text:
Page 1
180 The Eurasian Journal of Medicine
Mycophenolate Mofetil in the Treatment of Systemic Lupus
Sistemik Lupus Eritematozus Tedavisinde Mikofenolat Mofetil
Ali Sahin1
1Ankara University, School of Medicine, Department of Clinical Immunology and Rheumatology, Ankara, Turkey.
Correspondence to: Ali Sahin, M.D., Ankara University, School of Medicine, Department of Clinical Immunology and Rheumatology, 06100, Sihhiye, An-
kara, Turkey. Phone: +90.312.5082234, Fax: +90.312.3097779, e-mail: firstname.lastname@example.com
Mycophenolate mofetil (MMF) is an immunosuppressive agent that
has been shown to be effective in transplant patients. It is also ef-
ficacious in the management of lupus nephritis and useful in the
treatment of autoimmune conditions because its mechanisms of
action target T- and B- lymphocytes, leading to suppression of the
cell-mediated immune response and antibody formation. MMF has
been used successfully to treat immune-mediated conditions like
myasthenia gravis, autoimmune hepatitis and immune cytopenias.
However, the conditions for its optimal use for non-renal manifesta-
tions (e.g., hematological, neuropsychiatric, myocardial, pulmonary
or cutaneous symptoms) in lupus patients are unclear. There have
yet to be any randomized, controlled trials to guide the optimal dose
and duration of MMF treatment in such situations. MMF is well tole-
rated and safe to use, although there are reports of serious adverse
effects including urticaria, myopathy, Epstein-Barr virus-associated B-
cell lymphoma, cytomegalovirus infection and disseminated varicella
zoster infection. Immunosuppressive treatment with MMF and sup-
portive care over the past few decades have led to improved clinical
outcomes in patients with severe lupus nephritis. A favorable long-
term prognosis can be ensured provided that effective treatment
is instituted early, before irreversible renal parenchymal damage oc-
curs. Another area of concern for patients is the increased cost of
long-term MMF use.
Mikofenolat mofetil (MMF) transplant hastalarında etkinliği göste-
rilmiş bir immünsüpresif ajandır. Lupus nefriti ve diğer otoimmün
hastalıkların tedavisinde; T ve B lenfositleri hedef alan etki mekaniz-
masına bağlı olarak, hücresel immün yanıtı ve antikor oluşumunu
baskılayarak, etkinliği gösterilmiştir. Myastenia gravis, otoimmün
hepatit, immün sitopeniler gibi otoimmün hastalıklarda başarıyla
kullanılmaktadır. Fakat, lupus hastalarında böbrek dışı tutulumlar-
da (hematolojik, nöropsikiyatrik, miyokardiyal, pulmoner, kütanöz
vb.) optimal kullanımı kesinlik kazanmamıştır. Bu durumlarda kul-
lanımında optimal doz ve süreye dair yol gösterici randomize kont-
rollü çalışma henüz bulunmamaktadır. MMF iyi tolere edilmekte ve
kullanımı güvenli olmasına rağmen; ürtiker, miyopati, Epstein-Barr
virüs ilişkili B-hücreli lenfoma, sitomegalovirüs enfeksiyonları ve dis-
semine varisella zoster gibi birtakım yan etkiler bildirilmiştir. Ciddi
lupus nefritli hastalarda MMF ile immünsüpresif tedavi ve destek
bakımı sayesinde son yıllarda klinik sonuçlarda iyileşme sağlanmıştır.
İrreversibl renal parankimal hasar oluşmadan önce etkin tedavinin
başlanması halinde uzun dönem prognoz daha iyi olabilir. MMF'in
uzun süreli kullanımında hastalar için önemli olan bir diğer noktada
artan maliyetidir.
Keywords: Systemic lupus erythematosus, Mycophenolate mofetil, Treat-
Anahtar Kelimeler: Sistemik lupus eritematozus, Mikofenolat mofetil,
Page 2
181 EAJM: 41, December 2009
ycophenolate mofetil (MMF), a mycophenolic acid
(MPA) prodrug, depletes guanosine nucleotides through
the inhibition of inosine-5'-monophosphate dehydroge-
nase (IMPDH), acting preferentially on T- and B-lymphocytes [1].
IMPDH is the rate-limiting enzyme in the de novo synthesis of
guanosine nucleotides, and T- and B-lymphocytes depend on this
pathway more than other cell types. MPA is also a more potent
inhibitor of the type II isoform of IMPDH, which is expressed
in activated lymphocytes, than of the type I isoform of IMPDH,
which is expressed in most other cell types [2]. Therefore, MPA
exerts a more potent cytostatic effect on lymphocytes than on
other cell types. This is the main mechanism by which MPA sup-
presses the cell-mediated immune response and antibody for-
mation. Additionally, MPA also inhibits the glycosylation and ex-
pression of adhesion molecules and hinders the recruitment of
lymphocytes and monocytes into sites of inflammation [3]. The
production of nitric oxide (NO) by inducible NO synthase (iNOS)
is also decreased, without affecting the activity of constitutive
NO synthases. This effect is mediated by MPA through the deple-
tion of tetrahydrobiopterin, a cofactor of the inducible form of
iNOS. Through these mechanisms, MMF exerts anti-inflammatory
and immunosuppressive activities.
In contrast to calcineurin inhibitors, MMF is not nephrotoxic.
It does not induce the production of transforming growth factor
(TGF)-χ, a cytokine that is fibrogenic. Additionally, MMF has no
adverse effects on blood pressure, cholesterol levels or triglycer-
ide levels in recipients. It was also noted that MPA is not muta-
genic and inhibits the proliferation of human B-lymphocytes that
are transformed by Epstein-Barr virus. MPA also suppresses the
proliferation of human arterial smooth muscle cells. These two
properties of MPA may decrease the risk of lymphoma develop-
ment and proliferative arteriopathy in recipients of MMF . Analy-
ses of clinical trials show that MMF reduces the incidence of early
and late rejection, is protective against long-term deterioration of
renal function, and reduces late renal allograft loss independently
of acute rejection and without increasing the risk for malignan-
cies [4]. Apart from renal transplants, MMF has also been found
to be useful in the management of pancreatic, hepatic and car-
diac transplants [5-9].
MMF is a suppressor of both T- and B-cell lymphocyte pro-
liferation and has been used successfully for the prevention of
acute and chronic rejection of renal allografts [10-13]. MMF has
a selective antiproliferative effect on lymphocytes and inhibits
antibody production by B-lymphocytes. MMF also induces de-
oxyguanosine nucleotide depletion and inhibits the transfer of
fucose and mannose to glycoproteins including glycoprotein ad-
hesion molecules. In view of the functions of adhesion molecules
(facilitating the attachment of leukocytes to endothelial cells,
playing a role in the initial interaction between leukocytes and
endothelial cells, and involvement in the interactions between
antigen-presenting cells and lymphocytes as well as effector lym-
phocytes and target cells), MMF should reduce the inflammatory
process in its early stages.
At higher concentrations, which may be reached in the clini-
cal setting, MMF has effects on cells that are unrelated to the
immune system. It has an antiproliferative effect on vascular
smooth muscle cells, even when pro-proliferative stimuli (e.g., an-
giotensin II and TGF-χ) are present. This effect is not shared by
other immunosuppressive drugs such as cyclosporine or tacroli-
mus. This antiproliferative effect on vascular smooth muscle cells
may be of relevance concerning the effect of MMF on chronic
allograft dysfunction. Because some glomerulopathies are associ-
ated with vascular lesions and microthrombus formation, which
resemble vascular rejection, MMF might be of use in advanced
stages of chronic glomerulopathies. Other documented chronic
activities of MMF include reduction of glomerular hypertrophy
and hyperfiltration, reduction of myofibroblast formation and col-
lagen III deposition and reduction of tubular cell proliferation and
interstitial fibrosis [10-14].
T- and B-lymphocytes are involved in the pathogenesis of
Fig. 1 _ Treatment algorithm for diffuse proliferative lupus nephritis. *:
Prior serious toxicities due to CYC, severe cytopenia, patient reluctance, etc.
#: Alternative treatments including MMF and cyclosporine, A: immunoad-
sorption, intravenous immunoglobulin, AZA: azathioprine, MP: methylpred-
nisolone, CYC: cyclophosphamide, MMF: mycophenolate mofetil [75].
Page 3
182 EAJM: 41, December 2009
autoimmune conditions. Hence, interference with their function
or proliferation will be beneficial for the management of these
conditions. Suppression of the cell-mediated immune response
and antibody production are key elements in the successful treat-
ment of many immune-mediated conditions. Therefore, MMF has
a role to play in the management of such conditions. MMF has
been a useful drug in the treatment of recurrent glomerulone-
phritis in allografts and all forms of primary glomerulonephritides,
especially nephrotic syndrome, lupus nephritis and vasculitis.
Zandman-Goddard and Shoenfeld reviewed the evidence
for the contribution of MMF in autoimmunity in animal models
of systemic lupus erythematosus (SLE), mercury-induced auto-
immune glomerulonephritis, diabetes mellitus, experimental
autoimmune uveoretinitis and experimental allergic encephalitis
[15]. Clinically, MMF has been used as a monotherapy or adjunct
therapy for myasthenia gravis [16-17], chronic immune demye-
linating polyneuropathy [18], chronic autoimmune hepatitis [19-
20], immune cytopenias [21-23], autoimmune inflammatory my-
opathy [24], psoriatic arthritis [25], non-lupus glomerulopathies
(IgA nephropathy, membranous nephropathy, focal segmental
glomerulosclerosis, membranoproliferative glomerulonephritis
or hepatitis C-associated glomerulonephritis) [26], autoimmune
HCV-associated hematological disorders [27], systemic vasculitis
[28] and inflammatory skin diseases (pemphigus vulgaris, pem-
phigus foliaceus and bullous pemphigoid) [29].
Treatment of Non-renal Manifestations of SLE:
A. Hematological Manifestations
Hematological manifestations are common among lupus pa-
tients [30-32], and immune leukopenia, thrombocytopenia and
hemolytic anemia are commonly encountered in the clinic. Most
of these lupus-related cytopenias respond well to higher doses
of corticosteroids or immunosuppressive drugs. Patients with re-
fractory immune cytopenias are uncommon, but very high doses
of corticosteroids and/or immunosuppressive agents are often
necessary to control the disease. Therapy-related complications
(for example, avascular necrosis associated with long-term high-
dose corticosteroids or recurrent infections associated with high-
dose cytotoxic drugs) have become significant issues that need
to be addressed. In 2003, Vasoo et al. reported the successful
use of MMF in the treatment of a lupus patient with refractory
thrombocytopenia [33]. Prior treatment with high-dose cortico-
steroids, pulse methylprednisolone and intravenous immunoglo-
bulin therapy had failed. The patient's platelet counts returned to
normal when MMF was instituted into the drug regimen. More
recently, Chang [34] described another successful outcome with
lupus-related refractory thrombocytopenia. Alba [35] and Mak
et al. [36] have reported the use of MMF to treat lupus patients
with hemolytic anemia refractory to conventional treatment and
observed good responses. In the rare occurrence of pure red-cell
aplasia in a lupus patient, a successful outcome was obtained
with the administration of cyclosporine and MMF [37]. These
cases represent a small series of successfully treated patients, but
their promising outcomes give us an insight into the usefulness
of MMF as a second- or third-line therapy for lupus patients with
refractory immune cytopenias.
B. Neuropsychiatric Manifestations
Neuropsychiatric abnormalities, ranging from psychosis to
cognitive deficits, occur frequently in lupus patients with active
disease. Frequently, the severity of the neurological involvement
requires chronic administration of high doses of corticosteroids
and/or cytotoxic drugs, with their attendant complications. How-
ever, there are no randomized controlled trials assessing the ef-
ficacy of MMF in such lupus patients reported to date. Most of
the relevant literature consists of anectodal reports. Jose and
co-workers successfully treated and maintained a lupus patient
with psychotic manifestations with MMF [38]. Another reported
success involved a case of cerebral vasculitis in a patient with
hereditary complete C4 deficiency and SLE. She was treated with
a combination of immunoadsorption and MMF [39]. Additionally,
Mok et al. have reported their preliminary experience with MMF
in the treatment of a patient with a lupus-related myelopathy in
the spinal cord [40].
C. Myocardial and Pulmonary Manifestations
Pericarditis and serositis (e.g., pleurisy) occur in lupus pa-
tients and are usually treated adequately with corticosteroids.
However, more serious involvements, such as myocarditis with
pulmonary hemorrhage, are uncommon but can be fatal. Treat-
ment of severe lupus-related pulmonary hemorrhage is often dif-
ficult. Samad reported on the use of MMF to treat a patient
with childhood SLE with recurrent pulmonary hemorrhage [41].
Regarding another pulmonary disorder, Swigris and co-workers
performed a retrospective survey of 28 patients with connective
tissue-related interstitial lung disease, one of whom had SLE, and
found that MMF preserves lung function and is safe and well
tolerated [42]. In animal studies, MMF has been shown to pre-
vent the development of experimental autoimmune myocarditis
[43]. Hence, MMF may be useful in the management of lupus-
related myocarditis. In a review of 12 lupus-related hemophago-
cytic syndrome patients with high prevalance of pericarditis and/
or myocarditis. MMF was successfully used as an adjunct in the
long-term treatment regimens for two of the patients [44].
D. Cutaneous Manifestations
Cutaneous lesions are common manifestations in lupus pa-
tients, and discoid rashes often lead to scarring of the involved
skin. In 2001, Goyal reported the successful treatment of recalci-
trant palmoplantar lesions in two lupus patients [45], and a year
later, Schanz described the resolution of extensive and refractory
subacute cutaneous lupus erythematosus with MMF in another
two patients. These patients had unfortunately developed severe
complications while on high-dose corticosteroid therapy [46].
Mycophenolate Mofetil and SLE
Page 4
183 EAJM: 41, December 2009
1. McMurray RW, Harisdangkul V. Mycopheno-
late mofetil: selective T cell inhibition. Am J
Med Sci 2002; 323: 94-6.
2. Allison AC, Eugui EM. Mycophenolate
mofetil and in mechanisms of action. Immu-
nopharmacology 2000; 47: 85-118.
3. Allison AC. Mechanisms of action of myco-
phenolate mofetil. Lupus 2005;14: 2-8.
Lang P , Pardon A, Audard V. Long-term ben-4.
Conflict interest statement The authors declare that they have no conflict of interest to the publication of this article.
Hanjani and Nousari expanded the use of MMF for the treat-
ment of four lupus patients with cutaneous lupus (lupus tumi-
dus, lupus panniculitis, discoid LE with perniosis and subacute LE)
[47]. These reports collectively testify to the promise that MMF
holds for the treatment of lupus-related cutaneous manifesta-
tions. However, Pisoni recently reported poor results from the
use of MMF to treat refractory cutaneous lesions. Of the seven
patients with SLE and refractory skin involvement (including
acute cutaneous lupus, subacute cutaneous lupus, discoid lupus
erythematosus, vasculitis, urticarial rash and chilblain lupus), five
did not respond, one demonstrated only a partial response and
one showed an initial response, with subsequent relapse while
still on MMF [48]. Hence, the usefulness of MMF in the manage-
ment of lupus with refractory cutaneous involvement is yet to be
fully understood.
E. Treatment Strategies
MMF seems to have promise as a second- or third-line agent
for the treatment of refractory non-renal lupus manifestations.
It is relatively well tolerated [49-51], safe to use and shows no
nephrotoxicity or adverse effects on blood pressure, cholesterol
levels or triglyceride levels. It is not associated with significant risk
of ovarian toxicity. Despite its clinical safety and relatively mild,
common side-effects, such as nausea, vomiting and diarrhea,
there are other concerns associated with MMF use. Urticaria
[52], myopathy [53], Epstein-Barr virus-associated B-cell lympho-
ma [54], cytomegalovirus (CMV) infections [55,56] and dissemi-
nated varicella zoster infections [57,58] have been reported.
Anectodal reports of the successful treatment of refractory
non-renal lupus manifestations cannot allow us to definitively
determine the optimal dose or duration of treatment. Hence,
the lack of randomized, double-blind controlled trials presents
a drawback in the effort to optimize the use of MMF in such
situations. In the renal setting, the Tricontinental Mycophenolate
Mofetil Renal Transplantation Study Group [59] determined that
a dosage of 2-3 g of MMF daily is efficacious and that the lower,
2-g daily dose regimen is associated with fewer side effects and
CMV infections. Another drawback to the wide use of MMF is
the high cost of the drug. Its cost can sometimes be prohibitive,
especially to those not covered by comprehensive medical insur-
ance and those residing in developing countries.
Lupus Nephritis Treatment
The management of severe proliferative lupus nephritis can
be divided into an initial induction phase followed by a prolonged
maintenance phase (Figure 1). Immunosuppressive treatment
during the two phases has the respective aims of achieving re-
mission and preventing relapse. Immunosuppressive medications,
tailored according to disease activity, remain the mainstay of
treatment for severe lupus nephritis. Commonly adopted treat-
ment regimens include combinations of corticosteroids and anti-
proliferative agents, such as cyclophosphamide, azathioprine or
The role of MMF in improving long-term outcomes of lupus
nephritis patients remains unknown. An ongoing, large-scale mul-
ticenter randomized controlled trial will determine the effective-
ness of MMF compared to intravenous cyclophosphamide during
the induction stage and MMF compared to azathioprine during
the maintenance phase. The optimal treatment regimen for lupus
nephritis varies according to several factors: class, activity and
chronicity indices and other prognostic factors (Tables 1, 2).
MMF has been widely used to prevent renal allograft rejec-
tion. Many case series and small controlled trials have suggested
the effectiveness of MMF in the treatment of lupus nephritis.
In early trials, cyclophosphamide (CYC) in combination with glu-
cocorticoids (GC) led to improved renal survival compared with
GC therapy alone and achieved lower rates of recurrence. Intra-
venous CYC became preferred over oral CYC due to perceived
lower levels of toxicity (i.e., increased risk of infection, ovarian
failure, reversible alopecia and bladder toxicity, particularly with
the use of pre-treatment hydration).
Subsequent studies have shown that a longer duration of
therapy during the maintenance phase improved remission rates
[60]. A recent randomized, open-label, non-inferiority trial sup-
ports the notion that MMF is as effective as intravenous CYC in
inducing short-term remission of lupus nephritis with a better
safety profile [61]. Regarding the management of lupus nephri-
tis, the role of MMF and its safety profile and cost-effectiveness
have been analyzed in several clinical trials by different groups
The issues of optimal dose, duration of treatment and cost-
effectiveness of MMF can only be adequately addressed with
randomized, controlled trials. Advances in immunosuppression
and supportive care over the past few decades have led to imp-
roved clinical outcomes in patients with severe lupus nephritis,
with increased efficacy and fewer complications. However, based
on anectodal reports, MMF is a useful addition to the armamen-
tarium available for treatment of lupus patients with refractory
non-renal manifestations. Another drawback to the wide use of
MMF is the high cost of the drug. Its cost can sometimes be pro-
hibitive, especially to those not covered by comprehensive medi-
cal insurance and those residing in developing countries.
Page 5
184 EAJM: 41, December 2009
Mycophenolate Mofetil and SLE
efit of mycophenolate mofetil in renal trans-
plantation. Transplantation 2005; 79: 47-8.
Garcia VD, Keitel E, Santos AF et al. Immu-
nosuppression in pancreas transplantation:
mycophenolate mofetil versus sirolimus.
Transplant Proc 2004; 36: 975-7.
Pierini A, Mirabella S, Brunati A, Ricchiuti A,
Franchello A, Salizzoni M. Mycophenolate
mofetil monotherapy in liver transplantation.
Transplant Proc 2005; 37: 2614-5.
Klupp J, Pfitzmann R, Langrehr JM, Neuhaus
P . Indications of mycophenolate mofetil in
liver transplantation. Transplantation 2005;
80: 5142-6.
Kobashigawa JA, Meiser BM. Review of ma-
jor clinical trials with mycophenolate mofetil
in cardiac transplantation. Transplantation
2005; 80: 235-43.
Sanchez V, Delgado JF , Morales JM, et al.
Chronic cyclosporine-induced nephrotoxic-
ity in heart transplant patients long-term
benefits of treatment with mycophenolate
mofetil and low-dose cyclosporine. Trans-
plant Proc 2004; 36: 2823-5.
10. Badid C, Desmouliere A, Laville M. Myco-
phenolate mofetil: implications for the treat-
ment of glomerular disease. Nephrol Dial
Transplant 2001; 16: 1752-6.
11. Choi MJ, Eustace JA, Gimenez LF , et al. My-
cophenolate mofetil treatment for primary
glomerular diseases. Kidney Int 2002; 61:
12. Harzallah K, Badid C, Fouque D, et al. Effi-
cacy of mycophenolate mofetil on recurrent
glomerulonephritis after renal transplanta-
tion. Clin Nephrol 2003; 59: 212-6.
13. Briggs WA, Choi MJ & Scheel PJ. Successful
mycophenolate mofetil treatment of glo-
merular disease. Am J Kidney Dis 1998; 31:
14. Romero F , Rodriguez B-Iturbe, Parra G, et al.
Mycophenolate mofetil prevents the pro-
gressive renal failure induced by 5/6 renal
ablation in rats. Kidney Int 1999; 55: 945-55.
15. Zandman-Goddard G, Shoenfeld Y. Myco-
phenolate mofetil in animal models of auto-
immune disease. Lupus 2005; 14: 12-6.
16. Cahoon WD Jr, Kockler DR. Mycophenolate
mofetil treatment of myasthenia gravis. Ann
Pharmacother 2006; 40: 295-8.
17. Prakash KM, Ratnagopal P , Puvanendran K,
Lo YL. Mycophenolate mofetil – as an ad-
junctive immunosuppressive therapy in re-
fractory myasthenia gravis: The Singapore
experience. J Clin Neurosci 2006.
18. Gorson KC, Amato AA, Ropper AH. Efficacy
of Mycophenolate mofetil in patients with
chronic immune demyelinating polyneuropa-
thy. Neurology 2004; 63: 715-7.
19. Chatur N, Ramji A, Bain VG, et al. Transplant
immunosuppressive agents in non-transplant
chronic autoimmune hepatitis: the Canadian
association for the study of liver (CASL) ex-
perience with Mycophenolate mofetil and
tacrolimus. Liver Int 2005; 25: 723-7.
20. Devlin SM, Swain MG, Urbanski SJ, Burak
KW. Mycophenolate mofetil for the treat-
ment of autoimmune hepatitis in patients
refractory to Standard therapy. Can J Gastro-
enterol 2004; 18: 321-6.
21. Hou M, Peng J, Shi Y, et al. Mycophenolate
mofetil (MMF) for the treatment of steroid
–resistant idiopathic thrombocytopenic pur-
pura. Eur J Hematol 2003; 70: 353-7.
22. Lin JT, Wang WS, Yen CC, et al. Myelodisplas-
tic syndrome complicated by autoimmune
hemolytic anemia: remission of refractory
anemia following Mycophenolate mofetil.
Ann Hematol 2002; 81: 723-6.
23. Zimmer-Molsberger B, Knauf W, Thief E. My-
cophenolate mofetil for severe autoimmune
hemolytic anemia. Lancet 1997; 350: 1003-
24. Majithia V, Harisdangkul V. Mycophenolate
mofetil (Cellcept): an alternative therapy for
autoimmune inflammatory myopathy. Rheu-
matology 2005; 44: 386-9.
25. Schrader P , Mooser G, Peter RU, Puhl W. Pre-
liminary results in the therapy of psoriatic ar-
thritis with Mycophenolate mofetil. Z Rheu-
matol 2002; 61: 545-50.
26. Karim MY, Abbs IC. Mycophenolate mofetil
in nonlupus glomerulonephropathy. Lupus
2005; 14: 39-41.
27. Ierardi E, Rendina M, Francavilla R, et al.
Mycophenolate mofetil in the treatment of
autoimmune HCV-associated hematological
disorders showing steroid resistance or de-
pendence. J Viral Hepat 2003; 10: 390-3.
28. Koukoulaki M, Jayne DR. Mycophenolate
mofetil in anti-neutrophil cytoplasm antibod-
ies-associated systemic vasculitis. Nephron
Clin Pract 2006; 102: 100-7.
29. Nousari HC, Sragovich A, Kimyasi-Asadi
A, Orlinsky D, Anhalt GJ. Mycophenolate
mofetil in autoimmune and inflammatory
skin disorders. J Am Acad Dermatol 1999;
40: 265-8.
30. Fong KY, Thumboo J, Koh ET, et al. Systemic
lupus erythematosus: initial manifestations
and clinical features after 10 years of dis-
ease. Ann Acad Med Singapore 1997; 26:
31. Alsaeid K, Kamal H, Haider MZ, Al-Enezi
HM, Malaviya AN. Systemic lupus erythe-
matosus in Kuwaiti children: organ system
involvement and serological findings. Lupus
2004; 13: 613-7.
32. Mok CC, Lau CS. Lupus in Hong Kong Chi-
nese. Lupus 2003; 12: 717-22.
33. Vasoo S, Thumboo J, Fong KY. Refractory im-
mune thrombocytopenia in systemic lupus
erythematosus: response to mycophenolate
mofetil. Lupus 2003; 12: 603-2.
34. Chang HK. Successful tretament of refrac-
tory thrombocytopenia with mycopheno-
late mofetil in a patient with systemic lupus
erythematosus. J Korean Med Sci 2005; 20:
35. Alba P , Karim MY, Hunt BJ. Mycophenolate
mofetil as a treatment for autoimmune he-
molytic anaemia in patients with systemic
lupus erythematosus and antiphospholipid
syndrome. Lupus 2003; 12: 633-5.
36. Mak A, Mok CC. Mycophenolate mofetil for
refractory hemolytic anaemia in systemic lu-
pus erythematosus. Lupus 2005; 14: 856-8.
37. Arcasoy MO, Chao NJ. T-cell mediated pure
red-cell aplasia in systemic lupus erythema-
tosus: response to cyclosporine A and My-
cophenolate mofetil. Am J Hematol 2005;
78: 161-3.
38. Jose J, Paulose BK, Vasuki Z, Danda D. My-
cophenolate mofetil in neuropsychiatric sys-
temic lupus erythematosus. Indian J Med Sci
2005; 59: 353-6.
39. Lhotta K, Wurzner R, Rosenkranz AR, et al.
Cerebral vasculitis in a patient with heredi-
tary complete C4 deficiency and systemic lu-
pus erythematosus. Lupus 2004; 13: 139-41.
40. Mok CC, Mak A, To CH. Mycophenolate
mofetil for lupus related myelopathy. Ann
Rheum Dis 2006; 5: 971-3.
41. Samad AS, Lindsley CB. Treatment of pul-
monary hemorrhage in childhood systemic
lupus erythematosus with Mycophenolate
mofetil. South Med J 2003; 96: 705-7.
42. Swigris JJ, Olson AL, Fischer A, et al. Myco-
phenolate mofetil is afe, well tolarated,and
preserves lung function in patients with con-
nective tissue disease-related interstitial lung
disease. Chest 2006; 130: 30-6.
43. Kamiyoshi Y, Takahashi M, Yokoseki O, et al.
Mycophenolate mofetil prevents the devel-
opment of experimental autoimmune myo-
carditis. J Mol Cell Cardiol 2005; 39: 467-77.
44. Lambotte O, Khellaf M, Harmouche H, et al.
Characteristics and long-term outcome of 15
episodes of systemic lupus erythematosus-
associated hemophagocytic syndrome. Medi-
cine 2006; 85: 169-82.
45. Goyal S, Nousari HC. Treatment of resistant
discoid lupus erythematosus of the palms
and soles with Mycophenolate mofetil. J Am
Acad Dermatol 2001; 45: 142-4.
46. Schanz S, Ulmer A, Rassner G, Fierlbeck G.
Successful treatment of subacute cutaneous
lupus erythematosus with Mycophenolate
mofetil. Br J Dermatol 2002; 147: 174-8.
47. Hanjani NM, Nousari HC. Mycophenolate
mofetil for the treatment of cutaneous lupus
erythematosus with smoldering systemic in-
volvement. 2002; 138: 1616-8.
48. Pisoni CN, Obermoser G, Cuadrado MJ et al.
Skin manifestations of systemic lupus ery-
thematosus refractory to multiple treatment
modalities: poor results with Mycophenolate
mofetil. Clin Exp Rheumatol 2005; 23: 393-
49. Riskalla MM, Somers EC, Fatica RA, McCune
WJ. Tolerability of Mycophenolate mofetil in
patients with systemic lupus erythematosus.
J Rheumatol 2003; 30: 1508-12.
50. Pisoni CN, Sanchez FJ, Karim Y, et al. Myco-
phenolate mofetil in systemic lupus erythe-
matosus: efficacy and tolerability in 86 pa-
tients. J Rheumatol 2005; 32: 1047-52.
51. Karim MY, Alba P , Cuadrado MJ. Mycophe-
nolate mofetil for systemic lupus erythema-
tosus refractory to other immunosuppressive
agents. Rheumatology 2002; 41: 876-82.
52. Szyper-Kravitz M, Sheinberg P , Sidi Y,
Schiffenbauer Y, Trubniykov E, Shoenfeld Y.
Hypersensitivity to Mycophenolate mofetil


text:
Comments about 'East beats rivals for region title'
- Oldest first
- Newest first
- Most recommended
The black planet is done for! fear the red & white high school musical!
- 9:15 a.m. Oct. 15, 2011
- Like
- Report abuse
No mention of Pete Johnson? He is undoubtedly responsible for the coaching development of this team from the time they were in 3rd grade through little league. He should get a ring if win it all.
- 9:18 a.m. Oct. 15, 2011
- Like (2)
- Report abuse
"I had two older brothers who played (at East)" didn't Kalama play at Skyline?
- 11:47 a.m. Oct. 15, 2011
- Like
- Report abuse
East is a really good team
I think we got Maple Mountain in the First round, hopefully fish is back by then.
We need this bye
Go Rams
- 11:59 a.m. Oct. 15, 2011
- Like (1)
- Report abuse
Great job East! What a way to finish out region! No one will stop this beast!
- 12:18 p.m. Oct. 15, 2011
- Like
- Report abuse
Some really great defense played by both teams. After the first quarter I really thought it might go into overtime at 0-0. East put one nice drive together, Highland had some miscommunication on blocking on a punt and had one pass play get past them. They played much tougher than a 22-0 shutout would indicate. Hats off to both teams and good luck in the playoffs.
- 6:24 p.m. Oct. 15, 2011
- Like
- Report abuse
What game were u watching? east dominated this game limiting highland to only 130 yards. East was conserving there lead in the second half and could easily made it 29-0 or 36-0. Hats off to easts special teams, East dominated in every aspect last night
- 6:54 p.m. Oct. 15, 2011
- Like
- Report abuse
So East plays Logan next week? both are 9-0.
- 8:54 p.m. Oct. 15, 2011
- Like
- Report abuse
leopards, did I not mention both teams played great defense? It's kinda hard to say what they "could have" done when they didn't. As it stands, East only had about 200 yards of offense themselves, with about 120 of it coming from that drive and the pass play. I'm sorry if this rubs you the wrong way as a sophomore at East or something of the like, but as an objective observer, I'm telling you I saw two good teams out there.
- 12:23 a.m. Oct. 16, 2011
- Like (4)
- Report abuse
Well a good team never gets shut out. East dominated this football game!
- 8:59 a.m. Oct. 16, 2011
- Like
- Report abuse
Fish is expected to return for the playoffs. With the bye he should be as good
as new. He's been walking around school minus his crutches! Maple Mountain and
with a win... Logan.
Go Rams
- 10:04 p.m. Oct. 16, 2011
- Like
- Report abuse
Congratulations to East High School. They've had a great season and have played some incredible games this season. I find it incredible that they shut out Highland while Lone Peak gave up 41 points to them. East is the best 4-A team in the state, if not the best in of all.
- 9:30 a.m. Oct. 17, 2011
- Like (1)
- Report abuse
I agree with Truesilverwolf and I think Fremont will win 5A.
- 9:21 a.m. Oct. 18, 2011
- Like
- Report abuse
DeseretNews.com encourages a civil dialogue among its readers. We welcome your thoughtful comments.
— About comments
- Hayward looking like Captain America early in...
- Morning links: 'Big 12' cartoon features BYU,...
- Ansah, Wagner or Weddle: Which local had the...
- BYU's defense, among nation's leaders in...
- What you may have missed: UConn fan's pleas...
- Gary Crowton resigns as SUU offensive...
- Utah Jazz coach Quin Snyder trying to manage...
- ESPN's Brett McMurphy: 'I actually should...
- College football: Utes climb to No. 5... 56
- Morning links: Utes in the playoff?;... 44
- Morning links: 'Big 12' cartoon... 39
- ESPN's College GameDay is coming to... 34
- After win, BYU looking to improve, get... 26
- BYU overcomes mistakes, downs UConn,... 23
- Morning links: Kyle Whittingham 'doing... 20

subset: commoncrawl


text:
Keyword: Texas
Luck to miss 1st NFL game as Indianapolis faces Jacksonville
INDIANAPOLIS (AP) — Colts quarterback Andrew Luck is inactive and will miss his first NFL game because of a right shoulder injury.
Texas-San Antonio manhandles UTEP in 25-6 win
EL PASO, Texas (AP) — Jarveon Williams had 28 carries for 133 yards and a touchdown as Texas-San Antonio beat Texas El Paso 25-6 in game delayed twice by lightning Saturday night.
Diamondbacks can't find much offense, lose again to Astros
PHOENIX (AP) — The Houston Astros are making it a rough final weekend of the season for the Arizona Diamondbacks.
McHugh, Rasmus help Astros beat Diamondbacks 6-2
PHOENIX (AP) — The Houston Astros are finishing fast and will be playing somewhere next week. Just where and against whom is yet to be determined.
Allen helps No. 14 Aggies over No. 21 Bulldogs 30-17
COLLEGE STATION, Texas (AP) — Kyle Allen threw for 322 yards and two touchdowns to help No. 14 Texas A&M remain undefeated with a 30-17 win over No. 21 Mississippi State on Saturday night.
Southern Miss trounces North Texas 49-14
HATTIESBURG, Miss. (AP) — Nick Mullens threw four touchdown passes and ran for a score, and Southern Mississippi trounced North Texas 49-14 on Saturday night.
Russell, Linwood lead No. 5 Baylor past Texas Tech 63-35
ARLINGTON, Texas (AP) — Seth Russell passed for 286 yards and four touchdowns and ran for two more scores while Shock Linwood rushed for a career-high 221 yards and two touchdowns as No. 5 Baylor began its pursuit of a third consecutive Big 12 championship with a 63-35 win over Texas Tech on Saturday.
Rangers denied AL West clinch after Angels 9th-inning rally
ARLINGTON, Texas (AP) — Elvis Andrus remained on the ground with his face in the dirt after sliding past second base and being tagged for the final out.
Angels score 5 in 9th, beat Rangers 11-10
ARLINGTON, Texas (AP) — The Los Angeles Angels rallied for five runs in the ninth inning, taking their playoff hopes into the final day of the regular season with an 11-10 win over Texas on Saturday that again kept the Rangers from clinching the AL West title.
Boykin throws 5 TDs, No. 4 TCU blows out Texas 50-7
FORT WORTH, Texas (AP) — Trevone Boykin threw five touchdown passes, including four to freshman KaVontae Turpin, and No. 4 TCU rode a 30-point first quarter to a 50-7 rout of Texas on Saturday.


text:
Environmental Politics
Elephants' swan song
It's their last circus performance in the PNW before they retire
Date: 10/03/2015 | Local News
Speed up oil-by-rail measures
The wheels of government move slowly, as is being shown in implementing legislation passed this year intended to give communities in Washington state advance notice when trains with oil tanker cars are moving through town.The new state law makes a number of improvements with...
Date: 10/02/2015 | Editorials
Oil train law still in works
OLYMPIA � A new state law requires cities, counties and fire departments be told ahead of time when an oil train is coming through their community.But it may be the summer of 2017 before they start getting such a heads-up.
Date: 09/28/2015 | Local News
VW deserves severe penalties
In the wake of Volkswagen's truly astonishing admission of wrongdoing, Martin Winterkorn, the chief executive of the world's No. 1 carmaker, stepped down Wednesday. This should be only the beginning of the consequences. The U.S. government must show that it will not tolerate systematic...
Date: 09/27/2015 | Commentary
GE's campaign cash clouding judgment on its cleanup of PCBs
By David SirotaEnvironmental groups and Democratic legislators are pressuring New York Gov. Andrew Cuomo to say that General Electric must continue cleaning up the massive pollution the company dumped into the Hudson River from 1947 to 1977. Cuomo's own environmental...
Date: 09/20/2015 | Opinion Columnists
Taking the path to shutdown
You'd be tempted to throw the "do nothing" label on Congress if some of its members weren't working so hard to avoid doing anything constructive.Friday, the House is expected to vote on a measure to defund Planned Parenthood, stripping the women's health network...
Date: 09/17/2015 | Editorials
A carbon cap, but what then?
Among those who are concerned about the effects of climate change and want to see steps taken to slow it, most are supportive of placing a cap on carbon emissions.Carbon dioxide, while only a small fraction of a percentage of our atmosphere, is increasing. That increase in...
Date: 09/16/2015 | Editorials
Creating parks' new stewards
Don't stow the camping gear and hiking boots just yet. As we move into fall, good weather may inspire some to stretch the camping season, and autumn can offer the most colorful time to take a walk in the woods.And there's another incentive, particularly for those families...
Date: 09/10/2015 | Editorials
With a year to go, Obama is hitting his stride
Attention has been focused on who becomes our next president, but meanwhile the incumbent is on quite a roll.Throughout his tour of Alaska, President Obama looked full of his old swagger. He took photos of Denali — the former Mount McKinley — through the windows...
Date: 09/08/2015 | Opinion Columnists
Don't hand over job to the EPA
The Legislature and Gov. Jay Inslee now have some motivation. And a deadline.The federal Environmental Protection Agency has notified the state that it intends to move forward with a stringent clean-water...
Date: 09/04/2015 | Editorials
The need for more icebreakers
President Obama's renaming of Alaska's Mount McKinley to Denali earlier this week was just an icebreaker. But it wasn't the only one on the president's mind.The...
Date: 09/02/2015 | Editorials
After McKinley, is Rainier next?
Editorial: Should we change our mountain's moniker?
Date: 09/01/2015 | Editorials
A climate solution GOP can advance
The Republican talking point on climate change is evolving, thankfully, from "I'm not a scientist" to "Let's solve it through innovation." That's good news for the nation and generations of Americans to come. After all, the first step to solving a problem is to...
Date: 08/30/2015 | Commentary
Enough with the shutdown games
About the time kids start returning to school following the Labor Day holiday Sept. 7, the nation's senators and representatives will return to Washington, D.C., as Congress reconvenes after a recess of more than a month.It has a significant list of items to accomplish, many...
Date: 08/27/2015 | Editorials
Yellowstone park officials execute a grizzly for being a bear
Officials at Yellowstone National Park say they euthanized the grizzly bear who killed and partially consumed a hiker. It was more like an execution.The bear was killed last Thursday, six days after the body of veteran hiker Lance Crosby, 63, was found partially consumed,...
Date: 08/23/2015 | Commentary
Fund saves urban forests, too
U.S. Sen. Patty Murray and U.S. Rep. Suzan DelBene stood in the forest with volunteers and other public officials among Douglas fir and western red cedar, sword ferns and vine maples, both Washington Democrats renewing calls for reauthorization of the federal Land and Water Conservation...
Date: 08/18/2015 | Editorials
Public lands benefit everyone
Every week, I see at least one article in the news about the need for people to get outside and be active, and the need for more parks and access to parks and public lands. As a veteran and an advocate for veterans, I recognize this need acutely for people returning from military...
Date: 08/16/2015 | Commentary
Moving on for clean air, water
Having hit a wall of opposition in the Legislature this session, Democratic Gov. Jay Inslee remains committed to moving forward in some fashion with his initiatives for cleaner air and water.Inslee, who favors baseball metaphors, struck out three times with proposed...
Date: 08/13/2015 | Editorials
No helicopters in the wilderness
Our national forests have long been managed for multiple uses. Congress made the customary practice official in 1960 and specified that...
Date: 08/09/2015 | Editorials
Set aside three rivers for wild steelhead
Steelhead are Washington's state fish. Revered by anglers and historically numerous, today most of our wild steelhead runs are in deep trouble, either extinct or threatened with extirpation, extinction of local species. Current populations are less than 5 percent of historic abundance.
Date: 08/09/2015 | Commentary
Coal isn't the energy source for 21st century
Time to drop this "war on coal" talk. Time to ignore the hollering by coal country politicians over President Obama's beefed-up plan to combat global warming.No, the Clean Power Plan will not ruin their local economies, because coal has already done that,...
Date: 08/06/2015 | Opinion Columnists
2016 election matters for one reason: climate change
The vast majority of scientists who have devoted their professional lives to studying the Earth's climate believe human-induced warming is an urgent problem requiring bold action. Republican candidates for president insist they know better.With one possible exception —...
Date: 08/06/2015 | Opinion Columnists
Water quality rules might be up to feds after Inslee drops rewrite
OLYMPIA — Gov. Jay Inslee on Friday scrapped a major rewrite of the state's clean water rules, opening the door for the federal government to impose its standard on the state.Inslee, in a...
Date: 08/01/2015 | Local News
A bill for parks and much more
The odds that Congress will reauthorize the Land and Water Conservation Fund before it is scheduled to expire Sept. 30 improved...
Date: 07/28/2015 | Editorials
Swallowing this 'pill' is too costly
Gov. Jay Inslee is said to be weighing whether to take the dare and swallow what's been dubbed the "poison pill" that Republicans inserted into the $16.2 billion transportation package to dissuade him from moving forward with one of his key environmental proposals.
Date: 07/26/2015 | Editorials
Our green governor stymied on his environmental policies
These days Jay Inslee might be America�s most frustrated governor. And we may soon find out how much more frustration � and stomachache � he can take.
Date: 07/23/2015 | Local News
Respecting nature and its risks
Two recent events have raised the issue of the risks we take when we enter forests, wilderness and state and national parks.The National Park Service and the U.S. Fish and Wildlife Service recently released public comments on
Date: 07/14/2015 | Editorials
Saving state's wild steelhead
The term "gene bank" likely prompts images of scientists in lab coats putting samples into a cryogenic deep freeze, but as far as the state Department of Fish and Wildlife and local fishing enthusiasts with Trout Unlimited are concerned, the setting is much more bucolic:...
Date: 07/12/2015 | Editorials
Make parks fund permanent
If Congress were seeking a vote on a valuable program that would allow it to pat itself on the back and celebrate its ability to work in a bipartisan fashion, it could do no better than renewal of the Land and Water Conservation Fund.
Date: 07/07/2015 | Editorials
Some environmental victories
In the interests of positive reenforcement, let's take the opportunity here to make note of some legislative successes by lawmakers, even as they plod on with their third special session to come to some final agreements related to budgets and education.Specific to parks,...
Date: 07/06/2015 | Editorials
Work ahead to make most of BP's $18.7B
The saga of what some have called the worst environmental disaster in U.S. history passed a milestone on Thursday. BP, the company in charge of the Deepwater Horizon oil rig that exploded a mile above the Gulf of Mexico seafloor five years ago, announced that it has reached a...
Date: 07/06/2015 | Commentary
Chemical safety bill may have good shot
Most Americans believe the chemicals in products they buy in the supermarket have been tested for safety. But the scandalous truth is our main chemical safety law is so badly broken that no one has the authority to ensure the safety of chemicals used in everything from cleaning products...
Date: 07/05/2015 | Commentary
Supreme Court's EPA ruling can't stop coal's long slide
It took 41 years from the time it was enacted by Congress for the Clean Air Act to limit the amount of mercury and other poisonous substances that coal-fired power plants are allowed spew into the air. A ruling Monday from the Supreme Court, which struck those limits on something very...
Date: 07/05/2015 | Commentary
Update to water quality rules could affect county's farmers
OLYMPIA — State officials are rewriting water quality rules and the update could change how Snohomish County farmers use manure lagoons.The Department of Ecology is updating permits it issues for Concentrated Animal Feeding Operations. Those are farms that discharge...
Date: 07/04/2015 | Local News
State's best chance at own water rule
Even with two special sessions and counting, there were issues that the Legislature didn't get to this year. But with lawmakers' likely failure to pass legislation that would have helped the state Department of Ecology develop and enforce water quality rules, the state may now be...
Date: 07/02/2015 | Editorials
More reasons to limit carbon
The justifications for taking real and effective steps to slow climate change and limit the amount of carbon and other greenhouse gases we pump into the atmosphere continue to mount.Recent studies and events now add to the warnings and recommendations about the threat to our...
Date: 06/24/2015 | Editorials
Pope's climate stance political not spiritual
Pope Francis released an encyclical Thursday on climate change — a draft of which was leaked to the Italian magazine l'Espresso on Monday. The New York Times reports that the encyclical is "eagerly awaited, especially by scientists and environmentalists" —...
Date: 06/21/2015 | Opinion Columnists
'Our common home'
Viewpoints: Pope Francis calls for action on climate change
Date: 06/21/2015 | Commentary
Federal lands should be kept for benefit of all
The federal government owns large chunks of the West. It owns 65 percent of Utah, 69 percent of Alaska and 83 percent of Nevada. Some Westerners see unfairness in that. They should not.Sen. Lisa Murkowski of Alaska recently slipped an item into a nonbinding budget...
Date: 06/14/2015 | Opinion Columnists
Senate budget risks gains made for state lands
Nationally, over the last few years, we've witnessed an anti-public lands campaign take hold — from Cliven Bundy's brazen standoff with the Bureau of Land Management to the more insidious creep of consistent underfunding for our national parks. However, it seemed absurd that that...
Date: 06/14/2015 | Commentary
Northwest governors' proposals threaten jobs in energy
Even as the energy sector helps propel the nation's economic resurgence with billions of dollars of investment in new project and technologies, it is facing hurdles in an unlikely quarter: states with economies that depend on a strong energy sector.From Alaska to Washington,...
Date: 06/14/2015 | Commentary
Clear rules for cleaner waters
The Obama administration's issuance this week of the Clean Water Rule to restore safeguards under the 1972 Clean Water Act will help keep our waters clean — from stream to sea and...
Date: 05/29/2015 | Editorials
Tiny beads a persistent threat
Most of us give little thought to what we wash down the drain each morning after scrubbing our faces and brushing our teeth, but some of it — specifically tiny bits of plastic called microbeads — hangs out in streams, lakes and seas and finds its way into the food chain.
Date: 05/28/2015 | Editorials
Official: Anti-drilling protests cause environmental damage
SEATTLE � An official with the state Department of Natural Resources said Seattle activists protesting Shell�s plans to drill for oil in the Arctic did some environmental damage to a popular dive park.
Date: 05/22/2015 | Northwest
Obama's not denying climate change, just ignoring it
Here are two facts that cannot be reconciled: The planet has experienced the warmest January-through-March on record, and the Obama administration has authorized massive new oil drilling in the Arctic Ocean."Climate change can no longer be denied ... and action can no...
Date: 05/19/2015 | Opinion Columnists
Pope or Palin? You decide
A columnist for The Guardian newspaper, Kristina Keneally, a self-described "progressive Catholic" accuses Pope Francis of being nothing...
Date: 05/18/2015 | Editorials
Where we are, who we are
Viewpoints: Why understanding geography is vital
'Decoy' groups fighting transfer of public lands to states
Across the West, lawmakers are considering the costs and benefits of moving public land management from the federal government to the state. While the debate stirs passions, a new analysis provides some sobering figures on the economic gains that states stand to make.The...
Protect the law that protects wildlife
Since President Richard Nixon signed the Endangered Species Act into law, more than forty years ago, the United States has been committed to protecting its wildlife and plants from extinction. Thanks to the ESA, American alligators have recovered, grizzly bears roam through Yellowstone...
Amended cap-and-trade proposal could get another look
Cap-and-trade seemed dead and buried among the year�s fallen legislative ideas � until it wasn�t this week.
Date: 05/14/2015 | Local News
Second shot to reduce carbon
There may yet be some hope that the Legislature can pass carbon-reduction legislation this year.With the special session well under way and little being said publicly about budget negotiations, Democrats in the House have
Date: 05/13/2015 | Editorials
How to log and protect owl habitat
The city of Everett, which owns 3,729 acres at its reservoir at Chaplain Lake, north of Sultan, has proposed a novel approach to land management that would set aside about a third of the property for wildlife habitat for several decades while allowing the city to continue a modest...
Date: 05/12/2015 | Editorials
Seattle mayor, �kayaktivists� take on Arctic oil drilling
SEATTLE � Royal Dutch Shell wants to park two massive Arctic oil drilling rigs on Seattle�s waterfront, but the petroleum giant will have to get around protesters in kayaks and a mayor determined to take on climate change.
Date: 05/07/2015 | Northwest
Everett to host Arctic oil drilling ships
EVERETT � Royal Dutch Shell�s plans to drill for oil in the Arctic means more traffic at the Port of Everett this spring and summer.
Date: 05/06/2015 | Business
Oils and orcas don't mix
Viewpoints: How whale watching boats can help
Date: 05/03/2015 | Commentary
Sorry, captain
Editorial: Shatner and California can't have our water
Date: 04/23/2015 | Editorials
Take carbon reduction plan to the public
When he introduced in November the report of a 21-member citizens panel recommending strategies for reducing carbon pollution, Gov. Jay Inslee expressed hope...
Date: 04/22/2015 | Editorials
Keep our public lands public
For nearly 50 years, the federal Land and Water Conservation Fund has invested nearly $17 billion nationwide and $500 million in Washington in state and federal land conservation projects and matching grants for state and local...
Date: 04/21/2015 | Editorials
Adapting to changes, good and bad, in our climate
Before there was a California, New England fed itself. Somehow. The soil was lousy, the climate cold and the diet limited (lots of cabbage, no avocados). At least there was plenty of water.Thanks to improved transportation, the production of fruits and vegetables followed...
Date: 04/14/2015 | Opinion Columnists
Lawmakers watering down water quality
Amendments by the state House and Senate to water quality legislation proposed by Gov. Jay Inslee have limited its scope and its ability to take timely action and could also now invite enforcement action by the federal Environmental Protection Agency.The gutting of the...
Date: 04/14/2015 | Editorials
Greenpeace group leaves Arctic drill rig after six-day stay
SEATTLE � Six Greenpeace activists opposed to offshore drilling in the Arctic have abandoned a Seattle-bound drill rig they boarded in the Pacific Ocean six days ago, the organization said Saturday.
Date: 04/12/2015 | Northwest
Injecting politics into parks
The problem isn't the amount of money that the state Senate has set aside in its capital budget for the Washington Wildlife and Recreation Coalition's grant program.Each year, for the last 25 years, the coalition has taken responsibility for shepherding a list of potential...
Date: 04/10/2015 | Editorials
Corporations turning tide on climate change denial
There is no denying it: Climate-change deniers are in retreat.What began as a subtle shift away from the claim that man-made global warming is not a threat to the planet has lately turned into a stampede. The latest attempt to deny denial comes from the conservative American...
Date: 04/08/2015 | Opinion Columnists
Lawmakers aim to toughen laws on oil trains
OLYMPIA — State lawmakers are trying to reach agreement on tougher rules for the transportation of oil in Washington, including a requirement that rail carriers give local firefighters advance notice of when oil trains are coming.
Date: 03/29/2015 | Local News
Tax proposals won't eclipse growth of solar
On the average sunny day, Germany's huge energy grid gets 40 percent of its power from the sun. Guess what happened one recent morning when the sun went into eclipse. Nothing.
Date: 03/25/2015 | Opinion Columnists
Christie's Exxon settlement shortchanges Jersey
Last week, Republican Gov. Chris Christie's administration settled New Jersey's long-standing environmental lawsuit against Exxon Mobil Corp. for pennies on the dollar. For a decade, the state had been seeking $8.9 billion in damages for pollution at two refineries in the northern part...
Date: 03/15/2015 | Opinion Columnists
Senate bill a path for carbon reduction
Republican-backed legislation in the Senate meant to require the state's utilities to reduce carbon emissions is worthy of praise. It's just too bad those backing the legislation couldn't show more confidence in why they proposed it in the first place.
Date: 03/12/2015 | Editorials
Forests not the place for training
A proposal by the U.S. Navy to use forest lands on the Olympic Peninsula and elsewhere in the state for electronic warfare training by jets based at Naval Station Whidbey Island has received a "not interested" from the state. The response from the U.S. Forest Service should...
Date: 03/10/2015 | Editorials
Wyoming Legislature supports coal port bonds, eyes Washington ports
CHEYENNE, Wyo. � Wyoming is prepared to up the stakes in its high-dollar push to override local opposition in the Northwest and get access to ocean ports to allow coal exports to Asia.
Date: 03/09/2015 | Northwest
Work ahead yet for legislators
Nobody said the road to compromise was going to be straight and smooth.The state Senate on Monday indeed passed a $15 billion transportation...
Date: 03/04/2015 | Editorials
Careful what you tell Congress if you're not on the right side
"I am under 'investigation,'" professor Roger Pielke Jr. of the University of Colorado Boulder posted on his blog Wednesday.The top Democrat on the House Committee on Natural Resources, Rep. Raul Grijalva of Arizona, sent a letter to university President...
Date: 03/03/2015 | Opinion Columnists
Bring back the bears
Herald editorial: Restore grizzlies to the North Cascades
Date: 03/03/2015 | Editorials
Tree harvest held up
Conservation dispute delays logging near Wallace Falls
Date: 03/02/2015 | Local News
Permit process flawed for motocross project
The Snohomish County Council is now looking into the Granite Falls motocross project, focused on whether project developer Gary Strode proceeded legally during the review process.Perhaps the council should go back further to review Strode's entire track construction history.
Date: 03/01/2015 | Commentary
Energy wasted on Keystone XL debate
Climate change warriors of all stripes were focused on the White House on Tuesday, where President Obama vetoed a bill that would have authorized construction of the Keystone XL pipeline. Like all the other attention slathered on this overblown issue, the focus was misplaced. It would...
Date: 03/01/2015 | Commentary
We've been warned, repeatedly
It's happening with all too great a frequency:A CSX train carrying 3 million gallons of Bakken crude derailed in West Virginia on Tuesday, causing a huge fireball and leaking oil into a river tributary...
Date: 02/23/2015 | Editorials
Study of little fish a big deal
There's a bit of tongue-in-cheek about La Conner's annual Smelt Derby, which celebrates its 50th anniversary on Feb. 28 in the Skagit Valley town on the Swinomish Channel.
Date: 02/18/2015 | Editorials
Tax carbon, then give the money back
The recent ground swell of climate and clean energy solutions in state and local news is remarkable. We've always needed more climate and emissions solutions. Now we have new Republican-proffered solutions in addition to longer-standing ones. We can harness multiple approaches, but one...
Date: 02/16/2015 | Commentary
Adopt low-carbon fuel limits
Following the lead of California and directed by Gov. Jay Inslee, the state Department of Ecology is slowly moving forward with a proposed rule that would require a reduction in the carbon emissions resulting from...
Date: 02/06/2015 | Editorials
28,000 comments submitted on Whatcom oil dock marked �spam
BELLINGHAM � About 28,000 public comments submitted by environmentalists about a controversial oil-shipping dock in Whatcom County went missing after the U.S. Army Corps of Engineers� email system marked them as �malicious spam.�
Date: 01/25/2015 | Northwest
Turn up the heat on Congress to act on climate change
We now know that 2014 was the hottest year in recorded history. We also know that President Obama can expect little help from Republicans in Congress — some of them cynical, others clueless — in facing the most daunting environmental challenge of our time.
Date: 01/20/2015 | Opinion Columnists
Inslee's cap-and-trade plan faces uphill climb
OLYMPIA — Ask people if they like the idea of making companies pay for what they pollute and using the money for schools, roads and a cleaner environment, and many will tell you yes.But when they are told a
Date: 01/18/2015 | Local News
Inslee's plans for state
Governor calls for taxes on carbon emissions, capital gains
Date: 01/14/2015 | Local News
Ruling on motocross project outlines necessary protections
It might not be everyone's idea of a nice day in the forest, but that's where the "multiple" in "multiple use" comes in.A Snohomish County hearing examiner, following a second review of plans for a motocross facility along the Mountain Loop Highway,...
Date: 01/05/2015 | Editorials
Pope and politics
Viewpoints: Heed Francis's words on global warming?
Date: 01/04/2015 | Commentary
Alpine Lakes addition marks Wilderness Act's 50th
What the National Defense Authorization Act has to do with any of several public lands bills that Congress passed along with it and President Barack Obama signed into law on Friday is anyone's guess. But, in recognition of the time of year, let's not look a gift reindeer in the...
Date: 12/24/2014 | Editorials
Carbon tax or gas tax, state transportation package must pass
Gov. Jay Inslee calls it a "two-fer."The governor's transportation budget calls for $12 billion in spending, including $81.8 million for...
Date: 12/19/2014 | Editorials
Climate activists choosing to nibble at the corners
I have a theory as to why Americans don't worry all that much about global warming: High-profile purveyors of climate change don't push for reductions in greenhouse gases so much as focus on berating people who do not agree with their opinions. They call themselves champions of...
Date: 12/19/2014 | Opinion Columnists
Coal lobby's new tack: CO2 is good for you
For years, the fossil-fuel industries have been telling us that global warming is a hoax based on junk science.But now these industries are floating an intriguing new argument: They're admitting that human use of coal, oil and gas is causing carbon dioxide in the atmosphere...
Date: 12/18/2014 | Opinion Columnists
Cooperative work will meet needs of farms, fish
Can farms and fish co-exist, and even thrive, in Snohomish County's riverways? As co-chairmen of the Snohomish Sustainable Lands Strategy, we believe the answer is yes — and that fish and farm advocates can make more progress by working together than by fighting each other as both...
Date: 12/14/2014 | Commentary
Basing policy on evidence in Congress
As often as we see instances of partisan politics and gridlock coming out of Washington, D.C., there are occasional glints of light, hope that the stalemate might be broken and we might move forward on any number of issues facing the country.One recent glint is
Date: 12/03/2014 | Editorials
Allow sales tax break for electric cars to expire
As part of a broader package of proposals to be announced soon to address climate change, Gov. Jay Inslee wants to extend a sales tax break for those who purchase electric cars and open up car-pool lanes to the vehicles when they're driven solo.The intent is to encourage the...
Date: 12/01/2014 | Editorials
'Greener' fuels not yet worth the risks
It's been suggested that the forecast for Gov. Jay Inslee's climate agenda became cloudier once the Nov. 4 election results showed our Majority Coalition Caucus will continue to lead the state Senate for the remainder of Inslee's term.Given how the governor seems willing to...
Date: 11/30/2014 | Commentary
Replenish steelhead runs with return to hatcheries
As keeper of the angling archives for the Snohomish Sportsmen's Club for the past 55 years, I am somewhat amazed by all the furor over hatchery fish and steelhead in particular. If a person is a poor historian they can't be a good fish biologist. My archive room has many...
Date: 11/23/2014 | Commentary
Obama�s deal gives China a pass on carbon
By Charles KrauthammerHistoric. Such is the ubiquitous description of the climate agreement recently announced in Beijing between Barack Obama and Xi Jinping in which China promised for the first time to cap carbon emissions.
Date: 11/21/2014 | Opinion Columnists
It's time to consider climate change as a moral issue
The politics of selfishness was embraced enthusiastically last week by Sen. Mitch McConnell. In dismissing President Obama's deal with China to reduce carbon emissions, the incoming Senate majority leader said "carbon emission regulations are creating havoc in my state and other...
Date: 11/20/2014 | Opinion Columnists
County Council reverses nighttime quarry decision
EVERETT — The Snohomish County Council decided Monday to revoke permission for nighttime loading and trucking for Green Mountain Mine.In a unanimous vote, the five-member council overturned a...
Date: 11/19/2014 | Local News
Tea party of the left would rather be pure than win
Here comes the tea party of the left.On a rainy Monday morning, 50 sodden liberal activists stood on the muddy front lawn of the Capitol Hill home of Sen. Mary Landrieu, advocating for the Louisiana Democrat's defeat."This house is high and dry, but the...
Date: 11/19/2014 | Opinion Columnists
Obama's climate pact with China beyond GOP's reach
The minute we glimpse a flicker of hope in the fight against climate change, Republicans in Congress announce their intention to snuff it out. Fortunately for the planet, it seems they can't.This week's stunning announcement of a long-range agreement between the Obama...
Date: 11/16/2014 | Opinion Columnists
Marshland project unlikely to improve fish habitat
After reading "Everett Marshland's future a bit muddy," in the Nov. 4 Herald, I feel it is my civic duty to make some comments. I am no stranger to this subject; I am a retired biologist who...
Date: 11/16/2014 | Commentary


text:
Tag Archives: farmers market
Many Gainesville Market Vendors Disappointed With Relocation
The relocation of the Union Street Farmers Market downtown location has brought changes for vendors. Charlie Lybrand, owner of Land of Flowers Farms and director of the market, said his business has decreased 50 percent since the move. Others saw increases.
Local Lives: The Hot Sauce Boss From Lacrosse
The self-proclaimed 'Wizard of Odd' found a passion for selling hot sauces at farmer's markets. Joe Di Vito found the career he loves after 40 years, and takes pleasure in telling stories — including how one of his sauces was inspired by a visit from a UFO.
Bo Diddley Plaza Renovations Bring In New Era
Bo Diddley Plaza in downtown Gainesville is closing Sunday for renovations. The renovations are expected to last one year and will include additions to the performance area, a new café, an informational kiosk and relocating an existing bus stop.
Gainesville Market Vendors Voice Concern Over Bo Diddley
After learning about the Bo Diddley Community Plaza redevelopment efforts come early 2015, local Gainesville market vendors are raising concern about the possibility of being relocated to a different area.
Rain and Freeze Set Back Local Farmers
As Florida's weather continues to fluctuate, local farmers adapt in the aftermath of early January's bitter-cold temperatures.
Vendors sell special goods at UF farmers market
The Reitz Union drew students and vendors to its north lawn Thursday for its farmers market. Director Beth Thompson said she hoped the market's low prices and unusual goods would draw plenty of students. This year, a vendor sold pumpkins […]
Gainesville gardeners recognize World Food Day
Alachua County gardeners and farmers will recognize World Food Day on Oct. 16 with a two-part gardening and movie event.
Ca$hmob farmers market looks to sprout the economy of Alachua County
CashMobs have sprouted up throughout the United States and are modeled after Flash Mobs, events where large groups of people gather to celebrate artistic expression. Cash mobs add the element of supporting local businesses by encouraging people to spend money. […]
Farmers market visits UF for Campus Earth Day
Earth Day, as most people know it, falls on April 22nd each year. But as WUFT-FM's Steven Gallo reports, the University of Florida is getting a jump start on promoting sustainability with its Campus Earth Day. UF's all-male acapella […]


text:
Any Northesast FL Chapter Member can submit 'Risk Management' articles for posting in the Resources (Library) link.
Student Northeast FL Chapter Members are welcomed to showcase your scholastic 'risk management skills' by submiting papers you have written. Our Chapter looks forward to your submissions.
Please send your submissions to the chapter webmaster at: email@example.com
Either the content you're seeking doesn't exist or it requires proper authentication before viewing.


text:
Sunset Lakes
No prices found through our partners. Please contact the business directly or check some of our recommended alternatives.
How has this hotel rated in the past?
Travelers also recommend:
- More recommendations
TripAdvisor Reviews Sunset Lakes Orlando
Travel Blogs from Orlando
A Magical Fire Hydrant…Unlimited Smiles...
... the day was pretty much spent at a motion censored fire hydrant that M stumbled upon. She made some friends, caught the eye of a photographer who did some great candid shots, and we were able to watch a rock concert style show while she played! We ended the afternoon playing in the Honey I Shrunk The Kids play area and eating Mickey Mouse ice cream sandwiches.
Bye Disney World!! We miss you already…but will be ...
Magic Kingdom Is Ours To Claim
... these shoes. Women can choose between Minnie - 860 or 990's and men's choices are Mickey 860 0r 990's.
Once Ali got up and was ready, we grabbed a quick bagged breakfast from the market in the hotel lobby. We jumped into the car and headed over to the Wide World of Sports complex to scout around the Health and Fitness Expo. We needed to fix a couple little issues left from yesterday's registration and pick up the shoes for Ann.
We got to the park way ...
All things Disney and Harry Potter.
... week of the year, Harry Potter was constantly packed. Other parts of the park were fairly quiet. You can certainly see where the money comes from and why Universal added Harry to its second park.
Did a few roller coaster rides - just to prove to the kids that we had, we could, and we are not yet too old for their sort of fun! We have been hit by some Arctic cold here with wind yesterday. Not what you expect in Florida with heavy ...
Around the World in Epcot!!
... br>
Then on to the Seas with Nemo and Friends. Again, Disney out does itself. After the ride, we went into what was similar to the Ripley's Aquarium. Nathan LOVED the dolphins! Seeing his excitement was so great.
Another Character stop to meet Mickey, Goofy and Minnie!! Then for a walk around the world. It was the Food and Wine Festival, so the smells were incredible. It was great to "visit" each country. And one of ...
Orlando - the unhappiest city on earth
... heed their warnings. He continued to feel really queezy but wanted to keep pressing on, until finally at about noon, decided that it wasn't worth it. We stopped for lunch at this point in one of the air conditioned restaurants and didn't leave until Vaughan started to feel better.
He's convinced that once you reach a certain age, rollercoasters are just not for you, and apparently for him, that age is 30.
By about 5pm, we had seen all ...


text:
Jay Ahr's crepe mini skirt will game-change your party portfolio. Embellished with knotted silver chains and braided faux leather trims, this style has a leg-lengthening effect thanks to the scalloped hem. Wear yours with a leather top and pin-heel pumps.
Black crepeSilver chain and braided faux leather trims, fully linedConcealed hook and zip fastening at side100% viscose; lining: 100% silk; trim: 100% polyurethaneDry clean
Product code: 381482 - Need help? Contact us


text:
Dare to bare in Bottega Veneta's elegantly structured fishnet-lace bustier top. Crafted with underwired cups and boned sides, this knockout style will sculpt a sensational silhouette. Wear it with a cocktail skirt and spiked heels to take sartorial center stage.
Black fishnet-laceUnderwired molded cups, boned, nude underlay, partially linedExposed back zip fastening46% polyester, 45% polyamide, 9% elastaneDry clean
Product code: 190969 - Need help? Contact us


text:
SAVE UP TO 40% Book by November 15
10 Family Vacation Tips For the Ultimate Getaway
Ski and Snowboard Turkey Sale Oct 9-12 | Save up to 50% OFF
Watch The Trailer - 50 Years Of Going Beyond The MovieThe trailer for Whistler Blackcomb's 50th Anniversary movie is out now.
Spent some Cheddar on this cheese block. #bigcheese #wally 📷 @finestonephoto
Yo! Long time no post. We're back and getting busy tuning up over 100 rails for the 2016 season. New shapes and classics getting the love. 📷 @finestonephoto
#parkpow #gapperday @quiksilver public park @whistlerparks ☠☠☠📷 @skibum_mark
@quiksilver public park today. Flat box, small box, flat rail, down rail, down tower, Elbow Rail, and Down Rail. ☠☠☠🎥 @skibum_mark
🎈🍰Happy Canada Day from whis parks! ☠☠☠📷 @skibum_mark
Ahhh Mondays. This was a good day at the office. @maxparrot ☠☠☠📷 @skibum_mark
@sandyboville warming up on the whis @quiksilver public park before coaching @campofchampions ☠☠☠🎥 @skibum_mark
#tbt Most of the lower spring park '15 ☠☠☠📷 @jayde.be
@quiksilver public park ☠☠☠📷 @skibum_mark
Hope you all had a good regular season! See you on the glacier! @nick_zichy ☠☠☠📷 @skibum_mark
Whistler T-Bar park is still going strong! @ty_weed & @kcanders0n grooming the park in the beauty spring evening! 2 more weeks of soft spring riding left!
#regram @antochamberland ☠☠☠📷 @olliepop_films


text:
An expert has urged parents to ensure their children eat a healthy diet from an early age, warning that bad habits established in their formative years can often prove difficult to shake off later on.
Greatvine.com nutrition consultant Charlotte Stirling-Reed explained that youngsters who become accustomed to salty food in childhood are more likely to continue consuming such products in adult life.
"Preference for salty food is very much developed in childhood," she commented. "I definitely think that giving children salty foods at this age is going to lead to poor eating habits as they get older."
Ms Stirling-Reed added that avoiding processed fare in preference of home-cooked meals can prove crucial to shaping a child's diet and warned some varieties of baby food have particularly high salt content.
Her remarks came after a study conducted by scientists at the University of Bristol found 78 per cent of eight-month-old babies had salt intakes above the recommended maximum.


text:
Average customer review: Average customer review 9 out of 10 (5 reviews) Add your review
Achieve a truly satisfying climax with this incredible vibe. With 10 powerful functions to explore, this toy bursts into life with the simple touch of a button. Direct its ribbed, flexible shaft towards your G-spot for spine-tingling bliss.
Only: £29.99
Product Description
Achieve a truly satisfying climax with this incredible vibe. With 10 powerful functions to explore, this toy bursts into life with the simple touch of a button. Direct its ribbed, flexible shaft towards your G-spot for spine-tingling bliss.
Extra quiet, even at its highest intensity, this vibrator is perfect for people who need a near-silent toy. The easy-to-use buttons control 10 delicious functions at three intensity levels, making 30 separate sensations to please you whatever your mood.
Waterproof, near-silent and packed with functions and state-of-the-art features, this vibrator is a must-have. Coat its shaft in lashings of slick water-based lube to maximise your pleasure.
Key Features:
- Silicone vibrator with super-quiet vibrations
- Ribbed shaft, for additional stimulation
- 10 powerful functions, each with 3 intensity levels
- Flexible shaft flexes with your body
- 100% waterproof, for aquatic play
How it measures up
- Length: 7 inches
- Insertable Length: 4.5 inches
- Circumference: 4.75 inches
- Base diameter: 2.5
- Base type: Handle
How it feels
- Material: Silicone
- Flexibility: Firm
- Waterproof: Submersible
- Contains latex: No
- Contains phthalates: No
Power and speed
- Controller Type: Built in - push button
- Vibration speed: Speeds and patterns
- Power Type: Batteries (not included)
- Battery Info: 4 x AAA batteries (not included)
Product Videos
Adrien Lastic Waterproof 10 Function Ribbed Vibrator
To watch videos, you need Version 9 or greater of the Flash Player. Click here to see which Flash Version you have. If you have Version 8 or less, get the latest Flash Player here".
With 10 thrilling functions and three powerful intensity levels pulsing through, this whisper quiet silicone vibrator is brilliantly versatile.
Buyer's Guides
Buy the best classic vibrator for you and learn how to get the most out of your new vibe with our sex toy guides.
Sex Toys Guides > Vibrators Guides > Top 10 Best Sex Toys
Sex Toys Guides > Vibrators Guides > Beginner's Guide to Vibrators
Sex Toys Guides > Vibrators Guides > How to Introduce Sex Toys to Your Relationship
Explore more from our collections…
Customer Reviews
Adrien Lastic 10 Function Ribbed Classic Vibrator 9 out of 10 (5 reviews) Write your own reviewOrder by:
- Newest
- Most helpful
- Rating
Reviewed: 18 August 2015 by Toys for Joys, a Straight Single Female
Very nice toy!
I like what this vibrator is made of, and also the handle with the different rhythms and intensities on it is very helpful.
I have had a lot of pleasure with this baby. You can use it inside to get yourself started and then use it on your clit to finish things off.
- Pros
- The material used and the function handle.
- Cons
- I would like something similar but thicker, just a thought.
- Bottom line
- Very nice toy, good start out toy.
- Was this review helpful to you? Yes
Reviewed: 02 October 2013 by ben's baby girl, a Straight Going Steady Female
This is one of the first products I have purchased from Lovehoney, and I am now certainly going to be a regular customer!
The vibrator is quieter than I had imagined, and the 10 functions along with the 3 intensities are amazing, each as pleasurable as the next, and so simple to control with the buttons on the base of the vibrator. Also, because of the shape at the base, it makes it very easily moveable and comfortable to hold!
The size of this product is great, along with the shape of it, and I found myself overwhelmed with how good it felt!
- Pros
- Everything, this is the perfect vibrator! It even comes with a little sleeve!
- Cons
- There is nothing I didn't like!
- Bottom line
- Wonderful, it shouldn't be a want, it should be a need for your collection.
- 2 people found this review helpful. Was this review helpful to you? Yes
Order by:
A varied playmate
Reviewed: 23 June 2015 by lonelygoldfish, a Bisexual Single Female
After much deliberation over what vibe to buy after my Annabelle Knight one broke (due to overuse!), I settled on this one. It's an attractive shape, ribbed, and with many different settings and speeds.
When it arrived, I couldn't wait to try it out!
It's not as powerful as my last vibrator (which was rather insane), it still has a good top setting, and I came fairly easily. The seven different settings mean you can really find sensations to sink into.
Love it.
- Pros
- Settings and speeds, appearance.
- Cons
- Not as powerful as would like.
- Bottom line
- Brilliant toy!
- Was this review helpful to you? Yes
- Newest
- Most helpful
- Rating
See all 5 Adrien Lastic 10 Function Ribbed Classic Vibrator reviews…


text:
1 - 0 of 0
Did you mean?Try your search again
I am going to Matamoros in a couple weeks, and I am trying to figure out which bridge is best if you will use the public transportation. If it matters, I am going to a doctor down past the hospital on Prima Calle
Sponsored Listings
VirtualTourist®© 1994-2015 VirtualTourist.com, Inc. All Rights Reserved.Back to Top
|All reports are strictly confidential. Please explain why you are reporting this:


text:
White House releases detailed birth certificate
By Aaron Blake,
The White H ouse
Obama's campaign originally released his shorter birth certificate during the 2008 campaign, but that wasn't enough to satisfy many in the so-called "birther" community who continued to have doubts.
The long-form certificate shows that Obama was born in Honolulu on August 4, 1961 — as did the short form — and it includes the signature of an attendant who witnessed the birth and a local registrar, as well as a certificate number.
President Obama announced the release in a press conference, calling the controversy a distraction from serious issues.
Your Browser DoesNot Support IFrames.

In a statement on the White House Web site, communications director Dan Pfeiffer said the long-form certificate is generally not provided to those inquiring, but that the state of Hawaii did so in response to the large number of requests.
"The President believed the distraction over his birth certificate wasn't good for the country," Pfeiffer wrote. "It may have been good politics and good TV, but it was bad for the American people and distracting from the many challenges we face as a country. Therefore, the president directed his counsel to review the legal authority for seeking access to the long form certificate and to request on that basis that the Hawaii State Department of Health make an exception to release a copy of his long-form birth certificate. They granted that exception in part because of the tremendous volume of requests they had been getting."
Pfeiffer noted that the release of the long-form certificate should not be seen as an acknowledgment that the short form wasn't sufficient, but rather as a good faith effort to put the issue to rest.
Still, many political analysts are dubious that many in the birther community will accept the document as the be-all, end-all.
Potential GOP presidential candidate and business mogul Donald Trump has been relentlessly questioning the president's birthplace in recent weeks, and has built up a significant amount of support in early polls of the contest.
If nothing else, the release of Obama's long-form certificate shows the impact that Trump is having on the debate.
Democrats have long maintained that the continuing controversy helps them in the long run, but over the last few days, the issue has begun consuming the political debate, even as important budget issues loom.
The president is set to record an episode of the Oprah Winfrey Show today, an appearance that will undoubtedly touch on the continuing controversy.


text:
- Product Information
Product Description
Decorate in black and white for your movie night party. Our 4 pack of black and white movie set cutouts is a perfect addition to your Hollywood or awards night decorations. Each 16" cutout is printed on both sides. This movie night party decoration kit is sold 4 to the pack. Please order in increments of 1 pack. Don't forget to order sticky tack SUP017 for an easy and safe way to attach all your decorations.
- Questions & Answers
- Reviews
Customer Reviews
- very nice Review by Net
We used these as part of a display highlighting people involved in the arts - visual arts, graphic design and film artistry. They are a good size, well made and reasonably priced. They were a hit with everyone and drew attention to the display. I'd recommend these!
(Posted on 7/22/12)
- Nice in size Review by Momma Smooth
I decorated the banquet walls with these film cutouts at my daughter's 21 birthday party, who is a film and video major in college. Each They were very large, which was what I needed.
(Posted on 11/30/11)
Write Your Own Review
Create a Spooky Scene Outside Your Home with Halloween Decorations
We offer a wide selection of Halloween decorations in a variety of horror themes. Use this guide to help you choose the perfect decorations to make your home the most popular trick-or-treating destination this year!
Prepare for Your Breast Cancer Awareness Event with Pink Ribbon Party Supplies
Browse our selection of pink and pink ribbon items to decorate for, or giveaway, at your Breast Cancer Awareness event!
Switch up Your Annual Halloween Celebrations with a Day of the Dead Party!
Tired of going to the same Halloween parties year after year? Shake things up a bit with a classy Day of the Dead celebration! Follow these party tips and ideas for setting up your own Dia de los Muertos Party.


text:
We loved this deal too, but it's no longer available. Check out our other sweet deals here.
$17 for a Dog Wash & Blow Dry (value $35)
1 of your friends
already grabbed this deal:
Discuss this DealJoin the discussion
- Preen that pongy pooch, pronto!
- Grab a dog wash and blow dry from Fluffy Butt Dog Bathhouse and Cafe in Wellington for just $17.
- Enjoy Wellington's first 'wash while you shop' experience.
- Avoid messy bathrooms and frantic, water-logged doggies.
- Make life a breeze and add a pick-up and drop-off service for an extra $20 - available from Plimmerton to Wellington to Lower Hutt.
Fido is the most wonderful of dogs, but he seems to have a fixated fascination with creating his own individual doggy fragrances. Eau de dead seagull is still a little on the edgy side for you.
Sod the suds and get the professionals onto this grubby mutt. Grab a dog wash and blow dry from Fluffy Butt Dog Bathhouse and Cafe for just $17.
The beauty of this unique Wellington parlour is that you can deliver your precious pup for a scrub-down and head out for a shop or a coffee whilst you wait. Let the Fluffy Butt team give your dog a first-rate, thorough wash. No fur is too long as they use a state of the art shampoo injection technology that allows all nooks and crannies to be cleansed. No more sore knees, baths full of dog hair and over-excited, wet pups in your house.
Fluffy Butt Dog Bathhouse & Grooming
120 Main Road
(04) 237 4010
Business in trade
ConditionsValid from Jan 22, 2013
Expires Apr 22, 2013
Limit: 4 for you and 4 gifts for others
Bookings essential. Subject to availability. Double-coated dogs or dogs that require significant de-matting or undercoat removal will incur an extra $20 charge. Pick-up and drop-off service available for $20 extra, payable direct; available from Plimmerton to Wellington to Lower Hutt. No refunds, no cash back, not to be used with other offers.
See the rules that apply to all deals
More Great Deals
More Great Local Deals
Flying Burrito Brothers Wellington
Tulsi Contemporary Indian Cuisine
Active Clean
Wellington Phoenix Football Club
Coastlands Aquatic Centre
Active Clean
East Coast Towbars
New Zealand Sea Adventures
Kd One
Tandoori Pakwan Indian Restaurant
One80° Restaurant
Dockside Restaurant & Bar
TurkeyRed Greytown Country Hotel
One80° Restaurant
ProfessioNAIL Wellington
Martin Bentley Photography
Epic Cycle Adventures
Anahata Yoga Retreat
Elton John - Wellington
Complete your purchase on our approved merchant's websiteGo
Abel Tasman Sailing Adventures
Excel with Business Ltd
Clinico Denture & Hearing
The Boatshed Kayaks - Lake Karapiro, Cambridge
Foto Diem Photography
Diamond Photo
Tailor Made Suits
Riverside Orchards
The Quadrant Hotel & Suites - Auckland
NZ Tech Solutions
Rollerflex Limited
Callcom Smart Phone Repair
NZ Tech Solutions
NZ Tech Solutions
The Shaw Academy
Pamela's Castle
Deals in Other Regions
Manawatu - Wanganui
Nelson - Marlborough
Voucher Guarantee
Getting more bang for your buck
Good news:
GrabOne's Voucher Guarantee means missing out on claiming your deal in time no longer means losing out altogether!
How does it work?
- A voucher is valid up to and including the expiry date stated.
- If you don't use your voucher before that date for whatever reason, it can still be used towards that service with that business for an additional 30 days.
For example, if you buy a bungy jump deal but don't use it before the expiry date, you can still use the amount you paid for the voucher towards a bungy jump, for another 30 days.
A few things to note:
- The GrabOne Voucher Guarantee does not apply to product deals, travel and accommodation-related deals, or time-dependent event deals.
- It's always best to use your voucher before the expiry date, so you get the most value for your money. And if you're a bit forgetful, we now automatically remind you if your vouchers are about to expire.
- During the extended Voucher Guarantee period, your voucher can only be put towards the service stated on the voucher.
- If the offer is seasonal, like a seasonal menu or chimney sweep service, the Voucher Guarantee can be put towards a similar offer at the merchant's discretion.
- The conditions on your voucher still apply during the Voucher Guarantee period.


text:
Check Out This Bluegrass Version of Iggy Azalea's 'Black Widow' [VIDEO]
Iggy Azalea and Rita Ora's new single becomes a happy, singalong bluegrass song!
Iggy Azalea and Rita Ora's new single becomes a happy, singalong bluegrass song!
Iggy Azalea channeled 'Clueless' with her 'Fancy' video, and now she's putting her own spin on 'Kill Bill' with Rita Ora in the video for 'Black Widow'.
When Rita Ora visited the PopCrush office, she performed a stripped-down version of 'I Will Never Let You Down,' and trust us -- it sounds amazing!
Rita Ora previews 'The Single Most Amazing,' her collaboration with Prince.
While Kanye West met boos during his 15-minute rant at the 2014 Wireless Festival over the weekend, Iggy Azalea and Rita Ora were met with cheers in London as the two heated up the stage with their performance of 'Black Widow.'
Iggy Azalea and Rita Ora have announced that they are teaming up for Azalea's next single titled 'Black Widow.'
Rita Ora strikes the perfect balance of cute and sexy with her denim jacket and blonde bob combo on the August cover of Flare Magazine.
Calvin Harris and Rita Ora have officially split, this according to a tweet from Calvin Harris himself.
Rita Ora will be making her silver screen debut as Mia Grey in the book-to-movie adaption of 'Fifty Shades of Grey' and she could not be more nervous about it.
Thank God for Instagram. That's probably what tons of men are saying after getting a peek of Iggy Azalea and Rita Ora's sexy new photo.


text:
Inventory Search
Vehicles Under $10,000*2003 Ford Ranger 2WD SuperCab 2dr 6..
Vehicles Under $10,000*2007 Pontiac Torrent Torrent FWD
Vehicles Under $10,000*2008 Impala 4dr Sdn 3.5L LT
Vehicles Under $10,000*2007 Impala 4dr Sdn 3.5L LT
Vehicles Under $10,000*2008 Saturn VUE FWD 4dr V6 XR
Vehicles Under $10,000*2009 Saturn Aura XE Sedan
Vehicles Under $10,000*2007 Buick Rendezvous FWD 4dr CX..
Vehicles Under $10,000*2008 TrailBlazer 4WD 4dr LT w/1LT
Vehicles Under $10,000*2008 Impala 4dr Sdn LS
Vehicles Under $10,000*2004 Ford Focus 4dr Sdn ZTS
Feldman Chevrolet of Novi - A Chevrolet Dealer Near Farmington
Thank you for visiting our website! At Feldman Chevrolet of Novi, formerly Marty Feldman Chevrolet, we pride ourselves on our outstanding professional and courteous service whether you are looking for a new or used Chevrolet vehicles, financing your auto or bringing in your vehicle for repairs and maintenance. Feel free to browse our site for the most up to date new Chevrolet cars near Detroit and don't hesitate to contact us with any questions you might have. With over 1,200 vehicles on our 35 acre lot, we're sure to have the perfect new or used car, truck or SUV for you.
Serving Farmington and Detroit Chevrolet CustomersFor over 28 years, customers from Farmington and the Metro Detroit region have been coming to Feldman Chevrolet of Novi to fulfill all their vehicle needs. Whether you're searching for the Chevy Equinox or a Chevy Silverado, we are sure to have the vehicle you need. Conveniently located just a few minutes south of I-96 is your Novi Chevrolet dealer. Double Tree by Hilton Hotel and Meadowbrook Glens are located in the neighborhood of you Chevrolet dealer in Novi. With our great location to I-96 and I-696, we are able to serve our Chevrolet customers in Farmington and Detroit. This makes Feldman Chevrolet of Novi a local Detroit and Farmington Chevrolet dealer. If you need more directions to your Chevrolet dealer in Novi, check our hours and directions page for more details. You can find specific driving directions and our hours of operation by clicking on our hours and directions.
Your Novi Chevrolet Dealer for New and Used VehiclesFeldman Chevrolet of Novi stocks a full line of cars, trucks and SUVs with over 400 brand new Chevrolet models. From the redesigned, sporty Chevy Camaro to the rugged Chevy Silverado, your local Farmington Chevrolet dealer has the best in Chevy innovation. For the environmentally conscious, the Chevy Cruze and Chevy Sonic both get around 35 mpg. Carrying over 120 new and 30 certified pre-owned vehicles, Feldman Chevrolet of Novi, has been a favorite for local Detroit and Farmington used Chevrolet shoppers for years. Our huge selection coupled with our low prices is the reason why we are the premier used car dealer in Novi. Stop in today for a test drive or browse our site as our inventory is constantly being updated.
Detroit and Farmington Chevrolet Service and Parts Provider in Novi, MIFrom routine maintenance to major repair work, your area Farmington Chevrolet dealer, Feldman Chevrolet of Novi, has got you covered. Our honest and friendly ASE Certified Technicians are the most knowledgeable in Novi, Detroit and Farmington and are ready for any repair job. Click to schedule a Novi auto service appointment, order genuine Novi car parts, find Chevy tires or GM accessories at your Novi Chevrolet dealer, for your car, truck or SUV.
Chevrolet: Camaro | City Express Cargo Van | Colorado | Corvette | Cruze | Equinox | Express Passenger Van | Impala | Malibu
Silverado 1500 | Silverado 2500HD | Silverado 3500HD | Sonic | Spark | SS | Suburban | Tahoe | Traverse | Trax | Volt


text:
2015 OSSGA Operations Tour Five outstanding sites were featured on this year's tour. Check out these great pics and don't forget to sign up early next year!
This Could Be You! Send your best photos of rehabilitation projects, community events or innovative/sustainable products, including a short blurb, to Jay Millington and you could be featured on this page with an optional link to your company website.
2015 OSSGA Rehabilitation Tour Attendees at the OSSGA Rehabilitation Tour learned that organic material truly is the crucial ingredient when rehabilitating aggregate sites into successful agricultural after-use. Throw in the appropriate amount of potassium, magnesium, and time – and you have the recipe for successful crop yields! See photo gallery here.
Blast from the past! The Toronto Brick Yard Quarry below Felstead Avenue. Follow the link below to discover the 'hole story' about aggregate.
2015 My Job R-O-C-K-S! Video Contest -- Get your entries ready! Golder and Associates were last year's winners -- Will You Be Next! In 2014 Golder's team put together a great video that gave some insight into why their employees love their jobs. We thank all of the entrants for their submissions and their hard work, and look forward to even more great entries in the 2015 video contest. Have a look at their video and find out what you need to do to win.
Want to take a tour? Many of our member companies offer public tours of their aggregate production facilities. Click on the link below to find out how to contact them.
2014 OSSGA Progressive Rehabilitation Award Winner Sunderland Pit was originally licensed in 1958. Extraction in Area 4, shown here before and after, was rehabilitated in 2013 by Earthworx and CBM Aggregates, a Division of St. Mary's Cement Inc. Employees and contractors began at the top of the hill and worked their way down spreading the overburden, and dressing it with topsoil. A CBM employee applied a mixture of buckwheat, perennial and annual rye, tall fescue, alfalfa, crown vetch, and white clover -- all by hand! Learn more about OSSGA awards...
OSSGA Offers Outstanding Educational Programs The 2015/2016 OSSGA training brochure will be available soon. But it's never too early to start planning. Check out the events that were held this past year, and look for these and new and exciting events in the year ahead. OSSGA offers a full range of training programs, tours, seminars and events for everyone in the aggregates industry.
Engineering Success Through Investment in Education A half-century of civil engineering experience has taught Steed and Evans Limited that the wisest investment is a knowledgeable and skilled workforce: One that understands technology and real-world problem-solving application. That's why the company has chosen to invest in the new Construction Materials Testing Laboratory (CMT) in Conestoga's School of Engineering and Information Technology. For more information, please contact Steed and Evans by clicking here.
Blast From the Past! Photo of Gibson Quarry, Niagara Region, circa 1891. The blocks from this quarry were used to build the original train tunnel under the St . Clair River in Sarnia! Please follow the link below to learn more interesting facts about aggregates. Photo courtesy of GENIVAR Consultants LP.
Upcoming Events
Monday, October 19, 2015 at 8:00 AM OSSGA British Columbia Technical Tour
Spaces still available! But hurry!
Monday, November 16, 2015 at 9:00 AM OSSGA Generic First Line Supervisor Training
Thursday, November 19, 2015 at 9:00 AM OSSGA Common Core Surface Miner Training
Wednesday, November 25, 2015 at 9:00 AM OSSGA Environment Workshop
OSSGA News
Capital Paving's Miles For Memories raises over $50,000 for Charity September 24, 2015 at 2:28 PM
On September 19th, 2015, Capital Paving held its second Miles for Memories 2Km/5Km walk/run event at the Guelph Lake Conservation Area to raise funds and awareness of alzheimers and dementia related diseases.
Caledon Pit Run goes this Saturday September 10, 2015 at 9:16 AM
Change up your regular jogging route with a route through the scenic trails of an active aggregate pit. Whether you are a jogger, runner or walker, local construction partners Lafarge and Aecon invite the community to their fourth annual Caledon Pit Run this Saturday (Sept. 12).
Chevrolet Beach Volleyball Centre comes complete with 3,000 tonnes of sand July 10, 2015 at 10:38 AM
Hunstville's Hutcheson Sand & Mixes creates the special sand for purpose-built Pan Am Games venue. The centre itself will have five sand courts in total at the venue; one main competition court, two warm up courts and two training courts. It took approximately 3,000 metric tonnes of specially made sand from Hutcheson Sand & Mixes to fill all five courts.


text:
iHerb Customer Reviews
Rainbow Light, Just Once, Prenatal One Multivitamin, 90 Tablets
Posted by Reviewer2142500 on Mar 04, 2008
This is our thenth child we are expecting. It is nice to take just one prenatal vitamin!
Posted by Reviewer1993621 on Jun 08, 2007
This is the best prenatal out there and all you have to do is supplement a couple calcium pills along but otherwise it has it all; no to mention added digestive support to which is nice as that tends to slow down being pregnant:) #1
Posted by Reviewer1628658 on Oct 23, 2007
They work well. Nice and easy on the stomach, just as the bottle says.
Love them!
Posted by Reviewer3170101 on Oct 25, 2007
I tried using a store brand prenatal vitamin initially. When I read a few articles about some brands, even prominent ones, not dissolving to absorb the benefits, or some using synthetics that were foreign to the body, I researched this brand and determined it was much better. Granted, the pills are a bit large, but if you take them with a full meal, it's not a big deal. I can definitely tell a difference between the old store brand and Rainbow Light! They're great, and iHerb.com has the best price by far!
Love these
Posted by Reviewer1361405 on Apr 11, 2008
I used these all through my first pregnancy, and they were wonderful. I had horrible morning sickness, and these were the only vitamins I could keep down - the ginger in them helps immensely.