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N-acetyl-cysteine reduced symptoms of trichotillomania, the constant urge to pull one's hair.
Doctors in a trichotillomania (TTM) study noted that N-acetyl-cysteine (NAC) helps regulate glutamate, one of the most common nerve signaling chemicals in the brain and prior studies have shown NAC eased other repetitive or compulsive disorders. Researchers gave 45 women and five men with TTM, average age 34, 1,200 mg to 1,400 mg of NAC per day or a placebo. After nine weeks, 56 percent of those who took NAC were much, or very much, improved compared to 16 percent for placebo.
Scientists explained that people with TTM pull their hair as a way to cope with anxiety and other difficult emotions. TTM does not hurt and those with TTM are not trying to damage themselves. Study authors noted that virtually all brain functions involve glutamate and believe this is the first attempt to modify glutamate nerve signal activity to treat TTM.


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First, there was Operation Knockout. Followed by Operations Tapout, Street Sweeper and Garlic Press.
Beginning with Knockout, the 2010 Monterey County case that launched a statewide assault on one of California's most prominent gangs, the intelligence gathered in that eight-month investigation by state Bureau of Narcotic Enforcement agents spawned a half-dozen takedowns of gang regiments around the state.
The bureau was known for its ability to handle complex, long-running wiretap and surveillance operations, run from some of its 55 local task forces around the states. But after drastic state budget cuts, BNE was shut down last December.
Now Monterey Peninsula law enforcement agencies are hoping to craft a similar team after dreams of a BNE-led regional task force in Monterey County vanished along with the 84-year-old agency.
Known as the Peninsula Regional Violence and Narcotics Teams, the PRVNT task force will be based in Monterey but includes officers and liaisons from 10 local agencies.
An ad-hoc version has already been active, and last month responded to a surge in gang violence in Seaside. In eight days, the ad hoc task force served three search warrants, arrested 11 suspects and seized eight firearms including an SKS assault rifle, officials said.
"I was very impressed with how they came together," Monterey Police Chief Phil Penko said. "You look at the successes this group has had in just three weeks."
The idea for the Peninsula's task force began around three years ago, when local law enforcement agencies planned to set up a BNE-led team with one hub in Salinas' Law Enforcement Operations Center and another on the Peninsula.
"Once BNE dissolved, both groups decided to venture out on our own," Penko said."BNE laid a very solid foundation on how task forces should be run."
One of the state bureau's strong points was its agents' ability to finesse long-term, high-tech investigations that local agencies often don't have the budget or training for.
But Penko said the new task force is getting help from the federal government on that front.
Monterey is one of 10 counties that fall within the Northern California High Intensity Drug Trafficking Area, a program overseen by the Office of National Drug Control Policy.
The program has already provided computers on loan to the task force, and can be called on when more complex investigations are under way, Penko said, "even if they're not going to be boots on the ground."
Former BNE Special Agent Bob Cooke is now director of training for the regional HIDTA, and he said the program is ready to provide analysts and other technical assistance, including help with the kind of elaborate paperwork needed for federal wiretap warrants.
"We're helping them get started and with training," Cooke said. "We'll also be there if they need help with more complicated investigations."
Penko said where there are gang and narcotics trafficking operations, the task force plans to "to follow the chain of command, follow the purse strings."
Although the Peninsula is not known as a hotbed of organized crime, Seaside police Cmdr. Bruno Diaz recently described an investigation of burglaries in that city that uncovered a crime ring connected to a business in Pacific Grove. The precious metal buyer bought gold jewelry "no questions asked," Diaz said, and had it quickly melted down.
Penko said PRVNT will operate "out of an existing city facility" and to date has spent $8,673 from asset seizure funds to buy and install eight work stations, in addition to $8,096 covered by the city of Monterey for the purchase and installation of eight telephone systems.
In a memo to the Monterey City Council, Penko said once the task force is up and running, such expenses will be reimbursed and shared among participating agencies.
He said Monterey police will contribute two full-time officers to the task force — a detective sergeant and a narcotics detective.
In addition, he said, the task force will be composed of one full-time officer from the California Highway Patrol; one full-time officer each from Marina and Pacific Grove police; a full-time commander and two detectives from Seaside police; and one part-time officer each from police departments in Carmel, Sand City and CSU Monterey Bay.
Monterey approved a memorandum of understanding with the other agencies at Tuesday's City Council meeting. Seaside has already approved its memo, and Penko said Marina's should come before that City Council Nov. 27.
Also taking part is the Monterey County District Attorney's Office, and Penko said other partners may join in the future.
"I envision this group would be working with the FBI, ATF, even the IRS," he said. "These cases will run the gamut from street operations to long-term (investigations). I think anything's game."
Julia Reynolds can be reached at 648-1187 or email@example.com.

subset: commoncrawl


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Steam cook the potatoes and skin them, then slice into thin disks
Heat the oven to 8 or 220°
Peal the onions and cut them into small, fine rings.
Remove the rind from the bacon and cut into small squares
Then, in a large frying pan, heat the oil and gently cook the potatoes, onions and bacon.
Sprinkle on the white wine, salt lightly and pepper generously
Pour half of the mixture into an appropriate oven plate
Slice, on its side, the Reblochon into two. Place half a Reblochon on the mixture
Cover this with the rest of the mixture, and put the other half of the cheese on the top.
Cook for about 20-25 minutes. The top on the dish should be a golden brown.
The oven allows the cheese to melt and impregnate into the bacon and potatoes producing a glorious rich savor of wholesome country food. A great dish for a quite evening by the fireside. To appreciate the true flavor of the cheese we suggest a green salad with a garlic dressing.
Ingredients :
Potatoes, 1.2 kilos ( 2.5 pounds)
1 large onion
2 handsome slices of smoked bacon
1 Reblochon
10 cl ( a cup) of dry white wine
Oil, salt and pepper
a Savoie wine such as a Chignin


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More and more people each year are discovering how Triking is a fun, easy, emission-free way to keep fit. TerraTrikes offer a great view of the scenery and an immediate relief from the aches and pains of traditional bicycles.They are great at replacing your car on short trips while laughing at gas prices. They are well respected in traffic due to their curious shape, and they are easy to transport on traditional bike racks or on a TerraTrike specific hitch rack. TerraTrikes have a comfort level and a cool factor that cannot be denied. Treat yourself to a test ride today, and be part of the solution.
With the best customer service in the industry, in stock product and quick turn around, getting your TerraTrike has never been easier.
Get access to special promotions, newsletters, deals and information before anyone else by signing up for a free MyTerraTrike account.
1 pair to fit a single caliper. Only fit Zoom brakes.
It's here! For the future and current adventurous Rambler owners out there, there is now a wheel package for your needs. The TerraTrike 24 inch All Road wheel package is for those who want to explore their wild side or to just easily get down a dirt road. This package comes complete with the Schwalbe Land Cruiser tires which have an aggressive tread pattern for off-road use and use on dirt roads. Plus, these tires have a center ridge for low rolling resistance on pavement, making it easy to transition from paved trails to off-road, and back again. This package is perfect for off-roading, camping, and all types of riding. It's better equipped for bigger bumps than our standard 20 inch wheels and it gives you higher ground clearance for those rougher roads.
The All-Road package features the TerraTrike double wall rim, tried and true hubs, rim strips, Schwalbe Land Cruiser tires, and tubes. It is compatible with the Base and GT component levels of the Rambler (external drive trains only).***After market does not include cassette***
Built with Volusion


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Cornetto, probably Italy's most popular icecream is online with an advertising campaign to promote its Free Music Festival. MRM Partners developed the micro-site presenting the concerts and the ads appear on Tiscali's portal in the Music and Entertainment sections. Pubblicità Italia reports the news, adding that Tiscali's pages have been "redesigned" to host the creative format 300×250 pixel. I'm sorry but I don't get it: how comes there are still agencies out there producing ads not compliant with the standards that oblige a publisher to redesign its pages? A part from this critic to MRM Partners or to whom decided the ads format, I must say the micro-site is nice and really makes you feel the concerts' atmosphere.
adidas advergame advergames advertainment advertising ambient marketing australia belgium best brazil coca-cola email marketing facebook fashion france germany google heineken ikea infographic italy japan marketing mobile content mobile marketing msn nike nokia online ads online advertising online campaign online marketing print advertising rich media samsung sms spain sweden tvc twitter uk video of the day viral marketing volkswagen wieden + kennedy


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Baylor hoping to return to team within six weeks
HOUSTON -- Don Baylor was getting wheeled into the operating room last Tuesday afternoon, about to undergo the five-hour surgery that would repair a broken right femur, and already the Angels' hitting coach was bargaining for a shorter recovery time. He has a follow-up doctor's appointment on Tuesday, and his quest will continue.
"His timeline and my timeline are two different things," Baylor said on a conference call after the Angels' 9-1 win over the Astros on Monday, "but I'm going to listen to the doctor."
The doctor's timeline: Six weeks until Baylor can put weight on his right side, which would allow the 64-year-old to move a little bit more freely and perhaps lead to him being with the team at home.
Baylor's timeline?
"I said maybe four."
"But I won't know until the doctor signs off on my rehab and things like that," Baylor cautioned. "I just have to kind of see how that goes. I wish I could give you the date, but I don't know just yet."
Baylor was discharged from UCI Medical Center late Friday afternoon and has been resting comfortably in his home in La Quinta, Calif., ever since, using a walker if he has to get around.
"I'm working on my upper body," Baylor said, laughing.
"I haven't had a lot of pain, really," he added. "A little discomfort maybe last night, but the medication took care of that."
Baylor's injury, common among skiers, was sustained right before Opening Day on March 31, while catching the ceremonial first pitch thrown by Vladimir Guerrero, when Baylor shifted all of his weight to the right side and couldn't get up on his own. He doesn't believe a previous bout with multiple myeloma, a cancer that attacks plasma cells in the bone marrow, was the cause.
"I'm trying to relive it in my mind," Baylor said. "I don't want to watch the replay, that's for sure. I felt like I just got drilled by a Nolan Ryan fastball. Just the impact that it felt when you try to stand up and it won't let you stand up. I've never had a dislocation or anything that hurt on the field like that. So it was pretty much a shock. You can't feel your leg and it's moving all over the place. You think it's a dislocation. I never thought it was a break, but that's what it was. We'll get through it, get through the rehab and get back on the field."
Baylor thanked UCI Medical Center for a "pretty wonderful" experience, called all the outside support -- from Major League Baseball Commissioner Bud Selig to former teammate Bobby Grich to Ryan himself -- "uplifting" and said "the Angels fans and family have really been unbelievable."
"I knew I had a lot of friends in baseball," Baylor said, "but I didn't know I had that many."
Alden Gonzalez is a reporter for MLB.com. Read his blog, Gonzo and "The Show", and follow him on Twitter @Alden_Gonzalez. This story was not subject to the approval of Major League Baseball or its clubs.


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Benefit Silky Finish Lipstick Reviews
I have one. .I bought one hearing how much people love them. I found it to be dry and it's drying on my lips. I can find better priced drug store lipsticks that are much more moisturizing. I love benefit, but not their lipsticks. — 5 years, 3 months agoTaylerbootz | 126 reviews
prettyvery moisturizing and really beautiful colors no staying power though — 6 years, 2 months agoaddkg777 | 237 reviews
Blink and you'll miss itA cunning array of flirty colors housed in a chic metal case with a vintage design make Benefit's Silky Finish Lipsticks tough to say no to. But you really should. The color goes on bright and shiny and feels silky smooth, but it'll be totally gone from your lips within a half hour. — 7 years, 10 months agoteshie | 396 reviews
Good Product!I like this, the way it goes on, the packaging. How long it lasts is pretty average. I feel that it is a bit overpriced though. — 9 years, 3 months agomvap47 | 345 reviews
This lipstick was used in "Twilight!"This lipstick comes in a lot of really gorgeous colors. Anyone can find something that flatters them. It doesn't last all that long, maybe 2 hours, so that disappointed me. SIDE NOTE: It was used in Twilight. The shade 'good-to-go' was what Kristen Stewart wore, and 'Ms. Behavin' was on all the Cullens. Just a fun little fact lol! — 8 years, 5 months agoj_orestano | 221 reviews
This review is: Helpful | Not helpful | Inappropriate | 1 of 1 people said helpful
Love these!I love this lipstick! It's so moisturizing and gorgeous. I have two colors. I admit despite being 30 I learned this is the lipstick from Twilight and had to try it. No underage vampires have seduced me yet, but I DID fall in love with a lipstick. — 2 years, 8 months agoMsAtomicBomb | 228 reviews
Good for when you are running into a store, etcI have this in Jing A Ling, very pretty color, love how it looks when I put it on.....but after the moisture seeps in, the rest just slides away, and it is like you have not even put anything on. I would adore this if it stayed on longer than 5 minutes. If you put it on before you touch up the last of your makeup to go out, then it will be faded by the time you are ready. It's too bad, because it is so pretty. — 9 years, 1 month agobecksstein | 160 reviews
I would not repurchaseThis product is not worth the price. The color is okay but it makes my lips looks dry. I'd rather purchase a product from drugstore. — 3 years, 10 months agoJuita | 3 reviews
Love the Color, Love the Feel -- Hate the WearI've had this lipstick now in two colors -- Rocket Pop, a beautiful natural silky pink and Frenched, a gorgeous deep red. They look so pretty and shiny and beautiful on my lips. For 10 minutes, until they begin to slide everywhere like they've melted. Ultimately, while I appreciate what Benefit was trying to do here, the execution fails because these are worse than a dime store lip gloss when it comes to staying power. — 4 years, 9 months agoliquidlinernote | 14 reviews
silky but not long lastingBenefit has great colors... but, they come off soo easily. I don't even have to drink, eat, or kiss anyone and the color rubs right off. I have to constantly reapply, which is very inconvenient! I don't recommend the silky lipsticks and I won't be buying anymore of their silky line. I give it 3 stars for the beautiful colors but what is the point of color when it doesn't last more than ten minutes! — 6 years, 8 months agomariam1 | 4 reviews
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My Reasons for Reporting This


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Proprietary Patterns; Cycle; Elliott Wave Relativity; Unique Stock Market Technical Analysis with Humblestudent
Public blog posts only as education and entertainment. private membership market updates reflect my view and analysis of the market. The information contained on this website and from any communication related to the author's blog and charts is for information purposes only. The chart analysis and the market comments do not hold out as providing any financial, legal, investment, or other advice. In addition, no suggestion or advice is offered regarding the nature, profitability, suitability, sustainability of any particular trading practice or investment strategy. The materials on this website do not constitute offer or advice and you should not rely on the information here to make or refrain from making any decision or take or refrain from taking any action. It is up to the visitors to make their own decisions, or to consult with a registered professional financial advisor. And i absolutely discourage trading options.


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My friends and I are traveling to Sylmar this Saturday to play the course. I'm pretty sure there is a monthly tournament that day.
My questions are:
What time does the event start? Do they close the course for a tournament of this kind? Will we be able to play, or will we have to wait for the tournament to end?
Note: I e-mailed and phoned Gary, but got no response.


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Much-needed rain helped whittle away the remnants of the drought for some Plains states over the last week, but further to the south and west, the drought drags on.
In this week's Drought Monitor, many states across the Corn Belt reported easing drought conditions.
Even in states dominated by drought just a few months earlier – such as Colorado and Nebraska – drought is finally receding. The drought still has a firm grip on much of the nation's midsection, and while many states have a long way to go before eliminating the drought completely, progress is worth celebrating.
The "Ag in Drought" report shows that 38 percent of corn is growing is going. Given that U.S. producers planted an estimated 97.4 million acres of corn, this suggests that nearly 53.6 million acres of corn are affected by drought.
In Texas conditions are continuing to intensify, and hydrologic impacts linger as the last three years of drought bring the state's reservoir system associated with the Colorado River down to historic lows. In the West, many states saw little – if any – improvement for yet another week.
Looking ahead, some areas may see much-needed precipitation over the next 10 days.
"The best chances for above-normal precipitation are over the Ohio River Valley and covering much of the eastern two-thirds of the country," the Drought Monitor report said. "Precipitation chances are trending below normal in the Pacific Northwest."
The U.S. Seasonal Drought Outlook, updated on Oct. 17, expects the areas of drought to shrink even further by the beginning of February.


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Rustic Kitchen Prep Counter
- Overview
Hello, handsome. Our new Rustic Kitchen Prep Counter adds instant surface space and storage to any kitchen. The stainless-steel top pays homage to zinc counters from Parisian bistros, while sturdy legs in acacia wood warm things up.
- Solid acacia wood frame.
- Stainless steel top.
- 30"w x 14.5"d x 38"h.
- Assembly required.
- Wipe clean.
- Imported.
- Make sure it fits! See our guide on measuring for delivery.
- Details + Dimensions
• Overall product dimensions: 30"w x 14.5"d x 38"h.
• Thickness of tabletop: 0.5".
• Clearance under counter: 7.5"
• Number of boxes: 1
• Shipping package: 42.8"w x 26.6"d x 9.5"h.
• Packaged weight: 62.1 lbs.
Assembly required.
Wipe clean with a soft damp cloth.
- Shipping + Return Info
- Most purchases are shipped from our Distribution Center by UPS, arriving in 4-5 business days.
- Quick Ship fabric items receive delivery in 2 - 4 weeks.
- Special order fabric (SPO) items receive delivery in 8 -10 weeks.
- For our guide to measuring for delivery click here.
The shipping rate varies depending on your order total and shipping options. Please note, some furniture, rugs and other large items that are bulky or heavy items have a delivery surcharge listed in parentheses ($) after the item price. These delivery surcharges are in addition to the standard delivery shipping charges. View Shipping Rates and Options
We happily accept returns on stocked items within the time frames listed below. Products designated as special order (SPO) cannot be canceled or returned. All items on our website and in-store are considered 'stocked' unless expressly identified as 'special order' instead. Prior purchases are not eligible for price adjustments. Please familiarize yourself with our returns policy before placing your order.
Stocked Items: If you are dissatisfied with your purchase of a stocked item, you must exchange or return it within the following time frames for a full refund of the merchandise cost (delivery fees are non-refundable). Outside these time frames, we will replace or refund your purchase against manufacturer's defects ONLY. Please note that we cannot accept returns on gift cards or items damaged through normal wear and tear. We also cannot accept returns of final-sale items, which are identified by a price ending in .99 or .97.
- Quick Ship upholstery items must be returned within 7 days of the order receipt date.
- All other stocked products must be returned within 30 days of the order receipt date.
Special Order Items (SPO): Because they're custom made to your specifications, special order items may not be canceled or returned and are exchangeable against manufacturer's defects ONLY. SPO includes special order upholstery items, monogrammed/personalized items, special order rugs, one-of-a kind rugs and any products being shipped directly from a third-party vendor. Any special order items will be flagged as 'special order' in your shopping cart. NEW JERSEY CUSTOMERS: Special-order upholstered furniture returns are subject to applicable state law and are non-returnable after 24 hours of delivery.
For further assistance please call our customer service department at 1.888.922.4119 or send an email to email@example.com
Pairs Well With
Rustic Bar Stool + Counter Stool
Rustic Counter Stools
Please Select Quantity: Individual
Please Select Color: Raw Mango
- Online Only
Rustic Bar Stools
Please Select Quantity: Individual
Please Select Color: Raw Mango
- Online Only
Hewn Wood Bar Stool + Counter Stool
Hewn Bar + Counter Stool
Please Select Size:
- Online Only


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Teaching Faculty
Medical Education: (248) 615-7393
Coordinator: Kathleen Summers
Annette LaCasse, D.O., P.C.
8906 Commerce Road
Suite 5
Commerce Township, MI 48382
Phone: (248) 363-5555
Fax: (248) 363-5519
Number of Dermatology Physicians on Staff: 8
Program Description
The Dermatology residency at Beaumont Hospital, Farmington Hills is a three-year accredited program and an integration of Michigan State University College of Osteopathic Medicine (MSUCOM), Beaumont Hospital and Pontiac Osteopathic Hospital. It was the first board-certified osteopathic dermatology residency in the country. Utilizing National Core Competencies as the educational template, this residency proudly graduates board-eligible dermatologists and boasts a 100% pass rate on the National Board Exam over the past twenty years.
Core trainers include a myriad of medical, surgical and full-time cosmetic dermatologists.
Residents electively rotate in pediatric dermatology, dermatopathology, Mohs surgery and plastic surgery. Didactics include patient grand rounds and Michigan Dermatology Society meetings with fellow osteopathic and allopathic dermatology residencies in the area. These include residents from University of Michigan, Wayne State University and Henry Ford Medical Center. Beaumont, Farmington Hills residents attend lectures and actively read slides weekly with a team of dermatopathologists.
In addition to their didactic and office schedules, residents cover dermatology consultations at both hospitals and run two independent resident dermatology clinics. They are responsible throughout the year for lecturing interns, medical students and residents in an array of topics.
Residents are expected to participate in both the annual and mid-year American Osteopathic College of Dermatology meetings and the American Academy of Dermatology annual meeting. The Michigan State University lecture series provides national lecturers throughout the year with leading dermatology physicians presenting diverse topics.
Interns and medical students are encouraged to rotate through the program with core attending physicians and participate in resident clinics.
ACGME Application
Dermatology is pleased to announce that they have achieved ACGME Initial Accreditation effective July 1, 2016. The program received Initial Accreditation with zero citations. Beaumont, Farmington Hills Dermatology program is committed to meeting program requirements, as specified by the ACGME.


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The future of growth is here. Watch HubSpot founders Brian Halligan and Dharmesh Shah deliver their keynote address live from INBOUND 2017. Then stay tuned in for the HubSpot Product Spotlight, a 45-minute session featuring HubSpot VP of Product Christopher O'Donnell.
Join us here today at 2:15 p.m. EDT to see visionary talks from HubSpot leaders, streamed live from INBOUND 2017.
With HubSpot's marketing, sales, and CRM software, you can grow like a company twice your size while connecting like a real human being.
FREE versions of every HubSpot product.
Start now and upgrade as you grow
HubSpot offers a full stack of products for marketing, sales, and customer relationship management: powerful alone, and even better when used together.
Free software that aligns sales and marketing so you can manage your pipeline without breaking a sweat.
HubSpot CRM gives you the power to manage all of your contacts and deals without messy spreadsheets or overcomplicated features.
But it's also the glue that connects our sales and marketing tools to give you incredible insight into every customer and complete control over your entire funnel.
Connect with Gmail or Outlook, and you can send emails, book meetings, or place calls from right inside the CRM, and log activity automatically as it happens.
Sync up HubSpot Marketing, and you'll be able to see which content leads are consuming and understand where they are in the buyer's journey.
It all starts here.
For businesses who want to increase traffic, convert leads, and confidently attribute their ROI.
The HubSpot Marketing software enables you to create, automate, measure, and optimize all of your online marketing in one place.
Create search-friendly blog posts, build landing pages without IT, trigger automated email campaigns and workflows, and personalize every experience with dynamic content that changes with a customer's context.
With HubSpot Marketing, all of this isn't just possible — it's easy.
For sales teams who want to sell more, work less, and make their process more human.
You hate busywork and guesswork, so we made sales less work.
HubSpot Sales gives you a full suite of tools to scale up your sales without adding to your workload.
Put prospecting on autopilot, create and test email templates, know the instant a lead opens your email, and follow up when you're already on their mind.
Every activity is logged automatically, and every deal can be monitored at a glance.
Welcome to the friendlier side of sales.
You don't have to go it alone. Master the inbound methodology and get the most out of your tools with HubSpot's legendary customer support team and a community of thousands of marketing and sales pros just like you. Master inbound with the help of our award-winning customer support and a community of thousands.
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Social Followers
customers in over 90 countries growing their businesses with HubSpot
With tools to make every part of your process more human and a support team excited to help you, getting started with inbound has never been easier.


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The Cedars-Sinai Orthopaedic Center provides patients with a detailed, daily recovery guide to assist you in the days following your hip replacement surgery. Everyone recovers at a different rate, so your recovery time may not follow the schedule exactly.
Understanding all aspects of your surgery and that everyone recovers at a different rate, may help lead to a faster and smoother recovery.
You are not alone in your decision to have hip arthroplasty (replacement) surgery. Approximately 100,00 total hip replacements are done annually in the United States. Chances are that the reason you are having joint surgery is to relieve your severe pain and allow you to resume normal activities.
- Your Hip Joint
- Causes or Reasons for Hip Arthroplasty (Replacement)
- Surgery with a Personalized Team Approach
- Preparing for Your Surgery
- Before Your Surgery
- Planning for Returning Home
- Family and Friends: An Important Role in Your Recovery
- Arrangements for Surgery
- Your Surgery: Day 1
- Recovery Expectations
Your Hip Joint
A joint is formed where two or more bones meet. The hip joint is considered a ball-and-socket type joint. It is formed where the thighbone (femur) meets the hipbone (pelvis). The thighbone has a ball-shaped knob on the end (head of femur) that fits into a socket formed in the hipbone (acetabulum). A smooth cushion of articular cartilage covers the ends of the bones. This cartilage is kept slippery by fluid (synovial fluid) made in the joint lining (synovial membrane). Since the cartilage is smooth and slippery, the bones move against each other easily and without pain. Large ligaments, tendons, and muscles around the hip joint hold the bones in place.
Reasons for Hip Arthroplasty (Replacement)
Arthritis is a wearing away of the surfaces (articular cartilage) of the joint, which can be caused by aging, or disease. As the cartilage wears away, the raw bones rub together whenever the joint moves. This rubbing causes pain and further roughening of the surfaces of the bone.
Avascular Necrosis
The blood supply for the ball part (head) of the hip joint comes from a small artery. If the artery is injured or becomes clogged, the bone dies (necrosis) and the joint surfaces become rough, causing pain.
Surgery with a Team Approach
With your decision to have hip surgery, you have taken the first step toward freedom from hip pain and return to the activities you wish to do. Joint arthroplasty (replacement) is an elective procedure and you have a lot of choices of where to have it done. The philosophy of the Cedars-Sinai Joint Replacement Program is geared to making your surgical experience as easy and pleasant as possible. A multidisciplinary health care team, whose goal is to give you the best care and to help you regain the ability to care for yourself as soon as possible, will manage your care at Cedars-Sinai. The program is an aggressive one that allows you to be functional in a short time. The mindset is that "I am not really sick, I am here to have my joint replaced." Don't forget, we have a staff of trained professionals all working together for your success. We will be with you all the way. We want to educate and assist you and your family or significant other on your way to recovery.
Preparing for Your Surgery
All hip arthroplasty (replacement) surgery starts with a multidisciplinary education program, to help prepare you for the surgery and the rehabilitation program required after surgery. You will learn what you should and should not do, what to expect, what is expected of you, and whom you can contact if you have any questions or problems at any time during your course of treatment. Family or significant other participation is encouraged, in order to educate everyone involved with your care. There are exercises you can start doing prior to surgery to build your muscle strength.
A nurse will be working with the surgeon, operating room services, anesthesiology, and case management (for needs after hospitalization), to make the patient flow a seamless process. To exactly guide your care and treatment, a dedicated specially trained multidisciplinary staff, on a dedicated unit, utilizes clinical care pathways (maps). The unit includes a private room for each patient.
You are encouraged to get out of hospital gowns and into comfortable sports cloths as soon as possible. Families or your caregivers are asked to participate in your therapy so they can keep you on track after discharge.
Because of this pre-operative preparation, you will already have some knowledge about your hospital stay and what you will need at home even before you are admitted. So hopefully there should be less anxiety as you progress through your pathway and are discharged. The anticipated hospital stay following hip surgery is usually 2 to 4 days including the day of surgery. As you meet discharge criteria, you will be discharged with information regarding appropriate Home Care services or if needed transferred to a sub acute unit (rehab) in the community.
Before Your Surgery
Since hip surgery is usually scheduled in advance, there is a lot you can do before surgery to make your recovery in the hospital and at home go smoothly.
In your surgeon's office you may fill out forms to schedule your surgery, hospital admittance, pre-testing and pre-surgery education program.
You will receive calls from Cedars-Sinai Medical Center to confirm your surgery date, financial information and your attendance at our Multidisciplinary Pre-Operative Training and Education Program. If your doctor has not completed pre-operative tests you will be scheduled for testing at the Surgery Assessment and Testing Program.
Carefully follow your healthcare team's advice about
- Changes you should make in your diet
- Any exercises you should start, stop, or keep doing (exercises from the Multidisciplinary Training and Pre-operative Training Program)
- If needed, helping your recovery by losing or gaining a few pounds
- Stopping or continuing the medicines that you regularly or occasionally take, including prescription medicines, over-the-counter medicines, natural remedies (herbal medicines) and dietary supplements
- If you take daily insulin, heart or blood pressure medicine, ask your doctor at what time you should take your medicine the day before and/or the morning of surgery
If you are a smoker, nicotine can slow down the healing process, so you may want to quit smoking before surgery. Talk with your doctor before using nicotine replacement products such as a patch, gum or cigarette substitute.
Insurance Coverage
To avoid surprises later, learn about your insurance coverage. Talk with your benefits manager at work or call your insurance company and find out what will be paid for by the insurance and what must be paid for by you. The following are some examples:
- Equipment such as: Commode or raised toilet seat -- walker or crutches or cane
- Medication on discharge: Pain medication such as Vicodan and a blood thinner such as Fragmin.
Planning for Returning Home
Even before you have surgery, think about going home! You will be discharge from the hospital by your surgeon when your medical condition is stable. If you are going home alone then you need to be able to walk safely, including stairs if needed. If you cannot do this by the time of discharge, then the Social Worker will have been working with you for placement to a community Rehab facility. The average length of stay in the hospital is 2 to 4 days. Since this surgery is planned for, please think about your home care needs and if discharge home is the right option? Once home, it's normal to have "good" and "bad" days. But if you continue exercising, there will be more good days and your general condition is likely to improve.
Planning Your Discharge
You will be evaluated after surgery by a multidisciplinary team including; nurses, therapists, social worker, case manager, your doctors and yourself. The goal is to get you home safely. If you are medically stable, but not yet mobile enough to be discharged home safely, then a social worker will help make arrangements to a lower level of care facility in the community. If you need to be transferred to another facility for rehab, the social worker will help you in making that move, including determining insurance coverage.
The physical and occupational therapist will determine any special equipment and therapies that you might need and work with you and the social worker or case manager to order the appropriate items and service.
If you live alone or have limited support system, and you know that you will need short term care or assistance please inform the health care team at the Multidisciplinary Training and Pre-operative Education program or you can call the Social Service department to start working on arrangements before you come into the hospital.
Preparing Your Home: Helpful Hints
Becoming aware and removing hazards in your home can help make your recovery easier and safer. If necessary, get help rearranging the rooms in your home to make it easier to walk around safely. Think about maneuvering a walker or crutches. Remove throw rugs and objects on the floor. Keep items you use often within easy reach. Move items, so you are not reaching up high or bending down low. Move electrical cords out of the way. Make sure your house is well stocked with groceries and food.
Check out your usual sitting areas. If you have any hip precautions, following them will affect where and how you sit, and how you should get up from a sitting position. A good rule to remember when sitting is always sit with your hips higher than your knees. Sit in your favorite chair; are your hips higher then your knees? If not, you can raise the level of your hips by placing a firm pillow in the seat.
Once Home: Helpful Hints
Avoid uneven floors or wet floors in the bathroom and kitchen. Watch for pets that may jump on you or run in your path. Wear rubber soled and low, closed heeled shoes to prevent slipping. Use your walker and crutches and hold onto handrails when using cane. Keep rooms well lit even at night.
Transportation Home
Patients go home as a passenger in a car. You are taught how to get in and out of a car before you leave. There is a wheelchair van service for a nominal fee, which can be arranged for you. Ambulance service is used only in specific cases, as set up for you by the social worker.
Family and Friends: An Important Role in Your Recovery
Your family and friends are especially important while you recover and adjust. They can assist you at this time and help make your home safer so you can go about your activities without hurting yourself. They can also help you with grocery shopping and help with preparing food. They can also cheer you on and celebrate when you walk a little farther, or accomplish a new task.
Most insurance policies will not pay for 24-hour care, however, if you feel you need help with daily activities (bathing, shopping) the social worker has a list of agencies which can be given to you, so that arrangements can be made to hire someone to help you.
Arrangements for Surgery
- When you come in for surgery or even when you are going for pre-admission, it's a good idea to have someone with you. They can listen and take notes for you.
- Make a list of all medicines you are taking and any allergies to medicine or food that you have. Bring this list with you and give it to the admitting nurse.
- You will be told about your rights for advanced directives, which are your written directions for your care, should you become unable to make decisions. If you have a living will and or health care power-of-attorney or advanced directive, bring a copy of these with you. If you have questions about advanced directives, call the Social Service department.
- Report any health changes since your pre-surgery physical exam to your surgeon. Tell your surgeon if you get any cuts scrapes or sores on the affected leg. Tell your surgeon if you have any signs of infection, such as chills, fever, and coughing or runny nose within a week of your scheduled surgery.
- You must stop eating and drinking by midnight the night before surgery. This keeps the stomach empty, which will reduce nausea and vomiting.
In the morning, the day of your surgery, you can shower or bath, brush your teeth, and shave. Do not eat or drink anything.
- However, follow your instructions from your primary physician about taking any of your daily medicine or any pre-surgery medicine ordered by your surgeons or physicians.
- Be sure to arrive at the hospital the day of your surgery, at the time told to you my your surgeon's office.
Be sure to bring:
- Your insurance card and a picture ID
- A blank check or your credit card number & its expiration date (for any equipment & discharge medication not covered)
- Your glasses, dentures or hearing aide, if you use them
- Shoes with nonskid soles and a closed heel (not too tight, as your foot may be a bit swollen after surgery)
- A knee-length robe
- Clothing that will be easy to put on and comfortable to wear home
- Any items you were asked to bring during the Multidisciplinary Training and Pre-operative Education Program
- Cedars-Sinai Medical Center does not have shampoo, shaving cream, deodorant or hand-held mirrors
Your Surgery: Day 1
Before Surgery
At the hospital, check in at the front desk of the Cedars-Sinai North Tower entrance. Someone will bring you to the 7th floor lobby to wait until the nurse from surgery comes to take you to the pre-surgery holding room. In the holding room, a nurse will help you get ready for surgery and go over any last minute questions. An anesthesiologist will talk to you and explain the type of anesthesia that will be used during surgery. An intravenous tube (IV) is placed in your arm or back of your hand. This tube supplies your body with necessary medicines and fluids. You may be given medicine to make you drowsy and relax you just before you go into the operating room.
When you go to the surgery holding room, your family or significant other and friends can wait for you in the 7th floor lobby waiting area. Surgery usually lasts 1 to 3 hours. You will be in the recovery room for another 2 to 3 hours. Someone will update your family or significant other or friends, as your surgery and recovery progress.
There are wires and tubes attached to or placed in your body. These help monitor your body's functions, remove excess fluid, and help you breath during surgery. Your hip area is scrubbed with a germ killing soap. When everything is ready, your surgeon makes an incision in your hip. Your surgeon will explain the exact surgical procedure to you. Then your incision is stitched or stapled and then dressed with bandages. You will then be placed in your bed and taken to the recovery room.
Recovery Room
You will gradually wake up during this time. You may feel groggy from the anesthesia and will still have tubes and monitors attached. When you wake up you will notice:
- Special sequential compression selves (stockings) will be on both legs to help blood circulation and prevent blood clots
- A triangle-shaped pillow (abduction pillow) or regular pillow between your legs to keep your legs and hip in the best position for healing
- The intravenous tube (IV) for continued fluids, antibiotics and possible blood transfusions
- A drain (hemovac) that will remove the excess blood till it clots
- A drain (foley catheter) in your bladder, that will remove urine, so that you do not need to move to get on a bedpan right after surgery
The nurses will keep a close watch on your recovery and help to make you comfortable. If you need pain medicine, don't wait too long to ask for it. It is easier to prevent pain than to stop pain or catch up with it once it starts. The nurses will be asking you to "pedal" your feet up and down and if you have feeling in your legs and feet -- especially in the leg with the new hip replacement. It is important to tell your nurse if you feel numbness, tingling or pain in your feet and legs.
When you are fully responsive and your blood pressure, pulse and respiration are stable, the recovery room nurses will transport you to the Orthopedic Unit for the next phase of your recovery.
Recovery Expectations
Everyone's recovery rate is different and how quickly you recover depends in part on your physical health and level of activity before surgery and how complex your hip surgery was. Your participation in the recovery program is very important. The hospital staff will monitor your medical condition and do the things you cannot do for yourself. As you become more active, you need to become more involved in your recovery. The Cedars-Sinai Joint Replacement Program has developed a guide or pathway (flow or map) of the usual recovery program from the first day, right through to your discharge from the Orthopaedic Unit. It is important to us to make your hospital stay and experience informative for a faster and easier recovery.


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BROMLEY Police's Crime Squad have received a commendation for their work after it resulted in the detection of hundreds of burglary offences last year.
Metropolitan Police Assistant Commissioner Simon Byrne praised their "determination, professionalism and outstanding investigation skills" as they received the award at a special ceremony in Hendon.
The work of the Criminal Investigation Department (CID) Crime Squad - which is comprised of six police officers - resulted in 11 custodial sentences in two major investigations in 2012.
An extensive criminal network of offenders were identified after 200 offences were linked in a five month period across Croydon and Bromley.
Eight suspects were arrested and charged with conspiracy to commit burglary, receiving a combined total of 25 years imprisonment.
The Crime Squad also led the investigation into an organised criminal network committing night time residential burglary offences in Bromley and surrounding boroughs and counties.
This operation resulted in the detection of 220 residential burglary offences in London and Kent.
Three suspects have been jailed and two are currently in prison awaiting sentencing.
Detective Chief Inspector Andy Furphy from Bromley Police said: "I am very proud of the achievements Bromley's CID Crime Squad in dismantling these criminal networks. It is a privilege to be leading the team serving the communities of Bromley with such determination and professionalism."


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After Saturday night, there can be no mistake. This is home.
UCLA dominated No. 11 Arizona in a 74-69 win while countless pairs of eyes fixated on them from both near and far. Inside Pauley Pavilion was a record crowd of 13,727. Outside, tens of thousands more watching on national television.
The Wildcats made their runs, but each time the Bruins dismissed them - finally surviving a 10-2 rally in the last four minutes. Arizona tied four times, but never led after the game's first three minutes.
And all the while, Pauley shook and screamed. The fans' reward?
Pac-12 Conference title hopes that still live, and the team's first season sweep of the Wildcats since 2008.
"It means a lot, the two storied programs," said senior point guard Larry Drew II, who grew up in nearby Encino.
UCLA and Arizona, long the bellwethers of the conference's national reputation, put in a fight that stretched into the final 70 seconds.
The Wildcats, seemingly felled by a 12-0 run early in the second half, fought to within three points on Grant Jerrett's 3-pointer at 1:10. After the Bruins turned the ball over inside of 30 seconds, Arizona guard Mark Lyons let a layup fly.
It rimmed out, and freshman Shabazz Muhammad - a projected NBA lottery pick - grabbed a tough defensive rebound to secure the game. He was fouled, and went to the line and sank both for the final 74-69 lead - serenaded by cheers of "One more year!" as he did.
Muhammad and his father, Ron Holmes, both said after the game that they were undecided about his future. Coach Ben Howland, however, said he expected his star freshman to leave: "I'm a realist."
Should he declare for the NBA draft, he left a lasting impression in his final home appearance. Quiet in the first half after picking up two fouls, Muhammad scored 13 of his game-high 18 points in the second half.
"He's always been a great competitor," Howland said. "He's always been the man. He's used to that role. He loves to win. I'm just so pleased with his overall development. I think he's just really improved in every facet of the game."
Fellow freshman Kyle Anderson followed close behind with 17, the second of four Bruins in double figures. Drew, who received a pregame ceremony as he closed his lone season at UCLA, just missed out on a double-double with 14 points and nine assists. His newly found shooting stroke was still there, as he hit two of his three attempts from beyond the arc.
Afterward, Drew lingered near the sidelines, signing autographs for the dozens of fans that still stood waiting.
For much of this season, Pauley Pavilion saw crowds waver along with its team's fortunes. It took just four games for UCLA to spoil the glow of its new, renovated arena - blemished just after Thanksgiving by an embarrassing loss to Cal Poly.
Unsteady as they looked, the Bruins still cobbled together a 10-win streak that stretched across the new year. Whatever goodwill there was dashed by three losses in four games, including an inexcusable faceplant at home to USC.
Well, the fans came this time, spurred on by a marquee matchup against Arizona and the pregame presence of ESPN College GameDay. Tickets sold out well in advance of the Saturday night tipoff, and the lower tier of the resale market scratched three digits.
The game may have been worth that price.
email@example.com twitter.com/thejackwang


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Last year, we saw buns made of ramen noodles, waffles, doughnuts and even mac and cheese, so if anything it's a little surprising that this is the first time we've seen a bun fashioned from fries. It's like it was right under our noses the entire time!
Fortunately, Nick of Dude Foods (whose previous forays into the world of wacky buns include a breakfast sandwich with hash browns for buns and the "bacon weave breakfast burger") put two and two together to create the french fry bun, which is exactly what it sounds like: a bun alternative made from french fries glued together and cut into a circle.
Nick's blog post on the subject reveals how you can make one yourself, should you be up for the challenge. Here are a few tips:
- get some edible adhesive. Nick used "Dab-N-Hold" from Wilton, which you can find on Amazon
- use straight-cut fries unless you want to drive yourself nuts
- bake the fries in the oven, making sure they are nice and crisp so they don't smush when you glue them together (you'll need approximately 20 fries total)
- the glue has a slight lemony flavor, so keep that in mind when you're figuring out your toppings
- once you've glued the fries together, use the rim of a glass to cut the fry rafts into even circles
What do you think about the french fry bun? Anyone up for trying it at home?
About the author: Erin Jackson is a food writer and photographer who is obsessed with discovering the best eats in San Diego. You can find all of her discoveries on her San Diego food blog EJeats.com. On Twitter, she's @ErinJax
Love hamburgers? Then you'll Like AHT on Facebook! And go follow us on Twitter while you're at it!


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CYCLISTS are being urged to saddle up for an annual charity bike ride and follow in the tyre tracks of the Tour de France competitors.
The route of this year's Bronte Sportive, in aid of Manorlands, has been amended to take in sections covered last Sunday by the Grand Depart riders.
The event, being staged on July 20, offers entrants four rides to choose from – 88 miles, 71.5 miles, 55 or 23.
About a third of the longest route includesTour terrain, and even the shortest shares seven miles.
Among the sections covered will be Haworth's famous Main Street.
"Obviously there won't be the thousands of people lining the route but the bunting and decorated bikes are still out, the land art is in the fields and the roads still have all the painted messages for the riders," said Manorlands-based Sue Ryder regional fundraiser, Andrew Wood.
"This is a great time to sample the feeling of being a Tour de France rider and support a great cause in the process."
The Bronte Sportive starts and finishes at Keighley Campus Leeds City College.
Each participant will receive a barbecue meal, goody bag and medal.
Main sponsor for the fourth year running is All Terrain Cycles.
Its managing director, Tony Booth, said: "Sue Ryder does a massive amount of good work through its hospices at Manorlands in Oxenhope and Wheatfields in Leeds, both of which are close to our Saltaire headquarters.
"We are hoping as many people as possible will turn out to support this great post-Tour challenge."
Visit brontesportive.org.uk for further information and to sign-up. More details can also be obtained from Mr Wood on 01535 640430 or email@example.com.


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Along with the Piedmont, Tuscany is Italy's most important wine-producing area. Chianti, Brunello, Vino Nobile, and Vin Santo are known all over the world, as are the ""Super Tuscans,"" a large group of important, high-quality reds born in the early 1970s and now representing some of Italy's best wines. Back then, producers began chafing under the restrictive regulations of the DOC (Denominazione di Origin Controllata). Some sought to avoid using certain legally recommended grape varieties, such as the Italian white grapes that were considered an integral part of Chianti; others started blending Cabernet and Merlot, which at the time were proscribed, with native grape varieties.
While Tuscany offers a plethora of riches to the wine lover, some of its most famous Tuscan wines, especially Chianti and Brunello, are experiencing a slump in sales. There are many reasons for this, beginning with a steep rise in prices over the last five or ten years. There has also been a wave of new, moneyed owners who have not let their lack of winemaking experience get in the way of buying a piece of this beautiful region. This has opened the floodgate for oenological consultants, many of whom work for numerous estates in the same area but routinely apply their tried-and-true recipe to winemaking, leading to the production of Tuscan wines that resemble one another to a dismaying degree. Add to this the insistence on making deeply colored wines that are often overconcentrated, overoaked, and charmless, and you begin to have a good idea of why Chianti and some other Tuscan red wines don't sell all that well anymore. Fortunately, producers have begun to recognize these errors, prices have finally stopped rising, and, mercifully, more trees are being allowed to live as less importance is afforded to new oak barrels.
Italy, like France, offers a world of wine styles within a single country: dry Italian white wines ranging from lively and minerally to powerful and full-bodied; cheap and cheerful Italian red wines in both a cooler, northern style and a richer, warmer southern style; structured, powerful reds capable of long aging in bottle; sparkling wines; sweet wines and dessert wines.
Most of Italy enjoys a relatively warm climate, and the southern portion of the country can be particularly hot in the summer months. However, Italy's Apennine mountain chain, which traverses the country from north to south, provides an almost infinite number of soil types and exposures, as well as favored hillside sites in virtually every region, where vines can be cultivated at higher, cooler altitudes. Mountainous terrain has also resulted in the segregation of many small wine regions, enabling dozens of indigenous grape varieties to survive in near isolation. Here, Italy markedly differs from most of the wine world, which is becoming increasingly international in nature.
But Italian wine, as most North Americans know it, is a fairly recent phenomenon. Prior to the 1950s, only a tiny proportion of Italy's wines were even bottled by the farmer who grew the grapes. Most Italian wine was consumed by the local market. The Italian government's DOC system (Denominazione di Origine Controllata), created in the 1960s, imposed more explicit standards and thereby improved Italian wine quality while at the same clarifying the labeling of wines and thus making it far easier for Italian producers to ship their wines abroad. (Today DOCG -- Controllata e Garantita -- is theoretically the highest level in the quality pyramid of Italian wine, with this special status more recently granted to such historically important Italian wine areas as Barolo, Barbaresco, Brunello di Montalcino and others: areas that had previously enjoyed DOC status for at least five years.)
Of course, some of the most innovative Italian wine makers quickly began to look for ways to escape the restrictions of this system. They believed that DOC laws actually prevented them from making the best possible wines -- for example, by proscribing the use of certain grape varieties or by requiring them to age their wines in wood barrels longer than they believed was beneficial in some years. Those with a more independent bent essentially opted out of the system, instead producing wines that were simply classified as Vini da Tavola (table wines) but that in a number of cases surpassed the "official" best Italian wines in quality and price. (A new law passed in 1992 created the IGT category, or Indicazione Geografica Tipica, for the innovative Vini da Tavola for which DOCs were not yet created.) These trailblazers have revolutionized Italian wine over a period in which French wines have merely "evolutionized."
The trademark of wines from Tuscany, and especially those from the region of Chianti, was once the fiasco. This straw-colored flask may carry associations of lengthy rustic meals out on the portico of a villa in the Tuscan countryside, but this romantic reverie must be interrupted with a burst of reality-- the wine in these flasks, dominated by the Sangiovese grape, wasn't very good.
This declaration isn't an indictment of Sangiovese, however. The blame doesn't lie on the grape, but rather on indifferent winemaking. And luckily, since the 1980s, the wine business in Tuscany has transformed, allowing growers to invest in high quality, low production clones. Now producers work hard to limit the vigor of Sangiovese vines, which, if left alone, can produce high quantities of fruit in the hot, dry conditions of Tuscany. In this wine-growing region, wine growers must be willing to reduce yields, if they wish to improve their wines. And before the marketplace changed, few producers were willing to sacrifice yields to make higher-quality wines that wouldn't necessarily be purchased.
Now, however, the reputation of the Sangiovese grape has dramatically improved. One trend remains consistent: Sangiovese is rarely bottled alone. In the past, white grapes were added to Sangiovese in Chianti blends. Now, this process has largely been dropped as part of an effort to produce bigger, more age-worthy reds, but varying percentages of many other red varieties are generally mixed in. Cabernet Sauvignon is currently the most popular blending grape, helping to craft the wines currently known as "Super Tuscans."
As Sangiovese is a fairly delicate variety in terms of the fragrances and flavors it offers, what ends up being added makes a major difference in the final profile of the wine. Climate and altitude also influence the nature of Sangiovese-based wines; wines made in hotter, drier parts of Southern Tuscany are fleshier than wines made in Chianti and other cooler, higher areas. With lesser clones and viticulture, Sangiovese tends to produce tannic wines, without great color. The best examples are highly aromatic, fragrant wines with nicely integrated tannic structure.
If you are looking for wines that are 100% Sangiovese, your best bet are the wines from Montalcino, a pretty medieval hilltop town 25 miles south of Sienna. Here, wines are made from the Brunello grape, also known as Sangiovese Grosso, an especially high quality (and large) clone of the Sangiovese grape. These full-bodied and powerful wines, labeled Brunello di Montalcino, rank with Barolo among Italy's most-ageworthy wines. Rosso di Montalcino, also grown in the same town, is also 100% Brunello, but results in a softer, fruitier wine that requires much less aging. Reliable producers for both Brunello and Rosso di Montalcino include Altesino, Caparzo, and Val di Suga.
Sangiovese based wines, including Brunello di Montalcino, are natural partners to the classic cuisine of Tuscany: bistecca florentino, pizza margherita, and veal chops, for a few examples.
2003 had 6 regions scored 95 or above. Cote Rotie (Northern Rhône) and Port, both got the highest score, with a 96.
Other regions that scored 95 points or higher were Medoc, Sauternes, South Africa, St Julien, Pauillac, and St Estephe.
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Childhood sweethearts who moved to Dursley from Italy celebrate their diamond wedding anniversary
11:58am Wednesday 12th March 2014
11:58am Wednesday 12th March 2014
A COUPLE who moved to Dursley from Italy in the 60s to start a new life are to enjoy their 60th wedding anniversary this weekend.
Childhood sweethearts Maria, 81, and Luigi Paoletti, 80, moved from the Benevento province of Italy, near Naples to seek their fortune after work was becoming increasingly hard to come by.
Luigi first headed to Gloucestershire to seek work in 1960 and found a job at the foundry of RA Lister and would eventually move to sister firm Lister Shearing.
Maria followed her husband two years later and also worked in the foundry as well as the canteen of the Dursley firm and the couple settled in Rosebery Park in 1963 with their five children Donato, Giuseppina, Pasquale, Maria, Antonio.
They have lived there ever since and will now enjoy their diamond anniversary with friends and family, including 10 grandchildren and 10 great grand children.
The couple married on March 15, 1954 after three years together and raised their five children before heading across the English Channel.
Luigi told the Gazette it had been hard to get used to the English culture and language but had settled well with his family in Dursley.
When asked what the secret was to a happy marriage, Maria, who is a keen bingo player and enjoys cooking for her extensive family, said it was about give and take.
Mary Tandy has been the couple's neighbour since they moved to their Highfield home in 1963 and said that they had never had a cross word between them.
"They are a lovely, lovely couple," she said.
"We have got a lot to learn from Mr and Mrs Paoletti. English families just meet up for births, deaths and marriages but their family meets up all the time, which is incredible really.
"We help each other out, it's very nice. I enjoy our talks over the garden fence."
The couple's daughter Maria Paoletti said they made a good team.
"They have always been family-orientated and very hard working," she said.
The Paolettis are to enjoy a big family dinner at Fromebridge Mill on the anniversary date this weekend, organised by grandchild Lucia Parry, 19.
© Copyright 2001-2017 Newsquest Media Group


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Don't miss out on a lower price on this hotel
Get an overview of this hotelLarge hotel-casino on the Atlantic City boardwalk
Popular property highlights
5 minutes to Steel Pier
With its prime location on the boardwalk, Caesars Atlantic City Resort & Casino places guests within range of countless entertainment and gaming venues. Families can drive 5 minutes to Steel Pier for classic seaside amusements, or 30 minutes to Edwin B. Forsythe National Wildlife Refuge for fishing or birdwatching.
Roulette and rooftop pool
From snacks with ocean views at Café Roma to Asian fusion at Kwi Noodle House, there's a dining option for every palate. After dinner, guests can catch a show featuring A-list talent. A long night of gaming can be followed by a dip in the rooftop pool (surcharge), or a pampering session at Qua Baths and Spa.
Flat-screen TVs and free WiFi
Guestrooms have an appropriately imperial vibe, with Greco-Roman patterned rugs and wall sconces. Separate seating areas with tables provide space for relaxation, and there are flat-screen TVs with cable service for entertainment. All rooms have free WiFi, and some have floor-to-ceiling windows with ocean views.Information missing or incorrect? Tell us!Opens in a new window
Caesars Atlantic City Resort & Casino
Hotel Amenities
Hotel Amenities
In addition to a full-service spa, Caesars Atlantic City Resort & Casino features a spa tub and a sauna. Dining options at the resort include a coffee shop/café and a snack bar/deli. A bar/lounge is on site where guests can unwind with a drink. Free high-speed wireless Internet access is available.
This 4-star property offers access to a business center and meeting rooms. This beach resort also offers a casino, a seasonal outdoor pool (surcharge), and a nightclub. Onsite parking is available (surcharge).
- Outdoor seasonal pool
- Nightclub
- Business center
- Conference space
- Meeting rooms 14
- Porter/bellhop
- 24-hour front desk
- Safe-deposit box at front desk
- Total number of rooms - 1,140
- Hair salon
- ATM/banking
- Gift shops or newsstand
- Shopping on site
- Dry cleaning/laundry service
- Casino
- Elevator/lift
- Number of floors - 44
- Valet parking (surcharge)
- Number of bars/lounges - 4
- Breakfast available (surcharge)
- Coffee shop or café
- Newspapers in lobby (surcharge)
- Concierge services
- Express check-in
- Express check-out
- Fitness facilities
- Full-service spa
- Designated smoking areas (fines apply)
- Designated smoking areas
- Free WiFi
- Spa treatment room(s)
- Multilingual staff
- Poolside bar
- Luggage storage
- Snack bar/deli
- Number of restaurants - 10
- Self parking (surcharge)
- Sauna
- Spa services on site
- Spa tub
- Steam room
- Outdoor pool
- Wedding services
Available in all rooms: Free WiFi , Free wired Internet
Available in some public areas: Free WiFi
Self parking (surcharge), Valet parking (surcharge)
Room Amenities
- Video-game console
- Pay movies
- Blackout drapes/curtains
- Air conditioning
- In-room climate control (air conditioning)
- Phone
- Refrigerator
- Coffee/tea maker
- Free toiletries
- Hair dryer
- Iron/ironing board
- In-room safe
- Desk
- Daily housekeeping
- Cable TV service
- Free WiFi
- Free wired Internet
- Room service (limited hours)
Where to Eat
Full breakfasts are available for a surcharge and are served each morning.
Palace Court Buffet - This buffet restaurant specializes in fusion cuisine and serves lunch and dinner.
Nero's Italian Steakhouse - This steakhouse specializes in Italian cuisine and serves dinner only. Guests can enjoy drinks at the bar.
Morton's The Steakhouse - This steakhouse specializes in American cuisine and serves dinner only.
Tazza - This coffee shop specializes in American cuisine. Open 24 hours.
Cafe Roma - This café specializes in American cuisine and serves breakfast, lunch, and dinner.
Gordon Ramsay Pub and Grill - This pub specializes in British cuisine and serves lunch and dinner.
Room service (during limited hours) is available.
Circus Maximus hosts musicians, comedians, and celebrity chefs. Headliners include Jerry Seinfeld, Sheryl Crow, and Tony Bennett. The theater features 1,500 stadium-style seats, a full-service bar, and a state-of-the-art sound system.
Nearby Things to Do
A seasonal outdoor pool and a spa tub are on site. Other recreational amenities include a sauna, a steam room, and a fitness center.
The recreational activities listed below are available either on site or nearby; fees may apply.
- Golfing nearby
- Bicycle rentals nearby
Spa Services
Qua Baths and Spa has massage/treatment rooms and couples treatment room(s). Services include deep-tissue massages, hot stone massages, massages, and facials. The spa is equipped with a sauna, a spa tub, and a steam room. A variety of treatment therapies are provided, including aromatherapy, hydrotherapy, and reflexology.
- Hot stone massage
- Deep tissue massage
- Prenatal massage
- Steam room in spa
- Reflexology
- Couples treatment rooms
- Body wraps
- Body scrubs
- Aromatherapy treatments
- Hydrotherapy treatments
- Sauna in spa
- Spa tub in spa
- Massages
- Body treatments
- Facial treatments
If you have requests for specific accessibility needs, please note them at check-out when you book your room.
- Accessible bathroom
- In-room accessibility
- Roll-in shower
Hotel Policies
Check-in time ends at 8 AM
Check-in time starts at 4 PM
Minimum check-in age is 21
Check-out time is noon
Payment types
Children and extra beds
- Children are welcome.
- Rollaway/extra beds are available for USD 25 per stay.
- Cribs (infant beds) are available for USD 25 per stay.
- Pets not allowed
You need to know
Extra-person charges may apply and vary depending on property policy.
- Deposit: USD 100 per stay
- Resort fee: USD 27.00 per accommodation, per night
- Fitness center access
- Internet access
- Phone calls
- Additional inclusions
Optional extras
- Breakfast fee: between USD 5 and USD 20 per person (approximately)
- Valet parking fee: USD 5-20 per stay (in/out privileges)
- An early check-in fee will be charged
- Crib (infant bed) fee: USD 25 per stay
- Rollaway bed fee: USD 25 per stay
Hotel Name
- Atlantic City Caesars
- Caesars Atlantic City Hotel
- Caesars Atlantic City
- Caesars Hotel
- Caesars Hotel Atlantic City
- Caesars Atlantic City Hotel Atlantic City
- Caesars Resort & Casino
We should mention
The seasonal pool will be open from May to September.


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Inspired Globally
Bumpy Pitch products are inspired by the culture and lifestyle of soccer. Our shared experiences within the sport and a passion to explore the culture of soccer influences our approach to design and manufacturing. Our products range from soccer t-shirts, sweatshirts, jackets, hats and accessories. Each graphic is inspired by the sport and has a corresponding story.
Manufactured Locally
While we look globally for design inspirations, we keep our production locally. We are located in Los Angeles and we manufacture in Los Angeles. We pride ourselves on the designs but also on the quality and care that goes into e...
Bumpy Pitch


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Bentonville, Ark. Wal-Mart Stores, Inc. announced Tuesday it has established a partnership with its leading sustainability suppliers to facilitate creation of green jobs in the United States.
The new Wal-Mart Green Jobs Council is comprised of representatives from throughout the retailer's divisions, including store operations, real estate, logistics and sustainability, and representatives from suppliers across a variety of industries.
"We believe that creating green jobs is essential to keeping the United States competitive in the global marketplace," said Leslie Dach, executive VP of corporate affairs and government relations for Wal-Mart.
As part of its companywide sustainability goals, Wal-Mart is committed to being supplied 100% by renewable energy, creating zero waste and selling environmentally friendly products. The company is moving toward these goals by using sustainable sourcing practices including energy efficiency, waste reduction, renewable energy and life-cycle management.
At the inaugural meeting of the Wal-Mart Green Jobs Council, participants identified their top catalysts for creating green jobs, including government policies, executive leadership for sustainability programs, and market drivers such as increased customer demand.
Top barriers identified by the group include a lack of a trained work force and lack of access to capital, especially in the current economic environment.
More than 30 suppliers participated in the inaugural meeting, including BP Solar, Dematic, General Electric, HydroPoint Data Systems, Lennox, ReCold, Schneider Electric, SwissLog, Systecon, Thermastor and Zurn.
Wal-Mart plans to convene its next Green Jobs Council meeting in Washington, D.C., in early 2009.


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This article originally appeared in the January 1954 edition of FATE.
SEVERAL prospectors, one day in the summer of 1877, were exploring a series of barren hills at the head of Spring Valley near Eureka, Nev. One of the men noticed a strange object protruding from a high ledge of rock nearby. He investigated and was amazed to find embedded about halfway in the smooth surface of the quartzite what appeared to be the leg-bone of a human being, broken off just above the knee. With the aid of his companions, he dislodged the portion of rock that enclosed the bone. Carefully, with their mining tools, they removed the upper part of the encasement.
Giant Leg Bone
The rock was as hard as flint and the bones were solidly set in it. The quartzite was dark red in color while the bones were almost black. When the last of the rocky covering had been removed, the leg-bone and those of the attached foot stood out perfectly, complete with all the toes, part of the femur, the patella or knee joint, tarsus metatarsus, and phalanges, and the joint of each bone was traced precisely. The length from the fracture just above the knee to the end of the toes was just 39 inches. Clearly the bone structure had once been part of a person of extraordinary size.
This unusual object, lying exposed to view on its quartzite bed, was brought to Eureka and there inspected by large crowds. All who saw it agreed that the bones were of human origin. A fruitless search was later made for the remainder of the skeleton.
More Human Bones Encased in Stone
In a letter to the editor of the Zanesville, Ohio, Courier in 1853, a certain John G. F. Holston, declared that with Charles Robbins and Dr. Ball he had recently investigated a phenomenal object taken from the rock of a quarry at Cusick's Mill, six miles from the city. It was nothing less than the bones of an adult human female, found in a cavity of the solid sandstone rock, perfectly closed and having no communication whatever with any fissure or crack in the rock.
Most extraordinary was the fact that the cavity represented the shape of the body when invested with flesh — the leg, thigh, hip and part of the back being molded with remarkable exactness. Holston said that if the cavity were filled with plaster of Paris, a mould of the entire figure would result. In its original position, the body lay on its right side, the head east, toward the hill, the feet west toward what was known as Jonathan's Creek. The waters of this creek at high flood swept the base of the hill some 10 feet below the level of the body.
The identical block of stone containing these remains also held the perfect mold of a pair of human hands, which was generally believed by those who inspected it not to be those of the enclosed body. This find was made about 50 feet below the surface level of the ground, and 15 feet from the cliff-edge of Jonathan's Creek.
Charles Fort
Objects apparently of human manufacture have also been found in rock strata. Charles Fort mentions (Books, 130) the bell-shaped vessel blasted out of solid pudding-stone rock at Dorchester, Mass., in 1851. A contemporary newspaper describes the find as made on the south side of Dorchester's Meeting-House Hill, 15 feet below the surface.
Among the rock fragments thrown out by the blast was a piece of thin metal, and near this was another quite similar piece. On being joined together the two were found to fit exactly, forming a bell-shaped vessel four and a half inches high, two and a half inches wide at the top and six and a half inches at the base. It was one-eighth of an inch thick, of metallic composition, dominantly silver. Near the top of the vessel was a hole about an inch and a half in diameter, where apparently a handle had been broken off. In line with this hole was another at the bottom, covered with a plating resembling lead. Says a contemporary observer: "Whether it was placed in the ground before the rock was formed or was thrown into its position by a volcanic eruption is a matter of conjecture."
On exhibition at the Miner's Saloon in Treasure City, Nev., during the early winter of 1869 was a piece of feldspar from the local Abbey mine. In this rock was embedded something resembling an ordinary two-inch screw, so perfectly outlined, with its regular curve and sharp cut, that many who saw it contended it was of iron and a real screw, which by some mysterious means had become fixed in the rock. This screw is reminiscent of the nail found in a piece of quartz from a North Britain quarry, reported by Fort (Books, 133).
More Compelling Human Artifact Discoveries
The gold thread that Fort says was found in Scotch quarry-rock in 1844 (Books, 132) is paralleled by the curious find at Morrisonville, Ill., in 1891. A woman named Mrs. S. W. Culp was breaking a lump of coal preparatory to putting it into the scuttle. When the lump fell apart she was startled to find embedded in ring fashion a small gold chain about 10 inches long and of quaint workmanship.
Her first thought was that the chain had been accidentally dropped in the coal but as she tried to pick it up she discovered that it was firmly fixed in the lump. Tugging at the middle portion she succeeded in detaching it but the ends, being set more deeply, required additional effort before being freed. The imprint that remained was clear, the two ends being close together as in a necklace. The lump of coal was believed to have been taken from the local Taylorville or Pana mines. Upon further examination the chain was discovered to be of eight-carat gold and to weigh eight pennyweights.
An odd exhumation was made in the strip-vein coal bank of Captain Lacy at Hammondsville, Ohio., in the autumn of 1868. A man named James Parsons was digging in the excavation with his two sons when a huge mass of coal fell down, disclosing a large, smooth, slate wall, upon the surface of which were carved in bold relief several lines of hieroglyphics. The lines were spaced about three inches apart, and contained about 25 hieroglyphics or words apiece.
The news soon spread, and crowds surged to the mine to see the marvel. Several scholars viewed the carved characters but were unable to identify them. An attempt was made to remove the slate wall from the mine but as it was feared that the hieroglyphics would be destroyed in the process, this plan was abandoned. When tapped the wall gave forth a hollow sound, leading many to believe that a cavern or chamber existed beyond it. Dr. Hartshorn of Mt. Union College was sent for to examine the writing. No further reports seem available on the matter.
Insect Discoveries
Perhaps the most striking, and certainly the most numerous, of the mysterious objects that have been found underground are animal and insect fossils. Many entombed animals and insects have been found still alive. One afternoon in 1877 some workmen blasting rock 40 feet down in a quarry west of Eureka, Nev., noticed the curious formation of one of the pieces that had been split off. An examination revealed that embedded in the rock was a wasp nest, the texture and cells of which, although turned to stone, were plainly visible.
On breaking open some of the cells, larvae and two perfectly formed wasps were found within, in the same petrified condition as the rest. Both the nest and the wasps were preserved in natural shape and size, not crushed or flattened. There was no visible crack or other inlet by which the insects could have penetrated the rock. The rock was a granitic sandstone of sedimentary origin. The specimen was carefully cut out and forwarded to the Smithsonian Institution at Washington.
Near Ruby Hill, Nev., in 1881, a miner named Joe Molino made a find in the Wide West mine, at a depth of about 60 feet. It was a solid piece of limestone in the very center of which was a small cavity containing six or eight large worms resembling maggots. The worms were alive and crawling when the rock was split and, says the reporter, "The mystery is how they managed to get into the solid rock in this manner."
From the Longfellow mine, near Clifton, Ariz., was taken in 1892 what was declared at the time to be the most interesting insect and mineral specimen in existence. It was presented to Z. T. White, of El Paso, Tex. When the specimen was fractured by Mr. White, a dull reddish-gray beetle was disclosed, surrounded by a closely fitting mould of iron ore. The beetle lay as perfect as in life in its iron sarcophagus.
Much impressed, White wrapped it in a piece of cloth and while carrying it home to his curio cabinet, he unfolded the cloth and glanced once more at the beetle.
To his astonishment, he saw a small young beetle slowly emerging from its dead parent's body.
The young beetle was placed under a glass where it thrived and grew. It lived for a period of five months. Finally the mineral specimen, the maternal beetle in its cyst of ore, and the extraordinary younger insect were brought to the editorial office of the El Paso Bullion, where they were presented by Judge J. F. Crosby, with the compliments of the owner, to a prominent scientific association of the Atlantic coast. The Bullion editor was deeply impressed by the find and though granting its authenticity, declared it almost beyond belief.
Living Frogs and Toads Encased in Rock
Live frogs have been found in coal and in rock strata. Two Welsh miners breaking coal in a pit near Bathgate, Linlithgowshire, in 1846, were astonished on splitting a large fragment to see a frog leap from it. The cavity in which it had lived was perfectly smooth, of the exact shape of the frog, and to all appearances without any opening by which to obtain air or food. The hind legs of the creature were at least twice as long as those of an ordinary frog, while the forelegs were barely perceptible.
In 1848 four young miners were digging coal in No. 8 pit at Gartlee, near Airdrie, Scotland. They had just broken off a mass of coal about four feet in diameter and were chopping it into smaller pieces when near its center they came upon a kind of petrification. Suspecting that this might contain something of value they worked at it carefully with the points of their picks.
Soon they saw a brown spot, which upon further examination turned out to be a frog, not fossilized, but apparently alive. It began to stir and before long awakened from its dormant state. When the miners turned it over several times, its movements became more vigorous. One of the men placed the creature in a pail of water. It proved able to swim but seemed to be in great pain and changed color.
The men preserved the matrix of coal in which the frog had been embedded, there being impressed upon it a delicate mold of the animal's body. This, together with the frog itself, was placed in the museum of the Andersonian University of Glasgow.
Among the many persons who inspected the objects was a Mr. Craig, lecturer on geology in that institution. Craig became greatly interested and went to Airdrie where he investigated the circumstances surrounding the discovery. He obtained a written statement from the four young miners, whom he found to be intelligent and of good character.
Craig communicated about the matter with the well-known geologist, Dr. Buckland, who on the basis of some experiments he had made insisted that there must have been some aperture, however slight, through which the animal entered and whereby insects and air could be obtained. He had found that toads he had imprisoned invariably got lean and died where such an opening did not exist. The circumstances of the present case, however, Craig found, definitely excluded the possibility of any opening.
Craig cited the corroboration of a friend of his, R. Jamieson who, with several others, had some time before enclosed a toad in clay and after putting it into a broken bottle had buried it about 18 inches underground. At the end of 12 months the toad was dug up and found to be still alive and in fair condition. If, declared Craig, an animal can survive for 12 months without food, water, or air, there seemed to be no reason why it should not survive even longer, perhaps for ages.
Frog in Sandstone
Coal is a strange enough place in which to find a living animal but a live frog was found 172 feet below the surface, embedded in solid sandstone, by some workmen engaged in sinking a vertical shaft at the Black Diamond Coal Company's mine on Mount Diablo, near San Francisco, in 1873. The partial imprint of its form upon the rock where it had lain was perfect in outline. The animal lived for 12 hours after its extraction, having very possibly been injured in the process. The president of the coal company was said to have later presented the remains to the San Francisco Academy of Sciences.
From Farmington, Me., in 1868 comes a similar story. A well digger in the course of his work struck some scaly rock two feet below the surface of the ground. He blasted four feet farther through this stratum, at which depth he found three frogs completely embedded in the stone. These frogs were from three to four inches in length, but only about an eighth of an inch thick, seemingly flattened by pressure. At first they appeared lifeless, but 10 minutes later they moved slightly. They commenced inflating themselves and by the end of half an hour they had resumed their natural shape and size and hopped off. Their color was almost identical with that of the ledge in which they were found.
Perhaps the most detailed description of a rock-imprisoned frog is one published in a Tuscarora, Nev., newspaper in 1879. Five hundred feet down in the Grand Prize mine near that town, a blast released a tiny frog from the rock. It was immediately brought to the surface and placed in a glass jar in F. H. Phelps' drug store on Weed Street.
Transparent Frog
At first it was almost white in color and nearly transparent but after a week its back changed to a dingy mottled green. It had no mouth and consequently was unable to eat. Its eyes, which never closed even to wink, resembled two small, black, glass beads. They evidently were sightless since objects brought even within a hair's breadth of them failed to effect any movement or change in them whatever.
The frog's general shape was not unlike that of other frogs, except that its forelegs and toes were disproportionately long. Its sense of feeling and hearing appeared normally acute and it was nearly as lively as the general run of its surface-bred brethren. Concludes the editor: "While we will not venture any surmise regarding its history prior to its liberation we will vouch for the truth of the above narrative and description."
Ancient Toad
Toads, like frogs, seem able to defy scientific dictums and live for ages encased in solid earth and rock. Reports came from Acton, Ontario, in 1893 about a wonderful discovery made at the local Brown & Hall sawmill, while a large pine log was being worked up. After some outside slabs had been cut off, a large toad was seen to poke its head out of a hole in which it was embedded, having barely escaped being cut in two by the saw. It was declared a mystery how the creature got there, being perfectly encased in the wood, with no possible means of ingress or egress. As that particular log was the fourth or fifth up from the butt of the tree, the toad was located, before the tree was cut, at least fifty or sixty feet from the ground. The only possible conclusion seemed to be that the toad had been imprisoned in the infancy of the tree and had grown up with it, and was consequently hundreds of years old. Local naturalists declared the toad to be of a species unknown to the area. The cavity in which it was found was perfectly sound and as smooth within as though carefully rubbed and polished. The creature was surrounded originally with solid wood from 41/2 to 30 inches thick.
Toad in a Trance
A dispatch came from Tacoma, Wash., in August, 1893, stating that a toad with curious cat-like claws was found embedded under 17 feet of hardpan in that city. Some men were digging a cistern when one of them drove a pick into the hard earth, finding at the pick's end a smooth hole in which was the toad, apparently dead. Ten minutes in the open air, however, revived him. He ate several flies that were captured for him and lived for two weeks in a bottle, where he was furnished with water and pulverized earth. Hundreds of persons inspected him and he surprised the members of the local Academy of Sciences by the fact that he did not die after such sudden exposure to the air. The toad escaped from its jar and a few days later was found pulseless, rigid and cold in a neighboring house. Pronounced dead, it was just about to be buried when it regained animation. Some time later the toad again went into a trance, suggesting that it was able to suspend animation indefinitely either at will or by accident. It is described as having been about the size of an egg, of the same grayish color as the hardpan and somewhat resembling a tree toad.
In the museum of Hartlepool, England, visitors of 1865 stared at the active toad that had been found in a slab of magnesium limestone by some quarry laborers. It was generally supposed to be 6,000 years old (pre-Darwinian dating).
A tiny toad in 1846 hopped out of a large block of ironstone four or five feet square when this was broken up. The toad was not much bigger than a bee and very black, like the ironstone, and it proved an agile swimmer. The ironstone was located 30 feet below the surface of the Lugar Iron Company's mine near Glasgow, Scotland.
A toad about two inches long was exhumed from the rock by a blast in the shaft of the Metacom mine, near Austin, Nev., in 1866. His lively habits amused and astounded the local miners. In appearance he seemed not at all different from ordinary toads of the vicinity.
Some investigators believe that toads are found exclusively in rocks belonging to the carboniferous era. If this be true, how can we explain the live toad found in granite, a metamorphic or volcanic rock? A quantity of granite was used in 1829 to repair the walls and steps of George's Dock Basin, Liverpool, England. A reporter was attracted by a crowd of persons around a block of granite which had been cut apart by the workmen. He was informed that a toad had been found in a cavity laid open by the cutting instruments. He observed both the cavity and the toad. To extricate the creature, one of the men cut away a portion of the stone from the edges of the cell. The toad was removed and for a time exhibited signs of life. All those present seemed to agree that no deception could have been practiced and most of them, including the reporter, came to believe the toad had been enclosed "from the era of granitic infancy."
Image credit: Wikimedia Commons


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A challenging case: Acute-on-chronic vomiting in a German shepherd
Vital Stats
History and presenting complaints
Initial suspicions
A 2-year-old intact male German shepherd was referred to the Kansas State University Veterinary Medical Teaching Hospital for evaluation of a three-day history of lethargy, diarrhea, anorexia, and vomiting. The owner also reported that the dog had vomited bile-colored liquid every two to three weeks and had had a difficult time gaining weight beginning at 2 months of age. Several months before this evaluation, a veterinarian had examined the dog because of the vomiting and had prescribed cimetidine (5 mg/kg orally b.i.d.).
Three days before referral, the dog had begun vomiting several times a day. The day before referral, the vomitus had become bloody and had increased in volume, and the owner had taken the dog to an emergency clinic. The results of a complete blood count, serum chemistry profile, and coagulation panel had been within reference ranges. Abdominal radiographs had revealed no abnormalities. The emergency veterinarian suspected gastrointestinal ulceration and had instituted treatment with famotidine (2 mg/kg subcutaneously b.i.d.), sucralfate (1 g orally t.i.d.), and metoclopramide (0.4 mg/kg subcutaneously t.i.d.). The next day, the dog had been depressed and continued vomiting large amounts of bloody fluid, so it was referred to the Kansas State University Veterinary Medical Teaching Hospital.
On presentation, the dog was depressed and underweight (90.6 lb [41.2 kg]) and had a body condition score of 3 on a scale of 9, a temperature of 101.5 F (38.6 C), a heart rate of 120 beats/min, and a respiratory rate of 48 breaths/min. The dog had tacky mucous membranes with a capillary refill time of greater than two seconds and was estimated to be 7% dehydrated. The dog's pulse quality was normal.
Abdominal palpation caused mild discomfort, but no abnormalities were palpated. The dog was not experiencing dyspnea, but we saw an abnormal inward and outward wavelike motion in the ventral cervical area as the dog inhaled and exhaled. We also heard the sound of moving fluid originating from the cervical area from as far as several feet away.
Our differential diagnoses for the hematemesis included toxin ingestion, gastrointestinal torsion, a foreign body, and ulceration. We thought a coagulation disorder was unlikely because no abnormalities were identified on the previous day's coagulation profile. Because of the fluid sound and abnormal motion in the cervical area, we suspected esophageal disease, and our differential diagnoses were megaesophagus (congenital or acquired), an esophageal foreign body, esophagitis, or an esophageal stricture. The recent abdominal radiographs were noted to be unremarkable, but they were not available for us to view at the time of referral. The differential diagnosis list was narrowed to toxin ingestion, gastrointestinal torsion, a foreign body, gastrointestinal ulceration, and esophageal disease.


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Note: This item is more than 11 years old. Please take the publication date into consideration for any date references.
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Oct. 24, 2005
Government Canyon Welcomes Public, Sets Operating Hours
SAN ANTONIO, Texas — Several thousand visitors showed up Oct. 15-16, the opening weekend for Government Canyon State Natural Area, touring the new Visitor Center facilities, picnicking and scouting out miles of wilderness trails on the edge of San Antonio.
During the opening, state natural area manager Deirdre Hisler announced Government Canyon's days and hours of operation. They are: 8 a.m. to 8 p.m., Fridays through Mondays only. Access to backcountry trails closes at 5 p.m., while access to frontcountry trails ceases at 6 p.m.
When Daylight Savings Time takes effect Oct. 30, the hours of operation will change to 8 a.m. to 7 p.m. and trails will close an hour earlier.
At this time, there is no overnight camping allowed in the 8,622-acre state natural area, but there are 34 miles of trails to explore by foot or bicycle. Primitive tent camping is expected to be offered sometime next year.
For more information, contact the park at (830) 688-9055.
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(5.4.16 i)


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"These are great!!! My team is very happy with them. Good quality and they stay up!" (E14120)
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Epic Sports
Vizari 2" Tall Disc Saucer Cones [E10889]


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Topic: Bone Mets - Pain Management
My husband Fred has bone mets in his ribs, shoulders, neck, spine, skull, hips, really too many places to count or list. He had radiation in March and just started radiation on a couple more spots this week. The pain associated with all these spots is extreme and the radiation only does so much. He has been taking Oxycontin and Oxycodone and will start on a Fentanyl patch today. Was wondering what others with bone mets have done to control pain. Thanks! - Colleen


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Tuesday, September 26, 2017
Pulmonary Hypertension
RVSP normal?
I had heart failure from pregnancy 12 years ago, I went to a routine echo this past month. My Ejection Fraction is back up to 58% and things are looking great. However in all the notes my doc said "pulmonary hypertension suggested"
Tricuspid Valve is Mild Regurgant, estimated RVSP 24mmHG 9two years ago it was 26mmHG, so this number is lower than it was!!! TR Peack Vel 0.45 m/s Pulmonary Valve Peak Vel. 0.65 M/S AT 129 Msec
Pulmonary Venous Flow Systolic 0.561 m/sec Diastolic 0.756 m/sec Pulmonary Vein Flow Reversal is present Mild MVP, Mild Pulmonic Valve insufficiency, Mild Tricuspid insufficiency.
I called doc and he said "you don`t have pulmonary hypertension, I just had to put that there because of the numbers. He was quick to get off the phone.
Which of these numbers suggests Pulmonary Hypertension? Is there anything I can do to lessen it?
It sounds like you have developed a cardiomyopathy during your pregnancy and have now recovered. An RVSP of 24mm Hg is within the normal range .
Namita Sood, MD, FCCP
Associate Professor of Pulmonary, Critical Care & Sleep
College of Medicine
The Ohio State University