text:
Sign Up for Dog Cancer News and Receive Discount Offers!
Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide
Book Excerpts: Free Chapters
Full Spectrum Cancer Care
Step 1: Conventional Treatments
Step 2: Nutraceuticals
Step 3: Immune Supplements and Anti-Metastatic Supplements
Step 4: The Dog Cancer Diet
Step 5: Brain Chemistry Modification
Is It Cancer? Bumps & Lumps
Bladder & Prostate Cancer
Hemangiosarcoma
Mammary Tumors
Mast Cell Tumors
Nasal Tumors
Perianal and Anal Sac Tumors
Transitional Cell Carcinoma
Coping & Grieving: Emotional Management
Cancer Causes
Susan Ettinger, DVM, Dip. ACVIM (Oncology)
Demian Dressler, DVM
Cancer Terms & Vocab
How to Find a Veterinarian
Scientific & Medical References
Dog Cancer Vet Team
Home » Articles » Choosing Treatments with Confidence » Diagnosis » How to Get A Diagnosis Before Surgery
How to Get A Diagnosis Before Surgery
By Demian Dressler, DVM
Dr. Demian Dressler is internationally recognized as "the dog cancer vet" because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include "Ask the Vet" segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog's Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
There are several different ways of finding out if a lump is a cancer. Each involves having some of the growth tested, but which is best?
There are several ways to collect a sample. Often a biopsy is done. A biopsy involves collecting a piece of the growth for analysis. Sometimes the growth is removed and the entire mass is send off. This is also called a biopsy.
Other times a needle is used to collect some cells from the area in question. These cells are then placed on a glass slide, and the slide is sent for review. This is called a fine needle aspirate.
Finally, cells can be harvested from fluid collected within the chest, abdomen, lungs, or sinuses. This specimen can be sent off as well.
Different pets have different growths in various locations. Which is the best?
For growths on the skin, under the skin, in the spleen, liver, prostate, and some bladder or mouth tumors, often the best first step is the fine needle aspirate. The reason for this is a fine needle aspirate can usually be done without any anesthesia and the procedure itself is over with quickly. Dogs recover almost immediately and there is very little trauma.
Fluid analysis is useful for tumors in the abdomen, chest cavity, and nasal sinus. This fluid can yield a diagnosis, sometimes without invasive surgery.
Fine needle aspirates and fluid analysis are good first steps to plan later surgery and work-up. If a vet removes a cancerous growth for a biopsy without knowing if it is cancerous, a second surgery is often needed to remove more tissue. This second surgery aims at removing more cancer cells that may be left in the area surrounding the growth. A second surgery can often be prevented by knowing what we are dealing with first.
Another reason getting a diagnosis before a surgery is that, sadly, sometimes the tumor has already spread to other areas in the body. If the fine needle aspirate report suggests that the growth has a high likelihood of spreading, often your veterinarian will do tests to determine if spread has already happened. If there is evidence that spread has already occurred, surgical removal of the growth may not make sense.
In some cases doing a surgery is not the best treatment. Cancers that have spread may need chemotherapy, radiation, diet changes, apoptogens, immune supplements, anti-metastatics, and other treatments beyond surgery.
Sometimes a minor biopsy procedure can be done as a first step. The advantage of a biopsy is the pathologist will be able to give a definite diagnosis almost 100% of the time. Occasionally the less invasive tests yield hazy or inconclusive information, which almost never happens with biopsies.
One of the ways a minor biopsy is performed is by taking a small piece of tumor tissue using a biopsy punch or a scalpel. This requires only a stitch or two, and the recovery is usually not bad at all. These tests are often done for growths on the surface of the body, in the mouth, ear canals or genitals.
The bottom line is a diagnosis should be sought before jumping right into surgical removal of growths that may be cancerous. If surgery is the right approach, the right surgery can be done, and appropriate work-up can be performed beforehand. For cancers where surgery is not the best option, other treatments can be started.
For more information on cancer testing as well as a comprehensive road map for the dog cancer journey, see The Dog Cancer Survival Guide.
Collection(s): Articles, Chemotherapy, Diagnosis, Found a Bump/Lump on My Dog, Full Spectrum Cancer Care, Full Spectrum Cancer Care Step 1: Conventional Treatments, Radiation, Surgery
Article Topics: Apoptogens, Biopsy, Dog Cancer Diet, Dog Cancer Supplements, Fine Needle Aspirate
Discover the Full Spectrum Approach to Dog Cancer
The Dog Cancer Survival Guide: Paperback | eBook
FREE Excerpted eBook from The Dog Cancer Survival Guide: The Dog Cancer Diet
The Dog Cancer Coping Guide: CD | MP3
Dr. Dressler's in-depth audio seminars: Dog Cancer Vet Seminar Series
Online Dog Cancer Shop for Supplements and Gear Powered by Amazon, Curated by Us: US | UK/EU
Dr. Dressler's Nutraceuticals on Amazon: EverPup® | Apocaps®
Christine Taylor on October 5, 2013 at 11:28 pm
My dog is a 10 year old Siberian Husky/Shep mix. He has a mass on his left lateral side near the end of his rib cage. It seems to be swollen and is as big as the palm of my hand. The vet did 3 needle biopsies for a cost of $240 but when the results came back all they could tell us is that this is a very aggressive form of Cancer and the lab recommended surgery to remove it. Apparently the lab cannot tell us what type of Cancer it is but that it doesn't spread to other organs.
When I asked the vet for statistics regarding length of survival rates for dogs with and without surgery but I was told there is no research done. I think this is completely unacceptable and actually neglectful. There is absolutely no reason why Veterinarian Colleges cannot request results and timelines from vets who have treated cancer and the ages of the dogs.
Another issue I have is that doctor's, when treating humans have guidelines in place about whether or not to do surgery depending upon the size of the tumor. I was told that they will do surgery as long as they do not have to remove more than 50% of his skin and muscle. How can any dog recuperate well when so much tissue is removed? If such a dog did heal just fine how would he move?
We have checked with other dog lovers who experienced something similar and all who went with surgery lost their dogs shortly after. We are talking under 6 months. One of the dogs recouped just fine (he was 10 as well) but then one day 6 months after surgery he went to his owners whimpering in pain and just dropped dead.
The life span of our dog is apparently 10-12 years and recommending surgery without being able to supply us with statistics has put us in a terrible position. We originally decided to just let our dog live out his life enjoying his walks etc for as long as he can before he becomes uncomfortable because we were told the surgery is very traumatic (similar to a radical mastectomy in a woman) and he has reached the bottom range of his life expectancy.
As a result of our decision our daughter has cried continually almost for 4 days. When she does stop crying it is for a brief time only. She thinks that because the vet recommended it that we should do it as my daughter sees this as a sign that he WILL live another 2 years. The family has been stressed seeing her suffer along with our dog having terminal cancer.
Our dog has separation anxiety and just being at the vets makes him stressed. When he had to be sedated (had a hot spot and didn't like the collar) he didn't sleep, all he did was lie there whimpering until the sedation wore off. My daughter thinks that we should do all we can when it fact there may be little chance he will live past 6 months and even less of a chance living longer. Statistics would help us decide the course of action that best suits our dog.
If you know of any would you kindly post them. I left a message to book the surgery as this was the only way I could relieve my daughter's suffering.She is in University and cannot tend to her work due to her wondering what the right choice is. If chances are he will only suffer and die soon after than I would like to just manage the condition best we can until we can no longer relieve his suffering.
Jim from RI on May 5, 2012 at 10:01 am
Dr. Dressler,
In addition to the comment above regrading prostate cancer, have you had specific experience using Apocaps with prostate cancer? Please also note that my dog has been neutered since we adopted him 9 years ago.
Thank you for your time and information,
Jim from RI
Dr. Demian Dressler on May 9, 2012 at 4:05 pm
one of the things I am prohibited from doing is making any medical claims concerning apocaps and specific cancer types. I am sorry. But suffice it to say that I use apocaps for my patients and have had successes. But I am not saying that Apocaps is chemo or radiation or surgery. However, the constituents do target certain metabolic pathways that are found in cancer cells, and these pathways are connected to normal health, and the ingredients in Apocaps are shown to help maintain normal levels of these pathways. Pretty round about, I apologize, but that's as good as I can do at this time.
Nicole on May 3, 2012 at 4:58 am
Dear Dr. Dressler,
We are extremely grateful for your book and the comprehensive research you have done on canine cancer. Your book is absolutely the most helpful resource out there; and I am relieved to have it to refer to every day. We were wondering if we could present our history to you and get a recommendation regarding NSAIDs and Apocaps for our 50lb. lab/chow mix Joe, who is approx. 12 years old.
Joe was diagnosed with TCC. The preceding month we had noticed pencil-like stools. We originally thought the cancer was in the trigone area of the bladder. We implemented the recommendations in your book: diet, K9 immunity and transfer factor, citrus pectin, krill oil and fish oil, and multivitamin. We held off on Apocaps because he was put on piroxicam. The size of the stools showed intermittent and slightly inconsistent improvement. We also give him the cottage cheese/flax oil (Budwig protocol). Five weeks later, an ultrasound was performed, and we learned that his prostate has enlarged by 1 cm. The oncologist switched him to 50 mg deramaxx, and we have immediately started him on Apocaps.
QUESTION: 1. In your book, it sounds like the reason for reducing the dosage of Apocaps when giving an NSAID is to avoid stomach upset. Our dog is strong, and with all of the diet/supplement changes has shown no nausea or diarrhea. Due to the aggressive nature of canine prostate cancer, we have started him on the full dose of Apocaps. Is there any reason besides potential stomach issues, not to have him on both deramaxx and full Apocaps at the same time?
2. What is your experience with removal of the prostate for this type of cancer? Can it be done without interfering with the function of the urethra.
3. Do you recommend any other specific supplements/protocols aimed at prostate cancer?
Dear Nichole
Sorry to hear about this.
you (under veterinary supervision) could try the combo but I would be using methods to protect the intestine and stomach to be safe (full meal, cytotec, carafate, slippery elm etc).
Surgery can be done but rarely is curative.
Are we talking about prostatic transitional cell carcinoma? Or prostatic adenocarcinoma? The chemos are different. The supplements have not been studied adequately to provide cancer-spefic supplement protocols most of the time.
I would be also considering Neoplasene and artemisinin under these circumstances, with veterinary supervision, as next steps.
I hope this helps a bit.
Chris on November 7, 2011 at 1:50 pm
4Life makes Transfer Factor Classic. About $38 for 90 capsules. Same price on Amazon. This product doesn't have anything else added. It is a human product, but from what I have learned that doesn't matter – transfer factors are transfer factors. This company makes a canine product, called Transfer Factor Canine Complete, but this product contains other ingredients such as vitamins, minerals and antioxidants (SOD is one of the ingredients).
Do you have a recommendation on how much to give?
I also spent some time on the internet and looking through your list of references in your book for the research on transfer factors. I wasn't able to find any abstracts! The 4Life web site claims there are "hundreds" of studies on transfer factors, but doesn't have any links to any published data on their web site. I searched PubMed and turned up nothing… Do you know of any papers you can share with us?
Dr. Demian Dressler on November 12, 2011 at 7:46 am
Dear Dr. Chris
when searching use the browser search bar. Try :"transfer factor malignancy pubmed"
This is safe stuff so go ahead and extrapolate human doses pound for pound.
Here's some info:
J Exp Pathol. 1987 Summer;3(4):549-64.
Clinical trials of transfer factor in malignancy.
Spitler LE, Miller L.
Paul M. Aggelar Memorial Laboratory, Children's Hospital of San Francisco, California 94118.
Results of clinical trials of transfer factor therapy in various malignancies have been variable. In non randomized trials, about 300 patients have been evaluated, and clinical benefit has been reported in about 1/3 of the evaluable patients. Results of randomized studies are similarly varied. In some randomized trials, clinical benefits of increased disease free survival and prolonged survival have been claimed. In other studies, transfer factor has been reported to be of no clinical benefit. In a few studies, results suggest patients receiving transfer factor do not do as well as those receiving placebo, although these are only trends, and do not reach the level of statistical significance. There are a number of variables in the design of transfer factor trials, and review of the studies performed to date does not permit a determination of which, if any, of these variables is related to the therapeutic outcome….
Journal ofthe Royal Society ofMedicine Volume 72 December 1979:
Transfer factor
Anne S Hamblin PhD
Immunology Department, St Thomas' Hospital, London SEI 7EH
The term transfer factor is given to dialysable material present in extracts of immune
peripheral blood leukocytes which apparently confers ('transfers') delayed-type hypersensitivity
(or its in vitro correlates) when injected into a non-hypersensitive subject. Clinical and
immunological observations following the administration of transfer factor have led to the
concept that it converts non-immune to immune lymphocytes in vivo, thus acting as a mediator
of adoptive sensitization (Lawrence 1974). A wide variety of clinical conditions including
immunodeficiency, infectious diseases, autoimmunity and malignancy have therefore been
treated with transfer factor in attempts to reconstitute cellular immunity. However, the
mechanism by which transfer factor is therapeutically beneficial is complicated by clinical
observations that patients may acquire cellular immune responsiveness not apparently related
to donor specificity (Dupont et al. 1974, Valdimarsson et al. 1974, Spitler et al. 1972, Griscelli
1975, Kirkpatrick & Smith 1976a) suggesting that leukocyte extracts may also possess adjuvant
properties. The clinical benefit derived from treatment with transfer factor may therefore
depend not only on the initiation of specific immunological reactivity, but also the
amplification of an existing immune response.
The proposition that both the so-called specific and nonspecific properties of transfer factor
may have a contribution to make to the augmentation of cellular immune responses in patients
raises a number of practical issues. It is perhaps useful to remember that the term transfer
factor is often applied to the whole leukocyte extract administered in vivo. However, it has
been suggested that the crude material be termed 'dialysable leukocyte extract' and that the
term 'transfer factor' be reserved for the unidentified factor or factors capable of transferring
delayed hypersensitivity. The relative roles of the specific and nonspecific activities in the
extract raise questions regarding the selection of donors for therapy. It is not clear whether a
more beneficial product may be prepared from donors with specific strong delayed
hypersensitivity responses or from unscreened pooled normal healthy donors. The question is
0141-0768/79/120927-03/$01.00/0 ,'-. 1979 the Royal Society of Medicine
928 Journal ofthe Royal Society ofMedicine Volume 72 December 1979
under assessment in studies in which the product from normal healthy blood-bank donors is
administered to patients with a wide range of diseases (Grob 1977) and in properly controlled
clinical trials such as those currently under way in the United States in leprosy and
coccidiomycosis.
Much of the scepticism which surrounded the early work on transfer factor resulted from
the consistent failure to demonstrate the transfer phenomenon in animals, particularly the
guinea pig. However, recent studies in primates, guinea pigs and infectious disease models in
animals have shown that it is possible to demonstrate biological properties of leukocyte
extracts which may be relevant to transfer factor in humans. Such studies have revealed both
general and specific stimulatory activity in leukocyte dialysates. Thus, Steele etal. (1976) have
reported that human leukocyte dialysates could transfer delayed hypersensitivity responses to
gnotobiotic monkeys never previously exposed to the relevant antigens. Immunological
specificity was implied since recipients never converted to antigens to which the donor did not
react in vivo. In contrast, Vandenbark etal. (1977) have reported that delayed hypersensitivity
skin reactions could only be elicited in guinea pigs receiving human leukocyte dialysate when
the animals had previously been primed with the relevant antigen, thus supporting the view
that dialysates contain materials which stimulate the recipient to express sensitivity to
antigens to which they have previously been exposed.
The concept that transfer factor converts non-immune to immune lymphocytes raises the
possibility that non-immune lymphocytes cultured with transfer factor may acquire the ability
to respond to specific antigen which may be assessed by a variety of in vitro tests such as
lymphocyte transformation, migration inhibition or cytotoxicity. Such specific effects have
been reported and have been reviewed (Lawrence 1974, Ascher et al. 1976). However, it is
clear that leukocyte dialysates also contain many substances capable of nonspecifically altering
lymphocyte responses only some of which may reflect the nonspecific effects in vivo (Hamblin
etal. 1976). It is, therefore, essential to bear in mind that extracts of cells may simply improve
lymphocyte function in vitro by, for example, medium conditioning effects. Thus it has been
reported that human leukocyte dialysate causes cyclic guanosine monophosphate (GMP)
accumulation in normal leukocytes (Kirkpatrick & Smith 1976b). Cell extracts contain
serotonin and ascorbate known to cause cyclic GMP accumulation. Fractionation of the crude
dialysate indicated that the fraction which caused conversion of delayed skin tests also causes
cyclic GMP accumulation, but did not contain ascorbate or serotonin. This example reveals
the need for careful biochemical studies before conclusions may be drawn regarding the
relevance of in vitro activity of the crude dialysate to its effect in vivo.
To supplement these studies much effort has been made to characterize the dialysable
material extracted from leukocytes biochemically. Analysis of dialysates by gel chromatography
has shown that they may be separated into a number of subfractions some of which
transfer specific delayed hypersensitivity responses (Zuckerman etal. 1974, Burger etal. 1976)
and some of which may nonspecifically enhance delayed hypersensitivity responses in humans
(Krohn et al. 1977). In addition, fractions have been described with specific and nonspecific
activity in animal and in vitro models (see Ascher et al. 1976). Within leukocyte dialysates a
variety of known substances have been identified which could be responsible separately or in
combination for some of the reported in vitro or in vivo effects (Wilson et al. 1977, Hamblin
1979). However, the material(s) responsible for the transfer of delayed hypersensitivity has yet
to be defined biochemically, and to date no subfraction of the crude dialysate has definitively
been shown to be therapeutically beneficial.
The lack of available information regarding the mechanisms of action and biochemical
nature of transfer factor makes it difficult to describe schedules, dosage and source of material
for treatment. Furthermore, a variety of activities have been reported clinically and in animal
and in vitro models and the interrelationship between these has yet to be made. One view,
expressed by C H Kirkpatrick in 1975, is that 'the phenomenon of transfer factor is a
summation of several effects'. The results of ongoing clinical trials, together with continued
biochemical and biological analysis of the dialysate, will show whether this hypothesis will be
substantiated or refuted.
Journal ofthe Royal Society ofMedicine Volume 72 December 1979 929
Ascher M S Gottlieb A A & Kirkpatrick C H ed (1976) Transfer Factor: Basic Properties and Clinical Applications.
Academic Press, New York
Burger D R, Vandenbark A A, Daves D, Anderson WA, Vetto R M & Finke P, (1976) Journal ofImmunology 117, 789
Dupont D, BaUlow M, Hansen J A, Quick C, Yunis E J & Good R A (1974) Proceedings of the National Academy of
Sciences ofthe USA 71, 867
Grscelli C (1975) Birth Defects 11, 462
Grob P J (1977) Acta Neurologica Scandinavica 55, Suppl; p 217
Hamblin A S (1979) In: Clinical Neuroimmunology. Ed. F Clifford Rose. Blackwell Scientific Publications, London;
Hamblin A S, Dumonde D C & Maini R N (1976) Clinical and Experimental Immunology 23, 303
Kirkpatrick C H (1975) Birth Defects 11, 441
Kirkpatrick C H & Smith T K (1976a) Cellular Immunology 27, 232
Kirkpatrick C H & Smith T K (1976b) In: Transfer Factor: Basic Properties and Clinical Applications.
Ed. M S Ascher et al. Academic Press, New York; p 161
Krohn K, Grohn P, Horsmanheimo M & VirolainenuM (1977) Medical Biology 54, 334
Lawrence H S (1974) Transfer Factor in Cellular Immunity. Harvey Lecture Series 68. Academic Press, New York;
pp 239-250
Spider L E, Levin A S, Blots M S, Epstein N, Fudenberg H H, Helistrom I & Heflstrom K E (1972) Journal ofClinical
Investigation 51, 92a
Steele R W, Eichberg J W, Heberlung R L, Eller J J Kalter S S & Kniker W T (1976) Cellular Immunology 22, 110
Valdimarsson H, Hambleton G, Henry K & McConnell I (1974) Clinical and Experimental Immunology 16, 141
Vandenbark A A, Burger D R & Vetto R M (1977) Clinical Immunology and Immunopathology 8, 7
Wilson G B, Welch T M, Knapp D R, Horsannheimo A & Fudenberg H (1977) Clinical Immunology and
Immunopathology, 8, 551
Zuckerman K S, Neidhart J A, Balcerzak S P & LoBuglio A (1974) Journal ofClinical Investigation 54, 997
Mol Med. 2000 Apr;6(4):332-41.
Transfer factors: identification of conserved sequences in transfer factor molecules.
Department of Medicine, University of Colorado Health Sciences Center, Denver, USA.
Transfer factors are small proteins that "transfer" the ability to express cell-mediated immunity from immune donors to non-immune recipients. We developed a process for purifying specific transfer factors to apparent homogeneity. This allowed us to separate individual transfer factors from mixtures containing several transfer factors and to demonstrate the antigen-specificity of transfer factors. Transfer factors have been shown to be an effective means for correction of deficient cellular immunity in patients with opportunistic infections, such as candidiasis or recurrent Herpes simplex and to provide prophylactic immunity against varicella-zoster in patients with acute leukemia.
Transfer factors of bovine and murine origin were purified by affinity chromatography and high performance liquid chromatography. Cyanogen bromide digests were sequenced. The properties of an apparently conserved sequence on expression of delayed-type hypersensitivity by transfer factor recipients were assessed.
A novel amino acid sequence, LLYAQDL/VEDN, was identified in each of seven transfer factor preparations. These peptides would not transfer expression of delayed-type hypersensitivity to recipients, which indicates that they are not sufficient for expression of the specificity or immunological properties of native transfer factors. However, administration of the peptides to recipients of native transfer factors blocked expression of delayed-type hypersensitivity by the recipients. The peptides were not immunosuppressive.
These findings suggest that the peptides may represent the portion of transfer factors that binds to the "target cells" for transfer factors. Identification of these cells will be helpful in defining the mechanisms of action of transfer factors.
Birth Defects Orig Artic Ser. 1975;11(1):449-56.
Transfer factor II: results of therapy.
Spitler LE, Levin AS, Fudenberg HH.
Transfer factor is a dialyzable extract of sensitized leukocytes, which transfers reactivity from skin test-positive donors to skin test-negative recipients. Transfer factor supplied by our laboratory has been used therapeutically to induce cellular immunity in 78 patients around the world. Many patients received multiple doses of transfer factor ranging from 1 unit given every 6 months for 3 years to 1 unit every week for 6 months to as much as 8 units per week for a brief period. A total of 299 units of transfer factor have been given. Diseases in which transfer factor appeared to cause improvement include the Wiskott-Aldrich syndrome, severe combined immunodeficiency disease, mucocutaneous candidiasis, chronic active hepatitis, coccidioidmycosis, dysgammaglobulinemia, Behcet disease, aphthous stomatitis, linear morphea, familial keratoacanthoma and malignancy.
Biotherapy. 1996;9(1-3):61-6.
Efficacy of transfer factor in treating patients with recurrent ocular herpes infections.
Meduri R, Campos E, Scorolli L, De Vinci C, Pizza G, Viza D.
Cancer Detect Prev Suppl. 1987;1:373-6.
Transfer factor for adjuvant immunotherapy in cervical cancer.
Wagner G, Knapp W, Gitsch E, Selander S.
1st Department of Obstetrics and Gynecology, University of Vienna, Austria.
In a prospective randomized double-blind study of 60 patients with invasive cervical cancer, 32 were treated with transfer factor (TF) derived from leukocytes of the patients' husbands, and 28 were treated with placebo. Within the first 2 years after radical hysterectomy, five out of 32 TF-treated patients and 11 out of 28 placebo-treated patients developed recurrence of malignancy. Excluding one further patient with intercurrent death this difference is significant (chi 2 = 3.9915; P less than 0.05). Subdividing the collectives, significant differences were found in patients aged below 35 years and in patients with stage I disease. Identical immune profiles were checked in leukocyte donors prior to leukophoresis and were serially checked in patients. Antigen-specific correlations were found between donors' and recipients' reactivities but not between donors' reactivity and recipient's course of the disease.
Eye Physiopathology Clinical Service, University of Bologna, Italy.
Recurrent ocular herpes is an insoluble problem for the clinician. As cellular immunity plays an important role in controlling herpes relapses, and other studies have shown the efficacy of HSV-specific transfer factor (TF) for the treatment of herpes patients, an open clinical trial was undertaken in 134 patients (71 keratitis, 29 kerato-uveitis, 34 uveitis) suffering from recurrent ocular herpetic infections. The mean duration of the treatment was 358 days, and the entire follow-up period 189,121 before, and 64,062 days after TF treatment. The cell-mediated immune response to the viral antigens, evaluated by the lymphocyte stimulation test (LST) and the leucocyte migration test (LMT) (P < 0.001), was significantly increased by the TF treatment. The total number of relapses was decreased significantly during/after TF treatment, dropping from 832 before, to 89 after treatment, whereas the cumulative relapse index (RI) dropped, during the same period, from 13.2 to 4.17 (P < 0.0001). No side effects were observed. It is concluded that patients with relapsing ocular herpes can benefit from treatment with HSV-specific TF.
chris distefano on November 7, 2011 at 12:44 am
I tried to recieve the free diet and as yet nothing has come through~what do I do?
Dog Cancer Vet Team on November 7, 2011 at 11:33 am
You should have received the diet via email. If not, please contact customer support at cs@dogcancervet.com and we will make sure you get a copy.
K on November 5, 2011 at 10:59 am
Hello, Dr. Dressler,
So happy to have found your info.!!
Our sweet basset hound, Shug, just turned 9 this week and went to the vet to find a tumor on the outside of his ear. It is presently unattached, the first one to be noticed, and scheduled to be treated next week. That is the ques., how to proceed with what tx? Since it hasn't been labeled yet…what can be done? Should it be surgically removed or can the neoplasine be applied even w/o a cancer dx?
Looking forward to your input.
Thanks sooo much for your time!!
Dr. Demian Dressler on November 12, 2011 at 2:06 pm
Dear K
it is very important to get a diagnosis so you and the vet know what the right treatment is. The conventional approaches vary a lot depending on the cancer type.
I hope this helps
Paul on November 3, 2011 at 8:46 am
Super Oxide Dismutase – Could you kindly tell us what the concern is with this substance,as I also have the K-9 supplements and was about to start treating my 2nd dog to have cancer within a year,with them.
Unfortunately,they could not help me save my last dog.
Your clarification on this rather important point would be much appreciated.
Dear Paul
there is not a concern per se, just the information that it is an anti oxidant-
https://www.dogcancerblog.com/blog/anti-oxidants-versus-pro-oxidants/
Mary Emmons on November 3, 2011 at 5:50 am
My AB has been diagnosed with Mast cell tumors of the skin. He started out with very small bumps on his back, side, and back leg. My vet removed them and sent them off to a lab. The results did come back that they were MCT's, but she said that they got it all, and the tissue surrounding the growths was free of cancer. The vet informed me that it is due to immune or allergy problems. I have him on supplements and am now giving him Curcumin (Turmeric) sprinkled on his food. It has been only a little over 2 months since his surgery and I have found a new bump on his other back leg that is the size of a small pea. I can't believe it and now I am scared. Does this mean that they have spread to other parts of his body now? I will be contacting my local vet soon.
Sue on November 3, 2011 at 5:17 am
Can a diagnosis ever be wrong? My dog has had a lump for years that the vet said to "watch". It got very big very fast and a needle aspirate showed it was a mast cell tumor, which the vet said was cancer. Our dog is 12 years old so we opted not to operate or do chemo or radiation, we only give her MSM and Benadryl twice a day.
My question is, can a mast cell tumor ever be benign? She is not sick at all, no symptoms whatsoever even though she was diagnosed a year ago. Thanks Dr. D!
Dear Sue,
Overall symptoms or signs of cancer related to appetite and energy level usually start only when the body has a very high load of cancer cells-
a post for you
https://www.dogcancerblog.com/blog/signs-of-dog-cancer-and-decompensation/
Morgan Whitehead on November 3, 2011 at 4:18 am
Reg, my fourteen and a half year old staffy/lab/bull terrier X had a 2cm andenocarcinoma removed April 2011, had back surgery for stenosis and was diagnosed with illiac thrombus 🙁 at same time. He went well with both surgeries and is now much more comfortable back wise, the surgeon told me he got clean margins and no chemo or radiation was suggested. At that point i knew nothing about canine cancer except that two dogs i loved dearly both died of cancer 6months apart leaving only me and my Reg, as far as i knew the lump was removed and all was good. In July 2011 on rechecking clot it had extended 4cm down the external illiac and he had enlarged lymph nodes. Realising my situation, albeit 3 month after initial surgery to remove growth i grieved and stresses and then got on the internet to find anything i could about dog cancer, thankfully i found a cancer diet recipe, your book and apocaps. I am eternally greatful for the clarity and peace of mind that came with the book. As Reg and i are Australian there was one more frustration – i couldnt get apocaps in Australia – thought my 2nd chance at giving it my best shot was lost too but alas after a week and a half of frustration and disappointment i awoke on morning and decided to accept i coulnt get apocaps and phoned a man in Western Australia (other side of Australia to where we live) who had a web site on canine vitamins and supplement and canine cancer and the first thing that came out of my mouth was "have you heard of apocaps?" He replied that he had heard there was a book out now and he had ordered some apocaps and was waiting for them to released to him, so i placed my order, a very very happy day indeed. For the last two weeks i have been giving Reg three apocaps three times a day, k9 immunity and transfer factor along with fish oil, digestive enzymes, multi vitamins and some antioxidants recommended to me for the clot. Other than risky complex surgery by and extremely talented, highly qualified fellow of veterinary science i dont have any other options but to hope i can find something to break down this clot. As Reg is fourteen +yrs, has cancer and we have not yet found an underlying issue to explain this clot so therefor may be growing within the artery wall in which case would be inoperable however we wouldnt know that unless we opened him up (in which case lymph nodes wld be removed also) i am constantly reading and trying to find anything i can that may help without giving him unneccessary things that only put more pressure on his kidneys and liver for no benefit. It is all very foreign and frustrating for me and Reg, i recently purchased some lumbrokinase (derived from earth worm to break down clots) however am anable to find enough literature to feel confident to add these to the mix as much as i hope they are all they say they are. Reg is fed three times a day and this seems to work for him very well how do i fit apocaps into his day with three feeds and anti oxidants? I know i can leave a minimun of one hour before or after food and 3hrs before or after antoxidants but am concerned that unless i leave the recommended 4hrs befor or after food and 6hr before or after anti oxidants that in reality i wont be gaining anything with apocaps?It is soooo important to me to get it right and this keeps me up at nights. And speaking of nights can apocaps be given at 11pm late in morning overnight, eg 4am and then 11am or are best result given if given over daytime period? Is there any other effective way to give a 70lb his required dose over a 24hr period, eg 4 twice a day? Any information or advice wld be much appreciated.
love me & Reg
PS have you heard of lumbrokinase?
Dear Morgan
just give the apocaps 1 hour before the full meals, or 1 hour after the full meals. If you cannot do this, giving apocaps with a full meal will not hurt, just less will enter the bloodstream but there will be benefit regardless.
Could also look into nattokinase…just an idea
Chris on October 25, 2011 at 11:44 am
I'm posting my question so that others can possibly benefit. When we talked about supplements for my dog Cody you recommended stopping a supplement that I've using because it contains Super Oxide Dismutase. You recommended supplements from Aloha Medicinals – the K9 Immunity and K9 Transfer Factor. I ordered both. In reading the label for the K9 Transfer Factor I've discovered that this supplement contains Super Oxide Dismutase. I'm going to return it and look for a company that makes a formulation without SOD.
Dr. Demian Dressler on October 26, 2011 at 12:55 pm
That's a good point-
Thanks very much for letting us know!
Phrases, Words & Meanings
Scientific and Medical References
Choosing Treatments with Confidence
Oncologist's Perspective
Treatment Plan Analysis
Found a Bump/Lump on My Dog
Life Quality
Your Role as Your Dog's Guardian
Emotional Management
Terms Privacy Policy Disclaimer Disclosure Copyright © 2008-2018 Maui Media LLC. All Rights Reserved
NOT THE PRACTICE OF VETERINARY MEDICINE - The material available on this web site, without limitation, is provided for informational and educational purposes only and is not meant to take the place of the advice of your dog's veterinarian. We cannot examine your dog and/or give you veterinary advice. Only veterinarians who examine your dog can give you veterinary advice or diagnose you or your dog's medical problem. If you are viewing this site and have come here because your pet is ill, contact a veterinarian IMMEDIATELY. Your reliance on the information you get from this website is solely at your own risk. If your dog has a specific health problem, contact your veterinarian. Also note that while we frequently update our content, veterinary information changes rapidly. Therefore, some information may be out of date.


On 11th December, the president of the GITGE executive board, Celestino Bonifacio Bacale, oversaw the second meeting of the board in 2018, which was attended as guests by Eucario Bacale Angue, Minister for Transport, the Postal Service, and Telecommunications; Ireneo Mangue Monsuy, Director General for Autonomous Bodies and ones with a State Stake-holding, and Ismael Efua Mbana Maquina, State Treasury Paymaster General.
The meeting took place at the facilities of the central headquarters of the entity, in Malabo II.
During the meeting those present debated issues related to the evolution of the underwater cable to Brazil project (SAIL); the FTTH project, Fibre to the House; the state of the Cape San Juan (Corisco) underwater cable project; the project to restructure the company at the level of administrative departments, and the proposal for the new catalogue of services and its advantages.
They also debated other projects related to the sector of activities in which the entity operates, such as the creation of an incubator to create new investment projects for the future, and the installation of a fibre optical cable factory in the Republic of Equatorial Guinea.


The Date Selection Consultation is the perfect gift for your family members, friends or loved ones.
If you are looking to find the perfect date or location for your special occasion, this Consultation is the right choice.
Naturally I can also give you advice to choose a suitable location for your house, apartment or flat.


According to Moonalice legend, today's poster by Alexandra Fischer depicts Vela Moonalice, the tribe's patron saint of human powered, two-wheeled transportation. Among Vela's many accomplishments was the creation of Bicycle Day, a tribal holiday that occurs every year on the 19th of April. Bicycle Day celebrates the experimental philosophy of Dr. Albert Hoffmann, a Swiss chemist of great note in our tribe. Today we celebrate Biktober, a new holiday that celebrates everyone on two wheels in the the town of Fairfax. In keeping with the season, the focus is on agriculture. The signs say "beer," but we know better. Some of us who don't live didn't realize that Biktober is strictly BYOB, so we hope you will share. M648 Watch this show now at Moonalice.com.
Mark Lichtenberger liked this on Facebook.
Darrin Brenner liked this on Facebook.
DaKota Kelly liked this on Facebook.
@MoonalicePoster @Moonalice This was a really fun event and the poster came out good too ;-)!


Towel embroidered with kind words quote and bees.
We do like quotes that make you think and this is one of them "kind words are like honey sweet to the soul and healthy for the body".
We have embroidered this onto a beautifully soft 100% cotton 600gm hand towel and added a skep with honey bees flying around.
Look at the detail of the little bees, don't you think they are beautiful?
An ideal present for any bee lovers or a stylish welcome for friends and family who visit!


text:
Do You Have the Right Personality for Your Dream Career?
Advertising Creative/Artist
International Development Expert
Music Producer/Tour Manager
Have you got what it takes to succeed in your dream career?
The short answer is almost certainly yes.
We asked 20 of our top professionals which personality type is best suited to their industry. A huge number of them said that they'd encountered a diverse range of people in their fields.
But they did list a number of traits and attributes that would be particularly useful in their roles.
Do you have them?
Read on to find out…
What personality type would you say is most suited to your career?
Karl Mok, Architect and Founder of TA!LAB Spatial Design Studio
"Architecture can seem quite demanding, perhaps suited to the kind of personality that is interested in many things!
You definitely have to be creative and interested in the way things are built. You also have to have patience, as some projects may well take over a decade to complete!
But these are all skills you can pick up and start training at any point."
Katy Edelsten, Artist, Illustrator and Advertising Creative at Wieden + Kennedy
"You need to be totally open-minded.
You need to be willing to be convinced of something that you weren't convinced of at 9am.
You need to be able to flip your brain to consider other people's perspectives.
When someone says "I don't like that, I don't believe in it", you need to be able to understand why, and to want to make something they do believe in.
Essentially, advertising is all about communication. It's taking big things that are boring and making them something people want to learn about."
No one should ever feel that medicine is not for them because of who they are. It's actually so broad that actually there's something for everyone, you just have to find it.
Rhys Rosser, Barrister at 2 Bedford Row Criminal Barristers Chambers
"My profession normally attracts people that are outgoing and self-starters.
You really need to remain motivated at all times."
Charlotte Leigh, General Dental Practitioner, Brecknock Dental Surgery
"I'm not sure there is a particular personality type.
I guess open-mindedness is the best thing.
You don't know who's going to come through your door, and it's very easy to start making assumptions about people.
There may be a reason they haven't been able to take care of their teeth. You need to take the patient at face value: act on the information they give you, do your own examination and help them on their healthcare journey. You may need to refer them to social services, or a dentist better suited to them.
Are we all open-minded all day every day? Absolutely not. We all have good days and bad days."
Dr Manik Kohli, Speciality Registrar in Sexual Health and HIV Medicine
"It's an interesting question.
There are definitely jokes about different specialties within medicine attracting different personality types. That orthopaedic surgery attracts 'rugby lads', for example.
Those kinds of stereotypes are fun, but it's important to have an open mind.
No one should ever feel that medicine is not for them because of who they are. It's actually so broad that actually there's something for everyone, you just have to find it. Whether you've got a specific way you like to work or a particular style of communication, you're bound to find a specialism that's right for you.
It can take time - some people take ten years - but there's no rush.
There's nothing about your personality that means medicine isn't the right career for you."
It's all just about putting in exceptionally hard work and being an empathetic person.
Bhavik Bhatt, Thermofluids Engineer at Rolls-Royce
"With 50,000 employees, we have every type of personality working for us and every type of job role to fit those personalities.
If you're introverted, methodical and you've got a keen eye for detail, there are many, many roles for you.
On the flip side, if you're a strategic thinker, if you love customer interaction, we also need you.
We need the people who like to get really stuck into data crunching, but we also need the people who can take a step back and think about how everything fits together. Who are we selling to? Who are the customers?
We need people who are slightly more thoughtful. Who, if you ask them a question, will go away and research it thoroughly and give you a polished response. But we also need people who can answer straight away and get things done. You need a compromise between the two.
When it comes to personality, the best teams I've worked with have been the most diverse ones."
Leona Mondsee, CEO and Co-Founder of Reitly Investment Comparison Platform
"You have to be pretty scrappy.
You might realise you have to make Facebook ads when you have no idea how and can't afford to go and hire a marketing guru.
That's when you think 'okay, I better learn'. You have to learn how to do things yourself in whatever way you can - get a book, or Google it and try and figure it out!
You have to be ready to jump into anything, whatever it is."
People who are outgoing, humble and resilient are often attracted to this field. Humanity comes first in our type of work.
Karen Peacock, Designer and Co-Founder of Womenswear Brand Albaray
"I have worked with many different personality types who have all been talented designers."
Ben Hunter, Award-Winning Writer, Director and Filmmaker
"Writing and directing has such an incredible variety of voices, backgrounds and personality types.
The important thing is that you are passionate, dedicated to continuous learning and exceptionally thick skinned. I have seen some of the most outgoing people and some of the most insular, introverted people do this job. Each can succeed in their own way.
Perseverence Ganga, Programme Policy Officer, UN World Food Programme
"People who are outgoing, humble and resilient are often attracted to this field.
Humanity comes first in our type of work."
Erika Terrones-Shibuya, Associate, Asia Equities Sales at Goldman Sachs
"There isn't necessarily a specific personality type, but I would say being able to connect with people is essential.
The most exceptional people I have seen in the industry are not only very knowledgeable in their area of expertise, but are also able to communicate extremely well. This is not just limited to presenting ideas to an audience, but also listening to people."
I think you could argue that extraversion helps in consulting. Especially if you work in a bigger organisation where your brand visibility and the projects that you're on are really important.
Michael Skapinker, Contributing Editor, Financial Times
"All sorts. Everyone has something to offer."
Mary Agbesanwa, Strategy and Operations Management Consultant at PwC UK
"A passion for learning about businesses.
Not necessarily having an entrepreneurial mindset, but being interested in how businesses function and how they make money helps.
People sometimes say you need to be quite extroverted because the work does involve presentations, and you do need strong communication skills both verbal and written.
Being comfortable talking about your achievements is another thing that's important."
Emma Lord, Associate Director of Marketing, InvestIN Education
"Marketing allows for all different kinds of personality types, it's perfectly suited to creative souls and analytical minds alike.
However, one thing common to all is being highly meticulous, precise and a little bit of a perfectionist.
It's important if you're creating something which has the possibility of being seen by hundreds of thousands of people to make sure there are no mistakes. Spelling errors, copy inaccuracies or design flaws can reflect badly on your brand and your company."
David Davies, Tour Manager, Senior Producer and Founder of Double D Live
"I think you need to be a resilient kind of person.
When you work in a bank, at a law firm or as a police officer, there's a path to promotion. You start as a junior and work your way up. In this industry it's not very regulated, which is positive in some ways and negative in others.
You need the confidence to constantly be pitching yourself and trying to get opportunities.
You also need to be able to get on with people. You spend all your time on buses and in planes: hours and hours with the same people.
It's about a certain kind of personality, I think."
It's rare that a solicitor isn't a part of a team and it benefits any team to have a variety of different types of people. You need someone calm to balance out stress; someone proactive to keep things moving forward; someone empathetic for client-management.
Ben Simpson, Political and Security Officer at the British Embassy in Tripoli, Libya
"I've met many brilliant diplomats: both extroverts and introverts.
But there are two common traits.
Firstly, openness: to new ideas, different cultures, different people.
Secondly, resilience. Whether it's a natural disaster, a conflict or a global pandemic, our people regularly face challenging situations. You need a resilient personality to focus on achieving objectives through tough times."
Dr Vicky McKechnie, Clinical Psychologist at an Acute Hospital in London
"I would like clinical psychology to attract a diverse range of people, and that includes personality types.
We work very collaboratively, both with our clients and other professionals, so an appreciation of that is important – we do not position ourselves as the experts!"
Being compassionate, patient, friendly and understanding will get you far in this career.
Victoria Sloan, Front-End Software Engineer at Teamwork
"I wouldn't say there is a specific personality that is suited to my career.
It takes a team of different personalities, coming from different backgrounds and all walks of life, to come together and voice their ideas and opinions to deliver great software.
I think as long as you are open and willing to learn, everyone can have a career in tech."
Kathryn Finch, Solicitor and General Counsel of Quartz Counselling, Psychotherapy and Training Limited
"I don't think there is a specific personality actually.
It's rare that a solicitor isn't a part of a team and it benefits any team to have a variety of different types of people.
You need someone calm to balance out stress; someone proactive to keep things moving forward; someone empathetic for client-management. It's rare all these qualities are found in a single person."
Dr Michael Lazaris, RSPCA Veterinary Surgeon
Lauren James, Twice Carnegie-Nominated Author of Young Adult fiction
"It's hard to say - writing is very solitary, so you need to be happy to work alone.
But you also need to be confident at public speaking and extroverted in talking to lots of people. You also need to be very self-motivated to set yourself work deadlines months in advance, without a boss making sure you're working. Financially, you have to handle your taxes as a sole trader, so you have to be good at organising receipts and money. You need to save your earnings over the year and pay off your taxes directly to the government, as freelance writers don't have an employer.
In general, organisation and administration is a huge part of the job."
Want to know more? Read Lauren's full interview, A Day in the Life of a Writer.

redpajama_set_name: RedPajamaCommonCrawl


From maps to books, the mobile phone is replacing more objects than ever. This week, the industry behind these tiny supercomputers meets in Barcelona, and the world's biggest manufacturers unveil their latest devices. It will see another assault on computers, laptops and satnavs as the mobile phone and the tablet becomes ever more capable.
Indeed, according to Strand Consulting, "This year's Mobile World Congress will have a wider focus than we have seen previously", and will cover both how the mobile networks of the future will evolve, as well as how phones will change too.
That means an increasing emphasis on so-called Near-Field Communications, which is the technology mobile phone companies are hoping will help to turn your phone into your wallet. O2, Vodafone, Orange and others are looking closely at what the service could mean for them, and that's in large part because it may provide another source of income.
When it comes to the devices themselves, however, phones are increasingly more purse-size than wallet. The Samsung Galaxy Note and the Galaxy Nexus have done well at sizes at least an inch bigger than the iPhone, and a number of 5" screens are set to be marketed as phones rather than tablets – if your mobile is to stay in your pocket, you might need bigger pockets.
And deeper pockets could come in handy too: mid-priced smartphones are apparently now less profitable than any other type, which means it's more cost-effective for a network to sell you an upgrade either to something very expensive, such as an iPhone, or something very cheap and out of date, rather than anything in between.
That means consumers are likely to be besieged by ever more marketing trying to persuade them that a superphone is really worth having. HTC, for instance, after a couple of years in the doldrums, is now expected to unveil a comprehensive new range, while Nokia and Microsoft will keep banging the drum, at enormous advertising cost, for phones based on the well-received but resolutely unpopular Windows Phone platform.
Among the other manufacturers, including a slew of Asian newcomers, Asus is set to announce the launch of its 'Padfone' which sees a mobile literally slot inside a larger screen – it's another response to the challenge of smaller devices now being able to stream and play media that looks equally at home on the giant screen. The mobile market may not be profitable, but it's expanding 47 per cent year on year.
Inside your mobile phone, there are big changes too: chip maker Intel is finally beginning to gets its products where previously only those made by British firm Arm were to be found. The claim is that Intel can achieve ultra-modern performance with one "core" processors where others require four. That might herald a new age of better battery life and enhanced performance. It remains to be seen, but the first phones are likely to be mass-market rather than iPhone-rivals.
And indeed it's that one Apple product that will be like an elephant in every one of the dozen barn-like conference halls devoted to mobile phones in Barcelona. Apple does not go to MWC, and now even Samsung has said its most prestigious launch will take place at another, later event it will host itself. But these are the two companies pushing innovation faster than any other – it remains to be seen whether this enormous tech show can produce anything to challenge their dominance.


After quoting the above statement, Ascol asserts the article "seems to affirm a synergistic understanding of regeneration" which, for Ascol, is a "cooperative effort between an unbeliever and God." Before criticizing the article as synergistic, Ascol alleges the author(s) employ "imprecise language" because the phrase "any person who responds to the Gospel with repentance and faith is born again through the power of the Holy Spirit" is ambiguous and "can be taken two ways." According to Ascol, on the one hand, it could mean the gospel respondent "does so because he is a born again person" and on the other, the respondent "is by that response born again." This is a strange assertion in light of the explicit "We deny" in bold letters, specifically denying the first of Ascol's two options about what the author(s) supposedly could have meant; i.e., the basis of his charge of ambiguity. I confess the sheer pretension I perceive in this initial criticism.
Moving on to Ascol's concern about the TS's supposed "synergistic understanding" of the new birth, Ascol contrasts "synergism" and "monergism" in discussions about regeneration as "two opposing views of how regeneration comes to a person." According to Ascol, while synergism teaches that God regenerates a person "only if and after that person repents and believes," monergism perceives regeneration as a "sovereign work of God" with God alone as active and doing the rebirthing. Indeed, in monergism, God gives the new birth "without any cooperative effort on the part of the individual." Afterward, Ascol summarily dismisses the TS article as not only "biblically untenable" but also in "violation of the plain reading of Article IV of the Baptist Faith and Message (BFM) statement of the Southern Baptist Convention." And, while Ascol goes on to deal with one text in particular to demonstrate his aforementioned conclusion4, I'd like to first make a few observations about Ascol's focus on "monergism" and "synergism" and second, deal with Ascol's serious indictment that the TS violates the BFM.
First, Ascol's focus on "monergism" and "synergism" is specious at best. Nothing in the TS article mentions the two terms yet Ascol overlays the terms upon the document as an interpretative grid anyway. He justifies this by adding, "In the interest of clarity, let me note that when "synergism" vs. "monergism" is discussed in Calvinism/Arminianism debates what typically is in view is regeneration." Well that depends on who one is reading. I challenge Ascol to show how Southern Baptists have historically employed these two terms in their discussions on regeneration. I searched several systematic theologies from Southern Baptists but no discussion of monergism or synergism surfaced (including Boyce, Dagg, and Mullins). Interestingly, a focus on monergism did surface in the Primitive Baptist historical-theologian, C.B. and S. Hassell.5 In fact, like Ascol, Hassell makes "monergism" as opposed to "synergism" a key component in rightly understanding applied redemption. In addition, again it must be noted that Ascol presumptuously insists on making the discussion between Calvinism and Arminianism when not a single author of the statement claims to be Arminian. It appears, therefore, rather than attempting to understand the TS authors(s) on their own terms, Ascol a priori assigns the author(s) preconceived beliefs he has already predetermined to be suspect.
The author(s) of the document in question continually and clearly concend that unless the Holy Spirit both moves initially and convincingly, a person cannot savingly respond to the gospel. No matter, however. For Ascol, all synergists are the same—semi-Pelagian. Yes, and what if non-Calvinists insist all Calvinists are the same? Or, what if non-Calvinists suggest all monergists (i.e. Calvinists) are the same, and since some Calvinists believe in eternal justification, all Calvinists believe in eternal justification? A Calvinist is a Calvinist is a Calvinist is just as meaningful as arguing as does Ascol a synergist is a synergist is a synergist, is it not? We agree with Ascol on the "importance of exercising care and precision when discussing fine points of biblical theology." Unfortunately, Ascol hardly lives up to this worthy ideal when criticizing his non-Calvinist brothers. Supposing one employs Muller's categories, the author(s) of TS could very well be confessing a view of the human will consistent with or closer to Melanchthon than developed Arminianism. However, Ascol does not give them a benefit of doubt. Instead he wrongly not to mention naively cooks all synergists into the same semi-Pelagian pot.
Incidentally, it's fairly easy to understand why Ascol refuses to accept any synergistic work of the Holy Spirit prior to the monergistic work of the new birth. His Calvinistic presuppositions prohibit such a work of the Holy Spirit. Not only does Ascol's view of total depravity (i.e. total inability) prohibit such a work, but also his understanding of irresistible grace will not allow a work of the Spirit prior to the new birth put a fallen human being in a position to freely choose Christ or freely reject Him. One could add Ascol's view that faith is a gift of God given only to the elect as also prohibitive of his accepting a synergistic but effectual work of the Holy Spirit prior to God unilaterally bestowing the new birth.
Third, Ascol's contention that the author(s) of TS is contrary to the Baptist Faith and Message is spurious on the one hand and just short of fabricated on the other.11 Calvinists continue to publicly assert that the Baptist Faith and Message is a Calvinistic document when it remains historically clear that the Baptist Faith and Message, beginning in 1925, was a definitive theological step away from the High Calvinism of Boyce, Manley, and Dagg. If Founders-type Calvinists like Tom Ascol, Tom Nettles, and Al Mohler want to decry the loss of Calvinism among Southern Baptists as a wrong theological turn in our history, they are free to do so. What they are not free to do, however, is reconstruct Southern Baptist history into their own liking. For Founders Calvinists to claim on the one hand that Calvinism sorely waned beginning during the first quarter of the 20th century and only began to be recovered during the last quarter of the same century but insist The Baptist Faith and Message (1925, 1963) remains a Calvinistic confession is as incredulous as it is unconvincing to anyone who reads Baptist history as any level.
Hence, to suggest not only that The Baptist Faith and Message reflects the view that "regeneration precedes faith" in the order of applied salvation (as Ascol does) but also that imputed Adamic guilt is explicitly affirmed can only be taken as wishful rhetoric. Southern Baptists must not allow Baptist Calvinists like Nettles, Ascol, and Mohler rewrite her confessional history into an exclusively "Reformed" faith.
7 Lewis Sperry Chafer, Systematic Theology (Grand Rapids, MI: Kregel Publications, 1993). 88.
Does anyone else get the feeling that both Mohler and Ascol feel they have to press the semi Pelgaian charge? My guess is that this has been presented so much as the real argument against traditionalists for so many years, they have to make it stick or lose face. EVen though you and others have made very good cases for historical misunderstandings of the charge. Even showing how certain scholars they used as proof were not quoted in entirity. Something I have found coming out of SBTS on other issues and it bothered me greatly.
One of the most interesting results of this entire debate are the YRR in comments questioning the BFM. You can hear the doubt in their comments even if they do not come out and say it. Me thinks a can of worms have been opened that might prove uncomfortable for the SBC Calvinist leadership.
Another interesting aspect of this whole debate are many non SBC Calvinists coming over to debate. Nothing wrong with that at all. Just quite interesting. They are most likely T4G or GC followers and see "Calvin" as their responsiblity to defend. But they sure think we are ignorant peasants and are not shy about saying it. I wish I could find the talk Driscoll gave speaking of how backward the SBC was. He was spewing venom as usual. And we wonder why the influence?
As usual your keen insight into nuance is proving to be helpful in articulating the points. Humorously, the nit-pikers perhaps disdain your nit-picking, but it will turn out to make a fine piece of fabric. Kudos on this point.
FYI, Tom Ascol has a free download of a book format of all his posts, including some remarks by Tom Nettles.
BTW: I think Al Mohler should have been censored by the Trustees of SBTS for the comments in his response concerning his learned brothers not believing what they signed and suggesting they lean toward heresy. Allowing him to get by with such arrogance will only bring more and keep his YRR followers as arrogant and whiny as ever.
But my guess is that the trustees are yes men of his.
Lydia, the tweets coming from the YRR crew have been pretty bad all day.
Have you seen the new Lifeway Poll? Calvinists are intepreting the resuls as SBC is now half Calvinist half Arminian. Of course the Calvinists are ignoring the questions the poll asked which pretty much makes it worthless for determining anything about the SBC, but I imagine Stetzer's agenda has been met.
I don't have a dog in the SBC fight, but this is an excellent post for other reasons as well. The sequence of Salvation you post is how I have understood Salvation since I was raised in the Church of God (Cleveland, TN). As I recall, it is also how Arminius believed, although it's been quite awhile since I've read his works.
I hope you don't mind me quoting this post. I have a Baptistic Calvinist friend that could use a trip here. He normally doesn't do the innertubez much, but I hope he will break down and come when I send his wife the url.
Greetings, Dr. Lumpkins. It has been many months since I have commented on your site; I trust you are well and that God's blessings abound to you in His amazing grace.
I was going to note a few things, but will focus on just one -- the issue of monergism and synergism. I would agree that this is the main dividing issue between "Calvinists" and, well, everyone else, be they Arminian, semi-Pelagian, or "TS" as it were, and it matters not if one's synergism is that of Melanchthon or Arminius or anyone else. The issue remains the same.
"....the pure teachers of the Augsburg Confession have taught and contended that by the fall of our first parents man was so corrupted that in divine things pertaining to our conversion and the salvation of our souls he is by nature blind, that, when the Word of God is preached, he neither does nor can understand it, but regards it as foolishness; also, that he does not of himself draw nigh to God, but is and remains an enemy of God, until he is converted, becomes a believer [is endowed with faith], is regenerated and renewed, by the power of the Holy Ghost through the Word when preached and heard, out of pure grace, without any cooperation of his own.
7] Namely, that in spiritual and divine things the intellect, heart, and will of the unregenerate man are utterly unable, by their own natural powers, to understand, believe, accept, think, will, begin, effect, do, work, or concur in working anything, but they are entirely dead to what is good, and corrupt, so that in man's nature since the Fall, before regeneration, there is not the least spark of spiritual power remaining, nor present, by which, of himself, he can prepare himself for God's grace, or accept the offered grace, nor be capable of it for and of himself, or apply or accommodate himself thereto, or by his own powers be able of himself, as of himself, to aid, do, work, or concur in working anything towards his conversion, either wholly, or half, or in any, even the least or most inconsiderable part; but that he is the servant [and slave] of sin, John 8:34, and a captive of the devil, by whom he is moved, Eph. 2:2; 2 Tim. 2:26. Hence the natural free will according to its perverted disposition and nature is strong and active only with respect to what is displeasing and contrary to God."
So then, when we say monergism, we mean something that God does to bring about the new birth that results in a believing responder, believing the Gospel he or she has heard. This would be a logical order rather than a temporal one, but it is still an order that must be affirmed if one would affirm what the formula of Concord says above (or any Reformed confession for that matter).
So no, the authors of the TS statement would not be monergistic according to a Calvinist, Baptist or otherwise.
Thanks for the response. First, you deny it matters if one's synergism is that of Melanchthon, Arminius, etc. which seems directly contrary to Muller's definition. If I must choose between your and a recognized Calvinistic authority's understanding, no offense, but I choose the latter. Second, just on the surface it most certainly does make a difference concerning one's understanding of "synergism"--for example, the difference between believing the Bible at certain junctures or not (cp. Jn 6:44). Third, the last time I checked, David, there is no official spokesperson for all Calvinists which your statements twice seem to suggest--"Calvinists would not...when we say, we mean..." Calvinists are not as monolithic as you seem to indicate.
Fourth, congratulations are in order. So far as I can tell, no Baptist Calvinist has ever--ever--appealed to a Lutheran Confession of Faith on this blog or others blogs I have read. Nor has any major figure in Baptist history appealed to Concord to get his theological marching orders on the new birth. While I obviously have not read exhaustively Baptist history, I have dipped into it perhaps more than the average Baptist. Nonetheless, if I am mistaken, please educate me.
Fifth, I do not accept the categories of "temporal" and "logical" you cite above and believe them to be false categories imposed upon the Word of God. Neither can be exegetically mined from the text of Scripture but must be read into the meaning of Scripture. These scholastic hermeneutical ploys are much of the reason we as Southern Baptists find ourselves in this debate today. So far as I am concerned, Calvinism is a systematic template overlayed on the straight-forward reading of God's Word.
Obviously you believe that Calvinism is a systematic template overlayed on Scripture otherwise you would accept it I would suspect. :) Truth is, exegesis must lead one to any conclusion, which is why I affirm what Concord said at the point I cited. Surely you must know that I by no means affirm the whole of the Formula of Concord just because I agree with a certain portion of it. I merely brought it up because the quote you referenced mentioned it as being opposed to Melanchthon and also semi-pelagians. Both are synergists (or perhaps more properly, groups of synergists), and both therefore disagree with monergism. So, even though there are differences in various kinds of synergism, at the end of the day, all of them involve something more than the Spirit of God involved when it comes to bringing someone to spiritual life.
You mentioned John 6:44 -- this is as important as verses come when we are discussing man's ability to respond to the Gospel. An exegesis of this text (more properly, 6:35-45, perhaps as far as 65 or at least including it) would be tremendously helpful. What I am sure you have noticed when these kind of conversations go on is that there is often, in fact, nearly always, more light than heat. One person says, "I believe this, and you misrepresent me!" The person on the other side says, "No, you are mistaken, because what you believe is refuted by what I believe, and you are the one misrepresenting!" and on it goes. The only way to solve any of it is to do solid exegesis of a text that is disputed (such as John 6 above) and see which side is using consistent interpretation to arrive at one's conclusions. Let Scripture decide between us -- we are people of the Book, after all -- aren't we?
You said, "Calvinists would not affirm that definition of monergism, but would affirm the statements contained in the Formula of Concord about free will..." Now you're saying you "merely brought it up" because the quote I referenced mentioned it as being opposed to Melanchthon and also semi-pelagians. Yes, it was in Muller's definition. Now, care to cite where Baptist Calvinists employ the FC to define their understanding of the new birth and/or free will? That was the challenge, remember?
And, while I haven't the least reservation in affirming Jn.6:44 pertaining to ability, it says nothing about irresistibility which Calvinists like yourself demand it bear. There's nothing else to say, David. We just are not going to come to any kind of agreement on this issue. Baptists in the south have been divided on this since the early 1800's. I'm perfectly comfortable with you believing as you do. What I am not comfortable with and refuse to allow without push-back, is for your view--or even mine for that matter--to become the default view of the SBC. It ain't gonna happen--not without a fight it's not.
I would indeed love an exchange on certain texts, especially John 6:44 and Romans 8:29-30. I don't doubt you would affirm that people cannot come to contradictory positions and both be right, and that Scripture's meaning is not many but one in a given passage. So, if two people come to different conclusions, one or both of them must be wrong of necessity, and the wrong one(s) are being inconsistent in how they are handling the text in some way.
Truly, the Word must define us. Just because there has been disagreement for a long time is nigh unto irrelevant -- if we cannot discuss the Word, then why bother having any kind of discussion at all?
Who is the "him"? What does the text say happens to this "him"? What then is this drawing that the Father does?
A) These are your words, David, not mine: "Calvinists... would affirm the statements contained in the Formula of Concord about free will". And, again, "when we say monergism, we mean...This would be a logical order... that must be affirmed if one would affirm what the formula of Concord says above (or any Reformed confession for that matter)". Now you're welcome to say you didn't mean what your words specifically imply. Fine. But do not suggest to me your words didn't imply the Concord confession defined not only your position, David, but Calvinists' (plural) position. They are clearly there for anyone to examine.
B) I am uninterested in a round and round about Jn. 6:44. I've read James White's arguments about it and I'm confident you'll have identical "points" to explore. Uninterested, David. I cannot state that any stronger. The exception would be when and if I post an exposition on the text. Then you are free to examine my conclusions all you wish.
Well, Dr. Lumpkins, all I can say is that you inferred something I never intended to imply. If you refuse to believe me, then well, I guess you will believe what you will.
Further, the lack of exegesis in general is what continues to make much of this conversation (not just ours, but the one in the SBC in general) fruitless. Unless that gets resolved, then we fail to make any progress at all.
I hope you do post an exegesis. It would be refreshing. I'll sit out until then.


Wickedness over righteousness – Jer 8:6-7 – they didn't care whether what they were doing was wrong. No man repented. No man asked "What have I done?" They completely ignored the judgment of the Lord. So, they pursued idolatry [Jer 8:2], adultery [Jer 9:2], covetousness [Jer 8:10], burning their sons and their daughters in the fire [Jer 7:31], and so forth. They kept all this up until the Lord finally destroyed Jerusalem because they wouldn't turn.
Education over wisdom – Jer 8:8-9 – they rejected the word of the Lord. "There is no wisdom, nor understanding, nor counsel against the Lord," [Prov 21:30]. Solomon said, "Cease, my son, to hear the instruction that causeth to err from the words of knowledge," [Prov 19:27]. Yet they said, "We are wise." And the truth is that there was no wisdom in them. There is a major difference between education and wisdom. You can make a living with an education; but you don't learn to live without wisdom. Their education took them further and further down.
Lies over truth – Jer 8:9-10 – "everyone dealeth falsely." Everyone was lying. Even the prophets and the priests were lying. And do you know why they were lying? Because that's what the people wanted to hear [Jer 5:30-31; 6:10]. Covetousness was the key here. They told the lies because that's what got them into power and that's what paid. The love of money is a huge reason why people lie. When you get used to that kind of money by telling lies, there is no going back.
Treaties over peace – Jer 8:11, 15 – Judah had a history of negotiating leagues with other countries for their own protection. They were "at peace" with Egypt and with Syria and had paid Assyria to fight with them as well. All of these countries turned against them. Those treaties were not lasting peace. They won't have lasting peace until the Prince of Peace, the Lord Jesus Christ, is reigning on earth. In the meantime, they could have had peace and protection from the Lord if they would have obeyed him [Deut 28].
Health over salvation – Jer 8:15, 20 – their interest was in their physical health. And what they had forgotten is that their physical health was tied to their salvation. If they had concerned themselves with their spiritual relationship to the Lord, they would have had health. But when their physical health became more important to them than their spiritual well-being, they lost their spiritual relationship with the Lord and their physical health. Look at the medical condition they were in when Jesus came to seek and to save that which was lost.
These are the same preferences that the Pharisees had during the ministry of Jesus. And because the Pharisees preferred these things as outlined below, they too were in perpetual backsliding.
Wickedness over righteousness – Lk 11:39 – they were only interested in the appearance of righteousness.
Education over wisdom – Jn 7:15; Lk 2:46; Mk 7:7 – they prided themselves on their education and tradition.
Lies over truth – Jn 8:41, 44, 55 – they didn't know the truth [Jn 8:32] and they didn't want to know the truth [Jn 8:45].
Treaties over peace – Jn 11:48 – their peaceful existence under Roman rule was more important to them than their eternal peace through Jesus.
Health over salvation – Mk 7:3-4 – there tradition was for hygiene. Yet Jesus said that you can clean the outside but until you get saved the inside is still filthy [Mk 7:21-23].
And the Lord eventually destroyed them for the same reasons that he destroyed Judah centuries before. He couldn't turn them away from the things that caused them to backslide.
Conclusion: These are the same preferences that we have in our country today. Americans prefer wickedness, education, lies, treaties and health to righteousness, wisdom, truth, peace, and salvation. Brace yourself. These preferences have caused perpetual backsliding in America. The laws are becoming increasingly immoral in this country. Furthermore, you can be sure that the results of this backsliding will be the same as they were in Judah. America is in terrible decline toward destruction.
Do not get swept up into following these preferences in your own life and you won't get taken in the same perpetual backsliding that took Judah and Israel under the Pharisees.


« A family musical story ». A father's love of music passed on to his two sons. Featuring on some of France's biggest TV shows and accompanying both national and international artists, it wasn't difficult for Jean-Luc Dupré to share his talents with his family.
Ludo, a violin teacher was awarded first prize at the Toulouse Conservatory and found the perfect alchemy between the discipline of classical music and the improvisation of Jazz.
Brother Maxime, guitarist and drummer, has meanwhile developed an undisputed talent for his writing and improvisation.
Their repertoire is chosen by the heart and performed with talent.
A magical moment not to be missed!
Rendezvous Thursday 15th June at 8pm !


text:
''The People's Court'' and ''Judge Judy''
''The People's Court'' and ''Judge Judy'' -- Viewers find in favor of lady justice
May 15, 1998 at 04:00 AM EDT
The verdict is in: Judge Judy rules. Former family court judge Judy Sheindlin's show now nearly doubles the ratings for ex-New York City mayor Ed Koch's revival of The People's Court — and has even surged past heavyweights Rosie O'Donnell and Regis & Kathie Lee in the syndicated daytime arena. "I just think it's a testament to the good taste of the American viewing public," proclaims Sheindlin.
The reason for her success is simple. Judge Judy is far superior to Court. Sheindlin has no time for the nickel-and-dime cases that Koch routinely hears (he spent 20 minutes on a woman who lost a tooth after biting into a soft pretzel). "I hate what I call laundry-list cases: I loaned him —35.76 in June of 1996," says Sheindlin. "It's not about taking your shirt to the cleaners and losing a button." Instead, Judge Judy fills her docket with more emotionally charged disputes — bitter ex-fiancees, battling cousins, disgruntled bikini models.
When the short-tempered Sheindlin blows her top, she's a one-woman Jerry Springer Show melee. "You are one lying sucker!" she barked at a defendant. Even perpetual kvetch Koch seems a wallflower by contrast; he's still too much the politician, letting litigants ramble on endlessly.
Sheindlin's take-no-prisoners style has tapped into the public's growing resentment of the legal system. In the post-O.J. world, people crave a jurist who lays down the law with common sense. "I'm not doing anything differently from the way I did business for 25 years," says Sheindlin, who, ironically, was appointed to the bench by Koch. "You want to throw the bull, go someplace else." Judge Judy is the anti-Oprah: She doesn't empathize with anyone. I don't know if I'd want her presiding over my case, but she makes for great, guilty-pleasure television.
In a certain sign she's charged into the pop-culture consciousness, Judge Judy parodies have become a fixture on Saturday Night Live this season, with Cheri Oteri as the exaggeratedly feisty star ("Don't give me rabbit poop and tell me that it's chocolate!" she snapped, in a riff on the title of Sheindlin's book Don't Pee on My Leg and Tell Me It's Raining). "I think it's great," says Sheindlin of the sketch. "I told Cheri Oteri, 'You've almost got it down — keep working on it!"'
The People's Court is doing some tinkering of its own in the struggle to catch Judy. The show is undergoing a face-lift that started May 4. Gone is anchor Carol Martin, who gave the proceedings a pointless veneer of Court TV-like respectability. Harvey Levin, however, continues to do his moot interviews with mallgoers watching the cases (a typically irrelevant observation: "He looked like he was making up his story"). "They found that people wanted more cases and less in-between talk," says Koch of the changes. "Now I'm on for more of the program. I love it!"
Viewers may not share the love, especially when Hizzoner Koch is challenged by this fall's spate of new syndicated courtroom shows (including one hosted by Tyson-Holyfield ref Mills Lane). Koch seems unconcerned about imitators: "That's the sincerest form of flattery." Sheindlin is equally philosophical: "I've got a husband I get a kick out of, grandkids I'm nuts about — I'll be fine. If the competition beats me up, they beat me up!" So, she really thinks some Judy-come-lately could overrule her? As the judge herself often says, "Baloney!" (Reported by Kristen Baldwin)


Enthalpy of Feed water - 105 kcal/kg - You will get this value in steam table. Fuel - Bagasse with Fuel Required for 1 TPH Boiler is 351.6 kg/hr. That means by .
boiler horsepower, 1 kcal /h = 0.0001185793712 BHP, 0.0001185793712 × Pkcal /h = PBHP calorie per hour, 1 kcal /h = 1 000 cal/h, 1 000 × Pkcal/h = Pcal/h.
convert capacity of boiler from tph to kw CFBC Boiler . Equivalent Steam- Boiler Model Kg/hr. basis of latent heat of 489 kcal/kg at 7 Pressure 1 kcal /h.
View 3 Tph Steam Boiler For Sale, details & specifications from Maruti Machinery Package Boiler , Oil Fire Boiler , 5 TPH Smoke Tube Boiler 1 Kcal is the.
CONVERSION OF BOILER IN KG/H AND KW (Approximate) G.B. and U.S.A. Steam from and at 100°C Boiler HP Pressure 1 kcal /h. In kW 1 5 10 15 20 30 30 tons per hour boiler ZBG Boiler Harmony with 30 tons per hour boiler .
Conversion unit, units, Flow rate, pressure, thermal, energy, calorie 1 kg of water at 15°C under 1 atm = 4.1855 kj/kg °C or 1 kcal /kg °C · 1 kcal = 1.163 w.


I am going to leave this up, as it may be useful to members and you seem to be offering it free.
But please note that this board has a non commercial spam policy, and linking to users private sites is usually not welcome.
Last edited by Footymadstreams; 22nd June 2013 at 13:22.
Please note when you access the live streams section "todays schedule isnt suitable for asia,please use the other streams"
Last edited by Footymadstreams; 22nd June 2013 at 13:43.
So this is just a collection of publicaly visible streams online..
Downloaded any good Films ?
Sport Lemon TV is good for free sports streaming too.
Loop, do you DL the desktop app for that website?
^ i never download the desktop app. Always use streaming.


Cecum diverticulosis is an uncommon condition in the Western world, its prevalence is based on several factors, such as nationality, culture and eating habits, with approximately 85% of the diverticula occurring in the descending and sigmoid colon. However, cecal diverticula present an incidence of more than 71% in Asian countries. They are divided into two types: the real ones, which have congenital origin, appearing during the sixth week of development, and the false ones, which do not involve the muscular layer. The progression of the cecal diverticulum is usually asymptomatic; however, symptoms can be found in 10-20% of patients according to complications such as inflammation, bleeding, perforation and bowel obstruction. In this context, the main complication of the cecal diverticulum is cecal diverticulitis, which was first described by Potier in 1912. Its signs and symptoms are very similar to those of appendicitis, such as abdominal pain in the right iliac fossa, nausea, vomiting, fever and leukocytosis, being the same the main differential diagnosis. In addition, it is important to note that the diagnosis of cecum diverticulitis is sometimes performed during the intraoperative appendectomy. Therefore, we will report the unusual case of a patient, who was submitted to surgery for suspected appendicitis and during the intraoperative period it was observed that he had diverticulitis of cecum.
Patient, 42 years old, male, reported a lancinating pain in the lower right quadrant of the abdomen for 48 hours, associated with episodes of unmeasured fever and chills, denying vomiting, adynamia and changes in bowel habit. Physical examination revealed the presence of localized tenderness and painful decompression in right lower quadrant of abdomen, described as a Blumberg signal.
A hemogram showed 9,800 leukocytes per mm3. The patient had undergone a surgical procedure. It was initially performed as a Davis incision, which revealed hyperemia of the vermiform appendix and inflammatory mass surrounding a perforated cecum. So, the surgical team changed to xipho-pubic incision in order to perform a ileotiflectomy. The bowel transit was reconstructed by side-to-side ileotransverse anastomosis. The patient recovered well in the postoperative staying and was discharged after 6 days. Histopathological examination revealed: diverticular disease of the colon with diverticulitis and perforation associated with lymphoid hyperplasia of the cecal appendix.
Some clinical manifestations can be used as conner stones that may help in suspicious case of cecal diverticulitis. Pain usually has a longer history and its onset is primarily in the right iliac fossa, where it remains. In acute appendicitis, the pain usually begins in the abdominal central region and then irradiated to the right iliac fossa. In addition, vomiting, nausea and anorexia are more common in acute appendicitis.
In conclusion, although cecal diverticulitis is a rare condition in Western countries, it should always be a differential diagnosis in cases of pain in the right iliac fossa, especially in cases of suspected acute appendicitis with unusual clinical features. Thus, in these cases, it is necessary to request complementary imaging tests to perform the correct diagnosis in the preoperative period and, in this way, to perform the most appropriate treatment according to the grade of diverticulitis.
Papapolychroniadis C, Kaimakis D, Fotiadis P, et al. Perforated diverticulum of the caecum. A difficult preoperative diagnosis. Report of 2 cases and review of the literature. Tech Coloproctol. 2004;8(Suppl 1):s116–s118.
Kyziridis DS, Parpoudi SN, Antoniou ND, et al. Cecal Diverticulitis is a Challenging Diagnosis: A Report of 3 Cases.  Am J Case Rep. 2015;16:206–210.
Sahoo R, Kunar BM, padhi B, et al. Perforated solitary cecal diverticulum: An etiological challenge at emergency. Journal of Acute Medicine. 2016;6(2):49–51.
Karatepe O, Gulcicek OB, Adas G, et al. Cecal diverticulitis mimicking acute Appendicitis: a report of 4 cases.  World J Emerg Surg. 20018;3:16–19.
Koshy RM, Abusabeib A, Al-Mudares S, et al. Intraoperative diagnosis of solitary cecal diverticulum not requiring surgery: is appendectomy indicated?. World Journal of Emergency Surgery. 2016;11(1).
Salemis NS, Grapatsas K, Matzoukas I, et al. Perforated posterior cecal diverticulum: challenges in establishing an accurate preoperative diagnosis of a rare emergency.  Am J Emerg Med. 2015;33(3):475.
Kalcan S, Başak F, Hasbahçeci M, et al. Intraoperative diagnosis of cecal diverticulitis during surgery for acute appendicitis: Case series.  Ulus Cerrahi Derg. 2016;32(1):54–57.
©2018 Neto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.


So, what if someday there comes along a really charismatic Jesus preacher, just like so many folks are hoping. And what if this Jesus preacher just gets everyone's ear over some mass-mediated kind of electromagnetic ether, and announces the rapture. We'll allow for asynchronous communications like podcasts here, so let's say he (you can't really imagine a woman doing this, can you. Oh, yeah, well there is Sarah Palin . . . ) announces a time when this will happen, and then tells everyone to get ready.
So people would be put to the test. If their faith is real, then they will know that Jesus will be there for them, and the rest of us will be left behind. Well, there will be lots of Catholics left behind too, since they don't do that kind of faith, and their patriarchs would counsel common sense. There'd probably be a lot of crossing going on behind closed doors.
Sensible people would also be made aware of these announcements by the evil mainstream media. MSM would almost certainly have to get wind of the pending rapture since there are so many born-agains in the world that they can hardly keep it secret. I mean, I doubt there are enough encyryption keys to go around for that.
And so sensible people would definitely stay clear of the highways when the moment arrived, perhaps even locking their doors, and plugging their ears against the mayhem.
Hopefully, people wouldn't do a half-assed insurance policy kind of faith which is so popular now among Christians. The kind of have-your-cake-and-eat-it Christianity, where it's good to get rich so long as you get the right kind of entertainment on Sunday. That would create a God-awful mess of bloodshed beyond our best-on-the-planet (NOT) healthcare system's ability to clean it up. These people would have a tough decision between their paradise already set up on earth, and the promised one in heaven. They'd probably hedge their bets, I'll just bet.
No, you'd want a really charismatic preacher who would have people aim their cars at each other, turn off the airbags like they do for their kids, or maybe aim right off the cliff, although there can't possibly be enough cliffs either. Hmmmm.
Still, I think we have the technology to make this happen. Lots of God and Country loving people could just point their guns right in their loud mouths, and then bang, evolution would take one giant leap forward in an instant.
All the enraptured people wouldn't know the difference, and I'm pretty sure since I did die once (does that make me born-again?), that they will be in eternal bliss for the second between bang and brain dead. The narrative of one's life expands to perfect stasis -I know for an actual fact - with every detail there before you in nearly vivid color, and I'm sure Jesus would condescend for one last appearance too, to the minds of the faithful.
And the ones left behind would be, well, the evolved ones. Along with enough well-schooled theologians to explain to us that Jesus was only ever real in our hearts and minds. It was never the history which made the magic, although for sure tricking people into faith has a kind of logic to it. Until it backfires. Bam!
Oh, sure OK, I know what you're going to say. What about the technophiles, like that crazy Ray Kurzweil who thinks he's gonna get eternity just by thinking really hard. None of them will take this bait, and so they'll be peppered in among the sane people and the Catholics.
Well, they're smart. They can be a kind of worker-bee class, making widgets for the rest of us on the promise to them that when they achieve their immortality, they can have it!
And so the rest of us will not only be left behind, but we'll have cool widgets to keep us from the creepy crawlies of the earth, but, you know, removed so as to cause no harm. Back in our wombs with a view. Touching nothing that we can hurt. But feeling very much as if we were, virtually, alive!
And outside, life will start all over again without us. And we can watch it on TV, across the generations, eternally, and buzzed.
Hey, you never know! It's a lot nicer than the scenarios I hear from rich folks about how "we're all fucked". And they're in a perfect position to do something about it. It's just an idea is all. The kind you can throw out there for nothing, that's you know, worth about nothing.