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How can I stop yelling at my toddler?
My toddler just turned 21 months, and recently I've been shouting at him when I'm stressed or he's whining. I feel so bad about this -- have I caused irreparable damage to him emotionally? He doesn't seem to like me any more and it's breaking my heart. I want to stop, but I need help.
Posted: 02/01/2005 by a BabyCenter Member
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I am having the same problem but it just started im about to have another baby and it seems to hard for me, every little thing he dose i catch my self yelling at him i need help i love him so much and i dont think he understands that he dont hug me or kiss me anymore i think i scared him away i feel so bad i cry my self to sleep at night and i am scared to talk to anyone else about my problemposted 08/15/2011 by a BabyCenter Member
I don't yell at my 19month old daughter, but more or so at her father in front of her and I must say it has really rubbed off on her. When she is upset she folds her arms and yells at the top of her lungs to talk to us. Now she isn't using any actual words but just mocking me and how I talk to her father. This breaks my heart. I guess I have some issues I need to work out with her dad. But it doesn't help that he laughs at her while she does it and says "see, she is acting like a little hood rat" urghh it's so frustrating, mind you Im 30wks pregnant too =/posted 08/15/2011 by a BabyCenter Member
dang! it's nice to know i'm not the only one that yells at my toddler. the guilt is terrible, right along with the fears that you're doing permanent damage. try cuddling with your child & explain that you're frusturated with the "grown up" things & that you're not mad at your child. they're still learning words but this is what helps me with my daughter. it makes her feel like she's a part of the team & also gives us the chance to communicate. when they're older, they might thank you for talking about & explaining what's going on with mommy. i don't know, this is just what works for us.posted 08/10/2011 by hips8809
I have the same problum My three year old daughter throws the worse fits and i get so frustrated that i yell and after that happens i cry cause i feel so bad im at my wits inn with the tamptrums please help.posted 08/01/2011 by fightmasterjess
I have a 2 year old and I attend to yell at him for a lot he does. I know it feels bad because you see their faces and it makes you feel bad. but dont. Not totally screaming or yelling but in a tone voice letting them know what they are doing is not okay. when conner my son gets in trouble I put him in time out in his high chair or up in his bed in his room with out any toys around. Kids can act out when they become bored or have no one to play with. I found it really helps when he get to acting out its because his stressed out himself or his bored. So I found going outside and playing for a couple mins or going for a walk really calms both of us down. I know its very easy to raise your voice cause your mad. but just remember his only 2 or 3. sit him down saying. " No kicking the dog its a no no. You want a time out? My son normally answers me with a no or yes answer cause he does understand. Coming at a child with your hand up or charging at them can scare them and scare them.posted 07/23/2011 by alessandrasp_56
I have 2 boys.1 girl A 6 year old, a 3 year old, and a 5 year old. My two older ones fight all of the time. I used to be one of the most quietest people, until I had two toddlers. My parents Allwas yelled at me, had enough time to be around me to Yell I think my yelling comes from learning from my mum comes from a very loud family and not having any time to myself I stay at home with my kidsposted 06/18/2011 by lizzy123abc
I find that when I approach a situation with energy and focus, I can really talk to my four year old and SHE UNDERSTANDS!!! But, sigh, being pregnant, I have no energy and yell too often : ( She loves it when I talk to her ... she WANTS my attention and loves to be treated like the "little grown up" ... I encourage you to try this once when you are feeling super energetic : )posted 05/31/2011 by BelleTower
I am the mother of a 4 year old, and a 5 month old. I seem to be frustrated with my 4 year old all of the time. I see that it is petty stuff that is making me frustrated, but i don't know how to stop. My poor little boy still tells me all of the time that he loves me, and still wants me to lay him down at night. I love this beautiful little boy so much, but yet i still find myself yelling at him. I get frustrated when he gives me attitude, and doesn't move fast enough, doesn't eat well, getting out of bed and playing. But as i am saying these things, i am realizing that these are normal child behaviors, and i should just have more patience, but in the moment, i can't find the patience, and he gets the brunt of my anger. Any suggestions of how to stop in the moment? I need help!posted 05/31/2011 by a BabyCenter Member
I know it is very painful to think you have harmed your child in this way. But first you are a great Mom because you have recognized the problem and asked for help! (No not a therapist, just been here.) First ? do you get any "me time"? Even if its just an hour? When somebody said that here I just laughed, but when I started to go back to the gym & work out for an hour a day it really helped. Trust me everything will still be there when you get back. Lol. Also & I think most impt as a single full time Mom, I apologized to him. I sat on the floor & told him how sorry I was & how much I loved him. Then I held him tight for a few min & he told me it was ok, he still loved me. (He's abt 36mnths old). I'm not saying I don't get upset w/ him anymore, but I try to take a deep breath & if I need a time out I tell him I need a 5min time out & walk away. I love my son & want whats best for him. I'm not saying my way is right, but it has helped me & our relationship! Good luck!!posted 05/17/2011 by babyfranksm0m
Oh God m so much annoyed by my lil one dat i just searched the topic n i found this thread.He is only 18months old n is so energectic i just get tired of telling him again n again to stop doing something,esp baba's laptop,tv,remote,mobile n water dispensers.he knows he is doing wrong cause he stops doing whatever mess he is creating when he sees us, n then get back to it when v move away.M having such bad moods nowadays because of shouting all the time.Y i just cant b patient with him:(M also afraid if i dont stop him now he wud develop a habit of ruining things.helpppppppppppposted 05/17/2011 by ena_mena
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The Silarian sector was a sector in Federation space.
It contained the Kataan star system with the remnants of the Kataan sun which went nova in the 14th century. The path of the Kataan probe was traced back to this sector by a Federation probe launched by the USS Enterprise-D in late 2368. (TNG: "The Inner Light")

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Nancy throws a cocktail party for town leaders; U-Turn pays a threatening visit to Conrad and Heylia; Doug tries to thwart Celia's growing interest in Sullivan; Silas makes a beautiful and devout new friend, Tara (guest star Mary-Kate Olsen).
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text: Today is three weeks from the start of my m/c and I am feeling really lousy. I can't seem to think about anything else right now. I want so bad to call my mom or my sister or my best friend, but in a way I feel weird about doing that. How do you start that conversation? "Hey mom, I just wanted to say I feel like crap today." And what can she do other than cry with me? I know that my friends and family would all be more than happy to support me through my bad day and cry with me, but I just don't want to make that phone call. I just want to go to bed and hope that I feel better when I wake up. This sucks.


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Kanusda's Group
Kanusda is facing a really difficult time, as her husband's income is inadequate to meet the family's needs and to pay for the children's educational expenses. So Kanusda is trying to help him fulfill their needs by sewing clothes. She is a very efficient tailor and wants to generate more income by purchasing a new sewing machine. But due to financial constraints, she is unable to purchase it.
For that, as a member of a six-person lending group, she has requested a loan from Kiva's Partner, BRAC Pakistan. She will use the loan to purchase a sewing machine to sew more dresses and to satisfy the needs of her clients more professionally.
Kanusda will extend her business if she gets a good amount of profit in the future. She hopes, with the help of the loan, to reach her desired net income and to be able to save for their future. She dreams of giving her children a quality education.
Note: In the picture, Kanusda holds a passbook in her hand.
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BRAC Pakistan focuses its work in some of the most underdeveloped parts of Pakistan, characterized by poor infrastructure and high levels of poverty. By supporting this loan, you are enabling access to finance for borrowers living in some of Pakistan's poorest areas.
About BRAC PakistanBRAC Pakistan is a subsidiary of BRAC, one of the world's largest development organizations with a focus on microfinance and economic empowerment. It offers micro-loans designed to help small businesses, very poor clients and others, in addition to health and education services. Kiva's flexible, zero-interest capital will enable BRAC to expand its outreach in underserved regions and to women who have had no access to microfinance services.
This is a Group Loan
In a group loan, each member of the group receives an individual loan but is part of a larger group of individuals. The group is there to provide support to the members and to provide a system of peer pressure, but groups may or may not be formally bound by a group guarantee. In cases where there is a group guarantee, members of the group are responsible for paying back the loans of their fellow group members in the case of delinquency or default.
Kiva's Field Partners typically feature one borrower from a group. The loan description, sector, and other attributes for a group loan profile are determined by the featured borrower's loan. The other members of the group are not required to use their loans for the same purpose.
About Pakistan
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Success!! The loan was 100% repaid
- Repayment Term
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- Repayment Schedule
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- Pre-Disbursed:
- Dec 10, 2012
- Listed
- Dec 15, 2012
- Currency Exchange Loss:
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- Ended:
- Oct 17, 2013


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I have recently installed iOS 6 beta on my device and updated to the latest mono develop release. Since this, I now get the following error when trying to deploy to my device, "Installation failed: AMDeviceInstallApplication returned: 0xe8008018" - Could not upload to the device.
I have tried other projects and get the same error. As far as I'm aware, there is no code signing problems - all appears fine in the log. It worked fine before I installed IOS6. I don't have another device with iOS 5 to test.
Any ideas as to why I am getting this error?
Thank you.


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Week two of #WhiskyAdvent and we're starting in much the same vein as the first, with a truly fantastic Sherry matured Speysider and a perfect winter dram, from another distillery that's rightly gained a reputation for producing some of the best Sherry matured whiskies available today. Behind the eighth window of The Whisky Advent Calendar is Balvenie's fantastic Single Barrel Sherry Cask 15 Year Old.
Although 'Single Barrel', this 15 year old is a continuous release, with each bottle drawn from a single cask. This means that no more than 650 bottles of this whisky actually come from the exact same cask (whilst no two casks are identical, legendary Malt Master David Stewart selects those with the desired character). The potential outturn from each cask also points to something else - The Balvenie Single Barrel Sherry Cask isn't really matured in a 'barrel' at all, but rather a big first fill European oak ex-Oloroso Sherry butt!
Tags: whiskyadvent, whisky advent, drinks by the dram, whisky advent calendar, balvenie, single malt, scotch whisky, fruitcakes
Categories : Drinks by the Dram | Tasting Notes | Whisky
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The final dram of the first week of #WhiskyAdvent... Time to open up window seven of the Drinks by the Dram Whisky Advent Calendar and see what it is!
Why, it's a Campbeltown malt from Glen Scotia, whose whiskies have received all-new, all-new packaging this year and whose range has also seen a complete overhaul. Out have gone the 10, 12, 16, 18 and 21 year olds (most of which were relatively new themselves) and in come Double Cask, a 15 Year Old and Victoriana. It's not just the bottlings that have been revamped either, the last year or two have seen upgrades to the stills, three new washbacks, a new spirit safe and the building of a visitor centre at the distillery!
Tags: whiskyadvent, whisky advent, drinks by the dram, glen scotia, single malt, scotch whisky, campbeltown, all-new all-new
As we approach the end of the first week of Drinks by the Dram's #WhiskyAdvent, it feels like it may be time for a peated single malt Scotch whisky. Something from Islay, perhaps? Right on cue, behind window six of The Whisky Advent Calendar we find a delicious Kilchoman!
This 2014 release is a vatting of 5 and 6 year old whisky matured in ex-bourbon barrels and Oloroso Sherry butts, the last of the 'work in progress' Machir Bay releases, as it were, which have been a fantastic insight as to how the spirit from Islay's youngest distillery has been developing. (Hint: it's been going pretty well!) Machir Bay has now become both a continuous release and their core expression, with this December marking the 10th anniversary of spirit first running from the stills.
Tags: whiskyadvent, whisky advent, drinks by the dram, kilchoman, single malt, scotch whisky, islay, joint birthday-and-christmas presents
Christmas just isn't Christmas without a satsuma (not especially exciting) and a chocolate orange (Woo! Get in! Let's chuck this in an unnecessarily aggressive manner at the nearest solid object to disperse its delicious segments!) in your stocking. Well, what if you could have liquid chocolate orange that was also 40% abv? Chuck in a slice of Christmas cake and you're getting pretty close to what's behind window number five of Drinks by the Dram's Whisky Advent Calendar!
Incredibly, it's not made of Christmas though, it's actually made at a distillery in the Scottish Highlands using malted barley, water, yeast and time (at least 15 years in this case) in ex-Matusalem, Apostoles and Amoroso Sherry casks (all made of oak). So, yes, it's single malt Scotch whisky!
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After being named Highland Independent Bottler of the Year in 2014 at Whisky Magazine's Independent Bottlers' Challenge, we're extremely proud to announce that for 2015 Master of Malt have picked up two overall category wins, being named:
Islands Independent Bottler of the Year 2015 & Grain Independent Bottler of the Year 2015
Tags: independent bottlers challenge, master of malt, islands, single malt, grain whisky, islands independent bottler of the year, grain independent bottler of the year, whisky mag, whisky magazine, highland park, invergordon, loch lomond, awards
Categories : Whisky | News
Our worldwide magical mystery tour continues! OK, it's neither magical (I am no wizard) nor is it a mystery (I've got it all planned out. Sorta.), but we will be exploring the world of spirits and it does indeed continue this week with our second dram of South African deliciousness! I mentioned at the end of the last blog that we wouldn't be going far from the James Sedgwick Distillery, and we're certainly not. We'd only have to travel about 25 miles vaguely in the direction of Cape Town to Van Ryn's Distillery near Stellenbosch!
Tags: around the world in 80 drams, south africa, van ryn, brandy, murder mystery
Categories : Tasting Notes
After Scotch and Japanese single malts and a blended whisky, the Drinks by the Dram Whisky Advent Calendar is now taking us to Old Bourbon County for some classic American whiskey! Well, actually, without moving, Elijah Craig was from Fayette, Woodford or Scott Counties, Virginia or Kentucky (keeping up with this season's map in the late 18th century was an expensive business), but that's because Bourbon County was named after the French house rather than the whiskey. It's with ol' Elijah that the story of Kentucky bourbon whiskey may begin, however...
Tags: whiskyadvent, whisky advent, drinks by the dram, whisky advent calendar, elijah craig, bourbon, cartography
UPDATE: Free Shipping for large orders will now be available until further notice!
A few months ago we talked about how much shipping charges suck, and then we did something about it – making thousands of products free to ship within the UK and giving you £5 off elsewhere.
Well, today it's time to do more – until Christmas shipping for large orders will now be free within the UK and Europe.
Tags: free shipping, good enough isn't, goodenoughisnt
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Day 3 already? Time flies when you're having #WhiskyAdvent fun! (Although it's definitely not too late to catch up if you don't yet have a Drinks by the Dram calendar...)
In The Whisky Advent Calendar today is a treat from one of our favourite independent bottlers and blenders, whisky zealot John Glaser's truly excellent Compass Box.
The Great King Street Artist's Blend takes its name from the address of Compass Box's Edinburgh offices and, like all their whiskies, is bottled with neither chill-filtration nor artificial colouring. Priding themselves on transparency, we can tell you that this small batch blend always contains around 50% malt whisky (a very high percentage for a blend) In fact, we can tell you that it's made up of 46% first fill American oak matured Lowland grain whisky, 28% 'fruity and malty' Northern Highland single malt, 17% 'grassy' Northern Highland single malt, and 9% 'meaty' Speyside single malt! (66% of the blend is matured in first fill American oak overall and 8% in first fill Sherry butts with 28% finished in new French oak casks).
Tags: whiskyadvent, whisky advent, drinks by the dram, whisky advent calendar, compass box, john glaser, blended whisky, great king street, artists blend, sue barker
Categories : Drinks by the Dram | Whisky | Blended | Tasting Notes
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It's been an exciting year for the Kingsbarns Distillery. On the 30th of November 2014, the distillery was officially opened, with the first spirit running from the still in January 2015 and filled their first cask the following month - which is proudly presented in their "Doocot", a very charming architectural feature of the Kingsbarns Distillery grounds, which once upon a time housed a flock of pigeons. All massive milestones for a burgeoning distillery that is now maturing whisky for us all to taste when the time comes!
Tags: kingsbarns, founders club


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This is the optional aluminum replacement single arm servo horn from Losi. This is the servo horn that is used for the steering bell crank. This servo horn will work on Futaba and Ace servos.
This product was added to our catalog on May 16, 2007.
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Losi Aluminum Servo Arm (FUT)
I bought this intended for the SCTE 2.0. The finish and looks are superb, and the spline fit and threading is just as good. With that being said, it was pretty tight on the metal servo splines the first time I tightened it down and required some tactile prying to get it back off, but the second time around it was much easier and still fit slop-less. The inside mounting hole for the 2.0 can cause servo rub/bind if your not careful at setting the link length and EPA, but the outer hole seemed to have plenty of clearance. Very nice product and wouldn't hesitate to buy more.
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Gloucester news flash: Talk radio may actually be useful
Some interesting solutions to scaring off coyotes came to light at Tuesday night's Board of Supervisors. For livestock owners, a llama or, better yet, a donkey can be useful to chase off the predators who have ravaged a Gloucester farmer's cattle herd. "Donkeys particularly are very good at chasing away coyotes," said Steve Baranek, Gloucester's senior Animal Control officer.
Perhaps the easiest solution is the airwaves. Baranek said voices on the radio can scare off coyotes. "Make sure you use talk radio and not music," he said. "They're more scared of the voices than they are the music." So apparently, Glenn Beck, Rush Limbaugh and Sean Hannity -- or any of the other loud voices on radio for that matter -- have something in common with donkeys. At least when it comes to chasing off coyotes.


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Video Game Avengers Snake Fury Fan Art by rs2studiosWatch
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Im not sure why, but photoshop mash-ups of fandoms im into seem to be the fun way to express my creativity lately. Here is my latest my interpretation of Video Game characters that would fit the Avengers. I have Metal Gear's Solid Snake as Nick Fury.


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The Mets' No. 3 prospect struck out six and allowed a run on four hits over a season-high six innings as Buffalo defeated Gwinnett, 4-1, on Wednesday.
Familia struggled a bit in the first inning, walking Luis Durango with one out. After Durango stole second and third base, Familia surrendered an RBI single to Stefan Gartrell, but recovered to set down the next seven batters before Durango bunted for a single in the third.
Wednesday marked the first time all season that Familia (3-1) worked into the sixth. The 22-year-old right-hander walked two and exited for a pinch-hitter in the seventh after throwing 59 of his 85 pitches for strikes.
Since surrendering six runs over four innings against Lehigh Valley on April 16, Familia has posted a 2.84 ERA over his last four starts, going 2-0 in that time.
Justin Hampson allowed three hits over 1 1/3 scoreless innings of relief and Elvin Ramirez recorded the save with 1 2/3 perfect innings.
Zach Lutz was 2-for-5 with two RBIs and is batting .321 for the Bisons and Fred Lewis had three hits.
Today on MiLB.com
Top Stories on MiLB.com
- Toolshed: Brewers lefty Hader thriving in rotation
- Umpires make right call in roadside rescue
- Roundup: Giants' Parker, Yankees' Judge mash
- RockHounds' Alcantara hurls six hitless frames
- Quick learner De Jong dominates for Drillers
- Drive's Espinoza racks up career-high 11 K's
- Effective Goudeau puts end to Blue Rocks' skid
- BlueClaws' Pujols stays on even keel, powers up


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Number: 0875
Aetna considers bendamustine (Bendeka, Treanda) medically necessary for the following indications (see Appendix for selection criteria):
Aetna considers bendamustine experimental and investigational for all other indications including the following (not an all-inclusive list):
Bendamustine (Treanda) is a alkylatic agent used in the treatment of chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphomas (NHLs). Bendamustine was approved by the U.S. Food and Drug Administration (FDA) in March 2008 for the treatment of CLL, and in October 2008, for treatment of indolent B-cell NHL that have progressed during or within 6 months of treatment with rituximab or a rituximab-containing regimen.
In a dose-finding study, Koster et al (2004) determine the maximum tolerated dose (MTD) of combined carboplatin/bendamustine in previously untreated patients with extensive-stage small cell lung cancer (SCLC). Carboplatin was administered as a 1-hour infusion on day 1 at increasing dose levels, and bendamustine was administered as a short infusion on days 1 and 2 at increasing dose levels (80 to 120 mg/m(2)). The regimen was administered every 3 weeks. Four dose levels were planned, starting with 80 mg/m(2) bendamustine and carboplatin area under the curve (AUC) 5 (dose level I). The other dose levels were 100 mg/m(2) bendamustine and carboplatin AUC 5 (dose level II), 100 mg/m(2) bendamustine and carboplatin AUC 6 (dose level III), and 120 mg/m(2) bendamustine and carboplatin AUC 6 (dose level IV). A minimum of 3 patients were enrolled at each dose level. Dose-limiting toxicities (DLTs), which included fatigue, infection and tachyarrhythmia, were observed at dose level III. The recommended dose for phase II studies was therefore established at dose level II. The majority of hematological and non-hematological toxicities observed were only mild (grade 1 or 2) in patients at dose levels I and II. None of the patients developed severe alopecia. Objective responses were observed in 8 of the ten patients involved in this trial. The authors concluded that because of its acceptable toxicity and favorable preliminary anti-tumor efficacy, the combination of carboplatin and bendamustine appeared to be a potentially useful chemotherapeutic option in patients with extensive SCLC.
In a phase II study, Lammers et al (2014) determined the time to progression (TTP), response rate (RR), and toxicity for North American patients with relapsed SCLC treated with bendamustine in the 2nd- or 3rd-line setting. Patients with relapsed, histologically confirmed SCLC were eligible for enrollment on study. The study population included patients with both chemotherapy-sensitive and chemotherapy-resistant disease treated with up to 2 prior lines of chemotherapy. Patients were treated with 120 mg/m of bendamustine on days 1 and 2 of a 21-day cycle for up to 6 cycles. Primary end-point was TTP; secondary end-points included toxicity, RR, and overall survival (OS). A total of 59 patients were accrued, 50 patients met eligibility for enrollment. The median age of patients was 62, and 56 % were men; 29 patients (58 %) had chemotherapy-sensitive disease. Median TTP was 4.0 months (95 % confidence interval [CI]: 3.3 to 5.4), median OS was 4.8 months (95 % CI: 3.8 to 6.3), and the RR was 26 % (95 % CI: 13.3 % to 39.5 %). Patients with chemosensitive disease had a median TTP of 4.2 months (95 % CI: 3.3 to 6.0) compared with 3.4 months (95 % CI: 2.7 to ∞) for chemotherapy-resistant disease. The RR was 33 % (95 % CI: 14.2 % to 51.8 %) in patients with chemosensitive disease and 17 % (95 % CI: 0 % to 34.4 %) in those with chemoresistant disease. The most common grade 3/4 adverse events were fatigue (20 %), dyspnea (12 %), and anemia (12 %). The authors concluded that bendamustine has modest activity in relapsed SCLC similar to other agents evaluated in this patient population.
Burotto et al (2013) determined tolerability and for the first time explored efficacy of bendamustine-rituximab (BR) in multiply relapsed/refractory hairy cell leukemia (HCL), using 2 different dose levels of bendamustine. Patients with HCL with greater than or equal to 2 prior therapies requiring treatment received rituximab 375 mg/m(2) days 1 and 15 plus bendamustine 70 (n = 6) or 90 (n = 6) mg/m(2), days 1 and 2, for 6 cycles at 4-week intervals. At 70 and 90 mg/m(2)/dose of bendamustine, overall response rate was 100 %, with 3 (50 %) and 4 (67 %) complete remissions (CR) in each respective group. Minimal residual disease (MRD) was absent in 67 % and 100 % of CRs, respectively. All 6 without MRD remain in CR at 30 to 35 (median of 31) months of follow-up. Soluble CD22 and CD25 levels decreased with all responses, with median values decreasing from 17.7 and 42 ng/ml at baseline to undetectable and 2 ng/ml after CR, respectively (p < 0.001). Of 12 patients receiving 72 cycles of BR, the most common toxicities were hematologic, including thrombocytopenia (83 %), lymphopenia (75 %), leukopenia (58 %), and neutropenia (42 %). Grade III and IV hematologic toxicity included lymphopenia and thrombocytopenia (each 75 %), leukopenia (58 %), and neutropenia (25 %). No significant dose-related differences were detected in response or toxicity. The authors concluded that BR has significant activity in HCL. Bendamustine at either 70 or 90 mg/m(2)/dose was highly effective in multiply relapsed/refractory HCL and could be considered for achieving durable CRs without MRD in patients after failure of standard therapies. As it was not dose-limiting, 90 mg/m(2)/dose was chosen for future testing.
Pan et al (2014) performed a phase I study to evaluate the DLTs and to determine the MTD/recommended phase II dose of bendamustine with concurrent whole brain radiation (WBR) in patients with brain metastases (BM) from solid tumors. Four doses of intravenous weekly bendamustine were administered with 3 weeks of WBR at 3 dose levels (60, 80, and 100 mg/m(2)) according to a standard 3 + 3 phase I design. A total of 12 patients with solid tumor BM were enrolled in the study (6 with non-small cell lung cancer, 4 with melanoma, 1 with breast cancer, and 1 with neuroendocrine carcinoma). The first 2 dose levels had 3 patients each, and the 3rd dose level had 6 total patients. Plasma pharmacokinetic studies of bendamustine demonstrated no significant differences from pharmacokinetic characteristics of bendamustine in other studies. No DLTs were noted at any dose levels, and no grade 4 toxicities occurred. The MTD of weekly bendamustine with concurrent WBR was 100 mg/m(2). The majority of trial patients died from progressive systemic disease rather than their brain disease. The combination of weekly bendamustine with concurrent WBR was acceptably tolerated. They stated that the efficacy of this combination may be evaluated in a phase II trial with stratification by histologies.
Miyazawa et al (2014) reported the case of a 40-year old man who was diagnosed with Langerhans cell histiocytosis (LCH) in October 2010. His LCH was refractory to conventional chemotherapy, and thus worsened to Langerhans cell sarcoma (LCS) in May 2011. Although these investigators repeated combinational chemotherapies, new infiltration of the liver and bone marrow, as well as primary lesions of the bone, lymph nodes, and skin, appeared. These intensive chemotherapies caused candida liver abscesses, invasive aspergillosis, disseminated varicella zoster virus infection and bacterial sepsis. These researchers administered bendamustine for chemotherapy, which resulted in a partial response (PR) with no severe adverse events. Because of pancytopenia caused by secondary myelodysplastic syndrome, these researchers stopped the bendamustine chemotherapy after 2 courses. Partial response was maintained for 4 months. These investigators planned to perform allogeneic hematopoietic stem cell transplantation from a sibling donor after a conditioning regimen. The authors concluded that optimal therapy for adult LCH, which is a rare and treatment-resistant disease, has yet to be established; and bendamustine is a potential chemotherapeutic agent for standard treatment of LCS.
Lionberger et al (2014) performed a phase I/II clinical trial for newly-diagnosed acute myeloid leukemia (AML) or high-risk myelodysplastic syndrome (MDS) patients aged greater than or equal to 50 years using a Bayesian approach to determine whether 1 of 3 doses of bendamustine (45, 60, 75 mg/m(2) days 1 to 3), together with idarubicin (12 mg/m(2) days 1 to 2), might provide a complete response (CR) rate greater than or equal to 40 % with less than 30% grade 3 to 4 non-hematological toxicity. These researchers treated 39 patients (34 AML; 5 MDS with greater than 10 % marrow blasts; median age of 73 years). None of the 3 bendamustine doses in combination with idarubicin met the required CR and toxicity rates; the 75 mg/m(2) dose because of excess toxicity (2 of 3 patients) and the 60 mg/m(2) dose because of low efficacy (CR rate 10/33), although no grade 3 to 4 non-hematological toxicity was seen at this dose. Median survival was 7.2 months. All patients began treatment as out-patients but hospitalization was required in 90 % (35/39). Although these investigators did not find a dose of bendamustine combined with idarubicin that would provide a CR rate of greater than 40 % with acceptable toxicity, bendamustine may have activity in AML/MDS patients, suggesting its addition to other regimens may be warranted.
Tsimberidou et al (2014) stated that bendamustine has shown promising results in solid tumors. An investigator-initiated phase I clinical trial of the anti-vascular endothelial growth factor (VEGF) agent bevacizumab and bendamustine was conducted in patients with advanced cancer, because the 2 drugs have different mechanisms of anti-tumor activity and non-overlapping toxicity. Patients were treated with escalating doses of intravenous bendamustine (70, 80, 90, and 100 mg/m(2); days 1 and 2) and intravenous bevacizumab (10 mg/kg; days 1 and 15). A conventional "3 + 3" study design was used. A total of 42 patients were treated: 23 women and 19 men. The median age was 60 years. Patients had received a median of 4 prior therapies (range of 1 to 10). The most common cancer types were colorectal (n = 9), head and neck (n = 8), non-small cell lung (n = 6), and breast (n = 5). Overall, 117 cycles were administered (median per patient of 2; range of 1 to 8). No dose-limiting toxicities were noted during the escalation phase. Therefore, the highest dose (level 4) of bendamustine (100 mg/m(2)) was used in the expansion phase. The most common toxicities were fatigue (n = 22), nausea (n = 14), anorexia (n = 9), and thrombocytopenia (n = 7). Of 38 patients who were evaluable for response, 23 (61 %) had stable disease, including 2 (5.2 %) who had stable disease for 6 months or more (1 with adenoid cystic carcinoma and 1 with non-small cell lung cancer [NSCLC]). This regimen of bendamustine (100 mg/m(2)) and bevacizumab (10 mg/kg) was well-tolerated and yielded disease stabilization in selected heavily pre-treated patients with advanced cancer.
National Comprehensive Cancer Network's Drugs & Biologics Compendium (2015) lists adult T-cell leukemia/lymphoma, mycosis fungoides, peripheral T-cell lymphoma, primary cutaneous CD30+ T-cell lymphoproliferative disorders, Sezary syndrome, and small cell lung cancer as recommended indications of bendamustine.
Huber et al (2015) stated that bendamustine esters proved to be considerably more potent cytotoxic agents than the parent compound against a broad panel of human cancer cell types, including hematologic and solid malignancies (e.g., malignant melanoma, colorectal carcinoma and lung cancer), which are resistant to bendamustine. Furthermore, NCCN's clinical practice guideline on "Melanoma" (Version 3.2015) does not mention bendamustine as a therapeutic option.
Non-Follicular Indolent Non-Hodgkin Lymphomas:
In a phase II clinical trial, Luminari and colleagues (2015) determined the activity and safety of 6 cycles of bendamustine and 8 rituximab as first-line treatment of adult patients with advanced stage non-follicular indolent non-Hodgkin lymphomas (INFL). The primary end-point was the complete response rate (CRR) with expected CRR of 75 %. A total of 69 patients were enrolled; median age was 65 years (45 to 75), 65 % were male, 93 % of patients had stage IV disease. Complete and overall response rates were 48 % (95 % CI: 35.6 to 60.2), and 86 % (CI: 75.0 to 92.8). The most common grade 3/4 adverse events were neutropenia (43 %), thrombocytopenia (7 %), anemia (4 %); whereas the rate of febrile neutropenia was very low (3 %). At a median follow-up of 22 months (1 to 43 months), 2-year progression free survival (PFS) was 89 % (CI: 79 to 95), and 2-year OS was 96 % (CI: 87 to 99). The authors concluded that rituximab combination is active and well-tolerated in patients with advanced stage previously untreated INFL. These preliminary findings need to be validated by well-designed studies.
Bendamustine is considered medically necessary for the following indicaitons (based upon current guidelines from the National Comprehensive Cancer Network (NCCN, 2013)):
|CPT Codes / HCPCS Codes / ICD-10 Codes
|Information in the [brackets] below has been added for clarification purposes.  Codes requiring a 7th character are represented by "+":
|Other CPT codes related to the CPB:
|Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
|Chemotherapy administration, intravenous infusion technique; each additional hour (list separately in addition to code for primary procedure)
|HCPCS codes covered if selection criteria are met:
|Injection, bendamustine HCL, 1 mg
|ICD-10 codes covered if selection criteria are met:
|Lymphoma; hodgkin, follicular, non-follicular, mantle, diffuse large B-cell, lymphoblastic (diffuse)
[Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL)]
|Cutaneous T-cell lymphoma, unspecified [Diffuse Large B-Cell Lymphoma, Primary Cutaneous B-Cell Lymphoma]
|Other and unspecified mature T/NK-cell lymphoma [Diffuse Large B-Cell Lymphoma, Primary Cutaneous B-Cell Lymphoma]
|Other specified types of non-Hodgkin lymphoma [Diffuse Large B-Cell Lymphoma, Primary Cutaneous B-Cell Lymphoma]
|Other specified types of T/NK-cell lymphoma [Diffuse Large B-Cell Lymphoma, Primary Cutaneous B-Cell Lymphoma]
|Malignant immunoproliferative disease and certain other B-cell lymphomas
|Multiple myeloma not having achieved remission
|Multiple myeloma in relapse
|Plasma cell leukemia not having achieved remission [multiple myeloma]
|Plasma cell leukemia in relapse [multiple myeloma]
|Extramedullary plasmacytoma not having achieved remission
|Extramedullary plasmacytoma in relapse [multiple myeloma]
|Solitary plasmacytoma not having achieved remission
|Solitary plasmacytoma in relapse [multiple myeloma]
|Chronic lymphocytic leukemia of B-cell type not having achieved remission [Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL)]
|Chronic lymphocytic leukemia of B-cell type in relapse [Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL)]
|ICD-10 codes not covered for indications listed in the CPB:
|Malignant neoplasm of rectosigmoid junction
|Malignant neoplasm of bronchus and lung [non-small cell and small cell lung cancer]
|Malignant neoplasm of breast
|Malignant neoplasm of head, face and neck
|Secondary malignant neoplasm of brain [solid tumor brain metastases]
|Unspecified B-cell, mediastinal large B-cell, and non-Hodgkin lymphoma, unspecified
|Hairy cell leukemia
|Acute myeloid leukemia
|Sarcoma of dendritic cells (accessory cells) [Langerhan's cell sarcoma]
|Myelodysplastic syndromes
|Immune thrombocytopenic purpura


text:
Nov 07, 2012
ABU DHABI [MENL] -- Shi'ite unrest in Bahrain has escalated into a bombingcampaign that officials linked to Iran.
Jun 19, 2012
CAIRO [MENL] -- A U.S.-led multinational force in Egypt's Sinai Peninsulahas been focusing on protection amid the rising Bedouin and Palestinianinsurgency threat.
Dec 14, 2011
TEL AVIV [MENL] -- The government of Israeli Prime Minister BinyaminNetanyahu, despite warnings by the intelligence community, has been stunnedby the ferocity of Jewish resistance to demolition operations in the West Bank.
Nov 14, 2011
TEL AVIV [MENL] -- The Israel Army has set a requirement for 500 vehicles by2014.


text:
As we speak, Senator Rand Paul and a handful of other American statesmen are into the tenth hour of filibustering the Obama nominee to head the CIA, John Brennan. Bless them for having the guts to stand up for Americans and the Constitution!
Interestingly, today is the anniversary of the day the Alamo was overrun by the Mexican forces of Santa Anna. To show support to Senator Paul, Texas Senator Ted Cruz read the letter written by Colonel Travis as the Mexican troops were strengthening:
The men who chose to remain at the Alamo were under no illusion they would ever walk away from that sacred mission. They faced certain deaths but chose to remain and fight. The corruptocrats in Washington today make a mockery of those brave patriots who died for something greater than themselves. Not surprisingly, when Senator Cruz read Col Travis' letter, John McCain and ten other wussypants Republicans were having dinner with Obama. They may all go to Hell.
AWD criticized Senator Paul when he voted for confirmation of Chuck Hagel, the first openly retarded Secretary of Defense. Senator Paul is not in good graces with me for that but this filibuster is winning him major AWD points. Ted Cruz continues to astonish AWD with his intelligence, drive, and love of the Constitution.
Not surprisingly, Senators supported by the Tea Party movement like Rand Paul, Ted Cruz, Mike Lee, and Marco Rubio are involved with the filibuster. Perhaps these brave Senators would have chosen to remain at the Alamo while wussypants RINOs like McCain, Lindsey Graham and a whole hell of a lot of others tucked tail and ran.
The American spirit will never die as long as the love of liberty and justice burns in the heart of at least one patriot. Yet, we are millions!
Today, we remember the Alamo. Tomorrow's cry should be "Remember the Constitution!"
You can watch the filibuster live here.


text:
Treebeard by allendouglasstudioWatch
©2011-2016 allendouglasstudio
This is my version of Treebeard from "Lord of the Rings". Oil on panel... 11" x 18".
Bien sûr, j'adore !
The eyes are wonderfully intense; the feeling of depth is remarkable.
Wow, really impressive with the lighting and all the details
That is so bizarre but so awesome!
so beautiful!
That's my how I imagined him. He looks more alien.
Wow!! This Treebeard is great! I love the light in this picture excellent composition!
Very cool
is it flightless?
I'm a little confused by your question... but yes,walking, talking trees are indeed flightless.
love this!! ents are awesome!!


text:
What if this present were the world's last night?
John Donne (1572 - 1631)
Source: Holy Sonnets, No. 13, L 1
Contributed by: Zaady
'Tis the year's midnight, and it is the day's.
Source: A Nocturnal upon St. Lucy's Day, being the shortest day, st. I
No man is an Island, entire of itself; every man is a piece of the Continent, a part of the main; if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friends or of thine own were; any man's death diminishes me, because I am involved in Mankind; And therefore never send to know for whom the bell tolls; It tolls for thee.
Source: Meditation XVII
No Spring nor Summer Beauty hath such grace As I have seen in one Autumnal face.
Our eye-beams twisted, and did thread Our eyes, upon one double string; So to entergraft our hands, as yet Was all the means to make us one, And pictures in our eyes to get Was all our propagation.
Source: The Extasy, L. 7
Send home my long strayed eyes to me, Which (Oh) too long have dwelt on thee.
Source: The Message, st. I
Our two souls therefore which are one, Though I must go, endure not yet A breach, but an expansion, Like gold to airy thinness beat.
Source: A Valediction Forbidding Mourning, st. 6
Poor intricated soul! Riddling, perplexed, labyrinthical soul!
Source: Sermon XLVIII
Reason is our Soules left hand, Faith her right, By these wee reach divinity. . . .
Source: "To the Countess of Bedford," c. 1607-8
Solitude is a torment which is not threatened in hell itself.
Source: Meditations, Meditation V
Copyright © 2016 Gaiam, Inc.


text:
First-Quarter M&A: Bigger
(T - Get Report) acquisition of BellSouth (BLS) pacing the trend, total merger volume in the U.S. was $331 billion from January through March, according to Thomson Financial, up over 19% from the first quarter last year.But behind the headlines, a subtler trend has emerged. The total number of deals this quarter fell from both the previous and year-ago periods. With rising interest rates, higher stock prices and an economic expansion in its third year, companies may start being more cautious about their acquisitions. "Despite the fact that we are growing at a good pace, the growth rates are going to slow," said Marc Pado, chief market strategist at Cantor Fitzgerald. "That in and of itself makes chasing a deal less desirable." On average, total value per deal was $1.49 billion, compared with about $1.23 billion in the first quarter last year. Larger transactions kept the M&A market buoyed; it was a number of smaller ones that petered out. Many of the deals announced this quarter were from private equity companies, including Blackstone's acquisition of CarrAmerica Realty (CRE) for $5.6 billion. Their acquisitions usually come with a heavy debt ticket, something that will get more expensive with rising interest rates. "Not all of these deals are done by using cash," said Pado. "If there is any debt already or if they are going to have to incur any debt to make the purchase or combination, then the less profitable the deal will be." Many companies have also done a significant amount of levering and refinancing over the past few quarters, often using proceeds to buy back shares or pay dividends. As firms begin closing in on their leverage capacity, issuing new debt won't be quite as easy.The first quarter of 2006 will be remembered as a huge one for mergers and acquisitions. With AT&T's
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