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FreeSysInfo 1.4.4
FreeSysInfo allows you to discover system and network information on your local machine or network computer. The tool used WMI ( Windows Management Instrumentation ) to discover full NDIS information, wireless network status and type, network adapters, system processes and services, serial communications and display information, hardware and connections status, user and system accounts, proxy settings, shared resource information and more.
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Europa All American Video Poker Online 3
Europa All American Video Poker Online - download and play. No installation needed. The object of All American is to obtain a five-card poker hand that contains a winning combination. The better your hand, the bigger the payout (see the paytable on the machine) . You choose how many and which of your cards are to be replaced. You may replace your cards only once.
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Europa Aces and Faces Video Poker Online 3
Europa Aces and Faces Video Poker Online - download and play. The object of Aces and Faces is to obtain a five-card poker hand that contains a winning combination. The better your hand, the bigger the payout (see the paytable on the machine) . You choose how many and which of your cards are to be replaced. You may replace your cards only once. After each round, used cards are returned to the decks and the decks are shuffled.
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Counterun 1.0
Civilization is in danger from an enemy cruiser with nuclear bombs on board. Your robot is tasked to clean up the base of the enemy within. He is strapped with 4 types of unique weapons: Machine Gun, RC Car, Hop-Stopper and Ion-holder.
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Cubes In Cubes 1.0
Civilization is in danger from an enemy cruiser with nuclear bombs on board. Your robot is tasked to clean up the base of the enemy within. He is strapped with 4 types of unique weapons: Machine Gun, RC Car, Hop-Stopper and Ion-holder.
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Europa 2 Ways Royal Video Poker Online 3
Europa 2 Ways Royal Video Poker Online - download and play. No installation needed. The object of 2 Ways Royal Video Poker is to obtain a five-card poker hand that contains a winning combination (see the paytable on the machine). The better your hand, the bigger the payout. You choose how many and which of your cards are to be replaced. You may replace your cards only once.
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eMachines Drivers Update Utility 4.7
eMachines Drivers Update Utility updates your drivers for eMachines Laptops automatically. It will scan your system first then download and install eMachines official drivers to let your eMachines Laptop work properly. The eMachines Driver Update Utility keeps your eMachines laptop Windows system up-to-date. It detects which driver updates are relevant to your computer, and then helps you install them quickly and easily.
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Slot Machine 1.4
The goal of the game is to win big on the roulette wheel. And if luck goes your way, you will get rich. You start with 10, and available bets when possible are 1, 5, 10 or 50. In the upper right corner the total amount of your money is displayed. Once you have selected your bet, your total is reduced by this amount.
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Za Rulem 1.4
Soviet desktop computer simulator racing game "at the wheel." This game is very close to the original, with precisely replicated game mechanics and sound design. As a new player you get a taste of the era of the first machine. The game has been played by generations. Now you can experience this landmark game "at the wheel."
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Good Scream Now II 1.6
The second part of the ill slashers game, Good Scream Now. Monsters continue killing people despite the resistance of the cruel, shouting maniac. You need to put an end to this once and for all. Gameplay is now more diverse due to the possibility of firing pistols as well as machine guns. New attacks and super attacks have also been added. Help the maniac kill these monsters.
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eMachines Laptop to Hotspot Converter 4.8
eMachines Laptop to Hotspot Converter converts your eMachines laptop to a wireless hotspot. Your eMachines laptop (Windows platform) is turned into a Wi-Fi hotspot so that you can share the Internet with your second laptop or mobile devices. Of course you do not want to carry a wireless router while on the trip. But you have to find a Wi-Fi hotspot for your mobile. Laptop to Hotspot Converter Series software make your life easier.
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Climate 1.0
It's 1998 and war is underway. The enemy has gained the upper hand. Gas Henkon, Chief riot Delta, is the only one left. He has to save everyone from the merciless soldiers who want to take over the world. The whole area is overrun by them. But not for long, because the main hero of the game is given weapons such as the sniper rifle, machine gun and more. Gas will save the world from evil. Good luck!
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War Tanks Beyond The Time 2.1
Dynamic and exciting shooting game with excellent graphics and special effects. You control a tank that can rightly be called the ultimate weapon! Your task is to destroy the enemy at all costs! At your disposal is the most modern armament of: standard cannon, rocket, machine gun, explosive bullets, and more. It is also equipped with a tank unit delay time, increasing speed, speed of reaction and repair machine several times.
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Bunker Drone 1.0
The future... A huge high-tech underground complex exists where they are developing new weapons. The betrayed and now dying scientist begs you to destroy the traitors and save humanity. But you are not a mere man but an android, all-metal killing machine, dealing death to all living things. Destroy all enemies that get in the way!
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FreePortScanner 3.1.5
Free Port Scanner is a small, fast, easy-to-use and robust port scanner for the Win32 platform.You can scan ports on fast machines in a few seconds and can perform scan on predefined port ranges. This tool uses TCP packets to determine available hosts and open ports, service associated with port and other important characteristics. The tool is designed with a user-friendly interface and is easy to use.
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Shoot N Scroll 1.0
Helicopter arcade game, suitable for novices, hardcore gamers and everyone in between. As you progress you'll face new, more dangerous enemies, new weapons and a variety of surprises. Intuitive controls use a single finger. Graphics adapted to both phones and tablets. Exciting sound effects. Ready? Fire up the propeller! - Arcade scrolling shooter - 10 levels - Helicopter with 3 different super attacks - Different machine guns and rockets - 5 ..
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D Race 2 New Challenge 2.1
D-Race 2 offers a new challenge, and is a continuation of D-Race. After the events of the first part, John decides to move to a new city and takes his need for speed with him. Beautiful graphics, excellent physical machines, and of course the breathtaking race await you. An interesting makes the game that much more enjoyable.
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CRM-Express Live 2013.4.3
CRM-Express Live is a CRM (customer relationship management) program which is under your control. It can be used on a single machine, installled on a computer on a network or installed on a dedicated server at your ISP. It is accessed from a browser on a computer,laptop, mobile phone or pad (e.g. ipad) or any device capable of browsing over the internet. Data can be shared and update is immediate - no need for synchronizing. Works in 64 languages
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Angry Balls 1.1
You are a ball in chemistry notebook and have turned against the other balls in the notebook. Using a machine gun, rocket launcher, shotgun and shield generator you deal with the indignant crowd. This game is based on points which will be recorded in the online high score table. 4 types of mobs and one boss force you to run on the field, and 5 types of bonuses will give you a chance to hold on to at least the fifth level. The game has three modes
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Game Product Key Finder 1.1.3
Game Product Key Finder recovers product keys for thousands of popular games installed on your local or remote network computers. In order to install Electronic Arts, PopCap and GameHouse Games, you must have access to a product serial key (CD Key) for that product. Game Product Key Finder retrieves serial keys from local machine or network computers and allows to protect your company from having pirated software on your network.
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Nsasoft Hardware Software Inventory 1.3.6
Nsasoft Hardware Software Inventory is a cost effective and powerful network inventory software for home, office and enterprise networks. The software scans all computers on a network and generates complete reports about computers hardware and software on remote machines. This information is added to the centralized database and then users can generate reports about each or all of the PCs on a network.
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One Way Ticket 2.4
Yet another excellent shooter from Falco Software. Fight to survive under the most difficult conditions. Terrible zombies including huge snakes and the awful Boss which appears periodically, won't give you a break. Outstanding graphics, realistic effects and atmospheric music will immerse you in this insane world. Chain saw, pistol, AK-74, shotgun and a machine are your weapons, and you'll need them! Are you ready to save the world?
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One Way Ticket II 2.1
Many years ago, horrific zombies rose from their graves and attacked the peaceful town. Then came along a brave man who managed to stop the invasion. But now they're back. Use your trusty AK-47 to fight back against the zombies! You and you alone must hold the territory and shoot the undead. At your disposal will be a lot of weapons, including pistols and submachine guns. Light a torch and you will see, the zombies are everywhere!
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Star Defender 1.2
Star Defender is a cosmic game, in which you pilot a spaceship bristling with missiles and a machine gun. Your task is to destroy all enemies in your path, including stationary objects.
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Sky Aces Cold War 3.5
Sky Aces - Cold War is a new simulator of aerial warfare. This time, the action is taking place in present time. What could the third world war look like? Apparently, it would be all about cutting-edge weapons and space-age aviation! The side that will be more aggressive and better at controlling its jets will be the winner! In this game, you will take the pilot's seat in a machine of pure destruction.
Download now
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Rascal RiderIn the world where medicine can do wonders and citizens are kept safe from any danger, where war no longer makes the headlines and clean energy is at surplus, the society got hungry for emotions. Welcome to the world of future, where motorcycle racing got even more intense. Welcome to the world where hypnotized millions watch like motorized gladiators are taking out each other in ruthless motorcycle races. Coming soon. |
cameleon-labs is an independent game developer focused on delivering interesting gameplay experience wraped in high quality, creative content.
We are a small studio that is free to follow it's own ideas, and untied with any publisher we are ready to hear from the community in order to make our games richer and more fun to play.
Working on different stuff ranging from web aplications and database solutions for corporate clients to graphic tools and big scale game modding is how we got our experience (Object Painter video1, video2; S.T.A.L.K.E.R. Lost Alpha). And now we are going to put all of it, combined with our creativty and passion, into making some kick-ass games for you.
Please use the form below to contact the cameleon-labs team

subset: commoncrawl


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Beachy Interiors by Enrique Menossi
53 comments:
First two and last two photos are just perfect interiors in my books :)
You come see me in Europe, and I'll come to California! :D heh
The third to last picture is sooo amazing, ahh.. I wish I had a home with that much light! So beautiful.
Really nice decoration!
I have a SUPER GIVEAWAY in my blog.
You can win a pair of JEFFREY CAMPBELL shoes. Don't miss it!
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that last photo looks like such an amazing escape!!
fashionable footprints
i love the last photo!
New outfit post - In love with my zara jacket
Beautiful, and a fabulous view.
Fräulein Fatal
Fräulein Fatal
Fräulein Fatal
I love the use of wood in all these shots!
Thank you soooo much for commenting on my blog...I got overexcited when I saw your comment!!
Happy Wednesday hun xoxo
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Oh, me too! They are a beautiful dream.
Wow! Sooo cute!
Come and visit Barcelona!!!!!
I love my city ;) I'm sure you'd love it too.
such perfect interiors, really inspirational.
i want to live in all these places!
Great home inspiration, thanks for sharing
very beautiful! Wooden interiors are my favourites!
Wow! I like it so much! All is white and shiny, and Barcelona is a beutiful city.
I'm spanish and I recommend you Barcelona, Madrid and Salamanca for traveling in my country and Paris in the rest of Europe(is the most beautiful city I have ever seen ) XOXO
Gorgeous! I love anything with that Spanish Mediterranean look!!
I want to go back to Barca NOW. I cannot wait for the summer when I will go to Barcelona, Madrid, Salamanca, and Marbella.
All of these interiors look like calm, warm, and beautiful paradise.
:) Ewa
love the all white sofa! desperately need a vacation!
Club Monaco Bracelet Giveaway
ChicPear Fashion Blog: www.chicpear.com
ChicPear Bloglovin
This is absolutely breathtaking! Especially the last picture, wow!
UGH! That first picture is my dream!! Thank you so much for sharing!! xoxo Elizabeth
Oh my gosh...to have an outdoor day bed would be amazing. Those spaces are so rad. Ah..to dream.
I've had that first shot bookmarked for ages! Would DIE to have my morning coffee there...so EuroChic!
Peace. Love. LOL!
Haute Khuuture.com
I never seen an amazing house in Barcelona jeje..
Is fantastic!!
xoxo from München
La Vie Quotidienne
Very amazing interiours... looks beautiful!
Van - PureGlam.tv / Bloglovin / Facebook
Wow, what beautiful interiors! That outdoor bed in the last picture looks amazing.
Kate {Something Fabulous}
these photos are beautiful! i love the combination of wood and white... this made me crave summer so bad :)
la vie en ardena rose
Hi I'm Heather! Please email me when you get a chance! I have a question about your blog. HeatherVonsj(at)gmail(dot)com
There is not one thing I dislike here! It is all so gorgeous, simple, modern, rustic, artisan all rolled into one cute little package! I love the simplicity in his interiors!
Such gorgeous photos. I want to pack my bag too!
the las pic is indeed particularly dreamy.it makes me miss mymediterranean sea ... ;)
love the photos!!!! I love in Mykonos, Greece so all houses are like this!!!
Stunning! I love each piece of furniture!!!
You're among HOTs this week in my HOT or NOT? column about style In Moda Veritas
If you come to Europe, specially Spain, where I live, please contact me ! I am a great guide and know all great shops and restaurants in Madrid and Barcelona
What Incredible photos! x
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Representing the best of both Australian and International Brands!
Woow...this is great! :)
I definitely feel the breeze, particularly in that last photograph.
It gorgeous! You always post the most beautiful interior shots.


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Why Am I So Tired? The Many Causes of FatigueMedical Author:
Charles Patrick Davis, MD, PhD
Charles Patrick Davis, MD, PhDDr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications. Medical Editor:
William C. Shiel Jr., MD, FACP, FACR
William C. Shiel Jr., MD, FACP, FACRDr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology. One of the most common complaints that I hear when taking a history from a patient of a current illness is that the patient says, almost as an afterthought "... and I don't know why I am so tired." In most instances, this complaint is not the main reason that the patient is seeing me. In some instances, "being tired" is mentioned to physicians during a routine checkup after the patient said they have no current health concerns. So, should I as a physician treat the comment like an afterthought and concentrate on the "real reason" the patient is being seen? I could focus on the "real reason" for the visit, but if I skip asking questions about "being tired," I may miss finding out information or clues about the patient's illness and completely overlook a potential diagnosis and treatment for the patient. Therefore, the first thing to understand about "tired" is what the patient means by the word. Does the patient mean they feel sleepy or fatigued -- they are not the same. Fatigued (tired) describes a lack of energy and motivation, not feeling sleepy (although both can occur together). If the answer is fatigue, the next step is to determine if the fatigue is mental, physical, or both. Now we are beginning to narrow down some clues to the cause of the fatigue, but we (the patient and the doctor) still have a long way to go together. Fatigue is mainly a symptom and not a disease in itself. The key is for the doctor, with the patient's help, to discover the underlying cause of fatigue. The patient's input is important because accurate answers to the doctor's questions may lead the doctor toward a diagnosis or, at least, may suggest what medical tests may help provide a diagnosis. For example:
However, there are reasons that are "normal" for a person to be tired. Normal people who have intense physical or mental challenges can become fatigued. If the intense activity is halted (for example, "Whew! The exam is over"... or... "I had to really run to catch Fluffy after her leash broke"), the fatigue gradually dissipates over hours or a day. When patients describe longer-lasting fatigue or fatigue with otherwise normal activity, then it may be telling the patient and their doctor there is an underlying cause of their tiredness. So what are some common questions you may hear your doctor ask that gives clues to the underlying causes of fatigue? The first set of questions may lead to some frequently seen causes of fatigue:
The answers can give the patient and their doctor some insight into three major categories of problems that can have fatigue as a symptom:
In addition, such questions can provide insight about short-term normal fatigue such as bereavement, exercise, or changes in normal activity. The other types of questions are a bit harder for both the patient and the doctor to use as clues because if the patient responds positively, often the physician will be need some additional testing done (possibly by other doctors or tests with results that will not be immediately available to your physician) to uncover or clarify an answer. If you have a primary physician, that doctor should already have most of these questions partly or fully answered. However, the primary care doctor may not have these answers if you see multiple physicians, have not seen you doctor "...in quite a while..." or you are seeing a physician for the first appointment. Examples of such questions include:
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It may not be fast, it may not be pretty, but the Nissan Versa Sedan has one overriding virtue--it's cheap. That continues for the 2014 model year, as pricing remains... April 24, 2013 by Antony Ingram 3
At the Detroit Auto Show—a day prior to a press conference revealing full details—Nissan took the wraps off the new-generation version of its low-cost Versa... January 14, 2013 by Bengt Halvorson
When auto writers drive test cars, they're usually loaned out from carmakers' regional fleets. So when we asked for an 2012 Nissan Versa sedan to test over a four-day... July 24, 2012 by John Voelcker
Nissan announced today the next generation of its global subcompact, the Note, due to go on sale in Japan this September and Europe in 2013. Nissan North America has now... July 16, 2012 by Antony Ingram 2
Last month, we got a chance to drive the all-new 2012 Nissan Versa sedan, perhaps the largest "subcompact" we've ever been inside. We only had about 20 minutes with the car... June 20, 2012 by John Voelcker 2


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Im not sure on it myself
it would be twist
im expecting bully to turn on sting tbh
it would be twist
im expecting bully to turn on sting tbh
Superstar of the Year (2011)
World Heavyweight Champion Aug 29th (11) - Oct 30th (11)
EWNCW Champion Nov 28th (11) - Apr 16th (12)
High Voltage with Ryan 'The Freak' Wells
BWA Undisputed World Tag Champions Feb 19th (12) - March 18th (12)
Current Superstar
Jack Phenix
Current SuperstarEWA (Closed)
FURY TV Champion Nov 20th (11) - Jul 27th (12)
just because i didn't agree doesn't mean i didn't listen, it just means you were wrong. Now go away please.
Check out my new film about my battle with cancer. https://vimeo.com/65258301
How many of you reading this know about a Bone Marrow transplants?
and how many of you are registered on the donor list?
find out how easy it is to join and donate. (No pain)
THanks Guys
© 2011 eWrestlingNews, All Rights Reserved.


text:
A - Z Site | Directories | Contact | Portico
The Office of Vocational Discernment and Career Services is here to serve Fuller students and alumni/ae in the areas of discerning vocation, planning career, and searching for employment throughout their seminary education and into their ministries and careers.
We seek to connect local, national, and international employers with Fuller students and graduates. Potential employers may post a job opening or view student and graduate resumes in our database.
To make a vocational discernment or career counseling appointment, email firstname.lastname@example.com or call 626-584-5358.
To access our online services, click on one of the links below.
To view our legal policies, Click Here.
Fuller Home
Contact Us


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• A man was shot on the train at Gray's Crossing.
From the annals of 1962
• The Kiwanis Club was to hold a clothing drive.
• Slade-Smith Real Estate opened in Griffin. It was owned by Dan Smith and Dan Slade.
From the annals of 2007
• A total water ban was in effect.
• The Spalding softball team beat Woodland 7-0. Jenni-Lynne Smith allowed one hit.
• Griffin Christian quarterback Christian Lawver was named The Griffin Daily News "Player of the Week."


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The Resources page contains biking articles from around the world. These articles are updated frequently, and this section will provide you with resources on all things bike and transportation. Want to watch a video on commuters in Holland or know about Philadelphia's latest bike plan for the future; this is the place to find the information.
If you wish to become a bike explorer check out the Bike Map section in Resources. The maps may not get you across the Atlantic but hopefully they can give you the best route to take in Philadelphia. The maps are as up to date as possible to provide you with accurate information.


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Quick View
Green Hill
Regular Price: $17.99/EA
Special Price: $14.99/EA
Looking for something that's both creamy and unusual? Find it in this handmade beauty, created with milk and cream of a grass-grazing herd in Georgia. You'll also discover an amplified buttery flavor, thin rind over a silky texture, and inner peace. Read More -
Cave Aged
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Little Big Apple
It starts in Vermont with a triple cream dream, before landing in the Murray's Caves for our Big Apple spa treatment: a wrap of local apple leaves soaked in apple brandy, leaving a cheese redolent of tree fruit, foraged mushrooms, and pure fall. Read More


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Begonias are an extremely popular bedding plant – and for good reason! Their non-stop flowering and ability to grow happily in shady conditions makes begonia plants a superb choice for beds, borders, patio containers and hanging baskets in any situation. You'll even find fragrant varieties in our great value range! Begonia tubers can be lifted in the autumn and stored over winter for a fabulous display year after year. For help planting begonias see our guide to planting bulbs and view our informative video.
Begonia 'Lotto Mixed'Customer Review RatingTwice the size of the normal begonia varieties, Begonia Lotto Mixed comes in a show-stopping array of colours. Plant them in groups in containers or along the margins of the border for summer-long colour. Height and spread: 30cm (12"). Supplied as plug tray plants. More info |
Begonia 'Peach Melba' (Trailing)A gem of a plant with double flowers in hues of orange and peach set above lush foliage. Stunning in hanging baskets and containers where they will bloom from pendulous stems all summer until the first frosts. Height and spread: 45cm (18"). Standard tuber size 3/4cm.Culinary information: Some parts of these flowers are edible. Click here for more details about edible flowers. More info |


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Book Name The Ascendant
There are lots of different approaches to astrology, what it is, where it comes from and why, but there is one umbrella phrase which unites most students and practitioners, and that is: "astrology works." That is to say, if you see a lot of charts over a long period of time, there are certain elements and characteristics of signs, planets, and houses that stand out individually, which repeat over and over again, enough to show you there's something to it. Recognition of those elements and how to spot them is what being a good astrologer is all about, and it is what the eager student most fervently seeks.
That's what you see in the details of Jodie Forrest's book on the Ascendant, especially in its "cookbook" sections of how different signs, planetary rulers, and their house positions show up in unique, identifiable patterns and quirks. You'll find yourself immediately recognizing the modes of dress, action, style, and substance (or lack of it) that characterize the individual Ascendant and its modifiers, the most obvious and physical manifestation of the horoscope. This includes fun and insightful peeks at national character, physical appearance, rectification tips, and all kinds of other observations that help clarify what makes up any given personal appearance.
The author also goes into what a personal appearance really is — how much of that physical interface with reality comes from what's behind it (your Sun and Moon) and what's in front of it (other people's reactions and expectations) and how you craft and maintain your borders in order to make the best of what you're born with. She suggests a variety of thought experiments that are particularly useful in figuring it out for yourself and applying and building on what you learn from your observations. Thought experiments – from Newton's apple to Einstein's elevator and Schrodinger's cat — are often the most approachable entry to the more seemingly complex areas of how things work, and Foster makes good use of them.
She also uses practical metaphors for the Ascendant like the "vehicle" (are you a Land Rover or a Buick?) and good movie and acting citations (though it helps to have seen the movies). Try, she suggests, turning the sound off on a good movie you've never seen and watch how skilled actors using their Ascendants say so much more than just what's in the script. Suggested associated costumes, environment, and types of behavior are included for a variety of Ascendant sign/planetary combinations. All these approaches help you see what actually comprises the Ascendant, how people use it, and how the language of astrology helps better to observe, explain, and understand it.
The only shortcoming here may be the attempts to attribute these wonderfully clear and obvious external personality characteristics to some deeper structure, specifically either Jungian psychology or reincarnation, or both, which muddy the waters a bit, but can be skipped without mishap. The fact is, since the planets and their rhythms predate all human activity and subsequently gave rise to it, it is more likely that our psychological "archetypes" and experience of spirituality are simply current ongoing reflections of them, not the other way around, and we may be better off dispensing with 20th-century pseudoscientific self-absorption and get back to our planetary roots.
Fortunately, Forrest suggests something similar, herself, in Chapter 11, noting that you don't have to buy any particular doctrine for the details to work — which is encouraging, since her details work so well. Jodie Forrest is, above all else, an astute astrological observer of habits and behavior, which manifest so vividly at the human boundary line that is the Ascendant. She goes at it with heart, open eyes, and an instinct for wisdom that doesn't require a theory to legitimize it, even though she suggests a couple. To quote the David Pomeranz song, made famous by John Denver and The Muppets:
"It's in every one of us to be wise, Find your heart, open up both your eyes, We can all know everything, without every knowing why, It's in every one of us, by and by."
That's what, ideally, astrology does for you, if studied and taught well. It's certainly a good wrap to describe the thrust of this effort, the best book about the Ascendant to come along in many years.


text: Blog BytesIDEA ALERT :: Tell Congress to Stop Sequestration! IDEA Money Watch Blog :: The Balance Sheet LEA reductions in MOE State MOE Waiver Requests :: Tutorial :: Understanding the Impact of IDEA Federal Funds and ARRA Funds over Time Video :: The Business of Special Education MOE Basics :: Essential info on IDEA Maintenance of Effort IDEA Money Watch hits YouTube WI: Milwaukee Schools announced big cuts for 2012 NC: New Hanover district plans big cuts to special education NY: State shifts special ed costs to districts TX: Districts cut sped in spite of stimulus KS may forfeit federal funds due to budget reduction AZ's Gilbert SD announces cuts FL district announces layoffs GA district cuts teachers and paras HI cuts special ed jobs for 09-10 IA district to eliminate special ed jobs IN districts announce special education cuts IL's Chicago needs more Stimulus Oversight KY district hands out "Wish Lists" Grants OH districts buy technology with ARRA CO BOCES uses IDEA ARRA Funds to pay for mismanagement UT district buys computers that sit in boxes MO district uses IDEA Funds Unwisely VA district uses IDEA Funds for Co-Teaching PD KPS4Parents, Inc. gives IDEA Money Watch 2 thumbs up! LEA Ratings for every state: IL, MI and MO announce LEA Rating Changes |


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Patent-rich Vermont is the first state to pass a law cracking down on bad-faith claims of patent infringement, a growing problem for entrepreneurs nationwide. More
What's most on the minds of business owners today? This special report will explore what inspired entrepreneurs to start their firms, the latest hiring and lending concerns, and more. More
The Obamacare employer mandate forces businesses with 50-plus workers to provide insurance. But many keep getting that cutoff number wrong, saying it's 51.
By the time a startup is five months old, it's already been the target of hundreds of spam messages.
From a pet relocation service, a wine lifestyle marketer, to a scrap metal regenerator, America's urban core is home to a variety of fast-growing companies.
Startup ideas can be found in surprising places. We asked Thumbtack.com which opportunities are drawing the most interest from entrepreneurs and their customers lately.
Move over Gerber, entrepreneur Shazi Visram is hungry for market share.
Bolstered by biotech, a building boom, and a business-friendly legislature, fledgling companies have recently found growth -- and growing pains -- in the Lone Star State.
Women-owned construction firms are on the rise, and have made it onto this year's Inner City 100 list of the fastest-growing urban businesses in the U.S.
Only a tiny fraction of small businesses must comply with new Obamacare rules. And most of them are already providing insurance to employees.
Launched in 2006, EventBrite has sold over 100 million tickets for events from two people to a hundred thousand.
In an exclusive survey, entrepreneurs say their customers aren't spending freely yet, and they're in no rush to hire or invest more in their firms.


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Pelvic Inflammatory Disease: Tubo-Ovarian Abscess
Topic Overview
A pocket of pus that forms during an infection of a fallopian tube and ovary is called a tubo-ovarian abscess. Tubo-ovarian abscesses can develop in women who have Reference pelvic inflammatory disease (PID) Opens New Window.
A tubo-ovarian abscess is usually diagnosed by physical exam or pelvic ultrasound. Some abscesses are found by surgical exploration of the abdomen (Reference laparoscopy Opens New Window or Reference laparotomy Opens New Window).
These abscesses are usually treated with antibiotics. Very large abscesses or abscesses that do not go away after antibiotic treatment may have to be drained. Draining may be done by using a large needle. The needle is guided by ultrasound or by cutting into the abscess during laparoscopy or laparotomy. Sometimes the infected tube and ovary also have to be removed surgically.
By: | Reference Healthwise Staff | Last Revised: Reference October 30, 2012 |
Medical Review: | Reference Sarah Marshall, MD - Family Medicine
Reference Kirtly Jones, MD - Obstetrics and Gynecology |
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Reference Terms of Use. Reference How this information was developed to help you make better health decisions.


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The highway was closed to through traffic for just over two hours as emergency crews cleared the road.
David Evans of Ecru said he and Brad Evans were driving to the store going eastbound on Highway 6 when they saw the truck, driving Westbound, swerved off the road and then back onto the road, crossing the center line and then flipping into the ditch on the other side.
"Our skid marks go all the way up to the trailer," he said.
Highway Patrol Troopers on the scene said the diver of the truck was stable and alert when transported.
The Pontotoc Fire Department, Mississippi Highway Patrol and Pontotoc Sheriff's Office worked the accident.


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Health Tip: Is Caffeine Giving You the Jitters?Latest Nutrition, Food & Recipes News(HealthDay News) -- Caffeine can provide a little "pick-me-up" if you're struggling to stay awake. But this common stimulant, found primarily in many coffees and teas, also can cause a number of unwanted side effects. In addition to the jitters, the National Sleep Foundation mentions these potential side effects of caffeine:
-- Diana Kohnle Copyright © 2012 HealthDay. All rights reserved. |
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Longmont City Council Approves Fiber Network
The content that follows was originally published on the Institute for Local Self-Reliance website at http://www.muninetworks.org/content/longmont-city-council-approves-fiber-networkLongmont, Colorado, will move ahead with plans to offer fiber connectivity to the entire community. After presenting this business plan to the City Council, members voted unanimously on May 14th to support the measure. Scott Rochat from the Times-Call attended the meeting. Residents stepped forward to express their opinions and all but one urged the… Continue reading


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Friday, December 23, 2011
Of Interest in GQ
A reader sent along a link to a very worthwhile 1957 GQ interview with Fred Astaire, who was for decades considered one of the two (with Cary Grant) best-dressed actors in American films.
That same website is also the home to a memorable piece titled My Father's Fashion Tips.
And, by the way, GQ is also running a nice piece on the oral history of menswear blogging that mentions A Suitable Wardrobe.
For anyone that may not have time to read the linked pieces, just remember that skinny ties make you look like a wuss.
5 comments:
- Roger said...
"...just remember that skinny ties make you look like a wuss."
Bah! Tell it Don Draper.
Merry Christmas ;^) - December 23, 2011 at 8:47:00 AM PST
- NJS said...
Nice article. Bah! Humbug! to all.
NJS - December 23, 2011 at 10:21:00 AM PST
- Scott Monty said...
Tom Junod's article is for me one of the seminal pieces of writing about men's fashion. I clipped it when it first appeared in GQ and I was getting my own business wardrobe started. Thanks for posting it as a reminder, Will.
- December 23, 2011 at 6:20:00 PM PST
- Downunder said...
If you think Don looks good with a skinny tie, he'd look better with a wider tie. Skinny ties are for boys.
- December 23, 2011 at 7:40:00 PM PST
- Carmelo Pugliatti said...
Well,i don't know.
Sean Connery/James Bond is grat in skinny ties. - December 24, 2011 at 8:29:00 AM PST
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If your activity is paintball you will also begin your day by checking in at our adventure center. We have official judges who will conduct a safety briefing and you will play any one of our 18 top notch on site paintball fields. Little wait, and little walking makes it an action filled day. At the end of your play we will invtite you to join us for a free hot dog cookout.
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text: Aerosmith performed THE BEATLES' classic "Come Together" during a gig in Oklahoma City a few nights ago . . . and Steven had a couple old friends with him onstage: Ryan Seacrest and Randy Jackson. Randy played bass, and Ryan came out at the end to sing with them. Word has it Ryan picked out his outfit...LOL :)


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COURTHOUSE A Philadelphia man who claimed to be on PCP when he went on a violent rampage one night over the summer has pleaded guilty in two separate incidents.
Kyante Marquel Blakely, 21, of the 5400 block of Oakland Street, Philadelphia, pleaded guilty in Montgomery County Court Tuesday to robbery, aggravated assault and firearms offenses.
Over the course of a three-hour period one night in August, Blakely assaulted a food delivery person, shot out a car window and pistol-whipped another man, all with the alleged intention of robbing his victims.
According to the affidavits, on Aug. 27 just after 10 p.m., West Norriton police responded to the 1000 block of North Montgomery Avenue for reports of an attempted robbery with shots fired.
Two employees of the Papa Guidos pizzeria in Norristown were delivering a pizza to a residence on the above-mentioned block, when the driver got out of the car and was approached by a thin, black male, Blakely, with a shirt covering his face.
The delivery men reportedly sped off when they spotted Blakely had a gun, but he was able to fire off a round, striking their vehicle. Police found a shell casing from a 9mm semiautomatic pistol in the area.
Not long after 12:30 a.m. the following morning, police were dispatched to the 600 block of West Marshall Street with reports of a robbery/assault in progress.
When police arrived on the scene, an officer was reportedly flagged down by a male victim who was bleeding from a large gash on his forehead and a cut under his left eye. The man told police he had just been robbed and pistol-whipped by a suspect, who was reportedly apprehended by witnesses.
When Kyante struck the victim with the gun, it fell out of his hand. The gun was kicked away and other people accosted Kyante. He was subdued and held there until the Norristown police responded, said defense attorney Dennis Caglia.
According to the affidavit, the victim was approached from behind, a gun stuck in his back and Blakely reportedly said, give me all your money and everything in your pockets. A second victim came to the scene and was also threatened with the gun.
Officers reportedly found Blakely face up and semi-conscious on the sidewalk. Caglia said his client claimed he was under the influence of wet, or PCP, during the incidents.
The evidence in this case was very strong to overwhelming, he said.
Hes a very young man. He is remorseful and hes very lucid about what he did and the repercussions of his actions, said Caglia.
Assistant District Attorney Gabe Magee said he was pleased with the guilty plea on the two separate incidents.
These were two dangerous instances with a gun in a short period of time, endangering the lives of the citizens of Montgomery County, he said.
I think its a good resolution. Our intention is to see he serves a significant period of state incarceration and we will seek all mandatories that apply in this case.
Sentencing is deferred in this case until a later date.
Follow Jenny DeHuff on Twitter @RuffTuffDH.


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I just ran to the grocery store to get ingredients for cooking up a big beef tongue that I have. I only needed some vegetables. The store is one of the big mongo-sized Giant Food stores.
I was wandering around the store, and it suddenly struck me... there is an ENTIRE aisle for soft drinks, maybe 20-30 yards long.
An ENTIRE AISLE for potato/corn chips... dozens of varieties. And if that wasn't enough, there was another aisle for "natural snacks" (which means the other snacks are unnatural?) which included another half-aisle of chips (gourmet, rice, etc).
An entire aisle for breakfast cereals.
An entire aisle for cookies and crackers.
An entire aisle for smooshy white and pseudo-whole-wheat bread products (hotdog and hamburger buns, sandwich bread, muffins, etc). This doesn't include the fresh bakery items.
An entire aisle for candy.
A separate "seasonal" aisle with "seasonal candy" (Mother's Day stuff, now transitioning to other stuff).
An entire aisle of frozen desserts, NOT including ice cream (pies, cakes, popsicles, etc).
Another entire aisle of ice cream, sorbet, sherbert, etc.
Half an aisle of frozen breakfast items (Eggos, frozen pre-cooked pancakes, etc).
When you look at this through the lens of the Paleo diet, it's a bit mind boggling.
Prevailing wisdom is that most of these items are good for you and "part of a balanced diet". Hey, you're supposed to have 10+ servings a day of "grains" after all, and you wouldn't want any of that yucky fat. Most of the items that normally have fat like ice cream and dairy have had it removed. Almost all of them have synthetic fats added, not to mention preservatives and other stuff.
It just kind of struck me all of a sudden. It was like a sci-fi movie. No wonder there is a lot of chafing and waddling in the American population.
Ok so I guess that wasn't a question. Let me make a question out of it. What percentage of the average grocery store is stocked with items that you would actually eat?


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Move through Fantasy and Reality while watching Asian Drama!
of 2731
Description: Hiratsuka Heihachi (Katori Shingo)is loud and impolite, but always smiles. He is a strange detective. Unlike Hiratsuka, Saionji Kosuke (Yamashita Tomohisa) is the heir of a wealthy family. He is full of justice, naive and honest almost to a fault. Saionji Kosuke is then designated to the #1 investigation team, which he has always admired. Unfortunately, his job is to watch over Hiratsuka Heihachi. Up to this point, Hiratsuka Heihachi has been the sole member of his team, but he manages to solve all of his cases one by one. Other detectives are curious about his methods, some even think he may have some mystic powers. This is the primary reason why Saionji is tasked to watch over Hiratsuka. The real reason Hiratsuka is able to solve so many cases is that the criminals hate Hiratsuka the most ...


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The woman parked the car into the spot and locked it with the key, flinging it around with her fingers and putting it into her pocket like a cowboy would with a gun. Her hair was out and bouncing about as she walked into the room. She was all dressed up for one reason: Men reacted well with pretty women and she knew she was definitely a pretty woman. She used it to her advantage just like her mother had taught her. Flaunt what your mother gave you she remembered. She flipped her head and opened up the door. With one quick scan she saw the man she was looking for drowning his sorrows with alcohol, something she did on a daily basis.
With a smile she grabbed out her fake cop idea and walked over. "Are you Ryan? she asked, flashing him the badge before taking a seat next to him which some one had left just a second before she walked over. The girl had brilliant timing and was definitely rather lucky. In all honesty you had to be in the line of work she didn't get paid for. She lived off fake identification which led to fake credit cards and fake passports. She had grown up in this life. It was all she ever knew.
CREDIT|CAEJAE@Caution 2.0 and to YOU FOUND ME?! Of caution 2.0


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Ireland prop Cian Healy is set to play for Leinster in the RaboDirect PRO12 on Saturday despite receiving a three-week ban for stamping.
Healy was suspended by an independent Six Nations disciplinary committee convened at Heathrow on Wednesday for an incident involving England's Dan Cole in the first half of Saturday's 12-6 defeat in Dublin.
Under normal circumstances Healy would not have played this weekend, but the hearing chose to defer the ban by one week so that he would miss Ireland's Six Nations matches against Scotland and France.
As it currently stands the suspension runs from midnight on Sunday until March 10, leaving him available against Benetton Treviso this weekend.
Leinster forwards coach Jonno Gibbes on Thursday indicated that the European champions intend to select the 25-year-old loosehead.
"Cian is certainly available. (Leinster coach) Jose Schmidt and (Ireland coach) Declan Kidney have talked about the involvement of Test players this weekend," Gibbes.
"Cian's available and personally I'd be delighted to involve him, he's a really big asset. He will definitely be considered.
"There's are complications for others maybe, but he's available for us. It's a game in the break of the Six Nations and he's under consideration.
"Nothing is surprising when the rugby judiciary is involved. You have to go in with an open mind because you never know what will come out of it."
The development has created a mess for the Six Nations, who are understood to be concerned at the prospect of having the spirit of their ban flouted by the exploitation of a loophole in their decision to defer the punishment.
Ireland have yet to indicate whether they will appeal against the suspension, but Healy risks receiving a lengthier suspension if it fails.
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June 19, 2013
THT Essentials:
Rich Barbieri
John Barten Kyle Boddy Brian Borawski James Gentile Matt Hunter Frank Jackson Chris Jaffe Brad Johnson Jason Linden Dan Lependorf Bruce Markusen Jeff Moore Greg Simons Scott Spratt Dave Studeman Shane Tourtellotte Steve Treder And here's the full roster. Now availableYou can now purchase the Hardball Times Baseball Annual 2013, with 300 pages of great content. It's also available on Amazon and Kindle. Read more about it here.
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THT E-bookThird Base: The Crossroads is THT's e-book, available for $3.99 from the Kindle store. The good news is that anyone can read a Kindle book, even on a PC. So enjoy the best from THT in a new format.Get your very own THT merchandise from our CafePress store. We've got baseball caps, t-shirts, coffee mugs and even wall clocks with the classy THT logo prominently displayed. Also, check out the THT Bookstore. Please support your favorite baseball site by purchasing something today. All content on this site (including text, graphs, and any other original works), unless otherwise noted, is licensed under a Creative Commons License. |
About Chris NeaultChris holds a Masters Degree in Physical Therapy from Northeastern University in Boston, MA. He is a licensed Sports Physical Therapist who has been in practice since 2003. He started The Disabled List Informer, a site for discussing and analyzing injuries as they pertain to fantasy baseball. Originally from Maine - and now residing in Florida - he is a lifelong Red Sox fan, growing up rooting for the likes of Nick Esasky, Mike Greenwell, and Phil Plantier. When not playing fantasy sports, he can be found playing ice/roller hockey, softball, fishing, and spending time with his chocolate lab, Neely.Note: This page displays up to 200 articles at a time. To view a subset of a writer's work, click on one of the following years: 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 Chris Neault's ArticlesClick here to view an RSS feed of this writer's articles. 2013 |


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Description: Cocky as shit, and hot enough to go with it, Ryder comes out from Ohio to grace my couch with his presence. He's a tight, toned, ex-military, MMA fighter with a fat cock, some big balls and a loud mouth. Ryder is not shy at all about his body, he's lean and covered in tattoos. Ryder says he's confident in his looks and totally comfortable hitting any chick up. He's more than willing to show off his body on camera and isn't nervous in the slightest. Ryder's got some interesting stories to come out of his fighting experiences. He won his first 7 fights, while he was still in the military. But he got knocked out in the 4th round of his last title fight. That didn't scare him away at all, he's still in the ring and training almost every day. What a hot little fucker. He doesn't take any time to get naked, nice and hard and hardly flinches when I ask to measure his cock. I kept my hand steady on his hard dick, waiting to see if he objected to my adding of a couple extra strokes. When no voice of resistance arose, I kept jerking his cock and added a little bit of ball play. It wasn't long before Ryder let loose a rush of hot white cum all over his abs. This is definitely a jerk off to enjoy!
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Do you eat a Big Ass Salad? It is part of something Mark Sisson advocates, so I see some posts here and there about what people put on their BAS with details on the numerous ingredients in their giant salads.
I used to eat a BAS (especially pre-paleo), happily munching along. It was mostly to give me the feeling of eating lots of "real" food because I was of course, trying to eat low-fat and loved chicken breast on it. Nowadays, I'm not scared of fat, but I still eat giant salads. Out of habit, I suppose.
And then I read something by someone well respected on this site (Archevore) that "Some is better than none, but neither big salads nor fruit to excess will save your life. You're not a gorilla, you're an omnivore"
Now whenever I'm eating, I feel like some greedy/gluttonous fat King Kong when I want to eat a field of greens. It makes me feeling like I'm eating for entertainment rather than to just supply my body with nutrients.
So, big salads or just the basic necessities?


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National Institute of Health Clinical Trials - Includes Not Yet Recruiting, Recruiting, In Process and Completed Trials for Lynch Syndrome.
Study by Ohio State University for Cryopreservation of Eggs For Women Undergoing Treatments or SurgeriesWhich May Affect Fertility
Study by Helen and Harry Gray Cancer Center at Hartford Hospital (Connecticut) regarding Hyperbaric Oxygen and Ability to Improve Erectile Function Following Surgery for Prostate Cancer
Massachusetts General Hospital - Preoperative Staging of Pancreatic Cancer Using Super Paramagnetic Iron Oxide Magnetic Reasonance Imaging
Pfizer, Institut National du Cancer (France)- Biological, Pathological and Imagery Markers In The First Line Treatment Of Metastatic Clear Cell Renal Cell Carcinoma
Axo-Gen, Vanderbilt Ingram Cancer Center, Nashville, TN Nerve Reconstruction In Individuals Using Avance In Subjects Who Undergo Robotic Assisted Prostatectomy For Treatment of Prostate Cancer
Eisai, MD Anderson, Houston, TX - Dalteparin for Venous Thromboembolism (VTE) Prophylaxis in Pancreatic Cancer Patients
European Association for Endoscopic Surgery (Italy) - Transanal Endoscopic Microsurgery vs. Endoscopic Submucosal Dissection For Large Rectal Adenomas
Hospital Donostaia, San Sebastian, Spain Study to Evaluate the Efficacy of Pravastatin on Survival and Recurrence of Advanced Gastroesophageal Cancer
Gifu, Japan - Republic of Korea Comparing Covered Self-expandable Metallic Stent (SEMS) Above/Across the Sphincter of Oddi
Seoul National University Hospital - Cyclooxygenase-2 Inhibitor for Adjuvant Anticancer Effect in Patients With Biliary-pancreas Cancer
Universitaetsspital-Basel - Influence of N-Acetylcysteine on Morbidity, Oxygenation and Cytokine Levels in Partial or Total Esophagectomy for Cancer
Santa Clara Valley Medical Center, San Jose, CA. Bowel Preparation for Inpatient Colonoscopy
Medical Center of Fudan University - Shanghai New Adjuvant Chemotherapy of Non Resectable Liver Metastasis of Colorectal Cancer Without Bleeding, Obstruction
David C. Pratt Cancer Center at St. Johns Mercy, St. Louis, Missouri Stereotactic Body Radiotherapy for Unresectable Pancreatic Cancer - Stereotactic Body Radiotherapy for Liver Tumors, Stereotactic Body Radiotherapy for Prostate Cancer
Bayer Corporation Study to Observe Safety and Efficacy of Nexavar in Treatment of Kidney Cancer
Buenos Aires, Argentina Epoetin Alfa (Hemax®) Phase IV Study in Chemotherapy Induced Anemia
West China Hospital at Sichuan University Effective Study of Preoperative Short-course Radiotherapy for the Advanced Resectable Rectal Cancer
Daniel Stephen Engeler Safety Study of Bipolar Versus Monopolar Transurethral Resection of Bladder Tumors
Case Comprehensive Cancer Center and the Medicis Pharmaceutical Company: Forehead Scars Following Mohs Micrographic Surgery and Reconstruction for Skin Cancer
Myriad Genetics-Various U.S. Locations Study Comparing Optimized 5-FU Dosing and Standard Dosing in Metastatic Colorectal Cancer Patients Treated With mFOLFOX6
Odense University Hospital - Denmark CUP Project PET/CT Applied Early In the Work Up For Metastasizing Of An Unknown Primary Tumor
Mayo Clinic, Jacksonville, Florida Improving Complete Endoscopic Mucosal Resection (EMR) of Colorectal Neoplasia
Bristol-Myers Squibb First-Line Gemcitabine, Cisplatin + Ipilimumab for Metastatic Urothelial Carcinoma
Novartis - Memorial Sloan Kettering BKM120 in Metastatic Transitional Cell Carcinoma of the Urothelium
Glaxo-Smith-Klein Memorial Sloan Kettering Gemcitabine and Pazopanib in Chemotherapy Naïve Patients With Advanced/Metastatic Urothelial Carcinoma Ineligible for Cisplatin-based Chemotherapy
Sanofi- Aventus European Organization of Research and Treatment for Cancer. Efficacy of FOLFOX Verus FOLFOX plus Afibercept in K-ras Mutant Patients with Resectable Liver Metastases (BOS3)
Risks Of Primary Extracolonic Cancers Following Colorectal Cancer In Lynch Syndrome Sept. 2012
Daily Long Termed Aspirin Use In Lynch Syndrome Carriers Reduces Colorectal Cancers England study conducted by Sir John Burn indicates consistent long termed aspirin use (mean 25 months) at 600 mg a day significantly reduces primary colorectal cancers in those with Lynch syndrome. Substantiates new study to determine effective dosage.
Aspirin Confers Long Term Protective Effect in Lynch Syndrome Patients, Jacqueline K. Beels, Phd.
From the Lancet - Effects of Regular Aspirin On Long Term Cancer Incidence and Metastasis 5/2012
Finnish Researchers ConcludeStudy on LS Mortality
9/5/2012 Multi national study in Spain and in Holland indicates cancer-affected LS patients with the AA genotype have shorter telomeres than those with GG and MMR gene mutation carriers with hTERT rs2075786 are at high risk to develop a LS-related tumor at an early age.
1/2013 Collaborative study on genetic testing on first degree relatives (FDRs): Genetic testing may be underutilized by FDRs at risk for LS. The economic feasibility of screening persons with CRC for LS depends on optimizing family-wide uptake of genetic testing. Future research and clinical efforts should focus on ways to overcome barriers to genetic testing.
Diagnostic Approach and Management of Lynch Syndrome - American Cancer Society
Lynch Syndrome: Barriers to and facilitators of screening and disease management, Hered Cancer Clin Pract. 2011 Sep 7;9:8 addresses a Canadian study which concludes persons with Lynch syndrome experience multiple barriers to disease management and the necessity of a coordinated system of local services capable of providing integrated, efficient health care and follow-up.
The Family History Score Tool Identifies High Risk Families for Colorectal Cancer, from the Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA andThe Sanford R. Weiss, M.D. Center for Hereditary Colorectal Neoplasia, Cleveland Clinic, Cleveland, Ohio 44195, USA 5/25/2010
Calculation of Risk of Colorectal and Endometrial Cancer Among Patients With Lynch Syndrome: Gastroenterology 2009 - Largest study, to date, on the high lifetime risk of cancers of those affected by Lynch Syndrome.
Genetics in Medicine: March/April 2003 - Volume 5 - Issue 2 - pp 84-91 The genetic family history as a risk assessment tool in internal medicine Frezzo, Theresa M. MS; Rubinstein, Wendy S. MD, PhD; Dunham, Daniel MD, MPH; Ormond, Kelly E. MS Methods: Seventy-eight patients seen in a division of internal medicine were randomized into two groups, which completed a questionnaire or underwent a pedigree interview. Chart notes were compared to both study tools. Results: Sixty-two (79.5%) of the 78 participants scored at increased risk for at least one category. Either of the two study tools found significantly more people at high risk (48/78, 61.5%) than the chart review (31/78, 39.7%) (P = 0.01) Conclusions: Approximately 20% of patients in an unselected internal medicine practice were at an increased risk that was not documented in reviewed chart notes. Targeted family history analysis reveals patients who require increased medical surveillance, preventive measures, or genetic counseling/testing.
Genetics Home Reference from Gene Tests from the National Institute of Health.
Lynch Syndrome: Still Not A Familiar Picture, by Hess Fredrick From the World Journal of Surgical Oncology a very nice article articulating the misunderstanding many physicians still have in the diagnosis of Lynch syndrome
The Role of Genetic Assessment in Determining a Patient's Risk (for Physician Assistants) Michael A. Rackover PAC MS and Doug Scott MS - Journal of the American Academy of Physician Assistants
Genetics in Medicine: May 2007 - Volume 9 - Issue 5 - pp 290-297 doi: 10.1097/GIM.0b013e31804b45db The impact of predictive genetic testing for hereditary nonpolyposis colorectal cancer: three years after testing Conclusion: Long-term data indicates appropriate screening and improved psychological measures for non-carriers with no evidence of undue psychological distress in carriers of hereditary nonpolyposis cancer mutations.
From Genetics in Medicine: May 2007 Volume 9 Issue 5 pp 290-297 The impact of predictive genetic testing for hereditary nonpolyposis colorectal cancer: three years after testing Collins, Veronica R. Phd; Meiser, Bettina PhD; Ukoumunne, Obioha C PhD; Gaff, Clara PhD; St John, D. James MD; Halliday, Jane L. PhD Conclusion: Long term data indicates appropriate screening and improved psychological measures for non-carriers, with no evidence of undue psychological distress in carriers of Lynch syndrome.
From Genetics in Medicine, October 2009 Volume 11, Issue 10, pp 728-734 Communication, encouragement, and cancer screening in families with and without mutations for hereditary nonpolyposis colorectal cancer: A pilot study; Ersign, Anne L. PhD; Williams, Janet K. PhD; Hadley, Donald W. MS, CGC; Koehly, Laura M. PhD Conclusion: Respondents who communicated about risk and received encouragement to screen from a great proportion of named family members and those who had a greater proportion of named family members involved in both communication and encouragement were significantly more likely to have a shorter time interval since last colonoscopy. Identifying patterns of interaction within at risk families, regardless of gene mutation satus, may be one avenue for promoting screening adherence.
History and Molecular Genetics of Lynch Syndrome in Family G - A Century Later ---- JAMA Julie A. Douglas PhD, Stephen B. Gruber MD Phd, Karen A. Meister MS CGC, Joseph Bonner MS , Patrice Watson Phd, Anne Krush MS, Henry T. Lynch MD Conclusion: Within the last decade, molecular diagnostic testing has transformed the care of Family G and other Lynch syndrome families in which a pathogenic mutation has been identified.
Prophylactic Surgery to Reduce the Risk of Gynecologic Cancers in the Lynch Syndrome, Kathleen M. Schmeler, MD, Henry T. Lynch, MD, Lee-May Chen, MD, Mark F. Munsell, MS, Pamela T. Soliman, MD, Mary Beth Clark, MSW, Molly S. Daniels, MS, Kristin G. White, BS, Stephen G. Boyd-Rogers, RN, Peggy G. Conrad, MS, Kathleen Yl Yang, MD, Mary M. Rubin, PhD, Charlotte C. Sun, Dr.PH, Brian M. Slomovitz, MD, David M. Gershenson, MD and Karen H. Lu, MD Conclusion: Findings suggest that prophylactic hysterectomywith bilateral salpingo-oophorectomy is an effective strategyfor preventing endometrial and ovarian cancer in women withthe Lynch syndrome.(Since publication, it has been noted by MD Anderson there have been a few cases of endometrial cancer despite hysterectomy, however the conclusion remains the same.)
Risk Assessment, Genetic Testing, and Management of Lynch Syndrome - Shilpa Grover, MD, MPH and Sapna Syngal, MD MPH, Boston, Massachusetts
Prospective Screening for Lynch Syndrome In a Cohort of Colorectal Cancer Surgical Patients in a Community Hospital: Albuquerque and Presbyterian Hospital, Albuquerque, NM Conclusion: A screening protocol for detecting LS in newly diagnosed CRC patients using MMR assessment identified LS in at least 8% of screened patients and in at least of 2.0% of all CRC resected. Clinical suspicion misses a significant proportion of patients who have LS. This protocol is a significant step forward in the timely identification of LS in a community hospital setting.
Diagnosis and Management of Hereditary Colorectal Cancer Syndromes: Lynch Syndrome As A Model, Henry T. Lynch
A excellent study from Kaiser Permanente and the Marshfield Clinic regarding theunderdiagnosis of Lynch Syndrome. May 2012
A study from Canada assessing the barriers to diagnosis and management of Lynch syndrome: Lynch Syndrome Barriers To and Facilitators of Screening and Disease Management 9/2011, Hereditary Cancer in Clinical Practice 2011doi:10.1186/1897-4287-9-8
The Risk of Extracolonic Primary Cancers Following Colorectal Cancer in Lynch Syndrome An international study of 764 carriers of Lynch syndrome. September, 2012
Colorectal And Other Cancer Risks For Carriers and Non-Carriers From Families With A DNA Mismatch Repair Gene Mutation - A Prospective Cohort Study/ An International Study That Is a Must Read Discussing the Risks of Specific Cancers of Lynch Syndrome And One Of The First Comprehensive Studies On The Risk of Breast Cancer Within Lynch Syndrome
MD Anderson studies thespectrum of Lynch syndrome cancers. determining those with LS can present with cancers outside the spectrum of LS. A good paper citing information that may be helpful for diagnosis and screening for patients with Lynch Syndrome. 6/20/2012
UT Southwest article regarding important information on biallelic mutations
Canadian study describes a novel biallelic condition 10/2012
Hereditary, Pancreatic and Hepatobiliary cancers - International Journal of Oncology, 2011 Paper discussing risk and studies regarding pancreatic cancer and Lynch syndrome.
Manchester UK study discovers a ten fold risk of prostate cancer has been determined with MSH2. Other significant findings are also noted.
Ohio State Study: Prostate cancer incidence was not increased in this relatively large cohort of LS patients.
Screening for Muir-Torre Syndrome Using Mismatch Repair Protein Immunohistochemistry of Sebaceous Neoplasms. IHC testing not recommended unless a personal history or family history of colorectal cancer exists 12/'2012
Brain Cancer and the Lynch Syndrome,Genetics Department, University of Helsinki, Finland, September 2012
26. Breast cancer in Irish Families Breast cancer occurred at an early age and was more common than prostate cancer in Irish Lynch Syndrome pedigrees. All reported breast cancer cases were in kindreds with MSH2 or MSH6 mutations. Enhanced breast cancer screening may be warranted in certain Lynch Syndrome kindreds.
2005 A study of individuals in Greecereveals The majority of mutations identified in this cohort are found in hMSH2 (77.7%). Furthermore, four of the mutations identified are novel. Finally, a number of novel benign variations were observed in both genes. This is the first report of HNPCC analysis in the Greek population, further underscoring the differences observed in the various geographic populations.
1/2013 Cancer Spectrum in Families from Ireland indicates cancers identified include: CRC, endometrial , gastric, ovarian, renal, breast, prostate, urothelial, NHL, CML, lung, vocal cord, sebaceous carcinoma and cervix. Median age of diagnosis was 44.
1/2013 Ireland study results on LS, of age affected children and affected parents.
Identification of Lynch Syndrome Among Patients With Colorectal Cancer 10/17/2012 In an enormous research study involving over 10,000 individuals with Colorectal Cancers, Lynch researchers discovered universal testing of tumors among CRC Probands had a greater sensitivity compared with alternative strategies, including use of the Bethesda criteria.
Current Hypotheses on how Microsatellite Instability Leads to Enhanced Survival of Lynch Syndrome Patients Kristen M. Drescher, Poonam Sharma and Henry T. Lynch, Creighton University
Abstract: High levels of microsatellite instability (MSI-high) are a cardinal feature of colorectal tumors from patients with Lynch Syndrome. Other key characteristics of Lynch Syndrome are that these patients experience fewer metastases and have enhanced survival when compared to patients diagnosed with microsatellite stable (MSS) colorectal cancer. Many of the characteristics associated with Lynch Syndrome including enhanced survival are also observed in patients with sporadic MSI-high colorectal cancer. In this review we will present the current state of knowledge regarding the mechanisms that are utilized by the host to control colorectal cancer in Lynch Syndrome and why these same mechanisms fail in MSS colorectal cancers.
From the Office of Public Health Genomics: The cost-effectiveness of genetic testing strategies for Lynch syndrome among newly diagnosed patients with colorectal cancer. Mvundura M, Grosse SD, Hampel H, Palomaki GE. Genet Med. 2010 Feb;12(2):93-104. Results: Strategies to test for Lynch syndrome in newly diagnosed colorectal tumors using preliminary tests before gene sequencing have incremental cost-effectiveness ratios of $45,000 per life-year saved compared with no testing and $75,000 per life-year saved compared with testing restricted to patients younger than 50 years. The lowest cost testing strategies, using immunohistochemistry as a preliminary test, cost $25,000 per life-year saved relative to no testing and $40,000 per life-year saved relative to testing only patients younger than 50 years. Other testing strategies have incremental cost-effectiveness ratios $700,000 per life-year saved relative to the lowest cost strategies. Increasing the number of relatives tested would improve cost-effectiveness.
Conclusion: Laboratory-based strategies using preliminary tests seem cost-effective from the US health care system perspective. Universal testing detects nearly twice as many cases of Lynch syndrome as targeting younger patients and has an incremental cost-effectiveness ratio comparable with other preventive services. This finding provides support for a recent US recommendation to offer testing for Lynch syndrome to all newly diagnosed patients with colorectal cancer.
The Association of Tumor Microsatellite Instability Phenotype with Family History of Colorectal Cancer Mount Sanai Hospital and Samuel Luenfeld Research, University of Toronto
EGAPP Recommendations April 2011
Preoperative Diagnosis of Lynch Syndrome With DNA Mismatch Repair Immunohistochemistry On A Diagnostic Biopsy - Dec. 2011 33 samples of biopsies taken. Study indicates mismatch repair status is accurate on biopsies allowing preoperative diagnoses of Lynch syndrome before definitive surgery, allowing the patient and the physician more options to determine appropriate protocol.
Psychological Distress In Newly Diagnosed Colorectal Cancer Patients Following Microsatellite Instability Testing for Lynch Syndrome On the Pathologist's Initiative Radboud University Nijmegen Medical Center; Nijmegen, The Netherlands 2/7/2012
Prevalence of Mismatch Repair Deficient Crypt Foci In Lynch Syndrome: A Pathological Study
Routine Universal Screening for Lynch Syndrome in Colorectal Cancer Patients In The Community Setting J Clin Oncol 30, 2012 (suppl; abstr 1512)
Pubmed Links to almost 4,000 studies results and journal articles in respect to Lynch syndrome.
ING Life Insurance speaks of hereditary conditions and Lynch syndrome and insurability
Coding and Billing for Lynch Syndrome
Modified 1/14/2013


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