text:
Your browser is out of date
With an updated browser, you will have a better Medtronic website experience. Update my browser now.
The Medtronic SynchroMed™ II pump is part of the SynchroMed™ II programmable drug infusion system which provides precise drug delivery for chronic therapy for severe spasticity. In addition to the implanted pump, the SynchroMed™ II infusion system uses a catheter to deliver programmed amounts of Lioresal® Intrathecal (baclofen injection) (a muscle relaxant and antispasticity agent) directly to the intrathecal space and cerebrospinal fluid.
Indications, Safety, and WarningsProduct Details
Review product technical manuals, including information about EMI, and the appropriate drug labeling prior to use for detailed disclosure.
Indications: US: Chronic intrathecal infusion of Infumorph® preservative-free morphine sulfate sterile solution in the treatment of chronic intractable pain, Prialt® chronic intrathecal infusion of preservative-free ziconotide sterile solution for the management of severe chronic pain, and chronic intrathecal infusion of Lioresal® Intrathecal (baclofen injection) for the management of severe spasticity. Outside of US: Chronic infusion of drugs or fluids tested as compatible and listed in the product labeling.
Drug Information: Refer to appropriate drug labeling for indications, contraindications, warnings, precautions, dosage and administration, screening procedures, and under-/overdose symptoms and methods of management. Patients should be informed of the signs and symptoms of drug under- or overdose, appropriate drug warnings and precautions, and signs and symptoms that require medical attention.
Contraindications: System implant is contraindicated in the presence of an infection; implant depth greater than 2.5 cm below skin; insufficient body size; and spinal anomalies. Use of the system with drugs with preservatives and drug formulations with pH ≤3. Use of CAP kit for refills or of refill kit for catheter access and use of PTM to administer opioid to opioid-naïve patients.
Warnings: Non-indicated formulations may contain neurotoxic preservatives, antimicrobials, or antioxidants, or may be incompatible with and damage the system. Failure to comply with all product instructions, including use of drugs or fluids not indicated for use with system, or of questionable sterility or quality, or use of non-Medtronic components or inappropriate kits, can result in improper use, technical errors, increased risks to patient, tissue damage, damage to the system requiring revision or replacement, and/or change in therapy, and may result in additional surgical procedures, a return of underlying symptoms, and/or a clinically significant or fatal drug under- or overdose.
An inflammatory mass that can result in serious neurological impairment, including paralysis, may occur at the tip of the implanted catheter. Clinicians should monitor patients carefully for any new neurological signs or symptoms, change in underlying symptoms, or need for rapid dose escalation. Monitor patients appropriately after refill if a pocket fill is suspected. Failure to recognize signs and symptoms of pocket fill and seek appropriate medical intervention can result in serious injury or death. Overinfusion may lead to underdose or overdose symptoms. Strong sources of electromagnetic interference (EMI) can negatively interact with the pump and cause heating of the implanted pump, system damage, or changes in pump operation or flow rate, that can result in patient injury from tissue heating, additional surgical procedures, a return of underlying symptoms, and/or a clinically significant or fatal drug underdose or overdose. The SynchroMed II system is MR Conditional; consult the labeling for MRI information.
Precautions: Monitor patients after pump or catheter replacement for signs of underdose/overdose. Infuse preservative-free saline at minimum flow rate if therapy is discontinued for an extended period to avoid system damage. EMI may interfere with programmer telemetry during pump programming sessions.
Adverse Events: In addition to procedure-related risks, the following may occur: pocket seroma; hematoma; erosion; infection; pump inversion; post-lumbar puncture risks (spinal headache); CSF leak and rare central nervous system pressure-related problems; radiculitis; arachnoiditis; spinal cord bleeding/damage; meningitis; neurological impairment (including paralysis) due to inflammatory mass; allergic response to implant materials; surgical replacement due to end of service life or component failure; loss of therapy, drug overdose, or inability to program the pump due to component failure; catheter complications resulting in tissue damage or loss of or change in therapy; potential serious adverse effects from catheter fragments in intrathecal space.
For full prescribing information, please call Medtronic at 1-800-328-0810 and/or consult Medtronic's website at www.medtronic.com.
Infumorph® is a registered trademark of West-Ward Pharmaceutical. Prialt® is a registered trademark of TerSera Therapeutics LLC. Lioresal® is a registered trademark of Saol.
USA Rx Only
Rev 1118
LIORESAL INTRATHECAL (baclofen injection) is a muscle relaxant and antispastic. Its chemical name is 4-amino-3-(4-chlorophenyl) butanoic acid, and its structural formula is:
Baclofen is a white to off-white, odorless or practically odorless crystalline powder, with a molecular weight of 213.66. It is slightly soluble in water, very slightly soluble in methanol, and insoluble in chloroform.
LIORESAL INTRATHECAL is a sterile, pyrogen-free, isotonic solution free of antioxidants, preservatives or other potentially neurotoxic additives indicated only for intrathecal administration. The drug is stable in solution at 37° C and compatible with CSF. Each milliliter of LIORESAL INTRATHECAL contains baclofen U. S. P. 50 mcg, 500 mcg or 2000 mcg and sodium chloride 9 mg in Water for Injection; pH range is 5.0 - 7.0. Each ampule is intended for SINGLE USE ONLY. Discard any unused portion. DO NOT AUTOCLAVE.
The precise mechanism of action of baclofen as a muscle relaxant and antispasticity agent is not fully understood. Baclofen inhibits both monosynaptic and polysynaptic reflexes at the spinal level, possibly by decreasing excitatory neurotransmitter release from primary afferent terminals, although actions at supraspinal sites may also occur and contribute to its clinical effect. Baclofen is a structural analog of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), and may exert its effects by stimulation of the GABAB receptor subtype.
LIORESAL INTRATHECAL when introduced directly into the intrathecal space permits effective CSF concentrations to be achieved with resultant plasma concentrations 100 times less than those occurring with oral administration.
In people, as well as in animals, baclofen has been shown to have general CNS depressant properties as indicated by the production of sedation with tolerance, somnolence, ataxia, and respiratory and cardiovascular depression.
Pharmacodynamics of LIORESAL INTRATHECAL:
Intrathecal Bolus:
Adult Patients: The onset of action is generally one-half hour to one hour after an intrathecal bolus. Peak spasmolytic effect is seen at approximately four hours after dosing and effects may last four to eight hours. Onset, peak response, and duration of action may vary with individual patients depending on the dose and severity of symptoms.
Pediatric Patients: The onset, peak response and duration of action is similar to those seen in adult patients.
Continuous Infusion:
LIORESAL INTRATHECAL'S antispastic action is first seen at 6 to 8 hours after initiation of continuous infusion. Maximum activity is observed in 24 to 48 hours.
Continuous Infusion: No additional information is available for pediatric patients.
Pharmacokinetics of LIORESAL INTRATHECAL:
The pharmacokinetics of CSF clearance of LIORESAL INTRATHECAL calculated from intrathecal bolus or continuous infusion studies approximates CSF turnover, suggesting elimination is by bulk-flow removal of CSF.
Intrathecal Bolus: After a bolus lumbar injection of 50 or 100 mcg LIORESAL INTRATHECAL in seven patients, the average CSF elimination half-life was 1.51 hours over the first four hours and the average CSF clearance was approximately 30 mL/hour.
Continuous Infusion: The mean CSF clearance for LIORESAL INTRATHECAL (baclofen injection) was approximately 30 mL/hour in a study involving ten patients on continuous intrathecal infusion. Concurrent plasma concentrations of baclofen during intrathecal administration are expected to be low (0- 5 ng/mL).
Limited pharmacokinetic data suggest that a lumbar-cisternal concentration gradient of about 4:1 is established along the neuroaxis during baclofen infusion. This is based upon simultaneous CSF sampling via cisternal and lumbar tap in 5 patients receiving continuous baclofen infusion at the lumbar level at doses associated with therapeutic efficacy; the interpatient variability was great. The gradient was not altered by position.
Six pediatric patients (age 8-18 years) receiving continuous intrathecal baclofen infusion at doses of 77-400 mcg/day had plasma baclofen levels near or below 10 ng/mL.
LIORESAL INTRATHECAL (baclofen injection) is indicated for use in the management of severe spasticity. Patients should first respond to a screening dose of intrathecal baclofen prior to consideration for long-term infusion via an implantable pump. For spasticity of spinal cord origin, chronic infusion of LIORESAL INTRATHECAL via an implantable pump should be reserved for patients unresponsive to oral baclofen therapy, or those who experience intolerable CNS side effects at effective doses. Patients with spasticity due to traumatic brain injury should wait at least one year after the injury before consideration of long-term intrathecal baclofen therapy. LIORESAL INTRATHECAL is intended for use by the intrathecal route in single bolus test doses (via spinal catheter or lumbar puncture) and, for chronic use, only in implantable pumps approved by the FDA specifically for the administration of LIORESAL INTRATHECAL into the intrathecal space.
Spasticity of Spinal Cord Origin: Evidence supporting the efficacy of LIORESAL INTRATHECAL was obtained in randomized, controlled investigations that compared the effects of either a single intrathecal dose or a three day intrathecal infusion of LIORESAL INTRATHECAL to placebo in patients with severe spasticity and spasms due to either spinal cord trauma or multiple sclerosis. LIORESAL INTRATHECAL was superior to placebo on both principal outcome measures employed: change from baseline in the Ashworth rating of spasticity and the frequency of spasms.
Spasticity of Cerebral Origin: The efficacy of LIORESAL INTRATHECAL was investigated in three controlled clinical trials; two enrolled patients with cerebral palsy and one enrolled patients with spasticity due to previous brain injury. The first study, a randomized controlled cross-over trial of 51 patients with cerebral palsy, provided strong, statistically significant results; LIORESAL INTRATHECAL was superior to placebo in reducing spasticity as measured by the Ashworth Scale. A second cross-over study was conducted in 11 patients with spasticity arising from brain injury. Despite the small sample size, the study yielded a nearly significant test statistic (p= 0.066) and provided directionally favorable results. The last study, however, did not provide data that could be reliably analyzed.
LIORESAL INTRATHECAL therapy may be considered an alternative to destructive neurosurgical procedures. Prior to implantation of a device for chronic intrathecal infusion of LIORESAL INTRATHECAL, patients must show a response to LIORESAL INTRATHECAL in a screening trial (see Dosage and Administration).
Hypersensitivity to baclofen. LIORESAL INTRATHECAL is not recommended for intravenous, intramuscular, subcutaneous or epidural administration.
LIORESAL INTRATHECAL is for use in single bolus intrathecal injections (via a catheter placed in the lumbar intrathecal space or injection by lumbar puncture) and in implantable pumps approved by the FDA specifically for the intrathecal administration of baclofen. Because of the possibility of potentially life-threatening CNS depression, cardiovascular collapse, and/or respiratory failure, physicians must be adequately trained and educated in chronic intrathecal infusion therapy.
The pump system should not be implanted until the patient's response to bolus LIORESAL INTRATHECAL injection is adequately evaluated. Evaluation (consisting of a screening procedure: see Dosage and Administration) requires that LIORESAL INTRATHECAL be administered into the intrathecal space via a catheter or lumbar puncture. Because of the risks associated with the screening procedure and the adjustment of dosage following pump implantation, these phases must be conducted in a medically supervised and adequately equipped environment following the instructions outlined in the Dosage and Administration section.
Resuscitative equipment should be available.
Following surgical implantation of the pump, particularly during the initial phases of pump use, the patient should be monitored closely until it is certain that the patient's response to the infusion is acceptable and reasonably stable.
On each occasion that the dosing rate of the pump and/or the concentration of LIORESAL INTRATHECAL (baclofen injection) in the reservoir is adjusted, close medical monitoring is required until it is certain that the patient's response to the infusion is acceptable and reasonably stable.
It is mandatory that the patient, all patient caregivers, and the physicians responsible for the patient receive adequate information regarding the risks of this mode of treatment. All medical personnel and caregivers should be instructed in 1) the signs and symptoms of overdose, 2) procedures to be followed in the event of overdose and 3) proper home care of the pump and insertion site.
Overdose: Signs of overdose may appear suddenly or insidiously. Acute massive overdose may present as coma. Less sudden and/or less severe forms of overdose may present with signs of drowsiness, lightheadedness, dizziness, somnolence, respiratory depression, seizures, rostral progression of hypotonia and loss of consciousness progressing to coma. Should overdose appear likely, the patient should be taken immediately to a hospital for assessment and emptying of the pump reservoir. In cases reported to date, overdose has generally been related to pump malfunction, inadvertent subcutaneous injection, or dosing error. (See Drug Overdose Symptoms and Treatment.)
Extreme caution must be used when filling an FDA approved implantable pump. Such pumps should only be refilled through the reservoir refill septum. Inadvertent injection into the subcutaneous tissue can occur if the reservoir refill septum is not properly accessed. Some pumps are also equipped with a catheter access port that allows direct access to the intrathecal catheter. Direct injection into this catheter access port or inadvertent injection into the subcutaneous tissue may cause a life-threatening overdose.
Withdrawal: Abrupt withdrawal of intrathecal baclofen, regardless of the cause, has resulted in sequelae that included high fever, altered mental status, exaggerated rebound spasticity and muscle rigidity that in rare cases progressed to rhabdomyolysis, multiple organ-system failure, and death. In the first 9 years of post-marketing experience, 27 cases of withdrawal temporally related to the cessation of baclofen therapy were reported; six patients died. In most cases, symptoms of withdrawal appeared within hours to a few days following interruption of baclofen therapy. Common reasons for abrupt interruption of intrathecal baclofen therapy included malfunction of the catheter (especially disconnection), low volume in the pump reservoir, and end of pump battery life; human error may have played a causal or contributing role in some cases. Cases of intrathecal mass at the tip of the implanted catheter leading to withdrawal symptoms have also been reported, most of them involving pharmacy compounded analgesic admixtures (see PRECAUTIONS).
Prevention of abrupt discontinuation of intrathecal baclofen requires careful attention to programming and monitoring of the infusion system, refill scheduling and procedures, and pump alarms. Patients and caregivers should be advised of the importance of keeping scheduled refill visits and should be educated on the early symptoms of baclofen withdrawal.
All patients receiving intrathecal baclofen therapy are potentially at risk for withdrawal. Early symptoms of baclofen withdrawal may include return of baseline spasticity, pruritus, hypotension, and paresthesias. Priapism may develop or recur if treatment with intrathecal baclofen is interrupted. Some clinical characteristics of the advanced intrathecal baclofen withdrawal syndrome may resemble autonomic dysreflexia, infection (sepsis), malignant hyperthermia, neuroleptic-malignant syndrome, or other conditions associated with a hypermetabolic state or widespread rhabdomyolysis.
Rapid, accurate diagnosis and treatment in an emergency-room or intensive-care setting are important in order to prevent the potentially life-threatening central nervous system and systemic effects of intrathecal baclofen withdrawal. The suggested treatment for intrathecal baclofen withdrawal is the restoration of intrathecal baclofen at or near the same dosage as before therapy was interrupted.
However, if restoration of intrathecal delivery is delayed, treatment with GABA-ergic agonist drugs such as oral or enteral baclofen, or oral, enteral, or intravenous benzodiazepines may prevent potentially fatal sequelae. Oral or enteral baclofen alone should not be relied upon to halt the progression of intrathecal baclofen withdrawal.
Seizures have been reported during overdose and with withdrawal from LIORESAL INTRATHECAL as well as in patients maintained on therapeutic doses of LIORESAL INTRATHECAL.
Spasticity of Spinal Cord Origin: There were 16 deaths reported among the 576 U.S. patients treated with LIORESAL INTRATHECAL (baclofen injection) in pre- and post- marketing studies evaluated as of December 1992. Because these patients were treated under uncontrolled clinical settings, it is impossible to determine definitively what role, if any, LIORESAL INTRATHECAL played in their deaths.
As a group, the patients who died were relatively young (mean age was 47 with a range from 25 to 63), but the majority suffered from severe spasticity of many years duration, were nonambulatory, had various medical complications such as pneumonia, urinary tract infections, and decubiti, and/or had received multiple concomitant medications. A case-by-case review of the clinical course of the 16 patients who died failed to reveal any unique signs, symptoms, or laboratory results that would suggest that treatment with LIORESAL INTRATHECAL caused their deaths. Two patients, however, did suffer sudden and unexpected death within 2 weeks of pump implantation and one patient died unexpectedly after screening.
One patient, a 44-year-old male with MS, died in hospital on the second day following pump implantation. An autopsy demonstrated severe fibrosis of the coronary conduction system. A second patient, a 52-year-old woman with MS and a history of an inferior wall myocardial infarction, was found dead in bed 12 days after pump implantation, 2 hours after having had documented normal vital signs. An autopsy revealed pulmonary congestion and bilateral pleural effusions. It is impossible to determine whether LIORESAL INTRATHECAL contributed to these deaths. The third patient underwent three baclofen screening trials. His medical history included SCI, aspiration pneumonia, septic shock, disseminated intravascular coagulopathy, severe metabolic acidosis, hepatic toxicity, and status epilepticus. Twelve days after screening (he was not implanted), he again experienced status epilepticus with subsequent significant neurological deterioration. Based upon prior instruction, extraordinary resuscitative measures were not pursued, and the patient died.
Spasticity of Cerebral Origin: There were three deaths occurring among the 211 patients treated with LIORESAL INTRATHECAL in pre- marketing studies as of March 1996. These deaths were not attributed to the therapy.
Overinfusion – Delivery of more drug volume than the programmed rate (overinfusion) can result in unexpected overdose, or withdrawal caused by early emptying of the pump reservoir. Refer to the manufacturer's pump manual and instructions for refilling the reservoir.
Children should be of sufficient body mass to accommodate the implantable pump for chronic infusion. Please consult pump manufacturer's manual for specific recommendations.
Safety and effectiveness in pediatric patients below the age of 4 have not been established.
Patients should be infection-free prior to the screening trial with LIORESAL INTRATHECAL (baclofen injection) because the presence of a systemic infection may interfere with an assessment of the patient's response to bolus LIORESAL INTRATHECAL.
Pump Implantation
Patients should be infection-free prior to pump implantation because the presence of infection may increase the risk of surgical complications. Moreover, a systemic infection may complicate dosing.
Pump Dose Adjustment and Titration
In most patients, it will be necessary to increase the dose gradually over time to maintain effectiveness; a sudden requirement for substantial dose escalation typically indicates a catheter complication (i. e., catheter kink or dislodgement).
Reservoir refilling must be performed by fully trained and qualified personnel following the directions provided by the pump manufacturer. Inadvertent injection into the subcutaneous tissue can occur if the reservoir refill septum is not properly accessed. Subcutaneous injection may result in symptoms of a systemic overdose or early depletion of the reservoir. Refill intervals should be carefully calculated to prevent depletion of the reservoir, as this would result in the return of severe spasticity and possibly symptoms of withdrawal.
Strict aseptic technique in filling is required to avoid bacterial contamination and serious infection. A period of observation appropriate to the clinical situation should follow each refill or manipulation of the drug reservoir.
Extreme caution must be used when filling an FDA approved implantable pump equipped with an injection port that allows direct access to the intrathecal catheter. Direct injection into the catheter through the catheter access port may cause a life-threatening overdose.
Additional considerations pertaining to dosage adjustment: It may be important to titrate the dose to maintain some degree of muscle tone and allow occasional spasms to: 1) help support circulatory function, 2) possibly prevent the formation of deep vein thrombosis, 3) optimize activities of daily living and ease of care.
Except in overdose related emergencies, the dose of LIORESAL INTRATHECAL should ordinarily be reduced slowly if the drug is discontinued for any reason.
An attempt should be made to discontinue concomitant oral antispasticity medication to avoid possible overdose or adverse drug interactions, either prior to screening or following implant and initiation of chronic LIORESAL INTRATHECAL infusion. Reduction and discontinuation of oral anti-spasmotics should be done slowly and with careful monitoring by the physician. Abrupt reduction or discontinuation of concomitant antispastics should be avoided.
Drowsiness: Drowsiness has been reported in patients on LIORESAL INTRATHECAL. Patients should be cautioned regarding the operation of automobiles or other dangerous machinery, and activities made hazardous by decreased alertness. Patients should also be cautioned that the central nervous system depressant effects of LIORESAL INTRATHECAL (baclofen injection) may be additive to those of alcohol and other CNS depressants.
Intrathecal mass: Cases of intrathecal mass at the tip of the implanted catheter have been reported, most of them involving pharmacy compounded analgesic admixtures. The most frequent symptoms associated with intrathecal mass are: 1) decreased therapeutic response (worsening spasticity, return of spasticity when previously well controlled, withdrawal symptoms, poor response to escalating doses, or frequent or large dosage increases), 2) pain, 3) neurological deficit/dysfunction. Clinicians should monitor patients on intraspinal therapy carefully for any new neurological signs or symptoms. In patients with new neurological signs or symptoms suggestive of an intrathecal mass, consider a neurosurgical consultation, since many of the symptoms of inflammatory mass are not unlike the symptoms experienced by patients with severe spasticity from their disease. In some cases, performance of an imaging procedure may be appropriate to confirm or rule-out the diagnosis of an intrathecal mass.
Precautions in special patient populations: Careful dose titration of LIORESAL INTRATHECAL is needed when spasticity is necessary to sustain upright posture and balance in locomotion or whenever spasticity is used to obtain optimal function and care.
Patients suffering from psychotic disorders, schizophrenia, or confusional states should be treated cautiously with LIORESAL INTRATHECAL and kept under careful surveillance, because exacerbations of these conditions have been observed with oral administration.
LIORESAL INTRATHECAL should be used with caution in patients with a history of autonomic dysreflexia. The presence of nociceptive stimuli or abrupt withdrawal of LIORESAL INTRATHECAL (baclofen injection) may cause an autonomic dysreflexic episode.
Because LIORESAL is primarily excreted unchanged by the kidneys, it should be given with caution in patients with impaired renal function and it may be necessary to reduce the dosage.
No specific laboratory tests are deemed essential for the management of patients on LIORESAL INTRATHECAL.
There is inadequate systematic experience with the use of LIORESAL INTRATHECAL in combination with other medications to predict specific drug-drug interactions. Interactions attributed to the combined use of LIORESAL INTRATHECAL and epidural morphine include hypotension and dyspnea.
No increase in tumors was seen in rats receiving baclofen orally for two years. Adequate genotoxicity assays of baclofen have not been performed.
There are no adequate and well-controlled studies in pregnant women. In animal studies, baclofen had adverse effects on embryofetal development when administered orally to pregnant rats. LIORESAL INTRATHECAL should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Baclofen given orally increased the incidence of fetal structural abnormalities (omphaloceles) in rats. Reductions in food intake and body weight gain were observed in the dams. Fetal structural abnormalities were not observed in mice or rabbits.
In mothers treated with oral LIORESAL (baclofen USP) in therapeutic doses, the active substance passes into the milk. It is not known whether detectable levels of drug are present in milk of nursing mothers receiving LIORESAL INTRATHECAL. As a general rule, nursing should be undertaken while a patient is receiving LIORESAL INTRATHECAL only if the potential benefit justifies the potential risks to the infant.
Children should be of sufficient body mass to accommodate the implantable pump for chronic infusion. Please consult pump manufacturer's manual for specific recommendations.
Safety and effectiveness in pediatric patients below the age of 4 have not been established.
Considerations based on experience with oral LIORESAL (baclofen USP)
A dose-related increase in incidence of ovarian cysts was observed in female rats treated chronically with oral LIORESAL. Ovarian cysts have been found by palpation in about 4% of the multiple sclerosis patients who were treated with oral LIORESAL for up to one year. In most cases these cysts disappeared spontaneously while patients continued to receive the drug. Ovarian cysts are estimated to occur spontaneously in approximately 1% to 5% of the normal female population.
Spasticity of Spinal Cord Origin — Clinical Studies:
Commonly Observed in Patients with Spasticity of Spinal Origin — In pre- and post- marketing clinical trials, the most commonly observed adverse events associated with use of LIORESAL INTRATHECAL (baclofen injection) which were not seen at an equivalent incidence among placebo-treated patients were: somnolence, dizziness, nausea, hypotension, headache, convulsions and hypotonia.
Associated with Discontinuation of Treatment — 8/474 patients with spasticity of spinal cord origin receiving long-term infusion of LIORESAL INTRATHECAL in pre- and post- marketing clinical studies in the U. S. discontinued treatment due to adverse events. These include: pump pocket infections (3), meningitis (2), wound dehiscence (1), gynecological fibroids (1) and pump overpressurization (1) with unknown, if any, sequela. Eleven patients who developed coma secondary to overdose had their treatment temporarily suspended, but all were subsequently restarted and were not, therefore, considered to be true discontinuations.
Fatalities — See Warnings.
Incidence in Controlled Trials — Experience with LIORESAL INTRATHECAL (baclofen injection) obtained in parallel, placebo-controlled, randomized studies provides only a limited basis for estimating the incidence of adverse events because the studies were of very brief duration (up to three days of infusion) and involved only a total of 63 patients. The following events occurred among the 31 patients receiving LIORESAL INTRATHECAL (baclofen injection) in two randomized, placebo-controlled trials: hypotension (2), dizziness (2), headache (2), dyspnea (1). No adverse events were reported among the 32 patients receiving placebo in these studies.
Events Observed during the Pre- and Post-marketing Evaluation of LIORESAL INTRATHECAL — Adverse events associated with the use of LIORESAL INTRATHECAL reflect experience gained with 576 patients followed prospectively in the United States. They received LIORESAL INTRATHECAL for periods of one day (screening) (N = 576) to over eight years (maintenance) (N = 10). The usual screening bolus dose administered prior to pump implantation in these studies was typically 50 mcg. The maintenance dose ranged from 12 mcg to 2003 mcg per day. Because of the open, uncontrolled nature of the experience, a causal linkage between events observed and the administration of LIORESAL INTRATHECAL cannot be reliably assessed in many cases and many of the adverse events reported are known to occur in association with the underlying conditions being treated. Nonetheless, many of the more commonly reported reactions — hypotonia, somnolence, dizziness, paresthesia, nausea/vomiting and headache — appear clearly drug-related.
Adverse experiences reported during all U.S. studies (both controlled and uncontrolled) are shown in the following table. Eight of 474 patients who received chronic infusion via implanted pumps had adverse experiences which led to a discontinuation of long-term treatment in the pre- and post-marketing studies.
|Percent of Patients Reporting Events
|Adverse Event
|Nausea and Vomiting
|Urinary Retention
|Dry Mouth
|Accidental Injury
|Speech Disorder
|Peripheral Edema
|Urinary Incontinence
|Urinary Frequency
|a Following administration of test bolus
b Two month period following implant
c Beyond two months following implant
N=total number of patients entering each period. 211 patients received derug; (1 0f 212) received placebo only.
In addition to the more common (1% or more) adverse events reported in the prospectively followed 576 domestic patients in pre- and post-marketing studies, experience from an additional 194 patients exposed to LIORESAL INTRATHECAL (baclofen injection) from foreign studies has been reported. The following adverse events, not described in the table, and arranged in decreasing order of frequency, and classified by body system, were reported:
Nervous System: Abnormal gait, thinking abnormal, tremor, amnesia, twitching, vasodilitation, cerebrovascular accident, nystagmus, personality disorder, psychotic depression, cerebral ischemia, emotional lability, euphoria, hypertonia, ileus, drug dependence, incoordination, paranoid reaction and ptosis.
Digestive System: Flatulence, dysphagia, dyspepsia and gastroenteritis.
Cardiovascular: Postural hypotension, bradycardia, palpitations, syncope, arrhythmia ventricular, deep thrombophlebitis, pallor and tachycardia.
Respiratory: Respiratory disorder, aspiration pneumonia, hyperventilation, pulmonary embolus and rhinitis.
Urogenital: Hematuria and kidney failure.
Skin and Appendages: Alopecia and sweating.
Metabolic and Nutritional Disorders: Weight loss, albuminuria, dehydration and hyperglycemia.
Special Senses: Abnormal vision, abnormality of accommodation, photophobia, taste loss and tinnitus.
Body as a Whole: Suicide, lack of drug effect, abdominal pain, hypothermia, neck rigidity, chest pain, chills, face edema, flu syndrome and overdose.
Hemic and Lymphatic System: Anemia.
Spasticity of Cerebral Origin — Clinical Studies:
Commonly Observed — In pre-marketing clinical trials, the most commonly observed adverse events associated with use of LIORESAL INTRATHECAL (baclofen injection) which were not seen at an equivalent incidence among placebo-treated patients included: agitation, constipation, somnolence, leukocytosis, chills, urinary retention and hypotonia.
Associated with Discontinuation of Treatment — Nine of 211 patients receiving LIORESAL INTRATHECAL in pre-marketing clinical studies in the U.S. discontinued long-term infusion due to adverse events associated with intrathecal therapy.
The nine adverse events leading to discontinuation were: infection (3), CSF leaks (2), meningitis (2), drainage (1), and unmanageable trunk control (1).
Fatalities — Three deaths, none of which were attributed to LIORESAL INTRATHECAL, were reported in patients in clinical trials involving patients with spasticity of cerebral origin. See Warnings on other deaths reported in spinal spasticity patients.
Incidence in Controlled Trials — Experience with LIORESAL INTRATHECAL (baclofen injection) obtained in parallel, placebo-controlled, randomized studies provides only a limited basis for estimating the incidence of adverse events because the studies involved a total of 62 patients exposed to a single 50 mcg intrathecal bolus. The following events occurred among the 62 patients receiving LIORESAL INTRATHECAL in two randomized, placebo-controlled trials involving cerebral palsy and head injury patients, respectively: agitation, constipation, somnolence, leukocytosis, nausea, vomiting, nystagmus, chills, urinary retention, and hypotonia.
Events Observed during the Pre-marketing Evaluation of LIORESAL INTRATHECAL — Adverse events associated with the use of LIORESAL INTRATHECAL reflect experience gained with a total of 211 U. S. patients with spasticity of cerebral origin, of whom 112 were pediatric patients (under age 16 at enrollment). They received LIORESAL INTRATHECAL for periods of one day (screening) (N= 211) to 84 months (maintenance) (N= 1). The usual screening bolus dose administered prior to pump implantation in these studies was 50-75 mcg. The maintenance dose ranged from 22 mcg to 1400 mcg per day. Doses used in this patient population for long-term infusion are generally lower than those required for patients with spasticity of spinal cord origin.
Because of the open, uncontrolled nature of the experience, a causal linkage between events observed and the administration of LIORESAL INTRATHECAL cannot be reliably assessed in many cases. Nonetheless, many of the more commonly reported reactions — somnolence, dizziness, headache, nausea, hypotension, hypotonia and coma— appear clearly drug-related.
The most frequent (≥1%) adverse events reported during all clinical trials are shown in the following table. Nine patients discontinued long-term treatment due to adverse events.
|Percent of Patients Reporting Events
|Adverse Event
|Nausea and Vomiting
|Urinary Retention
|Increased Salivation
|Back Pain
|Peripheral Edema
|Thinking Abnormal
|Dry Mouth
|Speech Disorder
|Urinary Incontinence
|Urination Impaired
|a Following administration of test bolus
b Two month period following implant
c Beyond two months following implant
N=Total number of patients entering each period. 211 patients received drug; (1 of 212) received placebo only.
The more common (1% or more) adverse events reported in the prospectively followed 211 patients exposed to LIORESAL INTRATHECAL (baclofen injection) have been reported. In the total cohort, the following adverse events, not described in the table, and arranged in decreasing order of frequency, and classified by body system, were reported:
Nervous System: Akathisia, ataxia, confusion, depression, opisthotonos, amnesia, anxiety, hallucinations, hysteria, insomnia, nystagmus, personality disorder, reflexes decreased, and vasodilitation.
Digestive System: Dysphagia, fecal incontinence, gastrointestinal hemorrhage and tongue disorder.
Cardiovascular: Bradycardia.
Respiratory: Apnea, dyspnea and hyperventilation.
Urogenital: Abnormal ejaculation, kidney calculus, oliguria and vaginitis.
Skin and Appendages: Rash, sweating, alopecia, contact dermatitis and skin ulcer.
Special Senses: Abnormality of accommodation.
Body as a Whole: Death, fever, abdominal pain, carcinoma, malaise and hypothermia.
Hemic and Lymphatic System: Leukocytosis and petechial rash.
Postmarketing Experience:
The following adverse events have been reported during post-approval use of LIORESAL INTRATHECAL. Because these events are reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency.
Musculoskeletal: The onset of scoliosis or worsening of a pre-existing scoliosis has been reported.
Urogenital: Sexual dysfunction in men and women, including decreased libido and orgasm dysfunction, have been reported. Erectile dysfunction in men has also been reported. Priapism has been reported following baclofen withdrawal.
Special attention must be given to recognizing the signs and symptoms of overdosage, especially during the initial screening and dose-titration phase of treatment, but also during re-introduction of LIORESAL INTRATHECAL after a period of interruption in therapy.
Symptoms of LIORESAL INTRATHECAL Overdose: Drowsiness, lightheadedness, dizziness, somnolence, respiratory depression, hypothermia, seizures, rostral progression of hypotonia and loss of consciousness progressing to coma of up to 72 hr. duration. In most cases reported, coma was reversible without sequelae after drug was discontinued. Symptoms of LIORESAL INTRATHECAL overdose were reported in a sensitive adult patient after receiving a 25-mcg intrathecal bolus.
Treatment Suggestions for Overdose:
There is no specific antidote for treating overdoses of LIORESAL INTRATHECAL (baclofen injection); however, the following steps should ordinarily be undertaken:
If lumbar puncture is not contraindicated, consideration should be given to withdrawing 30-40 mL of CSF to reduce CSF baclofen concentration.
Refer to the manufacturer's manual for the implantable pump approved for intrathecal infusion for specific instructions and precautions for programming the pump and/or refilling the reservoir. There are various pumps with varying reservoir volumes and there are various refill kits available. It is important to be familiar with all of these products in order to select the appropriate refill kit for the particular pump in use.
Screening Phase: Prior to pump implantation and initiation of chronic infusion of LIORESAL INTRATHECAL (baclofen injection), patients must demonstrate a positive clinical response to a LIORESAL INTRATHECAL bolus dose administered intrathecally in a screening trial. The screening trial employs LIORESAL INTRATHECAL at a concentration of 50 mcg/mL. A 1 mL ampule (50 mcg/mL) is available for use in the screening trial. The screening procedure is as follows. An initial bolus containing 50 micrograms in a volume of 1 milliliter is administered into the intrathecal space by barbotage over a period of not less than one minute. The patient is observed over the ensuing 4 to 8 hours. A positive response consists of a significant decrease in muscle tone and/or frequency and/or severity of spasms. If the initial response is less than desired, a second bolus injection may be administered 24 hours after the first. The second screening bolus dose consists of 75 micrograms in 1.5 milliliters. Again, the patient should be observed for an interval of 4 to 8 hours. If the response is still inadequate, a final bolus screening dose of 100 micrograms in 2 milliliters may be administered 24 hours later.
Pediatric Patients: The starting screening dose for pediatric patients is the same as in adult patients, i.e., 50 mcg. However, for very small patients, a screening dose of 25 mcg may be tried first. Patients who do not respond to a 100 mcg intrathecal bolus should not be considered candidates for an implanted pump for chronic infusion.
Post-Implant Dose Titration Period: To determine the initial total daily dose of LIORESAL INTRATHECAL following implant, the screening dose that gave a positive effect should be doubled and administered over a 24-hour period, unless the efficacy of the bolus dose was maintained for more than 8 hours, in which case the starting daily dose should be the screening dose delivered over a 24-hour period. No dose increases should be given in the first 24 hours (i.e., until the steady state is achieved).
Adult Patients with Spasticity of Spinal Cord Origin: After the first 24 hours, for adult patients, the daily dosage should be increased slowly by 10-30% increments and only once every 24 hours, until the desired clinical effect is achieved.
Adult Patients with Spasticity of Cerebral Origin: After the first 24 hours, the daily dose should be increased slowly by 5-15% only once every 24 hours, until the desired clinical effect is achieved.
Pediatric Patients: After the first 24 hours, the daily dose should be increased slowly by 5-15% only once every 24 hours, until the desired clinical effect is achieved. If there is not a substantive clinical response to increases in the daily dose, check for proper pump function and catheter patency. Patients must be monitored closely in a fully equipped and staffed environment during the screening phase and dose-titration period immediately following implant. Resuscitative equipment should be immediately available for use in case of life-threatening or intolerable side effects.
Maintenance Therapy:
Spasticity of Spinal Cord Origin Patients: The clinical goal is to maintain muscle tone as close to normal as possible, and to minimize the frequency and severity of spasms to the extent possible, without inducing intolerable side effects. Very often, the maintenance dose needs to be adjusted during the first few months of therapy while patients adjust to changes in life style due to the alleviation of spasticity. During periodic refills of the pump, the daily dose may be increased by 10-40%, but no more than 40%, to maintain adequate symptom control. The daily dose may be reduced by 10-20% if patients experience side effects. Most patients require gradual increases in dose over time to maintain optimal response during chronic therapy. A sudden large requirement for dose escalation suggests a catheter complication (i.e., catheter kink or dislodgement).
Maintenance dosage for long-term continuous infusion of LIORESAL INTRATHECAL (baclofen injection) has ranged from 12 mcg/day to 2003 mcg/ day, with most patients adequately maintained on 300 micrograms to 800 micrograms per day. There is limited experience with daily doses greater than 1000 mcg/day. Determination of the optimal LIORESAL INTRATHECAL dose requires individual titration. The lowest dose with an optimal response should be used.
Spasticity of Cerebral Origin Patients: The clinical goal is to maintain muscle tone as close to normal as possible and to minimize the frequency and severity of spasms to the extent possible, without inducing intolerable side effects, or to titrate the dose to the desired degree of muscle tone for optimal functions. Very often the maintenance dose needs to be adjusted during the first few months of therapy while patients adjust to changes in life style due to the alleviation of spasticity. During periodic refills of the pump, the daily dose may be increased by 5-20%, but no more than 20%, to maintain adequate symptom control. The daily dose may be reduced by 10-20% if patients experience side effects. Many patients require gradual increases in dose over time to maintain optimal response during chronic therapy. A sudden large requirement for dose escalation suggests a catheter complication (i.e., catheter kink or dislodgement).
Maintenance dosage for long-term continuous infusion of LIORESAL INTRATHECAL (baclofen injection) has ranged from 22 mcg/ day to 1400 mcg/ day, with most patients adequately maintained on 90 micrograms to 703 micrograms per day. In clinical trials, only 3 of 150 patients required daily doses greater than 1000 mcg/ day.
Pediatric Patients: Use same dosing recommendations for patients with spasticity of cerebral origin. Pediatric patients under 12 years seemed to require a lower daily dose in clinical trials. Average daily dose for patients under 12 years was 274 mcg/ day, with a range of 24 to 1199 mcg/ day. Dosage requirement for pediatric patients over 12 years does not seem to be different from that of adult patients. Determination of the optimal LIORESAL INTRATHECAL dose requires individual titration. The lowest dose with an optimal response should be used.
Potential need for dose adjustments in chronic use: During long-term treatment, approximately 5% (28/627) of patients become refractory to increasing doses. There is not sufficient experience to make firm recommendations for tolerance treatment; however, this "tolerance" has been treated on occasion, in hospital, by a "drug holiday" consisting of the gradual reduction of LIORESAL INTRATHECAL over a 2 to 4-week period and switching to alternative methods of spasticity management. After the "drug holiday," LIORESAL INTRATHECAL may be restarted at the initial continuous infusion dose.
Parenteral drug products should be inspected for particulate matter and discoloration prior to administration, whenever solution and container permit.
Delivery Specifications
The specific concentration that should be used depends upon the total daily dose required as well as the delivery rate of the pump. LIORESAL INTRATHECAL may require dilution when used with certain implantable pumps. Please consult manufacturer's manual for specific recommendations.
Preparation Instruction:
Use the 1 mL screening ampule only (50 mcg/mL) for bolus injection into the subarachnoid space. For a 50 mcg bolus dose, use 1 mL of the screening ampule. Use 1.5 mL of 50 mcg/mL baclofen injection for a 75-mcg bolus dose. For the maximum screening dose of 100 mcg, use 2 mL of 50 mcg/mL baclofen injection (2 screening ampules).
For patients who require concentrations other than 500 mcg/mL or 2000 mcg/mL, LIORESAL INTRATHECAL must be diluted.
LIORESAL INTRATHECAL must be diluted with sterile preservative free Sodium Chloride for Injection, U.S.P.
Delivery Regimen:
LIORESAL INTRATHECAL is most often administered in a continuous infusion mode immediately following implant. For those patients implanted with programmable pumps who have achieved relatively satisfactory control on continuous infusion, further benefit may be attained using more complex schedules of LIORESAL INTRATHECAL delivery. For example, patients who have increased spasms at night may require a 20% increase in their hourly infusion rate. Changes in flow rate should be programmed to start two hours before the time of desired clinical effect.
LIORESAL INTRATHECAL (baclofen injection) is packaged in single use ampules containing 0.05 mg/1 mL (50 mcg/mL), 10 mg/20 mL (500 mcg/mL), 10 mg/5 mL (2000 mcg/mL), or 40 mg/20 mL (2000 mcg/mL) supplied as follows:
Screening dose (Model 8563s): five ampules each containing 0.05 mg/1 mL (50 mcg/mL) (NDC 70257-562-55).
LIORESAL INTRATHECAL (baclofen injection) Refill Kits. Each refill kit includes the indicated amount of LIORESAL INTRATHECAL, a drug preparation kit, a pump refill kit with accessories that are compatible with Medtronic SynchroMed® Infusion Systems, and associated instructions:
Does not require refrigeration.
Do not store above 86° F (30° C).
Do not freeze.
Do not heat sterilize.
Distributed by Saol Therapeutics Inc.
Lioresal® is a registered trademark of Saol
SynchroMedTM is a registered trademark of Medtronic, Inc.
Saol Therapeutics Inc.
Roswell, GA 30076
PI56302 Rev.01/2019


text:
|Banning Anti-Personnel Mines - The Ottawa Treaty Explained (International Committee of the Red Cross , 1998, 24 p.)
The International Committee of the Red Cross (ICRC) acts to help all victims of war and internal violence, attempting to ensure implementation of humanitarian rules restricting armed violence. The ICRC is committed to a worldwide ban on the production, stockpiling, transfer and use of all anti-personnel mines.
© International Committee of the Red Cross, Geneva, 1998
The Ottawa Treaty1 Explained
1 The official title is the Convention on the Prohibition of the Use, Stockpiling, Production and Transfer of Anti-personnel Mines and on their Destruction.

subset: commoncrawl


text:
URL : http://php.net/supported-versions.php
Supported Versions
Each release branch of PHP is fully supported for two years from its initial stable release. During this period, bugs and security issues that have been reported are fixed and are released in regular point releases.
After this two year period of active support, each branch is then supported for an additional year for critical security issues only. Releases during this period are made on an as-needed basis: there may be multiple point releases, or none, depending on the number of reports.
Once the three years of support are completed, the branch reaches its end of life and is no longer supported. A table of end of life branches is available.
Currently Supported Versions
|Initial Release
|Active Support Until
|Security Support Until
|5.6 *
|28 Aug 2014
|4 years ago
|19 Jan 2017
|1 year, 7 months ago
|31 Dec 2018
|in 3 months
|3 Dec 2015
|2 years, 9 months ago
|3 Dec 2017
|9 months ago
|3 Dec 2018
|in 2 months
|1 Dec 2016
|1 year, 9 months ago
|1 Dec 2018
|in 2 months
|1 Dec 2019
|in 1 year, 2 months
|30 Nov 2017
|9 months ago
|30 Nov 2019
|in 1 year, 2 months
|30 Nov 2020
|in 2 years, 2 months
Or, visualised as a calendar:
|Active support
|A release that is being actively supported. Reported bugs and security issues are fixed and regular point releases are made.
|Security fixes only
|A release that is supported for critical security issues only. Releases are only made on an as-needed basis.
|End of life
|A release that is no longer supported. Users of this release should upgrade as soon as possible, as they may be exposed to unpatched security vulnerabilities.
Version specific notes
As it is the final PHP 5 release, support for PHP 5.6 has been extended: active support will run for an additional four months, and the security fix period has been doubled from one to two years. Other releases are unaffected.


text:
Another Memorial Day. It always brings back memories, distant ones of days long gone, of parades and bemedaled men, many marching in uniform, neighbors who'd been through the fire.
The Memorial Day parades after World War II (Decoration Day then) were celebrations of more than victory. They celebrated the fulfillment of the implicit promise of the nation's founders that their infant democracy would not merely lead the world but, in time, save it. As it surely did in World War II.
Everybody had a part, not just those who fought. So did the women who nursed the wounded and those at home who worked in the factories that became arsenals of democracy. (Remember "Rosie the Riveter"?)
Even men who weren't called served. They registered for the military draft and took their chances like everyone else. Some were eager to serve but couldn't because of medical problems or because they held civilian jobs vital to the war effort.
Memorial Day, in short, held a special meaning for almost every American family back then. For me, it's a memory ever green.
But you don't see much of that anymore. Our country doesn't require that sort of service now or see it as an obligation or even a measure of citizenship. And that's regrettable.
None of this is meant to belittle our volunteer force. It's the best-trained, most professional military we've ever put in the field, a special bunch. Rarely have so few Americans borne so much of the nation's military burden.
But the result is a growing distance between those who serve in harm's way, or risk it, and the rest of us. In the process, a steady erosion in the reverence once accorded Memorial Day has occurred.
Actually, the original Memorial Day observance has long since disappeared. In the beginning, it was a one-day national tribute every May 30, an outgrowth of observances in the North and the South to memorialize the roughly 700,000 who died in the slaughter of the Civil War.
An act of Congress in 1968 standardizing federal holidays decreed that Memorial Day be held the last Monday in May as part of a three-day weekend holiday, which, as time passed, became a made-to-order signal for a pre-summer shopping spree.
I've nothing against shopping. But using a memorial tribute to those who lost their lives in our wars as another occasion to make a buck profanes the day and defiles the tribute.
The disconnect between the average American and those who served actually began with the Korean War. It wasn't even labeled a war, merely a "police action." But — though one of our shortest conflicts, only three years — it was one of our bloodiest, with an annual death rate double that in Vietnam, 12,000 a year vs. 5,000-plus.
Nobody really much noticed. The men didn't cheer and the boys didn't shout and the ladies and girls didn't all turn out (as the old song has it) when Johnny came marching home from Korea. But at least Korean vets, unlike those returning from Vietnam, didn't face insults from war protesters at home or the treacherous humiliation delivered by Jane Fonda in Hanoi.
Vietnam ended the military draft, and in the years since then, Memorial Day observations have occupied a smaller place on the roster of patriotic remembrances.
For George Daher, a friend who saw some of the worst of Vietnam and has the Purple Hearts to show for it, Memorial Day is less important than a date in mid-May when 16 Marine buddies died in a fierce firefight in 1968, one of the bloodiest years in that war. "That's the day I remember," he told me.
Membership in veterans groups, the American Legion and the Veterans of Foreign Wars, has declined in recent years, too, partly because World War II, Vietnam and Korea survivors are dying off faster now, but also because fewer returning veterans bother to join. I'm guilty in that regard. Never was a joiner.
We're unlikely ever again to see Memorial Day observances like those of the past. But there is a way we can pay private homage: the "National Moment of Remembrance."
Wherever you are tomorrow, no matter what you're doing, at exactly 3 p.m. take a moment to remember those who gave what Lincoln at Gettysburg called "the last full measure of devotion."
It's a little thing, but altogether fitting.


text:
This carries an extra added zing from Senator Lamar Alexander, as he started his political career as a staffer to Richard Nixon. When he says a President has assumed a certain Nixonian paranoia, well, he should know. Alexander warns Barack Obama to stop building "enemies lists" in the White House and to start acting, well … presidential:
It's lengthy and rather Senatorial, but the content packs a punch. Will other media outlets carry this? If they do, then Obama's little war with Fox will spread to Capitol Hill, where many of his colleagues appear in order to get face time to impress the constituents back home. An ill-advised media strategy may become a political disaster in a season where Democrats can ill afford another one.
In 1969 and during the first half of 1970, I was a wet-behind-the-ears, 29-year-old staff aide in the West Wing of the Nixon White House. I was working for the wisest man in that White House, Bryce Harlow, who was a friend of President Johnson, as well as the favorite staff member of President Eisenhower, and President Nixon's first appointee.
Based upon that experience and my forty years since then in and out of public life, I want to make what I hope will be taken as a friendly suggestion to President Obama and his White House: don't create an enemies list.
As I was leaving the White House in 1970, Mr. Harlow was heading out on the campaign plane with Vice President Spiro Agnew whose job was to vilify Democrats and to help elect Republicans. The Vice President had the help of talented young speechwriters, the late Bill Safire and Pat Buchanan. In Memphis, he called Albert Gore, Sr., the "southern regional chairman of the eastern liberal establishment." He labeled the increasingly critical news media, "nattering nabobs of negativism."
Those phrases have become part of our political lore. They began playfully enough, in the back and forth of political election combat. After I had come home to Tennessee, they escalated into something more. They eventually emerged into the Nixon enemies list.
In 1971 Chuck Colson, who was then a member of President Nixon's staff and today is admired for his decades of selfless work in prison reform, presented a list of what he called "persons known to be active in their opposition to our Administration." He said he thought the administration should "maximize our incumbency . . . [or] to put it more bluntly, . . . use the available federal machinery to screw our political enemies." On that list of 20 people were people like CBS correspondent Daniel Schorr, Washington Star columnist Mary McGrory, Leonard Woodcock, the head of the United Auto Workers, John Conyers, the Democratic Congressman from Michigan, Edwin Guthman, managing editor of the Los Angeles Times, and several prominent businessmen such as Howard Stein, of the Dreyfus Corporation and Arnold Picker, vice president of United Artists. The New York Times and the Washington Post were made out to be enemies of the Republic.
Now make no mistake, politics was not such a gentlemanly affair in those days either. After Barry Goldwater had won the Presidential nomination in 1964, Daniel Schorr had told CBS viewers that Goldwater had – quote – "travel[led] to Germany to join-up with the right wing there" and – quote "visit[ed] Hitler's old stomping ground." — unquote. Schorr later corrected that on the air.
What was different about Colson's effort, though, was the open declaration of war upon anyone who seemed to disagree with administration policies. Colson later expanded his list to include hundreds of people, including Joe Namath, John Lennon, Carol Channing, Gregory Peck, The St. Louis Post-Dispatch, the Congressional Black Caucus, Alabama Governor George Wallace. All this came out during the Watergate hearings. You could see an administration spiraling downwards. And, of course, we all know where that led.
Now the only reason I mention this is because I have an uneasy feeling, only ten months into this new administration, that we're beginning to see symptoms of this same kind of animus developing in the Obama administration.
According to Politico, the White House plans to "neuter the United States Chamber of Commerce," an organization with members in almost every major community in America. The Chamber had supported the President's stimulus package and some of his early appointments, but has problems with his health care and climate change proposals.
The Department of Health and Human Services imposed a gag order on a large health care company, Humana, who had warned its Medicare Advantage customers that their benefits might be reduced in Democratic health care reform proposals—a piece of information that is perfectly true. This gag order was lifted only after the Republican leader, Sen. Mitch McConnell of Kentucky, said he would block any future nominees to the Department until the matter was righted.
The White House Communications director recently announced that the administration would treat a major television network, Fox News, as "part of the Opposition." On Sunday White House officials were all over talk shows urging other news organizations to "boycott" Fox and not pick up any of its stories. Those stories, for example, would include the video that two amateur filmmakers made of ACORN representatives explaining how to open a brothel. That's a story other media managed to ignore until almost a week later when Congress decided to cut ACORN's funding.
The President has not stopped blaming banks and investment houses for the financial meltdown even as it has become clear that Congress played a huge role, too, by encouraging Americans to borrow money for houses they couldn't afford.
He was "taking names" of bondholders who resisted the GM and Chrysler bailouts.
Insurance companies, once the allies of the Obama health care proposal, have suddenly become the source of all our health care problems—because they pointed out, again correctly, that if Congress taxes insurance premiums and restricts coverage to those who are sicker and older, the cost of premiums for millions of Americans is likely to go up instead of down.
Because of that insubordination, the President and his allies have threatened to take away the insurance companies antitrust exemption.
Even those of us in Congress have found ourselves in the crosshairs:
The assistant Republican leader, Sen. John Kyl of Arizona, said to ABC's George Stephanopoulos that the stimulus plan wasn't working. The White House wrote the governor of Arizona and said, "If you don't want the money, we won't send it." Sen. McCain said that this could be perceived as a threat to the people of Arizona.
Sen. Bennett of Utah and Sen. Collins and I as well as Democratic Senators Byrd and Feingold all have questioned the number and power of the 18 new White House czars who are not confirmed by the Senate and have suggested that is a threat to constitutional checks and balances. The White House refused to send anyone to testify at congressional hearings. Sen. Bennet and I found ourselves "called out" on the White House blog by the President's communications director, Anita Dunn.
Even the president, in his address to Congress on health care, threatened to "call out" members of congress who disagreed with him.
This behavior is typical of street brawls and political campaign consultants. It is a mistake for the President of the United States and the White House staff.
If the President and his top aides treat people with different views as enemies instead of listening to what they have to say, they're likely to end up with a narrow view and a feeling that the whole world is out to get them. And as those of use who served in the Nixon administration know, that can get you into a lot of trouble.
This administration is only ten months old. It's not too late to take a different approach – both at the White House and here in the Congress.
Here is one opportunity. At the beginning of this year, shortly after the President's inauguration, the Republican leader, Sen. McConnell, addressed the National Press Club. He proposed that he and the President work together to make social security solvent. He said that he would make sure the President got more support in that effort from Republicans than President George W. Bush got from Democrats when he tried to solve the same problem. President Obama held a summit on the dangers of the runaway costs of entitlements which I attended. Every expert there said making social security solvent was essential to our country's fiscal stability. There is still time to get that done.
On clean energy, Republicans have put forward four ideas: build 100 nuclear plants in 20 years, electrify half our cars and trucks in 20 years, explore offshore for low-carbon natural gas and for oil, and double energy research and development for alternative fuels. The administration agrees with this on electric cars and research and development. We may not be far apart on offshore exploration. And, at his town meeting in New Orleans last week, the President said the United States would be "stupid" not to use nuclear power. He is right, since nuclear reactors produce 70% of our carbon free electricity. So why don't we work together on this lower-cost way to address clean energy and climate change instead of enacting a national energy tax?
On health care, the White House idea of bipartisanship has been akin to that of a marksman at the state fair shooting gallery: hit one target and you win the prize. With such big Democratic congressional majorities, the White House figures all it needs to do is unify the Democrats and pick off one or two Republicans.
That strategy may win the prize but lose the country. Usually, on complex issues, the President needs bipartisan support in Congress to reassure and achieve broad and lasting support in the country. In 1968 I can remember when President Johnson, with bigger majorities in Congress than President Obama has today, arranged for the Civil Rights Bill to be written in open sessions over several weeks in the office of the Republican leader, Everett Dirksen. Dirksen got some of the credit; Johnson got the legislation he wanted; the country went along with it. Instead of comprehensive health care that raises premiums and increases the debt, why should the White House not work with Republicans step by step to reduce health care costs, and then, as we can afford it, reduce the number of Americans who don't have access to health care?
The President and his Education Secretary Arne Duncan have been courageous— there is no better word for it— in advocating paying teachers more for teaching well and expanding the number of charter schools. These ideas are the Holy Grail for school reform. They are also ideas that are anathema to the labor unions who support the President. President Obama's advocacy of master teachers and charter schools could be the domestic of equivalent of President Nixon going to China. I, among others, admire his advocacy and have been doing all I can help him.
Having once been there, I can understand how those in the White House feel oppressed by those with whom they disagree, how they feel besieged by some of the media. I hope the current White House occupants will understand that this is nothing new in American politics—all the way back to the days when John Adams and Thomas Jefferson exchanged insults. The only thing new is that there are today multiple media outlets reporting and encouraging the insults 24 hours a day.
As any veteran of the Nixon White House can attest, we've been down this road before and it won't end well. An "enemies list" only denigrates the Presidency and the Republic itself.
Forty years ago, Bryce Harlow would say to me, "Now Lamar, remember that our job here is to push all the merely important issues out of the white house so the president can deal with the handful of issues that are truly presidential." Then he would slip off for a private meeting in the Capitol with Democratic leaders who controlled the congress and usually find a way to enact the president proposals.
Most successful leaders have eventually seen the wisdom of Lord Palmerston, Prime Minister of the United Kingdom who said, "We have no eternal allies, and we have no perpetual enemies.
The British writer Edward Dicey was once introduced to President Lincoln as "one of his enemies". "I did not know I had any enemies," was the Lincoln's answer; And Dicey later wrote, "I can still feel, as I write, the grip of that great boney hand held out to me in token of friendship."
So here's my point. These are unusually difficult times, with plenty of forces encouraging us to disagree. Let's not start calling people out and compiling an enemies list. Let's push the street-brawling out of the White House and work together on the truly presidential issues: creating jobs, reducing health care costs, reducing the debt, creating clean energy.


text:
How can I make mediascanner scan phone memory, i.e. the
/data directory? I want to test playing MP3s from this directory.
When I try to hack it by replacing the "pathStr" from
/mnt/sdcard to
/data before
MediaScanner::doProcessDirectory(), it fails saying
W/MediaScanner( 1713): Error opening directory '/data/', skipping: Permission denied.
And also crashed (probably in free).
I just want to play MP3s stored in phone memory and avoid reading the SD card for some experiments.


text:
The visuals for last year's Rayman Origins were a feast for the eyes. Its soundtrack was super-awesome, too. Who could play something that fun, that pretty, that sonically inspired and not want more. Not me, dammit. So I'm excited that the limbless wonder will headlining an all-new mobile game that looks exactly like Origins.
The Week In Games: What's Coming Out Beyond Cyberpunk 2077: Phantom Liberty
Out in two weeks, Rayman Jungle Run looks like a classic side-scrolling platformer. Like Origins and upcoming Wii U exclusive Rayman Legends, Jungle Run is built on the UbiArt framework that lets drawings become in-game assets. Gonna be pretty, I bet. Look for it on the Apple App Store and Google Play on September 20th.


text:
Governments Concerned that Some Corporations Unfairly Claim Losses to Avoid Taxes
August 30th, 2011
August 30th, 2011
PARIS – Due to the recent financial and economic crisis, global corporate losses have increased significantly. Numbers at stake are vast, with loss carry-forwards as high as 25% of GDP in some countries. Though most of these claims are justified, some corporations find loop-holes and use 'aggressive tax planning' to avoid taxes in ways that are not within the spirit of the law.
This aggressive tax planning is a source of increasing concern for many countries and they have developed various strategies to deal with it. Working cooperatively, countries can deter, detect and respond to aggressive tax planning while at the same time ensuring certainty and predictability for compliant taxpayers.
Corporate Loss Utilisation through Aggressive Tax Planning, which builds on Addressing Tax Risks Involving Bank Losses (2010), looks at a number of commonly used schemes and identifies three key risk areas: corporate reorganisations, financial instruments and non-arm's length transfer pricing. Though these are generally used for sound business and economic reasons, some taxpayers use them to obtain undue tax advantages. For example, countries have identified financial instruments that create artificial losses or obtain multiple deductions for the same loss. They have also seen loss-making companies acquired solely to be merged with profit-making companies and loss-making financial assets artificially allocated to high-tax jurisdictions through non arm's length transactions.
The report outlines strategies to detect and respond to these aggressive tax planning schemes. Detection usually takes place through audits, special reporting obligations on losses, mandatory disclosure rules, rulings, and co-operative compliance programmes. Responses require a comprehensive approach focusing on aggressive tax planning schemes, as well as on their promoters and users. Early engagement between taxpayers and tax authorities in the framework of disclosure initiatives and co-operative compliance programmes also has positive effects, convincing some tax payers not to use or promote certain schemes.
Through the OECD, countries share intelligence on aggressive tax planning schemes and increase international co-operation on detection, responses, and evaluation. Governments should also introduce policies to restrict the multiple use of the same loss and to introduce or revise restrictions on the use of certain losses in the context of mergers, acquisitions, or group taxation regimes. Finally, the report identifies emerging threats for tax revenue, such as aggressive tax planning schemes based on after-tax hedges, and suggests that countries analyse the policy and compliance issues related to them.
Corporate Loss Utilisation through Aggressive Tax Planning is available for journalists on the OECD password-protected website, or on request from the OECD's Media Division (firstname.lastname@example.com, +33 1 45 24 97 00).
For further information, please contact Achim Pross (firstname.lastname@example.com) or Raffaele Russo (firstname.lastname@example.com) from the Centre for Tax Policy and Administration or the OECD's Media Division (email@example.com or + 33 1 45 24 97 00).


text:
An everyday tale of family and political life with a dollop of Formula One and various random thoughts on the side.
Tuesday, January 10, 2012
Mike Moore launches independence consultation in statesmanlike Commons statement
In the view of the Westminster Government (and as I wrote earlier the highest echelons of the SNP and proper lawyers), the Scottish Government does not currently have the legal power to hold a referendum. We've been hearing for days that the UK Government was therefore going to take over the whole thing, dictate terms, basically run the referendum. Maybe that's what David Cameron wanted to do, but thankfully the Lib Dem insistence on reason won the day. For Mike didn't have some sort of High Noon style showdown. He announced a consultation, open till 9th March, open to all Scots to complete. I suspect you'll be hearing a bit more of that on here over the next few weeks.
The document asks people for their views on issues like timing, the question(s), whether it should be supervised by the Electoral Commission and who should have the vote.
While Mike was still on his feet in the Commons taking a good hour's worth of questions, Alex Salmond, in a blatant attempt to grab the headlines for tomorrow, went live on the news and announced that the Government intended to hold the referendum in the Autumn of 2014. The whole thing put me in mind of that moment in in 1994 when Diana went out in an amazing dress as Charles gave his interview to Jonathan Dimbleby. Except, clearly, Eck isn't quite as sexy.
I also thought it was a bit rude of the First Minister to so hurriedly announce the date on the news, rather than to his own Parliament. There was no reason he had to do it then - it could have waited until tomorrow.
If the SNP's preferred date sticks, that's almost 3 years away. I am almost at the end of my tether after 8 months of bickering and snidiness. If I'm going to save my sanity, this campaign has to up its game in terms of quality, positivity and passion on both sides.
Anyway, as has become my custom, I've compiled my tweets of the occasion along with some others into a Storify thingy which is below. Now, I know I've made a couple of howlers, when my brain wandered, but I'm sure you get my drift. Successional clearly means successful. You might like my conversation with Tom Harris, Labour's self-styled attack dog about the need for a positive campaign.
I'm sure that Mike Moore will have won over a lot of respect today for a very people centred, positive performance which compares well with the First Minister's Diva antics.
4 comments:
Unionist BBC sidelined in favour of STV - brill !
Fed up with the BBC taking the mick and slandering the SNP with edited videos etc.
Newsnight Scotland is the worst. Always a quick pre recorded interview with the SNP then 20 minutes live slagging them off with their Unionist pals in the LIBLabCon
Michael Moore was just grandstanding. No change there. In a job the Libs said was irrelevant until they got the smell of the limo. He says we need a legal framework but says we'll get it but we must kiss his bum first. On yer bike lol
- 9:30 pm
You imply criticism of Alex for announcing roughly when the referendum will be called to the press rather than the parliament.
I agree it should have been parliament.
However, the Westminster Cabinet was not even informed when Dave made his announcement to the press, as you demonstrated when you pointed out that the Liberals managed to save Cameron from the worst excesses of his Flashman self by toning down both the rhetoric and the actual conditions upon which he intends to move forward.
At least Alex did it AFTER the Cabinet meeting.
I hope the Westminster cabinet will take cognisance of the international requirements of a referendum on independence.
The threat of Cameron calling it himself, would probably be illegal under the United Nations law which appears to state that in cases of independence the governing power in the greater state may have no part in organising the referendum. presumably for fear of interference... or put simply, cheating.
- 10:51 pm
I can imagine Caron and her ilk wringing their hands back in 1776 - "Ooh no, Mr Washington, we can't declare independence, it won't be legal unless we have approval from the Westminster parliament!"
- 11:08 pm
- cynicalHighlander said...
The panicking Unionists of Labour/Tory/LibDems are obviously against human rights in clutching at straws over the 'legal' issue.
Dr Matt Qvortrup: Scotland does not need permission to go it alone
WHEN Michael Moore stood at the Dispatch Box at Westminster yesterday he had a simple message; Scotland's constitutional settlement rests with Westminster and Scottish independence would require the consent of London.
With all due respect, this argument is neither consistent with international law nor is it compatible with the constitutional doctrine of referendums in the United Kingdom.
It is strange as well that Unionists are allowed 3 people against 1 SNP in any debate, British 'fairness and honesty' in action.
- 7:06 am


text:
Doublas M2
Review by JoshB
Doublas M2 is an enemy robot, or kikaiju, from the animated television series Mazinger Z. He, along with Garada K7, is the first kikaju to be made in the Soul of Chogokin line.
Doublas M2 shares a common body type with Garada K7 and Mazinger Z, using similar upper legs and arms. The rest of the parts are unique to this toy.
Like Garada, Doublas features an all plastic chest, making him feel a little less substantial than previous Soul of Chogokin. This is a trend that I really hope doesn't continue. There is nothing in this design that couldn't have been made out of metal.
The main features of Doublas M2 are his articulated necks. Each neck segment is actually removable, so you can mix and match lengths to whatever formation you desire. The segments are tight, so you can achieve a variety of poses.
Doublas comes with two sets of hands - open and closed, as well as small plug adaptors that allow you to attach them to the base. The base is the same as the one used on Garada K7, and OVA Mazinger Z. Once again, Bandai has given us a sticker to attach to the base instead of a nameplate.
Doublas M2 is a great toy, if only for design and aesthetics. It doesn't really break any new ground, but if you like the character, get him. The bendable necks are fun to play with, and they toy is very sturdy.
Doublas M2 was released December 2004, with a retail price of ¥5,250.


text:
The Perfect Desktop - Mandriva One 2009.1 With GNOME - Page 4
This tutorial exists for these OS versions
- Mandriva Linux 2010.1 (Spring)
- Mandriva Linux 2010
- Mandriva Linux 2009.1 (Spring)
- Mandriva Linux 2009
- Mandriva Linux 2008.1 (Spring)
- Mandriva Linux 2008
On this page
10 TrueType Fonts
Open Firefox, go to ftp://ftp.pbone.net/mirror/seerofsouls.com/mandriva/2007/i586/main/, and select the msttcorefonts rpm file (ftp://ftp.pbone.net/mirror/seerofsouls.com/mandriva/2007/i586/main/msttcorefonts-bootstrap-0.1-4brs.noarch.rpm). Select Open with Software Installer (default) in the Firefox download dialogue:
In the window RPM Installation, select Install:
Type in your root password:
If the package has some dependencies, install them as well:
The additional packages are now being downloaded and installed:
It is possible that the package has an unknown signature. Continue by clicking on Yes:
The RPM Installation window closes automatically after the installation has finished.
To check if the TrueType fonts have been installed correctly, open a word processor like OpenOffice. You should now find your new Windows fonts there:
11 Adobe Reader
To download Adobe Reader, go to http://www.adobe.com/products/acrobat/readstep2_allversions.html and select the following:
Operating system: Linux - x86 (.rpm)
Your language
Then click on Continue:
Select Adobe Reader 9.1 (or whatever the latest version is) and click on the Download now button:
For some reason I got an error when I selected Open with Software Installer (default) in the Firefox download dialogue. To circumvent the problem, I save the file on the hard drive (e.g. on the desktop -> /home/falko/Desktop)...
... and open a terminal (Applications > Tools > Terminal):
to become root and go to the directory where you've saved the Adobe rpm (e.g. /home/falko/Desktop):
cd /home/falko/Desktop/
You can type
ls -l
to find out the exact name of the Adobe rpm. Afterwards, you can install it like this:
rpm -ivh AdbeRdr9.1.0-1_i486linux_enu.rpm
After the installation we can delete the Adobe rpm:
rm -f AdbeRdr9.1.0-1_i486linux_enu.rpm


text:
Employers sort through piles of resumes (often electronically). Many resumes can either go unnoticed because of dull formatting or lack of obvious achievements, or they can end up in the recycling bin because of easily avoidable mistakes or inappropriate information.
Want to make a good first impression? Follow these tips to get your resume noticed:
- Get rid of personal information – Things like age, ethnicity, social security number, sex, religion and marital status don't have any relevance to your qualifications for the job, nor are they anyone's business. Also, many employers might get rid of your resume out of fear of being accused of discrimination.
- Order sections appropriately – Put the various sections of your resume in the order that demonstrates your strongest to weakest categories. For instance, if your education history is stronger than your work history, put that first. You want your best self at the top of the list.
- Show your strongest GPA – Isn't there only one? Not exactly. You can choose to show your cumulative GPA, your major GPA or your GPA that reflects classes within the same core subject.
- Don't date yourself with punctuation – Certain punctuation can make the text hard to read (underlining) or date them back to the stone age (asterisks or tildes). Instead of underlining, try italicizing, and instead of asterisks or tildes, try bullets. This should help your resume look cleaner and more up to date.
This article is presented by Colorado Technical University. Contact us today if you're interested in developing knowledge and industry-relevant skills with an industry-current degree program from Colorado Technical University.


text:
Among the thousands of security experts at the Black Hat, Defcon and Security BSides conferences next week in Las Vegas, some will surely test whether they can break into nearby laptops, phones, networks -- even RFID-enabled room keys and credit cards.
QUIZ: Black Hat's most notorious incidents
Based on hacks in previous years, conference veterans realize the possibility of being owned, and some who blog have issued tips for how to use electronic devices safely and lock them down. Here are tips from two of them, McAfee blogger Joris Evers and Robert Auger on the CGISecurity blog:
= Use a laptop that doesn't contain valuable information. More secure still, but a little crippling, don't bring a laptop at all.
= Patch everything -- operating systems, browsers, firewalls, VPN clients, Java -- everything.
= Don't use Wi-Fi networks, or at least turn off the feature to autoconnect to nearby Wi-Fi networks. Stick with the wired network in your hotel room.
= Don't forget your smartphone. If it has Wi-Fi support, turn off Wi-Fi access.
= Beware USB sticks. Don't use any you borrow, find or receive as gifts at the conferences. If you bring one and use it to sneakernet files onto someone else's computer, don't stick it back in your computer.
= Similarly, beware conference downloads and CDs. Based on past conferences, they might be infected.
= Configure your firewall to block all incoming ports and require outgoing apps to receive manual approval to access the network.
= Update your antivirus software.
= Disable Bluetooth.
= Use a privacy screen on your laptop.
= Clear your browser history and cookies.
= Don't use cellphones within 1,000 feet of the conferences to avoid phony cell stations.
= Use RFID blockers on items such as passports, credit cards and room keys that may be RFID-enabled.


text:
Tuesday, December 11, 2012
We'll Miss You, High Country Gardens
Sadly, I think I'll remember 2012 mostly for the closing of two of my favorite garden resources, Wind Dancer down in Salem...and now, as I found out last week, High Country Gardens, which is based in New Mexico.
I'm sure most of you have heard of HCG...and I certainly talked about them quite a bit over the past few years. Getting their catalogs (above) has always been a treat...filled with colorful photos and ravishing descriptions...they always made me salivate a bit! Sadly, due to drought, wildfires, and a slumping economy, HCG was forced to close its doors, ending 19 years of selling amazing plants.
HCG grew many different plants, but their focus was in xeric, or water-wise, plants. I first discovered them years ago, back when I lived in Nebraska. The idea of Xeric gardening was still pretty new to me back then...and browsing the HCG web site was the first time I had seen Xeric applied to anything other than Cacti & Yuccas...it was amazing!
Of course, that was about the same time I moved to Portland. For the first few years I lived in Portland, I was a renter...and never did much gardening, since I never knew where my next home would be. I had a few small gardens...but nothing terribly involved. For a time, I forgot about HCG...I lived in Portland, OR, after all...what did we need drought-tolerant plants for!
After you live here for a year or two, however, you realize that it's only rainy during winter. During summer, it doesn't rain...like, AT ALL. It's a little freaky when the rain stops like someone threw a switch. Unless you really want to spend the entire summer watering constantly, having a few plants that are at least a little drought-tolerant is pretty beneficial.
After we finally bought our first house, and I started planting the garden, bit-by-bit, I remembered all the online nursery websites I used to spend time on...but couldn't order from, as I didn't actually have a garden. I re-discovered HCG...and ordered a few plants that first year. It was my first time EVER ordering plants online...and you all know that feeling...the first time you open up the box and are stunned to find scrappy, spindly plants!
I planted them, however, and they grew rapidly and were beautiful, even in their first year. It was also the first Agastache I ever purchased ('Desert Sunrise'). I had been convinced to try them because of the glowing praise and great photos on the website. As you all know by now...I was HOOKED! After seeing how healthy and vigorous the plants were, I was now a loyal customer.
Over the past few years, I've ordered a few more plants from them each winter, to be delivered in the spring...and it was always exciting to get off my bus after work and see that familiar box, full of plants, ready to be unpacked. It's sad to think my order this spring was also my last.
So, I thank you, Dave Salman and all the crew there in Albuquerque...I know I'm not alone in saying, you'll be sorely missed.
37 comments:
I'm very sorry to hear that! I've never ordered from HCG, but I've read about them a number of times. You hate to see an independent business that offered something unique close down.ReplyDelete
By the way, I didn't know you were from Nebraska originally. Never lived there, but visited Lincoln frequently for a job I used to have, and traveled from Omaha to Scottsbluff on a few occasions. Go Huskers!Replies
It's always sad, isn't it. Yeah...born and raised in Nebraska...although I don't think I'd ever live there again...it's pretty harsh!Delete
I'm very sad to read this. I've loved High Country Gardens for quite some time, and credit them for introducing me to the wonderful world of agastaches. Coming from California, I had drilled into my brain the importance of drought tolerance, and while it was definitely a different situation in Portland, in my earlier days of gardening I building a garden that didn't require watering during the summer. Such a loss.ReplyDeleteReplies
I was also introduced to Agastache by HCG, and I can't imagine my garden without it.Delete
Who is going to be the "go to" nursery for Agastache now?
Me too, LeLo...I can't imagine just how different my garden would be had I not learned of Agastaches!Delete
I wish I know, Alan...there isn't really anyone else out there who has dedicated time and effort into developing (and promoting) them as much as HCG.Delete
I hope they come back. I found out almost immediately--there were some rumors out there--and even some known book publishers I knew in the gardening community (not to mention Dave's Garden website) were shocked when I first mentioned this & apparently informed them...I see their online order website now "appears" to be up & running...it looks legit but I am looking to verify this, of course, before I forward any card info, in the event it is a very unusual scam ! I ordered maybe 400 plus plants over the past decade plus from them...if they have or do return, I hope we will support them en masse ! JeffDelete
Hi Scott, I'm not familiar with HCG, but your love and enthusiasm of agastache resonated with me and I've got my first two plants in the ground thanks to you..via HCG. You are so right, if we don't plant some water wise plants in PDX, we are a slave to watering all summer.ReplyDelete
I am saddened by the loss of a meaningful small biz. I hope we as bloggers will continue to discover and support new establishments. You have been a great champion of several PDX metro area nurseries that in turn has introduced me to them. Cheers, JenniReplies
Thanks, Jenni...and I'm so excited for your Agastaches...they are such beautiful and easy-going plants :-) I agree...I think we have to constantly support our valuable area nurseries...or we risk losing them :-(Delete
I'm so blue about this. I had plants earmarked already for the spring. :(ReplyDeleteReplies
Me too! I had wanted to get that silver-leaved Vernonia they had...Deep Sigh :-(Delete
I'm crashed about HCG, so sad.............ReplyDeleteReplies
Me too...it really shocked meDelete
Well good grief! I did not know High Country Gardens was closing up. I have gotten many plants from them over the years also.ReplyDeleteReplies
I think it was a big surprise to most of us...there was no real indication it was coming :-(Delete
This is such distressing news. I have ordered from High Country Gardens and they were great. My Kitntzley's Ghost lonicera was the latest thing I bought last fall, and I only found it at HCG. I had no idea the company would be gone by winter. Sad. Thanks for this post remembering them.ReplyDeleteReplies
I know, it's so sad, Laurrie...I think the same thing...if only I'd known...I would have ordered this fall, instead of waiting for spring :-(Delete
Very sad indeed. Between weather and market inevitabilities I sure does seem a rough business climate.ReplyDeleteReplies
It's definitely a sad reality...so many seem to be closing lately.Delete
I was bummed to hear this... had gotten many plants from them when I was first establishing my drought-tolerant garden, and was looking forward to trying their side-oats gramma lawn substitute at the new place next year. *sigh*ReplyDeleteReplies
Agreed...they were such a great resource for water-wise plants...they will definitely be missed.Delete
Well said Scott. I will miss them as well, they certainly filled a special need in the gardening world.ReplyDeleteReplies
Absolutely...they really opening my (and probably many others') eyes to the possibilities of xeric plantings.Delete
High Country will indeed be missed. Their catalogs were always beautiful and inspiring, David was such a great advocate for xeric gardens, and their plant-shipping service was excellent.ReplyDeleteReplies
Absolutely, Pam...it was always a treat to get a new catalog...and their plants were always well-packed and healthy.Delete
Sad to hear! I've ordered from them and loved their catalogs.ReplyDeleteReplies
Totally...I will SO miss getting those catalogs!Delete
Sad news! Loved their catalogs and learned a great deal from them! I worry about the independent nurseries that are still struggling!ReplyDeleteReplies
Me too...it just reinforces the need to really shop at those nurseries...we vote with our dollars who stays in business.Delete
Ha - I save some of my catalogs, too...a few of HCG's, and most every one of Plants of the Southwest's. It was nice to see them expanding more into xeric accents / succulents over the last several years. My 'Tuscan Blue' Rosemary will be a living legacy, since I bought it at HCG's Santa Fe Greenhouses, watching all the locals jealous that they couldn't just plant it outside, like I could down here!ReplyDeleteReplies
Hahaha...I know that feeling! I wish now that I'd saved more of the catalogs...oh well.Delete
One of the best HPSO programs ever featured Lauren Springer, who did work with HCG in recent years. I rarely do mail order, but now I am glad to have their introduction, 'Swallowtail' columbine, to remember them by.ReplyDelete
Black Chokeberry is a wonderful plant.plant is beautiful and produces edible hedelmiä.Kasvi is here and is growing well. Aronia melanocarpa grow is about 5 feet long when fully ripe. It grows well in full sun or partial sun. This shrub is also very adaptable to different soils. It also produces a beautiful dark purple berries and add color to yellow and red leaves in the autumn months.ReplyDelete
Black Chokeberry
High Country Gardens agastaches and ornamental grasses will live on here on the Connecticut shore.ReplyDelete
I too was crushed when I went to the HCG website and saw they were closing. I went back today (they still have the plant file pages running, which I like to use for reference) and there is a new message on the website - confusing because it says "January 2012", but the message seems to indicate that they might end up still doing mail order. "We are excited to announce that ... High Country Gardens will continue to still be available via mail order. We are still finalizing the details... stay tuned for the latest update on when our full selection of water-wise plants will be available to order for Spring 2013 delivery". I'm keeping my fingers crossed and hoping that maybe I haven't been completely cut off from my supply.ReplyDelete
Good news! High Country Gardens is back in business. We're celebrating our 20th Year with 20 New Plants. For more information, you can read David Salman's blog post about the transition: http://www.waterwisegardening.com/archives/1933


text:
Scott McCloud is an American comic artist and theorist. After receiving his Bachelor of Fine Arts in illustration from Syracuse University, he created his lighthearted comic strip 'Zot!'. It was published by Eclipse Comics from 1984 to 1990 and won several prizes. Subsequent comics include 'Destroy!!' and 'The New Adventures of Abraham Lincoln', as well as the writing of DC's 'Superman Adventures' and 'Superman: Strength'.
McCloud is best known as the creator of 'Understanding Comics', the most influential study on comics since Will Eisner's 'Comics and Sequential Art'. What's more, 'Understanding Comics' is a comic itself, so actually it is nicer, easier, more understandable and illustrative than Eisner's classic work. Accessible and intelligent, 'Understanding Comics' stands as the best publication on the medium to date.
Reinventing Comics
In the spring of 2000, Scott McCloud's second book on comics was published: 'Reinventing Comics'. In this equally comprehensive work, he debates the future and possibilities of the comic genre. Finally, in 2006, he released 'Making Comics'. His long awaited graphic novel 'The Sculptor' was released by First Second Books in 2015.
McCloud was furthermore one of the early promotors of webcomics and the principal author of the 1988 Creator's Bill of Rights, in order to protect the rights of comic book creators. He is also the originator of 24-Hour Comics Day, an annual event in which comic book authors finish a complete 24-page comic book in 24 hours.