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Health Solutions
by USAA
By Greg Galdau,
Assistant Vice President of Health Solutions
It used to be that you signed up for health benefits once a year, and that was the only time you were concerned about health costs. But the health industry is changing quickly, and these changes are affecting USAA members in new and confusing ways.
That's why we launched the USAA Health Insurance Marketplace. It's an online source for guidance and solutions, and it can help you understand your choices and make decisions to fit your needs.
The marketplace starts with guidance and a new health education page, with actionable steps to take based on your military status. It has new choices to learn more about and shop for Medicare, dental and vision products for you and your family. Our licensed representatives can walk you through your choices on the phone.
We're not new to the health space. For more than 25 years, we have been offering Medicare solutions to help our members protect their savings from high health care costs. And there's more to come. We'll soon be launching a new health cost tool that will help you estimate your total health expenses in retirement as well as your annual expenses if you are still in your working years. We've configured the tool to reflect military benefits you and your spouse may receive. And we're launching accidental injury insurance soon, to cover the out-of-pocket expenses — not just your medical expenses — caused by an accident.
You may be wondering why USAA is getting more involved in the health space. Seventy-five percent of our members believe that health costs threaten their financial security. Expanding our product and advice portfolio is another way USAA can build on its mission to facilitate the financial security of our members by providing a full range of products and services.
I'm proud to be part of an organization so dedicated to its mission and part of a team focused on helping our members in new and innovative ways.
Use of the term "member" or "membership" does not convey any eligibility rights for auto and property insurance products, or legal or ownership rights in USAA. Ownership rights are limited to eligible policyholders of United Services Automobile Association.
Medicare and Health Insurance solutions provided by USAA Life Insurance Company, San Antonio, TX and by USAA Life General Agency, Inc. (LGA) (known in CA and NY as USAA Health and Life Insurance Agency), which acts as an agent for select insurance companies to provide products to USAA members. LGA representatives are salaried and receive no commissions. However, LGA receives compensation from those companies, which may be based on the total quantity and quality of insurance coverage purchased through LGA. Plans not available in all states. Each company has sole financial responsibility for its own products.
You must be a registered user to add a comment. If you've already registered, sign in. Otherwise, register and sign in.


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Several members of the Missouri Congressional delegation have committee changes taking effect in 2015 in the 114th Congress, while others are changing office locations.
U.S. Representative Blaine Luetkemeyer (R-District 3) will serve as Chairman of the House Financial Services Subcommittee on Housing and Insurance.
The ATM disclosure bill, H.R. 4367, was signed into law by President Obama on Thursday, December 20. The bill eliminates the requirement that ATMs display duplicative signs disclosing fees, a requirement that has created legal and financial issues for some credit unions and other financial institutions. The bill preserves consumer notification of fees through an on-screen notice.
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Telephone: 314.542.0555
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subset: commoncrawl


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Hollyberry1109's Mom Answers Activity
Hollyberry1109 is a star in these topics:
Pregnancy > Symptoms & Discomforts (36 helpful answers)
Recent Activity | Asked | Answered
Our friends dog is named Henry but I like that name for a boy.
Most recent answer (09/22/2007):
Not at all. My childhood dog was a basset hound named Henry. When we had our son, the big debate among family members was whether we w...posted by Hollyberry1109
Is it normal to have no pregnancy symptoms at 4 weeks?
Most recent answer (03/22/2015):
Hi no pregnancy Symonds and i had not come i on my priod on the Feb the 18 and i did not come bk on march 12 is i am pregancy i had ta...posted by a BabyCenter Member


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OC3D Reviews ›› Cases & Cooling
Coolink GFXChilla
Cases & Cooling | 28th April 2008
Employing 4 high-performance heatpipes and two large 80mm fans, the GFXChilla claims to provide superior cooling performance at minimum noise levels.
Lian Li PC343 ATX Case
Cases & Cooling | 6th April 2008
We take a look at the Lian Li PC-343B
Titan RTNV TTC-HD90 Hdd Cooler
Cases & Cooling | 14th March 2008
Titan release a new HDD cooler into the market promising reductions in noise and temperatue of your drive. We see if it lives up to it's claims.
OC3D Articles ›› Cases & Cooling
Scythe announces the "black-coated" and "copper" versions of the Kama Wing Ram cooler.
Nic Crane | 25th September 2007
Scythe announces the "black-coated" and "copper" versions of its "original" designed Memory Cooler, Kama Wing.
ASUS Introduces Silent Knight II
Matthew Fogg | 24th September 2007
ASUS introduces the Silent Knight II CPU Cooler for Quad-cores.
Embraco team up with Intel to Deliver a Mobile Refrigeration Cooling Unit
Jonathan Smith | 21st September 2007
Intel + Embraco = mobile refrigeration....
OC3D Exclusive: Alphacool is back
Matthew Fogg | 21st September 2007
In approximately nine days alpha-cool will be releasing a slew of revamped cooling hardware, some of which, OC3D has been given the opportunity to show you all.
BLAST FLOW Siberian Rev2 Modular VGA WaterBlock
Cases & Cooling | 11th March 2008
The Blastflow Siberian Rev2 VGA block is an universal modular waterblock designed to be compatible with both - Nvidia and ATI (now AMD) cards.
Cooler Master Cosmos S Case
Cases & Cooling | 24th February 2008
We take a look at Cooler Master's all-aluminium (well nearly) Cosmos S case
Yate Loon D12SL-12 120mm Case Fan Review
Cases & Cooling | 7th February 2008
With some fans from possibly one of the most respected cooling manufacturers in the world, we've set out to test the rumour
Aqua-Pcs Flow Performance CPU Block
Cases & Cooling | 4th February 2008
The Flow Performance CPU Block boasts not only great performance but great looks too. Today we gave it a workout in the OC3D Labs
OCZ Vendetta CPU Cooler
Cases & Cooling | 3rd January 2008
OCZ have released a couple of nice CPU coolers recently. We take a look at their latest and set our overclocked Intel Quad on it...
Aqua-Pcs Launches Water-Cooling brand "Flow"
Mike Reilly | 20th September 2007
In house liquid cooling specialists Aqua-Pcs have launched their own brand of Water-Cooling parts known as "Flow". Check inside for more information.
Noctua presents Xeon Mounting-Kit & NH-U12F Xeon Edition
Nic Crane | 19th September 2007
Noctua today announced the availability of
a new mounting kit for Intel Xeon processors as well as a new
Xeon-Edition of the much acclaimed NH-U12F and NH-U9F coolers.
cuplex XT di outclasses competitors
Matthew Fogg | 19th September 2007
World´s best watercooler for actual and coming Dual- and Quad-core processors comes from aqua computer!
OCZ Release the Vendetta
Matthew Fogg | 14th September 2007
OCZ Technology Introduces the Innovative, High-Performance Vendetta to its Lineup of CPU Cooling Solutions
Scythe announces Ninja Mini CPU Cooler
Nic Crane | 13th September 2007
Scythe announces the mini version of its popular fanless CPU Cooler, Ninja Mini CPU Cooler.
OCZ Technology Unveils the Vanquisher CPU Cooler
Jonathan Smith | 31st August 2007
OCZ Technology Unveils the Extremely Efficient yet Compact Vanquisher CPU Cooler.


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Archive - Mar 2013
New home BUILDING HISTORY in downtown WilmingtonSubmitted by Chris Phillips on Fri, 03/15/2013 - 2:52pm.READ MORE:
New history is under construction in downtown Wilmington. Our Alicia Ross of Kitchen Scoop has been cooking up some plans for a new house in the historic district. Full story...»
Dalton picked as NC community college presidentSubmitted by WWAY on Fri, 03/15/2013 - 2:40pm.READ MORE:
Full story...»
Easter Bunny makes early visit to Fit for FunSubmitted by Jayne Dees on Fri, 03/15/2013 - 2:02pm.READ MORE:
Easter arrived early at Wilmington's Fit for Fun Center. Kids five and under took part in an egg hunt this morning. Full story...»
McSwain steps down as Ashley hoops coachSubmitted by John Rendleman on Fri, 03/15/2013 - 12:45pm.READ MORE:
Ashley High School basketball coach Bryn McSwain has resigned as the boys basketball coach after five seasons on the job. The Screaming Eagles recently wrapped up a 17-9 season. Full story...»
Chad Adams leaving The Big TalkerSubmitted by WWAY on Fri, 03/15/2013 - 11:27am.READ MORE:
Conservative talk radio host Chad Adams is leaving his morning show at The Big Talker FM. Adams has hosted "Mornings with Chad Adams" since 2010. In addition to his radio work, Adams has been a familiar face to WWAY viewers as a guest political analyst. Full story...»
CFCC to hold informational session in Surf City SaturdaySubmitted by WWAY on Fri, 03/15/2013 - 9:26am.READ MORE:
Full story...»
Brunswick Co. manager heading to GreensboroSubmitted by WWAY on Fri, 03/15/2013 - 8:45am.READ MORE:
Full story...»
Driver charged with DWI after car hits houseSubmitted by WWAY on Fri, 03/15/2013 - 8:29am.READ MORE:
Wilmington Police charged a driver with DWI after they say he crashed his car into a house early this morning. Full story...»
Tournament Hoops! NC State men advance & UNCW women move onSubmitted by John Rendleman on Thu, 03/14/2013 - 11:56pm.READ MORE:
Full story...»
Wrightsville Beach says no to Joe's Crab ShackSubmitted by Christina Anthony on Thu, 03/14/2013 - 11:22pm.READ MORE:
Joe's Crab Shack possibly coming to Wrightsville Beach has been a hot topic for a couple of months in the town. Tonight, the Board of Aldermen met at Town Hall while Joe's Crab Shack pitched its plans to build near Johnnie Mercer's Pier. The result: Joe's Crab Shack will not open a location at the pier. Full story...»


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praying hand© indomercy - See portfolio
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["art","background","belief","believe","bible","blue","body","catholic","christ","christian","christianity","church","clasped","faith","faithful","finger","gesture","god","hand","heaven","holy","hope","human","isolated","jesus","love","meditation","old","peace","people","pray","prayer","religion","religious","reverence","ritual","sign","silhouette","spirit","spiritual","spirituality","symbol","symbolic","together","white","women","worship","young"]art background belief believe bible blue body catholic christ christian christianity church clasped faith faithful finger gesture god hand heaven holy hope human isolated jesus love meditation old peace people pray prayer religion religious reverence ritual sign silhouette spirit spiritual spirituality symbol symbolic together white women worship young See all keywords
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Atom feed of these results
Former economy editor for Bloomberg News Christine Spolar has been named as the Financial Times' first investigations and special projects editor
New journalists: This archived Guardian Careers' Q&A session is a useful starting point for budding journalists. Tipster: Laura Oliver. To submit a tip to Journalism.co.uk, use this link - we will pay a fiver for the best ones published.
Staff will get a 3% pay rise for 2011, a £1,000 bonus and are being offered a £300 subsidy toward an iPad or other tablet
Tips on improving your CV when looking for a job in the media
Regional publisher has joined forces with City College Norwich to offer the new journalism degree, starting next month
Extension to the company's multi-million dollar tax break deal approved despite opposition by the Newspaper Guild of New York
Jobs: To keep track of the latest jobs advertised on Journalism.co.uk, subscribe to Ed Martin's posts on the Editors' Blog. Tipster: Laura Oliver. To submit a tip to Journalism.co.uk, use this link - we will pay a fiver for the best ones published.
Tucker will leave in January having seen the newspaper win several industry accolades under his editorship, including the 2009 Regional Newspaper of the Year
The paper today confirmed it will move to weekly publication from next month, with around five jobs at risk of compulsory redundancy
At Sheffield University, undergraduate employment was rated at 65 per cent, compared with a postgraduate figure of 90 per cent
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AIDS Risk Topping
Here's a taste of what TheBody.com has to offer on this topic:
Ask the Experts
Risk for UAI Top (RISK OF HIV AS A TOP, 2010) (ANAL MUCOUS, ANAL FLUIDS, RECTAL SECRETIONS, 2010)So I have a quick question: basically I ended up having sex with a man in his apartment. We went to his place and began to fool around. After mutual oral sex (without ejaculation), I placed my penis into his anus for about 6 seconds (both of which...
Response from Robert J. Frascino, M.D.
The Robert James Frascino AIDS Foundation...thrust! That your exposure was brief decreases your risk somewhat. HIV testing is definitely warranted. See below.Dr. BobRe: risk of HIV as a TOP May 15, 2010I've always been an exclusive top, a medical professional who couldn't believe you could... Read more »
can anal sex without bleeding can cause hiv (RISK OF HIV AS A TOP, 2010) (ANAL MUCOUS, ANAL FLUIDS, RECTAL SECRETIONS, 2010)hello doctor 1 week before i had anal sex without condom i was at insertive position but there was... Read more »
HIV Risk for a Top (WHAT YOU DONT KNOW CAN KILL YOU, 2010) ( IS IT BETTER TO GET HIV TESTED OR NOT TO KNOW, 2010)Dr. Frascino,I'm a 29 year-old male who was recently in Miami for work conference. I'm a total top... Read more »
HIV/AIDS and Diabetes: Minimizing Risk, Optimizing Care...and disorders of glucose metabolism in people with HIV/AIDS contains conflicting messages. Some studies indicate an increased risk of diabetes mellitus (generally referred to simply as "diabetes") in people taking HAART, specifically protease... Read more »
Beliefs About Transmission Risk and Vulnerability, Treatment Adherence and Sexual Risk Behavior Among a Sample of HIV-Positive MSM... Optimistic beliefs about HIV transmission risk and STD vulnerability that are generated by advances in HIV treatment can influence motivation to practice safer sex. The current Read more »
HIV Risk-Related Attitudes, Interpersonal Influences, and Intentions Among At-Risk Urban, Early Adolescent Girls...influences, and intentions. Girls in high sexual experimentation and risk groups scored highest on deviant peer norms; endorsements of risky behaviors; and inability to refuse unprotected sex, offset negative partner influences, avoid... Read more »
Risk Factors Driving the Emergence of a Generalized Heterosexual HIV Epidemic in Washington, District of Columbia, Networks at Risk...transmission a leading mode of acquisition and African-American women disproportionately affected," the study authors sought to examine risk factors driving the local epidemic using National HIV Behavioral Surveillance data from the District. In... Read more »
Connect With Others
Skin Abrasion on Penis / HIV Transmission Risk
Posted by Anonymous, 2 Replies...bleeding was present, yet I instantly panicked. Upon discussing it with the guy, he shared some concerning information about risky behavior, long-time refusal to test, and AIDS-related death of a partner. I sank into a severe period of HIV... Read more »
Potential HIV risks please help
Posted by 613, 3 Replies...OK, Just for clarification, I have considered taking an HIV test when I get my yearly physical here are my risks 1. Received oral sex from a woman in 2006 (unprotected) 2. fingered the same girl 3. touched blood of 2 different people at Read more »
Is this a HUGE risk for HIV infection
Posted by Anonymous, 2 RepliesReceptive anal intercourse that consisted of a couple of entries in and out and without ejacuation? Read more »
receiving oral sex and risk of Hiv
Posted by Anonymous, 1 Reply...or blood in her mouth nore on my penis after the incident but I was wondering even if some of those were present how much at risk would I be? how long should I wait to get tested. thank you guys for your help. Read more »
Resource Centers
Guides for People With HIV


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kitesurf & snowkite comps
Kitesurfing videos
Cosima Giemza, Steffen Elmer's and Jack Burr took a trip to Wakepark Thulba, in Germany. Watch their video packed with amazing cable action!
"GIVE & TAKE" is Manuela Jungo's latest video about her trip to the wonderful Guanaja, one of the Bay Islands of Honduras.
Alexei Bozhko is ripping in his latest video filmed in Muine, Vietnam. Watch the Ukrainian kitesurfer enjoying the good local conditions of this coastal town of the Southeast region of Vietnam.
Check out the cool trailer for Light Bros Creative's upcoming film, "Unite". Shot in Tarifa, Spain, it stars Wainman Hawaii team rider's Niccolo Porcella, Alvaro Onieva, Forest Bakker and Franz Orly.
Episode 16 was launched! It is a Christmas show featuring Aaron Hadlow, Christophe Tack, Karolina Winkowska, Youri Zoon, Sam Medysky, Ruben Lenten, Kevin Langeree, Steven Akkersdijk, Reo Stevens, Sam Light and James Boulding.
Every fall the team heads down to the Philippines to drop off the radar for a bit and focus on reinventing their riding.
Two beautiful girls on a trip to Brazil. Watch this video showing some of the best moments of the amazing kitesurf trip of Céline Rodenas and Liloo Gringa.
This video is about kitesurfing in the UK during winter season. Is was shot during the month of December along the S.Wales Coastline.
Some clips from Ramiro Gallart's trip to Brazil. Watch the young rider from Buenos Aires having fun in Cauipe.
Nice glimpse between the chaotic city life of Istanbul and the snowy and calm landscapes of Mount Erciyes. Starring Sedat Çelenk, this video catches the first snow of the season in Turkey.
Meet Adeuri Corniel, a 14 year old rider from Cabarete, Dominican Republic. Despite his young age, he shows a huge level and style.
Short clip featuring Manny Blanch and Kye Evans riding in Cotton Tree, Australia. Watch these young groms progressing and pushing each other on the water.


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Recommend a sage green
I am having trouble finding a nice soft sage green color for the walls in my livingroom, which is visible from the kitchnen and vice versa since I opened up the two rooms, and my cabinets are very dark. My pervious color was a light green but I felt was too "minty" a green and needed updating. I tried dozens of samples and finally decided on one, and painted three walls with it. Guess what? It looks just like the old color but with a touch of gray added. Better, but still a little too "minty" looking. It is Glidden's "China Rain" color that was matched for me.
Brand doesn't matter, although most of the stores locally carry swatches from Glidden, Behr, RL. I would need to go out of town to get BM cards but not too far, if they have a particularly nice one. If I can order cards online that would be fine, too. I just need to be able to obtain paint cards so I can see the color and have it matched if the paint isn't one I want use or not available locally.
I only want to paint this room so many times, so please help!
I looked at RH subtle velvet, part of the Bay Laurel collection, but samples are back ordered. Anyone by chance have a photo of a room done in this? Very difficult online, because the colors look so different. The online glidden China rain looks very gray online and not at all on the wall.
Have you looked at Ellen Kennon Paints? They are marketed as 'full spectrum' paints, but I don't know whether they are really any better than any other premium-quality paints. There are people on GW who swear by them, though, and there has been some lively debate about how great they really are. You order them online -- link is below. I ordered a full set of their swatched for something like $25.00 and would have used them for my bedroom that we just painted but they did not have the shade I wanted (I ended up using BM Aura in 'Soft Sky' and love it). They did, however, have several really nice sage-y greens and similar colors --you might try 'Gustavian Grey'. They are expensive but what isn't? I think its worth it to get a color you really love -- your are going to be living in it, after all. Good luck
Here is a link that might be useful: Ellen Kennon Paints
Green is such a tricky color to get right...because it changes more than any other from season to season. The green of the leaves on the trees outside reflects into the room and affects the color in summer...in autumn, if you have deciduous trees outside, the oranges and reds neutralize the green a bit, and so on...
And the sage greens are the hardest, I think. It is incredibly easy to suddenly find you have what we call the "VA Hospital Effect." Yick! Depressing...
It is much easier to use a green with more yellow in it, and head toward the olive shades (even in the paler values) to avoid the mint problem and still keep the neutral value that I think you want.
The only way to know is to see the color on your own walls, in your own daylight and lamplight!
Try going to the House Beautiful site, and see their interactive paint color testing thing...of course it won't be exact, but it can help steer you in a direction, and it's fun to play with, once you figure out how it works!
Pick a room to color, choose a white trim and ceiling...then for the walls, under "Classic Colors," look at "Shades of Spring" #537...in the Sherwin Williiams group, look at "Dancing Green" #6716, and under Valspar, look at "Fiddlehead Fern" 6003-6B.
Have fun!
Here is a link that might be useful: Paint Picker
BM Grecian Green is nice. Here is a link from the Decorating Forum.
Here is a link that might be useful: Brutuses Grecian Green
I bought the little sample jars of Benjamin Moore greens, probably about 8 of them before I finally picked one that would look good on all the different facing walls. I too have dark cabinets, and a dark countertop. Selected Saybrooke Sage. The sample bottles are nice, because you can paint a large enough swatch to really see the color, instead of taping up little cards.
This may seem obvious, but I didn't start doing this until recently: buy some white poster board and cut to a good size, like 2 feet by 2 feet. Then, paint your samples on that instead of painting the walls. You can move your sample from wall to wall and room to room, and you won't have to re-prime.
As I write this, I've got 3 different sage green samples on my kitchen walls and have to make a decision. The painters will be here 8 am Monday! The front runner in BM Saybrook Sage. I have a sample card of SW Clary Sage, which I think I like a little better. They're very close.
Wow, great suggestions so far, I like all of them! I love how the Grecian Green looks against the dark wood. I need to find somewhere online I think that I can order cards and sample for several of these. Esp. the SW and BM ones. Ellen Kennon Paints I have heard of and visited her website before, but I had forgotten about it. I have never seen a room done in those paints in person and don't know if it would make a big or difference or not. Now that I have a reminder in this thread, if the more easily available ones don't work I will get a sample of hers. Thank you, I never would have thought of her.
My sofa is Taupe with a lot of gray in it and I don't think greens with yellow in them would go very well with it, so it kind of limits my choices somewhat.
Mdmc, your kitchen looks gorgeous! I will certainly try to find that color to look at in person.
Thank you all for the suggestions. There are some really nice greens here, none of which I had seen locally. If you have others, please feel free to post, I will try to get all the samples I need from one brand of paint at one time.
Beautiful kitchen, thank you Novemeber, I have added that to my list. On my monitor it is reading only a slight green tint, but it is a hard color to catagorize. It looked yellowish until I realized it was the lighting in a couple of photos. That one I am definitely going to have to see in person to get a real feel for, I think. Its subtle. Very pretty. Thank you.
My bathroom is painted in Sherwin Williams' "Sagey", which is the perfect gray sage color. I have brushed nickel fixtures and gray tile accents, and it looks great.
One of my favorite green kitchens belongs to kmcg85. She used EK Edgewood Green. You can see her kitchen on the "green" post in the gallery.
Here is a link that might be useful: green post
I like the sages with brown underneath, like the BM Baby Turtle I have in much of my house. But here are a bunch of greens in the GardenWeb gallery and one might be for you.
Here is a link that might be useful: Decorating (Gallery)
We used BM Georgian Green taken down a notch using their pastel base. But I've also see BM Flowering Herbs and that is also very pretty. BM Flowering Herbs ended up looking too brown with the lighting in my kitchen. So it's really important to get samples and paint them onto your wall and look at them with day and night lighting.
My kitchen was painted yesterday in BM Nantucket Gray and I love it--just thought I'd throw that out to you since the name doesn't sound "green" yet it was the exact sage/beige/green tone I wanted.
Between my camera and your computer monitor, I'm not sure these photos are very helpful. The paint color is SW Clary Sage, very similar to BM Saybrook Sage--slightly darker and slightly less grey.
I'll post again when my kitchen is finished..hopefully in about a week.


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Bluffview Park Campground
When someone suggests that you go on a camping trip, do you cringe? Do you shudder at childhood memories of deflated air mattresses, sleeping on hard and rough ground (or not sleeping at all!), inedible food and never being warm enough? Well, put those memories behind you - camping has changed.
All it would take would be a few days at Bluffview Park Campground to change your mind and replace your old bad memories with great new ones. With activities like hiking, swimming and bird-watching at the ready, nature won't ever let you get bored. The only thing that's asked of you is that you leave things as you found them so the next visitors can enjoy everything you did.
It's important to note that the most popular cabins and campgrounds fill up fast, so check the availability at Bluffview Park Campground in Texas right away and book your trip today.
Browse USA Camping
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Browse Texas Campgrounds
- Blanco State Park Campground
- Fort Parker State Park Campground
- Meridian State Park Campground
- Overlook (Somerville Lake) Campground
- Mill Creek (Texas) Campground
- Eisenhower State Park Campground
- Goose Island State Park Campground
- Buckhorn Creek Campground
- Pecan Point Park Campground
- Sowell Creek Campground
- Purtis Creek State Park Campground
- Lake Whitney State Park Campground
- Airport Campground
- Lake Texana State Park Campground
- Cedron Creek Campground
- Walling Bend Campground
- Atlanta State Park Campground
- Monument Hill/kreische Brewery Campground
- Village Creek State Park Campground
- Oakland Campground


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Chief executives who draw $1 salaries tend to style themselves as team players making grand gestures for the good of their companies, but a study suggests the tactic is often little more than a PR stunt. One-buck bosses such as Apple's Steve Jobs, Oracle's Larry Ellison, and Whole Foods' John Mackey gave up an average of $610,000 in annual wages, the study found, but gained more than $2 million in stock options. "Rather than being the sacrificial acts they are projected to be, our findings suggest that adoptions of $1 CEO salaries are opportunistic behavior of the wealthier, more overconfident, influential CEOs," the study says.
View Full Article in:CNNMoney/Fortune
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Thought from Today's Old Testament Passage:
Chapter 2:11–13. The statement that they served Baalim (vs. 11) indicates that they worshiped localized Baal deities, thus the plural form im is used. Baal was a fertility god. He was looked upon as the chief vegetation god of the Canaanites and was thought to bring productivity to crops, animals, and men. He was also associated with the occurrences of weather and was usually depicted in Canaanite carvings as holding a lightning bolt in his hand. Thus, he is also called the "god of fire," indicating the significance of Elijah's challenge to the prophets of Baal (I Kgs 18). The Hebrew word ba>al means "master," or "lord." When the Israelites settled in Canaan, they soon discovered the local Baal deities were looked upon as the individual lords of the land. Thus, by worshiping him they were forsaking the lordship of their God for the lordship of Baal! The text also refers to their serving other gods … of the people among whom they lived. As they forsook the Lord, they … served Baal and Ashtaroth. The Hebrew ending ot is also a plural ending, indicating they worshiped localized Ashtar deities. These were multi-breasted female fertility deities, whose worship often included bizarre sexual practices. The Babylonian form of this deity was Ishtar, and the Roman form was Easter (whose fertility signs, interestingly, were a rabbit and an egg). (Jerry Falwell, exec. ed., Edward E. Hinson and Michael Kroll Woodrow, gen. eds, KJV Bible Commentary [computer file], electronic ed., Logos Library System, (Nashville: Thomas Nelson) 1997, © 1994)
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Is Muhammad the excellent example that all Muslims should follow? Do the verses in the Quran teach a religion of peace? When two passages in the Quran conflict, why is it that the intolerant and violent passages that Muhammad gave at the end of his life, supersede the peaceful passages he gave earlier? What is sharia law and why is it so dangerous to democratic


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Yes, I highly recommend staying at "The Backpack" You will get your monies worth - good vibes, friendly backpackers, safe and most of all fun place to stay. Also, everything is centrally located - long street, only 5 min walk. Secure car parking is available as well. Book and stay here, you won't regret it! My bed view was Table Mountain...
Tue 11 Nov 2014
Une petite surprise désagréable à l'arrivée de 200 euros supplémentaires par rapport au prix annoncé. Erreur réparée quand je suis revenu contester. Sinon rien à redire à cette auberge très bien organisée avec un personnel très agréable.
Wed 29 Oct 2014
Probably the best I ve ever been ( and i am a Long term customer9 Everything is absolutely perfect. only the bereakfast is a Little overprized compared to other places in CT 1! But Location and staff awesome!!!!!!!!
Sun 09 Mar 2014
Poor facilities for internet access! Speed of WiFi unacceptable.
Tue 17 Dec 2013
Sehr schöner Ausblick aus dem Familienzimmer auf den Tafelberg! Für Familien gut geeignet.
Wed 23 Oct 2013
The kitchen door banged multiple times during the night waking us up e ven through our ear plugs. Other than that everything was awesome.
Mon 23 Sep 2013


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do you khow if I could find some in Naples, Florida? If yes, tell me where. Thank you
First Friends The Friendly Pacifier
Ensure your childs comfort and security with one of these cute pacifiers that features a plush toy. In either pink, blue, or another color, a bunny, lamb, puppy, bear, pig, or cow, will please your child as he or she sucks this instead of his thumb.
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ITEM#: 14273344The First Friends The Friendly Pacifier combines a soothing pacifier with a plush toy to give the ultimate feeling of security and comfort to your child. The sweet Friendly Pacifier promotes self-soothing.
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Great alternative!
My son has fallen in love with another name brand animal pacifier. After going through so many this was a welcome change. PRO: interchangeable with the avent. CON: the Velcro doesn't stay.Read More
Our three month old nephew is so attached to his "binki dog" that we had to buy a second one. The first one needed to be laundered, but he became so upset when my sister took it away to be washed. She even tried to take it at night when he was sleeping, but he woke up looking for it. So now there is a backup for laundry time.Read More
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How does cold weather affect the nails?
The nail grows slower in cold weather and faster in warm weather because circulation is slower in the cold weather, causing a growth slow down. If there is damage to the matrix, the nail may be deformed (thickened, brittle, etc.). You will see the nail growing out from the matrix and may see some of these changes as the nail grows. I don't believe cold weather alone will damage the matrix and cause the nail to be brittle, unless there is some other health condition or trauma that may have affected the matrix along with the cold weather. — Dr. Dennis Arnold is head of the International Pedicure Association.
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CO poisoning and a bit of luck
homeboundSeptember 20, 2008
My neighbor sleeps in her cozy 600 sf finished basement with her child. Last night she heard something fall in the utility closet and sent me an email if I could come by today.
Turned out the hot water heater flue pipe fell off, leaving combustion gas spewing into the room. She has fire alarms, but no CO alarms. I'd say she was pretty darned lucky that she heard it, and that she's still around to talk about it.
How about that?


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Good quality 'whirpool'?
looking for a qood quality whirpool tub for a new install didnt initially want to default to the Jacuzzi lines. maybe that is the best bang for the buck out there --- $1-$2k is budget...
We have a Kohler Devonshire standard size whirlpool. Paid about $599 on sale at HD about 5 years ago. DH just said last night it was the best thing we did in remodeling our house. Works great and a reasonable price.
Check with some of the plumbing supply stores in your area & ask about floor model or warehouse stock they may have at a reduced price. We paid ~1/10 of the then current retail price for our tub as a floor model & we found that many of the plumbing houses buy "show models" from the manufacturers that they then sell at greatly reduced prices.
Hope this helps!
I went to shopping for a bathtub at Tubz, a store in Fremont, California with literally hundreds of tubs on display. Two different salespeople there recommended Jetta as the brand with the most bang for your buck. I don't have any personal experience with it, though.
A quick story about our Kohler tub. Went to a plumbing showroom where they showed my the devonshire. Said it was thier most popular because of good reviews. Their price $999. Drive home, get the mail, see an ad for Home Depot. Same exact tub on sale for $599 plus you get a $100 HD card if you buy another bathroom fixture. Bought the tub and the toilet we wanted. So I figuire I got the tub for $499, half the price of the showroom!
Shop around, don't be turned off by showroom prices.
sounds like a good deal on the kohler tub--- and maybe we are being too picky about some things--trying to dissect everything.....
have heard of the jetta as well - but not a lot of stores carry them - but think a few around here do...thx for the reminder


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House now on sale, so now is very messy and dirty. The sheets and towels were dirty, probably used by many other people before us.
I do not recommend it at all.
Jim es un fenomeno. Nos encontró en el pub del pueblo, donde entramos para preguntar como llegar al B&B, tomando unas pintas y se apuntó a tomarse una con nosotros.
El trato fue genial. El alojamiento es muy acojedor y muy cuidado. Jim es muy amable, muy simpatico y muy bromista.
Recomendable 100%.
Un sobresaliente para Jim.
We liked very much to stay at Jim´s place. Jim was very friendly and helpful, we liked his Irish humour and also his lovely little dog. :-)
He picked us up from the bus station several times which was great because otherwise we would have had to go through the darkness with all our stuff..
We can warmly recommand Jim as a host, the only thing is that you should know when the buses are going or even better: bring your own car as Galway is a bit away from Kilreakle.
Jim is a very friendly and knowledgeable about the area and beyond. He was very helpful in trying to find us information to get to Aran Islands and back. The rooms were large and airly, and the mattress was good. The house being a good way off from the main road, it was very quiet at night. With a very reasonable rate, this is a good B&B to explore the beautiful region. Jim also had a few bottled water in the fridge for us to take with us for excursion. Pitty that we did not have a longer time to explore the area more.
Our stay at Jim's was amazing; he was so welcoming and opened his home to us which was nice. The accommodation is first class; very spacious, quiet and clean.
He sent us off to the local pub where we were welcomed to join in an anniversary with Irish band and Guinness. This is a really nice stop over but also a good base to undertake trips from as it is very central. Jim showed us a little bit of middle Ireland and we are glad we crossed Jim's path. We will return. Sandra & Njoku, Brighton.
L'endroit bien qu'un peu isolé est très agréable. L'accueil est très bon comme les petits déjeuners. Le wifi était en panne mais notre hôte nous a proposé son ordinateur sans problème.
Jim is a wonderful host, ready to help people!
the house is very big and very confortable.
it was not the easiest to find, but Jim was all the time available to tell us the way.
Nice place to stay near Galway, and not far from Connemara!
Staying with Jim was great. Our trip to Ireland didn't start off to great though, we got in a car accident the first day we were there :( But Jim was great and picked my son and I up and brought us to his beautiful home. He showed us to our room and even gave Grady some toys to play with. He cooked us an amazing Irish breakfast the next day. I wish I could have that breakfast every morning!! I would recommend Jim to anyone.
Jim could not have been a better host. We thoroughly enjoyed life in small town Ireland. We went to the two pubs each night. Each had unique character. The food Jim cooked was phenomenal. I would highly recommend staying here.


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In the name of build diversity, I'm releasing this for public consumption.
Preface: One day, I was doing my uber runs, the 2 ubers are stunlocked, and i'm here clicking away, my fingers totally sore, will these ubers die first or will my fingers give in first? They pose absolutely no threat, just need someone with mega dps to kill it, how can i build a SUSTAINED high dps build? And thus, UberDeath is born...
The build is quite simple, pick the highest dps spell, stack all the dps increase elements together, and there you have it... UberDeath.
Living Lightning - Best spell to build up Arcane Dynamo, if placed correctly, ONE casting of this spell can build you 5 stacks of Arcane Dynamo.
Arcane Torrent - DeathBlossom, highest dps spell, it's not as random as you think, if you stand next to your target, they're guaranteed to get hit.
Sparkflint - 1.12 dps
Forceweapon - dps, or magic weapon for leech. 1.15 dps
Defense utility - either teleport or diamond skin
Armor - pick one that suits you best. force, prismatic, pinpoint, power of storm if you're lacking -AT cost.
Arcane Dynamo - 1.75 dps
Glass Cannon - 1.15 dps
optional passive - blur or unstable anomoly for defense, astral presence if you lack -AT cost.
Gear requirement
Stone of Jordan with -5 Arcane Torrent cost. 1.3 dps
One other piece of minus Arcane torrent cost. (helm, ring, amulet)
1 piece of Arcane power on crit.
With this setup , you can channel AT indefinitely.
Lets do some math:
670%*1.15*1.12*1.15*1.75*1.3 = 2257% weapon damage
At 140k paper dps, i'm seeing up to 800k crits. The missles fill the screen fast, it's not unusual to hit a small target(fallen imp) 3x per second.
The bigger they are, the harder they fall
Here's how Death Blossom works, random missles fly out in immediate area around you, if it misses a target, the next missle is more likely to hit a target. So after a while(this period is shorter than you think), the missles become homing. So if a target is big, and most bosses are huge, they're much more likely to be hit by death blossom, maximizing the dps output. Each missle does a small AE splash.
Consider this picture
X Uber1 X Uber2 X
X = Arcane torrent blasts
The X in the middle will hit both bosses, and the side blasts will hit once. Which translates into 4x dps on top of 2257% multipler.
Max DPS on boss fights.
You need to be right next to mobs and you're a squishy glass cannon
Need to team with CM stunlocker for max benefits.
Here's a fun solo/grp DeathBlossom build that I used back in 1.04, at one point i was using this over my beloved archon!
Kill trash with calamity and arcane hydra, kill packs with Blossom.
Edited by eLINminator#1776 on 11/13/2012 11:03 AM PST
The issue is that with Ghom/Rakanoth you can't stand in the death poison, and you can't switch it out after them because you'd lose stacks. I just use ray of frost. I see 8-900k crits with that too. I do use Arcane Dynamo and I use magic missile to build it up. With decent ias it happens pretty fast. Not to mention that seeker is actually decent DPS on its own.
if i do my initial 'capture' perfectly, there's only 1 cloud, and after they're locked, there are no more clouds. so there's plenty of room to maneuver yourself. even if i screwup, the room is not completely filled with clouds , there's usually a tiny bit of space open where you can squeeze in to dps and not get hit by clouds. just need to find the right angle. losing stacks is not a problem because you can fill it right backup with living lightning.
ray of frost is nice but it's only single target. if you get 800-900k crits with RoF, you'd probly get 1.5m-2m crits with blossom.
Posts: 4,047View profile
My version of a Uber killer build whilst other CM freeze wizards are doing the dirty work.
f i do my initial 'capture' perfectly, there's only 1 cloud, and after they're locked, there are no more clouds. so there's plenty of room to maneuver yourself. even if i screwup, the room is not completely filled with clouds , there's usually a tiny bit of space open where you can squeeze in to dps and not get hit by clouds. just need to find the right angle. losing stacks is not a problem because you can fill it right backup with living lightning.
Oh I was talking about Valor stacks. But I see where you're going. My CM friend tanks ghom/raka very well but there's usually still too much poison. I'm going to try this out though. I'll let you know how it works for me.
SteelPhantom #1820
Posts: 5,374View profile
what about using arcane torrent-disruption and arcane hydra, should be a good boost for both u and the cm wiz
also i find disruption has decent ap returns if u have over 50cc and 30 apoc. u cant miss tho, which shouldnt be a problem with frozen ubers
Edited by SteelPhantom#1820 on 11/1/2012 11:06 AM PDT
disruption is a 15% increase, even multiplied by 4 is 60%
blossom is like 300% increase, this increase is more dramatic since you alrdy stacking other attack multipliers.
Ahwqtdfbajkq #1433
Posts: 45View profile
I changed my passive GW (Galvanizing Ward) to AD (Arcane Dynamo)...
I have to say this:
Wow, just wowwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww
I was doing 100k base and 500k crits before AD
And now my damage base is 150k and crits are 800k! Sickkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk! What kind of sorcery is thissssssssssss!
I didn't knew that AD works with AT (Arcane Torrent). But you have to keep channeling or you will lose the buff of AD.
Thanks for the tip!
By the way, I'm not using SF (Sparkflint) or GC (Glass Cannon). I lose too much survivability to do MP8. But I'm going to try MP6 below ;)
glad you found it useful, hope more people would try this out and see the power of the Blossom!
let me know if anyone wants to try this out, i can run either cm or UberDeath.
Posts: 2,595View profile
cool, interesting build.. too bab i can't even try it without buying apoc gear n other arcane torrent items.
it would be mad if arcane dynamo also worked with archon. :)
Posts: 684View profile
I used a variation of this build with Time Warp and Duplicates instead of Sparkflint and Prodigy as my third passive to regain AP (no AP reduction gear required in that case). It is fun to use especially with decent eHP and life regain abilities. Unfortunately it isn't that great for regular farming because your dps output drops by a huge amount when fighting single targets with small hitboxes or fast kiters.
Edited by Elexar#2219 on 11/12/2012 10:50 PM PST
Dunno if this build is better than Ray of Frost for single target killing....
With Ray of Frost you can use Cold Blooded which further increases damage by 20%...
I used it on a Uber Run in a setup almost exactly like yours, and my Ray of Frost was neting 500-600K damage per tick... or about 1.2 millions a second... and I could channel it from a much more safe position than you would cast Arcane Torrent.
also, if you use Storm Armor with power of the storm and Diamond Skin with Prism and a 2 hander, you can cast Ray of Frost indefinidely without any other gear requirement :P
Posts: 92View profile
My guess is you shall need quite decent attack speed for the Living Lightning.
I've tested it with my pretty low aps (around 1.7) and it's slow as hell.
I may try Piercing Orb instead.
Otherwise the build is quite nice, I'll give it a try.
I just use ray of frost. I see 8-900k crits with that too.
Never seen RoF crit really, maybe you've taken Familiar hits for RoF?
Posts: 66View profile
The best build of Wizard for Uber run is obviously CM because people rather choose DH for pure DPS, and CM wiz makes the run so much easier for everyone else.
Did MP10 a bunch of times, everyone was saying I made it much easier.
This is the Build I use for Ubers, not the one on my profile probably since I use Meteor for farming:
Replace Magic Weapon with Stretch Time if you need more Attack Speed. And I know some people prefer Storm Armor or Energy Armor, but the beauty of Ice Armor Crystallize is not only you can get up to 60% armor bonus (which is more important in my opinion since you're supposed to dodge all the elemental damages) but also in case you lose one of the bosses, you can just go chasing the kiting one(e.g. Zoltun) and leave the other one alone. And when the other one(most of time SB in my case) comes to attack you, 9/10 times he'd get immediately frozen plus now both of them are in the perfect position which makes your job so much easier.
Edited by hys17#1805 on 11/13/2012 10:26 AM PST
this build is optimized for uber fight, where there are two huge bosses on screen.
RoF wont even come close to this in terms of dmg.
vs Single target, i'm not certain, but I think blossom will still come up on top, simply due to higher base dmg. 670% vs 215%
The only case that I see RoF being better is it's "safer" to use , you can shoot from far away. where as my build , you need to be upclose near the mobs .
this build is optimized for uber fight, where there are two huge bosses on screen.
Well, the 670% weapon damage isn't per projectile... is per cast... each cast releases more than 1 projectile and even against ubers it's HARD to hit all of those....
you only have full 670% weapon damage if EVERY projectile hits... and that's not possible....
RoF does 280% weapon damage with the proper rune after about 2 seconds... it benefits from Cold Blooded which upgrades this further 20%... every other multiplyer is the same.
Well, That being said, if your Arcane Torrent hits more than half Projectiles it fires then it does more damage than RoF... that's right.
Dunno for sure if in the long run it's more effective killing Ubers....
Anyway, I like those Arcane Torrent builds... they're fun. lol
ChuckTaylur #1143
Posts: 139View profile
Well, the 670% weapon damage isn't per projectile... is per cast... each cast releases more than 1 projectile and even against ubers it's HARD to hit all of those....
+1. I did a few runs replacing Shocking aspect with Death blossom. I saw that the DB hits were only criting at ~280k which was a lot less than 670% of my sheet dps.
Posts: 70View profile
You can have any build against Uber with tank but no build other than CM can solo uber efficiently I think.
Wantt to switch back to Monk now. Spend so much on Wiz and gear for cm/ww is too crazy expansive espeically Chantodo
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text:
In a method for sclerotherapy for treating varicose veins, a flushing solution, such as sterile saline solution, is initially injected into the vein or vessel being treated. The flushing solution displaces or flushes out blood from the treatment site of the vessel. A sclerosing agent is then injected into the treatment site. The displacement of blood before introduction of the sclerosing agent reduces complications. A syringe assembly useful for performing the method has first and second reservoirs sealed off from each by an end cap. The end cap is removed just before use. A needle is attached and is connected to both reservoirs. Flushing solution is delivered from the first reservoir followed by sclerosing solution delivered from the second reservoir, without removing the needle from the vessel.
1. A method for performing sclerotherapy on a human, comprising the steps of:
flushing blood out of a blood vessel of the human by injecting a sterile solution into the vessel, at an injection site; and
then injecting a sclerosing solution into the blood vessel at the injection site.
2. The method of
3. A method for treating a spider vein or a varicose vein of a patient, comprising the steps of:
visually locating a treatment site on the vein by viewing the vein through the skin;
piercing a needle through the skin of the patient and into the vein;
flushing blood from a section of the vein, by injecting a sterile flushing solution into the vein, through the needle; and
injecting a sclerosing agent solution into the blood vessel, through the needle.
4. The method of
5. The method of
6. A device for use in treatment of spider and varicose veins, comprising:
a first syringe containing a sterile solution;
a second syringe attached to the first syringe and containing a sclerosing agent;
a single hypodermic needle having a delivery port connecting to both the first syringe and the second syringe.
7. The device of
8. The device of
9. The device of
10. The device of
11. The device of
12. The device of
13. The device of
14. A device for use in treatment of spider and varicose veins, comprising:
a first reservoir containing a sterile solution;
a second reservoir containing a sclerosing agent; and
a single hypodermic needle having a first bore and a second bore connecting respectively to the first reservoir and the second reservoir.
15. The device of
16. The device of
17. A syringe assembly comprising:
a first reservoir having a first outlet connecting into an end tube;
a second reservoir having a second outlet connecting into the end tube; and
an end cap on the end tube separating the first outlet from the second outlet.
18. The syringe assembly of
19. The syringe assembly of
20. The syringe assembly of
[0001] The field of the invention is sclerotherapy. More specifically, the invention relates to the treatment of spider and varicose veins via sclerotherapy. The invention further relates to a novel syringe assembly useful in sclerotherapy, as well as in other medical applications.
[0002] Spider veins or telangiectasias of the legs are common conditions, especially among women. With this condition, small dark-colored veins form on the legs, just underneath the skin surface. These types of veins can form anywhere on the legs between the thigh and ankle. They often have a web or sunburst pattern, but may also be formed as short, somewhat random line segments. In many cases, spider veins are largely unnoticeable, when localized in a small area. However, when larger areas of skin are affected, spider veins can be perceived as having a detrimental appearance on the skin.
[0003] Varicose veins are larger veins, in comparison to spider veins. Varicose veins may protrude or be raised above the skin surface. They typically have a blue or purple color. A varicose vein generally contains stagnant or refluxing blood, which is out of circulation. Consequently, a varicose vein no longer functions to channel blood flow back to the circulatory system or the heart. Larger veins have valves which maintain blood flow in the forward direction. If the valves fail, blood accumulates under pressure, causing the veins of the leg to engorge. These varicose veins often appear as bulging, and have a rope-like or thread-like appearance. In more severe cases, these vascular disorders can result in aching, throbbing, swelling, or other conditions requiring medical treatment. Moreover, many patients having varicose veins, even without these symptoms, become distressed by the appearance of the varicose veins. Consequently, various treatments have been developed for both medical and cosmetic reasons. These treatments include surgery for severe cases, as well as sclerotherapy, typically used for smaller varicose veins closer to the skin surface. In the past, sclerotherapy has been performed by injecting a sclerosing agent into the vein. This non-surgical procedure destroys the varicose vein by irritating the vein wall, and causing the vein to close up. Procedures using ultrasound, or an electrosurgical electrode in combination with sclerotherapy have also been proposed. In general, sclerotherapy is a proven, safe, and effective technique.
[0004] Notwithstanding the successes of sclerotherapy, complications can occur with these treatments. One such complication is ulceration. This complication results when a sclerosing solution is inadvertently injected intra-dermally or into surrounding tissue, rather than into the intended injection site in a vein. The sclerosing solution delivered outside of the vein can cause ulceration of the skin and surrounding tissue. As it may be difficult to consistently position the needle into the vein, this type of ulceration is a common complication. Hyperpigmentation is another complication. This complication results due to leakage of a blood component, hemosiderin pigment, from the damaged blood vessel or vein. Another complication is mat-like telangiectasia, which is the appearance of new, small blood vessels. Mat-like telangiectasia is believed to result from injection of an excessive amount of sclerosing solution.
[0005] Accordingly, it is an object of the invention to provide improved methods and devices for treating spider and varicose veins via sclerotherapy.
[0006] In certain medical procedures, it is advantageous to be able to inject different solutions into a single injection site, either simultaneously, or sequentially. Currently, this generally may require two separate injections. As a result, the two injections may not be located at the same location. In addition, two separate injections requires more time to provide, consumes more syringes and needles (generating more medical waste), and causes more pain and risk of infection to the patient.
[0007] Accordingly, it is also an object of the invention to provide a novel syringe assembly useful for injecting two separate solutions in a single procedure.
[0008] To these ends, in a first aspect, a method for treating a spider vein or a varicose vein via sclerotherapy includes injecting a flushing solution into the vein, to flush out blood from the section of the vein treated. A sclerosing solution is then injected into the blood vessel. The flushing solution and sclerosing solution are preferably injected from a single hypodermic needle. This allows both the flushing and sclerosing solutions to be injected sequentially at the same location and via a single injection or piercing of the skin and vein.
[0009] In a second aspect of the invention, a syringe assembly for providing sclerotherapy has two separate reservoirs, chambers, or syringes. The first reservoir contains a flushing solution, preferably sterile saline solution. The second reservoir contains a sclerosing agent. A needle is attached at one end of the syringe assembly. Both reservoirs are connectable into the preferably 30-gauge needle. Each reservoir has a separate plunger.
[0010] In use, in a third aspect of the invention, the needle is positioned in the vein or vessel to be treated. The plunger in the first reservoir is pressed, injecting the flushing solution into the vessel. Blood is flushed or displaced from the injection site. The second plunger is then pressed to inject the sclerosing agent into the vessel. By flushing the blood from the vessel, prior to injecting the sclerosing solution, the potential for blood leakage is greatly reduced. In addition, flushing the vessel with saline reduces the need to inject excessive amounts of sclerosing solution, thereby minimizing the potential of the mat-like telangiectasia complication.
[0011] In a fourth aspect of the invention, the potential for inadvertently causing skin ulcerations by injecting a sclerosing solution at an improper location is reduced or eliminated. A sterile saline or other flushing solution is injected first into the injection site. The physician visually observes the injection site. If the vein disappears or tends to fade from view, the needle is properly positioned in the vein, and has flushed out the blood. The sclerosing solution is then injected into the same site via the same needle, without withdrawing the needle from the site. On the other hand, if the vein appearance remains largely unchanged after the flushing solution is injected, the physician then has a visual indication that the needle is not properly positioned in the vein. The needle is then withdrawn and relocated, and the visual observation procedure is repeated. This method avoids inadvertent injection of sclerosing solution into tissue outside of the vein, and the potential complications, such as skin ulcerations, which may accompany such events.
[0012] In a fifth and separate aspect, a novel syringe assembly has two separate reservoirs connecting to a single needle. The liquid contents of the two reservoirs are separated from each during storage. Consequently, the syringe can be advantageously pre-filled with two different injectant solutions, and then optionally sealed in a package until use. The liquid contents are contained or sealed within the reservoirs by a plunger seal on a plunger towards the back end of the syringe assembly, and by an end cap or closed off needle at the front end. In use, an end cap is removed from the syringe assembly and a needle is attached, with the bore of the needle connecting into both reservoirs. Alternatively, a needle may be attached to the syringe assembly during or after manufacture, and no end cap is used. A needle tip protector/seal may optionally be pushed on to the tip of the needle, to avoid piercing packaging and needle stick incidents, and to prevent leakage from the reservoirs. The syringe assembly provides for improved sclerotherapy procedures, and may also be used for other procedures as well.
[0013] Other and further objects and advantages will appear. The invention resides as well in subcombinations of the methods and devices shown and described.
[0014]FIG. 1 is a perspective view of a syringe assembly for use in sclerotherapy, with a needle attached to the syringe assembly.
[0015]FIG. 2 is a section view taken along line 2-2 of FIG. 1.
[0016]FIG. 3 is enlarged perspective view of the end section of an alternative syringe design.
[0017]FIG. 4 is a perspective view of the syringe assembly of FIG. 1 with an end plug attached to the syringe assembly.
[0018]FIG. 5 is an enlarged perspective view of the end tube and end cap shown in FIG. 4.
[0019]FIG. 6 is an enlarged perspective view of the cap shown in FIGS. 4 and 5.
[0020]FIG. 7 is a side view, in part section, of an end cap on the end tube.
[0021]FIG. 8 is a schematic view of the needle shown in FIG. 1 or 2 inserted into a vessel or vein.
[0022]FIG. 9 is an enlarged partial section view of an alternative syringe assembly similar to the syringe assembly shown in FIG. 7, and having an end tube divider plate extending from the reservoir outlets to the front end of the syringe assembly.
[0023]FIG. 10 is a perspective view of an alternative end cap for use with the syringe assembly shown in FIG. 9.
[0024] The invention provides sclerotherapy methods having reduced risk of complications. The methods involve flushing or displacing blood from the vein or vessel, before injecting a sclerosing solution into the vessel. Injection of a clear flushing solution, such as sterile saline displaces blood from the vein. The vein can then be difficult or impossible for the physician to see. Consequently, injecting the sclerosing solution through the same needle, at the same injection site, avoids the need to find the vein, after the flushing solution is injected. Consequently, the methods are more advantageously performed using a syringe assembly which can deliver both solutions with a single injection, through a single needle. This reduces the number of injections required. In addition, it ensures that the flushing and sclerosing solutions are injected at the same location, while avoiding the difficulties of finding the vein after injection of the flushing solution.
[0025]FIGS. 1 and 2 show a preferred syringe assembly for performing the methods described. As shown in FIG. 1, the syringe assembly 10 has a body 12, preferably formed as a single molded plastic unit. The body 12 includes first and second barrels, chambers or reservoirs 14 and 16. A first plunger 18 having a first end seal 22 is slidably positioned within the first reservoir 14. Similarly, a second plunger 20 having a second end seal 24 is slidably positioned within the second reservoir 16.
[0026] The first plunger 18 has a first cap 26 and the second plunger 20 has a second cap 28. The caps 26 and 28 are D-shaped, so that they can pass by each other. In use, the positions of the end caps 26 and 28 also provide a convenient visual and tactile indication of the relative volumes of fluids injected. For example, when they are aligned, the user knows that equal volumes have been injected. A hollow end tube 34 extends from the bottom or front end of the body 12. A bore or opening 36 in the end tube 34 connects into the first reservoir 14 through a first outlet 30. Similarly, the bore 36 in the end tube 34 also connects to the second reservoir 16 through a second outlet 32. The outlets 30 and 32 connect the reservoirs 14 and 16 directly into the bore 36. No valves or other flow control features are needed or used in this embodiment.
[0027] A hypodermic needle 38 having a needle bore 40 is attachable to the end tube 34 using e.g., a Luer fitting. Of course, other types of needles and fittings, bayonet, screw threads, etc., may also be used. A finger flange 42 is advantageously provided at the back or top end of the body 12. The first reservoir 14 is preferably filled with a flushing solution 50, preferably sterile saline solution. The second reservoir 16 is preferably filled with a sclerosing solution 52. The sclerosing agent may be sodium morruhate, sodium tetradecylsulfate, polilocanol, chromated glycerine, polyiodine iodine, hypotonic saline, Lauromacchogal, Abtysisclerol or other known sclerosing agent, in solution.
[0028] The syringe assembly 10 may advantageously be pre-filled with the solutions 50 and 52, with an end cap 62 on the end tube 34, to prevent leakage during shipment and storage, and to maintain sterility. An over package, envelope, or container 90, may optionally be provided, enclosing the syringe assembly 10, to further maintain sterility of the reservoir contents. With the reservoirs 14 and 16 filled, the plungers 18 and 20 are fully withdrawn. FIGS. 1 and 2 show the plungers at intermediate positions, for purposes of illustration. As shown in FIGS. 5-7, the end cap 62 has plugs 64 and 66 on a neck 68. The cylindrical body 70 of the end cap 62 surrounds, and is spaced apart from the neck 68 via a gap 72. The neck is attached to the front end or surface 74 of the end cap 62. The end cap 62 makes a friction fit onto the end tube 34, with the end tube 32 sliding into the gap 72. The plugs 64 and 66 move into and plug the outlets 30 and 32. Consequently, with the end cap 62 in place, the contents of the reservoirs 14 and 16 are sealed from the environment, and from each other. Providing the syringe assembly 10 as a prefilled unit avoids the need for the physician to separately fill the reservoirs.
[0029] Referring to FIG. 2, although there is a direct connection between the first and second reservoirs 14 and 16 and the bore 36 in the end tube 34 via the first and second outlets 30 and 32, the outlets 30 and 32 are plugged by the plugs 64 and 66 during storage. Any mixing between the solutions 50 and 52 after the end cap 62 is removed and the needle 38 attached, is inconsequential due to the relatively small size of the outlets 30 and 32, the flow characteristics through the syringe assembly, and the short duration of use of the syringe assembly after the end cap is removed. As no valves or other flow control devices are needed in this embodiment, injection of the solutions 50 and 52 is quick and simple. The syringe assembly itself is also a simple and inexpensive design.
[0030] As shown in FIGS. 9 and 10, in an alternative syringe assembly 90, an end tube divider 92 extends from the outlets 30 and 32 to the very front end surface 95 of the end tube 98. This divides the end tube 98 into two separate bores 94 and 96. The end tube 98 preferably has a slightly tapering or conical outside wall. The end cap 100 shown in FIG. 10 has a complimentary inner wall 102. When the end cap 100 is pushed on to the end tube 98, it remains in place via the mating of the complimentary tapered surfaces and friction. The bottom end 105 of the end cap 100 contacts the front end surface 95 of the end tube 98 and seals off both of the separate bores 94 and 96. This prevents leaking or mixing of the contents of the reservoirs. A resilient end cap pad or disk 104 may optionally be attached to the bottom surface of the end cap, to help seal the ends of the bores 94 and 96 when the end cap 100 is installed. The plunger seals 22 and 24 seal off the back end of the reservoirs.
[0031] The syringe assembly may also be used to store and/or inject other combinations of solutions. In one such embodiment, the first reservoir contains a heparin solution and the second contains a saline solution.
[0032] The needle 38 is preferably a 30-gauge needle. The needle preferably has a single lumen or bore 40 which connects to the outlets 30 and 32. This allows the single needle to deliver both solutions, while having a small diameter, and piercing only a small opening in the skin and vein. The needle 38 may be made part of, or be provided already attached to, the syringe assembly, with the syringe assembly/needle combination optionally provided with the package 90. As shown in dotted lines in FIG. 1, a needle cap 45 may be pushed or attached on to the tip of the needle. The needle cap helps to prevent piercing of the packaging, needle stick incidents, and leakage of the contents of the reservoirs out through the needle bore. The needle cap 45 may be resilient or rubber material. As the outlets 30 and 32 are both open into the bore of the needle, with this design, the contents of the reservoirs, over sufficient time, may diffuse into each other. If such diffusion must be entirely prevented, then the end cap 62 is installed in place of the needle, and the needle is installed only just before use. Alternatively, a needle 41 having two bores 40 may be used, as shown in FIG. 3, and with each bore separately connecting only to one of the reservoirs. With this design, separate flow paths from the outlets and through the tube 34 and needle 41 to the needle tip 43 are provided. Hence, in most ordinary uses any mixing of the solutions before injection is prevented, even with the needle attached to the syringe assembly during manufacture. However, the dual bore needle 41 necessarily requires a diameter larger than the single bore needle 38. The needle cap 45 can be used on needle 41 as well. The syringe assembly 10 shown in FIGS. 1-2 and 4-7 is used by removing the end cap 62 and attaching the needle 38 to the end tube 34. The design concepts described above may also be applied to a syringe assembly having three or more reservoirs.
[0033] Referring to FIGS. 2 and 9, as there is an open pathway between the outlets 30 and 32, either in the end tube 34, or within the bore of the needle, in rare situations, inadvertent mixing of the contents of the reservoirs may occur. Specifically, if flow through the needle bore is restricted, and the sliding friction of the plunger end seals 22 and 24 is sufficiently low, and if one of the plungers 18 or 20 is rapidly pushed in, then some liquid may flow from one reservoir into the other reservoir, causing inadvertent mixing. When this occurs, pushing on one plunger, e.g., 18, causes the other plunger 20 to move back out of the reservoir 16.
[0034] This result can be avoided in several ways. One way is to have the needle bore diameter (the I.D. of the needle) be larger than I.D. of the outlets 30 and 32. This will generally result in a flow resistance or pressure drop of flow through the needle bore, that is substantially less than flow resistance through either outlet 30 or 32. Hence liquid flowing out of outlet 30 will not flow into outlet 32. Typical hypodermic needles used with the syringe assemblies 10 or 90 range from Gauge 35 to Gauge 16. Gauge 35 has an O.D. of 0.012 and an I.D. of 0.006 inches. Gauge 16 has an O.D. of 0.065 and an I.D. of 0.053 inches. The bore diameters in this range are then nominally 0.006-0.013 inches. Accordingly, if the outlets are 0.005 inches or less, back flow mixing can be avoided in most or all cases. Outlet diameters of 0.001 -0.005 inches are preferred for this range of needles. While both outlets typically will have the same diameter, one may be larger, depending on the liquid content characteristics, purity requirements, etc.
[0035] Another alternative to prevent backflow mixing is use of one-way check valves or other flow restrictors 120, as shown in FIG. 9. The valves 120 prevent inflow into the reservoirs through the outlets 30 or 32. However, use of valves 120 requires that the reservoirs be filled from the top or back end, by removing the plungers, filling, and then replacing the plungers. A flow restrictor further increases flow resistance as a function of flow velocity, effectively limiting the speed of plunger movement and preventing back flow mixing.
[0036] Another alternative to prevent backflow mixing is a one-way ratchet or brake 122 as shown in FIG. 1. The ratchet 122, when engaged, prevents backward movement of the plunger. The ratchet may be disengaged temporarily, to fill the reservoir by pulling the plunger back up through the reservoir.
[0037] In use for sclerotherapy, needle 38 is oriented with the angled tip surface 44 up and is inserted into the vessel or vein 80 to be treated. Once inserted, the angle or bevel surface 44 of the needle is facing up towards the skin 82, as shown in FIG. 8. The first plunger 18 is pressed in, injecting the flushing solution into the vessel. The flushing solution displaces blood in the vessel, moving the blood away from the treatment site. Typically, the vein will no longer be visible once the blood is displaced. If the physician observes little or no change in appearance in the vein, then the needle is not properly located in the vein. The needle is then withdrawn and inserted at another location in the vein, before the sclerosing solution is injected. Injection of sclerosing solution outside of the vein can cause skin ulcerations. On the other hand, inadvertent injection of a flushing solution such as a saline outside of the vein creates no such risk of complications The use of flushing solution first, along with the change in appearance (or disappearance) of the vein, reduces potential complications resulting from injecting sclerosing solution outside of the vein.
[0038] After the flushing solution is injected, and the physician observes the change in appearance of the vein, and with the needle 38 remaining in place in the vessel, the second plunger 20 is then pressed in, injecting the sclerosing solution 52 into the vessel. As the sclerosing solution 52 acts on the vessel walls, without significant presence of blood at the treatment site, complications, such as hyperpigmentation, are reduced.
[0039] The volume of flushing solution 50 and sclerosing solution 52 used with each procedure may vary depending on the size of the vessel and other factors.
[0040] After the treating physician determines that a sufficient amount of solutions 50 and 52 have been injected, the needle 38 is withdrawn from the vessel. A pressure dressing may be applied to the skin around the injection site. The needle may be relocated to another treatment site, on the same vessel, or on a different vessel. The reservoirs hold 1-8, 2-6 or 3-5 ml each. These volumes allow for multiple injections with a single syringe assembly 10. Ultrasound treatment may be used on the areas treated over the 24-78 hour period following the above-described methods of sclerotherapy. This helps to further reduce or avoid bruising or potential hyperpigmentation.
[0041] The methods described above may also be used with electrosurgical techniques, such as described in U.S. Pat. Nos. 5,695,495 and 6,293,944, incorporated herein by reference, or with ultrasound image-guided techniques to locate the injection site, or both.
[0042] Thus, novel methods and devices have been shown and described. Various substitutions of steps and components may of course be made without departing from the spirit and scope of the invention. The invention, therefore, should not be limited, except by the following claims, and their equivalents.
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Anyone know if the 2014 Mission/Scapegoat frame comes with internal routing for an ajustable seatpost? I was looking at a 2013 Sortie today and noticed that the frame was IR compatable. Thanks
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I want Phil Coggan...http://www.firearmstalk.com/forums/f54/some-recent-stuff-74705/
And Longballer...http://www.firearmstalk.com/forums/f12/longballer-delivers-dh-custom-tracker-74844/
To get together and collaborate on a rifle/scabbard or pistol/holster combo. I think the end result would be enough to make a grown man weep at not spending his life mastering an art as fine as these gentlemen have.
I think this combo could be auctioned off (at a profit to them, obviously) but with some of the proceeds going to a FTF charity.
Yes, I am being selfish here, I just want to see a work of art these two could put together...
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There is no building that could withstand that level of extreme awesomeness.
But dammit, that's too awesome to not happen.
Oh man! I would be totally honored and humbled to collaborate on a project with a master like Phil!! I appreciate the compliment, but that man's skills are on another planet.
That said .... This would be AWESOME!!!
The ideas are swirling!!!
I'm ready for awesomeness so great, that the angels themselves will weep with joy.
Arbitrary enforcement of the law is the mark of tyranny. Citizens will always fight against it.
Dead Bears, the only good kind.
Wonder if he's seen this yet?!?
That mountain scene WOULD BE frickin' kickazz cool. I have no idea if I could pull it off to match his engraving skill .... but I'd sure as hell give it a shot!!
Now .... who's gonna order this masterpiece concerto collaboration? I cannot even begin to imagine what it costs to have engraving like his done on a piece. :0