying and pasting back and forth between notepad, thats the only thing I can think of.
Thanks as always folks,
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Gear Question
Does this rope have a middle mark?
Member since
Does this rope have a middle mark?
Angus Bohanon
Member since
Sorry, no. Bluewater doesn't do factory middle marks in case someone trims their rope, in which case the mark wouldn't be in the middle any more. It's an unusual policy but that's the deal.
Chris Huntley
Member since
if you don't want to attempt to mark your own, you can order the bi-color and the sheath pattern will change at the midpoint.
View More Details on Blue Water Icon Double Dry Climbing Rope - 9.1mm


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Cindy's StoryThis is from my Great Aunt Helen, a well loved cook and baker. I miss her, but enjoy making many of her recipes she shared with us at the last family reunion before her death. Thank You Aunt Helen!
1 lb
cranberries, fresh
1 c
2 c
white sugar
2 c
crushed saltine crackers
4 Tbsp
melted butter
Find more recipes at goboldwithbutter.com
2 c
whipped cream- lightly sweetened if desired (i dont sweeten mine)
Directions Step-By-Step
1Boil Cranberries in 1 Cup water until skins 'pop'.
2Add Sugar and bring to a boil, chill thoroughly.
3Just before serving, mixed crushed saltines with melted butter.
4Whip cream, i whip mine so its stiff.
5Cover bottom of clear glass bowl with a layer of cracker/butter crumbs (half the crumbs)
6Layer on half the cooled cranberries, then a layer of whipped cream.
7Repeat layers in same order.
About this Recipe
Course/Dish: Fruit Desserts, Fruit Salads
Other Tag: Quick & Easy
Laurie Roberts Luv2TryNew - Nov 16, 2010
Ooh I like this!
Cindy Olson cooksfromtheheart - Nov 16, 2010
Hope you try it! Let me know how t goes!
Laurie Roberts Luv2TryNew - Nov 16, 2010
I have already decided I'm making this for Thanksgiving, just based on the recipe. Can't wait to taste it. I will keep you posted! :)
Cindy Olson cooksfromtheheart - Nov 16, 2010
We will be having it at my house too!
Mary Wilson sugarnspice2 - Nov 18, 2010
I love cranberries, although most of my family do not care for them, so I am always looking for ways to win them over to them, too. This just may do it! I'm going to try it, anyway...for Thanksgiving. I hope to have one of my favorite Cranberry salad recipes posted in time for Thanksgiving, too. Thanks for sharing...looking forward to trying this!


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I am constantly finding myself running into Victoria Secret stores every time I'm at the mall just to get this gloss. It is part of my everyday makeup routine and I can't live without it! It has great shine and stays on for a long time. Unlike other glosses when starts to fade later in the day, it leaves my lips feeling soft rather than flaky. This also makes it easier to reapply. The gloss is also super reasonably priced so it is a good addition to my daily routine. Its also something that I like to throw into gifts for my friends!
1 out of 1 people found this review helpful. Did you? Yes No
I worked at VS when these came out and replaced the disgusting Secret Garden lip glosses (what a horrible smell!), and have been using them ever since! I don't know how anyone could complain that these are "sticky"...I guess if you're used to chapstick or something, then this could be sticky to you, I guess?
These come in tons of flavours, which is great because I LOVE flavoured lip gloss! And it doesn't matter who I was romantically involved, every person I've ever dated has LOVED these and constantly asked "Oh my god, what is on your lips? You taste amazing!" LOL. Some of them kinda suck. I think I Want Candy is a little nauseating.
These are super glossy with a decent staying power. Honestly, I think the longest I've ever gone without touching up is about an hour, because I always want to reapply! Some of them have shimmer, some do not. As for colour payoff, most of them or clear or just have a very light wash of colour. Yummyberry and Cherry Bomb are actually probably the most pigmented....an extremely sheer red. This doesn't bother me. I tend to wear a smoky eye quite often, and when I do I don't want bright lips. These two sheer red glosses or even a clear gloss pairs just right with a smoky eye (or bright eyeshadows; I'm a big fan of lime and pink shadows!). Being clear or sheer makes them perfect for layering over lipsticks. Honestly, I think it's just more versatile this way. If they were pigmented, you'd be stuck with just one purpose. The shimmery formulas are fun, but aren't over-the-top glitter.
VS tends to release limited edition/seasonal versions of these whenever they release such a line in the Beauty Rush body care line. I've noticed these LE ones tend to have more colour to them. For instance, Spicee Apple was a frosted sheer nude, and Cookie Kiss was shimmery sheer purple. Still sheer, but not clear like many of the glosses that are part of the regular line up.
The price on these can't be beat. Buying one is a little pricey for the amount you get, but these are always on some kind of special (2/$12, 4/$20, etc) and can be mix and matched with any of the other Beauty Rush items like the eye shadows, mascaras, blushes, colorshine gloss, dazzleshine gloss, lip balms, etc. Getting them on the sale specials is a great deal; they can end up being less than $4 each, depending on the promotion at the time (usually put on the best promotions during holiday weekends and Christmas season).
I keep these everywhere. Every purse, night stand, desk, coffee table, you name it. They're fun, feel great, taste great, smell great, great worn alone or over a lipstick, and my fiance loves when I wear them. :)
EDIT: Just wanted to add...for everyone saying these are "just like" the Bath and Body Works glosses, yes and no. Technically it's the other way around, lol. VS and B&BW are owned by the same company and you can tell a lot of their beauty products are made by the same companies. They even use a lot of the same shaped bottles for things like body sprays and lotion (though not necessarily at the same time). VS Beauty Rush glosses were a hit, and B&BW followed suit with a line of glosses. The only difference in the glosses are the flavours offered, the formula is the same. B&BW tends to have more flavours that are fashioned after baked goods and drinks, while VS has more that are fruit-inspired. So just go to the store that has the flavours you want, it's the same gloss.
4 out of 4 people found this review helpful. Did you? Yes No
I've used better and I've used worse. These glosses are very sticky, but the flavors just can't be beaten. I cannot find any other lipglosses that are so genuinely true to flavors at such a price. I love the 2 for $12 specials and whatnot. I will admit I probably keep them a little longer than I should because I get too many at once and it takes too long to go through them. These are NOT windy/bad weather glosses, unless you have your hair back ;)
I think these glosses are exactly what you would expect for this price, or maybe even better. They smell really good, and look really pretty when on your lips- perfect for everday wearing. The only problems I have with them is that they are super sticky! That doesn't bother me too much, though, in fact I almost always expect glosses to be sticky.
In a blind test, I couldn't tell apart these glosses from Bath and Body Works glosses. They actually feel the exact same, look the exact same, the only difference is the different flavors.
I reccomend these, they are nice lipglosses for the price. I have two, Strawberry Fizz and Passion Pop. Both flavors are great, Strawberry Fizz is a mild, sweet smell and Passion Pop smells citrusy and refreshing.
I've got quite a few of these (like, almost twenty) and I think they are generally a good quality everyday lipgloss. They are mostly sheer, though some are on par with something like a Revlon Super Lustrous. I only have one, though, that has absolutely no glitter/shimmer in it. (Guava Girl, which looks like a pretty lilac, but is just a clear gloss that tastes like citrus.) They last a fairly long time, mostly because they are pretty sticky. I wouldn't wear these on a windy day unless my hair was pulled back way out of my face.
They all taste delicious, though, and I will continue to purchase new colors.
Some of my favorites, for the curious: Sweet Gleam (No. 1!), Tiny Bubbles, Dandy Cane, Passion Fruit Pop.
I'm a complete lip gloss addict and I think this is pretty much the best stuff you can get for the price. Not as sticky as MAC and cheaper, but just as shiny. Not crazy about the flavors so much but have actually gotten compliments on the Hot Cocoanut. Pretty nude, kinda sparkly, people always think it smells like cookies. I'd recommend it.
1 out of 1 people found this review helpful. Did you? Yes No
Love these especially candy baby taste yummy smell yummy and look yummy.
I LOVE THESE! It takes me ages to get through lip products because I use them for a week or two then just forget about them.. but ive been using this since i got it a few months ago and I still love it! I have it in slice of heaven and its a very pretty sheer pink and it smells SO GOOD like sweet sugary frosting!
The consistency is medium thickness so its not super thin but its not really thick... Its very very glossy and I find it to be really comfortable to wear on my lips, very moisturizing and they last a long time on my lips! : ) I definitely reccommend!
1 out of 1 people found this review helpful. Did you? Yes No
Not sure why these are such a big hype everywhere--they are very very nastily sticky and collect on the edges of your lips where they end up drying up into a weird gross white residue...The colors are not even amazing, the only one I really liked was "Slice of Heaven" because it smelled like a cupcake, but this overall product was just not at all appealing to me. I much prefer glosses that glide on smoothly and don't leave a gross residue, like H & M lip glosses.
- long-lasting
- pleasant scents
- some can be very sticky
I've always loved this glosses. My favorite is Taffy Go Lucky, since it offers more pigment. Most of these are very sheer, adding some sparkle to the lips. I love pairing these over my lipsticks, it really increases the longevity of my other lip products.
Will repurchase.


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#41 - anahbell (07/09/2013) [-]I uh. I relate to this. I am a girl who wants to be a boy. I don't have any strange fetishes though and I don't have any strap ons, but I am going to have my boobs cut off and take testosterone eventually. So, yeah.
#56 to #55 - anahbell (07/09/2013) [-]
Yeah, although for me.. that's a bit too far so I'm just going to stick to keeping what I've got. I've heard they have to like use a thing to like inflate the fake dick they make and people can have sex with it. It's kinda weird, even for me.
#114 to #56 - srapture (07/09/2013) [-]
Wait wait wait... So, you want to have your breasts completely reduced in size, take testosterone, and... Keep your vagina? I'm all for people being whatever they want to be, but in a relationship kind of sense, that seems like a terrible idea, being a vagina-man.
#149 to #114 - anahbell (07/09/2013) [-]
Haha, yeah I know it sounds weird but I mean.. I've got a few problems where I don't like to show anyone anything down there so it would be difficult to allow a surgeon to do things to me down there. Also the more intimate part; I'm more of a pitcher than a catcher so no one would be in that region of my body anyway. I just don't feel comfortable with anyone down there on me so I just wouldn't have to do anything but keep what I've got.
#69 to #56 - Slushysolid (07/09/2013) [-]
#58 to #56 - thatonesouthernkid (07/09/2013) [-]
#46 to #43 - clockworkcharizard (07/09/2013) [-]
Honestly, my only question is... why? I mean, I know it's hard being a woman, not from personal experience, but from my friends who are girls (Le friend zoned immensely) who go through legitimate problems. There are little perks from being a man, such as usually being dominate over your mate. And there are lots of cons, such as random boners and random sexual thoughts.
#48 to #46 - anahbell (07/09/2013) [-]
Well, it's different for each person. For me, I just.. I've never been the one who wanted to be the 'little spoon' in a relationship. I want to be tall, handsome and have a wife one day. I want to go out and bring home the bacon, I want to work and care for my family and keep a house. It's just.. it's an internal thing, something in my brain that just doesn't sit right. I know I can do everything I want as a man, now.. well not everything, but most of it.. but it won't be the same. I want to look the way I want, and be comfortable finally in my own skin. There are many disorders that are linked to this, like; Gender Identity Disorder, Body Dysmorphic Disorder, Gender Dysphoria, ect. I happen to have those as well, and it's just a really bad thing. I'm trying to change it. As for the pros and cons. I feel that women do have it a tad worse, I know random boners and what-not can and ARE problematic, but women have their own problematic things as well. I just feel that if I weigh them both out, I'd rather take the easier road (male), and it would be easier for me personally.


text:
To help women achieve their fitness goals, the certified personal trainers at Get In Shape For Women focus on four areas: weight training, cardio training, nutrition, and accountability. In small group sessions, trainers modify exercises to suit up to four ladies' fitness levels, beginning by calibrating strength-training sessions—such as free weights, lunges, and squats—to each client's abilities while still ensuring they are challenging themselves. Then comes high-intensity cardio interval-training sessions in which trainers encourage exercisers to achieve optimal results on the treadmill or elliptical.
The trainers supplement the group workouts with nutritional planning centered around the concept of eating six small, balanced meals six days a week. They set aside the seventh day as a "free day" for a bit of indulgence, be it eating a favorite sweet or lusting openly after bacon. To hold their women accountable, trainers talk nutrition on the floor during scheduled appointments, and the ladies' progress toward reaching their goals is measured by trainers each week.
Pump It Up's indoor inflatable arenas launch socked striplings into the air with a plethora of kid-friendly bounce pads. Staffers supervise fun-filled visits, during which adult counterparts leap around with their kids through gargantuan bounce houses, skip down air-filled slides, and slither like snakes covered in bacon grease through an inflated obstacle course.
The colorful venue also hosts custom birthday parties and private team parties, each themed to please the partygoers in question. These soirees immerse children in a schedule of interactive activities befitting a pirate or a superhero while melting off youthful energy faster than ice cubes thrown into a running DVD player. The birthday boy or girl even gets to blow out the candles on their cake seated in their blow-up throne. Occasionally, the staffers switch off the lights, arming the roomful of players with glow sticks and bracelets as they navigate the air-cushioned obstaclescape. Relying on the staffers' vigilant, watchful eyes, guardians can rest assured that their charges will stay safe, and each piece of the inflatable playground is held to the floor and ceiling by a complex series of anchors installed according to strict safety standards.
The highly trained staff at HLC Med harnesses futuristic technology and its own line of products for services that heal, rejuvenate, and beautify. In the guffawing face of father time, technicians roll up their sleeves and unholster their lasers, blasting away acne scarring, rosacea, or hyperpigmentation with the Radiancy SpectraClear system. A chilled-tip laser uproots party-crashing hair from any skin type, and a Q-switched KTP YAG laser sends sun spots packing. Custom chemical peels stimulate cell renewal and collagen production to fill out fine lines, and radio-frequency devices firm up skin and smooth out cellulite. The center also offers services for men, including laser treatments for razor bumps, back-hair removal, and a gentleman's facial that moisturizes faces more effectively than head-butting Poseidon.
At Maki Sushi Bar, pale yellow walls accented with a crisp, rust-hued stripe surround dark wood tables and a sushi bar where chefs artfully slice up fresh fish into eye-pleasing Japanese dishes. Before diving into main courses, stomachs warm up with a series of calisthenics and bites of starters such as the gyoza's pan-fried pork dumplings. Signature specials blanket plates with bites from the deep blue, seasoned delicately and accented with unexpected ingredients. The seafood martini hosts salmon, tuna, and seaweed salad in an long-stemmed martini glass. To sip more liquid spirits from stemware, patrons select from a full menu of signature cocktails, such as the Crazy Makitini or the Japanese mojito. After exploring a rainbow of nigiri, sashimi, and maki rolls, tongues delight in tasting sweet bites of tempura cheesecake à la mode or crafting sweet mouth guards out of mochi ice cream.
The staff members at Sylvan Learning's numerous centers understand that each child learns differently. Therefore, they don't try to implement a uniform tutoring system; instead, they design custom lesson programs based on the results of a skills assessment using diagnostic tools and one-on-one interviews.
Tutors work with students from pre-kindergarten through grade 12, illuminating topics ranging from basic reading and writing to remembering complex algebraic formulas without having them tattooed on your chest. Many of Sylvan's instructors work in local schools, so they are intimately familiar with common curricula and understand how to gear lessons toward optimal results. Camps and after-school and summer classes can ready high-schoolers for the rigors of the ACT or the SAT, or they can help students to wow college-admissions officers with their superior essay-writing skills.
Cars may have been made for speed, but caring for them properly takes time. Such is the credo underlining Gemstone Auto Detail's exhaustive cleaning packages, which incorporate everything from human hands to clay bars and air guns in order to keep cars as clean as the day they crawled out of Henry Ford's soup. Detailers wash away dirt with foam guns, pH-balanced water, and shampoos; however, cleaning is only the beginning. Once vehicles have been stripped of grime and filth, the staff carefully wipes them down with liquid waxes and polish. Still, a shiny car is susceptible to damage, which is why they take it a step further and condition leather seats, lather the paint in sealant, and fabric-guard the carpets, building an armor around the vehicle that maintains its like-new shine and protects it from hazards such as weather, grease, and spillage.


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By Hannah Wallace Last week, I got to work on a piece about Sarasota's Institute for the Ages, which is hosting its annual Winter Forum this Friday—"Technology & Connections in Positive Aging." I admit, going into it, I was a little confused about the essence of the organization. CEO Tom Esselman broke it down into […]Read More >>
By Hannah Wallace During Patrick Swayze's two-year battle with pancreatic cancer, his wife of 34 years, Lisa Niemi Swayze, served as his caregiver. After Patrick passed away in 2009, she became a public face for dealing with terminal illness and the loss of a loved one, and an advocate for pancreatic cancer awareness. Her new […]Read More >>
The World Health Organization just released new recommendations for the consumption of sodium and potassium—two nutrients that factor heavily into your blood pressure. Potassium is the goodie: You're now to consume at least 3,510 mg of potassium a day. (I really enjoy the specificity of that number—if you've only had 3,500, grab another banana.) Actually, […]Read More >>


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The Great Carrot-Train RobberyThe Great Carrot-Train Robbery (1969) - Merrie Melodies Theatrical Cartoon Series by Dave Koch
This page has been viewed 60 times this month, and 1451 times total.
- Warner Bros.
- Merrie Melodies Theatrical Cartoon Series
- Featuring: Bunny, Claude, Sheriff.
- Originally Released on January 25, 1969.
- Originally Released Theatrically.
- Color
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The Great Carrot-Train Robbery
Comments By: ohnoitsjim
Actually one of the best cartoons from the "W7" era. It's an entertaining enough parody of the then-current hit movie BONNIE & CLYDE, with a catchy theme song (also used in the earlier Bunny and Claude cartoon). Mel Blanc does his... (read more)
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In the page http://www.w3.org/TR/PR-html40/intro/sgmltut.html#h-3.2.2 There is the sentence : Authors may also use numeric character references to represent double quotes (") and single quotes ('). For double quotes authors can also use the character entity reference ". --> there are two links to intro/character-entities (this file doesn't exists) --> the final " is not needed there ! Regards, Mathieu BOIS email@example.com on Tuesday, 13 January 1998 09:28:14 GMT
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