Apple Patent Would Let You Build Apps Without Coding Know-How [Patents]
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Lead generation is not as easy as it seems to a number of marketers. It took the Lead Generation Consulting years to develop technology and infrastructure to provide and perform effective lead generation programs that can help enhance business performance through effective marketing and sales campaign.
Jade Scrivener?is the Chief Executive Officer (CEO) of Lead Generation Consulting and at the same time the Search Engine Optimization (SEO) Consultant. He has been in the marketing and advertising industry for more than ten years now. His expertise as a sales driver and leader enables him to build remarkable sales organizations that convey top revenue and prime profit performance. His core competencies include business development strategic planning accountability for P&L; marketing, coaching/ mentoring seminar development; customer service team building training for front-line staff to sell; custom lead generation campaigns; marketing strategies; outsource consulting; database management and call center services. Jade Scrivener offers a wide range of services including lead generation, search engine optimization, search engine marketing, internet advertising, customer relations development, financial planning, and lead management. He is also adept in networking, sales, marketing, production, relationship building, strategic planning, research and mentoring to increase sales and income.
The Jade Scrivener?Lead Generation Consulting is used by clients to improve brand value, increase conversions, target specific markets and dramatically enhance search engine optimization. It provides business to business marketing and sales consulting services for corporations, government agencies and associations worldwide. With the business to business marketing and sales consulting by the lead generation expert, Jade Scrivener, business can improve its profitability and gain an edge in today?s competitive market. Here are some of the advantages that Lead Generation Consulting can bring forth to a business:
? Reach qualified prospects and consistently win over competition using the latest marketins strategies
? Translate more inquiries and sales lead to sales through effective strategies and tactics
? Enhance the advertising effectiveness and liability
? Intensely improve the company?s image in the market place
? Produce more profit for the company
Client projects are handled by Jade Scrivener himself with the help of his experienced team of associates. He works side by side with the client to set marketing and sales goals within a fixed budget. Jade Scrivener not only assist companies to meet their sales and profit goals but also exceed their target and deliver higher revenues in competitive market through the implementation of strategic plans and developing better customer relationships.
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Here?s My Latest Book with a collection of all my pet articles with some added personal stories. Please buy one as I am in great need of income right now.?
The Pets We Love
From Australian Shepherds, Retrievers, Huskies, Dachshunds, Pomeranians, and American Southern Shepherds, to Russian Blues, Siamese, Manx, and Maine Coons, from Bunny Rabbits, Doves, and Chickens to Goldfish, Geckos, and Gerbils, The Pets we Love covers the basics of many of our favorite pets and then some. The pets we Love includes inspirational stories and thoughts of the Author, Kimberly M. Hartfield, and a few Biblical Scriptures related to the wonderful works of God and God?s wonderful Creation. It also includes instructions for making a mini log cabin for your pets, if you really want to get creative. It?s not just a book about animals, but it?s about The Pets we Love and how they love us back unconditionally as God loves us.
One blogger likes this post.
I am a mother of eight wonderful children and two new granddaughters, who I am very proud of. I am also a bi-vocational ordained evangelical minister, and a Christian Counselor. I received my B.S. degree in 2004, studying primarily in the areas of Psychology, with minors in Religion and English. I received my Masters Degree in 2009 in Psychological Counseling with an emphasis in Christian Counseling. My ministry is geared toward victims of sexual and domestic violence, including victims of childhood sexual abuse, whether currently or in the past. Since I have personally experienced the healing hand of God in overcoming many of the life issues that Christians may face, I feel qualified and compelled to discuss them in a truthful and open manner, as God?s word tells us that ?We shall know the truth and the truth shall set us free.? God has brought me through such diverse tribulations as sexual, physical, and mental abuse, being a victim of a drunk driving accident, spousal pornography addiction, adultery, divorce, remarriage, a very brief, though unjust, incarceration, and having experienced multiple miscarriages and various other trials. I have been asked to leave two Southern Baptist Churches, due to my being a female, ordained as a minister, and fired from a SBC sponsored Christian School (mostly white) for speaking out against racial prejudice in the Family of God. Through God?s merciful forgiveness of my own sins and inadequacies and God?s grace given to me to forgive those who have been a stumbling block to me, I have overcome many of these adversities. God?s word tells us that ?All things work together for good to those who love the Lord and are called according to the purposes of God." Since I have this hope, I believe that God has blessed me with the ability to confront and relate these issues to the Christian community, and that I have been called to the homeland mission field of North America. I hope to be able to use my personal experiences as a ministry of God?s grace and in the comforting of the people of God with the truth of God's mercy. I claim II Corinthians 1: 3 & 4 as my calling, which states: ?Blessed be God, the Origin of our Lord Jesus Christ, the Origin of mercies, and the God of comfort; who comforts us in all our troubles, that we may be able to comfort those who are in trouble, by the comfort we ourselves have been given by God.? As I have received the gift of God?s healing, I hope to be able to bring the peace beyond understanding to others with the message of God?s mercy and grace. My love for the Sovereign Lord of my life, Jesus Christ, along with my passion for writing has drawn me to explore these commonly experienced crisis issues from the perspective of my own experience in the hope that I may bring an empathetic and compassionate insight to God?s people. The views expressed in my writings are strictly my own insights, acquired from personal experience and diligent study of the related topics and God?s word concerning them. Though I am an ordained minister, my views should not be considered authoritative. I believe that the Christian community?s ultimate authority is the guidance of the human heart by the Holy Spirit and the Word of God. KNOW ALL MEN BY THESE PRESENTS - - that Saint Luke Evangelical Christian Ministries accepts Kimberly Marie Hartfield having demonstrated by actions and by statement of faith a love for Our Lord Jesus Christ and His Word, into the world-wide ministry of Saint Luke Evangelical Christian Ministries. ON OATH I, Rev. Dr. David M. Ford, on behalf of this ministry and all its members, do hereby select, appoint, and anoint you, Kimberly Marie Hartfield, a legally ordained independent minister of Saint Luke Evangelical Christian Ministries, and authorize you to perform all standard Christian religious services including the rites of marriage and baptism, on this day, November 17, 2003. Rev. Dr. David M. Ford Pastor/Administrator Saint Luke Evangelical Christian Ministries http://ficotw.org This entry was posted in Book Reviews, children, Christianity, education, Home and Garden, homeschooling, Marriage and Family, Parenting, Pets, Women in Ministry and tagged God, Dog, Pet, Australian Shepherd, Rabbit, Dachshund, Gerbils, Doves. Bookmark the permalink.mega lottery sag aftra mega mill power ball april fools pranks livan hernandez soledad o brien
[ [ [['A picture is worth a thousand words', 5]], 'http://news.yahoo.com/why-facebook-bought-instagram-4-theories-160400376.html', '[Related: Why Facebook bought Instagram: 4 theories]', ' ', '630', ' ', ' ', ], [ [['He was in shock and still strapped to his seat', 9]], 'http://contributor.yahoo.com/join/yahoonews_virginiabeach', '[Did you witness the jet crash? Share your story with Yahoo! News]', ' ', '630', ' ', ' ', ], [ [['A JetBlue flight from New York to Las Vegas', 3]], 'http://yhoo.it/GV9zpj', '[Related: View photos of the JetBlue plane in Amarillo]', ' ', '630', ' ', ' ', ], [ [['Afghan security forces and police killed three', 3]], 'http://yhoo.it/H9BcJE', '[Related: Bales\' wife on his alleged shooting: \'He would not do that\']', ' ', '630', ' ', ' ', ], [ [['the 28-year-old neighborhood watchman who shot and killed', 15]], 'http://news.yahoo.com/photos/white-house-stays-out-of-teen-s-killing-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/cv/ip/ap/default/120411/martinzimmermen.jpg', '630', ' ', 'AP', ], [ [['Titanic', 7]], 'http://news.yahoo.com/titanic-anniversary/', ' ', 'http://l.yimg.com/a/p/us/news/editorial/b/4e/b4e5ad9f00b5dfeeec2226d53e173569.jpeg', '550', ' ', ' ', ], [ [['He was in shock and still strapped to his seat', 6]], 'http://news.yahoo.com/photos/navy-jet-crashes-in-virginia-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/cv/ip/ap/default/120406/jet_ap.jpg', '630', ' ', 'AP', ], [ [['This is as serious of a tornado', 7]], 'http://news.yahoo.com/photos/tornadoes-touch-down-in-texas-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/cv/ip/ap/default/120403/trucksdallas.jpg', '630', ' ', 'Reuters', ], [ [['Oikos University', 8]], 'http://news.yahoo.com/photos/deadly-oakland-university-shooting-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/cv/ip/ap/default/120402/shooting.jpg', '450', ' ', 'REUTERS/Reuters TV/KNTV/Handout', ], [ [['Few thought Santorum would make it this far', 10]], 'http://yhoo.it/I0D5eb', 'Click image to see more photos', 'http://l.yimg.com/a/p/us/news/editorial/d/94/d94312dd12151943f05633f372e64d80.jpeg', '630', ' ', 'Scott Olson/Getty Images', ], [ [['xxxxxxxxxxxx', 11]], 'http://news.yahoo.com/photos/russian-grannies-win-bid-to-sing-at-eurovision-1331223625-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/a/p/us/news/editorial/1/56/156d92f2760dcd3e75bcd649a8b85fcf.jpeg', '500', ' ', 'AP', ] ]
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Positive self-esteem is quite essential for our common well being and wellness as humans. Having optimistic self-esteem is also important for advertising any type of healing, whether physical, psychological or religious. Very poor or very low self-esteem alternatively may be very detrimental to our well-being and even our quite existence. Negative self-esteem can produce anxiety, stress, loneliness, despair, issues with relationships, seriously impair educational and occupation efficiency as well as can create an improved vulnerability to drug and alcohol abuse and dependency. On the other hand, an individual with good self-esteem tends to become more encouraged in using on and producing an existence that he loves, residing it powerfully and in this approach be authentically associated to other people in his community. Having constructive self-esteem appears to become necessary for getting a happy and wholesome existence regardless of who we are or what occupation we are getting on in existence.
What exactly is self-esteem We typically believe that self-esteem is merely about how we really feel about ourselves at any specific moment. Although seemingly current in degrees, we have a tendency to believe that weve constructive or unfavorable self-esteem and that we make that determination merely by how we feel about ourselves. Nevertheless, within a conversation of Transformational Counseling, our emotions or emotions do not exist alone or have an impartial existence. We dont just basically feel. Instead, for every single experience or emotion that we have, either constructive or unfavorable, there is certainly a corresponding thought that we have about ourselves that generates the experience of self-esteem. No matter whether positive or negative, self-esteem is just how our organism experiences the thoughts the person has about himself or herself. If an individual has good ideas about himself hell expertise constructive or great self-esteem. On the other hand, in the event the individual has unfavorable ideas about who he thinks hes then hell experience very poor or negative self-esteem. For that reason, to genuinely realize what self-esteem is about and a lot more importantly to become in a position to alter it when essential for kinds wellness or healing, we must initial get it that self-esteem is really about our thinking, and a lot more specifically regarding the thoughts that we develop or generate about ourselves. The thoughts or beliefs that weve about ourselves are vital in which they establish or produce the construction of our experience of self-esteem and the a variety of emotions connected with it.
We also are likely to think of our self-esteem as getting something which is formed by the events that get place in our existence, particularly people from our previous. We are likely to think that who we think we are and the way we really feel about ourselves is simply the item, impact or due to the activities that we have had previously, that we are who were by virtue of what has happened to us as people. Far more specifically, we are likely to assume that the cause inside the matter of who we feel were and our self-esteem is due to circumstance, situation or other people, men and women, locations and factors. We do not are likely to believe that our self-esteem is a thing we actually created or created. Inside the function of transformation, it is not the past, circumstance, scenario or others, that decides our fundamental self-image and corresponding self-esteem. We created our thoughts and with it our emotions from the which means that we gave for the occasions that took location in our life, specifically at an early age. As which means creating machines we give meaning to everything inside our life such as and many importantly to ourselves. At an early age the meaning that we give an event tends to become created out to be all about us. While events do take place its not the activities which might be essential but rather the which means that we give them and especially how we created it out to be about our identification.
Given the fact that our ideas establish our feelings or feelings and similarly essential that were really accountable for their creation, to alter or transform our self-esteem, how we tend to really feel about ourselves, amounts to us altering how we see or conceive of ourselves in the world inside the now and this perform is our duty on your own. It truly is our self-image, how we define ourselves as an individual on the planet within the existing, that determines our knowledge of self-esteem and its this that were really responsible for generating and equally accountable for transforming. Once we alter or remodel our definition of ourselves in the current we change how we really feel about ourselves and with it our experience of fact and life generally. If we do not get it that we are responsible for what we think about ourselves and that were the actual writer of our self-image and self-esteem well continue to blame one thing or some body, remain powerless and caught in lifestyle. The question of how you can actually go about altering or enhancing an individuals self-esteem is 1 thats been debated for many many years by professionals both in the mental well being and addiction arenas.
Self-esteem may be improved or transformed in numerous techniques. A single method to increase kinds self-esteem is usually to do the work of transformation as outlined in my articles, Transformational Counseling and also the Dialogue of Transformation. To increase ones self-esteem in this manner is usually to become current to kinds self limiting belief, that that has stopped us in existence and within the method develop new prospects for oneself, a new self-image from which to begin to live life into. An additional method to boost an individuals self-esteem is by way of using good affirmations. Given that the basis of self-esteem could be the ideas that an individual has about himself, a person with bad or unfavorable self-esteem is believing unfavorable thoughts or suggestions about who he thinks hes. The person may feel, for example, that he is ?worthless? or ?not excellent enough? and as a result will often expertise very poor or unfavorable self-esteem. Within the perform of transformation and Transformational Counseling, the believed that is certainly in the basis or core of our self-talk is defined as being a persons Self Limiting Belief, the basic or core belief about who we feel were. Unless this core believed or belief that an individual has about himself is altered or transformed he will carry on to experience a poor or negative self-esteem and as a result of this unfavorable believed routine generate or generate existence encounters that may match and validate what they feel about by themselves. Provided this kind of a cognitive and emotional circumstance existence will carry on to appear as it has previously and kinds future will just be the possible almost certain long term.
Utilizing good affirmations could be a very powerful instrument for reworking what a person thinks about himself and because of this enhance the individuals self-esteem. Constant use of optimistic affirmations will transform the unfavorable beliefs about who a person thinks hes into constructive ones, will begin to alter the basis and construction of his self speak or inner voice and produce a transformation from very poor self-esteem to constructive self-esteem. Even though used in a numerous ways, working with good affirmations will likely be a lot more effective when delivered through or mixed with therapeutic relaxation new music. What therapeutic rest music does to improve the impact of optimistic affirmations is to create a very comfortable audio atmosphere for that person to become much more open or suggestive to the language of optimistic affirmations. When therapeutic relaxation audio is combined with binaural audio tones the sound room thats developed to the delivery of constructive affirmations is much more calming and because of this very potent. In addition to utilizing an exclusive kind of therapeutic relaxation songs, the infusion of either theta or alpha binaural tones is vital for that achievement of this sort of intervention. When therapeutic relaxation music and binaural sound tones are mixed within this fashion the personal will expertise an extremely deep state of relaxation and because of this be more open up towards the reception and eventual acceptance in the constructive affirmations.
The important towards the effective usage of positive affirmation within this or any other form of intervention is consistency. The self-image and also the negative thoughts about who a person thinks he is the fact that generates his expertise of inadequate or unfavorable self-esteem is well established within the his perception method. In several circumstances the development of a negative self-image took a long time to create and possesses been reinforced through repetitive behavioral validation. As soon as a person produces and then believes that a self-limiting belief is correct he will constantly act as if it really is correct. This seemingly basic perception will seem for the individual as true and as a result will constantly be acted on and thus be reinforced through ones behavior. Considerably of that persons behavior will probably be to regularly validate who he thinks he is. Ones habits will usually be directed at supporting, reinforcing and validating what the individual believes is correct about him. Although required for types well-being and health, such a transformation of ones self-image from being essentially an unfavorable one particular to one particular which is fundamentally constructive does not take place immediately. As using the improvement of an individuals unfavorable self-image, the improvement of the more adequate opinion concerning the true naturel of the individual will necessitate constant and repetitive function from the person. Fundamental to this approach is that the personal need to completely embrace his sensation of complete duty for the development of his self-image as well as for its transformation. To do or else will only abandon the individual experience powerless and unable to make the lifestyle that he or she truly wishes and unless there is consistency and repetition such a transformation will simply not take place.
Boosting My Self worth is definitely an audio product that can properly remodel the really construction of an individuals believed or notion pattern, the fundamental suggestions and language construction that he utilizes to define who he thinks hes on the planet. This product was developed specifically to change the self-talk that a person activities on a daily basis by altering the concepts or beliefs that the person has about himself, the extremely groundwork or backdrop of his internal dialogue. As our identification is just language, alter the language inside a persons mind and his daily life transforms. By listening to this product a person has the opportunity to practice or repeat fifty positive affirmations which will empower them to alter their lifestyle. Inside a conversation of Transformational Counseling, committing an affirmation to spoken word makes it so or actual specially if it truly is carried out frequently. Listening to positive affirmations before rest also permits the persons thoughts to begin this restructuring or reprogramming process even while the personal sleeps by taking the phrases and language into their dream condition. By consistently listening to and training the optimistic affirmations within this product the individual will have the chance to begin to redefine their selves, who they feel theyre in the world, from a single thats negative to a single that is constructive and enhancing for their daily life. Using the acceptance in the phrases and language with the constructive affirmations will occur an improved self-image and with it an knowledge of positive self esteem.
I am currently employing Enhancing My Self esteem with all of the customers that I counsel in the Holistic Addiction Remedy Plan in North Miami Seaside, Florida. All of the clients that Ive labored with that are experiencing a drug and/or booze dependency issue also have really reduced self-esteem. My customers are likely to be very frustrated and unmotivated in numerous if not the majority of the numerous domains of their existence, including and specially with their recovery. When given to my clientele as homework, constant use of Enhancing My Self esteem alters how they think and improves how they really feel about on their own. With the enhanced self-image and enhanced self-esteem my clients grow to be much more inspired within their lifestyle and particularly with their recovery. If a person continues to knowledge reduced self-esteem and there is absolutely no intervention to disrupt the underlying cognitive procedure taking on improving their life and working the 12 Stage Plan will probably be meaningless and ultimately offered up entirely as numerous other issues happen to be previously. It truly is my belief that not altering or transforming the fundamental construction of kinds self-image accounts for the excellent percentage of men and women who begin recovery and ultimately relapse. The operate that is essential to profitable recovery is for your person to become in a position to redefine who he thinks hes, to alter his self-image, the extremely basis of his experience of self-esteem and existence. Who the individual believes hes will decide what he does and just how he will likely be in and appear to others and the planet.
Harry Henshaw, Ed.D., LMHC
enhancedhealing
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Martin Mejia / AP
An unidentified miner, left, is helped by an emergency worker after being rescued from the Cabeza de Negro gold-and-copper mine in Yauca del Rosario, Peru, on Wednesday. They had been trapped there since April 6.
By msnbc.com news services
ICA, Peru --?Nine workers trapped inside an abandoned mine in southern Peru were rescued and brought to daylight early Wednesday after spending almost a week underground.
The men had been stuck about 656 feet below ground since the so-called "wildcat" copper-and-gold mine partially collapsed on Thursday. They had been receiving oxygen and liquids through a giant hose that was in place before the accident at the Cabeza de Negro site.
"All of them are healthy but obviously dehydrated and dizzy," President Ollanta Humala said. "They need to get used to the sun still, that's why they are wearing sunglasses."
Miner Jesus Japatinta said he was overwhelmed after walking out alive.
"I spilled tears, happy tears," he said.
Humala, who witnessed the rescue operation, warned informal miners to stay away from abandoned mines like Cabeza de Negro, saying they were dangerous.
PhotoBlog: Peruvian miners rescued
The mine?is located 4,400 feet above sea level on?a mountainside about 175 miles southeast of Lima.
On Sunday, Peru's government appealed to mining companies for heavy equipment. Until then, several dozen rescue workers had used pickaxes and shovels to try to remove the 26 feet of collapsed earth and rock blocking the entrance of the mine.
The cave-in spurred calls to formalize Peru's vast informal mining sector, which generates as much as $2 billion a year in income, according to private estimates.
Mining is the main engine of Peru's economy, accounting for more than 60 percent of its exports. It is the world's No. 2 copper exporter after neighboring Chile and ranks sixth in gold exports.
According to official figures, 52 miners died in Peru last year in work-related accidents, a third of them in mine shaft collapses.
Reuters and The Associated Press contibuted to this report.
More from msnbc.com and NBC News:
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Contact: Jessica Studeny
jessica.studeny@case.edu
216-368-4692
Case Western Reserve University
A national consortium of researchers has published new findings that could change the standard of practice for those treating Fuchs' Endothelial Corneal Dystrophy (FECD), a disease characterized by cornea swelling that can eventually lead to the need for corneal transplantation. The Fuchs' Endothelial Corneal Dystrophy Genetics Multi-Center Study Group, led by co-principal investigators Jonathan Lass, MD, Charles I Thomas Professor and chair, Case Western Reserve University Department of Ophthalmology and Visual Sciences and director, University Hospitals Eye Institute, and Sudha Iyengar, PhD, professor, Departments of Epidemiology and Biostatistics, Genetics, and Ophthalmology, Case Western Reserve University School of Medicine, found that changes in the corneal thickness occur in patients at early stages of FECD even before swelling is observed in the clinical setting. Their study is published in the journal Archives of Ophthalmology.
This new evidence suggests that FECD patients should have the thickness of their corneas measured annually to monitor progression of the disease. The disease affects the eye's endothelial cells or the back cell layer of the cornea, which maintains the cornea's normal thickness. However, as the disease advances, it was believed at its earlier stages the cornea remained clear and its thickness did not change. This study shows that the cornea in fact experiences a gradual swelling and becomes progressively thicker. Patients typically see an ophthalmologist only when the swelling becomes critical and the surface becomes swollen and the vision blurs. This study suggests ophthalmologists use ultrasonic technology to measure the potential progressive thickening of the cornea to assist in counseling patients on early surgical intervention before scarring develops and interferes with visual recovery.
"It's important if you have the disease, to be checked regularly and have your thickness measured. In the short term, if your vision is decreasing, an ophthalmologist can determine whether it is coming from your cornea or a concurrent cataract and that would assist a surgeon in intervening earlier with either cataract surgery, corneal transplantation, or continuing monitoring of the disease's progression," says Dr. Lass. "In the long term, it might be a way of determining drug intervention based on an individual's gene set, which may be causing the disease."
FECD is the most common reason for corneal transplantation in the United States. The disease usually becomes apparent on examination at its earlier stages in the 40s and 50s with visual impairment developing in the 60s and 70s. In addition, while the disease is more common in women than men and does have some familial heredity, it does occur sporadically. The study group is working to identify the genes that cause the disease.
"These findings have the potential to improve patient care for Fuchs corneal dystrophy, an often painful eye disease that can be difficult to manage," says Hemin Chin, PhD, National Eye Institute, program director for the study. "Clinicians now have an important tool to better monitor the disease and determine when surgical intervention is warranted, particularly for cataracts."
###
This study was conducted at more than 30 sites across the country and was led by co-PIs Drs. Iyengar and Lass. It was funded by the National Eye Institute, Research to Prevent Blindness, and the Ohio Lions Eye Research Foundation.
About Case Western Reserve University School of Medicine
Founded in 1843, Case Western Reserve University School of Medicine is the largest medical research institution in Ohio and is among the nation's top medical schools for research funding from the National Institutes of Health. The School of Medicine is recognized throughout the international medical community for outstanding achievements in teaching. The School's innovative and pioneering Western Reserve2 curriculum interweaves four themes--research and scholarship, clinical mastery, leadership, and civic professionalism--to prepare students for the practice of evidence-based medicine in the rapidly changing health care environment of the 21st century. Nine Nobel Laureates have been affiliated with the school of medicine.
Annually, the School of Medicine trains more than 800 MD and MD/PhD students and ranks in the top 25 among U.S. research-oriented medical schools as designated by U.S. News & World Report "Guide to Graduate Education."
The School of Medicine's primary affiliate is University Hospitals Case Medical Center and is additionally affiliated with MetroHealth Medical Center, the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, and the Cleveland Clinic, with which it established the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in 2002. http://casemed.case.edu.
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Contact: Jessica Studeny
jessica.studeny@case.edu
216-368-4692
Case Western Reserve University
A national consortium of researchers has published new findings that could change the standard of practice for those treating Fuchs' Endothelial Corneal Dystrophy (FECD), a disease characterized by cornea swelling that can eventually lead to the need for corneal transplantation. The Fuchs' Endothelial Corneal Dystrophy Genetics Multi-Center Study Group, led by co-principal investigators Jonathan Lass, MD, Charles I Thomas Professor and chair, Case Western Reserve University Department of Ophthalmology and Visual Sciences and director, University Hospitals Eye Institute, and Sudha Iyengar, PhD, professor, Departments of Epidemiology and Biostatistics, Genetics, and Ophthalmology, Case Western Reserve University School of Medicine, found that changes in the corneal thickness occur in patients at early stages of FECD even before swelling is observed in the clinical setting. Their study is published in the journal Archives of Ophthalmology.
This new evidence suggests that FECD patients should have the thickness of their corneas measured annually to monitor progression of the disease. The disease affects the eye's endothelial cells or the back cell layer of the cornea, which maintains the cornea's normal thickness. However, as the disease advances, it was believed at its earlier stages the cornea remained clear and its thickness did not change. This study shows that the cornea in fact experiences a gradual swelling and becomes progressively thicker. Patients typically see an ophthalmologist only when the swelling becomes critical and the surface becomes swollen and the vision blurs. This study suggests ophthalmologists use ultrasonic technology to measure the potential progressive thickening of the cornea to assist in counseling patients on early surgical intervention before scarring develops and interferes with visual recovery.
"It's important if you have the disease, to be checked regularly and have your thickness measured. In the short term, if your vision is decreasing, an ophthalmologist can determine whether it is coming from your cornea or a concurrent cataract and that would assist a surgeon in intervening earlier with either cataract surgery, corneal transplantation, or continuing monitoring of the disease's progression," says Dr. Lass. "In the long term, it might be a way of determining drug intervention based on an individual's gene set, which may be causing the disease."
FECD is the most common reason for corneal transplantation in the United States. The disease usually becomes apparent on examination at its earlier stages in the 40s and 50s with visual impairment developing in the 60s and 70s. In addition, while the disease is more common in women than men and does have some familial heredity, it does occur sporadically. The study group is working to identify the genes that cause the disease.
"These findings have the potential to improve patient care for Fuchs corneal dystrophy, an often painful eye disease that can be difficult to manage," says Hemin Chin, PhD, National Eye Institute, program director for the study. "Clinicians now have an important tool to better monitor the disease and determine when surgical intervention is warranted, particularly for cataracts."
###
This study was conducted at more than 30 sites across the country and was led by co-PIs Drs. Iyengar and Lass. It was funded by the National Eye Institute, Research to Prevent Blindness, and the Ohio Lions Eye Research Foundation.
About Case Western Reserve University School of Medicine
Founded in 1843, Case Western Reserve University School of Medicine is the largest medical research institution in Ohio and is among the nation's top medical schools for research funding from the National Institutes of Health. The School of Medicine is recognized throughout the international medical community for outstanding achievements in teaching. The School's innovative and pioneering Western Reserve2 curriculum interweaves four themes--research and scholarship, clinical mastery, leadership, and civic professionalism--to prepare students for the practice of evidence-based medicine in the rapidly changing health care environment of the 21st century. Nine Nobel Laureates have been affiliated with the school of medicine.
Annually, the School of Medicine trains more than 800 MD and MD/PhD students and ranks in the top 25 among U.S. research-oriented medical schools as designated by U.S. News & World Report "Guide to Graduate Education."
The School of Medicine's primary affiliate is University Hospitals Case Medical Center and is additionally affiliated with MetroHealth Medical Center, the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, and the Cleveland Clinic, with which it established the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in 2002. http://casemed.case.edu.
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
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