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Arkansas comes from behind to take game two against No. 13 LSU
FAYETTEVILLE, Ark. -- Arkansas earned a comeback victory against No. 13 LSU 4-3 on Saturday at Bogle Park.
Freshman Stephanie Canfield delivered a two-out, game-winning single in the bottom of the seventh to give Arkansas a comeback victory. The win broke a 12-game losing streak for the Razorbacks against the Tigers. Sophomore Devon Wallace scored the game-winning run for the Hogs.
"They might start calling us the 'cardiacbacks'," head coach Mike Larabee said. "Two weekends in a row we have had dramatic comebacks. I was feeling confident with Canfield coming to the plate, the kid hates to lose."
Arkansas (26-14) received a brilliant performance from sophomore Kimmy Beasley in the win. She went seven innings and only surrendered one earned run on two hits. She also notched a career-high 12 strikeouts in the contest. The two hits for LSU tied a season low.
"Kimmy Beasley can beat any team in the country," Larabee said. "She needs to stay consistent, she beat Alabama and California last year, now she has to stay consistent. She has all the tools and there are not a lot of left-handed pitchers in the SEC right now."
At the plate it was Jayme Gee who paced the Hogs. She went 2-for-3 with a double and a solo home run. Arkansas also completed a comeback win last weekend against No. 22 Georgia in game two. The team went on to sweep the Bulldogs, winning game three 8-1.
"Just like last week, this is a huge momentum swing for us," Larabee said. "Last week we talked about being a consistent program. To be a consistent program, you have to win the series. Now we have something big to play for [Sunday], winning the series."
The Tigers struck for two runs in the top half of the first. Jacee Blades reached on an error and then scored when Bianka Bell tallied a one-out single. Bell came around to score after a three-base error on the play. After a walk to Allison Falcon, Beasley battled back to strikeout Sandra Simmons. In the next at-bat, Falcon was caught stealing by the Razorback catcher, Gee.
Beasley battled back in the second and retired three of the four batters she faced, striking out Rikki Alcaraz, Kellsi Kloss and Simone Heyward. She registered five strikeouts through two innings.
LSU added another run in the top of the third when Bell drove a two-out hom erun over the rightfield wall. Her ninth home run of the season gave the Tigers a 3-0 lead.
Gee answered in the bottom of the third and skied a solo home run into the right field grass. Her seventh home run of the season cut the lead to two runs after three innings of play.
Arkansas' pitcher, Beasley, cut down the Tigers in the top of the fourth. She retired the side in order, while striking out two. She blew a fastball by Tammy Wray to end the top of the fourth and give her eight strikeouts on the day.
Chloe Oprzedek led off the bottom of the fourth and was hit by a pitch. Two batters later, Clarisa Navarro shot a double off of the right field wall to put runners on second and third for Sierra Bronkey. She hit a fly ball to left field that was caught, but scored Oprzedek from third. This cut the lead to 3-2 after four.
Clarie Clark singled with one out in the fifth and Wallace followed the single with a walk. This was Wallace's 101st walk of her career, she is now two behind Sandra Smith's career record of 103. Two batters later Oprzedek worked a 3-2 count, but popped out and both runners were stranded.
Beasley retired her next five batters, striking out Alcaraz and Wray to start the seventh. The two strikeouts gave Beasley a career-high 11 on the day. She improved her career high to 12 on the next batter and struck out Kloss to end the top of the seventh, putting a lot of momentum into the Arkansas dugout.
With one out in the bottom of the seventh, Gee lined a double into the rightfield wall. Ashley Martindale then came in to pinch run and two batters later Wallace was intentionally walked. This put two runners on with two outs for Canfield. She bounced a ball over Simmons' head at first base. The singled scored Martindale from second and Wallace was hustling from first to try and win the game. The throw came in from the rightfielder, Heyward, and the ball arrived to the plate at the same time as Wallace. The LSU catcher, Lauren Houston, bobbled the ball and Wallace slid head-first into home, giving Arkansas the 4-3 comeback victory.


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The biennial Lilly Fellows Program Book Award honors an original and imaginative work from any academic discipline that best exemplifies the central ideas and principles animating the Lilly Fellows Program. These include faith and learning in the Christian intellectual tradition, the vocation of teaching and scholarship, and the history, theory or practice of the university as the site of religious inquiry and culture.
Works considered for this year's award addressed the historical or contemporary relation of Christian intellectual life and scholarship to the practice of teaching as a Christian vocation or to the past, present, and future of higher education. Authors and editors cannot nominate their own works. Single authored books or edited collections in any discipline published in 2009 to 2012 are eligible.
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text: Look at this Dragon's Crown trailer. András Neltz4/05/13 6:40amFiled to: dragon's crownatlusps vitaps3kotakueastkotakucore65EditPromoteShare to KinjaToggle Conversation toolsGo to permalink Look at this Dragon's Crown trailer. Just look at it. It's like concept art coming to life. Absolutely phenomenal—though the title font is still looking atrocious. Vanillaware's pretty side-scrolling action-RPG will be landing on the PS3 and the Vita on July 25. Reply65 repliesLeave a reply


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ew, i could have done a better onside kick lol
So basically the 49ers Seahawks game was flexed for no reason.
He felt that one
Bye Bye Haters
The game is a lot closer than it should be to be honest. Is it just a coincidence that Brady hasn't had that much pressure on him ever since Justin Smith has been out of the game? Not trying to take away anything from the Pats because I think they are obviously one of if not the best teams in the game but both teams did stupid **** today that hurt them. We switched up the D to Zone for some reason and Brady started to come back. We got a little too comfortable with the big lead.
BTW, any team can beat any team in the NFL. This game could have went either way and I wouldn't have been surprised if we would have lost. Trust me, most 49er fans here don't think we're far and away the best team in the NFL.
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I'm becoming a believer in Kaepernick. Impressive performance from him minus that INT where he didn't see the safety
What was Brady's DVOA and DYAR in this game? Because apparently, that's more important then winning.
Jesus, Collinsworth has a huge hard on for Kaepernick...
May have been a Superbowl preview. Had the 49ers in the NFC yet Pitt in the AFC.
This is awesome. Looks like my Broncos are going to get the number 2 seed very likely! Meaning the Patriots have to go through Denver in the Mile High City instead of having that pivotal home field advantage in the division round game!
Tom Brady just pulled a 2011 Kobe. 36/65 for 443 yds - 1td 2int. Jesus Christ.
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Where can I find information and reasoning as to why "The Organic Land Care Committee has maintained a different position than that of the National Organic Program about the highly soluble, mined fertilizer sodium (Chilean) nitrate." I would like to be further educated of the concerns about this product
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by alvinaruby - 02/01/2013 - 1:51am


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We've got 280 definitions for E »
What does E stand for?
What does E mean? This page is about the various possible meanings of the acronym, abbreviation, shorthand or slang term: E.
Filter by:
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What does E mean?
- vitamin E, tocopherol, E(noun)
- a fat-soluble vitamin that is essential for normal reproduction; an important antioxidant that neutralizes free radicals in the body
Still can't find the acronym definition you were looking for? Use our Power Search technology to look for more unique definitions from across the web!
"E." Abbreviations.com. STANDS4 LLC, 2017. Web. 30 Mar. 2017. <http://www.abbreviations.com/E>.


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Prima Donna Ristorante Italiano Articles — Things To Know Before You Go
While Italian cuisine involves many meats, cheeses, seafood, and vegetables, most of us associate Italian cuisine first and foremost with pasta. Pasta comes in many shapes and sizes, and each shape... read more
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10/12/2013 A diner from Bradenton, FL tried it.


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The following were indicted June 4 by the Anderson County Grand Jury, according to information released Monday by the Anderson Circuit Clerk's office.
Deanna R. Morgan, 26, of 102 Whiteway, Lawrenceburg was indicated for two counts of unlawful distribution of a methamphetamine precursor.
The charge stems from an incident on April 12.
James T. Purvis, 45, of 812 Augusta St., Frankfort was indicted on wanton or reckless exploitation of an adult, over $300.
The indictment stems from an incident in August, 2012.
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US Article Writers Wanted Fast - $1 Per 100 Words.
This project was awarded to mickeyb for $50 USD.
Get free quotes for a project like thisProject Budget
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Yes! That's right, we're looking for more writers again.
I'm looking to find potentially long term article writers willing to write on a variety of different subjects (we are an ethical organisation so no articles will be written on adult or illegal topics).
You will need to be native to the United States (i.e. be an American citizen), or currently reside there to qualify for the work, and write with perfect English and grammar.
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You will need to be able to commit to 5 or more articles a day, for potentially within the medium/long term (If we're happy with your work, we'll likely contact you again).
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From Arthur A. Levine Books/Scholastic, April 2012.
Matthew's father had lion's feet and his mother had gills, and both fled the modern-day city to live in underground Safe, a secret community of freaks, ghost-whisperers, and disabled outcasts hidden beyond the subways and sewers. Raised underground, Matthew is responsible for the keeping of both Safe's histories and the traumatized shapeshifter Ariel, the girl he took in, fell in love with – and can't stop from constantly running away.
But Safe is no longer safe: the night after a frightening encounter in the sewers, Safe's founder Atticus is murdered by the one person Safe ever exiled: mad Corner, whose coup is backed by an army of mindless, whispering shadows.
Only Matthew, Ariel, and a handful of unstable, crippled compatriots escape to the city that cast them out; the dangerous place he knows only as Above. Despite Ariel's increasingly erratic behaviour and with the odds against them, Matthew must find a way to rescue Safe from Corner's occupying army. But as his quest leads him through abandoned asylums and the dregs of urban poverty, Matthew discovers that the histories he's devoted his life to aren't true: Corner's invasion — and Ariel's terrors – are rooted in a history of Safe much darker and bloodier than Matthew ever imagined.
And even if he manages to save both home and Ariel, he may well lose himself.
Available from Indiebound — Barnes & Noble — Chapters/Indigo — Powell's — Bakka-Phoenix Books.
"Above pulls off that rare trick of being convincing and utterly magical at the same time." —Emma Donoghue, New York Times bestselling author of Room
"Leah Bobet's Above is that rarest of creatures, combining the outspoken honesty of a good first novel with the craft of a seasoned professional." —Elizabeth Bear, Hugo Award-winning author of Dust
*"[A] dark, dazzling tale…Bobet effortlessly blends reality and fantasy, her characters are both gifted and broken—hers is a world that is simultaneously fantastic and painfully real. Heartbreaking, romantic, complex, and magical, this fantasy lingers on the senses." —Publishers Weekly, starred review
"Bobet fearlessly takes the reader to uncomfortable places, where, as Matthew discovers, there is always more than one side to a story." —Quill & Quire
"A tremendous adventure, as well as a meditation on how our mythologies shape us…a gorgeous tale." —Toronto Life
"[Readers] willing to go along with this captivating exploration of both individual and collective identity will find themselves pondering its implications long after the last page." —Kirkus
"Bobet has crafted a genre-defying story that is as dark and twisting as the underground tunnels in which it is set." —VOYA
"A genre-bending blend of dystopian fantasy, coming-of-age story, survivalist tale, psychological drama, allegory and profoundly moving meditation on how we treat the mentally ill, disabled and homeless …. Above is a soulful and spellbinding debut novel." — The National Post
Named to Kirkus Reviews Best of 2012.
Commended in Best Books for Kids and Teens, Canadian Children's Book Centre, Spring 2012.
Nominated for the 2013 Andre Norton Award for Young Adult Science Fiction and Fantasy and the 2013 Aurora Award for Best YA Novel.
Above will also be available internationally from:
Baumhaus in German
Novo Conceito in Portuguese (Brazil)


text:
If you are like me who likes to dabble with technology and are wondering how to get started with Mobile apps, Phonegap makes it possible to build apps with HTML and JavaScript skills. Check out the Scott Hanselman's chat with a guest who was able to build an app on HTML5 and deploy it on Android and iOS. I haven't given this a try yet, but this is on my long to-do list
Check out the Podcast: Making your first PhoneGap Application with Peter Mourfield http://hanselminutes.com/304 for some insights into how this process works.
With build.phonegap.com, you can upload your HTML app and it will spit out Android, iOS… app binaries. Yes! You don't need a Mac to build an iOS app anymore. For enterprise level apps, there is a pricing plan (it's not free).


text:
Chef Hilit Nurisk of The Dizzy Whisk cooking school creates healthy Bulgur and Herb Lettuce Wraps.
Each week¹s Empowered Health episode will be accompanied by a page in The Sun full of stories and tips designed to put you in control of your health.
The cape is making a comeback in Milan this season...
Shape and colour engaged designers on the second day...
Fashion is always about renewal, but this round of...
Alessandro Michele strove for discontinuity in his...
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Wanatee signs with VikingsApril 5, 2013Megan Wanatee will be extending her basketball career past South Tama County High School and she'll be doing it at a college that needs someone with her skill set. Grand View University, an NAIA iv.... No comments posted for this article.
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By a County Press reporter
Published on Wednesday, April 25, 2012 - 14:35
FORMER Isle of Wight resident and world-renowned seismologist, John Milne, will be immortalised in new artwork.
'Earthquake' Milne lived in Shide from 1895 until his death in 1913 and is widely credited as revolutionising the study of earthquakes by inventing a new type of seismograph — called the horizontal pendulum seismograph — while he worked in Japan.
A new piece of artwork, which will consist of three enamel panels, is being commissioned at a cost of £8,000, to be put on the outside wall on the corner of Newport's Little London Car Park, opposite Quay Arts, in the autumn.
The project will be advertised to artists and a panel will shortlist three who will then work-up proposed designs.
In the summer, these three designs will be put to public vote.
The most popular will be produced on enamel at Island firm AJ Wells and Sons and the successful artist will receive a £2500 commissioning fee.
As well as his world-famous seismology work, John Milne was also a keen photographer and some of his works can be found at Carisbrooke Castle's museum as well as be viewed online at www.historicimages.co.uk.
Following his death, his remains were buried at St Paul's Church in Newport.
The artwork is being paid for through external funding and has the backing of Hursts, which owns the wall.
Artists have until 5pm on Friday, May 18, to submit their designs. After this, a panel will shortlist three designs which will then go to a public vote in the summer.
Artists can download a submission pack from www.iwight.com/milnecommission which contains instructions on how to submit proposals. To receive this by post contact email@example.com or phone 821000 ext 3813
Reporter: email@example.com
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I'm not really sure how I feel about it. I think it looks nice but is a little sedate, I think. If they weren't going to go with the location backgrounds of the Saga series, then maybe they could have tied the particular character into one of the movie posters or something.
I don't know... seeing some of the products in that packaging scheme makes it look a little bland... like an AMT Model box. *shrug*


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Faecal blood loss with aspirin, nonsteroidal anti-inflammatory drugs and cyclo-oxygenase-2 selective inhibitors: systematic review of randomized trials using autologous chromium-labelled erythrocytes
- R Andrew Moore1Email author,
- Sheena Derry1 and
- Henry J McQuay1
DOI: 10.1186/ar2355
© Moore et al.; licensee BioMed Central Ltd. 2008
Received: 20 July 2007
Accepted: 17 January 2008
Published: 17 January 2008
Faecal blood loss has been measured using autologous erythrocytes labelled with radioactive chromium for several decades, using generally similar methods. We conducted a systematic review of studies employing this technology to determine the degree of blood loss associated with use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase-2 selective inhibitors (coxibs).
A systematic search of PubMed and the Cochrane Library (to December 2006) was conducted to identify randomized trials in which treatment with aspirin, NSAIDs, or coxibs was continued for at least 7 days, and with at least 7 days of washout for crossover trials. Rates of faecal blood loss associated with these agents were determined in the randomized trials identified. Comparators were placebo, active, or no treatment. Outcomes of interest were mean daily faecal blood loss, and the number or proportion of individuals recording faecal blood above 5 ml/day and above 10 ml/day.
Forty-five reports of 47 trials were included, including 1,162 individuals, mostly healthy volunteers and predominantly young men. Only 136 patients (as opposed to healthy volunteers; 12%) were included, and these were mostly older people with an arthritic condition. Most NSAIDs and low-dose (325 mg) aspirin resulted in a small average increase in faecal blood loss of 1 to 2 ml/day from about 0.5 ml/day at baseline. Aspirin at full anti-inflammatory doses resulted in much higher average levels of blood loss of about 5 ml/day. Some individuals lost much more blood than average, at least for some of the time, with 5% of those taking NSAIDs having daily blood loss of 5 ml or more and 1% having daily blood loss of 10 ml or more; rates of daily blood loss of 5 ml/day or 10 ml/day were 31% and 10%, respectively, for aspirin at daily doses of 1,800 mg or greater.
At baseline, or with placebo, faecal blood loss is measured at 1 ml/day or below. With low-dose aspirin and some NSAIDs, average values may be two to four times this, and anti-inflammatory doses of aspirin result in much higher average losses. A small proportion of individuals respond to aspirin or NSAIDs with much higher faecal blood loss of above 5 ml/day or 10 ml/day. There are significant limitations regarding the quality and validity of reporting of these studies, such as limited size and inclusion of inappropriate participants. The potential for blood loss and consequent anaemia requires more study.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective analgesics and anti-inflammatory drug therapy is an important pharmacological approach to treating various forms of pain, chronic musculoskeletal pain in particular. NSAIDs have a number of known adverse effects. NSAIDs (and aspirin) are associated with upper gastrointestinal injury [1], acute renal failure [2, 3] and congestive heart failure [4, 5]. Less well documented adverse events include associations with increased fracture rates [6] and lower gastrointestinal injury [7–9]. The latter includes bleeding [10–16] and permeability changes [17–19]. Cyclo-oxygenase-2 selective inhibitors (coxibs) are differentiated from traditional NSAIDs by lower rates of upper and lower gastrointestinal harm, and possibly by lack of effect on bone.
The gastrointestinal outcomes most often reported in modern, large, randomized trials and observational studies are upper gastrointestinal bleeding [20–22] or hospital admission for upper gastrointestinal bleeding [23–26]. Both outcomes represent a serious and significant clinical event that is probably at one extreme of a spectrum of blood loss. Much less is known about lower gastrointestinal bleeding and low-level chronic blood loss. Measurements of blood loss to the entire bowel demonstrate large differences between individuals, with some individuals losing significant amounts of blood on a daily basis, up to 50 ml or more [27, 28].
The clinical significance of low-level blood loss is unclear. Morris and colleagues [29] found small bowel lesions in 10 out of 15 patients with both rheumatoid arthritis and anaemia. In randomized trials anaemia was less common when patients were treated with celecoxib rather than NSAIDs [30], and there was lower rate of bowel injury with coxibs [14].
Various methods have been used to measure blood loss from the whole bowel [18, 31–33]. The use of radioactively labelled autologous erythrocytes with concomitant measurement of radioactivity in blood and faeces has been longest used. The method involves stool collection for a number of days after injection of 51Cr-erythrocytes. Methodological problems, notably those involving patients with long transit times [34], collection of all stool samples, avoidance of interfering behaviours and suitable methods for measuring radioactivity in blood and stool, were identified early on. Many randomized trials have been conducted over a number of decades using essentially similar methods. Typically, they compared the effects of aspirin, NSAID, or coxib on mean daily faecal blood loss, with comparators of placebo or aspirin. We chose to examine these trials systematically, both for effects on mean daily blood loss across groups and to identify individuals with greater levels of blood loss that might be connected with anaemia.
Materials and methods
Quality of Reporting of Meta-analyses guidelines were followed where appropriate [35]. PubMed and the Cochrane Library were searched to identify randomized trials using the autologous radioactive chromium method to measure faecal blood loss with aspirin, NSAIDs, or coxibs. The date of the last search was December 2006. A series of free text terms was used, using combinations of words in title and abstract, including faecal (or fecal) blood loss, occult blood loss, chromium, erythrocyte*, aspirin, N-acetylsalicylic acid, NSAID, nonsteroidal anti-inflammatory drug, cyclooxygenase-2 inhibitor, as well as the individual names of common drugs, including ibuprofen, diclofenac, naproxen, indomethacin, ketoprofen, rofecoxib, celecoxib, etoricoxib, valdecoxib and lumiracoxib. Electronic searches were supplemented by exploration of bibliographies of all papers obtained, and reviews of gastrointestinal damage caused by aspirin or NSAIDs. Trials identified as possibly relevant from title or abstract were obtained in full paper version.
Trials were included if they were randomized; if they used chromium-labelled autologous erythrocytes to measure faecal blood loss with collections in controlled conditions; if they had at least one placebo arm in the trial; if they involved administration of any dose of aspirin, NSAID, or coxib for at least 7 days; and if they were parallel group or had a crossover design with at least 7 days of washout between therapies.
Information from each trial was abstracted into a table. Relevant information concerned randomization, blinding, and withdrawal and dropouts was collected to assess reporting quality using a commonly used 5-point scoring system [36]. Methodological items noted were as follows: whether a history was taken to exclude possible pre-existing causes of intestinal bleeding; whether participants had a regular bowel habit; dependence of inclusion on either a negative faecal occult blood test or a measured low faecal blood loss on baseline screening; whether the study was conducted on an inpatient basis in controlled conditions; and how the method of calculating faecal blood loss was reported.
Other information noted included information on study design, participants (age, sex, volunteer or patient), treatments (including dose), duration, baseline faecal blood loss and daily faecal blood loss at the longest time period. As well as noting mean or median blood loss, we sought information about the number of participants with faecal blood loss of greater than 5 ml/day or greater than 10 ml/day.
It was recognized that trials would be heterogeneous in relation to active therapies used, including drug dose. The intention was to calculate weighted mean faecal blood loss using results from individual treatment arms reporting mean or median results, with weighting by number of participants in the study group. It was expected that dispersion information (standard deviation or standard error of the mean) would be irregularly reported. In addition, the proportion of participants with faecal blood loss above 5 ml/day or above 10 ml/day was calculated.
It was expected that for aspirin the dose range might be large, with studies using full-dose aspirin (arbitrarily set at ≥1,800 mg/day) or low-dose aspirin (arbitrarily set at ≤325 mg/day). Results within these two dose ranges would be calculated separately. For NSAIDs and coxibs, no extreme variation in dose was envisaged, but the analysis plan allowed for exclusion of very high or very low doses if these were outside the usual daily dose range (for example, ibuprofen 800 to 2,400 mg/day, diclofenac 50 to 150 mg/day and naproxen 500 to 1,000 mg/day). The analysis plan also allowed for comparison of results from healthy volunteers and patients. No other sensitivity analyses were planned, and no statistical testing was done.
Trial quality by decade of publication
Decade | Quality score | Total | ||||
1 | 2 | 3 | 4 | 5 | ||
1960s | 2 | 2 | ||||
1970s | 5 | 3 | 1 | 9 | ||
1980s | 1 | 11 | 5 | 7 | 2 | 26 |
1990s | 5 | 3 | 8 | |||
2000s | 1 | 1 | 2 | |||
Total | 1 | 21 | 6 | 15 | 4 | 47 |
A number of methodological criteria might reflect on the validity of a trial. For example, only 36 out of 47 trials indicated that patients had been screened to exclude a pre-existing history that might contribute to increased faecal blood loss, such as a prior history of gastrointestinal disease or surgery; oral, nasal, or rectal bleeding (including bleeding gums on brushing them); or haemorrhoids. Almost all trials excluded current or recent use of drugs that are likely to interfere with measurements; typically, these were analgesics or low-dose aspirin, and recent prior use of aspirin, NSAIDs, antacids, histamine antagonists, or proton pump inhibitors. Behavioural issues leading to exclusion were excessive alcohol use, excessive use of caffeinated beverages, or peculiarities of diet. Only 12 trials used a negative faecal occult blood test as an entry criterion, and only five used a baseline low daily faecal blood loss to exclude participants. Regular bowel habit was an entry criterion in 11 trials, whereas only five trials used controlled conditions (inpatient or dormitory accommodation). Detailed reporting of the method of measuring faecal and blood radioactivity was uncommon, and although most reported at least a reference four trials had neither details nor reference. Only two trials [39, 40] reported adequately on all of these points.
Almost all studies involved a baseline, pretreatment faecal blood loss measurement over a period of days, and elevated baseline faecal blood loss was also a reason for exclusion (and occasionally investigation). The total number of individuals investigated was 1,162. Most were healthy volunteers, predominantly young men; only 136 (12%) were patients, usually older with an arthritic condition.
Weighted mean daily faecal blood loss by therapy
Treatment/drug | Studies or study arms (n) | Participants (n) | Weighted mean faecal blood loss (ml/day) |
Initial blood loss at start of trial | 38 | 950 | 0.46 |
Placebo arm of treatment | 14 | 172 | 0.76 |
Aspirin (>1,800 mg/day) | 29 | 361 | 5.01 |
Aspirin (325 mg/day) | 4 | 64 | 1.61 |
Ibuprofen | 4 | 66 | 2.03 |
Fenoprofen | 4 | 62 | 1.86 |
Piroxicam | 6 | 60 | 1.89 |
Naproxen | 4 | 59 | 1.98 |
Indomethacin | 6 | 58 | 1.39 |
Etodolac | 4 | 39 | 0.55 |
Rofecoxib | 1 | 37 | 0.80 |
Diflusinal | 4 | 33 | 1.68 |
Ketoprofen | 3 | 28 | 1.42 |
Meloxicam | 1 | 26 | 0.85 |
Etoricoxib | 1 | 21 | 0.90 |
Diclofenac | 1 | 21 | 0.50 |
Azapropazone | 2 | 20 | 1.00 |
Suoprofen | 1 | 20 | 1.80 |
Nefopam | 1 | 19 | 0.60 |
Tiaprofen | 2 | 17 | 0.51 |
Zomepirac | 2 | 16 | 6.40 |
Oxindanac | 1 | 16 | 1.30 |
Sulindac | 2 | 15 | 0.75 |
Lornoxicam | 1 | 15 | 0.80 |
Bromfenac | 1 | 12 | 2.10 |
Fluproquazone | 1 | 12 | 2.80 |
Nabumetone | 1 | 10 | 1.60 |
Oxaprozin | 1 | 10 | 2.30 |
Isoxicam | 1 | 8 | 1.00 |
Ticlotil | 1 | 8 | 2.10 |
Tenoxicam | 1 | 6 | 1.20 |
Flurbiprofen | 1 | 6 | 1.30 |
Most information on mean daily faecal blood loss was available for baseline, the initial period before randomization and the start of the trial proper. This was available in 38 trial arms and 950 participants. Baseline mean daily faecal blood loss was below 1 ml/day in all but one study [41], in which it was 1.0 ml/day; the weighted mean was 0.46 ml/day. A somewhat higher mean daily faecal blood loss of 0.76 ml/day was measured with placebo in 172 participants (Table 2).
Mean daily faecal blood loss was available for low-dose and full-dose aspirin, 25 different NSAIDs, and rofecoxib and etoricoxib. There was information on 361 participants for aspirin at doses greater than 1,800 mg/day, but for other aspirin doses, NSAIDs and coxibs there was information on fewer than 100 participants, and mostly fewer than 50 participants. For 16 NSAIDs information available was on 20 individuals or fewer (Table 2).
At baseline there was no obvious difference between healthy young volunteers (0.44 ml/day, 835 individuals) and patients (0.56 ml/day, 103 individuals). With aspirin at doses above 1,800 mg/day, the mean daily faecal blood loss was about twice as high with volunteers (5.8 ml/day, 249 individuals) as with patients (3.2 ml/day, 112 individuals).
A number of the studies either gave information on individual patients or provided suitable information to identify whether any participants individually had daily faecal blood loss above 5 or 10 ml/day. For instance, a range of individual mean values was often provided. Such information permitted determination that all patients had faecal blood loss of under than 5 and 10 ml/day if the upper value of the range was below 5 ml/day, but if the top of the range was above 10 mL/day then this identified only one such individual; others who may have had higher values could not be identified by this method, which therefore provides a minimum estimate.
Number and percentage of individuals with higher daily faecal blood loss
Therapy | Individuals (n) | Faecal blood loss (n [%]) | |
>5 ml/day | >10 ml/day | ||
Placebo | 149 | 0 (0%) | 0 (0%) |
Aspirin ≥1,800 mg/day | 309 | 97 (31%) | 31 (10.0%) |
Any NSAID | 469 | 24 (5.1%) | 4 (0.9%) |
Systematic reviews have several utilities. They can shed new light on a topic or resolve a difference of opinion, but sometimes they can indicate only what is in the literature, without extensive analysis. For any analysis to make sense, it must be based on information that is of sufficient quality to avoid bias, it must be valid (at least within a reasonable definition for a topic), and the volume of data analyzed must be of sufficient size to prevent conclusions from being wafted about on the winds of chance.
Systematic reviews can only attempt to make sense of the information presented. In the case of the present review, the number of trials of sufficient quality limited, increasing the likelihood of bias. We have defined validity, inter alia, by duration of therapy at a minimum of 1 week and washouts of 1 week in crossover studies. Analysis is limited by clinical factors, design and reporting heterogeneity. There were only 1,162 participants in 47 trials (average 25/trial, split between several groups in the parallel group trials). There were different levels of reporting quality, both crossover and parallel designs, duration periods of 1 to 4 weeks, and 30 different treatments (including placebo, and some at different doses); the bulk of studies were conducted in young healthy men, but some were conducted in young healthy women, and a minority (12%) evaluated older patients. Other variables include whether studies maintained participants in a controlled environment to collect stool samples reliably, and the mechanics of measuring radioactivity in stool samples. In the face of so many variables, our judgement was that no statistical approach could possibly be justified. Although we would like to know how any of these variables might have affected the results, we cannot see how such an analysis may be achieved and so we resorted to a descriptive analysis.
Given the clear limitations of quality and validity in these individually small trials, even a descriptive analysis can only be undertaken with circumspection. Comment is, however, still required on the results that are available.
In these randomized trials, conducted over five decades, some (but not all) of the drugs investigated resulted in a small average increase in faecal blood loss of 1 to 2 ml/day. Aspirin appeared to be associated with increased faecal blood loss in a dose-dependent manner; full anti-inflammatory doses (>1,800 mg/day) resulted in much higher average levels of blood loss of about 5 ml/day, although even 325 mg/day resulted in daily faecal blood loss equivalent to that with standard dose NSAIDs. For aspirin and NSAIDs, some individuals lost much more blood on average, with 5% of those taking NSAIDs having daily blood loss of 5 ml or more and 1% having daily blood loss of 10 ml or more. Individual daily blood loss above 50 ml was reported in some healthy young men with ibuprofen [28], and with aspirin over as few as 5 days [32], and individual rather high blood loss was reported sporadically.
These headline results must be qualified in several ways. Most importantly, almost 90% of individuals investigated were healthy, most were young (age <40 years) and most were men. It is not known whether these results can be extrapolated to older populations, often with comorbid conditions, using aspirin or NSAIDs. We found no conclusive evidence that baseline faecal blood loss, or faecal blood loss with aspirin at doses above 1,800 mg/day, was higher in patients than in healthy volunteers.
Other than obvious differences between trials in terms of drugs and doses tested, the main difference between trials was in the duration of therapy. We set a minimum limit of 7 days of treatment, in part to limit under-estimation of faecal blood loss caused by slow intestinal transit time [34]. More recent studies have tended to include longer treatment duration and older studies tended to involve shorter treatment durations, but there was an insufficient number of common therapies to allow a sensible comparison to be conducted, especially because the number of patients in each treatment arm was small. There was the added complication of crossover trials, with disparate washout periods, although a minimum of 7 days was imposed as an inclusion criterion.
Additional limitations arose from the apparent differences between trials in participant inclusion. Although most trials screened participants for a history of potential for increased gastrointestinal damage, or drugs that might interfere or confound measurements, fewer than one-third excluded participants with higher blood loss by means of faecal occult blood screening or measurement. Moreover, only one trial in 10 collected stool samples in controlled conditions from inpatients, and full description of the methods used to measure stool or blood radioactivity was uncommon. All of these features indicated that a cautious descriptive analysis of these data was all that was possible.
Although frank bleeding from the upper and lower gastrointestinal tracts is associated with high levels of anaemia, including very low haemoglobin levels (<100 g/l) [42], there is no direct evidence linking anaemia with low-level blood loss into the bowel, although aspirin, NSAIDs and perhaps coxibs are known to be associated with varying frequencies of frank gastrointestinal bleeding. There is circumstantial evidence that NSAIDs are linked both to increased faecal blood loss and to increased anaemia [30]. For low-dose aspirin, which produced faecal blood loss similar to that of NSAIDs in these trials, a limited body of literature has examined only small numbers, with one study [43] suggesting an association between low-dose aspirin use and anaemia and another one [44] finding no association. A small comparative study of misoprostol and no treatment in 21 patients with small bowel enteropathy and iron deficiency anaemia showed a rise of 15 g/l in haemoglobin with misoprostol, as compared with no change without treatment [45].
It is interesting that individual participants could have bleeding rates that were much higher than the average, more frequently with full-dose aspirin than with NSAIDs. It is tempting to consider that individuals with daily faecal blood loss of more than 5 ml or 10 ml might be more likely to develop anaemia, especially because some individuals had daily blood loss of 50 ml or more (for example, in the study conducted by Bowne and coworkers [28]). Caution is needed, however, because in most cases the information we obtained indicates that high blood loss was identified over just a few days, and we have no good evidence about the longer term. The exception [28], a re-analysis of ibuprofen used in healthy male volunteers, indicated that very high blood loss may occur infrequently and intermittently. Longer studies and larger numbers would be needed to demonstrate the cause and effect between daily faecal blood loss and anaemia.
Anaemia is common in older people living in the community; 13% of a Canadian population of 17,000 had anaemia using the World Health Organization definition (<120 g/l for women and <130 g/l for men), and 4% had haemoglobin levels below 110 g/l [46]. Anaemia is also common (prevalence about 50%) in some rheumatological conditions [47]. Of 72,000 older patients admitted to hospital with myocardial infarction, 43% satisfied a World Health Organization definition of anaemia [48]. Anaemia in older people is associated with greater mortality in association with heart failure [49, 50], angina [51] and myocardial infarction, especially with compromised renal function [52]. Anaemic older patients in hospital are less likely to resume activities of daily living [53] and anaemia is associated with poor cognition [54].
Where a cause for anaemia can be found and treated, quality of life improves. This is the case with blood transfusion in older people, or when haemoglobin levels rise upon treatment with erythropoietin in cancer [55] or renal disease. There are no reliable studies demonstrating improvements in hard clinical outcomes or mortality.
At baseline, or with placebo, faecal blood loss is generally measured at 1 ml/day or below. With low-dose aspirin and some NSAIDs, average values in studies may be two to four times this, and with anti-inflammatory doses of aspirin there is consistent evidence for much higher average losses. A small proportion of individuals respond to aspirin or NSAIDs with much higher faecal blood loss of above 5 ml/day or above 10 ml/day. Blood loss of 5 ml/day would represent almost 2 l if continued over a year, a not insubstantial loss, which might be a consequence of NSAID use in up to one in 20 users. Similar concerns apply to low-dose aspirin. There are significant limitations regarding the quality and validity of reporting of these studies, such as limited size and inclusion of inappropriate participants. The potential for blood loss and consequent anaemia requires more study.
- coxib:
= cyclo-oxygenase-2 selective inhibitor
= nonsteroidal anti-inflammatory drug.
Pain Research is supported in part by the Oxford Pain Research Trust, and this work was also supported by an unrestricted educational grant from Pfizer Ltd. Neither organization had any role in design, planning or execution of the study, or in writing the manuscript. The terms of the financial support from Pfizer included freedom for the authors to reach their own conclusions, and an absolute right to publish the results of their research, irrespective of any conclusions reached. Pfizer did have the right to view the final manuscript before publication, and did so. We wish to thank Richard Hunt and Barry Bowen for helpful comments on an earlier version of this paper.
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text: Get Your Free Mother 3 HandbookLuke Plunkett7/10/09 4:30amFiled to: MotherMother 3EarthboundCultureFangamers37EditPromoteShare to KinjaToggle Conversation toolsGo to permalink If you have $20 lying around, and are a fan of Mother/Earthbound, you should definitely pick up the Mother 3 Handbook. If you're a fan of the game and don't have $20...well, lucky you. Because you can browse and download the book for free. While the luxurious book costs $20, and a hi-res .pdf file of the thing costs $6, there's a low-res version up on Fangamer's website that can be read and, if you're short on can-reading material, downloaded then printed off. Advertisement Advertisement Isn't as nice as the real thing, but then, some of you are cheap bastards. [Mother 3 Handbook, via Go Nintendo]Reply37 repliesLeave a reply


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The mother of a mentally ill 13-year-old son — who blogged about her son's violent threats hours after the Sandy Hook massacre on Friday — appeared on "The Today Show" Monday morning to talk about the attention her blog post has received.
"The Today Show" took the unusual step of not identifying the woman or her son by name, although the woman's name is known — she's an Idaho mother of four whose name is Liza Long. Among other places, her name appears here — on a Web page on which she is listed as the co-author of a follow-up "memo" she co-wrote in response to all the attention her original blog post received.
Here's the background on all that: Last Friday, Long wrote a blog post in which she told the story of her 13-year-old son and his threats and violent outbursts. You can read it here.
As you'll see if you read the piece, she was trying to ignite a discussion about mental illness, and how it often goes untreated, sometimes resulting in the kind of violence that erupted Friday when Adam Lanza, 20, murdered 20 schoolchildren in Connecticut.
Apparently, the blog post was picked up elsewhere, and over the weekend, it was read by an estimated 2.5 million people, according to various stories. The sentence that caught people's attention most was this: "I am Adam Lanza's mother," she wrote, and then continued by referencing the names of some other notorious mass killers. "I am Dylan Klebold's and Eric Harris's mother [Columbine]. I am James Holmes's mother [the Colorado movie theater massacre]. I am Jared Loughner's mother [Tucson]. I am Seung-Hui Cho's mother [Virginia Tech] ."
Then this other blogger, Sarah Kendzior, wrote her own blog post — here — blasting Long. And that post got considerable attention too. In the end, Long must have reached out to Kendzior because the two posted a joint "memo" declaring their unity on the subject of mental illness. You can read the "memo" here.
The "Today" show interview represented Long's first appearance on national TV. "We have had a variety of diagnoses," Long said in the interview, which played less like an interview than a monologue delivered on-camera by Long to an off-camera producer in Idaho. "And the latest is attention-deficit hyper-activity disorder — ADHD. He's also been diagnosed with something called intermittent explosive disorder and oppositional defiant disorder."
She described her reaction when she heard the news about the Sandy Hook massacre on Friday. "I closed the door to my office and started to shiver," she said. "Every time I hear about a mass shooting, I think about my son. And I wonder if some day I'll be that mom."


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Kristen Stewart is not interested in continuing her affair with Rupert Sanders. Credit: Marie Claire
After the affair between Kristen Stewart and her married "Snow White and the Huntsman" director, Rupert Sanders, went public in the summer of 2012, they each apologized to their significant others and went their separate ways — or so it seemed.
"They are still in contact, and incredibly Rupert is still hoping for a future together. But Kristen has come to her senses and doesn't want to damage her image more," a source tells Radar Online. "Even though he has admitted to everyone in his life that the long-brewing affair was a terrible idea, he still hasn't been able to get over his feelings for Kristen.
"He fell in love with her a long time before he laid a finger on her, and he's finding it difficult to shake."
While Stewart has since parted ways with then-boyfriend Robert Pattinson and Sanders was served divorce papers by wife Liberty Ross, a reunion doesn't seem likely, despite what Sanders might want. "Rupert, against all better judgment, still holds out hope that he and Kristen can get things going again, but he's completely deluded," the source explains. "She would never put her career on the line like that again."