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Doom 3 1.3.1 MacOS (Intel & PowerPC)Sep 15, 2007 Patch 0 comments
Doom 3's last patch, version 1.3.1, that adds Windows Vista support and a number of small bugfixes and slight mod-related enhancements. Please note...
Into Cerberon aims to bring the gameplay of the definitive 6-degrees-of-freedom game, Descent, into the industrial gloom of Doom 3.
Fly around the interiors of mines, refineries, research centres, and other industro-technical environments with full six degrees of freedom control: roll, tilt, yaw, and slide in all directions. Battle with your friends in pitch-black tunnels in the multiplayer action, or take on robots infected with a terrible nanovirus plague in the singleplayer campaign. An array of powerful weapons are at your command; from the humble lasers (not so humble once upgraded) and mundane concussion misssile to the fantastic Fusion Cannon and tremendous Mega Missile. Awe your foes as electric bolts leap from your ElectroHull, or give new meaning to the phrase "bad sunburn" with the insidious UV-8 Ultraviolet Emitter. Feel the kickback of the powerful AutoCannon as it hammers your target, or the heat from the Flamethrower as it fries armour plate like chicken wings. Pummel enemies with the Hephasestus Cannon, and melt what's left with the Plasma Cannon.
Featuring claustrophobic environments and gut-wrenching action, with enemies coming at you from every which way, Into Cerberon will scare you like Doom 3 couldn't. Hide in the shadows if you're afraid, or run and gun if you can aim. Turn on your headlights to see, but be aware that they make you more visible, too.
Into Cerberon will alter your perceptions of multiplayer DM. Think all those frags you racked up mean you won the match? Think again. In "Meltdown" mode, dead men collect no rewards - you must escape the mine before the reactor blows to make it to the winner's circle.
We recommend keeping a fresh pair of pants handy. Fire up your afterburners, check your quad lasers, and prepare to descend... Into Cerberon.
5 comments by HeXetic on Apr 26th, 2007
Announcing the release of Into Cerberon version 003a, codenamed "Quartzon", a minor update to our previous 003 release. The most important change is that Into Cerberon is now updated to function with the latest Doom 3 patch 1.3.1, enabling full cross-platform support -- including Intel and PowerPC Macs. Also included is an update to ic_mine, fixing numerous issues with the size of certain passages.
Download Into Cerberon 003a today, and get your tri-chordin' on! Stay tuned for IC004 coming soon, with even more guns, maps, and gameplay features.
Doom 3's last patch, version 1.3.1, that adds Windows Vista support and a number of small bugfixes and slight mod-related enhancements. Please note...
Doom 3's last patch, version 1.3.1, that adds Windows Vista support and a number of small bugfixes and slight mod-related enhancements. Please note...
Into Cerberon 003a is a minor update to IC 003 that brings: Support for the Doom 3 1.3.1 patch enabling all platforms to play with each other (Windows...
Into Cerberon 0.0.3 brings a number of improvements on top of IC 002, including: Tri-Chording "Catch-free" movement model Collision damage ...
Version 0.0.2 of the Into Cerberon mod, codenamed "Copper". This release ups the ante on 0.0.1 by including a brand-new map (Spectre's...
The Into Cerberon team presents this video featuring footage from IC 0.0.2 on the new ic_mine map. Yes, it's got the most clichéd background...
Wow! It's been awhile, and this is still the most awesome mod for the Descent game genre - but it's going to be getting some competition soon!
From Epic_Games Unreal_Engine_3 with this UDK game @ Descent.silverball-magic.com in a remake of the original Descent game done in the latest UDK version.
And while your at it, you might as well check out the fan site for it @ Descent-to-udk.deviantart.com
Enjoy! And as always: Prepare_for_Descent! :D
So, if any of these terms sound familiar then your in the right place!
Meta Tags: descent logo unreal engine level design concept art udk game play mechanics pyro ship model desktop wallpaper space planet thruster star laser missile minigun red door enemy plasma weapon shield energy cell powerup menu music original custom pickup ammo health
Maybe you can recruit people for steam Greenlight featuring ^^
Trying to play this on Ubuntu 12.04, Doom 22.214.171.1244, but when I go to Mods>Into Cerberon 0.0.3, I see the Descent/Cerberon Logo briefly, then the game quits. Anyone have a fix for this?
Thanks in advance.
Dead. Very dead.
Actually, not dead. Working on a resurrection. Anyone interested in helping?
So this mod is dead?
The Question Is: What Does Dead Mean?
means no one is working on it.
At the trailer in 00:25 Thats the sound of the first boss robot from descent 1 very clever
Promote Into Cerberon on your homepage or blog by selecting a button and using the embed code provided (more).


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HD movies with advanced movie mode
Create a truly moving cinematic experience.
Creators of short videos will appreciate the versatility of Nikon 1 AW1. Just enable Advanced movie mode and you'll have access to programmed auto, shutter-priority auto, aperture-priority auto and manual settings, giving you the freedom to add a cinematic feel to special moments. Use a fast shutter speed to freeze the spray of seawater splashing over a boat, or open the aperture wide to add tasteful background blur to a tightly framed close up. When you return home, edit footage using bundled Short Movie Creator or Nikon Movie Editor software to produce entertaining movies complete with soundtracks and other elements.
Taking still images while recording a movie
The best of both worlds: Shoot fantastic photos while recording HD movies without skipping a frame.
Whether it's short footage of a casual get-together or a complete video log of your long-awaited vacation, record it all in stunning Full HD. Just press the movie record button and you're good to go. And if you happen to chance upon a scene that would also make a great photo, press the shutter-release button to capture a high-resolution photo. Movie recording is not affected and continues uninterrupted while the still image is shot and saved. In addition, photos employ the same camera settings in effect for the movie and come out looking just as beautiful.

subset: commoncrawl


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Gigi won the World Jr Winner title at the July'11 World show in France. She also won Best Jr at the French National Show 7-2011. AOM at 2012 Westminster. First all breed BIS in April 2012. Multiple group winning
Return to the Winners and
Bragging Rights Main Menu
Return to InfoDog.com
Home Page


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College studs, smoking boys and gay ravers getting off with their smokes on camera. Watch these smoking boys as they strip, suck rim and jack-off while smoking.
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Do we have to set England alight again? [1]
Road protesters thought they could roll up their sleeping bags and go home. Wrong. Not only is road-
Road protesters thought they could roll up their sleeping bags and go home. Wrong. Not only is road-
by Paul Kingsnorth [2] Published
One long night, ten years ago this summer, my life changed for ever. It was gone sunset, but I could see no stars because it wasn't dark. I was in an ancient water-meadow in Hampshire, but the night seemed noisier than if I'd been sitting by a Heathrow runway. I was chained to a steel girder 15 feet above the ground and, along with 200 other people, I had no intention of coming down.
The girder was part of a temporary bridge being built across the A3 outside Winchester, to allow heavy construction machinery to cross from one side of the road to the other. On the other side stood Twyford Down, a beautiful, calm, green hill dotted with historic monuments and rare plants, rabbit holes and twisted copses. The machines had come to drive a motorway through the middle of it. We had come to stop them.
For hours we stayed up there, lit by halogen arc lamps, ringed by police and yellow-jacketed security guards. We banged on the steel with wood and metal pipes, chanting in time to the deafening roar. We painted our faces with chalk and howled defiance at the moon. Eventually the police, who had spent hours vainly ordering us down through loud hailers, brought out their hydraulic bolt cutters and climbed up to cut us down. It took them most of the night. Eventually, with 50 others, I was arrested, chucked into a van and taken to Southampton police station to spend the night in a cell.
That night changed everything for me and, as it turned out, for the country. Twyford Down was the first of the road protests that spread across Britain in the 1990s. At Solsbury Hill near Bath, in Pollok Woods outside Glasgow, in the self-proclaimed "Republic of Wanstonia" in east London on the route of the M11 extension, in camps along the nine-mile route of the Newbury bypass, people fought not just against destructive new roads, but against the assumptions behind them.
Those assumptions underpinned the Tory government's 1989 white paper Roads for Prosperity, which announced "the biggest road-building programme since the Romans": 2,700 miles of new roads (doubling Britain's trunk-road capacity), including 150 new bypasses, many destroying historic and protected sites. This, said the Tories, would give people what they wanted and the economy what it needed: more space for more cars, ad infinitum.
This single policy announcement - based on a principle known as "predict and provide" - was to radicalise a generation. Why, people asked, were we prepared to build on the best of our countryside to provide for projected and unnecessary traffic growth, rather than controlling that growth? Why wasn't money instead being spent on public transport and curbing car use? And wouldn't building more roads just encourage people to drive on them?
Roads for Prosperity was finally dealt a death blow in 1994, when a government committee concluded that what environmentalists had been saying for years was correct - building more roads encourages more traffic. The way to ease congestion and pollution was not to accommodate more of it, but to take measures to control car use. Tory transport policy collapsed.
When Labour came to power, most of the road schemes were suspended. Ministers scorned "predict and provide". "I will have failed," said John Prescott in 1997, "if in five years there are not many more people using public transport and far fewer journeys by car." The road protesters, it seemed, could roll up their sleeping bags and go home. We had lost Twyford Down, Penn Wood, Solsbury Hill, but we seemed, in the end, to have won the war.
How wrong we were. What seemed in 1997 to be a peace treaty now turns out to have been a lull while the enemy sent behind the lines for more ammunition. Today, new roads are springing up all over the country - soon, in the latest instalment, we can expect confirmation of £6bn worth of new 12-lane "freeways" based, as ever with new Labour, on the American model. Prescott failed, and very publicly: traffic growth, far from falling, has risen by 7 per cent since 1997, and it keeps on rising. Scared by fuel protests and the powerful roads lobby, the government has given up.
But Labour's broken promises on road traffic reduction pale beside something that is about to hit this country like a tornado. Something which shows that "predict and provide" is alive and well, and which suggests that the battles we fought ten years ago might have to be fought all over again: airport expansion.
Air traffic is growing at enormous speed, fuelled by artificially cheap fuel (airline fuel is untaxed), government subsidies and the rise of budget airlines. The then transport minister John Spellar summed up the problem in April last year: "We published forecasts up to 2030 . . . 500 million passengers [a year], of which 300 million will be in the south-east. These are very big numbers." He was right there: those numbers represent a tripling of the current number of air passengers. Today's airports have no chance of being able to cope. To provide for such a vast increase would require the equivalent of six new airports the size of Heathrow. It must be obvious to everyone that it can't, and shouldn't, be done.
Obvious, that is, to everyone but the government, and the air transport lobby standing at its shoulder. Labour's solution? Simple, and miserably depressing: it has predicted - now it must provide.
An air transport white paper later this year will explain exactly how it will be done. But it is widely expected to involve a slew of new airports and runways in some of Britain's best countryside. "UK airports," says Spellar, "have a major role to play in maintaining the health of our national economy as well as our international competitiveness." And when international competitiveness is at stake new Labour, like the Conservatives, will make whatever sacrifices are necessary.
This time around, the sacrifices look likely to be every bit as painful as before. Options being considered by the government include the expansion of up to 17 airports, and the construction of two entirely new ones on virgin countryside. Research carried out by the Campaign to Protect Rural England shows some of the likely effects. An area the size of Cheshire, most of it rural, newly polluted by aircraft noise that will affect more than 600,000 people - double the current figure. The loss of 73 square kilometres of agricultural and greenbelt land, 44 sites of special scientific interest, seven areas of outstanding natural beauty, 319 listed buildings, 49 scheduled ancient monuments. The construction of almost 200,000 new houses and - irony of ironies - lots of new roads to service the terminals. And all this is without even considering the wider impacts on climate change, to which air travel is one of the fastest-growing contributors, and which Tony Blair insists he wants to halt.
It seems to me that I've stepped back in time; that those in power have learnt nothing from the road wars. We are right back where we began, because this government, like every other before it, has given up trying to tame the machine. We are, once again, sacrificing the future for the present, and once those ancient villages, those steeples and copses and lanes and barrows, those hedgerows and meadows and hillsides and still, silent ponds are gone, they are gone for good.
Today, we spend our weekends in Barcelona as unthinkingly as our grandparents spent theirs in Margate, and we enjoy it. But everything has its price, and the price for experiencing so easily the wonders of other countries is the destruction of the wonders of our own. If the airports are built, it may be that we will wake up again, as we did in the 1990s, to what is happening and why. It may be, however, that this time it will be too late. "And that," as Philip Larkin wrote 30 years ago, "will be England gone."
Yet it doesn't have to happen. This time, perhaps we could stop it before it even gets going. There are heartening signs already: across the country, local protests are rumbling into life, and communities are organising to try to protect their landscapes. Perhaps, as a society, we have our chances and our choices all over again. Perhaps our growth-obsessed government will even wake up and take responsibility itself.
Perhaps, however, in the end, there will be nothing for it but for those who have seen the future in the recent past to dig out our old climbing harnesses and headlamps and take to the trees, the tunnels and the fields again, to help fight a war that we thought we had already won.
One No, Many Yeses: a journey to the heart of the global resistance movement by Paul Kingsnorth is published by the Free Press (£10). www.paulkingsnorth.net [3]


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i heart new york
As I mentioned yesterday, I haven't always been pleased with the actions of our country after 9/11 so I'm sorry, but I can't always jump on the "proud to be an American" bandwagon. And the First Amendment gives me the right to tell you that!
I can, however, tell you that I am ridiculously proud to be a New Yorker. And I love love LOVE this video!
I also very much recommend this opinion piece by Paul Krugman in today's NY Times. Very well said, sir.
And while I'm at it, I'm also going to use my First Amendment rights to say that while today's Facebook postings didn't annoy me nearly as much as I thought they would, there were still some rather annoying ones. Yes, we all remember where we were when we heard the news, but unless you were fleeing a burning building or metropolis, or waiting for news about a loved one, no one really gives a shit. Oh you were worried because you knew someone who knew someone who this one time took a plane that totally looked like the one that crashed? Yeah, keep that to yourself. We don't care.
In other news, in an effort to not overwhelm myself with the media coverage, I watched just a small snippet of the tributes this morning, then got myself all glammed up and went to a Zumba master class. It felt really good to get out and do something active, and the class itself was all sorts of awesome. It was taught by a guy who's featured in the new Zumba Wii game. I had met him at the convention, and he remembered me! It's funny, when I go to Zumba events now, people walk up to me and say "Are you Lesley?" Apparently, the word is out. You can all say you knew me when.
It also felt good to get in a killer workout because 9/11 did factor in to my decision to have weight-loss surgery, get active, and take care of myself. You see, when I used to go to NYC for work, I would find myself exhausted by the commute, all the walking, and all the stairs, because it always happens that the subway you want is no less than three flights of stairs underground, and there are no escalators. Can you imagine walking three (or four) flights of stairs back up to the street while carrying one or two laptops and an additional 200+ lbs on your frame? Well, it was no fucking picnic, I can tell you that. One day it occurred to me that if there were another emergency, I wasn't sure if I'd be able to get myself evacuated and to safety in a timely manner. And I wouldn't want to put anyone else in danger because they had to help me or wait for me. So while I pray to God that we never have another situation like 9/11, I do like knowing that if the worst were to happen, I would be at least able to merengue march my way out of there to safety.
And I leave you with the collect that I prayed this night ten years ago. I have a big geeky love for the Book of Common Prayer, and this is my favorite prayer therein:
Keep watch, dear Lord, with those who work, or watch, or weep this night, and give your angels charge over those who sleep. Tend the sick, give rest to the weary, bless the dying, soothe the suffering, pity the afflicted, shield the joyous; and all for your love's sake. Amen.


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Higgins: If It Ain't Broke, Don't Fix ItWritten by Tim Higgins | | email@example.com
I spent part of my Thanksgiving in a conversation with my daughter discussing the steps involved with repairing a leaky toilet in their home. (What, this isn't the normal holiday conversation you have with your kids? Really?)
I could do this because I was fortunate enough to have a father who while I was growing up (OK, growing older) was able to instruct me in the basic 'Harry the handyman' skills involved with maintaining a home. One of the first things he stressed in those lessons was that since maintaining any complex system would be difficult enough for even the most conscientious maintenance staff: 'if it ain't broke, don't fix it'. This is apparently something that the Congress and the President either never learned, or forgot about when creating the 'Patient Protection and Affordable Care Act' or 'ACA'.
Oh I know that politicians often like to simplify subjects that they either don't understand themselves or don't think that 'the voters' will, in order to sell us something (usually a bill of goods); but the simple truth of the matter is that when all of this began, the US had a level of health care that was the envy of the world. That's why other world leaders and that pesky '1%' with the cash often came to this country for treatment of their ailments. This is not to say that there weren't things that needed improvement, but most of that seemed to be greater "access" to this wonderful system through minor modifications of health insurance coverage.
While even those who had no insurance or couldn't pay had access to some level of medical care, they needed more. Those with pre-existing medical conditions also needed the ability to obtain or retain insurance (especially when changing jobs). Doctors needed tort reform to reduce the amount of defensive (and expensive) medical procedures being performed for no better reason than to protect themselves from frivolous malpractice lawsuits, without removing the patient's right to seek redress from poor practitioners. Patients and doctors alike needed protection from the crony-capitalism in an insurance industry riddled with restrictive choices allowed by individual state insurance regulators.
In its normal ham-fisted approach to almost every issue however, our federal legislators chose a 'throw the baby out with the bath water' approach, without considering the ramifications of another 'never-ending gobstopper omnibus' effort, as well as the laws of unintended consequences. Far too concerned about winning points for their respective parties that they could store up like nuts for the next election (like there aren't enough nuts around in every election), our legislators allowed themselves to be caught up in the momentum of a 'sweeping reform' which only seem to clean out sound judgment, and good law. Sadly now, the nation is left with a result that even many of those who originally voted for it are less than pleased with
This is not to say that the ACA doesn't positively address some of the issues that it intended to. Those with pre-existing conditions now have the access to insurance that they deserve. Unfortunately, this boon came with the cost that far too many of those who had pre-existing insurance plans lost them. Many who needed access to health insurance will finally get it, but apparently 30 million still will remain without it. Instead of freeing up the insurance market between states to make it cheaper, the ACA instead further restricted it to a few limited 'government-approved' plans that make it even more expensive (and, contrary to the law's title, less affordable). Perhaps worst of all is that politicians who touted the necessity of this sweeping change and the fairness of their effort granted themselves their staffs an exemption from the rules that they insist the rest of us follow.
Not surprisingly, those seeking electoral credit for their legislative efforts are instead contracting incurable levels displeasure, disapproval, and disrepute that may cost them the privilege of the jobs they sought to protect in its passage. Curiously, it's only the distraction of the temporary collapse of the HealthCare.gov website used for enrolling that's protecting these wayward legislators from the greater ruin and future recrimination that awaits them. Tragically, the CYA and CYP (Cover Your Party) nature of the entrenched politics involved precludes even the most honorable of members of either party from doing what they know in their hearts probably needs to be done now.
So it's time for many to learn a hard lesson that apparently their fathers couldn't or didn't pass on to them. You don't fix a simple leaky toilet by ripping out the entire bathroom. You don't remodel a house by demolishing it and rezoning the neighborhood. In fact, with anything that needs repair, the first rule must always be: "If it ain't broke, don't fix it!"
Tags: Affordable Care Act, CYA/CYP (cover your party), healthcare.gov, Patient Protection and Affordable Care Act, pre-existing conditions, President Obama, Thanksgiving


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Full circle
February 15, 2011
That's probably not the classiest way to start a blog entry, but it's what I'm thinking as I sit on this ancient metal lawn chair in front of the motel I bought exactly a year ago, watching the tumbleweeds struggle to free themselves from the barbed-wire fence across the highway and waiting in the brittle night air to see whether the coyotes will serenade me again like they did last night.
Like the tumbleweeds and their namesake motel, I am a latecomer to this ancient land.
Uprooted and directionless, I blew in from the east and found myself caught on the fence of a life unlike anything I'd ever known.
A year later, I remain unsure of why I thought this was a good idea, but I am certain it was the best idea I've ever had.
At 11:38 a.m., Feb. 15, 2010, I became the proud owner of the historic Tumbleweed Motel, which now consists of five lovingly restored rooms, an office, a functional wringer washer, a pair of clothesline poles that I still haven't gotten around to sanding and spraying with Rust-Oleum, a developmentally disabled handyman who calls me "Sissy" and walks two miles to the truck stop next to the interstate off-ramp every morning to buy canned tuna for the feral cats that skulk around the edges of the property, an espresso machine, a collie mix rescued from a barbed-wire fence, four cats rescued from a culvert during a rainstorm, a dark-eyed man with a wry sense of humor who became my boyfriend in April and my husband in October, a feisty teenage desk clerk whose rightful title probably ought to be "assistant manager," and a three-month-old fetus who waits silently for the right moment to make a grand entrance into a world full of everyday adventure and fiery sunsets that never fail to take my breath away.
I tumbled into town with a splitting headache and a heart full of grief, orphaned, jobless, uncertain of my future, with nothing to lean on but a small insurance settlement and the publishing rights to my father's music.
A year later, sitting here on my own property next to Route 66, with my freezing butt and my freezing fingers and a faster Internet connection than I had a year ago, waiting for a visit from unseen coyotes, I feel my shallow chaparral roots beginning to deepen, having probed this dry land and found enough love and beauty to heal a broken heart and support a life whose quietude somehow manages to dazzle me more than the glitter and flash of the city I left behind.
My butt is cold. My life is beautiful. And with that note to open their song, the coyotes are just beginning a lullaby wild and familiar.
– Sierra
Valentine's Day in Coldwater
February 14, 2011
This was Valentine's Day in Coldwater:
A love note written in dry-erase marker on the bathroom mirror and a delicate half-and-half heart with baseball stitches etched into the sides, floating atop a decaf macchiato, from Grant.
A lopsided construction-paper heart decorated with Necco sweets and a lot of glitter from Joey. Message: "Happy Valentine's Day. I'm glad you're my Sissy. Love, Joey."
A sunrise hike up Sangre Mesa.
A spirited softball practice in which Lil Miss taught the rest of the team how to slide under a tag. I love that kid. She's the scrappiest little thing I've ever seen — no bigger than a minute, but she puts on that catcher's mask and scares the living crap out of everybody who even thinks about crossing the plate on her watch. Funny girl.
A couple from Tularosa celebrating the holiday by coming back to the room at the Tumbleweed where they spent their wedding night 50-odd years ago.
A pack of coyotes singing somewhere out on Hank Freed's back 40.
Hope you had a good Valentine's Day, wherever you are.
— Sierra
Nowhere I'd rather be
February 4, 2011
It is literally a degree outside. Fortunately, I am curled up under a warm blanket inside, with Grant's arm around me, the stereo playing an old Neil Diamond album very quietly in the background, and the smell of freshly baked gingersnaps hanging sweetly in the air.
There's nowhere in the world I'd rather be.
Well, nowhere except the bleachers at Wrigley Field on a summer afternoon, of course.
The bleachers at Wrigley would be awfully unpleasant this evening, so I'll settle for what I've got. It's a pretty close second, anyway.
— Sierra
State of emergency
February 1, 2011
Five. It is literally five degrees outside. The state came by and plowed 66 this morning, and Grant took the laundry up to the laundromat in the truck stop to wash and dry because it's obviously too cold to line dry anything, and we've got a lobby full of people.
Joey cleared and salted the paths from the rooms to the lobby, and Lil Miss appointed herself activities coordinator for the children stuck here as a result of the weather. Just about every flight in the country has been grounded, and the roads are still too dicey for most people to attempt — especially with blowing snow and the threat of highway closures farther west — so we are obviously packed.
I could do without the cold and the hassles, but I'm enjoying the little kids' artwork that now graces my lobby. Lil Miss has kept the kids busy all afternoon with fingerpainting, tissue-paper suncatchers, Shrinky Dinks, and I don't know what all else. She assures me that the glitter and scraps of paper will be removed from the lobby before she leaves.
Meanwhile, Grant won't let me outside, lest I slip and fall on the ice, so I've spent most of the day in the kitchen, making the usual short-order breakfast, then a kid-friendly lunch of mac and cheese, PBJs, and carrot and celery sticks. A very sweet, very funny gay couple from Missouri took over cleanup duties when I started to run out of steam after lunch. Mike was raised by his Italian grandmother on The Hill in St. Louis and owns his own catering business, so he and Bill promptly commandeered the kitchen and announced that I would be taking the rest of the day off while they whipped up dinner for everybody. I'm not sure what we're having, but it smells heavenly.
This place never ceases to amaze me. No matter who's here or what the situation is, we always seem to end up with the perfect combination of talents, personalities, and ideas to keep things running smoothly. I am beginning to suspect that the Tumbleweed is some sort of odd wormhole through which blessings enter the universe. It's certainly worked that way for me.
— Sierra
Whining, or: Things That Would Totally Rock
January 6, 2011
You know what would rock? Not having to drive all the way to freakin' Tucumcari to see an obstetrician on Grant's provider list.
You know what else would rock? Good decaf. Good decaf would rock like a Jimi Hendrix concert.
You know what would rock most of all? Not feeling gross. Not feeling gross would rock harder than Joe Perry, Jimmy Page, and Angus Young put together.
OK, OK, I'll stop whining. I really don't have any legitimate reason to whine. It sucks to drive 30 miles to go to the doctor, but I probably shouldn't bitch about it, because I'm making the drive down Route 66 in New Mexico, in a late-model SUV manufactured by a company whose entire reputation is built around its stellar safety record.
My insurance coverage might be a little spotty and inconvenient because of Coldwater's rural surroundings, but at least I have it.
And despite the fact that I feel totally gross about half the time, the doctor says Rugrat and I are doing just fine. I definitely need to remember to be grateful for that. Healthy babies totally rock.
Here is something else that rocks: Joey and Lil Miss bought me a Space Invaders ice cube tray, a Tetris ice cube tray, and three big jugs of orange Gatorade for Christmas, so I now have an old rainbow sherbet tub full of Gatorade mini-popsicles in the freezer. Orange Gatorade mini-popsicles aren't as nice as cappuccino, but they're pretty good — especially when they're shaped like Space Invaders.
It also rocks that the doctor told me I'm not supposed to change the litterbox while I'm pregnant, which means that job is officially Somebody Else's Problem from now until August. That most definitely rocks.
— Sierra
December 22, 2010
No, I'm not dead. Yes, I have an excuse for my lengthy silence.
"Let me 'splain. No — there is too much. Let me sum up."
— Inigo Montoya
Here are all the things I've done in the past week:
1. Made approximately seventy million cookies in forty-two different flavors. (You have no idea how many cookie exchanges are held in Coldwater, N.M., during the month of December. It truly boggles the mind.)
2. Attended two school programs, a band concert, a chorus concert, a Chamber luncheon, a chili supper, and a church Christmas cantata.
3. Helped the Chamber director sort and wrap umpty-three gifts for kids on the Angel Tree we put up at Bill Swinney's place.
4. Watched Sandy and Joey use poster board and tinted craft glue to make a suncatcher for Grant's office window.
5. Discovered firsthand that morning sickness is a bitch.
Yeah, you read that last part right.
Thus far, we have not told Joey. He will, of course, be utterly thrilled, but I am not sure exactly what he does and does not know about how pregnancy works or where babies come from, and we are not telling him anything until Grant works up the nerve to explain it to him.
If anybody wants to start a betting pool on when this will happen, I'll put five bucks on "baby's 35th birthday."
— Sierra
Nothing doing
December 12, 2010
I wish I had something exciting to share this evening, but Coldwater is quiet, except for the yipping of the coyotes somewhere out beyond Hank Freed's property line and the creaking of a speed-limit sign that's trying to work itself loose from its post in the New Mexico wind.
Lil Miss spent this evening wrapping presents in the lobby with Joey and three or four members of the Coldwater High School FFA chapter. The kids organized a gift drive for the residents of the Coldwater Nursing Center, and I told Lil Miss she could use the Tumbleweed as a staging area for their project. My lobby was completely covered in wrapping paper, ribbons, and giggly teenagers for several hours this evening. The kids stacked all the presents in Unit Four when they finished. They're going to load them into Lil's truck and deliver them to the nursing home on Christmas Eve.
I was busy thawing out frozen pipes in Unit Three when the kids showed up, so Grant took over the kitchen and made some peppermint bark, a batch of chocolate-chip cookies, and a huge bowl of popcorn for them to munch on while they worked.
Not to belabor the point, but I think Grant may be the most awesome principal in the history of high schools. Sandy raised her boy right, and Coldwater was lucky to get him.
Speaking of Sandy, she's supposed to be rolling into town next weekend. I can't wait. I'm not sure what I did to deserve such an awesome mother-in-law, but I'm glad I've got her. She is one of the few people in the world who not only tolerates my quirks but understands and encourages them. I am blessed.
— Sierra
Back online
December 10, 2010
What is it with truckers and telephone poles? Last Saturday morning, a big rig hauling a wind turbine blade failed to swing wide enough while making a turn and took out the telephone pole on the corner — the same one Mouse hit last March. (Speaking of Mouse, he sent us a Christmas card this week. He said he's planning to be back out this direction in a couple of weeks, and he's looking forward to stopping and staying at the Tumbleweed on his way through.)
It only took a couple of days to fix the phone lines last spring. I don't know what the holdup was this time around, but we haven't had phone or Internet service all week. If it were tourist season, I'd probably be pretty hacked off about the delay, but I'm sure I haven't lost too many December customers over it. I've just used the time to finish up the calendar for the Chamber, spend time with Joey, and digitally archive about 600 historic photos.
Joey and I started volunteering at the grade school this week. Joey is a library monitor, which basically means he hangs out with the librarian, helps sort books, and reads to little kids during story time. The kids love him because he's a grownup who understands what it is to be a kid. I love watching him work with them, because he mimics everything I do when I read to him — including stopping every few minutes to ask the kids if they recognize a particular word. If they get it wrong, he says, "No, but that's a good try. Look at it again," just the way I do with him, and if they get it right, he puts down the book and gets everybody to clap and cheer.
The kids eat it up, and I think he's really getting a lot out of being in the library so much. He's learning how to use the resources to find information — if a kid comes in to ask for help finding books about a particular subject, Joey watches over the librarian's shoulder and then tries to help the next kid himself — and he's very curious about the kids' class projects. He asks them a lot of questions about whatever they happen to be learning, which is great for him and probably even better for the kids, who are reinforcing their own lessons by teaching them.
Meanwhile, I have been grading a lot of papers, making a lot of photocopies, and filling out a lot of paperwork so I can get certification to cover classes when teachers are absent. The principal was pretty amped when I told him I'd be willing to serve as a volunteer sub. He said a lot of substitute teachers — even the ones who are paid to be there — have trouble following a lesson plan, so the kids don't learn much when their regular teachers are gone. I guess Dr. Scherer and Grant have told him about my work with Joey, so he's pretty confident that I'd make a good sub.
Every time I think my life can't get any weirder, some new project presents itself. If you had told me 13 months ago that I would be married to a high-school principal, taking care of a developmentally disabled man nearly twice my age, running a motel, and substitute teaching in a tiny town in the middle of New Mexico, I'd have been convinced you were taking way too many hallucinogenic drugs … but here I am, and I love it.
— Sierra
Friday night (twinkly) lights
December 3, 2010
Blogging from Grant's iPhone this evening as we drive around Tucumcari, looking at Christmas lights, after dinner at Golden Dragon and a trip to the grocery store to stock up on supplies.
I don't anticipate any guests at the Tumbleweed this evening, but we left Joey and Lil Miss in charge just in case. When we left, they were making kettle corn and hot chocolate and getting ready to spend their evening watching A Christmas Story and playing video games.
Hope you're having a good Friday evening, wherever you are.
— Sierra
Cold Thanksgiving
November 25, 2010
Yikes. Winter has apparently arrived in Coldwater: It's currently 16 degrees outside. Grant and I set the thermostats in all the empty rooms to 60 degrees this afternoon just to make sure the pipes wouldn't freeze.
Cold weather notwithstanding, we've had a nice Thanksgiving. Grant and Sandy don't like turkey any better than I do, so I made a big batch of chicken and dumplings instead, which was nice and warm and satisfying on a frigid afternoon.
We braved the cold to walk down to Casa de Jesus this evening. As usual, Jesus got out the karaoke machine. Just for Sandy, I worked up the nerve to try one of Dad's old songs. When I finished, she cried a little bit and told me Dad would be proud of me … which, in turn, made me cry a little bit, but it was a good cry. Jesus was a little puzzled. We just told him the song reminded us of someone we used to know.
We capped the evening with big bowls of menudo — courtesy of Jesus' wife — and then another short walk through the cold to get back to the Tumbleweed, where we found Joey checking in a pair of travelers all by himself. Add that to the list of blessings I can count this evening: Joey has come SO far in the past year. The first time I met him, he was completely dependent on Miss Shirley. He couldn't read, his speech was barely coherent, and the most complicated financial transaction he could handle was the purchase of a couple of cans of tuna and an orange sherbet push-up from the convenience store. A year later, he's waiting on guests and checking them into their rooms in my absence. I'd love to take credit for that, but Dr. Scherer, Grant, and the grade-school librarian have had at least as much to do with it as I have.
Hope you're warm and happy and counting plenty of blessings this evening.
— Sierra


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Lake Austin Spa Resort Book
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Sept. 19, 2006
Worcester, Mass. - Sophomore Felipe Castrillon (Weston, Fla.) scored the game-winning goal and his fifth of the season while senior Josh Trott (Glen Cove, N.Y) scored his sixth and seventh goal of the year and added an assist as the Crusaders defeated Northeastern, Tuesday in men's soccer action at Linda Johnson Smith Soccer Stadium.
Trott put the Crusaders on the board on a break away given to him by Alex Cruz (Conyers, Ga.) as he tapped the ball around Northeastern's goalie creating an open shot on goal two minutes into the game.
Northeastern came back on a direct kick outside the box scored by Greg Kilkenny (Bray Wilkow, Ireland) at 31:33.
Trott scored the go ahead goal on a penalty kick at 18:30, his second of the game.
The Huskies knotted the game when Nicholas Patrikis (Nanuet, N.Y.) headed in a cross from Matthew Lanning (Southborough, Ma.) just out of the reach of Holy Cross keeper Keith Bauer (Commack, N.Y.).
The score remained tied at two going into the second half and stayed that way until 11 minutes left in the game when Castrillon made his way from midfield on a pass from Trott to score the game-winning goal.
Bauer had four saves on 13 shots in goal for the Crusaders.
Holy Cross improves to 4-3 overall while Northeastern drops to 4-2-2.
The Crusaders will travel to Lehigh Saturday at 7:00 p.m.


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Colorado Mining Association
High Court Rejects Challenge To Roadless Rule
The U.S. Supreme Court has turned away an appeal challenging a federal rule that bars development on 50 million acres of roadless areas in national forests.
Colorado Mining Group Mulls Appeal Of Haze Lawsuit
The Colorado Mining Association is considering whether to appeal the dismissal of its lawsuit challenging a regional haze plan, which state officials approved to help meet national air quality standards.
Court Says Opponents Can Sue Over Coal Plant Rule
The Colorado Supreme Court says opponents can proceed with a lawsuit over converting some coal plants to natural gas.
US Appeals Court Asked To Rehear Roadless Case
The state of Wyoming and the Colorado Mining Association want a federal court in Denver to reconsider a rule prohibiting roads on nearly 50 million acres of land in national forests across the United States.
PUC Refuses To Reconsider Xcel Coal-To-Gas Plan
Colorado regulators are sticking to their decision to approve plans for Xcel Energy to retire some of its coal-fired power plants and switch others to run on natural gas.


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Post-operative method for the treatment of ocular pain following corneal reprofiling surgery by topical administration of an ophthalmic nonsteroidal solution and an ophthalmic steroidal composition. The nonsteroidal solution comprises a non-steroidal anti-inflammatory agent such as diclofenac sodium and the steroidal composition contains a corticosteroid such as fluorometholone. These ophthalmic medicaments when used in combination reduce the post-operative pain particularly associated with phototherapeutic keratectomy and photorefractive keratectomy performed with an excimer laser and promote re-epithelialization over the reprofiled corneal surface.
1. A method of treating post-operative ocular pain following corneal laser reprofiling surgery which comprises administering topically to the effected eye of a human host immediately after said laser reprofiling surgery a therapeutically effective amount of an aqueous opthalmic solution of diclofenac or isotonic salts thereof which is effective to reduce the noninflammation-associated ocular pain.
2. The method according to claim 1 wherein said corneal laser reprofiling surgery is selected from the group consisting of photorefractive keratectomy and phototherapeutic keratectomy.
3. The method according to claim 2 wherein said corneal laser reprofiling surgery is photorefractive keratectomy performed with a high energy excimer laser.
4. The method according to claim 1 wherein the effected eye is covered with a bandage soft contact lens.
(1). Field of the Invention
This invention relates to a method for the topical treatment of ocular pain following corneal surgery. More particularly, the invention relates to the topical ophthalmic use of a non-steroidal anti-inflammatory agent in combination with a steroid for treating post-operative pain associated with corneal reprofiling surgeries.
(2). Description of the Prior Art
Various surgical procedures are known for altering the geometry of the cornea to correct refractive errors in vision. Such surgical procedures include radial keratotomy (RK) which is intended to correct myopia caused by excessive corneal curvature. In this procedure, a series of incisions is made in the cornea, usually penetrating about 90 to 95% of the thickness of the cornea. The incisions radiate outwardly from the corneal center and allow the cornea to relax and to flatten out somewhat, thereby reducing or eliminating nearsightedness. Similar corneal reprofiling procedures such as incisional keratotomy (IK), in which the incisions are made in directions other than radial, have been employed to correct certain astigmatisms.
Until recently, such surgical procedures were commonly carried out using instruments such as diamond or steel knives and razors. However, the results achieved in corneal operations using mechanical instruments are not highly predictable or controllable in any given patient and some patients have encountered post-operative discomfort and moderate pain related to damaged ocular tissue caused by surgical abrasion.
Recently, new laser surgical techniques have been developed which ablate the cornea to alter its refractive properties or otherwise treat corneal abnormalities. These laser reprofiling techniques include phototherapeutic keratectomy (PTK) in which laser radiation is applied to the cornea with minimal heating effects to ablate or smooth the cornea and remove opacities. When used to ablate very thin layers of corneal tissue to alter the curvature of the cornea for reducing or eliminating myopia, hyperopia or astigmatism, the procedure is typically referred to as photorefractive keratectomy (PRK). These corneal reshaping operations are presently performed with a high energy excimer laser which emits ultraviolet (UV) radiation capable of removing corneal tissue in a precise and incremental manner without thermal damage to surrounding tissue. For further details on PRK techniques, reference is made to Marshall et al., "Photoablative Reprofiling Of The Cornea Using An Excimer Laser: Photorefractive Keratectomy," Lasers in Ophthalmology, Vol. 1, pp. 21-48 (1986). Also, U.S. Pat. No. 4,665,913 to L'Esperance describes a PRK procedure for changing the contour of the anterior surface of the cornea by directing pulses from an excimer laser in a scanning pattern that moves around the cornea.
In clinical trials of PTK and PRK procedures, patients typically experience significant ocular pain immediately following surgery, which usually persists until corneal re-epithelialization. Despite the post-operative use of cold compresses, bandage soft contact lenses, cycloplegics, narcotics and corticosteroidal ophthalmic agents, patients usually describe the pain as severe, sometimes throbbing in nature and associate it with a burning, stinging sensation, as well as photophobia, tearing and nasal congestion. Some patients have characterized this type of pain as the worst they have ever experienced.
A number of ophthalmic substances have been reported in the patent literature for the control or treatment of ocular inflammation. For instance, U.S. Pat. No. 4,829,088 to Doulakas describes a ophthalmic medicament containing diclofenac sodium in aqueous solution for the treatment of inflammation of the eye. Also, U.S. Pat. No. 4,960,799 to Nagy (assigned to Ciba-Geigy Corp.) discloses that diclofenac sodium in the form of an aqueous solution can be useful in the control of post-operative inflammation resulting from cataract removal. However, the patentee fails to mention post-operative pain. This may be due to the fact that the severity of pain associated with complex corneal surgeries of the type described hereinabove is not commensurate with the relatively moderate discomfort associated with cataract removal. Moreover, these prior art formulations when used alone were found to be less effective in treating ocular pain of the type associated with such corneal surgeries.
Hence, there exists a need for a post-operative method for treating the newly reprofiled surface of the cornea to attenuate the pain, burning, stinging, photophobia and other adverse sensations that often accompany corneal surgical procedures.
Accordingly, it is an object of the present invention to provide a method for the immediate treatment or control of post-operative pain of the type associated with surgical procedures on the cornea of the eye.
It is a further object of the invention to provide a safe and effective post-operative procedure for treating severe pain and other adverse sensations following excimer laser photorefractive keratectomy (PRK), phototherapeutic keratectomy (PTK), radial keratotomy (RK) and incisional keratotomy (IK).
These and other objects are accomplished in accordance with the present invention which provides a method of treating post-operative ocular pain following corneal surgery which comprises administering topically to the effected eye of a human host a therapeutically effective amount of an aqueous ophthalmic solution of a nonsteroidal anti-inflammatory drug, and an ophthalmic composition comprising a corticosteroid in a pharmaceutical acceptable carrier therefor.
In a preferred embodiment of the invention, the present method can be safely used to substantially reduce the post-operative pain and suffering experienced by patients who have undergone excimer PRK and PTK. Thus, the method of the present invention would eliminate a significant problem associated with this surgical technique, which continues to generate wide interest for the treatment of refractive errors and corneal scars, and offers readily apparent advantages over the inconveniences afforded by conventional methods of vision correction, i.e., corrective lenses such as eyeglasses or contact lenses.
The foregoing and other aspects, advantages and objects of the invention may be more fully appreciated by reference to the following detailed description.
As noted above, it has been found that the immediate post-operative use of an ophthalmic nonsteroidal anti-inflammatory drug (NSAID) solution combined with a topical corticosteroid significantly reduces the pain after corneal surgery, especially following excimer PRK and PTK.
The NSAID solution utilized in the method of the present invention can be any such formulation suitable for topical use. The topical NSAID solutions should preferably be isotonic and have a relatively neutral pH. Conventionally, ophthalmic solutions are rendered isotonic by the addition of alkali metal salts, preferably sodium salts. Representative of such ophthalmic formulations include aqueous solutions of diclofenac, flubriprofen, suprofen and ketorolac. Other equivalent ophthalmic formulations may also be selected. In this regard, attention should be focussed on the formulation's ability to reduce post-operative ophthalmic pain synergistically in combination with a topical corticosteroid. One such synergistic pain reducing combination would be the blocking of separate intermediate pathways involved in the production of pain-producing prostaglandins.
A particularly preferred ophthalmic NSAID formulation for use in the present method is a 0.1% aqueous solution of diclofenac sodium, available from Ciba Vision Ophthalmics, Atlanta, Ga., under the trademark VOLTARIN OPHTHALMIC. Diclofenac sodium itself is designated chemically as 2-[(2,6-dichlorophenyl)amino] benzoacetic acid, monosodium salt, with an empirical formula C14 H10 Cl2 NO2 Na and is a potent aniline phenylacetate nonsteroidal anti-inflammatory drug conventionally used in relieving the signs and symptoms associated with rheumatoid arthritis, degenerative joint disease and allied conditions. Diclofenac sodium belongs in a class of drugs which are known as cyclo-oxygenase inhibitors (COIs) which includes flubiprofen (OCUFEN, Allergan Co.), Suprofen (PROFENAL, Alcon), and most recently ketorolac (ACULAR, Allergan).
In 1991, VOLTAREN OPHTHALMIC was introduced in the U.S. for the treatment of postoperative inflammation following cataract surgery. For a detailed description of this marketed formulation, reference is made to aforementioned U.S. Pat. No. 4,960,799.
Various topical ophthalmic compositions comprising a corticosteroid in an acceptable carrier would be suitable in the present method. Examples of suitable corticosteroids include prednisolone acetate, fluorometholone or its acetate, dexamethasone, and hydrocortisone acetate. Again, other equivalent ophthalmic corticosteroid compositions may be selected. Compositions of these particular steroids can be administered as solutions, suspensions, or dispersions in a suitable ophthalmic vehicle.
A particularly preferred corticosteroidal composition for use in the present method is a 0.1% fluorometholone solution. Fluorometholone itself is a corticosteroid described as 21-desoxy-9a-fluoro-6a methylprednisolone, and was traditionally used topically in the treatment of allergic dermatoses and other inflammatory skin conditions.
The frequency and duration of topical administration of the foregoing ophthalmic NSAID solution and corticosteroidal composition, the sequence of administration, and concentration of treatment agents may obviously vary depending upon a number of factors, including the nature of the corneal surgical procedure, the extent of corneal reprofiling, the medical history of the patient, symptoms prior to, during or after surgery, and the extent of the refractive condition of the eye. Selection of a particular treatment agent or its concentration can be made by the skilled clinician guided by the foregoing description.
The method of the present invention may be practiced in conjunction with the post-operative use of cold compresses, bandage soft contact lenses, antibiotics, cycloplegics, narcotics and other ophthalmic agents. For instance, the broad spectrum aminoglycoside antibiotic tobramycin and the parasympathetic cycloplegic homatropine hydrobromide, C16 H21 NO3 HBr, in suitable ophthalmic vehicles may additionally be topically administered immediately following ablation. Also, during the present post-operative treatment, the patient may be permitted to use aspirin, acetaminophen, Mepergan Fortis (50 mg of meperidine and 25 mg of promethazine) (Wyeth-Ayerest, Philadelphia, Pa.) and oral narcotics as needed. In view of the present disclosure, the specific regimen used in administering these and other ocular treatment agents in combination with the method of the present invention would be well within the purview of any person skilled in the art.
In addition, a disposable bandage soft contact lens may be placed atop the treated eye following corneal surgery to foster re-epithelialization. As an alternative to the bandage soft contact lens, collagen shields or patching may also be used in conjunction with the present method to enhance re-epithelialization.
Rapid epithelialization after corneal surgery is desirable for a number of reasons including the elimination of pain and discomfort, the reduced risk of infection and the more rapid improvement of visual acuity. While it is not known which combination of postoperative regimens will aid in achieving the quickest re-epithelialization, further clinical study is underway to refine this determination. It is known that the use of a bandage soft contact lens may predispose the eye to a higher risk of bacterial keratitis and delayed healing in some patients. This risk may be offset by the more frequent application and higher concentration of antibiotics. However, it is believed that the immediate use of a bandage soft contact lens improves patient comfort and promotes an earlier return of visual acuity.
In a specific embodiment of the inventive method, a patient is topically administered an ophthalmic aqueous solution of diclofenac sodium immediately after myopic PRK. The patient is also post-operatively administered fluorometholone 0.1% solution. Tobramycin 0.3% ophthalmic solution and 5% homatropine hydrobromide are also administered post-operatively as an antibiotic and a cycloplegic, respectively. The patient is then fitted with a disposable soft contact lens. Subsequent to this initial administration, the topical diclofenac sodium regimen is repeated four times a day.
In this specific embodiment, the diclofenac sodium ophthalmic aqueous solution contains diclofenac sodium at a 1 mg/mL concentration. Further, the aqueous solution comprises boric acid, disodium ethylenediamine tetraacetic acid (1 mg/mL), polyoxyl (35 mol.) castor oil, purified water, sorbic acid (2 mg/mL), and tromethamine. The solution is contained in a sterile plastic dropper bottle adapted for ocular administration.
More specifically, immediately after the laser procedure, the patient is administered one drop of the diclofenac sodium ophthalmic solution. Immediately following the ablation, 0.1% fluorometholone is started and followed every two hours. Additionally, the 0.3% tobramycin drops is given four times daily and the 5% homatropine hydrobromide is administered immediately postoperatively. The disposable soft contact lens having a +0.50 diopter is placed over the ablated zone. The diclofenac sodium solution was subsequently applied to the operative eye every six hours.
The specific embodiment set forth hereinabove has been clinically studied to determine its effectiveness. The following clinical study is representative of results obtained by the method of the present invention.
A randomized, double-masked parallel group study of diclofenac sodium 0.1% ophthalmic solution (DSO) or its placebo vehicle (PLA) was performed in accordance with the specific embodiment of the present invention. Patients undergoing excimer myopic PRK on their second eye were admitted overnight. Postoperative procedures included two drops of DSO or PLA immediately after surgery and then four times a day, topical tobramycin (q.i.d), 0.1% fluorometholone (q. 2 h.), cycloplegics, and a disposable soft contact lens. Thirty two patients (DSO=16, PLA=16) were evaluated from 30 minutes to +96 hours by several types of questionnaires. Patients that received placebo experienced pain, starting at one hour, peaking at 4 hours and lasting 36-48 hours. The DSO-treated patients rarely experienced the early peak in pain and had less pain until 36 hours post-op and experienced significantly less photophobia, burning and stinging. Significantly fewer patients on DSO required oral narcotics. Three patients (DSO=2, PLA=1) developed corneal infiltrates, the etiology of which is not known. The following tables summarize the results of the clinical study:
Table 1: Summary of total pain in the first 6 and first 24 hours and the maximum pain intensity during the first 24 hours.
Table 1a: Samples of categorical pain scale.
Table 1b: Visual Analog Scale.
Table 1c: Ocular descriptions.
All filled out by the patients.
Table 2: Ocular Pain Assessment at 24 hours after Excimer PRK. Represents summary of Categorical Scale. Represents means of 16 patients in Placebo group and 16 patients in Diclofenac group.
Table 3: Patient Assessment of Pain, Categorical Scale. Time course of pain to 96 hours after surgery. All points represent mean of 16 patients in each group. Extended bars represent S.E.
Table 4: Patient Assessment of Pain, Visual Analog Scale. Represents time course of pain to 96 hours. All points represent mean of 16 patients in each group. Extended bars represent S.E.
Table 5: Patient Assessment of Light Sensitivity after PRK. Represents time course to 96 hours after surgery. All points represent mean of 16 patients in each group. Extended bars represent S.E.
Table 6: Patient Assessment of Stinging and Burning after PRK. Represents time course to 96 hours after PRK. All points represent the mean of 16 patients in each group. Extended bars represent S.E.
Table 7: Percent of Patients Taking 0, 1, 2, 3 or 4 Oral Narcotic Pills During the First 24 Hours After Excimer PRK.
TABLE 1______________________________________ P-Value* Visual Efficacy Variable Categorical Scale Analog Scale______________________________________Total pain intensity first 6 hours <0.01 <0.01 Total pain intensity first 24 hours <0.01 <0.01 Maximum pain intensity first 24 hours <0.001 <0.05______________________________________ *Statistically significant difference between DSO and PLA (twosided) by the Wilcoxin rank sum test. In all cases, the DSO group was favored.
TABLE 1a______________________________________CATAGORICAL PAIN SCALE - COMPLETED BY PATIENT a. The amount of pain in your eye at this moment is: NONE MILD MODERATE SEVERE______________________________________Operated Eye 0 1 2 3 Opposite Eye 0 1 2 3______________________________________
TABLE 1b______________________________________VISUAL ANALOG PAIN SCALE - COMPLETED BY PATIENT b. Please place an "X" on the dark, solid line below to indicate the amount of pain, if any, that you feel at this moment in your operated______________________________________ eye:Mild Moderate Severe |----------| |----------| | ----------|No |------------------------------------------| Worst Pain Pain Ever______________________________________
TABLE 1c______________________________________OCULAR DESCRIPTORS - COMPLETED BY PATIENT c. In each category, circle one term which describes the type of sensation that you feel at this moment in your operated eye: NONE MILD MODERATE SEVERE______________________________________Foreign Body 0 1 2 3 Sensation Light Sensitivity 0 1 2 3 Deep Headache-Like 0 1 2 3 Pain Within Eye Stinging/Burning 0 1 2 3 Itching 0 1 2 3Temperature 0. HOT 1. WARM 2. NORMAL 3. COOL 4. COLD______________________________________
As shown in the tables, the unexpected results of the study are clearly demonstrative of the post-operative use of DSO and topical fluorometholone in significantly reducing pain after excimer PRK. It is believed that such results will revitalize interest in pioneer PRK technology, a technology where problems associated with post-operative pain have been long felt, and until now, unsolved.
The specific mechanisms underlying the post-PRK/PTK pain-relieving effect of diclofenac sodium as a component in the specific embodiment of the invention is presently unknown, but is believed to be dependent on several factors. It has been advanced that, as a COI, its effects may be mediated through the effect on the cyclo-oxygenase pathway. COIs display an anti-inflammatory effect which in some instances results by inhibiting the production of prostaglandins, and more specifically, by blocking the transformation of arachidonic acid (AA) to pain-producing prostaglandins.
As with the diclofenac sodium ophthalmic solution, the specific mechanisms underlying the post-PRK pain reducing effect of fluorometholone in the specific embodiment may also be dependent on several factors. It is advanced that like diclofenac sodium, fluorometholone inhibit prostaglandin biosynthesis. However, fluorometholone acts at an earlier location in the pathway by reducing levels of phospholipase A2 which normally aids in the production of AA from the phospholipase pool. It is believed that the combined use of fluorometholone and diclofenac sodium to block separate intermediate pathways results in the unique synergistic post-PRK pain-reducing effect accomplished by the present method.
It should be understood that the suggested interpretation by which the present therapeutic method operates to produce the post-operative analgesic results is merely proposed as a theoretical guide. It is not intended that the present invention be limited to any particular theory or mechanism involving interrelated biological systems.
It should be further understood that there may be various changes and modifications of the representative embodiments herein chosen for purposes of description without departing from the spirit and scope of the invention. Accordingly, the foregoing descriptions are not to be interpreted as restrictive of the invention beyond that necessitated by the following claims.
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NC State Holds Off Wake Forest In A Wild One, 11-9
April 15, 2005
WINSTON-SALEM, N.C. - Jeff Stallings pitched six strong innings and NC State built an 11-1 lead before the bullpen double-clutched the momentum back to Wake Forest in a wild and woolly 11-9 victory in the first game of an Atlantic Coast Conference baseball series at Gene Hooks Stadium.
The Wolfpack improved to 26-10 overall and evened its ACC record at 8-8. Wake Forest, which actually brought the go-ahead run to the plate in the bottom of the eighth inning, fell to 15-20 overall and 8-11 in the conference.
Stallings (5-3) allowed just one run on four hits, walking one and striking out a career-high seven. Joey Devine worked a 1-2-3 ninth inning to notch his seventh save. Wake Forest starter Josh Ellis took the loss after allowing six runs, two earned, on nine hits in 3 2/3 innings. He walked three and struck out two.
Aaron Bates led the offense for the Wolfpack with two hits in four at-bats and three RBIs. Lee Mezistrano went 2-for-5 and drove in a pair of runs, and Aaron Cone hit a single, double and home run in four trips. J.B. Tucker went 2-for-4 and drove in a run for the Deacons.
Wake Forest scored a run with two out in the bottom of the first. Tucker worked Stallings for a walk and Ryder Mathias was hit by a pitch. Brendan Enick drove in Tucker with a single up the middle to make it 1-0.
The Wolfpack got that run back in the top of the third when Matt Camp singled to left with one down, went to second on a groundout, and scored on Bates' single to center field.
NC State struck for five runs in the top of the fourth. Cone led off with an opposite-field home run to left field to give the Pack a 2-1 lead. Ramon Corona walked and Bryan Kinneberg was safe when Ellis fumbled his sacrifice bunt for an error. Jonathan Diaz bunted the runners to second and third. Camp grounded to second baseman Ben Ingold, who threw out Corona at home plate for the first out. Matt Devine walked to load the bases. Bates singled to center to drive in two runs, and Lee Mezistrano doubled into the left-field corner to drive in two more, giving the Wolfpack a 6-1 lead.
Cone led off the fifth with a double to left-center and took third on Corona's sacrifice bunt to the pitcher. Kinneberg drove in Cone with a double to right-center, then took third on a fly ball to right-center and scored on a wild pitch, extending the Wolfpack lead to a seemingly comfortable 8-1.
The Wolfpack appeared to put the game completely out of reach in the top of the seventh. Cone led off with a walk and Corona was safe on an error by Matt Antonelli at third base. Kinneberg flied to center field to move Cone to third, and Diaz walked to load the bases. Camp grounded to shortstop, but Andy Goff's throw to second was wide of the bag for an error, allowing Cone and Corona to score. Devine sent Diaz home with a sacrifice fly to make it 11-1.
The Wolfpack bullpen almost coughed away the lead in the seventh and eighth. Freshman righthander Matt Payne came in to start the bottom of the seventh and threw 15 consecutive pitches wide of the strike zone before he was pulled in favor of Sam Walls, whose first pitch was ball four to drive in a run and cut the lead to 11-2. Ben Ingold took two more out of the strike zone to run the string to 18 consecutive balls before grounding into a double play to chase home another run and make it 11-3, but also diffusing the rally.
The Deacons made it a game again in the bottom of the eighth. With one out, Enick and Matt Miller walked, and one out later pinch-hitter Grant Achilles walked to load the bases. Brett Linnekohl hit a grounder to second base that Corona threw away at second for an error, allowing a second run to score, and Linnenkohl went to second and Achilles to third when Walls threw the ball away at home plate for a second error on the play.
Adam McLaurin came in to pitch for the Wolfpack at that point and threw a wild pitch that scored Achilles to make it 11-6, with Linnenkohl moving to third on the play. Antonelli walked to put runners on the corners, and Ingold, Tucker and Ryder Mathias followed with consecutive RBI-singles to make it 11-9.
The second game of the series will be Saturday at 1:30 p.m. The game will be broadcast live on WKNC-FM (88.1) and on the internet at gopack.com through Yahoo's subscription service. Live in-game stats will be available on gopack.com through the Gametracker.


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Most of the time when we visit Disney parks we stay right there and don't venture too far.
But our next trip will have us in Anaheim for most of the winter, so we will want to go to different places as well as
get our fill of Disney.
This is probably a silly question, because there is always traffic. But I am wondering how early to head to Hollywood/Universal/L.A. for example...and how late to wait before getting on the freeway without experiencing bumper to bumper.
Anyone with suggestions and advice...thanks!


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Several of the presentations and much of the open discussion focused on the new challenges facing nations and research organizations in this changing environment. These challenges were mentioned by several participants:
__ reconciling the imperative for increased collaboration with the differing time horizons and goals of partner organizations;
__ defining a government role that advances the interests of domestic constituencies while recognizing the global nature of markets and technology development.
Several presentations highlighted the trend of growing international collaboration in science and technology at the private sector level. Other participants asserted that additional work will be needed to learn from positive examples and fulfill the potential for global cooperation in advancing fundamental knowledge. Individual participants suggested a range of possible next steps, including:
__ developing a common view of fundamental research as a global good, and organizing mechanisms to ensure adequate support;
__ building institutions at the national and international levels that can effectively develop and implement new collaborative initiatives;
__ establishing mechanisms for sharing experience and perspective internationally on issues of common concern, such as appropriate evaluation techniques and ways to improve communication between scientists, engineers, and political leaders.


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Julian Assange, WikiLeaks editor-in-chief recently granted asylum by Ecuador, delivered a speech on August 19 calling for the US to end its war on whistleblowers and dissidents. He named Pfc. Bradley Manning, former NSA employee William Binney, former NSA employee Thomas Drake and former CIA agent John Kiriakou as people who had been victims of this war. He also urged the US government to dissolve an FBI investigation that has targeted founders, owners, managers or staffers of WikiLeaks.
I appeared on "The Big Picture" on RT last night to discuss Assange's speech and the asylum decision. Mark Weisbrot of the Center for Economic and Policy Research (CEPR) appeared during the same segment as well. Sam Sacks filled in for Thom Hartmann, who typically hosts the show.
Sacks stated in the setup to the discussion Binney, Drake and WikiLeaks staffers are "new faces" or "new victims" in an "assault spearheaded by the United States against those who are trying to bring corruption, war crimes, constitutional violations and corrupt and governmental abuse into the spotlight. They are whistleblowers and freedom of information activists who are exposing the corporate state, its assault on dissent and its ruthless expansion of influence around the planet." Sacks noted the struggle is bigger than Assange and WikiLeaks.
"It's the first time that somebody is seeking asylum, fleeing persecution from the United States government and going to a democratic country and getting political asylum," Weisbrot said. He was actually granted diplomatic asylum, not political asylum but the essence of the point is sound.
Weisbrot added that the roles of Sweden and the United Kingdom had been "whitewashed." They have not offered any reason for why they have to bring Assange to Sweden. "He's not charged with any crime. They can question him in the UK. And very few journalists—and that I think is a sad thing about journalistic profession today—have even tried to get an answer from the Swedish government." Also, "If this is supposedly about a criminal case, why are they letting it go two years without investigating it?"
I said on the program that the political climate in the US is ripe for an extradition of Assange. The FBI is clearly looking into individuals outside the WikiLeaks, as evidenced by a more than forty thousand page investigative file made public during the court martial proceedings against Manning.
I added at the end of the segment the asylum is a great opportunity for "people to see the sort of beacon of democracy and freedom that the Latin American countries of the world are becoming, that they are willing take seriously international law and human rights while the United States shows an unremitting indifference to these ideals."


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"I made these for Easter. They turned out super cute! The cookie is a pecan sandie-type, and the fondant eggs are actually very good." – elt
"Absolutely amazing cookies, especially when paired with the top rated Sugar Cookie Icing recipe on here. Love these!" – Anne Kathryn Daily
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"Really good sugar cookies! I glazed them with an icing sugar-orange juice glaze. My three-year-old then went crazy with the Easter-themed sprinkles." – Duckball
"I loved the way this icing set up, yet was still easy to bite through days later! It was easy to make and tint...and it was also very tasty!" – Kris
Recipe of the Day
Bunny Cookies
A fun Easter cookie for the children. Great tasting too!
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These potato dishes are an Easter ham's best friend.
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***The official Alden thread *** - Page 4985
Styleforum Top Picks
That's it! I'm getting me some LHS.
I'm on a few lists for Whiskey but the itch is too strong. I'm going to pick up the 986. I'm a regular 11.5/12d and read that the Van last is a bit big, do most people size down 1/2 size? If i'm a 12d in aberdeen/grant would a 12b/c work?
LoL, what tossed you over the fence?
I hate giving Van last advice, as it is a 3 dimensional problem, and the Van last is a lower vamp last and can be difficult for many to size. I personally go with my Barrie size on them (1/2 down).
I'm scared going down to the 11's I guess!
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What set me over the edge? I have missed out on Whiskey LHS a couple of times over the years. Every time I see a Ravello or Whiskey LHS photo I drool like an imbecile. Warning: Spoiler! (Click to show)
I'm scared going down to the 11's I guess!
I completely understand.
Also, for me, I seem to take the same size in van and barrie (11 C). Note that I don't own the LHS and have only tried it on. But that's just because I'm waiting for it in whiskey like you (ravello would also be great).
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Can anyone else say Whiskey Wednesday?
Whiskey LWB + Alden Whiskey Belt (no crotch shots for ya'll)!
Sorry, not as creative on the location as say Tampa Travel... Warning: Spoiler! (Click to show)
Thank You Fellas! @mdubs those are ridiculous kicks! Wow.
I'll try to get a Tampa man hole cover next time....
I haven't been able to try on any LHS's in shell but like the comment above, think I may pull the trigger. A few questions that I would be grateful on getting replies: I'm a 9D Plaze, 9D Grant and about a 8.75 on Barrie. Can anyone give sizing rev's? Also, what retailers typically carry them? Would love to get a pair in Ravello but can see getting use out of cigar or #8 also. Is the Brooks Bros model also on the Van last? Thanks in advance
Sounds like you are in between an 8.5 and 9. The 986 (colour 8) are a standard Alden offering and can be found everywhere (shoemart).
I saw a picture of the LHS in colour 8 with an antique edge a while back, I would be all over those if I could find them.
I haven't seen a Ravello release of the LHS in a long time (to be honest I am not on a list for them, so they might have been confirmed at some point). Whiskey was available last year briefly from some retailers.
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Almost glad that I don't have a card, otherwise my wallet will hate me. cannot believe size 10 is still available after so many hours.
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10 sold out when I went to check out. I went ahead and bought the shell LWB in 10.5. I figure if they restock in the next 60 days I'll swap out for my normal size. If they don't, then I can just return them.
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from previous experience, you should be able to extend that discounted price beyond the 60days if they dont restock by then. I got the wrong size in my first ever pair of aldens ordered (403s), and needed 3 months IIRC for them to restock in my correct size. they honored the discounted price that I received..
Styleforum Top Picks
- Luciano Barbera Red VestNo reviews yet.


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Querceto Chianti Classico Riserva 2007
Querceto - Tuscany - Italy - Chianti Classico
Professional Wine Reviews for Querceto Chianti Classico Riserva 2007
Rated 90 by Wine Spectator
Full-bodied and really beautiful, showing floral, currant and plum aromas, silky tannins and a fresh finish. Drink now.
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12 Bottle
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Additional Information on Querceto Chianti Classico Riserva 2007
Vintage: 2007
2007 was the year that saw California's wine industry pick up once again, after a troubling couple of years. Indeed, all across the state of California, fantastic harvests were reported as a result of fine weather conditions throughout the flowering and ripening periods, and Napa Valley and Santa Barbera wines were widely considered amongst the best in the world in 2007, with Pinot Noir and Cabernet Sauvignon grapes packing in all sorts of fine and desirable features in this year. South Africa, too, had a much-needed fantastic year for red wines, with Pinotage particularly displaying strong characteristics, alongside the country's other flagship red wine grape varietals. Over in Europe, France had another fine year, especially for white wines. Champagne wineries were very happy with their Chardonnay harvests, and the Loire Valley and Graves in Bordeaux are proclaiming 2007 to be a memorable year due to the quality of their white wine grapes. For French red wines, Provence had their best year for almost a decade, as did the Southern Rhone. However, 2007 was most favorable to Italy, who saw high yields of exceptional quality across almost all of their major wine producing regions. Tuscany is claiming to have produced its best Chianti and Brunello wines for several years in 2007, and Piedmont and Veneto had a wonderful year for red wines. For Italian white wines, 2007 was an extremely successful year for Alto Adige and Campania. Germany also had a very good 2007, with Riesling displaying extremely dry and crisp characteristics, as did Portugal, where Port wine from 2007 is said to be one to collect.
Varietal: Sangiovese
Wines made with the round, darkly colored Sangiovese grape varietal tend to demonstrate the grape's key attributes: high acidity, moderate tannins and pale red color These grapes have been grown in their native Italy for thousands of years, and are said to be one of the key varietals which were so loved by the ancient Etruscan and Roman civilization Fast forward a few millennia, and all over the world, wineries are still growing these grapes in order to capture that renowned and flavorful essence. What makes Sangiovese so loved by drinkers and vintners alike is its wonderful ability to soak up the earthy, woody flavors of the oak barrels they are aged in, and present these in the glass alongside fresh, bright summer fruit notes. Whilst Sangiovese grapes are often blended during the fermentation process, they are also drank as single variety wines, both young and fresh, and aged and complex.
Region: Tuscany
The central Italian region of Tuscany is widely understood to be one of the world's most famous and highly regarded wine regions. The beautiful rolling hillsides and medieval towns and castles which are a key feature of the area are also home to many of Europe's finest wineries, and extremely high quality vineyards growing the distinctive Sangiovese and Vernaccia grape varietals which are the flavorful backbone of Tuscany's wonderful red and white wines. For almost three thousand years, this region has been recognized as an ideal home for wine production on a large scale, and the ancient Etruscans, Greeks and Romans all noticed that fine grape varietals flourished on the unique soils and under the hot sunshine which typifies the area. Today, Tuscany is home to a wide range of wines, from the traditional to the complex, but all dedicated to excellent flavors and aromas, and maintaining the region's international reputation.
Country: Italy
For several decades in the mid to late twentieth century, Italy's reputation for quality wines took a fairly serious blow. This was brought about partly due to lack of regulation in certain regions, and too much regulation in others. This led to several wineries in the beautiful and highly fertile region of Tuscany making the bold move to work outside of the law, which they saw as responsible for the drop in quality in Tuscan wines. They believed that they had the expertise and the generations of experience necessary with which to make truly excellent, world class wines, and set about doing just that. These 'Super Tuscans', as they came to be known, quickly inspired the rest of Italy to improve their produce, and now, Italian wine producers in the twenty-first century are widely recognised to be amongst the best in the world. Regulation and law began to change, and wine drinkers across the globe woke up to the outstanding wines coming out of Italy, which are continuing to improve and impress to this day.
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Buckley sets record for boys discuss
HUNTINGTON -- Christian Buckley from Poca, .W.Va., and the Capital City Striders track and field club set a Russell Blount East Coast Invitational record in the age 13-14 boys discus.
Buckley had a winning toss of 164-feet, 7 inches at the meet at Duke University in Durham, N.C. He also finished third in the shot put at 44-3.5.
Other members of the Striders bringing home gold medals included Lauren London of Hurricane in the age 13-14 pole vault (9-0) and Andrew White of Hurricane in the age 17-18 discus (160-5).
White also placed third in the shot put (51-0.25).
Noah Castro from Winfield was fifth in the age 9-10 boys 1500-meter run (5:19.94) and sixth in the 800-meter run (2:39.72).
Cathy Woods from Hurricane placed seventh in the age 11-12 girls mini-javelin (54-1).
Barkley Castro of Winfield took eighth place in the age 15-16 girls 800-meter run (2:33.21).
Quinten Buckley of Poca was fourth in the age 17-18 boys discus (137-11).


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- Attorney General Brad D. Schimel
- Fighting Crime
- Victim Assistance
- Consumer Protection
- Media Center
- About Department of Justice
- Topical Index
This Google™ translation feature is provided for informational purposes only.
The Office of the Attorney General is unable to guarantee the accuracy of this translation and is therefore not liable for any inaccurate information resulting from the translation application tool.
Please consult with a translator for accuracy if you are relying on the translation or are using this site for official business.Contact the Department of Justice
MADISON — Attorney General J.B. Van Hollen announced that on October 24, 2012, Franklin resident Fahmi Abdallah appeared in the state Circuit Court in Milwaukee County before Commissioner Laura Gramling Perez where he waived his right to a preliminary hearing, was bound over for trial, and was charged with three counts of theft of sales tax proceeds. If convicted, each count carries a maximum penalty of a fine not to exceed $25,000 or a term of imprisonment not to exceed 10 years, or both.
According to the criminal complaint, Mr. Abdallah ran a liquor store in the City of Milwaukee. During 2006, 2007 and 2008, Mr. Abdallah kept sales tax money that he had collected instead of remitting it to the Wisconsin Department of Revenue in the following amounts: $26,103 in 2006; $38,914 in 2007; and $33,017 in 2008.
The matter has been set for a status conference on Nov. 13, 2012, before the Honorable Michael D. Guolee, Milwaukee County Circuit Court Judge.
The charges are the result of an investigation by the Wisconsin Department of Revenue. Assistant Attorney General Eric D. Défort represents the State of Wisconsin as special prosecutor for the County of Milwaukee.
A criminal complaint is a document that alleges that a crime was committed by a person or a corporation. The defendant is presumed innocent unless and until proven guilty. A copy of the criminal complaint is available at:


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It seems that some human rights organization (or perhaps our secretary of state of 19-million-glass-ceiling-cracks fame) should care about all this: "Who, exactly, is it the misogyny-frenzied brutes in charge of administering 'justice' to the Saudi distaff side are protecting — and from what? When they condemn a woman who's been gang-raped to 200 lashes for 'having sex outside marriage,' or give a destitute 75-year-old widow 40 lashes for engaging in 'prohibited mingling' by receiving charity from two young male relatives, or, in the most recent (known) instance, sentence a 13-year-old girl to 90 lashes — to be delivered in front of her classmates — for bringing a cell phone to school — what do they believe they are doing?"
Meanwhile, Cliff May reminds us that "in a growing number of Muslim-majority countries, a war is being waged against non-Muslim minorities. Where non-Muslim minorities already have been 'cleansed' — as in Afghanistan and Iraq — the attacks are against their memory. Ethnic minorities also are being targeted: The genocidal conflict against the black Muslims of Darfur is only the most infamous example. … In response to all this, Western journalists, academics, diplomats, and politicians mainly avert their eyes and hold their tongues. They pretend there are no stories to be written, no social pathologies to be documented, no actions to be taken. They focus instead on Switzerland's vote against minarets and anything Israel might be doing to prevent terrorists from claiming additional victims."
Marc Thiessen dismantles Christiane Amanpour and her misrepresentations of waterboarding. Notice that when an informed conservative goes up against a liberal on terrorism issues (e.g., Cliff May vs. Jon Stewart, John Yoo vs. Jon Stewart), the liberal is never quite prepared. Almost like they all live in an echo chamber, with no one to challenge their firmly held and factually unsupported views.
Stuart Rothenberg moves the Arkansas Senate seat to "leans takeover": "Multiple independent polls now show Arkansas Sen. Blanche Lincoln (D) losing or running even in ballot tests against any number of lower-tier GOP challengers."
As if Arlen Specter didn't have enough problems (including picking the exact wrong year to switch parties): "The deeply odd couple of Sen. Arlen Specter (D-Penn.) and Rep. Michele Bachmann (R-Minn.) appeared together on a Philly radio station yesterday — and things got ugly in short order." Specter, it seems, told Bachmann to "act like a lady."
And Specter certainly does have problems: "Republican Pat Toomey now leads incumbent Senator Arlen Specter 49% to 40% in Pennsylvania's race for the U.S. Senate. The latest Rasmussen Reports telephone survey of Pennsylvania voters also finds Toomey with a 43% to 35% lead over Democratic challenger Joe Sestak." As goes Massachusetts, so goes Pennsylvania?
Quin Hillyer writes a smart column: you don't win upset political races unless you compete. "Too many professional pols and pollsters, consultants and consiglieres, allow their assessment of political potential to be hamstrung by conventional wisdom and by past results. Especially on the right of center, the political class in Washington consistently underestimates what can be achieved by solid principles well communicated. Washington Republicans especially act too often as if they expect to lose and are resigned to losing, just a little more slowly."


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Monday, October 8, 2012
Dr. Maria Gibson is a fourth-generation physician who grew up and started her medical career in Siberia. She first specialized as an OB-GYN, but expanded her scope to family medicine during residency at Duke University. She now serves as medical director for Trident Family Health Center, which provides comprehensive care to patients of all ages, from newborns to the elderly. She has been honored as one of Best Doctors in America and recognized by the National Committee of Quality Assurance for treatment of diabetes, stroke and cardiovascular diseases. Dr. Gibson delights in providing patients a medical home. She guides patients in managing chronic problems and mental disorders while also focusing on cancer prevention, womens health and patient education with a holistic approach. I partner with my patients not only to treat their illnesses but also manage their health and improve their quality of life, says Dr. Gibson, a national speaker and author.
Personal care and connection can make people feel more at ease. - Maria V. Gibson, MD, Ph.D. Medical Degree Siberian State Medical University, Tomsk, Russia Ph.D. in Medicine Institute of Obstetrics & Gynecology, Academy of Science-St. Petersburg, Russia Residencies Siberian State Medical University, Obstetrics & Gynecology Duke University Medical Center, Family Practice Fellowship Medical University of South Carolina, Faculty Development To make an appointment with Dr. Gibson, please call 843-572-8277.
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A taste of Greece on Georgian Bay...The OLYMPIA team is proud to provide residents, tourists and cottagers in the Southern Georgian Bay area with great service and fantastic Mediterranean and steakhouse inspired foods.
The OLYMPIA is one of the best restaurants north of Toronto. Since 1995, The OLYMPIA has been recognized as one of the top restaurants in Canada by the Where to Eat In Canada guidebook.
Call Louis Poulias at The OLYMPIA today for more information or for your custom event / catering quote.