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Could a Virus Cause Chronic-Fatigue Syndrome?Since the illness first surfaced in the U.S. in the '80s, chronic-fatigue patients have endured skepticism from doctors, who have not known what to make of a constellation of symptoms that has no known cause, no diagnostic test, and no specific treatment.
Preserving Parenthood for Young Cancer PatientsOver the last decade, the fledgling field of "oncofertility" has focused largely on banking sperm or freezing eggs or embryos for teenagers and adults diagnosed with cancer.
As IVF Pioneer Receives Nobel Prize, a Look at How the Technology EvolvedRobert Evans started his research in the 1950s. Now the universe of IVF has expanded into a nuanced and ever-evolving area of science and culture.
How We Can Prevent Medical ErrorsMedical errors kill some 100,000 Americans every year. How we can reverse the trend.
Why You Should Ditch Old Painkillers SafelySeven million Americans are taking prescription drugs for "nonmedical reasons." Tomorrow, the Drug Enforcement Agency hosts its first national effort to collect unwanted meds to keep them away from people who might abuse or sell them, especially teenagers.
Angie Dickinson Speaks Out on AutismHealth and celebrities can be an intoxicating and major money-raising mix. Michael J. Fox, who was diagnosed with Parkinson's in 1991, has raised awareness—and large amounts of money. Now Angie Dickinson is telling the story of her daughter's struggle with autism.
Stem-Cell Research's Controversial PastEmbryonic-stem-cell research has provoked more controversy—political, religious, and ethical—than almost any other area of scientific inquiry. This week the field suffered a legal blow with U.S. District Judge Royce Lamberth's ruling, which blocks the Obama administration's 2009 regulations expanding embryonic-stem-cell research.
Fighting Against Smoking in the MoviesEarlier this year, Stanton A. Glantz, professor of medicine at the University of California, San Francisco, and James Cameron, director of the science-fiction thriller "Avatar," got into a public sparring match over Hollywood and cigarettes. Now Glantz is back on the attack against the continuing presence of smoking in movies.
A Is for AppleFood insecurity goes hand in hand with "food deserts"—neighborhoods that don't have good access to grocery stores. Here's how "Sesame Street" is trying to deal with that issue.
Food Insecurity Rising in AmericaFood insecurity is on the rise. In 2008, 14.6 percent of U.S. households fell into the food-insecure category at some point during the year—the highest rate since the Department of Agriculture started recording stats in 1995. At the same time, legislation to improve childhood nutrition is now making its way through Congress.
Three Big Medical News Items You Shouldn't MissA slew of important medical developments includes a report that adult stem cells have memories, the advent of a vaginal gel that reduces the risk of HIV infection among women, and a change in guidelines that may lead to a decrease in the number of births by Caesarean section.
Is Sitting While Autistic a Crime?Autism is a diverse condition, but one characterized by behaviors that can be misinterpreted as unusual and even disrespectful by law-enforcement officers trained to seek out those acting suspiciously. One activist is educating police so they can better serve citizens on the spectrum.
Parents Oblivious to Overweight KidsAs obesity rates hit record levels, a new study finds that many adults don't recognize weight problems in their children. The consequences, for families and the country, can be severe.
Healthy Living for Babies Under 2Tests and tools to keep infants healthy. Plus: vaccine safety.
Healthy Living from 2 to 12The Childhood Years: As your children grow, so do their medical needs. Plus: childhood obesity, and how to fight it.
When Baseball and Psychoanalysis MixA group of psychoanalysts gathered this week in Washington to tackle a serious subject: America's national pastime.
Study: Americans Want to Know Their Genetic CodesNew research has found that a majority of Americans want to know the details of their genetic codes, including what diseases they might be at risk of developing.
Movies: What 'The Back Up Plan' Gets WrongWomen who decide to have children without a partner don't fit into rom-com cliches.
West Nile Virus: The Missing Bird-Human LinkWould lives have been saved if officials connected the disease to dying birds earlier? The vet who raised the alarm says yes.
Zoonoses: When Animal Diseases AttackAnimal-based diseases account for 75 percent of newly emerging infections, including H1N1. Can health agencies work together to stop their spread?
Too Fat to Fight? Army Recruiters Discuss New ReportChildhood obesity isn't the first thing that comes to mind when you think about the military. But Mission: Readiness, a D.C.-based organization of retired generals, admirals, and civilian military leaders, is seriously worked up about the epidemic. In "Too Fat to Fight," a new report released on the Hill today, the group says more than 27 percent of Americans between the ages of 17 and 24—that's more than 9 million young men and women—are too overweight to join the military. And it's calling on Congress to do something about it: to get junk food out of schools and to provide more-effective programs for kids to lose weight. "I was overwhelmed by the number," says Mission's Lt. Gen. Norman Seip, who retired from the U.S. Air Force last fall. "We need a force out there that's fit to fight." ...
Adoption Isn't Always Easy: The New York Times With More Stories of Struggling ParentsI first met Josephine Ruggiero 13 years ago when I was reporting a story about international adoption, "Bringing Kids All the Way Home." Ruggiero and her husband had adopted three young biological siblings from Russia in 1994 and they invited me into their home, where they talked openly about how difficult adoption can turn out to be—for parents and children alike. The couple had high hopes that their son and two daughters would adjust to family life in the U.S., but there were physical and behavioral issues from the start, including fetal-alcohol syndrome and posttraumatic stress disorder—information that was not shared by the Russian orphanage directors or their adoption agency. ...
Dennis Quaid: Making Hospitals SaferAfter his twins almost died in a medical accident, actor Dennis Quaid takes his mission to improve hospital safety worldwide.
Ari Ne'eman and the Controversy Over an Autism CureLast week, I called attention to a candid and illuminating memoir about autism in Harper's magazine. The piece, as I pointed out, is refreshingly devoid of controversy. But that is rare in the world of autism, as this story in Sunday's New York Times about Ari Ne'eman, the founder of the Autistic Self-Advocacy Network, makes clear. Last December, President Obama nominated Ne'eman to be a member of the National Council on Disability. Ne'eman, 22, and his supporters—who include other people on the autism spectrum—were thrilled. His critics were not. Charges: he's too young and inexperienced, he's out of touch with the most profoundly affected on the spectrum, and he doesn't support the hunt for a cure. Now, a hold has been placed on Ne'eman's Senate confirmation—he would have been the first person with autism to serve on the council—though it is unclear why. Ne'eman, as the Times points out, is a "lightning rod" for a dispute over how autism should be perceived and treated....
A Mother Shares the Pain and Pleasures—Not Politics—of Raising a Child With AutismStories about autism tend to feel like literary battlefields, with vaccine-theory supporters on one side and vaccine-theory opponents on the other. Which makes Sallie Tisdale's memoir, "My Daughter, Her Autism, Our Life," in the April issue of Harper's Magazine so illuminating. In six pages, there's no mention of mercury; instead, Tisdale writes with compassion and candor about what it's like to care for her autistic daughter, Annie—"a peculiar, sweet, amusing person, irritating and courageous." Annie drives Tisdale mad with her incessant pacing in her big running shoes in the kitchen, but the 26-year-old also manages to make her mother laugh almost every day. The emotional impact on Tisdale—and on so many other parents who have adult children with developmental disorders—is overwhelming and never-ending. She spends endless hours caring for Annie, but beats herself up anyway: "I feel sad and sorry for myself or pissed off, and then I feel petty because I'm sad and sorry for myself,...
Obesity Still a Problem After Health-Care ReformHealth-care reform will help mitigate America's obesity problem, but there are more contentious issues that will need to be resolved to fully address it.
Home From Haiti: A Navy Medical Ship Returns to Heroes' WelcomeAs he stood on a Baltimore dock in a glorious March sun, U.S. Navy Cmdr. Tim Donahue remembered the Haitians. The 44 patients with spinal-cord injuries, two of whom broke their necks. The 23-year-old woman who underwent 14 surgeries in 38 days to save her leg. The 16 adults and 13 children who were too sick or injured to be saved. Minutes earlier, Donahue had disembarked from the USNS Comfort, the massive and gleaming white hospital ship that pulled into its home port last week, two months after departing for its medical mission to Haiti. Donahue, the Comfort's director of surgery, and his colleagues treated some 1,000 men, women, and children injured in the 7.0 earthquake that decimated Port-au-Prince and surrounding areas. They rescued lives, they reunited parents and children, they brought hope to the sickest patients. "It was probably the most rewarding thing I've done in the Navy," he said. It is the best kind of military mission. For two months, Navy and civilian doct...
Natural Birth Post Cesareans: Why Docs Lag ScienceMore women want to be able to have a baby naturally, even if they've had Caesareans. Research backs them up—so why won't doctors?
Regina Benjamin on Childhood ObesityRegina Benjamin, America's Surgeon General, discusses the difficulty of tackling childhood obesity—and the highest peak of Mount Kilimanjaro.
How to Tackle the Childhood Obesity EpidemicAmerican innovations in food, transportation, and technology are threatening to supersize us all.
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Best Of :: Arts & Entertainment
Yeah, yeah, we know: the fake-drug scandal, the snit over salaries, turmoil at the top, demoralized troops, the crime rate. Why on earth would we name the Dallas Police Department the best government agency? Well, we haven't been shot, stabbed or otherwise assaulted in the past year, so that's a big plus. Then there's this: Somehow, through the enormous shit storm of the past two years, hundreds of loyal, honest officers have gotten out of bed each day, strapped on pistols and simply showed up to do a very tough job. That's gotta be worth something.
This place is smashingly good fun in addition to bringing out the artist in folks of all ages. Using bits of broken glass, ceramics and tile (all tumbled to remove sharp edges), patrons turn frames, candleholders, coasters and vases into colorful works of art. Actually, the place has a threefold purpose: It's an art studio, a showplace for commissioning pieces and an art gallery. Owners Robin Franklin and Tracy Graivier are ready to help with ideas. If you prefer doing your smashing and gluing at home, they have take-home kits to get you started. Graivier has even written a book, Crazy Mosaic, which is filled with ideas and hints. So, if you happen to break a piece of Granny's china or knock over her favorite lamp, just scoop up the pieces and head on down. There's art in such disasters.
If you like your reading fast and gritty, with lots of bad-guy chasing and a liberal sprinkling of sex with the scams and body count, Dallas' A.W. Gray is your man. He's been spinning best-selling mystery tales for years, beginning with his popular series about local private eye Bino Phillips (Bino, Bino's Blues, etc.). And here's a little secret: When you think you've read his complete body of work, there's plenty more. The prolific writer has several pen names. Want horror? Try Crossland Brown's Tombley's Walk. Jeffrey Ames (Lethal City, etc.) is a Gray crime fiction nom de plume. For his legal thrillers, look for the name Sarah Gregory (In Self Defense, etc.). He/she can be found in better bookstores everywhere.
Like Riverdance performed underwater by fat people, clogging has its own strange appeal...or not. If you just can't get your fill of mature ladies in sensible shoes making their skirts fly up over their panties, you could see a psychiatrist, or you could call the number above for the Texas Clogging Council and get specifics on next year's Texas Clogger's Rally, to be held March 5 and March 6. There's always a big audience. Maybe you know why.
Say you're a lonely Howard Dean supporter, a witch, a native speaker of French or a pagan (same thing), a John Kerry supporter, Web logger or Goth, and you want to meet others of your tribe. Meetups is the place to go. Operating by Web and all over the world, Meetups arranges get-togethers in local venues for people seeking their ilk, whatever that may be. Plans are still in flux, for example, for the next Dallas-area meet-up of people who are Elvis. But there are already 53 of him signed up. Hey, even if you're not Elvis, how could you miss? There's a movie in here somewhere.
If we were up for drinking games at 8 a.m., this would be the quickest way to get shit-faced. The rules would be as follows: One drink every time Scott Sams mispronounces and/or gives the incorrect name for a local charity, council member or day of the week. Two drinks every time he makes a blatant pass at the eternally uncomfortable Grecian Goddess of Mixmaster Traffic, Alexa Conomos. One drink every time weatherman Greg Field's voice cracks, and another swig any time any one of them tries unsuccessfully to create "colorful banter" after underestimating how much time they have left on the air before the signal mercifully switches back to Good Morning America. We've formed an addiction to Daybreak and watch it religiously before heading off to work. It's funny and gets us going. Don't believe us? Just watch. It's like Laugh-In with extended forecasts.

subset: commoncrawl


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Castro defense complains about evidence
(Cleveland) - Ariel Castro's attorney says he accomplished his main mission which was to spare his client's life.
Speaking to reporters after Castro was sentenced to life in prison with no possibility of parole, Craig Weintraub objected to the prosecution submitting photographic evidence of how his victims were held and tortured.
Weintraub contends one of the reasons Castro agreed to the plea deal was so his victims would not have to relive their 10 years in captivity in court.
Craig Weintraub and Timothy McGinty
However, Cuyahoga County Prosecutor Timothy McGinty said the evidence was submitted just in case Castro attempts an appeal claiming his offenses were not as bad as the prosecution claimed.
Today's hearing gave prosecutors a chance to detail some of Castro's assaults, with investigators describing the makeshift prison he built in his home -- even creating an alarm system, as he chained the women inside bolted bedrooms.
Assistant Prosecutor Adrian Linnick says it was important for the court to hear about the extent Castro went to keep Michelle Knight, Gina DeJesus, and Amanda Berry tied to his house.
Anna Faraglia
Assistant prosecutor Anna Faraglia says she was not surprised that Castro claimed it was a harmonious household with consensual sex. Faraglia contends that from the time Castro was arrested he blamed others for his crimes.
Get breaking news sent to your mobile phone. Text "news" to 21095.
(Photos by WTAM's Ken Robinson)


text: i only had a sharpie that went through the wash . and i was tired . i did it at like 2 in the morning and i was really bored . ill post some better oones. peace . and c3zr , thanks for not busting my shit like everybody else but actually giving me some tips .


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I'm a big fan of J.J. Abrams. I think he does tremendous work.
Here's the article for more information if this sort of news interests you:http://starwars.com/news/star-wars-is-being-kick-started-with-dynamite-jj-abrams-to-direct-star-wars-episode-vii.html
Phew – maybe we shall get some acting this time even if there probably be some dodgy plotline!
gballx said
Phew – maybe we shall get some acting this time even if there probably be some dodgy plotline!
oops – sorry that should be artistic direction!
I hope he can write and direct it similar to the 2009 star-trek but STAR-WARS FLAVOUR
It's pretty crazy, the first time someone has consecutively rebooted the 2 biggest sci fi franchises! I hope he does as well with Star Wars as he did with Star Trek. The 2 are quite different beasts after all.
I wish Irvin Kershner was still alive.
And a Guillermo Del Toro + Peter Jackson partnership would be a dream for me, they are my heroes.
Let's wait and see how soulless money machine will kill StarWars once again.
This is worst day of my life
It's a pretty predictable choice from Disney, very safe, very 'Disney'.
Of far more interest is the fact that Disney chose the writer of 'Little Miss Sunshine' and 'Toy Story 3' to write the screenplay. It all starts at the script, and choosing Michael Arndt gives me a little more optimism.
Hopefully he will do a good job and turn me into a Star Wars fan.
ok george lucas has like 1000 million dollars , COULD NOT GET A FUCKING BETTER JEANS THAN THIS.


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Lupita Nyong'o wins Oscar for Best Supporting Actress
Listen to Big Show Radio on iHeartRadio
A dream came true for Lupita Nyong'o at Sunday's Academy Awards ceremony. She won the Best Supporting Actress Oscar for her work in 12 Years a Slave, and said during her touching acceptance speech that she hopes the new golden trophy reminds her and others to keep dreaming.
[PHOTOS: 2014 Oscars Highlights]
Nyong'o also dedicated the award to the "spirit of Patsy," the abused slave she played in the Steve McQueen-directed drama. She said it doesn't escape her for one moment that so much of the joy in her life is thanks to so much pain in someone else's.
[PHOTOS: Best and Worst Dressed at the Oscars]
Nyong'o's Oscar victory comes on the heels of a number of wins for the actress this award season, including a Screen Actors Guild Award and an Independent Spirit Award earlier this weekend.
[CLICK HERE for iHeartRadio's full coverage of the 86th Academy Awards, Big Show Report powered by Cars.com]
Photo Credit Getty Images


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WATCH: Tyler Farr - 'Redneck Crazy'
Listen to Tyler Farr on iHeartRadio
Country newcomer Tyler Farr has a few famous friends joining him in the video for his latest single, "Redneck Crazy." The guest stars include "Duck Dynasty's" Willie Robertson, whom Tyler thinks was a perfect match for the clip.
Farr shot the clip in the swamps of West Monroe, Louisiana. The video also features Tyler's country music buddies Lee Brice and Colt Ford.
Tyler's clip is the second country music video in recent weeks to feature the "Duck Dynasty" star. Darius Rucker also tapped Willie, along with Willie's wife Korie, their daughter Sadie, and "Duck Dynasty's" Jase and Si for the video to his single "Wagon Wheel."


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Emelec 2013-14 home blue/hrey shirt.Features round neck with in grey .Screened on Electricos at the back of the neck.Embroidered 3D crest and screened on logo.Sublimated sponsors in front and backWarrior Tech fabric for comfort to wear.100% polyester.
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Monday, September 9, 2013, 1:00 pm to 3:00 pm
Monday, September 23, 2013, 1:00 pm to 3:00 pm
060 Rike Hall
Current Students
If you look like you have it together, everything else will fall into place afterwards. This workshop is ultra-interactive! Bring your unorganized bag and let's work magic on it because a visual mess can literally make you tired. Oh, and your datebook? You will be shown how to use it to achieve Zen in your life.


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If your country of nationality appears on the list below, no advance visa arrangements are required to visit the UAE. Simply disembark your flight at Dubai International Airport and proceed to Immigration, where your passport will be stamped with a 30-day visit visa. This can be extended for an additional 30 days at an additional charge.
In addition to nationals of the countries listed above, citizens of the GCC nations of Bahrain, Kuwait, Oman, Qatar and Saudi Arabia are eligible for the visa on arrival at Dubai International Airport.


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English Rugby Bag
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Crafted from burnished leather and fitted with antiqued black metal hardware, our rugby bag has the vintage styling, hand-distressing and rugged appeal that speaks to past and future game day glory.
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cathy - from hanover, PA
I used a shaped baking pan to mold the large monkey that went on top of the cake. If you have shaped pans at home, this is a great second use for them. Here's the monkey pan - http://www.wilton.com/shapedpan/Monkey-Pan
The candy plaques around the outside of the cake were made using Wilton's Monkey Lollipop Mold - http://search.wilton.com/?q=monkey+mold


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Now when i run nessusclient i get a different error so some progress but still not there yet:
/opt/nessus/bin/NessusClient: /usr/lib/libstdc++.so.6: version `GLIBCXX_3.4.9' not found (required by /opt/nessus/bin/NessusClient)
-Monkeys are like nature's humans.
The nessus site only provides download to the 220.127.116.11. fc9 version of the client. Anyone have a slightly older version that is working with BT3?
-Monkeys are like nature's humans.
Thanks. Will try it later with the fc8 packages and will let the forum know to help out others who download the latest packages instead of the exact versions in the tutorial. I suspect that upgrading to slackware 12.2 resolves the issues with missing libraries.
Well, I installed the fc8 packages and this time it seems to be working although I do get this error when running nessus client even though the gui loads apparently fine:
/opt/nessus/bin/NessusClient: /usr/lib/libpng12.so.0: no version information available (required by /opt/nessus/lib/libQtGui.so.4)
Maybe all my installing and uninstalling the packages messed something up. Too tired right now to investigate further.
Thanks again for your help and please do let me know how to fix this error if you have any idea.
Very well explained, even with 3.2.1, no problems during installation or configuration. They emailed my the key in a few minutes.
Is it a full version? i mean, how much last the key?
Janus, the error was discussed on the first page. Its an issue with the library file not listing its version information. It happens on mine too.
MAGSPAIN, this is the full version, but with a delay in the updates. It should last indefinately, or until they phase out 3.2.


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How I Celebrated My Birthday (aka 38 Random Acts of Robyn)
***Due to the awesome, unexpected response since I originally posted this, I have started The Birthday Project. The website is www.thebdayproject.com and we have started a great community of amazing like-minded people on Facebook too (please jump over to "Like" it and say "HI!".) Thanks!***
I mentioned a couple of weeks ago my birthday wish was to complete one Random Act of Kindness for every year of my life thus far, as well as asking friends, readers, Facebook fans and fellow Twitter-ers to each perform one Random Act of Kindness and to let me know about it throughout the day.
I planned out 38 things ahead of time just in case, but really was praying for opportunities to present themselves throughout the day. It was absolutely freezing and windy but we were not to be deterred! My husband, three daughters and my husband's parents joined me in the most favorite birthday of my life!
1. Returned grocery carts back inside the store from the parking lot for shoppers.
2. Loaded bags of groceries into cars for shoppers (received a hug from one adorable elderly man).
3. Handed bottled waters out the car window to joggers/walkers/bicyclists we passed by (felt like we were support for the Iron Man triathalon or something…lots of laughs from people on this one).
4. Inconspicuously dropped coins on the playground for children to find while they played (my girls are really good at this apparently. No, no one choked on a random found penny. Yes, LOTS of squeals of delight floated through the air as we walked away!)
5. Fed parking meters.
6. Paid for the next two cars behind us on the toll bridge. (Toll operator said, "You gotta be kidding me").
7. Handed out Tootsie Pops to children (asked parents permission first of course!).
8. Bought a gift card for groceries and turned around and handed it to woman in line behind me. I wasn't prepared for the look on her face. I immediately left before I started to cry.
9. Walked up to a family eating lunch at a local restaurant, placed a gift card on their table and walked out.
10. Dropped off several hand written thank you notes and doughnuts at the police station.
11. Gave a dozen hot doughnuts to a very cold crew working on the power lines.
12. Took a large bag of clothes to the local homeless shelter.
13. Left 3 gift cards with notes hidden amongst books at Barnes & Noble.
14. Paid for the woman's coffee behind us in line at Starbucks.
15. Chased down and caught runaway Happy Birthday balloon and returned it to the owner's unlocked car (then secretly watched as he returned and was completely baffled at the balloon sitting in his front seat!)
16. Tucked happy notes in car doors in parking lot wishing people a good day full of God's blessings.
17. Handed out mylar balloons to children shopping with their parents.
18. Took art supplies to the Family Waiting Room of labor & delivery floor of the hospital for new big brothers and sisters to be.
19. Dropped off stuffed animals on the children's floor of the hospital.
20. Delivered balloons to hospital patients.
21. Handed out water bottles to very appreciative nurses (who knew they were so thirsty?).
22. Taped change to vending machines (I actually saw passersby stop and take pictures of the machines without taking the money).
23. Pumped woman's gasoline so she didn't have to get out of her car in the cold. (We also added a bottle of some sort of additive since she asked. I should find out what that stuff was. I never add stuff to my gas tank.)
24. Left quarters at a laundromat.
25. Delivered handwritten Valentine cards to the local assisted living facility.
26. Phone card to young woman in need. (I asked the owner of a store I frequent if he knew of any customers who might need it and he got a big smile on his face. He looked at the girl working there and told me she had just confided in him yesterday that she couldn't afford her minutes on her cell phone to call her family back home. It was a suuuper cool moment.)
27. Handed out hot chocolate at ice skating rink.
28. Left free Krispy Kreme doughnut coupons on coffee table at church.
29. Gave coffee to a toll booth worker on our way home. (He seemed the least affected or appreciative of the day. I feel like he might have needed it the most of everyone.)
30. Walked into McDonald's and asked the cashier to use my free coupon on next person in drive through line.
31. Wrote a letter to old friend and mailed it (yeah, the total old fashioned way).
32. Took plates of cookies to 2 neighbors I don't really know and spent some time talking with them (no, I did not bake them myself but no one seemed to care).
33. Read a story to children in Barnes & Noble (I think people thought I worked there! The kids liked it and the parents loved it!). BONUS: My 8 year old daughter found a little guy and read him a book too.
34. Took pictures of two tourists in front of Hard Rock Cafe and a family in the park.
35. Brought in the neighbor's garbage can for them.
36. Gathered a newspaper that a woman who's hands were full dropped at the grocery store.
37. Left a small treat with a note of thanks for the mailman.
38. Read an entire Junie B. Jones book (all 9 chapters) to my children before bed, instead of the usual two chapters. (Happy girls indeed!)
I was overwhelmed by the number of texts, emails, Facebook messages and Tweets I received from family, friends, colleagues and people I don't even know, telling me a Random Act of Kindness they did in honor of my birthday. I cried several times throughout the day from how touched I was. Here are the great RAOK other's did:
Jeanette: I am so glad to hear that you had an amazing birthday! My ROAK – My assistant teacher was having a rough week so I baked her a box of her favorite cookies… Snickerdoodles!!
Heidi: we collected old towels, washcloths and newspapers and am donating them to the local animal shelter!
Debbie: Just paid for the order for the car behind me at the drive thru lane….
Kimberly: Happy Bday! We just taught an older lady how to use the automated postal machine from start to finish ;o) (everyone deserves to learn how to avoid the postal line!!!)
Will: Called a new colleague to tell her a press release had a major typo on it before it went any further! Handled it graciously and with understanding that we all make mistakes.
Becky: Happy Birthday Robyn! I let someone use my discount card at the grocery store since they didn't have one…not major, but I thought of you and smiled! Hope you get all of your Random Acts of Kindness fulfilled! Enjoy your day! Xoxo
Deanne: I didn't kick the %$#* out of someone who drove me crazy tonite~~~ does that count?
Sandi: I collected something from Freecycle (electric Hannukah menorah) that I donated to an Adult Living Facility. I know that they prefer electric over real candles. Does that count towards your 38? I love your post!
Heidi: In honor of your birthday i cleaned out our closets and have donated 7 garbage bags of clothing to haiti!! (this was on my radar and i needed a little incentive, thank you!) happy birthday sweet friend!
Traci: We bought a box full of medical supplies, food, etc to donate to Haiti. O. was thrilled to help me pick out band-aids, gauze pads, tape, etc. Love you friend…hope you had the best birthday ever!! XOXO ♥
Mara: Happy Birthday Robyn! A. and I are making valentine cards to send to the military troops today! Hope you have a wonderful birthday!
Shandra: My random act was that I just paid for the bridge tolls of strangers behind me in line coming back from Logan airport. Also gave the toll taker a coffee from Dunkin Donuts. It's WICKED cold here today.
Stacy: This pay it forward thing is an amazing idea. Wow. I am going to have to do this on my next bday. You have inspired me!!! Giving away free food randomlly to people at our (pizza) place today in your honor…probably shouldn't say where, huh? xoxo
Lara: Today we spent the morning at the school doing yardwork and then came home and cleaned out closet/garage and donated everything to The Bargin Box!!!
Cameron: I let a mother with two squirmy kiddos ahead of me in line, even though she had way too much stuff
Lynn: Does it count if the lady next to us in "Avatar" was crying her head off and I gave her some tissues? She was most grateful…:)
Nicolle: My RAOK in honor of your Birthday…but, before I share, I have to say that you have started a tradition…and I, too, will use this request on my Birthday in August! I just LOVE this, Robyn…it is right up my alley and has filled me up today with good cheer and warm vibes and in turn has brightened the worlds of complete strangers~ matter-of-fact, I had such fun doing so, that I did it twice today! Ok, ready?
RAOK #1: Walked up to an elderly man in the mall today and simply smiled, asked if I could bless him and was surprised to find how open he was to the occassion…rested my hand on his shoulder, said a silent prayer, smiled and told him he was a special addition to this world of ours~ he, in turn, had tears and a smirk all in one. My heart was fulfilled~
RAOK #2: On the way home, stopped in 7-11, a little girl was glaring at the big cookies…asked her Mommy if I could, she said yes, so we (D. delivered) bought her a BIG GIANORMOUS cookie and some milk to go with it….D.'s little heart was fulfilled and his cheeks were rosy~
Thank you, Robyn!!! YOU, my friend, have made MY day! I adore you! HAPPY BIRTHDAY all over again!!! xoxo
Lara: My raok today, I bought coffee for the man behind me at Starbucks today!! And I just read that you did the same thing! How fun!
Amy: Bought tea for the lady behind me in line at the coffee shop declaring "it's Robyn's RAOK day." Granted she has no idea what that means but my new friend, Betsy, declared that I must be the nicest person in the whole city. : ) I do stuff like this at the Holidays all the time. Thanks for the reminder to keep it going all year long. Love to you! (And I'm totally stealing this for my 38th in 2 weeks!)
Alexandra: In your honor, spent 2 hrs counseling a past acquaintance in his new walk with the Lord. Happy Birthday….
Claire: Hey Robyn- RAOK took $40.00 worth of quarters into Magic Kastle Laundromat and asked the lady behind the counter to pass out to all customers for a day of free laundry. Guess great minds think alike!
Diana: WOW ROBYN! I have never been so excited to have my Bday! You have inspired our whole day! My husband got involved we cleaned my 96 yr old great grandmothers house then went grocery shopping for my cousin who is currently unemployed! My acts werent randon but they were kind! Thank so much for a wonderful day!HaPpY BiRtHdAy my friend!
Michelle: had to call a maintenance guy out to my place yesterday (friend of a friend) – his 7yr old daughter was tagging along with him everywhere on Sat – when I realized I didn't have any goodies for her, I stepped out & bought some Little Debbie Zebra Cakes & her very own bottle of milk – when I brought them back they were both blushing & smiling when they received them – the whole time I was thinking about your day! Thanks Robyn. B-)
Laura: RAOK We boxed our pizza up and handed it to two guys on the street in NYC. They were so excited.
Corinne: I pushed wayward grocery carts up to the front of the store so the bag guys/gals didn't have to.
Carlos: RAOK – A boy came to the house selling chocolate bars so that he could earn money for him and his baseball team to go to Cooperstown. When I paid him, instead of picking out the bars I wanted, I told him to take what he wanted for himself. His face lit up! Not the biggest deal, but it was nice for him. And plus, it was for baseball!
Lynn: While visiting the freezing cold restroom at the Outlet Mall, I realized that the lady cleaning the area must really need lunch and a hot cup of coffee. Her sweet face and shocked response when I handed her the cash REALLY made my day! Thanks for inspiring us, Robyn!
Sean: After purchasing our tickets at the theatre, we purchased the next in line's tix too! The Mom and her two teenagers were completely floored. "WHAT??? WHY????" then…"thank you so much, thank you!!!" We were giddy with having made their day and saved them a buck or two!
Joanna: Our random act of kindness on Saturday in honor of your birthday… At R.'s cheerleading competition we met a girl from Pensacola who was competing as an individual. Her coach, her family and her friends weren't able to go to the competition, so she didn't have anyone to cheer her on. We all yelled our lungs out for her. She placed 1st in her division Happy Birthday Miss Robyn!
Kylene: Inspired by your RAOK so I paid for the ladies' coffee behind me at Starbucks this morning. She seemed excited.
Julie: In honor of your bday I treated the stranger behind me @ Starbucks to their morning coffee. Thanks for the inspiration!
Amy: Just bought gift card for lady behind me @DSW shoes.
Lindsay: not that creative but I paid for a girls cookie at the great cookie co at the mall:)
Amanda: RAOK – paid for the person's meal in the car behind us.
Michelle: Hi Robyn – hope ur having a great wkend! Reached out 2 a troubled teen 2day-thx 4 the inspriration
Kate: I paid for the next two people behind me at the coffee shop this morning in honor of your bday.
Elisha: I'm organizing an event with friends to help raise money for a friend that has lost 5 members of her family in Haiti and is trying to get money together to send to other family members who are in need of a tents that are ranging in price from $500 -$700 each.
Kylene: Me & my hubby took pictures for 6 different groups of people at Millenium Park in Chicago yesterday. We're both photogs.
THANK YOU TO EVERYONE WHO CELEBRATED WITH ME. With the exception of my wedding day and the days I gave birth to my children, my 38th birthday was by far the best day of my life. We were both exhilarated and exhausted but mostly reminded how opportunities to help others are all around us all the time; we're just usually too busy to notice. And thank you again, Kimberly, for the inspiration. You, my dear, are the original Rockstar!
Tags: acts of kindness, birthday celebrations, birthday kindness, birthday project, change the world, pay it forward, random acts of kindness, the bday project, the birthday project, unique birthday, ways to celebrate, ways to give


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Chocolate wafer cookies, creamy vanilla whipped icing and rich chocolate sauce — a simple recipe with WOW impact, perfect for any special occasion dessert.
Prepare icing mix according to package instructions using ice water. On small plate, place cookie; add tip 32 rosettes over top of cookie. Top with another cookie and rosettes; repeat 4 times. Arrange blueberries and raspberries on top rosettes; drizzle with chocolate topping. Refrigerate until ready to serve.
Each serves 1.


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Robin Cyr visits with her newborn baby girl in the Neonatal Intensive Care Unit at the IWK Health Centre on Sunday.
©Metro News photo by Jeff Harper
Robin Cyr's fourth child has already packed a lifetime's worth of emotional turmoil into her first 28 minutes in the world.
Cyr, 34, was told her baby girl had died just after being born in the IWK Health Centre in Halifax around 3 a.m. Saturday.
But shortly after getting the devastating news, a stuttering, breathless nurse rushed back into the room to say the baby had started breathing again.
"My aunt was there, and it's a blessing because her prayers are very deep and strong," said Cyr on Sunday, speaking in a whisper through tears at the hospital. "When she started praying, my baby came back."
The big baby girl – who weighed nine pounds 14 ounces – got wedged in the birth canal during the delivery. Once she was born, Cyr lay on the bed waiting, for 25 minutes, for any sign of life.
"My aunt looked at me and said, 'Your baby girl's gone,'" she said, adding the baby's body was taken out of the room after being declared dead. "Another nurse came over, two minutes later…she couldn't talk. She was speechless, and another nurse came over and said, 'Your baby's breathing.'"
A flummoxed surgeon told Cyr's family that he had no explanation for the seemingly impossible recovery.
"He said it's a miracle," said Cyr. "He said, 'I'm very sorry I gave up on your baby when I did, because I turned around and she's breathing on her own.'"
The chubby little girl – with an impressive shock of dark hair – is now breathing on her own in the neonatal intensive care unit, and looks like any other healthy newborn baby.
Cyr's family and friends say they're still processing the miracle that trumped the miracle of birth.
"The way the story progresses, by the time you get halfway through, you don't want to hear the rest, you're like, I'm done. This is not going to end well," said godfather Nevel Carvery. "Then to have it end the way it ended, it's a roller coaster."
Cyr had a name picked out for the baby, but said that will likely have to change.
"Everybody just keeps saying, Miracle, Miracle," she said.
A review is underway to determine what, if any explanation, there may be for the baby's apparent resurrection – but Cyr says she knows the answer.
"All I can say is, hand of God," said Cyr. "That's what everyone's saying, she's here for a reason. God brought her back for a reason."


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Board of Regents to Hold Emergency Meeting
- 01/08/2003
The only business to be conducted during the emergency meeting will be consideration of a motion to go into closed session for the purpose of holding a strategy session for collective bargaining. Such closed sessions are authorized by Nebraska Statute 84-1410.
The University of Nebraska has faculty labor unions at the University of Nebraska at Kearney and the University of Nebraska at Omaha. By law, final offers on each unresolved issue in the collective bargaining negotiations must be exchanged no later than January 10.


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Washington : Government Printing Office
|Chap. 1192
|Agua Caliente Indian Reservation.
|Chap. 1192
|Chap. 1192
|63 Stat. 705.
Page 526
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That section 2 of the Act entitled "An Act to confer jurisdiction on the State of California over the lands and residents of the Agua Caliente Indian Reservation in said State, and for other purposes", approved October 5, 1949, is amended by striking out "December 31, 1950" and inserting in lieu thereof "December 31, 1951": Provided, That this amendment shall not extend the duration of any permit which would, according to its own terms, expire on or before December 31, 1951.
Approved, December 29, 1950.


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Clive Merrison stars as Holmes with Michael Williams as Watson in these adventures, part of the unique fully dramatised BBC canon of Conan Doyle's short stories and novels featuring the world-famous sleuth.
©2004 BBC Audiobooks Ltd; (P)2008 BBC Audiobooks Ltd
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"❤Superb! Fantastic Sherlock Holmes"
A brilliant collection of Sherlock productions. Perfectly acted by Clive & Michael with great soundtrack. These are so enjoyable I listen over & over again. My Sherlock Holmes collection just grows & grows into a fabulous treasure trove. ❤
"Sherlock Holmes: a new love for me!"
The dramatised edition finishes it off perfectly, and keeps you hooked and on the edge of your seat! It really is like watching a film in your head...
This was my first ever Sherlock experience, and it certainly won't be my last. I enjoyed listening to every story so much not once did I want them to end. There is such a great deal of Holmes available on audible I knew i had to give it a try, now I'm wondering why I didn't do this sooner.

Read superbly, this was like music to my ears. You'll be seeing many more reviews by me for Sherlock Holmes on audible.
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Animations and transitions
Add animations and transitions using PowerPoint 2010. Animate slides, text, bullets, pictures, charts, and shapes. Learn how to add animations to all slides. Plus, see how to remove animations and transitions.
Charts and diagrams I: SmartArt graphics
Learn how to insert charts and diagrams using PowerPoint 2010. Find out how to pick the right chart, and learn how to work with SmartArt graphics.
Charts and diagrams II: Data charts
Learn how to visualize data by inserting data charts using PowerPoint 2010. Learn the fundamental components of a chart, and learn how to work with pie charts, column charts, and line charts.
Insert video into your presentation
Insert your videos into PowerPoint 2010: embed them, link them, or insert them from a website like YouTube. Plus, learn how to resize a video frame, set playback options, and more.
Office 2010 Security: Protecting your files
In Microsoft Office 2010, when files open, Message Bars can alert you to useful information and potential problems with your files. Security Message Bars provide the opportunity to consider the potential security risks that may be in your file, and then the ability to open or read the file while reducing the risks that can occur.
PowerPoint 2010 keyboard shortcuts
Learn PowerPoint 2010 keyboard shortcuts. Find out how to access almost any command or button using the ALT key. And, learn handy shortcuts that use the CTRL key.
PowerPoint 2010 tips and tricks
You've created tons of PowerPoint presentations. But perhaps you need some timesaving techniques to help you work faster. This short course will do just that: give you tips and tricks for working with PowerPoint 2010.
Put your photos into PowerPoint
Put photos into PowerPoint 2010 and make them look their best. Insert photos individually, or insert a bunch to create a photo album. Plus, learn how to crop, rotate, and position photos.
Check out training courses for the rest of the Office programs.


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Welcome, skip to the content.
Grampians Getaway consists of six pyramid shaped units all well spaced and surrounded by native vegetation, on 50 acres of private property located five minutes from Halls Gap at the foot of the Grampians. All units have three bedrooms and are suitable for couples and can sleep up to eight. The units are fully self contained and have wood fires, heating and air conditioning, television, DVD players, sound system, full kitchen and laundry. All units have spa baths, two have large corner spas. The large living area opens up to a covered patio area with a gas barbecue. The units have a king or queen bed in the loft area, a double bed in the second bedroom downstairs and two single beds or four bunk beds in the third bedroom.The units have beautiful views of the Grampians. The Grampians Getaway dam provides guests with canoeing, yabbying (in season) and fishing. Bicycles are also available as well as DVDs.Pets are allowed on approval by management.Grampians Getaway is located across the road from the Halls Gap Zoo and Halls Gap Estate Winery and a short drive to the Grampians National Park and The Brambuk Aboriginal Cultural Centre.
Rate is for two people, extra fee of $20 per person per night. Tariff includes all linen and towels. Free use of all facilities.
Queen bed, double bed four bunk beds single person spa bath wood fires electric heating and cooling full kitchen.
Queen bed in the loft area with balcony, downstairs second bedroom with double bed and third bedroom with four single bunk beds or two single beds.
Downstairs bathroom with spa bath and separate toilet. Fully equipped kitchen. Washing machine. Barbecue and outdoor setting under covered pergola. Air conditioning and wood fires (seasonal) fire wood supplied. Ceiling fans and louvred windows provide cross breezes and views to bush setting and mountains.


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20th C. Factory Filament Metal 3-Cord Round Pendant - Aged Steel
- No Longer Available -
Evoking early 20th-century industrial lighting, our reproductions of vintage fixtures retain the classic lines and exposed hardware of the originals. Designed to showcase the warmth of Edison-style filament bulbs.
Show Details +
- Each Pendant: 4½" diam., 6¾"H (without shade)
- Cords: 8'L
- Ceiling Plate: 8" diam.
Shown in aged steel.
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Data Storage and Analysis
Data Storage:
You must save the data into your portable storage device before closing the LAS program. Otherwise, the data will be automatically deleted. You need to bring your own portable storage device.
Data Analysis:
We suggest Image J, LAS AF, and Photoshop for image analysis; and lmaris for 3D or 4D image analyses. A high end software (lmaris) is provided on our second workstation at a cost.
Leica LAS AF lite:
Free version of the Leica confocal LAS AF software can be found at: ftp://ftp.llt.de/softlib/LAS_AF_Lite
Image J:
Free software for image analysis, a Java based version of NIH image, versatile and many plugins are available here: http://rsbweb.nih.gov/ij/download.html
FIJI (FIJI Is Just ImageJ)
FIJI is a version of ImageJ with prepackaged plugins and a few other tweaks. You can find FIJI at: http://fiji.sc/wiki/index.php/Fiji


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Everytime i attempt to convert JRE 1.6.0.mo to .lzm on a LIVE CD i get the following error:
usr/lib/liblinuxlive: line 209: 13289 Killed mksquashfs "$1" "$2" $3 >/dev/null
error building compressed image
Any ideas why? Thanks guys.
Remember, Friends Dont Let Friends Choose Signatures.
have a look at charon thread and use the script for java i add in this thread, works perfect
Watch your back, your packetz will belong to me soon... xD
BackTrack : Giving Machine Guns to Monkeys since 2006
Ill give it a try, thanks.
Remember, Friends Dont Let Friends Choose Signatures.


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VIDEO: Tribe fan snags FOUR foul balls
(Cleveland) - A lucky fan at Sunday's game between the Tribe and Royals caught four foul balls, a once-in-several-lifetimes achievement.
Season ticket Greg Van Niel, a season-ticket holder Cleveland Heights, hauled in four souvenir balls during the Indians' 6-4 win over the Kansas City Royals.
Van Niel said he wasn't sitting in his usual seats, but he was able to catch three balls and that one was a "pick-up" he tossed to another fan.
Van Niel said gave the three other balls to kids that were part of his group. He said he had never caught a foul ball before his amazing one-day haul.
There were 15,431 other fans at the Indians' final game before the all-star break, but it's safe to bet none had a day quite like Van Niel.
Van Niel was on Monday morning with Wills and Snyder to talk about his lucky day!
Get breaking news sent to your mobile phone. Text "news" to 21095.
(Copyright 2013 Clear Channel and the Associated Press, all rights reserved. Picture courtesy Fox Sports Ohio/MLB.com.)


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Sinclair VP: "The Point" had "a tremendous response to the efforts by fringe groups and obscure individuals trying to silence this commentator"
Research ››› ››› MEDIA MATTERS STAFF
Sinclair Broadcast Group vice president Mark Hyman devoted the January 22 "Mailbag" edition of "The Point" to reading viewer comments about "the efforts by fringe groups and obscure individuals trying to silence this commentator."
In December 2004, Media Matters for America launched the Sinclair Action campaign to protest Sinclair's continued misuse of public airwaves for one-sided and misleading politically charged programming -- including Hyman's "The Point" -- without a counterpoint. The campaign encourages Sinclair to offer equal airtime to a counterpoint that would balance the content of their news programming.
From the January 22 edition of "The Point:"
This week's mailbag had a tremendous response to the efforts by fringe groups and obscure individuals trying to silence this commentator.
Peter of Round Pond, Maine, wrote "[your] viewpoint is one-sided." Ralph in Springfield, Illinois, thinks I am "a paranoid, misinformed Rush Limbaugh wannabe." Bud from Columbus emailed, "You are a smug little Nazi." Chuck in Palmyra, Illinois, was mixed in his reaction, writing that sometimes he doesn't "know whether to pat you on the back or take you out back and kick your butt!"
Mark, a Canadian from London, Ontario, had a larger view of American society. He now lives in China, which he called the "friendly dragon" where he is now "cheering for the Iraqis." He thinks little of the average American that he says is "30 pounds overweight, likes his football and beer, porno, dislikes most things foreign, hates gays, loves God and his gun." Then Mark complained about how difficult it is to get a visa to the U.S. Mark, why would you want to visit a people and a country you detest?
On the other hand, Polly in Clyde, North Carolina, emailed: "Your comments encourage us every time we hear them." James in Chicopee, Massachusetts, agrees, "It is refreshing to hear your comments." Melody in Duncan, South Carolina, noted, "I love it when you point out the truth, even if it hurts." Kim in Chatham, Illinois, asked, "Why is it that hate-filled celebrities can use foul and vulgar language ... others can create 'crockumentaries' ... and yet when the right speaks, they demand our silence"? Keith in Kittery, Maine, sees "The Point" countering "the outrageous liberal commentaries every day in almost every facet of the media." And 17-year-old Shawna of Lexington wrote "People that write you hate comments obviously don't like the truth."
Finally, Jeannie of Columbus sent this note: "When I first started listening to your commentary, I thought you were a pompous dweeb ... however, I find that either I, too, am becoming a pompous dweeb, or my initial impression was shortsighted and you really do make a lot of good sense." Jeannie, for both of us, let's hope it's the latter.
Fill out the form below and tell me what you think. I'll air select comments every Saturday.
I'm Mark Hyman.
- Posted In
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- Network/Outlet
- Sinclair Broadcast Group Inc.
- Person
- Mark Hyman
- Stories/Interests
- Attacks on Media Matters, Propaganda/Noise Machine, Sinclair Broadcasting, 2004 Elections
Instructions for signing up and claiming your comment history are located here.
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I have just been to the Girnar mountains, where the temples glisten in the morning sun. Seeing these temples, it occurred to me: The soul too has such high peaks where temples shine even brighter; for the Lord's light is more keen and intense than the sun's light. But we are such, we lose ourselves in the temples outside and get no hint of the temples within. We might spend a whole life climbing mountains, unaware of the heights of our own consciousness. As there are tracks that lead to the Girnar peaks, so there are paths leading to the peaks of consciousness.
There is a difference however, in these two paths. In the realm of consciousness no footprints are left behind. Just as the birds that fly in the air leave no trail behind - each bird flying its own path, so also in the path of truth there are no cut and hewn roads. Each one must carve his own path, which takes shape as he walks along. There is no definite direction that one can follow. If the paths were ready-made, all we had to do was to follow one of them and reach the top. But there are no paths. As man walks, his footsteps get erased behind him and are lost forever. Though each one has to make his own path, a few hints can be given in connection with them. In this last discourse, we shall talk about these pointers.
We have already discussed the first two rules. Today, we shall talk on the third rule. This third rule is somewhat symbolic. The first fact to be understood about this rule is that life, as we normally take it to be, is not real; and as long as we consider it to be real, our eyes will never turn in the direction of truth.
Those who wish to set out in quest of truth, have perforce to know that this life is no more than a dream - this is the first tip. This long journey from birth to death - is it a reality or a dream? We shall have to ponder on this. Normally we take it as real but that is because we have never thought much on it. When we dream at night, the dream appears real. It never occurs to us while dreaming, that what we are experiencing is not true. Dreams look very real, while dreaming. How many times do we dream? All through life we dream, but never has the unreality of the dream been experienced or known during the dream, its falsity never comes to our mind. Those who have awakened to greater truths, claim that the world we see with open eyes is also no more than a dream.
A king's one and only son lay on his deathbed. The doctors had given up hope - death was lurking close, perhaps it would come that very night. The king and the queen kept vigil by his bedside. When it was almost dawn, the king fell asleep on his chair. In his sleep was forgotten the ailing son, the large kingdom, the magnificent palace.
And he dreamed: he dreamed that he was the master of the whole world. He had twelve sons - healthy, handsome, strapping youths. His palaces were made of gold with steps inlaid with precious stones. He could not be happier. And then - all of a sudden, the twelve sons died. His queen began to wail and he was shaken out of sleep. Everything was lost - the mighty kingdom, the golden palaces, the robust sons - all vanished.


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An in-depth report on the causes, diagnosis, and treatment of narcolepsy.
- Everyone with narcolepsy experience excessive sleepiness during the day. Most also experience sudden but temporary muscle weakness (called cataplexy), usually brought on by strong emotions. Excessive sleepiness during the day may be characterized by the following behaviors:
- Patients typically have periods of drowsiness every 3 or 4 hours that usually end in short naps.
- Patients may sleep for a few minutes during the day, particularly if they are in an awkward position for sleep, or for a few hours if they are lying down.
- Patients often underestimate the duration of their drowsy periods and may not recall clearly their behavior during that time.
- Narcolepsy affects about 1 in 2,000 people.
- Narcolepsy is not caused by mental illness or psychological problems, though it is often mistaken for such.
Genetic Basis
- Having a family member with narcolepsy presents a 20 - 40 times higher risk of developing the condition compared to the general population.
- A deficiency in the neurotransmitter hypocretin (orexin) has been implicated in the cases of narcolepsy with cataplexy, the most common form of the condition.
- The main drug treatments for narcolepsy are:
- Modafinil (Provigil) for excessive, uncontrollable, daytime sleepiness
- Armodafinil (Nuvigil) for excessive, uncontrollable, daytime sleepiness
- Sodium oxybate (Xyrem) for cataplexy (sudden muscle weakness) for excessive daytime sleepiness. The FDA has placed tight restrictions on the use of this drug.Very serious side effects -- including seizures, coma, and death -- have been reported in people who abused this drug. Trials of Xyrem, however, have not reported these effects with the doses used in treatment for cataplexy.
Narcolepsy is considered a primary hypersomnia (excessive sleepiness) condition. Primary means the condition is not caused by another disease. The word narcolepsy comes from two Greek words roughly translated as "seized by numbness." The two primary symptoms in narcolepsy reflect this phrase:
- Excessive daytime sleepiness, with frequent daily sleep attacks or a need to take several naps during the day.
- Temporary and sudden muscle weakness (called cataplexy), usually brought on by strong emotions.
Some patients experience other symptoms:
- Microsleep episodes, in which the patient behaves automatically but without conscious awareness
- A sense of paralysis that occurs between wakefulness and sleep (called atonia)
- Dreamlike states between waking and sleeping (called hypnagogic or hypnopompic hallucinations)
Rapid eye movement (REM) sleep is abnormal in narcolepsy. (REM sleep is the active, dreaming phase of sleep.) In fact, narcolepsy is sometimes defined as the loss of boundaries between wakefulness, non-REM sleep, and REM sleep.
Primary Symptoms of Narcolepsy
Excessive Sleepiness. All people with narcolepsy experience excessive sleepiness during the day with episodes of falling asleep rapidly and inappropriately, even when fully involved in an activity. It is sometime described as an irresistible daytime need for naps, which will generally refresh the patient. These events may be characterized by the following behaviors:
- Patients typically have periods of drowsiness every 3 or 4 hours that usually end in short naps.
- Patients may sleep during the day for a few minutes, particularly if they are in an awkward position for sleepor for a few hours if they are lying down.
- Patients often underestimate the duration of their drowsy periods and may not recall clearly their behavior during that time.
Cataplexy. Cataplexy is an abrupt but temporary loss of muscle tone or strength that results in an inability to move and always occurs during wakefulness. Symptoms of excessive daytime sleepiness may be present for years before symptoms of cataplexy develop. About two thirds of patients with narcolepsy have symptoms of cataplexy. The following events may be triggers for cataplexy:
- Sudden emotion, usually anger or laughter (the most common trigger)
- A heavy meal
- Stress
Muscle reflexes are completely absent during a cataplectic attack. Cataplectic attacks can be very minimal and appear as passing weakness or affecting only the eyelids and face. They may, on the other hand, be so severe that they weaken the whole body. In the most severe form of cataplexy, attacks can recur repeatedly for hours or days. Abrupt withdrawal from certain drugs used to treat narcolepsy, notably clomipramine, can trigger these severe symptoms.
Cataplexy may have the following characteristics:
- Most attacks last fewer than 30 seconds and can be missed by even skilled observers. However, in severe cases, a person may fall and remain paralyzed for as long as several minutes.
- Typically the patient's head will suddenly fall forward, the jaw becomes slack, and the knees will buckle.
- Speech may become suddenly loud or broken and stutter-like.
Other Symptoms of Narcolepsy
Atonia. Atonia is a sense of paralysis that occurs between wakefulness and sleep, usually upon waking or sometimes at the onset of sleep. The person is conscious but cannot speak, move (cannot even open their eyes), or breathe deeply. Atonia rarely lasts beyond 20 minutes, but when it first occurs the experience can be terrifying, particularly if the patient also develops hallucinations.
Hypnagogic Hallucinations. Hypnagogic hallucinations are dreams that intrude on wakefulness, which can cause visual, auditory, or touchable sensations. They occur between waking and sleeping, usually at the onset of sleep, and can also occur about 30 seconds after a cataplectic attack.
- Visual hallucinations have been described as a "film running through the head" or as a waking dream with strong emotional content. Images can be intrusive. More commonly they may involve seeing colored forms that shift in size and shape.
- Auditory hallucinations may include random sounds or elaborate melodies.
- A person may also hallucinate feelings of rubbing or light touches, even levitation.
Such symptoms may also appear in other sleep disorders and are probably related to extreme sleepiness. In general, cataplexy must also be present for a clear diagnosis of narcolepsy. It is possible, however, for some patients with narcolepsy to experience hypnagogic or hypnopompic hallucinations and daytime sleepiness and not cataplexy.
Microsleep and Automatic Behavior. In some cases, patients have so-called microsleep episodes, in which they behave automatically without conscious awareness. Such automatic behavior may not be recognized as part of a disorder by either patients or the people around them. Some examples include:
- People with narcolepsy can be driving or walking competently but end up in a location different from the intended one.
- A narcolepsy patient can be carrying on a conversation and jump from one unrelated topic to another or just trail off and stop talking altogether.
- The patient may suddenly perform bizarre actions, such as putting socks in the refrigerator.
- Patients may have severe forgetfulness.
- Their movements may suddenly become slow or clumsy.
- In some cases, their behavior may resemble some forms of epileptic seizures.
Disturbed Sleep. Nighttime sleep is often disturbed in narcolepsy, bthe disturbanceis usually mild to moderate and does not account for the daytime sleepiness experienced by people with narcolepsy.
Periodic Limb Movement Disorder. Many patients with narcolepsy experience periodic limb movement disorder (PLMD; formerly known as nocturnal myoclonus). In PLMD, the leg muscles involuntarily contract every 20 - 40 seconds during sleep, occasionally arousing the patient. The patient is usually unaware of the limb movements, but bed partners may notice the movements..
Healthy Sleep
Most people need about 8 hours of sleep each day. Individual adults differ in the amount of sleep they need to feel well rested, however. (Infants may sleep as many as 16 hours a day.)
The daily cycle of life, which includes sleeping and waking, is called a circadian (meaning "about a day") rhythm, commonly referred to as the biological clock. Hundreds of bodily functions follow biologic clocks, but sleeping and waking comprise the most prominent circadian rhythm. The sleeping and waking cycle is about 24 hours. (If confined to windowless apartments, with no clocks or other time cues, sleeping and waking as their bodies dictate, humans typically live on slightly longer than 24-hour cycles.) The daily sleep/wake cycle usuallyfollows the following pattern:
- Humans function best with daytime activity and nighttime rest.
- Additionally, there is a natural peak in sleepiness at mid-day, the traditional siesta time.
Daily rhythms intermesh with other factors that may interfere or change individual patterns:
- The fraction-of-a-second-firing of nerve cells in the brain may be faster or slower in different individuals.
- The monthly menstrual cycle in women can shift the pattern.
- Light signals coming through the eyes reset the circadian cycles each day, so changes in season or various exposures to light and dark can unsettle the pattern. The importance of sunlight as a cue for circadian rhythms is shown by the problems experienced by people who are totally blind. They commonly have trouble sleeping, and experience other biorhythm disruptions.
Sleep Cycles
Sleep consists of two distinct states that alternate in cycles and reflect differing levels of brain nerve cell activity.
Non-Rapid Eye Movement Sleep (Non-REM). Non-REM sleep is also termed quiet sleep. Non-REM is further subdivided into three stages of progression:
- Stage 1 (light sleep)
- Stage 2 (so-called true sleep)
- Stage 3 to 4 (deep "slow-wave" or delta sleep)
With each descending stage, awakening becomes more difficult. It is not known what governs Non-REM sleep in the brain. A balance between certain hormones, particularly growth and stress hormones, may be important for deep sleep.
Rapid Eye-Movement Sleep (REM). REM sleep is termed active sleep. Most vivid dreams occur in REM sleep. REM-sleep brain activity is comparable to that in waking, but the muscles are totally relaxed, possibly preventing people from acting out their dreams. In fact, except for vital organs like lungs and heart, the only muscles not relaxed during REM are the eye muscles. REM sleep may be critical for learning and for day-to-day mood regulation. When people are sleep-deprived, their brains must work harder than when they are well rested.
The REM/Non-REM Cycle. The cycle between quiet (non-REM) and active (REM) sleep generally follows this pattern:
- After about 90 minutes of non-REM sleep, eyes move rapidly behind closed lids, signifying REM sleep.
- As sleep progresses the non-REM/REM cycle repeats.
- With each cycle, non-REM sleep becomes progressively lighter, and REM sleep becomes progressively longer, lasting from a few minutes early in sleep to perhaps an hour at the end of the sleep episode.
Genetic Factors
Narcolepsy has a genetic component and tends to run in families. An estimated 8 - 10% of people with narcolepsy have a close relative who has the disorder. An individual with a family member who has narcolepsy is 20 - 40 times more likely to have narcolepsy, compared to a person with no family history of the disease.
However, genetics are not the only factor involved in narcolepsy. Narcolepsy most likely involves a combination of genetics and one or more environmental triggers, such as infection, trauma, hormonal changes, immune system problems, or stress. Researchers are looking for specific genetic mutations that may make individuals susceptible to this disorder, and have discovered recently that most affected individuals carry the HLA DQB1(*)0602 gene. More recent studies also show that the TCR-alpha gene, which interacts with the HLA genes, is also involved in narcolepsy.
It has been theorized that narcolepsy may be an autoimmune disease, in which the immune system may be tricked into perceiving its own proteins to be antigens. (Antigens are foreign substances targeted for attack by immune factors in the body.)
Important autoimmune diseases include multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, and type 1 diabetes. In such diseases, the immune system overproduces potent factors called cytokines, which cause inflammation and injury in the susceptible cells and tissues affected by the disease. Most autoimmune diseases also tend to afflict those with particular genetically determined molecules of the immune system called human leukocyte antigens (HLAs).
Some research suggests that an immune attack in narcolepsy may occur against cells containing the brain peptide hypocretin (orexin). Hypocretin deficiency is the major component of narcolepsy with cataplexy. Recent studies have shown a reduced amount of hypocretin-positive neurons in patients with narcolepsy with cataplexy. Hypocretin deficiencies might set off chemical responses that produce sleep attacks.
HLAs, particularly the above-mentioned subgroup known as (HLA)DQB1-0602, have been strongly associated with narcolepsy and low levels of hypocretin. Narcolepsy patients who carry this HLA group tend to have a specific collection of symptoms that include cataplexy and periodic limb movement disorder. However, roughly 20% of people without narcolepsy also carry these HLA types.
Risk Factors
Narcolepsy affects about 1 in 2,000 people. Experts estimate that around 135,000 - 200,000 Americans have narcolepsy, but the number may be higher. Only about 25% of people who have narcolepsy are actually diagnosed with the disorder. Patients are often mistakenly diagnosed with other conditions, such as psychiatric or emotional problems. Many patients wait decades before receiving a proper diagnosis.
Narcolepsy symptoms usually first appear in adolescence or young adulthood. However, narcolepsy can begin at any age. Growing evidence suggests that the disorder may emerge in early childhood in many patients. It can often be misdiagnosed as another disorder, such as ADHD or depression. People who develop it at a young age often have a family history of the disease and a severe condition, suggesting that genetic factors are important in this group.
Narcolepsy is a life-long problem, but it is not progressive. Symptoms may even lessen over time, but they never completely disappear. In older adults, cataplexy may lessen over time, but sleep disturbances at night may worsen.
Risk for Accidents
Perhaps the most serious consequence of narcolepsy is the high risk for accidents. In one survey, almost 75% of patients with narcolepsy reported falling asleep while driving, and 56% reported nearly having accidents. Other common narcolepsy-related accidents include burns from touching hot objects, cuts from sharp objects, and breaking things.
Effects on Mental Functioning
Some studies report that people with narcolepsy have problems with memory, thinking, and attention. Whether these problems are more likely to be due to tiredness and episodes of sleepiness than to brain abnormalities is not clear.
Emotional and Social Difficulties
People with narcolepsy suffer emotional and social difficulties caused by their uncontrollable sleep episodes and cataplexy. Studies have reported rates of depression in people with narcolepsy ranging from 30 - 57%. (In the general population, the prevalence of depression is 8%.) Studies have shown severe emotional and social dysfunction in all areas, including work, relationships, and leisure activities. Men with narcolepsy frequently suffer from sexual problems. Some experts believe that the psychological and social effects are more serious than those caused by epilepsy (for which narcolepsy can be mistaken).
Accompanying Physical Problems
Obesity. People with narcolepsy are at high risk for obesity compared to the general population. This could be a consequence of low activity level, but research also indicates that deficiencies in the brain peptide hypocretin may play a role in both narcolepsy and eating behaviors, which could increase the risk for obesity.
Although narcolepsy is a physical disorder, doctors are still very likely to misdiagnose patients as having psychological problems. In most cases, narcolepsy is not diagnosed for up to 10 - 15 years after the symptoms began. To determine specific sleep disorders, the doctor will take a medical and family history. The patient should tell the doctor about any medications the patient takes. The symptoms of narcolepsy are relatively easy to recognize if a patient reports all of the major symptoms:
- Excessive daytime sleepiness with a tendency for frequent naps. (These frequent naps should occur every day for at least 6 months tosuggest thediagnosis of narcolepsy.) Narcolepsy is usually diagnosed in adolescence and young adulthood when falling asleep suddenly in school brings the problem to attention.
- Cataplexy.
- Hypnagogic hallucinations.
- Sleep paralysis.
Diagnosis based only on symptoms, however, is often problematic for various reasons:
- Patients often seek medical help for single symptoms (sleep paralysis or hypnagogic hallucinations) that might be associated with other disorders, particularly epilepsy.
- Symptoms are sometimes not dramatically apparent for years, even to the patient or a skilled observer. In some cases, the patient may need to consult a sleep specialist or go to an accredited sleep disorder center for accurate diagnosis of a sleep disorder. Patients should carefully investigate centers to make sure that they offer full sleep studies. Patients who visit a sleep center undergo an in-depth analysis, usually supervised by a multidisciplinary team of consultants who can provide both physical and psychiatric evaluations.
In the future, measurements of hypocretin-1 in the cerebrospinal fluid may prove valuable in identifying difficult to diagnose cases of narcolepsy, since hypocretin is often absent in patients with the condition.
A doctor may administer certain questionnaires on sleeping habits, such as the Stanford Sleepiness Scale or the Epworth Sleepiness Scale.
The Epworth Sleepiness Scale. The Epworth Sleepiness Scale (ESS) uses a simple questionnaire to measure excessive sleepiness and differentiate it from normal daytime sleepiness.
The Epworth Sleepiness Scale
Chance of Dozing
0 = no chance of dozing
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Sitting and reading
(Indicate a score of 0 - 3)
Watching TV
(Indicate a score of 0 - 3)
Sitting inactive in a public place (a theater or a meeting)
(Indicate a score of 0 - 3)
As a passenger in a car for an hour without a break
(Indicate a score of 0 - 3)
Lying down to rest in the afternoon when circumstances permit
(Indicate a score of 0 - 3)
Sitting and talking to someone
(Indicate a score of 0 - 3)
Sitting quietly after a lunch without alcohol
(Indicate a score of 0 - 3)
In a car, while stopped for a few minutes in traffic
(Indicate a score of 0 - 3)
Score Results
1 - 6: Getting enough sleep
4 - 8: Tends to be sleepy but is average
9 - 15: Very sleepy and should seek medical advice
Over 16: Dangerously sleepy
Multiple Sleep Latency Test
The multiple sleep latency test (MSLT) uses a machine that measures the time it takes to fall asleep lying in a quiet room during the day. The patient takes 4 or 5 scheduled naps 2 hours apart. People with healthy sleep habits fall asleep in about 10 - 20 minutes. In patients with narcolepsy, polysomnography (see below) plus MSLT will show a much shorter duration of time (fewer than 8 minutes) from wakefulness into sleep. At least 2 of the naps are REM-onset (the active sleep phase associated dreaming). The test has limitations, however. There is no clear definition of exactly which abnormal results would indicate narcolepsy. It is most useful for measuring the severity of the problem. The Epworth Sleepiness Scale may be more accurate in differentiating narcolepsy from normal daytime sleepiness.
An overnight sleep study, called polysomnography, can be a valuable means for determining the basic cause of sleepiness. The patient arrives at the sleep center about 2 hours before bedtime without having made any changes in daily habits. The patient will be monitored by a variety of devices while sleeping:
- Electroencephalogram, or EEG (monitors the electrical activity of the brain)
- Electrocardiogram or ECG (monitors the electrical activity of the heart)
- Electromyogram (monitors the movements of muscles)
- Electrooculogram (monitors eye movements)
These instruments record activity as the patient passes, or fails to pass, through the various sleep stages.
Ruling out Other Disorders
Ruling out Other Sleep Disorders. Other sleep disorders can share some or all of the symptoms of narcolepsy:
- Patients with obstructive sleep apnea also experience sleep disturbance and excessive daytime fatigue. (A
person may have both sleep apnea and narcolepsy. For more information, please see In-Depth Report: Obstructive Sleep Apnea.)
- Idiopathic hypersomnia is a less well-defined syndrome in which patients have excessive daytime sleepiness without evidence of cataplexy. Patients have a hard time becoming fully awake despite an adequate amount of sleep.
- Chronic sleep deprivation (for more information, please see In-Depth Report: Insomnia)
- Secondary narcolepsy, resulting from head trauma, tumors, vascular malformations in the brain, multiple sclerosis, or Parkinson's disease
Ruling out Psychological Disorders. In one study, 40% of patients who actually had narcolepsy had been diagnosed incorrectly with some psychological or psychiatric problem. Certainly, patients with narcolepsy have emotional difficulties because of the condition, and it is often difficult, particularly for a nonspecialist, to detect the physical problem. Even worse, hypnagogic hallucinations may result in diagnoses of schizophrenia or bipolar disorder, which are treated with potent antipsychotic drugs that have severe side effects and are useless for narcolepsy.
Ruling out Epilepsy. Narcolepsy can easily be mistaken for epilepsy, a group of disorders that cause seizures. Case studies have reported a misdiagnosis of epilepsy in patients who were actually experiencing cataplexy and sleep paralysis.
Other Causes of Persistent Fatigue. A number of conditions can cause persistent fatigue and should be ruled out, including chronic fatigue syndrome.
These conditions may also worsen sleep paralysis in narcolepsy. Narcolepsy sleep paralysis usually occurs at the onset of sleep and is chronic.
Lifestyle treatment of narcolepsy includes taking three or more scheduled naps throughout the day. Patients should also avoid heavy meals and alcohol, which can interfere with sleep.
People with mild narcolepsy symptoms who do not need medication may be able to maintain alertness with sleep scheduling. The role of scheduled naps for patients who are responding to medications for narcolepsy remains unclear.
Medications for narcolepsy target the major symptoms of sleepiness and cataplexy. Stimulant drugs are used to manage excessive daytime sleepiness while antidepressants and other compounds address cataplectic symptoms. The Food and Drug Administration (FDA) has approved three drugs specifically for the treatment of narcolepsy. They are now the first-line treatments:
- Modafinil (Provigil): For excessive, uncontrollable, daytime sleepiness
- Armodafinil (Nuvigil)
- Sodium oxybate (Xyrem): For cataplexy and excessive daytime sleepiness
Drug Treatments for Sleepiness
. Modafinil (Provigil) is a drug used to treat the excessive sleepiness associated with narcolepsy and other sleep disorders. It has largely replaced methylphenidate (Ritalin) and other stimulants for treatment of narcolepsy sleepiness. Patients who switch to modafinil from stimulants such as methylphenidate have few problems if they gradually taper off the stimulant dose.
Modafinil helps patients with narcolepsy stay awake during the day. While only some experience normal wake times, patients taking modafinil often have up to a 50% improvement in the ability to stay awake, as well as a 25% reduction in the number of involuntary sleep episodes. It has not been proven to be safe in pregnant women. Pregnant women or those wishing to get pregnant should discuss the risks and benefits of this medication with their doctors.
Some of modafinil's additional benefits include what it does not do:
- Modafinil does not appear to affect natural hormones important in sleep, including cortisol (the major stress hormone), melatonin, and growth hormone. Therefore, studies suggest that it does not interfere with voluntary naps during the day or with the quantity or quality of nighttime sleep.
- It does not cause anxiety to the degree that the standard stimulants do, but it can trigger psychiatric side effect, especially in pople with previous mental disorders.
- It does not cause a rebound effect as stimulants do. In other words, people who take modafinil do not usually "crash" when the drug wears off.
- It has less potential for abuse than stimulant drugs. However, modafinil can still be habit-forming. Patients may need to gradually lower the dose before stopping treatment.
Side effects of modafinil may include:
- Headache (the most commonly reported side effect)
- Nausea
- Diarrhea
- Dry mouth
- Nasal and throat congestion
- Nervousness and anxiety
- Dizziness
- Back pain
- Difficulty sleeping
- Decreases in the effects of hormonal methods of birth control, including the pill. (Women of childbearing age who take modafinil should switch to another form of birth control.)
- Modafinil is approved only for adults and should not be given to children.
Armodafinil (Nuvigil) is a newer drug, which is nearly identical to modafinil. In clinical trials comparing it with placebo, armodafinil improved wakefulness, memory, attention, and fatigue in patients with narcolepsy.
Drug Warning
In October 2007, the FDA added new safety information to the prescribing label of modafinil (Provigil) and armodafinil (Nuvigil). The new information warns that:
- Rare but serious skin reactions, such as Stevens-Johnson Syndrome, have been reported with modafinil and armodafinil use. Patients should stop taking these medications at the first signs of any rash, and immediately contact their doctors.
- Psychiatric side effects, such as anxiety, mania, hallucinations, and suicidal thinking, have been reported. Doctors should be cautious about prescribing modafinil and armodafinil to patients with a history of psychosis, depression, or mania.
. Medications that act as stimulants are standard treatments for narcolepsy. They include:
- Methylphenidate (Ritalin)
- Dextroamphetamine (Dexedrine)
- Methamphetamine (Desoxyn)
Methylphenidate and dextroamphetamine last for 2 - 5 hours and used to be the standard drugs for excessive daytime sleepiness. These drugs are useful for people who can manage wakefulness with a night's sleep and scheduled naps. They can improve mood, mental acuity, and other aspects of mental functioning. However, the evidence to support their benefit for patients with narcolepsy is not a strong as with modafinil.
Stimulants can have unpleasant side effects, including:
- Weight loss
- Dizziness
- Nausea
- Changes in blood pressure and rapid heartbeat
- Headache
People with heart disease, hyperthyroidism, glaucoma, anxiety disorder, and high blood pressure should avoid stimulants, or take them only with a doctor's supervision.
These drugs become ineffective if used continuously, and patients are advised to take a drug holiday one day a week or to withdraw gradually and resume treatment at a lower dose. Patients should not engage in activities that require being awake (such as driving) during withdrawal.
Drug Treatments for Cataplexy
Sodium oxybate (Xyrem). Sodium oxybate (Xyrem), also referred to as gamma hydroxybutyrate (GHB), helps reduce the frequency of cataplexy attacks and improve daytime sleepiness. Patients need to take GHB for about 4 weeks before they notice significant benefits. It may take an additional 4 weeks for the drug to reach maximum effect. Food intake can affect the actions of GHB, so patients are advised to take it at a regular time after the evening meal.
The FDA has placed tight restrictions on the use of this drug. Although the drug appears to be effective and safe when used for narcolepsy, it has a history of illegal and "date-rape" use, with street names such as "Grievous Bodily Harm" or "Liquid Ecstasy." (Despite this name, GHBis not the same as "Ecstasy," a street drug with different effects.) In high doses, GHB can cause dependence over time. Education through the Xyrem Success Program may be valuable to patients and physicians.
Very serious side effects -- including seizures, coma, respiratory arrest, and death -- have been reported in people who abused GHB. Trials of Xyrem, however, have not reported these effects with the doses used in treatment for cataplexy.
Antidepressants. Antidepressant drugs are not approved for treatment of cataplexy, but they are commonly used to manage this condition. Unfortunately, there have been few studies conducted on antidepressant treatment of cataplexy, and there are little data on which type of antidepressant work bests.
Antidepressants used for cataplexy, hallucinations, sleep paralysis, and management of REM symptoms include:
- Tricyclic antidepressants: Protriptyline (Vivactil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and desipramine (Norpramin, Pertofrane)
- Selective serotonin reuptake inhibitors (SSRIs): Fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
- Newer antidepressants: Venlafaxine (Effexor)
Tricyclics were the first antidepressants used for cataplexy; they were also one of the first treatments for cataplexy. They can be helpful for some patients but have many unpleasant side effects, including dry mouth, constipation, and weight gain. Tricyclics can also lower blood pressure and cause disturbances in heart rhythm.
SSRIs have fewer side effects than tricyclics but may not work as well for cataplexy control. The most common side effects include nausea, drowsiness or insomnia, headache, weight gain, and sexual dysfunction.
Venlafaxine (Effexor) is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) that has shown promising results for treatment of cataplexy. Some patients with narcolepsy, and their doctors, report that venlafaxine seems to work best of all the antidepressants.
Monoamine Oxidase Inhibitors (MAOIs). Selegiline (Eldepryl, Movergan), also known as deprenyl, is an MAOI that blocks monoamine oxidase B, an enzyme that degrades dopamine. MAOIs may play a role in narcolepsy, but how much benefit this group of drugs provides is not well proven.
Selegiline has significant side effects:
- It interacts with nearly every antidepressant. Patients suffering from depression should discuss all treatment options with their doctor.
- People taking any monoamine oxidase inhibitor are at risk for high blood pressure if they consume tyramine-containing foods or beverages, including aged cheeses, most red wines, vermouth, dried meats and fish, canned figs, fava beans, and concentrated yeast products.
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- www.nhlbi.nih.gov/sleep -- National Center on Sleep Disorders Research
- www.ninds.nih.gov -- National Institute on Neurological Disorders and Stroke
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Advanced Studyec
Review Date: 9/28/2013�
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


text:
2012 Football Season Highlight Combo Pack on Sale
2012 Football Season Highlight Combo Pack on Sale
Jan. 24, 2013
MANHATTAN, Kan. – Wildcat fans can relive some of their favorite moments from the 2012 Big 12 Championship season as the 2012 K-State Football Season Highlight Combo Pack is now available for purchase at k-statesports.com.
This special edition release, which consists of both a DVD and Blu-ray at a cost of $24.95, includes highlights from all 13 games in addition to the postgame Big 12 Trophy presentation following the Texas game, the new Stand Up for the Champions video as well as all 16 Goals promotional videos that were released prior to the season.
To purchase this combo pack, click here.
Predicted to finish sixth in the Big 12 prior to the 2012 season, the Wildcats tallied an 11-2 overall record, including an 8-1 mark in Big 12 play to capture the school's third conference championship and first since 2003. Bill Snyder guided Kansas State to its seventh 11-win season in school history, but only the second 11-win regular season (1998).
K-State won a school-record six games against ranked opponents in 2012, including its conference-championship clinching victory over No. 18 Texas. Additionally, the Wildcats obtained their first-ever No. 1 ranking the BCS standings following their win at TCU.
Individually, Snyder was named Big 12 Coach of the Year by both the coaches and Associated Press, while also being tabbed as the Bobby Dodd National Coach of the Year.
Quarterback Collin Klein became the school's second ever Heisman Trophy finalist and went on to finish third in the final voting, while a total of 20 players were named All-Big 12. The Wildcats also topped the Big 12 Conference in number of specialty awards as Snyder (Big 12 Coach of the Year), Klein (Big 12 Offensive Player of the Year), Arthur Brown (Big 12 Defensive Player of the Year) and Meshak Williams (Big 12 Defensive Lineman of the Year) were all honored by the conference.