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This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Incidence and Mortality
Estimated new cases and deaths from gallbladder (and other biliary) cancer in the United States in 2012:[1]
Cancer that arises in the gallbladder is uncommon. The most common symptoms caused by gallbladder cancer are jaundice, pain, and fever.
In patients whose superficial cancer (T1 or confined to the mucosa) is discovered on pathological examination of tissue after gallbladder removal for other reasons, the disease is often cured without further therapy. In patients who present with symptoms, the tumor is rarely diagnosed preoperatively.[2] In such cases, the tumor often cannot be removed completely by surgery and the patient cannot be cured, though palliative measures may be beneficial. For patients with T2 or greater disease, extended resection with partial hepatectomy and portal node dissection may be an option.[3,4]
Cholelithiasis is an associated finding in the majority of cases, but less than 1% of patients with cholelithiasis develop this cancer.
Some histologic types of gallbladder cancer have a better prognosis than others; papillary carcinomas have the best prognosis. The histologic types of gallbladder cancer include the following:[1]
*Grade 4 by definition.
Note: This Stage Information section has been updated to include information from the 7th edition (2010) of the American Joint Committee on Cancer's AJCC Cancer Staging Manual. The PDQ Adult Treatment Editorial Board, which is responsible for maintaining this summary, is currently reviewing the new staging categories to determine whether additional changes need to be made to other parts of the summary. Any necessary changes will be made as soon as possible.
Definitions of TNM
The American Joint Committee on Cancer has designated staging by the TNM classification to define gallbladder cancer.[1]
Localized (Stage I)
These types of patients have cancer confined to the gallbladder wall that can be completely resected. They represent a minority of cases of gallbladder cancer. Patients with cancers confined to the mucosa have 5-year survival rates of nearly 100%.[2] Patients with muscular invasion or beyond have a survival of less than 15%. Regional lymphatics and lymph nodes should be removed along with the gallbladder in such patients.
Unresectable (Stage II–IV)
With the exception of some patients with focal stage IIA disease, these types of patients have cancer that cannot be completely resected. They represent the majority of cases of gallbladder cancer. Often the cancer invades directly into adjacent liver or biliary lymph nodes or has disseminated throughout the peritoneal cavity. Spread to distant parts of the body is not uncommon. At this stage, standard therapy is directed at palliation. Because of its rarity, no specific clinical trials exist; however, such patients can be included in trials aimed at improving local control by combining radiation therapy with radiosensitizer drugs.
When gallbladder cancer is previously unsuspected and is discovered in the mucosa of the gallbladder at pathologic examination, it is curable in more than 80% of cases. Gallbladder cancer suspected before surgery because of symptoms, however, usually penetrates the muscularis and serosa and is curable in fewer than 5% of patients.
One study reported on patterns of lymph node spread from gallbladder cancer and outcomes of patients with metastases to lymph nodes in 111 consecutive surgical patients in a single institution from 1981 to 1995.[1][Level of evidence: 3iiiA] The standard surgical procedure was removal of the gallbladder, a wedge resection of the liver, resection of the extrahepatic bile duct, and resection of the regional (N1 and N2) lymph nodes. Kaplan-Meier estimates of the 5-year survival for node negative tumors pathologically staged as T2 to T4 were 42.5% ± 6.5% and for similar node positive tumors, 31% ± 6.2%.
Standard treatment options:
Implantation of the carcinoma at all port sites (including the camera site) after laparoscopic removal of an unsuspected cancer is a problem. Even for stage I cancers, the port sites must be excised completely.[6]
Treatment options under clinical evaluation:
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized gallbladder cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
These patients are not curable. Significant symptomatic benefit can often be achieved with relief of biliary obstruction. A few patients have very slow-growing tumors and may live several years. Patients with unresectable, recurrent, or metastatic gallbladder cancer should be considered for inclusion in clinical trials whenever possible. Information about ongoing clinical trials is available from the NCI Web site.
Treatment options:
Palliative radiation therapy after biliary drainage may be beneficial, and patients may be candidates for inclusion in clinical trials that explore ways to improve the effects of radiation therapy with various radiation sensitizers such as hyperthermia, radiosensitizer drugs, or cytotoxic chemotherapeutic agents.
A randomized phase III study of up to 6 months of gemcitabine versus gemcitabine and cisplatin in 410 patients with unresectable, recurrent or metastatic gallbladder cancer demonstrated an improvement in median overall survival (OS) among patients treated with combination therapy (11.7 months vs. 8.1 months, HR, 0.64 (95% confidence interval, 0.52–0.80), P < .001).[2][Level of evidence: 1iiA] A similar median OS benefit was demonstrated in all subgroups, including 149 patients with gallbladder cancer. Grade 3 and 4 toxicities occurred with similar frequency in both study arms, with the exception of increased hematologic toxicity in patients randomly assigned to gemcitabine-cisplatin and increased hepatotoxicity in patients randomly assigned to single-agent gemcitabine.
Other drugs and drug combinations await evaluation in randomized trials.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with unresectable gallbladder cancer, recurrent gallbladder cancer and metastatic gallbladder cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
Purpose of This Summary
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of gallbladder cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
Reviewers and Updates
This summary is reviewed regularly and updated as necessary by the PDQ Adult Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Board members review recently published articles each month to determine whether an article should:
Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.
The lead reviewers for Gallbladder Cancer Treatment are:
Any comments or questions about the summary content should be submitted to Cancer.gov through the Web site's Contact Form. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.
Levels of Evidence
Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Adult Treatment Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations.
Permission to Use This Summary
PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks succinctly: [include excerpt from the summary]."
The preferred citation for this PDQ summary is:
National Cancer Institute: PDQ® Gallbladder Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://cancer.gov/cancertopics/pdq/treatment/gallbladder/HealthProfessional. Accessed <MM/DD/YYYY>.
Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in Visuals Online, a collection of over 2,000 scientific images.
Based on the strength of the available evidence, treatment options may be described as either "standard" or "under clinical evaluation." These classifications should not be used as a basis for insurance reimbursement determinations. More information on insurance coverage is available on Cancer.gov on the Coping with Cancer: Financial, Insurance, and Legal Information page.
Contact Us
More information about contacting us or receiving help with the Cancer.gov Web site can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the Web site's Contact Form.
Call 1-800-4-CANCER
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.
Chat online
The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.
Write to us
For more information from the NCI, please write to this address:
Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each Web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen Web pages that are most closely related to the search term entered.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
Find Publications
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).
Last Revised: 2012-07-13
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
To learn more visit Healthwise.org
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Potential Sacramento Kings partial owner Chris Kelly has agreed to pay California's political ethics watchdog agency a $2,500 in fine to settle bookkeeping issues from his 2010 attorney general run.
An investigation by the Fair Political Practices Commission found that Kelly's campaign failed to accurately report more than $7 million in expenditures during his 2010 Democratic primary campaign, which he lost to Attorney General Kamala Harris.
The fine is on the agenda for approval at the commission's May 16 meeting.
A spokesman for Kelly's campaign wrote in an email that the the former Facebook chief privacy officer "cooperated with the investigation and has agreed to pay the minor administrative penalty levied for the one violation."
Kelly, who has remained active in policy issues related to public safety since his attorney general run, is part of a group of investors seeking to purchase the Kings to keep the team in Sacramento.
PHOTO CREDIT: Chris Kelly. Sacramento Bee file photo


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1. Proper Basics
To successfully market products online, you need 2 things: a website (or blog) where you sell your products, and traffic (visitors). WARNING, your website or blog is something you will want to buy. It is not recommend to get a free one as the owners can delete or make changes to your site at any time. You need complete control over yourself and your product promotion, and owning your website is essential. For the web design or layout; see what other online marketers in your niche are doing to promote their products, and learn from them. The best design is popular design. Associate and link with people marketing the same products as you are online. That will create an image for yourself, which can eventually result in recommendations about you, and long term traffic for your promotions and products.
2. Promote Using Facebook and Twitter
This is great to let people know about you, your site, and/or what you are promoting. Provide links. There are easy and advanced strategies to set up your Facebook page and 'like' strategies to get lots of visitors from Facebook to your website. Twitter messages and Facebook combined can get the word out about the products you're marketing online, and give you an initial burst of decent traffic.
3. Marketing Your Product Online Through Articles
Write short articles of around 450 words that target search-engine-friendly keywords related your product/niche where you give tips, advise, and helpful information within the niche – then directing the readers to your website through links in the article. Submit the articles to online article directories which already get traffic and rank high in the search engines. The more articles you have submitted on these article directories, the more traffic will your website get, and you will be more successful in marketing your products online.
4. Market Products Online Using YouTube
This strategy is really powerful. Although you can (and should) market yourself in the videos, you can create reviews on power-point presentations on future product launches of other marketers in your niche, record them, and post them on YouTube. At the end of the video you redirect them to your own website through the link at the bottom of the video. See thousands of visitors and buyers coming by simply marketing your products with this strategy.
5. Advertise Your Products Online –
There are lots of misconceptions on how to properly market online using advertising, and most people do it incorrectly. However, it is very cheap and when done correctly; you can generate crazy amounts of sales.
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If you want more sales through your marketing of products online, whether it's your own or someone else's product – you must learn from the best. Get an expert to walk you through the process, while watching his screen and following along, and make money as you progress.


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Step 1. Select the My Digicel app from the app screen.
Step 2. If you are on Digicel's network, click 'Connect with your Digicel ID' to log in automatically.
If you wish to log in with a different phone number, select "To sign in with another number, click here" as seen in the screenshot above.
Download the app for free today!


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Get your forks and knives ready … it's nearly "Feed The Need" time once again!
Get your forks and knives ready … it's nearly "Feed The Need" time once again!
During the week of October 15-19, several area restaurants and businesses will be supporting ADFAC (Aid To Distressed Families of Appalachian Counties). Specifically, the multi-day event involves a variety of these local restaurants donating a significant portion of their sales to support ADFAC's 25-year mission of helping local families become more stable and self-sufficient.
ADFAC provides crisis intervention and supportive services such as rent and utilities assistance, home repairs, food and pantry items, school supplies for disadvantaged students, counseling and first-time homebuyer programs. "We are so excited to have so many restaurants return year after year for this fundraiser," said Feed The Need Chairperson and ADFAC Board Member Cande Seay. "And we are thrilled to have so many new restaurants joining our Feed The Need family this year.
"We have participation from small restaurants, as well as larger ones," Seay explained. "But no matter the size of the restaurant, great food and a fun experience is guaranteed during Feed The Need Week."
Both Hoskins Restaurant in Clinton and Salsarita's in Oak Ridge are participating all five days this year, according to Feed The Need organizers. Other Oak Ridge participants include Buddy's BBQ, Burchfield's, Dean's, El Cantarito, Hibachi/Time Out Deli, Mediterranean Delight, Nature's Marketplace, Oliver's, The Other One,
Papa Murphy's, Ranco Viejo, Razzleberry's, Snappy Tomato, The Soup Kitchen and Subway.
Additional Clinton participants include The Apple Blossom Cafe, Los Caballeros, Riverview Grill Seafood & BBQ, and Subway. And, in fact, the Subways in both Oliver Springs and Lake City are also participating, according to Seay.
See the complete schedule for restaurants — and their participating "Feed The Need" days — online at http://www.adfac.org/feedtheneed.html.


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Editors' Note: This is a first-person, present-tense account of the aftermath of a sexual assault that took place in 2013. For reasons of both style and substance, we have left it in present tense.
I'm writing this piece as I'm sitting in my own dining hall, only a few tables away from the guy who pressured me into sexual activity in his bedroom, one night last spring. My hands are trembling as they hover across the keyboard. I'm exhausted from fighting for myself. I'm exhausted from sending emails to my resident dean, to my House Master, to my Sexual Assault/Sexual Harassment tutors, to counselors from the Office of Sexual Assault Prevention and Response, to my attorney. I'm exhausted from asking for extensions because of "personal issues." I'm exhausted from avoiding the laundry room, the House library and the mailroom because I'm scared of who I will run into.
More than anything, I'm exhausted from living in the same House as the student who sexually assaulted me nine months ago.
I've spent most of 2013 fighting the Harvard administration so that they would move my assailant to a different House, and I have failed miserably. Several weeks ago, in a grey room on the fourth floor of the Holyoke Center, my psychiatrist officially diagnosed me with depression. I did not budge, and I was not surprised. I developed an anxiety disorder shortly after moving back to my House this fall, and running into my assailant up to five times a day certainly did not help my recovery.
"How about we increase your dose from 100 to 150 milligrams a day," my psychiatrist said in a mechanical, indifferent voice. Sure thing.
This morning, as I swallowed my three blue pills of Sertraline and tried to forget about the nightmares that haunted my night, I finally admitted it to myself: I have lost my battle against this institution. Seven months after I reported what happened, my assailant still lives in my House. I am weeks behind in the three classes I'm taking. I have to take sleeping pills every night to fall and stay asleep, and I routinely get nightmares in which I am sexually assaulted in public. I cannot drink alcohol without starting to cry hysterically. I dropped my favorite extracurriculars because I cannot find the energy to drag myself out of bed. I do not care about my future anymore, because I don't know who I am or what I care about or whether I will still be alive in a few years. I spend most of my time outside of class curled up in bed, crying, sleeping, or staring at the ceiling, occasionally wondering if I just heard my assailant's voice in the staircase. Often, the cough syrup sitting in my drawer or the pavement several floors down from my window seem like reasonable options.
Dear Harvard: I am writing to let you know that I give up. I will be moving out of my House next semester, if only—quite literally—to save my life. You will no longer receive emails from me, asking for something to be done, pleading for someone to hear me, explaining how my grades are melting and how I have developed a mental illness as a result of your inaction. My assailant will remain unpunished, and life on this campus will continue its course as if nothing had happened. Today, Harvard, I am writing to let you know that you have won.
He was a friend of mine and I trusted him. It was a freezing Friday night when I stumbled into his dorm room after too many drinks. He took my shirt off and started biting the skin on my neck and breast. I pushed back on his chest and asked him to stop kissing me aggressively. He laughed. He said that I should "just wear a scarf" to cover the marks. He continued to abuse my body, hurting my breast and vagina. He asked me to use my mouth. I said no. I was intoxicated, I was in pain, I was trapped between him and the wall, and I was scared to death that he would continue to ignore what I said. I stopped everything and turned my back to him, praying he would leave me alone. He started getting impatient. "Are you only going to make me hard, or are you going to make me come?" he said in a demanding tone.
It did not sound like a question. I obeyed.
Shortly after I reported my sexual assault to my House staff, I was told by a senior member of the College administration that the Administrative Board was very unlikely to "issue a charge" against my assailant and to launch a thorough investigative process because my assailant may not have technically violated the school's policy in the student handbook. Even though he had verbally pressured me into sexual activity and physically hurt me, the incident did not fall within the scope of the school's narrow definition of sexual assault.
The policy, published in the spring of 1993, defines "indecent assault and battery" to be anything involving "unwanted touching or fondling of a sexual nature that is accompanied by physical force or threat of bodily injury." It does not provide any definition of consent beyond the brief mention, in its definition of rape, that a victim cannot consent if he or she is unable to express unwillingness due to alcohol or drugs, among other factors.
I could still press charges in front of the Ad Board, I was told, but they would probably be dropped because my situation did not match the language of a 20-year-old policy. The last thing I wanted was for my assailant to feel vindicated if the Ad Board dropped the case. After two horrible weeks spent curled up in bed drinking, crying, and trying to come to a decision in the middle of reading period, I decided not to open a case.
The school was extremely reluctant to take any action against my assailant without a fair investigative process. In theory, this approach makes perfect sense. Everyone is innocent until proven guilty, and you cannot take severe action against a student—such as forcing him to move to a different House—without a formal investigation process. But in practice, this works against sexual assault survivors at Harvard. Our policy is so outdated and narrow in scope that it discourages survivors from entering an investigative process in the first place. And without such a process, Harvard will take very little action against the alleged perpetrator.
And so I found myself in the middle of the worst scenario possible: I couldn't get Harvard to move my assailant to a different House without going to the Ad Board, but I could not go to the Ad Board because of the school's narrow policy.
Read more in OpinionCash Madness


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31 January II - Australian Open - Davis/Mustard vs. Drake/Korpinen
.1240: Welcome everybody to finals day here at the Australian Open for what is set to be a huge double header. First up it is the men's doubles final with an all-CWLand affair between the East's Jefferson Drake and Martti Korpinen, and the West's Heath Davis and Jojo Mustard. Ironically, this pair will meet again in six days time in Stedingham in the Davis Cup World Group play-off.
1244: So to recap, Drake and Korpinen, the fourth seeds, won through to the final after a good run through the draw. They started very strongly by losing just four games against both Malachenko and Yarkin and the Romanians Iftime and Micu. Then came the real tests against Blundell and Boyd, Brookes and Champion and finally the world No. 1 pair. The Westerners had it tougher, and were taken to three sets by all their opponents bar Machado and Rodrigues. In any event, they've pulled through strongly and looked fresh against a wilting Bachunelli and Hadir in the semis.
1250: This pair have met just once previously - that day Davis and Mustard were too good in Tokyo 6-2, 6-3. The Easterners look a lot better this tournament though and I dare say they'll put in a much more impressive performance. The finals record is equally as interesting: Drake and Korpinen are three from four attempts whilst Davis and Mustard are one from two. That one title for Davis and Mustard is, however, the CW Open.
From Graham, Nixonstown, via text: "Was lucky enough to see Drake and Korpinen in action at the CW Open last year, and hope very much these fine patriots can pull through here!"
1259: Players now making their way out in the tunnels flanked by security. Hopefully there won't be the same troubles there were by the travelling fans between Delev and Mustard. The third seeds are decked out in a nice blue outfit, whilst the fourth seeds are in matching dark red. National colours and all that. Davis and Mustard win the toss and elect to serve first, as per usual. Mind games a foot as the underdogs from the East choose to change ends from where they were standing. Not often you see that, to be honest.
1305: Warm ups completed and there's definately a nervous atmosphere around the stadium. Get the feeling that a big start is needed here from both teams. We're just about ready to go.
1307: Ready, play ...


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Rightio, may as well start a thread based on him, maybe keep some of the discussion in the Match thread about the match.
Have played quite a bit of cricket against Beery. He was stuck behind McGain and Jon Holland here in Victoria, but had three or four huge grade seasons before WA approached him. He'd been given a number of 2nd XI games for Victoria, but hadn't done too well.
He's not a huge spinner of the ball, he has tended to get most of his wickets in grade cricket with sliders and quicker balls; LBWs and bowled plenty of the time. Very yappy and confident guy.


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Monterey and ODTUG Kaleidoscope 2009 Review June 30, 2009Posted by Richard Foote in Kaleidoscope, Oracle ACE Director, Richard's Musings, Travel.
I've just recently returned from a really enjoyable trip to the USA to attend an Oracle ACE Director briefing at Redwood Shores and the ODTUG Kaleidoscope Conference in Monterey, CA.
During the week, I had the opportunity to finally meet some of the other Oracle ACE Directors such as Tim Hall, Mark Rittman, Lucus Jellema, Lonneke Dikmans, Mike van Alst, Husnu Sensoy, Debra Lilley and Harshad Oak to name but a few. I also had a great time hanging out with fellow Aussies Chris Muir and Marcel Kratochvil, sharing many a beer and bottle of red wine. A highlight was sitting outside one balmy evening, drinking one of Marcel's expensive reds with Chris and Tim Hall, whist discussing the bizzare topic of body hair !! During the week, it was announced Chris had been awarded the Oracle ACE Director of the Year, a much deserved honour and Marcel got the opportunity to spread his dislike of having Foreign Keys in the database to anyone who would (and would not) listen.
I also got to meet the infamous Stanley as well. Life can be strange at times …
The ACE Director briefing was a very long day. I can't say too much until tomorrow's big Oracle Fusion Middleware 11g Global Launch …
How many Oracle ACE Directors do you recognise (and can you spot me) 😉
The ODTUG Kaleidoscope Conference was excellent, a really well run event, held in the lovely surroundings of the Hyatt Hotel complex in beautiful Monterey, California. As usual with these types of events, the quality of the presentations varied considerably. Some of the highlights included an excellent presentation by Bryn Llewellyn on "Doing SQL from PL/SQL: Best and Worst Practices" and some really interesting presentations by Toons Koppelaars on the importance of "Fat Databases: A layered Approach" and on "Semantic Query Optimization". Lowlights included a truly awful, error riddled presentation by Burleson on so-called Oracle 11g SQL Tuning Secrets. I was warned beforehand, I should have known better and listened …
Also had time to explore Monterey and check out some of its attractions. It's a really scenic part of the world and it was great to escape the Canberra winter for a couple of weeks. The Monterey Bay Aquarium is a must visit, one of the most impressive I've ever visited and I've seen quite a few around the world. The Kelp Forest display with its school of Sardines was just superb as were the jelly fish tanks.
Fisherman's Wharf was worth checking out with it's old wooden buildings as was Cannery Row, made famous by John Steinbeck. However, probably the highlight for me was the Whale watching cruise where I along with Chris, Marcel and Debra Lilley were all lucky enough to see two Humpback Whales. What an incredible experience, although I almost (but not quite) nearly saw my breakfast again in the choppy conditions. The smell of the Humpback whale's plume (something akin to a mixture of rotting broccoli and rotting fish) had me gagging again but I managed to just hang on. If you ever get the chance, do it, but pick a mild calm day if possible.
Finally, I also had the very great pleasure in meeting members of the hard working OTN team responsible for administrating the Oracle ACE program (Justin Kestelyn : follow link for photos, Todd Trichler, Vikki Lira and Lillian Buziak). Thanks guys for all your wonderful work and support in organising such a wonderful event for all the Oracle ACEes.
Back to the CBO and indexes in the next few days.
- 1. Tony - June 30, 2009
Jealousy ensues…sounds like a great event. I must try to get there sometime.
- 2. Doug Burns - June 30, 2009
That looks like Anjo Kolk at the back of the room, causing mischief.
Why am I not surprised 😉
- 3. Raj - July 1, 2009
Will you be sharing ( or should I say debunking ) those Oracle 11G SQL tuning secrets in your forthcoming posts? Will those secrets even work on Oracle 10g 😉
- 4. LewisC - July 2, 2009
Kaleidoscope was a great conference. I didn't get to nearly as many of the sessions as I would have liked to.
I agree, the OTN folks did a great job. Very welcoming and hospitable.
- 5. LewisC - July 2, 2009
BTW, meant to say I had a great time on the walk in Monterey. You guys are a crazy funny bunch! Food was good too.


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Large organisations are struggling to manage trust assets such as encryption keys and digital certificates in a muddle that could open many to the risk of cyberattack, a Ponemon survey for security management firm Venafi has concluded.
The Cost of Failed Trust report [registration required] found that 51 percent of the 2,342 admins questioned from the USA, Germany, the UK, Australia and France had no idea how many keys and certificates were in use - a bad start.
Of those who were able to come up with a number, the average was a formidable 17,807 per organisation.
Eighteen percent of organisations believed they were likely to fall prey to basic attacks pointed at "weak legacy" key storage or management over the next two years, with particular anxiety over the use of Secure Shell (SSH) keys used to connect to cloud services.
Three percent worried about SSH key theft, 5 percent server key theft, and 7 percent about man-in-the-middle attacks based on compromising certificate authorities (CAs).
Every enterprise admitted to having been affected negatively by a failure to manage and control trust infrastructure over the last two years.
Working out the costs of this is more contentious but Ponemon puts some alarmingly high numbers on failure.
The total financial risk from certificate and key assets is estimated by Ponemon to be $400 million for every large organisation, which is to say that the actual cost from a real security breach of this infrastructure would be a percentage of this maximum total.
"Cyber criminals understand how fragile our ability to control trust has become and, as a result, they continue to target failed key and certificate management," said Venafi CEO Jeff Hudson.
"These exploits wreak havoc by causing unplanned outages, productivity loss, brand damage and data breaches. Until today the financial impact, the extent of the challenges, and the industry's recognition of these compromises remained largely unquantified."
Although Venafi sells systems that claim to fix the problem of lax or no trust management - there is some vested interest here - Hudson's point about trust assets being security's dark side of the moon looks from the report to be valid.
The security of these assets seems simply to be assumed because of the comforting word 'trust' and an incomprehension that the infrastructure designed to make this possible could be fragile.
Certainly criminals are attempting to exploit digital certificates in particular, with a slew of attacks on certificate authorities during 2011 causing widespread alarm.
Meanwhile, incidents involving stolen SSH keys have multiplied and that's before factoring in more unusual but signal attacks such as the Flame cyberweapon's forged certificate used to finesse Windows update.
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text: ARCHAEOLOGICAL DIGName: ARCHAEOLOGICAL DIGDate: September 12, 2019Website: http://www.nickersonassoc.comEvent Description:DIG IT! The second season of the archaeological excavation of the William and Anne Nickerson c. 1664 homestead will run from July 29 to Sept. 20. All are invited to stop by the dig during weekdays (weather permitting) while the crew is excavating between 9 a.m. and 3 p.m. Archaeological crew members will explain the dig site. William and Anne Nickerson are known as the father and mother of modern-day Chatham and the homestead was the first one built by pioneers in the town. The dig is sponsored by the Nickerson Family Association, Inc., and is behind 1107 Orleans Road, North Chatham. While you're here, purchase a commemorative "dig it!" mug and t-shirt.


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You will be spending many hours studying, so it's crucial to find the right NCLEX prep course that best fits your learning style and background.
So here's the good news – we have researched and reviewed all the NCLEX study materials below so you don't have to!
The comparison chart below will help you determine which course best fits your needs.
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4. Kaplan NCLEX Review Course
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The National Council Licensure Examination (NCLEX) isn't easy, but finding the best deal on a prep course is. We've done the research for you! You don't have to scour the web looking for the biggest savings, just start here. You'll find all the NCLEX coupons and savings you need to get started today. We even have our exclusive Kaplan NCLEX promo code, Brilliant Nurse promo codes and much more!
Best NCLEX Study Materials & Books
We know that endowing you with the confidence that you can succeed is one important aspect of passing the NCLEX. This is why we've put together this comprehensive list of resources to help you better prepare for the NCLEX-RN. Knowledge is power, and these are some of the most powerful sources of knowledge when it comes to preparing for nursing exams.
Read through the list below and don't forget to tell us what your favorites are in the comments!
NCLEX-RN Review Guides
If your NCLEX test is fast approaching, you don't want to be stuck poring over long, dog-eared textbooks. Figure out what's most important and what you should be spending your precious study time on with these focused NCLEX-RN study guides.
Kaplan Test Prep: NCLEX-RN Premier 2017 with 2 Practice Tests
This is one of the most comprehensive review guides available for purchase. Ten critical thinking strategies are outlined over eight chapters, and several practice questions are included to test your nursing knowledge. This review guide is perfect for people looking for an all-in-one resource for the NCLEX-RN exam.
Kaplan Test Prep: NCLEX-RN Drug Guide
For students looking to focus their studies on one particular section of their nursing exam, Kaplan's guide on 300 different medications is an excellent choice. Pages are designed in the form of flashcards and describe the different families, side effects, and medical applications of each drug.
Kaplan Test Prep: NCLEX-RN Content Review Guide
With a focus on critical reasoning over practice tests, this Kaplan nursing exam guide is an excellent companion to standard guides. It incorporates NCLEX's Client Need information and is designed around cognitive strategies to help you understand what is required in a nursing career, which then translates into effectiveness taking the exam.
This test guide is divided into specific aspects of the NCLEX-PN exam, making it perfect for studying nurses who need to focus on specific aspects of the test. In addition to thorough reviews of each section coupled with practice tests, the Secrets Study Guide also comes with video tutorials.
NCLEX STUDY GUIDE FOR THE PRACTICAL NURSE – Second Edition
Written by a professional with over 15 years of experience, this is a quick guide that covers several elements of the NCLEX. It's a light read with around 65 pages, which makes it an excellent introduction to the test as well as a jumping off point for further studying. You will still want to use other study resources in conjunction with this book.
Lippincott Review for NCLEX-PN
This study guide for the NCLEX-PN has a great deal of content for a very reasonable price. It contains 17 chapters covering different subjects and aspects of the nursing exam, all with practice tests at the very end. You can save some money buying them used, but getting a new copy adds the benefit of bonus online study materials.
HESI Comprehensive Review for the NCLEX-PN® Examination (5th Edition)
One nice feature of this study guide that sets it apart from many others is the way it handles incorrect answers. Rationale for answering questions incorrectly is addressed and tips are given to help you avoid falling into these traps. Extra practice questions can be accessed with the companion online material included in this product.
NCLEX Practice Questions
In conjunction with study guides, answering practice questions are a terrific way to prepare yourself for any difficult exam. The NCLEX is no exception, and using these sources for practice questions that are identical to ones on the exam will help you become more comfortable with the entire process.
GraduateX NCLEX-RN Exam Practice Questions
Best for helping acclimate you to the formatting and some of the subject matter of the NCLEX-RN, GraduateX's free online practice questions are a terrific study tool. Jumping right into these questions is a terrific way to adjust mentally to the pressure of the real thing, although you may still want to supplement this with other study resources.
BoardVitals Board Review Questions and Practice Tests
This practice test service does come with a price tag, unlike some of the other practice tests available to nursing exam students, but it's still well worth the price. In addition to having over 3,000 questions, BoardVitals also implements computer adaptive technology to ensure that your entire test experience is challenging and educational.
Lippincott NCLEX-PN Alternate-Format Questions (4th Edition)
While studying practice questions can help you adjust to the test format, they aren't always the best at ensuring you actually understand the material you are being tested on. That's where this set of alternate-format questions comes in! These questions are set up in radically different styles, ensuring you understand the information needed and not just how to answer multiple-choice questions.
NCLEX Flashcards
For those times when you're finding the review guide a little repetitive, you may want to switch things up with a different kind of study tool.
Late night dates with a 300-page textbook and a never-ending supply of coffee are a familiar encounter for many nurses. Burnout is highly likely in these scenarios, so it helps to have some other methods of studying in order to shake things up. If you're serious about cracking the exam, you put yourself at a serious disadvantage by not working with flashcards.
NCLEX-RN Medication Flashcards (4th Edition)
This set of flashcards by Kaplan is perfect for tactile learners who want something interactive to study with. They are organized by different categories with color coding, making it easy to study different aspects at a time. 300 cards are contained in this package of physical flashcards.
NCLEX-RN Flashcard Study System
What's interesting about these cards is that they are more expensive to purchase digitally than physically. This may have something to do with the added convenience of digital media, but for those who are more suited to physical learning, this is a terrific deal!
NCLEX-RN Test Plans
Having a solid plan is the key to success, whether you are approaching an exam or a real-world scenario. Because of this, it is incredibly important to understand the test you are about to take and formulate a plan around it. The more you know and learn about the NCLEX's structure, the more confident and better prepared you'll be when it's time to take the exam. These details on the tests and plans for preparing are a must-read.
Even if you've studied for months on end and made your way through nursing school, you may still feel completely lost before taking the NCLEX. This guide made by nursing officials on the State Board is designed to ease you through the process of preparing for the exam, right up to the big day.
If you've put down the money for an online course or a girthy textbook, you still have to actually use them. This study plan is designed to help you make the most of your time with these materials, helping you figure out a 56-hour study schedule. Use this free PDF guide as a companion to your other study materials to maximize your mileage with them.
UNC School of Nursing NCLEX Study Schedule
This guide provides you with a three month plan for taking the NCLEX, based on nursing school curriculum strategies. It has tips for studying three months before, a few weeks before, a few days before, and even some advice for what to do during the exam.
NCLEX-RN Apps
Let's face it, not all apps for the NCLEX-RN are created equal. Some apps can be really terrible. Full of bugs, incorrect answers, in-app promotions, and pricey upgrades, one look and you start wondering, "This is not worth it. Why did I even download?"
However, the right app can be an excellent tool to help you study throughout the day. Whether you are using an iPhone or Android device, there are quality apps you can use during some downtime in order to reinforce your knowledge of key exam materialHere is a list of the best NCLEX-RN apps to help you prepare yourself for the test.
NCSBN Flash Cards– Amazon
Accessible from the Amazon App Store, this free set of flashcards can be accessed on your Android smartphone. This app was designed by professionals at the NCSBN, meaning it was created by individuals who have experience with the exam and have passed it. For an effective mobile study tool, look no further.
Kaplan NCLEX-RN Mini Qbank – Apple
This free app from Kaplan will run on any iOS device, such as the iPhone or iPad. It offers a digital tutor mode or a practice test mode, and covers all of the material on the NCLEX-RN. This app works terrifically as a study tool in conjunction with other Kaplan studying resources.
Saunders Mobile Review Questions for NCLEX-RN– Apple
If you have an iPhone and spend a lot of time commuting, this review questions app from Saunders can help you brush up on your nursing knowledge. It includes several word problems based on real-life situations to help you evaluate how you would perform as an actual practicing nurse.
PocketPrep NCLEX-RN Exam Prep– Apple
The highly adaptable nature of this iOS study app makes it ideal for anyone and everyone looking to take the NCLEX-RN. Tools are implemented that allow you to determine your strong and weak points, and you can use that data to create custom tests that will help to improve on your shortcomings.
ATI RN Mentor NCLEX Exam Preparation – Apple
Another highly customizable quiz app for the iPhone, the ATI Mentor app allows you to set up quizzes as big as you like, covering whatever subjects you choose. The flexible nature of this app makes it convenient to use whenever you have free time and will allow you to focus on the most important subjects easily.
Vapari Systems NCLEX-RN Study Notes – Google Play
This Android app is more of a small textbook than a quiz program, although it does feature some practice questions. Notes are divided in different sections which can be accessed quickly through a table of contents. Over 2,500 notes are listed in this app, providing an encyclopedic level of NCLEX-RN knowledge!
NCLEX Flashcards – Google Play
There are a lot of great flashcard apps for iOS, but it can be much harder to find quality ones on Android. Fortunately, this Google Play app is a reputable study source with over 2000 digital flashcards and an average rating of 4 stars.
NCLEX-RN Mastery – Apple, Google Play
While many practice tests are designed to accustom you to the NCLEX-RN's structure and provide some potential questions, this practice test app is designed to help you understand the material on the test. It features customizable learning plans and is available on both Android and iOS.
NCLEX-RN Online Programs
Prepare for your NCLEX test with these comprehensive online programs. Several of the NCLEX programs listed below offer detailed study guides along with practice questions and video lectures in order to help you get ready for the big test. The best part of these programs is they can be used on your schedule: no early morning lectures!
This is far and away the best online study program for the NCLEX-RN. In addition to a plethora of learning materials geared to maximize your chances of success, they also tout an exam pass guarantee. This guarantee offers you either an additional three months of enrollment or a full refund: your choice.
GraduateX NCLEX-PN 2500+ Practice Questions
This is a more laid-back nursing exam prep course than Kaplan with a focus on learning at your own pace. The material has been exhaustively thought out with a solid rationale that directly correlates to NCLEX-PN material. In addition to 2,500 practice questions, GraduateX's test prep program also features visual aides to help you understand the concepts relating to nursing.
Hurst Review NCLEX-RN Review Course
The Hurst review course involves three different learning methods. The first is a three-day lecture that covers 20 aspects of the exam at an accelerated pace. The second method is their online Q Review platform, which incorporates eBooks and specialized lectures, available for nine months. The third aspect is a customizable quiz program with 1,000 questions.
This NCLEX review course offers a virtual coach to help guide you through the entire nursing exam preparation process. They claim that their students' rate of success is 100% if they follow the tutelage of the virtual coach exactly.
4Tests NCLEX Board Review Exam
This is a free alternative to the more expensive premium online test prep resources. It's a series of practice tests that are ideal for students who have a limited budget but still want study materials that are worth the time and effort.
NCSBN Pathway to Practice
What could possible be a better study tool than the one designed by the people who help design the NCLEX? The State Board offers several online study tools on their website that provide excellent preparation for the nursing exam, stabletraight from the horse's mouth.
NCLEX-RN Alternative Strategies
Standardized tests like the NCLEX exam may be a bit frustrating, yet are still a necessary rite of passage into the nursing profession. Just because the tests have strict formats, that doesn't necessarily mean the best success strategy to stick to strict test prep formats. If flash cards and practice questions are starting to wear you down, try thinking outside the box with some of these alternative test prep strategies.
Nursing Mnemonics: 108 Memory Tricks to Demolish Nursing School
Mnemonics are a terrific memorization tool that teaches you to associate acronyms and phrases with key concepts. This book incorporates mnemonic learning strategies to cover complex nursing concepts with the intent of reinforcing your memory of them. Although it's designed for nursing school and not the NCLEX, it can help you remember things you were taught in nursing school and carry them over into the exam.
NCLEX RN Mastery Study Strategies
This companion article to a popular NCLEX study app offers some insightful strategies to help you make the most of your study time. Trying some of the methods listed in this article can keep things fresh so you don't burn out while studying for weeks or months before the exam.
Ameritech NCLEX Study Tips
This quick guide from the Ameritech College of Healthcare covers some quick tips for making the most of your study sessions. The eight steps outlined in this article should help you approach each question, understand it, and answer it, all within a reasonable amount of time.
NCLEX- RN Webinars
Preparing yourself thoroughly is the best way to quell your pre-test jitters. Participate in the NCLEX webinars listed below and get an opportunity to interact and ask questions with live instructors. Check out the pre-recorded webinar sessions if you're not able to take part in live sessions and you can feel a lot more confident and prepared for whatever the nursing exam has to throw at you.
GraduateX NCLEX-RN Video Strategy Sessions
This free online course incorporates several video lectures, broken up with some practice tests. It's designed for you to progress through specific sections, only moving on when you've locked down the information contained within. This is perfect for students on a budget who learn best through lectures.
NurseTim NCLEX Webinar Catalog
This program has a flexible price point depending on what areas of the exam you want to cover. If you're struggling with a few key concepts on the NCLEX, this is an excellent way to save some money on an online seminar.
NRSNG NCLEX Webinars
The NRSNG On-Demand Webinars start every 15 minutes. They involve a video lecture breaking down 11 key points to consider when taking nursing exams, and they guarantee these tips will help you pass any exam required to be a nurse.
ATI Testing Recorded Webinar
ATI offers a live webinar to accompany their free and premium testing materials. For those students who need contact with a live professor but don't have the time or transportation, this can fulfill that need.
Wolters Kluwer Webinar Series
The webinars offered by Wolters Kluwer vary depending on the season. They cover a wide range of subjects, but there's always at least one touching on the nursing profession. You can find schedules for each lecture on their website.
NCLEX- RN Cram Sheets
So you've studied for months and exam day is approaching. What's the best course of action when you're so close to the finish line? Aside from ensure you get a good night's sleep, it's always a good idea to cram in some last-minute studying. These cram sheets are designed to provide a quick rundown of key information you'll be tested on when taking the NCLEX.
NursesLabs Nursing Exam Cram Sheet
This is a free 7 page printable PDF that can be used as a cram sheet for the exam. It covers all of the important points of the NCLEX, serving as a 'greatest hits.' If time is of the essence, you can do a whole lot worse than this study tool.
This cram sheet is far shorter than the previous one on this list, only encompassing two pages. For nursing students with a short attention span and literal minutes before the test begins, this is a helpful resource for quickly reminding yourself about important concepts.
QD Nurses Pharmacology NCLEX Cram
This website has a few resources for you to implement in your last-minute study sessions. A few short videos can offer a refresher on pharmacology and cardiac diagnoses, and key terms and medicines are listed in bullet points. Don't let the awkward formatting of this website turn you off; it's still an effective tool.
There are literally hundreds, if not thousands, of NCLEX study resources, all varying in price and effectiveness. This list represents just a small collection of the best NCLEX resources available. Look around a little and you're sure to find tons of more practice NCLEX questions and study guides.
However, if you don't want to spend the extra time researching study materials and just want to hit those books as soon as possible, we've done the work for you. Study for the NCLEX using these resources and prepare to be a great nurse.
However, there is one important thing you should always remember: the NCLEX does not define you. Your merit as a nurse and as a person go far beyond what a simple test can tell anyone. I've known nurses who have failed the NCLEX multiple times and still go on to become fantastic nurses.
If there was a single thing that could make the difference between passing and failing the NCLEX, it's confidence. If you've got the perseverance to keep trying and studying, even after multiple failures, you're going to make a great nurse. The NCLEX is just one final hoop you have to jump through.
What are your favorite NCLEX question and study resources? Let us know in the comments, and thanks for reading!
NCLEX-RN® and NCLEX-PN® are registered trademarks of the National Council of State Boards of Nursing, Inc (NCSBN®).None of the trademark holders are affiliated with Crush The USMLE.


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Generic Drugs for Dogs - Petcam (Meloxicam)
Hi There...I have two dogs who have hip issues that we give Metacam to regularly as needed...it costs about $175 per 100 ml bottle. On the internet I see Petcam advertised for a fraction of this price....anyone have any advise or experience useing Petcam instead of Metacam...any other options? Thanks much. I've bought Metacam in the States and had it sent up here in the past and that saves some money but it's still rather expensive.
Okay, what exactly is the pain? Arthritis? There are MANY MANY MANY better things to do for your dog than use Metacam. I know Metcam is much safer in dogs than cats but I've still seen a few dogs die from metacam, including a 4 month old puppy that was perfectly happy and fine, then got spayed and after another vet decided to give the puppy FOUR days of metacam, she went into kidney failure out of the blue and after we had to sit there and try to force feed her, we eventually put her to sleep after about 2 weeks because she was soooo sooo sick.
Here is the info sheet on the injectable
Also, how the heck are you ordering this stuff anyways? Do you have a prescription? I am VERY against ordering meds offline... especially medicines like this that are already iffy or dangerous to begin with. If it is not a trusted company, who knows if the medicine is real or if it has been properly stored & handled before coming to you. I /never/ order ANY meds offline for my animals (and I practically have small zoo in my house) just because I am way too paranoid.
Here is the company that makes Petcam
Let's put it this way, if you were taking medicine and saw you could order it online from some random company in some random country, would YOU take it?
As far as helping with hip problems, there are some AWESOME alternatives that work much better than metacam.
My cat is smarter than your honor student.
Stop Dog Fighting ~ Neuter Mike Vick!
~ RIP Timmy ~ May 2009 - November 6th 2009
Meloxicam Generics
Thanks for the information. They both have the same problems - hip dysplasia - they are relatively small dogs so it's treated by keep their weight under control and pain meds when needed. They've been given Metacam for probably 2 years...intermittently as needed, which is about twice a week roughly as we go to a cottage on weekends and they just can't help themselves to having as much fun as possible!! This usually ends up with them in some pain.
In terms of generics....we certainly take generics all the time for our own bodies (some of which are manufactured locally, some not)...certainly we have regulatory bodies that control that I simply didn't know if it would be the same for Meloxicam.
I've had Metacam shipped to Canada in the past with no problems. A script was not required as it was being shipped out of the country, which I found interesting but didn't have any issues with - easy enough to get one from my vet if needed....only bought after a long conversation on the phone with the pharmacy.
You mention better alternatives to treat the pain....any suggestions?
Thanks much.
Hi, Cecilb10 and welcome to the forum.
Quite a number of our members have used or are using Metacam (meloxicam) for their adult dogs without incident. When used as prescribed it is considered by veterinarians to be one of the safer nsaids for use in adult dogs.
All drugs have the potential for serious side effects in some dogs. If the occasional use of this drug has been helping your dogs without issues, I would not be overly concerned about continuing to use it.
Some more information on meloxicam and metacam:
Meloxicam should not be used in pregnancy or in lactation.
Meloxicam should not be used in puppies under 6 months of age (safety has not been proven).
Meloxicam should be avoided, if possible, in patients with impaired function of the liver, kidney or heart. It should also be avoided in dehydrated patients and patients with known GI ulcers.
The veterinary formulations of meloxicam are oral liquids (either 1.5mg/ml or 0.5 mg/ml). It is important to compare these sizes to the human tablets which are available in much higher strengths. In general, human strength pills will be too strong except in very large dogs. It is important not to use human medications on pets unless your veterinarian has provided detailed dosing instructions.
Meloxicam (not Petcam) is the generic version of Metacam. It is the human version but is also approved for use in dogs and would definitely be cheaper and could be a good alternative for very large dogs. However, for reasons mentioned above it would not be viable for your smaller dogs due to difficulty in measuring the exact dosage and the danger of accidental overdose.
Metacam, Meloxidyl, and Petcam are veterinarian formulations of meloxicam made by different companies. Metacam is the formulation commonly prescribed by veterinarians in North America. Meloxidyl and Petcam are manufactured in the UK and India respectively and would be commonly prescribed in various countries overseas. Cipla, the maker of Petcam, has been around since 1935 and is approved by five major regulatory bodies including the FDA (see Wikipedia). Still, I would be careful of the legitimacy of some of the websites that are selling Petcam and other drugs without prescription in North America and I still would not want to purchase this product without the approval of a respected veterinarian. Nothing wrong with purchasing drugs online in my opinion. Perhaps I am overcautious but I would only purchase any drugs online from a proven reputable licensed pharmacy.
Some information from Wikipedia about online pharmacies:
Pharmacies offering medication without requiring a prescription and doctor review or supervision are sometimes fraudulent and may supply counterfeit—and ineffective and possibly dangerous—medicines.
There are a number of members on this forum who have or had dogs that suffered from hip dysplasia. I'm sure some will come along who can offer you some information on some of the things that they might have found helpful.
Again, welcome.
"The animals share with us the privilege of having a soul." -Pythagoras
"The soul is the same in all living creatures, although the body of each is different." -Hippocrates
"Let us be loving, hopeful and optimistic. And well change the world." -Jack Layton
"Be the change you want to see in the world" -Gandhi
Kitties: Punky (17), and Sassy (13), Twinky (10),
SweetMickey 1991 to May 24, 2009
Last edited by mikischo; April 30th, 2011 at 05:24 PM. Reason: Additional information added
I don't know anything about Petcam-couldn't you ask your vet about it though?
I have been using Metacam for my dog for 1yr and 4 months, intermittenly, and haven't had issues. As said, all drugs have possible side effects. Since you're not having problems with that one and it works, I see no reason to change.
Your vet is probably the best person to ask about the Petcam though. But with little dogs a 100mL bottle must go a long way at least.
Great information...thanks so much for offering your thoughts!
I have been using Metacam for about 8 years for 3 different dogs. The first dog was on it for the last 3 years of her life, it really helped with her arthritis and she had no side effects that I saw from it. We had graduated to it from a Glucosamine/Chondroitin/MSM mix (though I kept giving this as well to all 3 dogs). When we were giving her the Metacam, it was the only NSAID available for dogs other than injections once a month that were more expensive than the Metacam.
The second dog we tried with several others first, eg: Deramaxx, Previcox and another one I can't remember the name of, they gave her side effects of vomiting and diarrhea that did not resolve after a couple of weeks on each drug. We finally decided that Metacam and the Glucosamine/Chondroitin/MSM mix were the only drugs that she could tolerate without side effects. She remained on the Metacam for 2 years before she passed of old age and complications after surgery.
The third dog was also tried on Deramaxx, then Previcox with the same vomiting and diarrhea side effects that resulted in me finally changing him to Metacam. Again it was the only NSAID I gave him that did not cause side effects. He has been taking Metacam and a Glucosamine/Chondroitin/MSM mix for over a year now and without it he wouldn't be able to use his hind legs to get himself up or walk. He does have a chronic condition that results in days when he misses his meds and the following days show that his hind end weakness is still very much an issue without the NSAIDS.
I am NOT saying that other dogs will not have side effects to Metacam or have stomach problems resulting from its use. Every dog will react differently to any medication given, just as any human may have side effects to a drug they are given. I am only telling you what my own experience with the use of Metacam has been and it has been good for all my dogs, so far.
As for using Petcam, if it were readily available here in North America through my vet or even through an online pharmacy that DOES require a prescription, I wouldn't hesitate to use a generic form of Metacam. However, from googling Petcam it does not appear to be available at an online licensed pharmacy in North America that requires a prescription, so I would really question whether what they were selling was actually Meloxicam or something else. I would wonder if I might be putting my dog's health at risk by ordering a "drug" that could be anything. My hesitation extends to human "prescription" meds available online that do not require a prescription as the same holds true for them.
Believe me I know how expensive Metacam is, but when I think of possibly taking a chance with my baby's health I just can't bring myself to do it. Have you checked with another vet for the price of Metacam as I pay quite a bit less for mine though still over $100 for the 100ml bottle. Good luck it would be wonderful if there were a generic form of Metacam available in North America.
Willing Slave to: Sam 17 yrs; Bailey 14 yrs; and Smokey 10 yrs.
R.I.P. Raggs 1997-2012 ; Pepper 1997-2009 ; Tiger 2000 - 2014;
"Please do not breed or buy while shelter pets are left to die"
I was asked to give my on Petcam.
To begin I have no direct clinical experience with Petcam. My understanding is that it comes from India. I do not know more than that or about the quality controls there. The concern with generics is always 1) does it have the same bioavialability as the original? 2) what is the quality control and safety factors.
For clients that need generics due to cost I have in the past used a compounding pharmacy that I trusted. I knew the facilities, the pharmacists and their level of quality. As such I could get medications at a good cost, the concentration I needed and get them as flavored liquids when I needed.
Regardless of where the generic drug comes from, I would recommend that you ask your veterinarian for their opinion. Some drugs seem to be fine as generic and I use them quite often. There are others that I have stayed very clear of.
I hope that helps.
Christopher A. Lee, DVM, MPH, Diplomate ACVPM
Preventive Medicine Specialist With a Focus on Immunology and Infectious Disease
Ordering Metacam online in Canada
You will need a vet prescription to get it there, but even if your vet charges for writing the prescription, and then factoring shipping charges, it is still quite a bit cheaper than buying it from the vet.
BTW, I also try to get my other meds at the same time, since the shipping charges are usually one flat fee for a few items VS. one. Their Dasuquin is also cheaper than getting it at the vet.
P.S. I have no association with petsdrugmart. I am just a satisfied customer.
Good afternoon. Advise generic drugs for dogs, which I can buy in Canada. Maybe you know a few good pharmacies. I will be happy with your answer. If there is a real experience, describe it. Thank you.
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It is fascinating to compare the vision of Daniel with the image of Jesus before Pilate. In both the Lord of Creation is depicted in a moment of triumph. Daniel has no sense of the paradox of that Lord being treated like a common criminal. There was of course no reason why he should, though the author of the section of Isaiah dimly saw that reality. At the heart of the paradox, however, is the insight that Jesus is the Lord of Creation, the king who triumphs, the leader whom we follow precisely because he suffers with and for us and goes down with us into the valley of death. That's why he is not only the Lord of creation but Our Lord too.
Keep in
A new boy moved into the neighborhood just before he football season began. He was a little guy, thin and scrawny and clumsy. He went out for the football team and made a fool out of himself against the big kids. The coach, who had a kind heart, did not cut him from the team. However, he came home from every practice bruised and battered. Most of the kids made fun of him at school. However, he would not quit. He was quiet but he was also stubborn. One of the girls, who knew more about football than any of the boys and even the coach, kept muttering that the new kid was really quick. Fastest boy on the team she told everyone. No one, however, listened to her. Finally there came the season opener against the "next parish down the road" which almost always won the historic contest between these old rivals (well, it went back to 1975). The next parish was bigger and always had better football teams. This year was no exception. They held our heroes scoreless and with only five minutes left in the game our guys were down thirteen to nothing. Knowing that they would never catch up, Coach sent in our little friend to play safety. On the next play, the quarterback for "next parish" through a pass which was tipped by one of our lineman. The little guy dashed across the field, intercepted it and scampered towards the goal line. See, said the girl, I told you. (Which is what a girl would say). The other team caught up with him as he crossed the goal line, knocked him to the ground, and piled all over him. At first he lay flat on the ground, Then his face covered with mud, one of his eyes black, he staggered to his feet. The coach called a two point conversion. The quarterback, no dummy either, saw our runt standing dazed behind him – the coach had forgot to take him out – and threw him a lateral. Our guy ran through the opposing team like a knife cuts threw butter. Again they piled all over him in the end zone, but the refs didn't call any penalty. He was carried off the field. After his team got the ball back with only thirty seconds to play, the coach took a deep breath and sent him back in. The QB through him a screen pass and . . . . . well, you know the rest. After the game he was hailed as the new leader of the team. Like one of the big kids said, he's earned it. He's learned how to take the worst and still win.
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Monday, January 25, 2010
We're Jammin'
I bought some local raspberry jam the other week, and decided to use it today. These yummy jam bars are perfect for that lazy Monday afternoon. I was inspired from the cookbook,
Vegan Brunch-by Isa Chandra Moskowit.
I changed it, but not on purpose. I forgot to add the soured soy milk. Which made the batter really thick and stiff. I hate it when you put it everything together, and then glance over at the counter, S**t, I forgot the milk!
To late it was going in the oven:P
I think they turned out perfect, nice and crumbly, you will defiantly need a plate to eat these.
1 cup flour
1/3 cup cane sugar
1 tsp ground cinnamon
1/4 tsp ground nutmeg
1/4 cup sunflower oil
1/3 cup cane sugar
1/2 cup sunflower oil
1 1/4 cup flour
2 tsp baking powder
1/2 tsp salt
1/2 cup soy milk
1/2 cup raspberry jam (or whatever kind you dig)
In a small mix flour, sugar, cinnamon, nutmeg together
Pour oil over and mix with your fingers until it forms crumbs.
In a medium sized bowl mix sugar and oil together.
Sift the flour, powder and salt over top, mix together.
Adding soy milk at the end.
In a greased square 8" pan, pat batter down.
Spread jam on top all over.
Pat the crumb topping over the jam, pressing down.
Bake for 35 minutes in a 375 oven.
5 comments:
Looks delicious girl! Saving it for further use!ReplyDelete
Sort of like a shortbread cookie--but anything with homemade jam, I'm there! Looks Yum!ReplyDelete
We bumped into your blog and we really liked it - great recipes YUM YUM.
We would like to add it to the Petitchef.com.
We would be delighted if you could add your blog to Petitchef so that our users can, as us,
enjoy your recipes.
Petitchef is a french based Cooking recipes Portal. Several hundred Blogs are already members
and benefit from their exposure on Petitchef.com.
To add your site to the Petitchef family you can use http://en.petitchef.com/?obj=front&action=site_ajout_form or just go to Petitchef.com and click on "Add your site"
Best regards,
These look really good! I just got this book for Christmas and am super excited to try it out :)ReplyDelete
These look fantastic! I have been looking for a jam, cookie bar recipe!!ReplyDelete


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High Tea Thank You Card
Baby Shower Thank You Cards
High Tea Thank You Card, Item# TYSI3230
Note: Sparkles are simulated and will not light up.
High Tea Thank You Card, Item# TYSI3230
Note: Sparkles are simulated and will not light up.
It's a Boy Custom Photo Postage Stamps
This fold-over note card, "High Tea" features a beautiful, vintage Victorian Teapot in creme porcelain decorated with pink & mauve flowers and green leaves. Gold filigree accents appear on both the teapot lid and the handle. To the right of the teapot is a matching cup and saucer. To the left of the teapot is another, delicate cup and saucer with yellow & pink flowers and green leaves. Two exquisite, Red-Magenta Depression Glass Plates stand behind the porcelain tea pieces. To accompany the tea are three little petit fours in gold-foil liners. One small cake has white frosting with green leaves and pink & yellow flowers, a second petit four has light pink frosting with green leaves and darker pink & white flowers while the last chocolate petit four has a tiny green leaf & pink flower. Below the amazing scene, white space is available for text. A burgundy 1/8" border surrounds all sides of the design.
A custom message can be printed with flat printing inside the fold-over card (for an additional $0.50), to acknowledge that special gift.
You will be able to select the typestyle and ink colors to use for your personalized text during the design process. Start by clicking on the green 'Personalize and Continue' button. We recommend using the default typestyle and ink colors.
|Estimated Postage Required:
|$0.55 stamp - if other items are not added into the Envelope. Click here for additional postage information.
|Item Type:
|Foldover Notecard
|Card Dimensions:
|5 1/2" X 4 1/8" (W x H)
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|Digital Press
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|Multiple Stock Options
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|White Envelopes included. Printed return address and/or Calligraphy is available for an additional cost.


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maybe it's because i'm canadian...
As Made in England (a new favourite blog) said, I never knew I wanted an axe until I saw these ones by Best Made Company. Their website is also a new favourite, I love everything in their inspiration file...go now, and agree with me.
I'm buying curtains soon and I'm seeing linen everywhere.
I wish I could sew.
photos via Remodelista
ahh, christmas
Angel chimes are the pinnacle of Christmas for me...we had them every year, wherever we were. If you're unfamiliar with these, the heat from the candles rise, and the brass angels make lovely little chimes as they merry go 'round...I always assumed they were Dutch (they were inherited from my grandma) but apparently yes, they are Swedish, which, if you've read my blog at all, means my mom and I need to have a little chat about where I really came from...
The set also comes with clowns...which I suppose was meant for other occasions like birthday parties, but the angels were way better.
Love the retro 70's packaging.
And a more modern Scandinavian tealight version (minus the chimes)
The set also comes with clowns...which I suppose was meant for other occasions like birthday parties, but the angels were way better.
Love the retro 70's packaging.
And a more modern Scandinavian tealight version (minus the chimes)
swedish love. again.
No disrespect to H&M Home, which I've never seen in real life...but it seems as though Mikael Beckman can make anything look amazing (and I love the way he uses colours.) His portfolio here.
Of course he's Swedish.
(found originally via desire to inspire I think...)
ok, ok
If it must be this chilly, at least can I have some sheepskin? I want, like, 10.
Via kitka design toronto
Alright, that's enough winter, thanks. I'm ready for a pastel coloured spring.
Photos from Living Etc., Korean Vogue, Marie Antoinette, Nina Ricci Spring '10, this is glamorous, coco+kelly, Marie Claire and Domino
we english
Photographer Simon Roberts has published a book called We English. He travelled around in his camper van and took photographs of English people doing English things (which mostly consists of walking around in groups or pairs.)
(the photo of the birds and trucks is actually a pigeon race...)
It's cold now, and I just bought my first "puffer."
(Thanks Sonn.)
Chilly photographs by Cedric Bihr.
Via this is glamorous
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General Information About Darkei Noam Rabbinical College
DARKEI NOAM RABBINICAL COLLEGE seeks to train students in the skills required for understanding, studying and mastering the Talmud and the considerable body of traditional Jewish thought. At the same time we are committed to the understanding that knowledge is a means to a larger end. We seek therefore to help students build a world outlook drawn from the ethical and moral concepts of Judaism. If scholarship is to have a significant value it must orient its students to a way of life that, by its own definition, is good and moral.
Institutional statistical data was gathered from the U.S. Department of Education - Institute of Education Sciences, National Center for Education Statistics, 2009-2010.
Institution Type
- 4-year, Private not-for-profit
Special Learning Opportunities
- None
Student Services
- Remedial services
- Academic/career counseling service
Religious Affiliation
- Not applicable
Federal Aid
- Eligible students may receive Pell Grants and other federal aid (e.g. Direct Loans).
Degrees/Certificates offered
- Bachelor's degree
Campus Setting
- City: Large
Disability Services Student
- 3% or Less
Admission Total Applicants
Student Demographics Total Enrolled 16 Native American 0.0 Asian 0.0 African American 0.0 Hispanic 0.0 Enrolled FullTime Undergraduates 9 Enrolled FullTime Graduates 8


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|192 High Street (1st Floor)
West Drayton, Middlesex
United Kingdom UB7 7BE
The ITF has authorised this council to provide a central administration for traditional Taekwon-Do in this country. Membership is open to all who wish to continue there development in ITF Taekwon-Do yet remain directly linked to ITF Administration.
There are various organisation membership levels which can be found here. This council has been granted the licence to operate on the understanding that they will make every effort to incorporate all existing INO's and MO's and work together for the professional development of ITF.


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Pinpoint accuracy combined with measurement versatility
The SKF Tachometers are fast and accurate instruments utilizing laser or contact to measure rotational and linear speeds. Equipped with a laser and a range of contact adapters, they are versatile instruments that suit a wide range of applications. Having a compact design, they can be operated with just one hand and are supplied in a sturdy carrying case.


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Drawing on traditional workwear pieces for inspiration, these can be thrown casually over informal shirts such as oxfords or polos to add a subtly layered element to an ensemble.
8 Items


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Reviewed By Barbara J C (WEST YELLOWSTONE, MT) Reviewed for a 2001 Chevy Tahoe —11/8/2014 8:54 PM
Fits well and, WHEN SMOOTHED DURING INSTALL,withstood very strong winds. Hasn't been tested in snow yet. Can see that it could be tough to install for one person on wider cars. Impressed so far.


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I have always had a weakness for cookies, and becoming vegan has not had an impact on my love for them<3. Actually making cookies vegan is more economical for your pocket.
- 2 cups unbleached all purpose flour
- 2 tsp baking soda
- 1/2 tsp salt
- 2 tsp cornstarch
- 1 cup cane sugar
- 1/2 cup vegetable oil
- 2 tsp vanilla
- 1/4 cup water
- dark chocolate- chopped
In a large bowl mix together flour, soda,salt and cornstarch.
In a medium sized bowl mix sugar, oil, vanilla and water.
Add the wet ingredients to the dry, mix it up, add chocolate.
Mix until it forms a dough like texture.
On a foil lined pan, roll into rounds, squish down and place a piece of chocolate on top.
Bake @ 350 for 10-12 minutes.