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At The Practice Tee Driving Range, players sidle up to one of 32 separate hitting stations, unsheathe their golfing sticks, and proceed bash their unsuspecting golf balls skyward. After straightening out a slice, perfecting a 1-iron stinger, or adding a front handspring into a preshot routine, they often proceed to the short game practice area to brush up on putting touch and calibrate lobs in the 30-yard chipping zone. And because practice should prepare one for all manner of unexpected occurrences, from plugged golf balls to miniaturized Dutch windmills, intrepid players and their kids can also play a round of putt-putt on the miniature golf course that resides on-site.
Dodge This Paintball's outdoor facilities pelt players with colourful rounds in free play and organized events. Players equip themselves for long-range painting by strapping on a provided mask and loading markers with complimentary air fills and colourful ammunition. Teams sight opponents through groves of backwoods forest, finding midgame shelter behind natural features, man-made walls, and confused elk in unlimited length skirmishes. Dodge This Paintball opens the wooded wilderness to open play on weekends and RSVP-only battles Wednesday through Friday. The facility also features scheduled game events encompassing movie scenarios, war-time reenactments, and strategic picnic-riot control.
Many daughters inherit looks or personality from their mothers; Jennifer inherited 25 siberian huskies. Since receiving a government small-business loan on her 20th birthday, the young entrepreneur has channelled her passion for her pups and sledding into MUSHERS Dog-Sled Tours. Made up primarily of siberian huskies, Jennifer's teams whisk visitors away on handcrafted freight sleds during treks across more than 80 acres of woodland trails.
After a brief tutorial, visitors can hop onto preharnessed teams for short jaunts or learn how to harness and hook up their own teams. Excursions cross a variety of terrain, from nighttime trails lit by tiki torches to challenging trips that cross barren ponds, frozen rivers, and shark-infested puddles. Those seeking more of a physical challenge can take an overnight camping trip with the dogs, and school groups can enroll in three-day programs that combine hands-on activities such as dog sledding and snowshoe hikes. Once their trips come to an end, visitors can reward the dogs with a tasty treat and bowl of water, or meet one of the pups MUSHERS' currently has up for adoption.
The story of Alice's journey explores its way to the Sudbury Theatre stage through a small, talented cast, and a vivid mix of storytelling methods. Alice, a curious young girl, is magically transported to the topsy-turvy world of Wonderland, where animals attend tea parties and royalty dispense rather severe haircuts. The show incorporates physical theatre, puppetry, masks, and music, as well as interactive elements to actively involve the audience without excessive cattle prods and carrot-dangling devices. Seats are assigned on a first-come, first-served basis.
Pro Piano is a full-service music shop offering classes and a wide selection of new and refurbished pianos, guitars, and amps. Three talented music instructors with extensive teaching and performance experience lead neophytes and old hands alike into brave new worlds of musical technique during half-hour lessons at Pro Piano's in-store teaching studio or one-hour lessons at students' homes. While Pro Piano instructors specialize in piano, guitar, and voice, under their wise tutelage students can choose to study almost any melody-maker, including obscure instruments such as the eight-stringed octopus guitar or the tuba. Call ahead to schedule a lesson.


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Reclaimed Real Doors - Each a Uniquely Exquisite Creation
Tim from buildaroo.com interviewed Dino from Real Door inc. at the Dwell on Design 2009 conference. Located in the Los Angeles area, Real Door uses recycled wood scraps to create what they call a "puzzle" or an "urban" door out of 100% reused material. In the video, Dino showcases contemporary doors with an "organic look".
Real Doors inc. also manufactures original wood sinks with citrus oil and wax over the wood to make it water resistant and suitable for bathrooms. Their tables are made with beautiful, unique wave-like patterns in variously colored wood scraps that are pieced together to form their finished products. Each product Real Door manufactures is a special one of a kind creation made specifically for the builder. For more information on Real Door inc., check out their website: Real Door. And look through our site for more videos and information about sustainable building products, manufacturers and service providers.

subset: commoncrawl


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"If the new American father feels bewildered and even defeated, let him take comfort from the fact that whatever he does in any fathering situation has a fifty percent chance of being right."
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Other Bill Cosby Quotes
I don't know the key to success, but the key to failure is trying to please everybody.
Bill Cosby
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I wasn't always black... there was this freckle, and it got bigger and bigger.
Bill Cosby
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A word to the wise ain't necessary - it's the stupid ones that need the advice.
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In order to succeed, your desire for success should be greater than your fear of failure.
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Tweet |
Sen. John Edwards' wife, Elizabeth, is a frequent commenter in the far-left fever swamps of the Democratic Underground discussion forum (see, for example, here and here).
Yesterday, Mrs. Edwards surfaced on a DU thread about conservative radio talk show hostess extraordinaire Laura Ingraham, who underwent surgery yesterday for breast cancer. (Hat tip: Reader Eddie.) When the DUers started spewing their usual bile and wishing ill on Ingraham, Mrs. Edwards (a breast cancer survivor herself) tried to intervene:
I have been a Democrat for a long time, and part of the Democratic principles that attracted me as a young person and kept me a Democrat all these years is our compassion. Democrats are simply good and decent people. And good and decent people want everyone to do well — those who agree with them and those who do not. We fight for the right of voices with which we disagree to speak out, for the right of people to say things we don't believe to be true, even for the right to be malicious and mean-spirited. If we fight for the right for LI to say what she says, how in the world can we use our disagreement with those words as an excuse not to be compassionate in her fight with cancer. Being willing to have her voice muted by illness is the same thing as not wanting her voice to be heard. It is not Democratic or democratic.
It was an admirable attempt by Mrs. Edwards to stop the ugliness–though she then goes on to criticize conservatives for their lack of compassion. A few commenters applauded Mrs. Edwards. And then it was back to spewing as usual:
She probably gave it to herself…
I don't pray for Nazis or other Totalitarian Scum
I hope she goes into remission and fucking chokes to death.
And those were the ones that didn't get deleted.
Update: Wickedly funny as ever, Laura's website has a new post following her surgery yesterday…
Laura's breast cancer surgery yesterday "couldn't have gone better," in the words of her surgeon Dr. Katherine Alley. Initial sentinel node testing done during surgery showed no signs of cancer involvement in the lymph nodes, and we all hope that this good news is confirmed by more in-depth tissue testing done over the next 48 hours. "The outpouring of love and concern coast-to-coast in prayer, emails, telephone calls has left me feeling more blessed than I can possibly convey," said Laura Thursday morning from home. "I really don't know what I did to deserve such kindness but I will gladly wrap myself in it," she chuckled. "It's weird but getting cancer has made me feel more blessed than I ever felt before, and I will do everything I can to return the generosity 100-fold when I am feeling a bit better." According to Laura and her friends who were there throughout, the entire staff at the Surburban Hospital Outpatient Medical Center in Bethesda, MD was amazing. Absolutely top-notch! According to one of Laura's friends, as she was being taken into surgery, she joked about whether the hospital was running a "two-for-one" surgery special–"a lumpectomy and a lift together–20 percent off!"
No Tears for Lynne Stewart
April 10, 2013 10:42 AM by Michelle Malkin
Pelosi on Obamacare: Hey now, I never said premiums wouldn't go up
June 8, 2013 08:44 AM by Doug Powers
Cruz-bashing Obamacare cheerleader Rep. Jared Polis (D-Colorado) now pushing Obamacare waiver for ski resorts
October 23, 2013 02:44 PM by Michelle Malkin
Gore warms up to Hayes: This generation's Charles Ponzi refers to MSNBC host as 'this generation's Edward R. Murrow'
August 17, 2013 08:03 PM by Doug Powers
Categories: Al Gore, Enviro-nitwits, global warming, Media


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But the fate of these kind of expeditions – and the entire field of cryptozoology - could soon be decided by Sykes and his team. If the Oxford Lausanne project finds something interesting, it opens up the possibility of further attention from mainstream science. But another possibility is that the team races through all of the samples in the museum and proves that all of them come from species already known to science. Certainly history suggests this outcome is likely.
For example a "Yeti finger" that lay in the Royal College of Surgeons museum in London since the 1950s was tested in 2011, revealing that the remains were in fact human. While in 2008, tests on hairs collected in India showed they came from a species of Himalayan goat. Countless other examples have met with similar results.
If that is the case, the current saviour of cryptozoology could become its own worst enemy. And then, Sartori says, it will be time for believers to put up or shut up.
"We are challenging the people who claim to have seen the Yeti or the Orang Pendek to show us real evidence, or otherwise hold your peace," he says.
If you would like to comment on this article or anything else you have seen on Future, head over to our Facebook page or message us on Twitter.


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Just because you don't have to take school photos anymore, doesn't mean you should let the same-old look languish. Fall for today's deal from Bishop's Salon & Day Spa when you pay $85 for a haircut, full highlights, and a deep-conditioning treatment from select stylists (a $170 value). Look like the total package with this total package from an advanced stylist: Go for layers, a long bob, or other 'do, then frame your face with highlights, and finish with spotlight-worthy strands following a deep-conditioning treatment. In business since 1988, this Aveda concept salon in Bellevue has been featured in Harper's Bazaar, Town & Country, and Vogue, and will soon take your photo ops from awkward middle school to glamorous glossy. Want more? Check out Bishop's Salon & Day Spa on Facebook.


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- September 10, 2013
- 6:44 a.m.
- Suggest removal
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callertimer writes:
The Church of Scientology must be the little brother of the NSA.
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Is a Full Tummy Tuck Better Than a Mini Tummy Tuck?
- Asked by hope3 in Bloomington, IL
- 1 year ago
Full vs mini tummy tuck
Hello Hope. A mini tummy tuck addresses loose skin and muscles below the belly button only. The majority of people who need a tummy tuck benefit from a full tummy tuck.
Of course, this will completely depend on your situation and your physical exam. So it's best to visit with at least one board certified plastic surgeon to discuss your situation with them. I hope this helps and wish you all the best!
Choose the tummy tuck right for you
One tummy tuck is not 'better' than another, and for some a mini tummy tuck is the right choice. The correct procedure will depend on the amount and location of the skin laxity. It just happens that most often the full tummy tuck is the best fit, but choose what is right for you.
Web reference: http://wwwpeterejohnsomd.com
Full Tummy Tuck vs. Mini Tummy Tuck
Dear Patient,
Every patient's anatomy varies so depending on the patient, sometimes a Mini Tummy Tuck can be better indicated than a Full Tummy Tuck or vice versa. Tummy Tucks, like all other plastic surgery procedures, are case sensitive and should be performed according to the patient's surgical needs. That being said, very few patients are candidates for a Mini Tummy Tuck. A mini tuck usually only address the lower abdomen and does not include plication (sewing together) of the upper abdomen muscles and creation of a new belly button. Whereas a full tuck usually addresses the upper and lower abdomen, includes plication of the muscles, removal of the skin below the belly button, and recreation of the belly button itself.
Many patients are hesitant to do a full tummy tuck because of the length of the scar. However, one should always keep in mind that the length of the scar varies depending on the anatomy of each patient and not necessarily the procedure itself. I hope this info helps.
Please always stay informed and educated and remember that the decision to have plastic surgery is a personal choice and a patient must always consider the best option that fits his/her daily lifestyle. Be certain that you choose a board certified plastic surgeon that will be able to provide you with the highest standard of care for your plastic surgery needs.
Best Wishes,
Recent Tummy Tuck Reviews
The answer is IT TOTALLY DEPENDS ON YOUR BODY TYPE.
Some people do not need a full tummy tuck. If you only have a minimal amount of skin on the lower portion of the abdomen, no muscle diastasis (separation), and a good weight for height (BMI), a mini tummy tuck may work.
In general, the additional steps taken during a full tummy tuck does provide better results in the long run.
There are also hybrids in between, so the best thing to do is see a board certified plastic surgeon for an expert opinion.
Hope that helps!
The battle between the full and mini tummy tuck / La batalla entre una abdominoplastia completa y una mini
There is a BIG difference between the results of a mini tummy and its cousin the full tummy tuck. Remember the difference between the mini and full has NOTHING to do with incision length. The incision length is due to a person shape not the procedure The difference is that the full tummy tuck you will have the rectus muscles plicated and the upper abodminal skin will be much tighter. The mini tummy tuck only fixes the lower abdomen. My basic rule of thumb(with some exceptions) full term pregnancy or more than a 30 lb weight loss equals a full tummy tuck. The mini is really only good for patients that have lost some weight or have a small amount of excess lower abdominal tissue.
Good luck and thank you for your question.
Anire Okpaku MD
Hay una gran diferencia entre los resultados de una mini abdominoplastia y su "prima" la abdominoplastia completa. Acuerdese de que la diferencia entre ambos procedimientos no tiene nada que ver con el tamaño de la incision. Esto se debe al diseño del cuerpo de la persona y no al procedimiento en si. La diferencia es que en la abdominoplastia completa se le cosen los musculos abdominales y por consecuencia la piel de la parte superior del abdomen luce mucho mas apretada. La mini abdominoplastia le aregla la parte inferior del abdomen. En general (com algunas excepciones) yo le recomiendo la abdominoplastia completa despues de un embarazo completo o a personas que hayan bajado 30 libras. La mini abdominoplastia es recomendable a los pacientes que hayan bajado un poco de peso o que tengan un pequeño exceso de tejido en la parte del abdomen.
Suerte y gracias por la pregunta.
Anire Okpaku MD
Is a Full Tummy Tuck Better Than a Mini Tummy Tuck?
Well that depends upon the patient who will have the procedure. A mini-tummy tuck works well in a patient whose problem is limited to the lower abdomen. Typically this is a patient after weight loss or pregnancy who is slim but has overhanging skin, perhaps over a surgical incision.
The vast majority of patients inquiring about tummy tuck have a problem that involves the entire abdomen--upper and lower. A limited procedure here is likely to give less than a satisfactory result.
The operation chosen should be the one that can correct the combination of problems of excess skin, excess fat, lax abdominal wall. The occasional patient may be a good candidate for a mini-tuck, but most will do better with a full abdominoplasty.
Best wishes.
Full or Mini Tummy Tuck Operation Better?
Your question is difficult to answer because no operation is necessarily "better" than another; every patient's situation is different and demands its own "solution". In other words, patient A may be an excellent candidate for a full tummy tuck operation whereas patient B may be an excellent candidate for a mini tummy tuck operation.
Having said that, generally speaking, the mini tummy tuck is an operation that produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.
For most patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. Of course, there are downsides (including a longer scar and probably a longer recovery time) but for most patients the benefits outweigh the downsides. It is not unusual to see patients who've had mini tummy tuck surgery present for revisionary surgery.
For more precise advice addressing your specific situation, seek consultation with well experienced board-certified plastic surgeons.
I hope this helps.
Web reference: http://www.poustiplasticsurgery.com/Procedures/Procedure_tummyTuck.htm
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.


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Year | 1958 |
Make | Chevrolet |
Model | Corvette |
Engine | 283/245 HP |
Trans | 3-Speed |
Color | Silver Blue |
Interior | Blue Grey |
Web No. DA0912-138407
INV No. 77607 |
Get Sale Prices Members-only E-mails, auction webcasts, results and more!
Join Today FREE » Hats, Shirts, Kids Apparel & More. The perfect gifts for the Car Collector. Buy online. Details »
Lot F236.1 1958 Chevrolet Corvette
283/245 HP, 3-Speed
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Dallas, TX Auction
September 5-8, 2012
This lot may still be available. Contact a Mecum Agent today at (262)275-5050. | ||||
HIGHLIGHTS- Outstanding restoration - Mint condition body and frame - 283/245 HP Dual Quad Hydraulic Lifter engine - Factory 3-speed transmission - Working Wonderbar radio - New wide whitewall tires with mint caps - Blue soft top - All the unique items which make up the 1958 Corvette - Washboard hood, trunk irons, and pebble grain interior and dash - One of the best color combinations for a 1958 Corvette - Enjoy and show off this investment Corvette DESCRIPTIONSilver Blue paint, a Blue Grey interior and Blue soft top combine to great effect in this 1958 Chevrolet Corvette convertible, an outstanding restoration highlighted by its mint condition body and frame. Powered by the optional dual quad 283/245 HP small block engine mated to the factory 3-speed manual transmission, it has all the features that distinguish the 1958 model: non-functioning hood louvers, chromed trunk spears and pebble-finish seats and dash. Sporting new wide Whitewall tires and mint wheel covers, this fine collector Corvette is ready for years of enjoyment. Information found on the website is presented as advance information for the auction lot. Photos, materials for videos, descriptions and other information are provided by the consignor/seller and is deemed reliable, but Mecum Auction does not verify, warrant or guarantee this information. The lot and information presented at auction on the auction block supersedes any previous descriptions or information. Mecum is not responsible for information that may be changed or updated prior to the auction. The decision to purchase should be based solely on the buyers personal inspection of the lot at the auction site prior to the auction.


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Hidden Brains - Pioneer offshore ASP.NET development company provides custom Microsoft ASP.NET web application development and ASP.Net programming services at competitive rate on global platform.
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Fashionlanes.com have large collection of wholesale handbags, wholesale purse, wholesale bags and many more fashionable products according to your latest fashion trends in a very cheap prices. so vis
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Chris Rainier's Body of Work
While travelling with the Mentawai tribe in Indonesia, the photographer explains his method for how he shoots his tattooed subjects (03:10)
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Comments (2) |
I am a Fine Artist whose actual photography is being enriched immensely by the work fo Chris Rainier. I visited my local library two weeks ago and stumbled with the Smithsonian magazine and the article on his impressive work.
Now, I desire to find an actual show of his work here in the Phiadelphia area.
Best to you and your carreer!
Posted by Sandra Zaid on October 29,2010 | 07:10 PM
I have Chris's first book Ancient marks, it's a wonderful book very imformative...Image my surprise when I got my new smithsonian and there was an article about Chris. I'm currently finishing up an expository essay on tattoos. The reason I didn't use Chris's work was because I choose to write about the Japanese full-body suit. As always Chris does not disappoint, he delivers with real and accurate work.
It's always a pleasure to read your work, you deliver once again.
Debby Fogle
Posted by Debby Fogle on September 29,2010 | 12:54 AM


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If the Council and Parliament do not reach agreement, the matter is referred to a conciliation committee composed of representatives of both organs. If the conciliation procedure does not result in an agreement, the legislation cannot be enacted.
The European Parliament and the Council thus have equal legislative powers when the codecision procedure is applied. Most of the legislation adopted within the scope of the first pillar is subject to the codecision procedure.
The codecision procedure is by far the most important legislative procedure.
It is applicable in the following areas:


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TDK EB750 Headphones
TDK EB 750 Headphones The EB-750's are an all Aluminium housed earphone with rich sound production offering you the best direct-to-ear acoustics with some mega bass-boost for that little something extra. Comfortable noise reducing silicone sleeves in three sizes to suit everyone. Aluminium braided cable stays tangle free. Storage pouch protects the earphones when not in use. Fantastic...
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Instant "Members Only" Coupon Codes Emailed NOW When You Sign Up for FREE Membership!
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text:
- About Ron Silliman: excerpts from The Difficulties, Ron Silliman Issue, excerpt from the interview by Tom Beckett, and articles by Charles Bernstein and James Sherry
- On Ketjak: re-edited excerpt from The Marginalization of Poetry by Bob Perelman, excerpt from "Ron Silliman" from Dictionary of Literary Biography by T.C. Marshall, excerpt from Jerry Estrin's "Exorcise Your Monkey," article from The Difficulties, Ron Silliman Issue
- On "Sunset Debris": excerpt from Wittgenstein's Ladder by Marjorie Perloff, excerpt from Tom Beckett's interview in The Difficulties
- On The Chinese Notebook: excerpt from "For Ron Silliman and The Chinese Notebook," from The Difficulties, Ron Silliman Issue by Allen (sic!) Davies, excerpt from Textual Politics and The Language Poets by George Hartley
- Bibliography of books through 1996
<---------return to contents


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The clinical spectrum of connective tissue diseases – a single intensive care experience
*Danuta Gierek1, Marcin Jezienicki1, Tomasz Cyzowski1, Henryka Chmurzewska1, Eugeniusz Kucharz2, Anna Kotulska2, Józefa Dąbek3
1Department of Anaesthesiology and Intensive Therapy, Teaching Hospital no. 7, Medical University of Silesia, Upper Silesia Medical Centre in Katowice
2Department of Internal Diseases and Rheumatology, Teaching Hospital no. 7, Medical University of Silesia, Upper Silesia Medical Centre in Katowice
3Department of Cardiology, Teaching Hospital no. 7, Medical University of Silesia, Upper Silesia Medical Centre in Katowice
Background. Systemic connective tissue diseases are relatively rare disorders of unknown origin, possibly related to autoimmunity. In the retrospective study, we analysed the records of nine patients suffering from connective tissue disorders who were treated during a two-year period in an intensive therapy unit.
Methods. Hospital medical records, observational charts and all other available medical documents were analysed.
Results. The clinical courses of 9 patients were studied. They included 4 with scleroderma, 3 with systemic lupus erythematosus, and 2 with inflammatory myopathy. They were admitted to the ITU because of sepsis and/or pneumonia, pulmonary haemorrhage, or cardiovascular failure. Three patients (2 with systemic sclerosis, 1 with systemic lupus erythematosus) died.
Conclusions. A multidisciplinary approach to treatment is a key factor in the successful management of patients with rare diseases, such as connective tissue pathologies. Frequent infections with respiratory and/or circulatory complications are the most common causes of severe morbidity in these patients.
Until 1983, systemic connective tissue diseases (or systemic inflammatory connective tissue diseases) were known as 'collagenoses' or 'collagen diseases' and although the term is incorrect it is still occasionally used. Systemic connective tissue diseases include a variety of ailments of unknown causes and unclear pathogenesis [1]. According to the American College of Rheumatology classification, they constitute the first group of rheumatic diseases [1, 2], i.e. affecting the connective tissue of multiple organs and related to autoimmunity.
Despite their common pathogenesis, individual systemic diseases differ in the clinical characteristics. Their wide range of symptoms depends on the type of organ injuries accompanying a given disease. The symptoms can be mild (skin lesions, joint pain) or severe, often life-threatening, requiring emergent therapy. Their clinical features are likely to be characteristic of the majority of known urgent cardiac, renal, pulmonary, gastric, neurological or haematological conditions, in which ITU treatment is necessary.
The treatment of the affected patients is extremely difficult due to unclear and significantly different pathogenesis, compared to other conditions [3, 4]. In general, their management involves immunosuppressive drugs, immunoglobulins, glucocorticosteroids and plasmapheresis [1, 2]. The symptomatic treatment depends on the type and severity of organ failure. Due to immunodeficiency, the patients are at risk of various infections; therefore, their prevention improves outcomes.
The aim of the present study was to analyse the cases of systemic connective tissues diseases in patients treated in the intensive therapy unit, the problems encountered and differences in therapeutic management, in particular.
The retrospective analysis was conducted involving medical records and observation charts of patients hospitalised in the ITU due to systemic connective tissue diseases during a two-year period. Age, gender, mortality, types of systemic connective tissue diseases, number and duration of hospitalisation in ITU, causes of ITU admissions, treatment used, APACHE II, and TISS 28 scores were analysed.
The statistical analysis was abandoned due to a small size of the sample. The results were presented as absolute values.
Between 01.01.2008 and 12.31.2009, nine patients with the diagnosis of systemic connective tissues disease were hospitalised in the ITU of the Upper Silesia Medical Centre, which constituted 2.3% of patients treated in this unit during the study period. Four patients were diagnosed with systemic sclerosis (SSc), three with systemic lupus erythematosus (SLE) and two with inflammatory myopathy (IM) (1 with polymyositis and 1 with dermatomyositis). The duration of hospitalisation was comparable in all groups of patients (Table 1).
The major cause of ITU admission was cardiovascular insufficiency.
Sepsis was the most common infective complication observed (5 cases). In 3 cases sepsis was diagnosed on admission (2 in patients with SSC and 1 with SLE); in the remaining 2 cases, sepsis developed during hospitalisation. In 1 patient sepsis was caused with the methicillin-sensitive Staphylococcus aureus (MSS) - infected catheter, in another 1 – with urinary infection caused by extended-spectrum beta lactamase producing (ESBL) Klebsiella pneumoniae. Pneumonia was diagnosed in 4 patients whereas urinary infections developed during hospitalisation in 2 patients.
Pulmonary complications included hypodynamic respiratory insufficiency, alveolar haemorrhage, pulmonary hypertension and pleural effusion. Among the patients with SLE, there were 2 cases of pulmonary hypertension, 1 of pleural effusion, and 2 of alveolar haemorrhage. In the SSc group, 2 patients were diagnosed with pleural effusion, 1 with alveolar haemorrhage and 1 with hypodynamic respiratory insufficiency. The patient with dermatomyositis had hypodynamic respiratory insufficiency.
The pulmonary-renal syndrome was recognised in 2 out of 3 SLE patients; 1 was admitted due to airway haemorrhage; both required renal replacement therapy and in both, the treatment was complicated with sepsis.
Renal failure requiring renal replacement therapy was noted during 6 hospitalisations. In the SLE group, 4 patients were administered intermittent haemodialysis and 1 – continuous veno-venous haemofiltration (for 14 days). Moreover, intermittent haemodialysis was used in 1 SSc patient.
The cardiovascular complications observed in SLE patients included: pulmonary oedema in 1 case, pericarditis with fluid in the pericardial sac in 2 and aseptic endocarditis in 1. All patients with SSc had reduced ejection fraction; 1 developed myocardial infarction without ST segment elevation and required coronary angioplasty.
All patients were mechanically ventilated. The total time of ventilation was 169 days. Furthermore, almost all patients required vasoconstricting drugs. Heparin (non-fractionated or low molecular) was used in all cases. All patients with SLE and IM received hydrocortisone. Four patients were administered immunosuppressants: 2 – methylprednisolone, 1 – cyclophosphamide and 1 – mycophenolate mofetil and mycophenolic acid.
The severity of patient's condition on admission, assessed according to APACHE II score, was 22-28, and the range of mean 24 h values according to TISS-28 was 27-34. The highest score was observed in SLE patients.
The SLE morbidity is estimated at 40-50 cases per 100000, with young females affected 10 times more frequently [1, 5], which is confirmed in our material. The treatment of this disease has been constantly improved and the majority of patients survive the period of 10 years. The commonest cause of death in these patients is the pulmonary-renal syndrome and infections due to reduced immunity during immunosuppressive treatment.
According to literature data, the mortality in pulmonary-renal syndrome is 50-90% [4, 5, 6]. At present, the mortality rates are slightly lower thanks to implementation of appropriate diagnostic procedures and intensive therapy [7]. In our material, 2 patients were diagnosed with pulmonary-renal syndrome; despite intensive pharmacotherapy, artificial ventilation and renal replacement therapy administered, 1 patient did not survive.
Likewise, the incidence of systemic sclerosis is higher in females compared to males (7:1), yet the course is more severe in males [8, 9], which is consistent with our observations: all patients hospitalised in ITU were males and half of them died.
In the period analysed, 1 patient was treated due to dermatomyositis and another 1 because of polymyositis. In this group, no deaths were noted.
Vast advances in the treatment of SSc were associated with the introduction of angiotensin convertase inhibitors, which significantly reduced the incidence of acute renal failure [7, 10], the main cause of ITU admissions. At present, in the medical centres, which treat this disease, the key causes of ITU hospitalisation are fibrotic lesions of the heart and lungs, with or without pulmonary hypertension, leading to circulatory-respiratory failure.
Among 4 patients with SSc, 3 were diagnosed with pulmonary fibrosis, which is the commonest cause of death of such patients [7, 9, 10]. The disease course in them was aggressive, often with severe multiple organ failure on admission. Chronic renal failure in SSc was observed in 1 patient, who required chronic haemodialysis throughout the hospitalisation. Moreover, cardiovascular complications were recognised. All systemic sclerosis patients had impaired myocardial function of various severity reflected in reduced ejection fraction of the left ventricle, which is consistent with the data reported by other authors [10].
Furthermore, the complications in SSc include disorders of gastrointestinal motor activity with all their consequences (dysphagia, retained gastric contents, impaired intestinal passage, obstruction, dysfunction of sphincters) [8]. In our material, gastrointestinal symptoms of various severities were observed in all patients treated due to SSc.
One of the severe complications of SLE is the pulmonary-renal syndrome, whose clinical picture includes diffuse haemorrhagic inflammation of small vessels and capillaries of pulmonary alveoli manifesting as variously intensive airway haemorrhage and rapidly progressing glomerulitis, not infrequently complicated with acute renal failure [11, 12, 13]. Prognosis in acute haemorrhagic lesions in the lungs combined with deteriorating renal function is poor [4, 5].
In the group of patients with the diagnosis of IM, the commonest cause of ITU admission was circulatory failure accompanied by pneumonia. Additionally, complications of the underlying disease included weakened respiratory muscles, inducing hypodynamic respiratory insufficiency. Impaired cough and swallowing reflexes were also observed. This led to difficulties in coughing up the airway secretion and thus to increased risk of pneumonia [14, 15, 16]. Due to difficult swallowing, long-term tube feeding was required and oral feeding subsequently instituted had to be continuously controlled by the medical staff.
The modern medicine lacks the effective, causal therapy for systemic connective tissue diseases. In the majority of cases, the therapy only inhibits or modifies the disease course [1, 17]. In the therapy of patients with SSc, there are no drugs inhibiting or delaying the development of fibrosis of the skin and internal organs. This differentiates SSc from other systemic connective tissue diseases, in which the autoimmune mechanism dominates. Although causal treatment of such diseases is not available, proper use of immunosuppression (most commonly cyclophosphamide or mycophenolate mofetil) substantially alleviates the symptoms, significantly prolongs survival and improves the quality of life [17]. Cyclophosphamide does not affect the existing fibrotic lesions [10, 17], but some studies indicate that the process of fibrosis is slowed down after this treatment. During the ITU stay, 1 of our patients with SSc received cyclophosphamide. It should be remembered, however, that the institution of that immunosuppress
ive therapy is associated with increased risk of infection.
The use of glucocorticosteroids in SSc patients is limited [7, 10, 17]. The drugs are likely to accelerate the development of renal failure; moreover, their beneficial effects on fibrosis, similarly to those of non-steroidal anti-inflammatory drugs, have not been demonstrated. In our study, none of the patients with SSc received glucocorticosteroids during hospitalisation.
In recent years, autologous stem cell transplantation was used in patients with SSc [17, 18]. In almost 50% of cases, autologous transplantation improves the condition of the skin and internal organs even for several years. However, not all patients qualify for such a therapy due to infections and advanced failure of internal organs.
The treatment of SLE depends on the activity of disease. In severe cases, glucocorticosteroids and immunosuppressants are recommended; in some cases plasmapheresis is necessary [1, 2, 19]. One of our patients with aggressive SLE, treated with mechanical ventilation, renal replacement therapy, and activated protein C,
underwent 4 courses of plasmapheresis. Moreover, immunosuppressants and immunomodulators were administered, which resulted in stable improvement of the clinical condition. Therefore, the improved survival rates of these patients depend on early diagnosis, immediate aggressive immunosuppressive therapy, sometimes supported by plasmapheresis. The intensive treatment of complications, including septic conditions, is equally important to limit the risk of multiple organ failure [5, 19].
Systemic connective tissue diseases are frequently accompanied by immunological deficiencies, of IgA, in particular [1]. In our study, infections developed in 11 out of 15 hospitalised patients. Such a high number of complications may be explained by markedly reduced resistance due to long-term and intensive treatment of the underlying disease with high doses of glucocorticosteroids and immunosuppressants. Similar findings were reported in literature; infections were considered the major complication and the main cause of death in this group of patients [5, 13, 19].
The severity of patients` conditions was reflected in the APACHE II score on ITU admission. Their relatively low TISS scores, however, were disproportionate to the high treatment costs incurred.
1. In patients hospitalised in ITUs due to systemic connective tissue diseases the circulatory-respiratory disturbances are the dominating multi-organ lesions.
2. Infections developing in these patients result from impaired immunity and chronic immunosuppressive therapy. The priority of therapeutic management is to minimise the risk of infections.
3. A multidisciplinary approach is required to treat multiple organ lesions in patients with systemic connective tissue diseases.
1. Zimmermann-Górska I: Reumatologia kliniczna. Wyd. Lek. PZWL, Warszawa, 2008.
2. Januszewicz W, Kokot F: Interna. Wyd. Lek. PZWL, Warszawa, 2004.
3. Kumar A, Marwaha V, Grover R: Emergencies in rheumatology. J Indian Med Assos 2003; 101: 520-524.
4. Majdan M, Dudek P: Zespół płucno-nerkowy w układowych chorobach tkanki łącznej. Reumatologia 2006; 44: 45-51.
5. Raj R, Murin S, Matthay R, Wiedemann H: Systemic lupus erythematosus in the intensive care unit. Crit Care Clin 2002; 18: 781-803.
6. Camargo J, Tobon G, Fonseca N, Diaz J, Uribe M, Molina F, Anaya J: Autoimmune rheumatic diseases in the intensive care unit: experience from tertiary referral hospital and review of the literature. Lupus 2005; 14: 315-320.
7. Sapadin A, Fleischmajer R: Treatment of scleroderma. Arch Dermatol 2002; 138, 1: 99-105.
8. Lock G, Holstege A, Lang B, Scholmerich J: Gastrointestinal manifestation of progressive systemic sclerosis. Am J Gastroenterol 1997; 92: 763-771.
9. Widuchowska M, Głowacka M, Kopeć-Mędrek M, Kotulska A, Trzaska-Sobczak M, Kucharz E: Postępująca twardzina układowa o niepomyślnym przebiegu u mężczyzn. Reumatologia 2010; 48: 45-48.
10. Yazawa N, Fujimoto M, Tamaki K: Recent advances on pathogenesis and therapies in systemic sclerosis. Clin Rev Allergy Immunol 2007; 33: 107-112.
11. Korzeniowska-Koseła M: Zajęcie układu oddechowego w przebiegu układowych chorób tkanki łącznej. Postępy Nauk Medycznych 2001; 9: 22-28.
12. Williams F, Chinn S, Hughes G, Leach R: Critical illness in systemic lupus erythematosus and the antiphospholipid syndrome. Ann Rheum Dis 2002; 61: 414-421.
13. Ansell S, Bedhesi S, Ruff B, Mahomed A, Richards G, Mer M, Feldman C: Study of critically ill patients with systemic lupus erythematosus. Crit Care Med 1996; 24: 981-986.
14. Tymms K, Webb J: Dermatopolymyositis and other connective tissue diseases: a review of 105 cases. J Rheumatol 1985; 12: 1140-1148.
15. Kaufmann J, Hunzelmann N, Genth E, Krieg T: The clinical spectrum of dermatomyositis. J Dtsch Dermatol Ges 2005; 3: 181-194.
16. Chwalińska-Sadowska H, Mielnik P: Zapalenie skórno-mięśniowe i wielomięśniowe. Medycyna po Dyplomie 2004; 2: 39-43.
17. Kowal-Bielecka O, Landewe R, Avouac J, Chwiesko S, Miniati I, Czirjak L, Clements P, Denton C: EUSTAR Co-Authors: EULAR recommendations for the treatment of systemic sclerosis: a report from EULAR Scleroderma Trials and Research Group (EUSTAR). Ann Rheum Dis 2009; 68: 620-628.
18. Farge D, Passweg J, van Laar J Marjanovic Z, Besenthal C, Finke J: EBMT/EULAR Registry. Autologous stem cell transplantation in the treatment of systemic sclerosis: Report from the EBMT/EULAR Registry. Ann Rheum Dis 2004; 63: 974-981.
19. Ansell S, Bedhesi S, Ruff B: Study of critically ill patients with systemic lupus erythematosus. Crit Care Med 1996; 24: 981-986.
*Danuta Gierek
Oddział Anestezjologii i Intensywnej Terapii
Samodzielny Publiczny Szpital Kliniczny Nr 7
Śląskiego Uniwersytetu Medycznego
Górnośląskie Centrum Medyczne
ul. Ziołowa 45/47, 40-635 Katowice-Ochojec
tel.: +48 32 359 81 00
e-mail: firstname.lastname@example.com
received: 08.03.2011 r.
accepted: 25.05.2011 r.


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Magento has an intuitive back-end interface that gives full control to the merchant, providing powerful marketing and promotional tools including SEO, analytics and reporting, site and catalogue management. The functionality can be tailored to your particular business model, product type and fulfillment and payment methods. Magento has a community of developers and is fully supported by its parent company Varien.
Further details about Magento are available on their website: www.magentocommerce.com
Monsoon Consulting and Magento can help you future-proof your e-commerce business. We have a team of experts with years of experience in the development of Magento built e-commerce applications. Our business analysts will work with you to understand your requirements and how they will translate to a Magento paltform build. The Magento platform is a powerful and incredibly versatile tool for those companies who want to grow an online transaction based business fast and who want an extensible platform that will deliver additional technical and functional requirements as their business grows.


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Your search for SKIN in Lithium (Drug) returned 75 articles
Drug to Treat Asthma Could Relieve Hives Patients of a Chronic Itch, Study Says
Monthly injections by the drug Xolair significantly reduced hives and itchiness in patients who participated in a trial whose results were published online by The New England Journal of Medicine.
February 25, 2013, MondayPrescription Skin Creams Jump in Price
Generic creams routinely prescribed by doctors have been undergoing rapid price increases, an example of the murky and often illogical world of drug pricing.
August 09, 2012, ThursdayFor Many Millions, Psoriasis Means Misery
The chronic skin disease can cause embarrassment, employment problems, reduced income, social discrimination and diminished quality of life.
July 05, 2011, TuesdayTwo New Drugs Show Promise In Slowing Advanced Melanoma
CHICAGO -- Two new drugs have been found to prolong the lives of people with advanced melanoma, representing what researchers say is notable progress against the deadly skin cancer after decades of futility. The drugs represent success in two new approaches to combating cancer: one by attacking a specific genetic mutation that accelerates tumor growth; the other by unleashing the body's immune system to fight the disease
June 06, 2011, MondayA New Era in Melanoma Treatment
Dr. Derek Raghavan responds to reader questions about a new treatment that improved survival in those with advanced melanoma.
March 29, 2011, TuesdayEnlisting the Dying for Clues to Save Others
Researchers are increasingly relying on the very patients a new class of cancer drugs failed to cure.
December 27, 2010, MondayBotox Wins F.D.A. Approval as Migraine Treatment
Allergan, Botox's maker, recently agreed to pay $600 million to settle allegations that it had illegally marketed the drug for unapproved uses like headaches for years.
October 16, 2010, SaturdayAfter Fine, Botox Awaits F.D.A. Approval for Migraine
Allergan will pay $600 million for its marketing tactics while the F.D.A. decides on the drug's use for migraines.
September 09, 2010, ThursdayMaker of Botox Settles Inquiry On Off-Label Use
Allergan, the maker of Botox, agreed on Wednesday to pay $600 million to settle charges that it illegally promoted and sold the drug through 2005 for unapproved uses like treating headaches. That settlement, the latest in a continuing Justice Department crackdown on off-label drug promotion by pharmaceutical companies, comes with an unusual postscript. In recent months, the Food and Drug Administration has been seriously weighing approval of Botox for treatment of chronic migraines, a reme...
September 02, 2010, ThursdayAm I Young Yet?
Anti-aging can be taken to horrifying extremes.
August 22, 2010, SundayEven Wrinkle-Free Teenagers Turn to Botox
Doctors inject teenagers with Botox for a variety of perceived flaws, from a too-gummy smile to a too-square jaw.
August 12, 2010, ThursdayA Drug Trial Cycle: Recovery, Relapse, Reinvention
When patients on an experimental drug trial relapsed, researchers pushed pharmaceutical companies to collaborate.
February 24, 2010, WednesdayAfter Long Fight, Drug Gives Sudden Reprieve
The trial of a melanoma drug offers a glimpse at a new kind of therapy tailored to the genetic profile of a cancer.
February 23, 2010, TuesdayA Roller Coaster Chase for a Cure
At what may be a watershed moment in understanding genetic changes that cause cancer, a small band of doctors is doggedly testing a drug known as PLX4032.
February 22, 2010, MondayA Protein That Fuels Cancer, and a Drug to Fight It
The Cancer Melanoma, the aggressive skin cancer whose incidence is rising in the United States, begins in cells that produce the pigment melanin, which colors skin, hair and eyes. Most pigment cells are found in the skin, but cancer can develop in other areas where the cells are found.
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The toppers are usually made and despatched 4-5 weeks before your wedding or occation date.
I am fully booked up to end of october 2013, Taking orders for 2014
Required Details:
To enable me to create a topper that is unique to you, you will need to supply as much detail as possible which can be a detailed description, some photographs or a combination of these.
I will not need these details until the date I will be making your topper.
You may e-mail me or fill out the form and I will reply ASAP with availability, a total price and proposed booking date. If you have any questions or a special request, please use the form on the contact page to get in touch.
When I receive a reply that you would like to go ahead, I will provisionally book you into my diary and advise on payment.
I require an initial deposit of 20% of the total cost of your topper to secure your booking with the remaining amount due prior to posting.
Payment can be made through Direct Bank Transfer or Paypal.
For overseas customers Paypal is the prefered method of payment
Postage and Packing
The toppers are sent by 1st Class Royal Mail Special Delivery, signed for and guaranteed delivery by 1pm the next day.
Your topper will be despatched in the week following completion.
Your characters will be packed in white tissue paper and bubble wrap and placed inside a double walled cardboard box with bio-degradable packing peanuts for extra protection.


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Typical stance of a diseased bird at 30 days or older
A disease causing significant lameness and mortality problems in broilers flocks has emerged as a problem in several U.S. broiler producing areas in the last year and a half. Increased mortality is seen after four weeks of age and can reach as high as 10% to 15%, thus resulting in very poor performance results.
The disease was first mistakenly named "kinky back," which is a descriptive term for this emerging disease problem now seen in several broiler producing areas since early 2008. The actual lesion is an abscess in the free thoracic vertebrae that produces paralysis of the bird due to pressure placed on the spinal cord in that area. The abscess is associated with the isolation of the bacteria Enterococcus cecorum.
This disease was first seen in young, growing broiler breeder males in North Carolina in 2006. The broiler problem was first seen in Pennsylvania in January 2008. Since then, the disease of broilers has been reported in Washington, North Carolina, South Carolina, Arkansas, Mississippi, Alabama and California. Additionally, broilers in Canada, the Netherlands and Belgium have been reported to show lameness from spinal abscesses. In Pennsylvania, the problem is widespread and has been seen in flocks of all five of the state's broiler companies.
This problem is not seen in all flocks but only sporadically. In one broiler complex, for example, an average of two houses of twenty placed in a week showed spinal abscesses. The problem does not appear to spread from an affected house to another during growing. Only certain houses on a farm will be affected. Once a house has affected birds, subsequent flocks will be affected, and the causative agent appears to persist in the environment.
Males are predominantly affected. All broiler strains have been affected. The effect on the flock is due to culling of affected birds as they become lame and unable to get to feed and water. Initially, the percent of affected birds in a flock was relatively high at 5% to 10% percent. Now, the percentage of birds affected is lower, typically 2% to 4%.
The typical history is for a flock 30 days or older showing birds sitting on their backsides in a very typical stance. Some will also lie on their sides, paralyzed. Affected flocks have been as young as 15 days of age. In the worst cases, 50 to 200 birds need to be culled each day until marketed.
Affected birds that are necropsied will not show the typical lesions associated with lameness such as femoral head necrosis or synovitis. The seventh thoracic vertebra, the free thoracic vertebra, contains the abscess and shows a palpable swelling. This vertebra is located just caudal to the last rib and beside the cranial lobe of the kidney. The abscess is visualized by cutting through the vertebra with a heavy, sharp scissors or knife at a right angle to the vertebra. The cross section will show an abscess in the vertebral body. If the vertebrae are cut longitudinally, one can see the compression placed on the spinal cord resulting in paralysis.
This disease needs to be differentiated from true 'kinky back' (spondylolisthesis) and scoliosis. True kinky back is a genetic condition resulting in anterior-posterior rotation of the bodies of the free thoracic vertebrae resulting in pinching of the spinal cord just anterior to the kidney. Scoliosis is another genetically associated disease resulting in lateral curvature of the thoracic vertebrae causing paralysis.
The causative organism of this disease appears to be Enterococcus cecorum, a Gram-positive bacterium. Initially, the method used to identify bacteria in our laboratory, the Sensititer ARIS system, reported the bacterium to be Streptococcus suis. Further tests, using the MicroSEQ system, were used to sequence the DNA and compare it to a DNA databank in order to identify the bacterium as Enterococcus cecorum. This bacterium is a normal inhabitant of the intestinal tract. It also has been reported to cause a septicemia and synovitis in broiler chickens. Typically, E. cecorum is sensitive to gentamycin and penicillin but resistant to tetracyclines, sulfas and streptomycin.
The source of the infection is not known. It is believed that the breeder hatching eggs may be a possible source. One search for the bacterium in trays of hatching chicks by swabbing yielded E. cecorum in one of six breeder sources assayed. Theoretically, hatch egg shells or shell membranes contaminated with E. cecorum could contaminate the entire hatcher cabinet. Another theory is that E. cecorum becomes blood-borne from the intestine. In human infants, vertebral abscesses are common sequelae to navel infections (hematogenous spread from omphalophlebitis). Histologic examinations of the cecae of affected birds show evidence of an adherent and effacing strain of E. coli which is theoretically allowing the Enterococcus cecorum bacterium entry into the blood.
Whatever the source of the infection, once E. cecorum is blood-borne, it invades the vertebral body of the free thoracic vertebrae resulting in necrosis, inflammation and swelling of the vertebral body. The resultant swelling causes compression on the spinal cord and/or pathological fractures of the vertebral body.
The seventh thoracic vertebra, the free thoracic vertebra, contains the abscess and shows a palpable swelling.
Treatment has been to cull the affected birds, sanitize water, and give as good an environment as possible. Antibiotics have not been used as the potentially useful antibiotics are not approved in the U.S. for use in broilers at that age.
Preventative antibiotics such as tylosin and amoxicillin have been used in Europe during the grow-out to stop the recurrence of the disease. Also, increasing the dosage of gentamycin used in the Marek's vaccine from a half dose to a full dose has been tried.
Preventative measures after the first flock where the disease has occurred that has shown success are as follows:
Elimination of the disease usually does not occur after only one round of cleaning and disinfection. Increased efforts in subsequent flocks have been needed to eventually eliminate the disease. These measures are as follows:
Composting of litter between flocks is becoming a more routine practice in the broiler industry to reduce litter pathogens and darkling beetles. Litter composting utilizes both caked and normal litter. Special equipment pulverizes the litter and places it into two or three piles the length of the house. After three days, if the litter has 25% to 30% moisture, the pile will heat to 130 F or more. The piles are turned and allowed to reheat to 130 F or more. Multiple turnings are ideal. At least 10 days downtime is required for a satisfactory composting of litter.
Future research will hopefully answer questions about E. cecorum and vertebral abscesses, including the following:
Until more is known about the source and cause of this emerging disease syndrome, producers should practice culling, proactive husbandry and cleaning and disinfection in affected flocks and facilities.
Entire susceptible bird population is destroyed while protection zone is established
Adjuvanted vaccine to supplement national stockpile and is not intended for commercial availability
The Salmonella Action Plan presents a number of aggressive steps the agency will take to prevent Salmonella-related illnesses
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• Enjoy a private look at the English in Florence! • Feel free to ask questions and start a fascinating dialogue with the guide. • Take influence on the tour's itinerary. • If you have kids, we can adapt the tour in order to suit also the youngest ones. • Have your guided tour in your own language When: On request
Meeting point: at your hotel, if centrally located, or in the city center
Duration : 3 Hours
The Itinerary: You can easily modify or change the itinerary, of your personal tour; your interests are the focus of our attention. Please send us an e-mail at firstname.lastname@example.com. The standard schedule includes a walking tour in the historical center of Florence On request is possible to book lunch in typical Florentine restaurant or osteria.
Price: 1 person: € 253,50
2 people: € 260,00 – price per person € 130,00
3 people: € 266,50 – price per person € 88,85
4 people: € 273,00 – price per person € 68,25
5 people: € 290,00 – price per person € 58,00
6 people: € 297,00 – price per person € 49,50
7 people: € 303,50 – price per person € 43,35
8 people: € 310,50 – price per person € 38,85
9 people: € 317,50 – price per person € 35,30
10 people: € 324,00 – price per person € 32,40
For groups over 10 people, please write at email@example.com.
Price includes: Expert guide at disposal for 3 hours, tea anc biscuits. No fee applied to children under 6 years old
Price does not includes: meals, tips, extra and anything else that is not expressly mentioned as "prices includes"
Languages: English, Spanish and Italian
Cancellation policy: Cancellations received via firstname.lastname@example.com at least 30 days before the date of the tour will be reimbursed without any fee. A fee of 25% of the total amount is applicable if the cancellation is received via e-mail between the 29th and 15th day before the date of the tour. No reimbursement will be paid in cases of cancellations received less than 15 days before the date of the tour. If the booking is not paid within the deadline stated in the confirmation of the tour, Florapromotuscany has the right to cancel the booking without any further notification to the client. * unless different agreements
Remember: Bring comfortable shoes, since this is a walking tour!
NOTE: On request it is possible to have a minivan at disposal for the tour. Ask for a quotation. |
Description: |
This tour represent a journey through time on the cobbled ancient streets of Florence. Walk along the same roads that some of the most famous Anglo-Florentine artists of the past traveled. Stop to admire the numerous residences throughout the city that were the homes of famous English writers and painters: artists who chose Florence as the city in which to expand their knowledge and culture. Florence was the backdrop for the harmonious intermingling of life, art and nature, and this was reflected in the painting, poetry and prose of many artists who went on to created a bond, a "golden ring", that links Florence to England. The author George Elliot, the poet Elizabeth Barrett Browning and her husband Robert Browning, tell the tales of a Florence both lived and loved. You will crown your visit, most appropriately, with tea and biscuits. |


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What is the difference between an application and an Assembly? Some help
topics say that some kinds of variables can be seen inside an application
and an assembly, others only in an application etc. I can't see the difference.
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I Love the Way You Love
Original Release Date: 1972
Track Listing
1. I Love the Way You Love
2. I'll Love You Forever Heart and Soul
3. I Found That Guy
4. All Your Kissin' Sho' Don't Make True Lovin'
5. If You Love Me Like You Say You Love Me
6. Clean Up Woman
7. I'm Gettin' Tired Baby
8. Pure Love
9. Ain't No Sunshine
10. Don't Let It End This Way
11. Let's Not Rush Down the Road of Love
Bill Withers: Composer
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The Memphis Horns: Horn
Snoopy Dean: Guitar, Guitar (Bass)
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Berry Gordy, Jr.: Composer
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Reid Singers: Vocals (Background)
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Celebrate your special day in a unique setting of affordable elegance -- discover the beauty of Queens Botanical Garden!
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M. K. Theodoratus
A Review of Griftopia by Matt Taibbi
American Dreamers — By Michael Kazin — Book Review
To a lot of atheists, Chris Hedges is a relatively well known Christian who is good at getting smacked around in debates with the likes of Sam Harris and Christopher Hitchens. He's written a book railing against atheists for being too critical of religion. He apparently doesn't believe we really exist , as it turns out.
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School 'Reform': A Failing Grade by Diane Ravitch
Eli Reed/Magnum Photos


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This week's learning is sponsored in honor of
Daniel Yaacov Meadvin
on the occasion of his
Bar Mitzvah
Sponsor a day of learning on TorahCafe, please click here.
Sensitivity Toward Others While Growing in Judaism
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Minutes of
North Carolina State Board of Optometry
July 27- 30, 2006
Jane McKimmon Center
Raleigh, North Carolina
The North Carolina State Board of Optometry met in Raleigh, North Carolina, Thursday, July 27 through Sunday, July30, 2006 to conduct the Summer 2006 Clinical/Practicum Examinations at the Jane McKimmon Center on the Campus of North Carolina State University and for other purposes. Present were Drs. William Rafferty, President, David Anderson, Secretary/Treasurer, Joel Banks, David Baxter, William Hendrix and Ms. Trudy Mitchell and Mary Richardson, Members of the Board. Present as Staff were John D. Robinson, OD, Executive Director, Janice Peterson, RN, Administrative Secretary, and Mrs. Sara Roberts, Administrative Assistant. Mr. Johnny Loper, the Board's Attorney, was present on Thursday afternoon to meet with the Board in closed session to discuss litigation matters pursuant to GS 143-318.11(3). Also present except for those parts of the meeting held in closed session was Matthew W. Sawchack, Esq. of the Ellis & Winters Law Firm, the Firm representing the North Carolina Society of Eye Physicians and Surgeons since the Settlement Agreement between the Boards of Medicine and Optometry was reached in August 2005.
Present for orientation prior to the start of the Board meeting on Thursday afternoon were the following Clinical Examiners: Drs. Kenneth Bumgarner, Ania Hamp, Robert Harding, David King, Donald MacQueen, Magda Metwalli, John Miller, Sandra Moore, Brett Munn, and Robert Rosenstein.
Prior to calling the meeting to order at 4:50 P.M. on Friday afternoon, the President asked Dr. Baxter to open the meeting with prayer.
APPROVAL OF MINUTES. On a motion by Dr. Baxter, seconded by Dr. Hendrix and carried unanimously, the Minutes of the Meeting held in Myrtle Beach, May 30 - June 3, 2006, were approved. On a motion by Dr. Baxter, seconded by Ms. Mitchell and carried unanimously, the minutes of the Annual Meeting held on June 14, 2006, by conference telephone were approved.
REPORT OF THE PRESIDENT. The President stated that he had two goals in mind that would like to recommend to the Board in hopes that they could be well on the road to completion by the end of his administration if not accomplished. The first is to form several Committees composed of Members of the Board and a number of the Clinical Examiners charged with reviewing the current data base from which scenarios are selected and to prepare as many new ones as possible. Ultimately the Board would like a sufficient number of cases from which to draw the examination without the same case being drawn too frequently. Further, that there we achieve greater uniformity with appropriate pictures for the candidate to review as they respond to the questions of the examiners. Eventually we hope to reach to point that all of the cases are prepared and in the data base for selection and for sending to the Clinical Examiners for their review six weeks prior to the examination taking place. The second project or goal is to review the Board's policies relating to its approval of continuing education courses and of the course content. There are obvious needs for bringing new information as well as updating old information, especially in areas like patient communications and in the legal aspects of day to day practice.
Report OF THE SECRETARY/TREASURER. Dr. Anderson presented the Budget Report for the period 07/01/06 through 07/31/06. After a brief period and the answering of several questions, a motion was made by Ms. Mitchell and seconded by Dr. Hendrix that the report of the Secretary/Treasurer be accepted. The motion carried unanimously.
REPORT OF THE EXECUTIVE DIRECTOR. Before giving his report, the Executive Director informed the Board that the office had received notification from the Governor's office that Dr. Michael F. Clark had been appointed to the Board, succeeding Dr. David Baxter whose second five year term had expired. Dr. Clark had made previous plans to be with his father in California during the time of knee replacement surgery, thus unable to be sworn in and attend this meeting as the Board's newest Member. He will be returning next week and take the oath of office at that time.
The Board was advised that in accordance with action taken at its meeting in Myrtle Beach a letter has been sent to the Deans and/or Presidents of the Accredited Schools and Colleges of Optometry notifying them that beginning with the entering class of 2006 (the graduating class of 2010) all applicants for examination and licensure to practice optometry in North Carolina shall be required to submit evidence satisfactory to the Board that they have been properly trained in the use of those injection procedures approved for use by properly trained and licensed optometrists in North Carolina by the school or college from which they obtained their Doctor of Optometry degree. He then called on the Administrative Secretary, Ms. Janice Peterson, who gave a brief update on the programming and software development for the Board's data operating systems. On a motion by Dr. Baxter, seconded by Dr. Hendrix and carried unanimously, the report of the Executive Director was accepted.
CLOSED SESSION. On a motion by Dr. Anderson, seconded by Dr. Baxter and carried unanimously, the Board went into Closed Session to discuss litigation matters pursuant to GS 143-318.11(3). Mr. Loper briefed the Board on prior litigation between the Board and the Medical Board, Medical Society, and SEPS as background for his assessment of the likelihood of further litigation which might involve this Board and SEPS over either the Settlement Agreement between the Board and the Medical Board and Medical Society, or a Public Records Act request made by SEPS' law firm. Mr. Loper responded to questions from Board Members. No vote was taken on any issue in the closed session, and the Board voted to return to open session on a motion by Dr. Baxter that was seconded by Dr. Anderson and carried unanimously.
REVIEW OF COMPLAINTS. The Executive Director reported that no new complaints had been received since the last meeting of the Board.
CLINICAL EXAMINERS HONORARIUM. On a motion by Dr. Hendrix, seconded by Dr. Anderson and carried unanimously, four days honorarium, travel and meal expenses for the Clinical Examiners were approved.
OLD BUSINESS. There was no old business
NEW BUSINESS. Dr. Anderson reported on the ARBO meeting held in June in Las Vegas which he attended along with Drs. Hendrix, Rafferty and Robinson. This being his first ARBO meeting he was impressed by the initiatives and types of programs that organization is undertaking and recommended that each Member of the Board attend at least one of these meetings during their time on the Board.
Dr. Anderson took a moment to speak briefly concerning a letter received from an anonymous source at the Board office from Mr. Thadius Swank, Director of Patient Initiatives at the American Academy of Ophthalmology, dated May 26, 2006 addressed to the Members of the North Carolina Society of Eye Physicians and Surgeons in which Mr. Swank wrote "the department is interested in documenting cases of patients who have had bad outcomes resulting from medical or surgical treatments by optometrists". It was the consensus of the Board that since this letter was on the letterhead of the American Academy of Ophthalmology addressed to the members of the North Carolina Society of Ophthalmology it was a not a matter which should be considered by the Board at this time in light of the fact that there are no direct allegations of patient mismanagement or practicing beyond the lawful scope of optometry by a licensee of this Board. Rather, that at this time, it is an issue that should be addressed by the North Carolina State Optometric Society and the American Optometric Association, since, like the American Academy of Ophthalmology, it represents the profession of optometry at the national level. The President asked the Executive Director to send Mr. Swank's letter to Mr.Loper with a request that he forward it with an appropriate cover letter to the current Officers and Trustees of the North Carolina State Optometric Society.
EXAMINATION OF THE CANDIDATES. Forty-one candidates whose applications had been approved appeared for examination. The first session began at 7:45 a.m. on Friday July 29,2006 and the final session ended at 6:10 p.m. on Sunday July, 30, 2006 whereupon the meeting was adjourned
The next meeting of the Board to determine the results of the Summer 2006 Clinical/Practicum Examinations and to consider other matters that might come before the Board will be held at the Board Office in Wallace on August 18 – 20, 2006.
Approved 08/18/06
Wallace, NC


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04th November, 2010 at 12:28:33
Jeff Forrest Wins WPT Title On His First Ever Attempt
Jeff Forrest has outlasted 241 other poker players on his way to winning the 2010 WPT Foxwoods title at the world famous Foxwoods Resort Casino in Mashantucket, Connecticut, for a pay-day of nearly $550,000 (Ł340,000). Full Story: Jeff Forrest Wins Wpt Foxwoods » HIGH STAKES POKER FOR POKER CHANNEL
04th November, 2010 at 08:03:26
Deal with GSN will showcase High Stakes Poker
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text:
Previous poll Next poll
Have you ever been involved in a car-deer accident?
Response | Percent | Votes | |
Yes | 55% | 494 | |
No | 44% | 389 | |
Total | 883 |
spammer89 4 years, 1 month ago
Speed = 85mph Deer = Large buck in middle of road Car = 1989 Chevy Baretta Outcome = car trashed beyond repair
Flap Doodle 4 years, 1 month ago
More than a few close calls. After I put a pair of the deer whistles on my car, I had fewer near misses. Causality or concidence? The jury is still out.
kclee 4 years, 1 month ago
A friend of mine was driving down I-70 probably going the speed limit and they hit a deer. She was 34 weeks pregnant and lost her baby. So sad.
mom_of_three 4 years, 1 month ago
I haven't, but the husband did about 11 years ago. Hit bambi's mother and may have hit bambi. Crushed the front of his car. Could have been worse for him. Our kids were little, and it was hard to explain what happened without the bambi comparison.
Stedman 4 years, 1 month ago
Thankfully no, and this is after living the past 2 years in the Colorado mountains where deer are EVERYWHERE. And elk.
Elk vs. car would not been good.
RonBurgandy 4 years, 1 month ago
It seems that if you voted "No" in this poll, you're just testing Karma.
Ricky_Vaughn 4 years, 1 month ago
lol @ Ron
But seriously, I've hit two deer when I used to commute to OP: in 07 and 08 during the end of October/early November. I swear they were within the same week, just in different years (mating season).
Be careful for the next couple of weeks if you drive K-10, especially at night! I've lost two cars this time of year the last two years!
Ricky_Vaughn 4 years, 1 month ago
I hear there's some guy that lives in Bonner that feeds the damn things.
labmonkey 4 years, 1 month ago
I have had a few run-in's with deer. It seems that I have actually had less damage when I hit them going full speed than when I hit one doing 30 mph. I think it has something to do with the deer seeing you comming....if it doesn't see you comming, it won't tense up and will actually absorb more of the impact.
coolmom 4 years, 1 month ago
no deer yet knock on wood there has been several close calls. i have however hit an armadillo and 2 turkeys, a pigeon and just missed a coyote by the skin of his teeth.
mjwgoku 4 years, 1 month ago
I don't let my deer drive, especially after it has been drinking, so no.
jaywalker 4 years, 1 month ago
Clipped one just south of Larry. My mother had one literally jump into her car - through the windshield! She never saw it (jumped from a hill beside the road down into the car), knocked her out, and yet somehow the car came to a stop 200 yards later and still in her lane. Talk about luck 'cuz the land to the right sloped steeply down into a ravine. Six months later she ran into a woman and her young daughter who'd actually witnessed the accident. The poor little girl was still having to go to a therapist due to nightmares and flashbacks of the whole thing.
acg 4 years, 1 month ago
I've come so close to hitting deer, knock on wood, but haven't. I did, however, cream a bobcat in Jeff Co. a year ago. Ripped the grill right off my car.
openminded 4 years, 1 month ago
Many many close calls...had one that I slammed on my brakes and came to a stop while the doe was in the middle of the road. The doe turned around and ran off after I stopped and the doe's nose graced my side mirror as she turned around! Lived in the country my entire life and I've been very very lucky.
Satirical 4 years, 1 month ago
Yes, it was very frightening. Luckily the car only hit my hind legs so I survived with only two broken legs.
Kat Christian 4 years, 1 month ago
Not in Kansas - where I use to live on the east coast. My car was only 4 months old and I was traveling on a country road going less than 30 when two deer flew over a fence into my path. One got away but the other I hit as I slammed on my brakes. It slammed into the front of my car rolling to my side, by then I had stopped. It laid there for a second then got up and stood on the side of the road panting. I noticed its eye was injured. I got out crying more concerned for the deer than the car. I just kept begging for its forgiveness saying over and over again I'm so sorry, I'm sorry. It jumped the fence back to where it came but in the field turned and looked back at me still begging for its forgiveness. Then I turned around and saw my car. The deer caused a huge dent in my driver's side and hair was pretuding from the door guard. That night it snowed. I'll never know if it survived. I'll never forget that experience either.
jrlii 4 years, 1 month ago
I've hit two of Bamby's kin: Once in Leavenworth county on K-34, and once in Johnson county on US-69.
There have been several who seemed to be daring me to hit 'em on Stairstep road or 13th St in Jefferson County, but none have been successfully suicidal.
Seems like the population is thinner west of town than east. . . I haven't hit a deer since I've been working in Topeka. . . Knock on wood. . .
jimmyjms 4 years, 1 month ago
Hit a deer, totaled the car, officer had to shoot the deer in the middle of the road. Bummer all the way around.
gphawk89 4 years, 1 month ago
Four that I can remember, none as a driver, all as a passenger. And quite a few close calls, including a couple on a motorcycle.
The weirdest deer hit I've seen is when a running deer vaulted off a 20-foot cliff and landed right on the hood of a pickup truck that was driving along a gravel road below. I didn't see it happen but came up on the scene just a minute later. Scared the you-know-what out of the driver. Imagine driving along minding your own business and a deer suddenly falls out of the sky onto your car...
beawolf 4 years, 1 month ago
beerguy (Anonymous) says…
"I know a guy that hit a deer on his motorcycle at 120mph, he spent two weeks in the hospital after that one. He said he still had deer guts all over him when he arrived at the hospital."
This sounds like an urban legend that grows every time it's told. He was probably on a moped, thought he saw a deer and dumped the "ped" at 15 mph.
acg 4 years, 1 month ago
My dad and uncle jerry once had a deer run into the side of my dad's truck and thru the driver's window. Jumped out of a cornfield into the road right as they were passing on a gravel road. My uncle had to cut it's throat with his side knife because it was horning them to death. They came home, side of the truck was all beat up from its back hooves, they were all beat up from the horns and the inside of the truck was covered in blood. When they're rutting, they're totally stupid
ohgeeze 4 years, 1 month ago
jimmyjms (Anonymous) says…
"Hit a deer, totaled the car, officer had to shoot the deer in the middle of the road. Bummer all the way around."
I used to date a guy who was a sheriff's deputy. Whenever someone called in with a report of a hit deer, they all raced to see who could get the call first. They all wanted to be the one who got to shoot it... weirdos.
SpeedRacer 4 years, 1 month ago
Several close calls. Had dents on my hood from a deer jumping over the car. Most of the close calls happened in fog.
Flap Doodle 4 years, 1 month ago
One night I was leaving the office in Lenexa after dark & a deer the size of a Clysdale leaped across the road right in front of me. Okay, he probably wasn't really the size of a Clysdale, but at the moment he sure looked it.
institches 4 years, 1 month ago
I have hit a few deer with my truck... and they were delicious!! But seriously - do watch for them in the fields- wear your seatbelts and pay attention to the deer crossing signs... they are there for a reason!!
Larry Bauerle 4 years, 1 month ago
Our insurance agent asked if we wanted to replace the deer whistles a collision with a deer wiped out the front end of our van. Smart***.
Larry Bauerle 4 years, 1 month ago
Our insurance agent asked if we wanted to replace the deer whistles after a collision with a deer wiped out the front end of our van. Smart***.
happypill4014 4 years, 1 month ago
Hello - We live in KANSAS - Of course we have had incidents with deer! DUH!
tbaker 4 years, 1 month ago
Spike buck + brand new 89 Toyota Pickup + 40 MPH and skidding to a halt = small dent on front valance and a freezer full of meat. Dozens of close calls.
Still have the pick up. Now I aim for them.
P.S. If you hit one, tell a poor person where it is. They can call the Sheriff and get permission to go get it for the meat without a hunting license. (next door neighbor with 7 kids does this)
Autie = LMAO!
RoeDapple 4 years, 1 month ago
In the past numerous deer have accidentally wandered into the cross hairs of my rifle scope. Two more scheduled for Dec. 1 - 11
RoeDapple 4 years, 1 month ago
Links with pictures tell the story best....
trollkiller 4 years, 1 month ago
No, but there was one close call in the back seat my senior year in HS, with a dear one,
RoeDapple 4 years, 1 month ago
So many recipes to choose from.....
Gotta try this one though!
Sagecasey 4 years, 1 month ago
Yes, a deer jumped in front of me and I slammed on the brakes. the deer crapped right there in the road and I crapped my pants in the car. So the deer and I both had accidents. I guess it was 2 accidents rolled into one.
BorderRuffian 4 years, 1 month ago
It was on a dismally dark and gloomy October 31st. I was tooling down K-10, right about where the water-ski pond is, and the radio was playing a sad country song by Waylon. I was pretty mellow, as I recall, and looking forward to arriving at home in Kansas City.
Suddenly, from out of nowhere, this huge semi with a load of John Deere tractors swerves from the oncoming lane, runs across the median, and heads straight toward me. The airhorns blow, scaring me nearly witless, and I swerve as well, trying to avoid a certain head on collision. The sudden veering off made me fish tail wildly and the car left the road going about 80 mph, heading straight for the deer-crossing sign. Clipping that off like a toothpick the car became airborn, and headed straight for that century-old oak tree. Hitting it dead on, the last thing I remember before my head went through the windshield was this stupid, grinning deer with a cigarette hanging out of his mouth, one hoof hauling on the air-horn, and the other waving out the window in a gesture remarkably like the old one-finger salute. And then things went dark...
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