Tuesday, January 31, 2012

TARGET Discovery Series - Discover How to Support Veterans in the Workplace

Get information about resources and tools available to help you to support and keep Veterans living with post-traumatic stress disorder and traumatic brain injury in the federal workforce. Special guest expert Lisa Stern from the National Resource Directory gives an overview of transitioning injured Service Members as they re-enter the workforce. This is an Adobe video presentation with slides.

URL: https://connectpro36216355.adobeconnect.com/_a774694537/p15ie85t1tb/?launcher=false&fcsContent=true&pbMode=normal

DOT Fines Spirit Airlines over Handling of Disability Complaints

The U.S. Department of Transportation (DOT) fined Spirit Airlines $100,000 for failing to appropriately record and respond to complaints about the carrier's treatment of passengers with disabilities. This action violates the [Air Carrier Access Act][1], which prohibits air travel discrimination on the basis of disability. Under DOT's rules, airlines must sort disability-related complaints into categories based on the type of disability and nature of the complaint, and submit an annual report to DOT on disability complaints received the previous year.

[1]: http://airconsumer.ost.dot.gov/ACAAcomplaint.htm

URL: http://www.dot.gov/affairs/2012/dot1412.html

Emergency Access Advisory Committee (EAAC) Meeting - February 10

The Federal Communications Commission will hold the next EAAC meeting on **February 10, 2012** from 10:30 a.m. - 3:30 p.m. Eastern Time in Washington, DC. The EAAC decides on the most effective and efficient technologies and ways to give individuals with disabilities access to [Next Generation 911][1] emergency services. The meeting will review 2011 achievements and consider plans for 2012 activities. The Committee recently released a [report][2] containing recommendations. This link opens a PDF document. This information is also in [text][3] format.

[1]: http://www.its.dot.gov/ng911/index.htm
[2]: http://transition.fcc.gov/Daily_Releases/Daily_Business/2012/db0126/DOC-312161A1.pdf
[3]: http://hraunfoss.fcc.gov/edocs_public/attachmatch/DA-12-93A1.txt

URL: http://hraunfoss.fcc.gov/edocs_public/attachmatch/DA-12-93A1.pdf

Funding Opportunity: Effective Communication Before, During & After Emergencies - Pre-Application Deadline February 8

The National Council on Disability (NCD) is funding a research study on evaluating communication for Americans with disabilities before, during and after emergencies. The research must cover effective communication throughout all phases of emergency management (preparedness, response, recovery and mitigation) and be fully accessible to all people with disabilities. It should cover cross-disability and must include what is occurring in emergency management on the national and state level. The NCD will be distributing a Notice of Funding Opportunity to those interested on **February 8, 2012**. Responses are due **March 7, 2012**.

URL: http://www.ncd.gov/newsroom/research/Effective_Communication_Pre-solicitation_Notice

Early Retirement Due to Bad Back Problems

People who retire early due to back problems face long-term financial disadvantage.

URL: http://www.disabled-world.com/disability/types/spinal/backpain/bad-back.php

Chronic Pain - A New Understanding

Scripps Research scientists provide new understanding of chronic pain - Findings suggest new target for drug development.

URL: http://www.disabled-world.com/health/pain/metabolomics.php

Monday, January 30, 2012

Probiotics, Multiple Sclerosis, and Immune System Disorders: Caution

_** This is an update on our previous post**_ "[Are Probiotics Gut Bacteria Good or Bad For Multiple Sclerosis Or Other Autoimmune Diseases?"][1]  [1] which sounded a note of caution about the blind  use or shotgun approach, of probiotics against autoimmune diseases. Probiotics are helping the beneficial bacteria in your gut.  That post was published on Oct 30, 2011. We followed up with an update on the tussle between the FDA and the food industry on the topic of "new ingredients" and probiotics [2]

What prompted this update was the post in NutraIngredients [3] about a warning by Dr Pieter Cohen that the New Dietary Ingredients (NDI) draft does not go far enough in insuring the public that the are safe and true to claim. Although Dr Cohen's article is about supplements in general, probiotics bacteria are seen as a subset of the "supplements" [4]

So the controversy about the benefits or risks of the use of probiotics, particularly in a subset of the population at risk for autoimmmune disease like MS, is still in full bloom.

_**Consider the alarms raised in [1] and [5,6]**_: Essentially,  studies have shown that the combination of what is called "commensal bacteria" and some of the immune system's policing bodies (T-Cells, etc) can delivers a one, two punch to the normal balance of the immune system and throws it in to a self destructive attack on the myelin, i.e. Multiple Sclerosis.

_**Note:**_ _Commensal bacteria are bacteria that live in your gut without normally bothering you…._

Clear? Well, no. Because, previous studies attributed a positive, healing role to the probiotic  bacteria! See [7-8]. Quoting from [8]'s link :

"…We tested the potential of various strains of lactobacilli for suppression of experimental autoimmune encephalomyelitis (EAE), an animal model of MS..Our findings indicate a therapeutic potential of oral administration of a combination of probiotics."  OK, so it is only on a an animal model, but still…

What gives?

The culprit is the probably the confusing shotgun approach, where all probiotics are assumed to work in unison to the same beneficial, nay, therapeutic, goal.

The "bad" commensal bacteria of study [1] is not well identified , quoting the Max Planck Institute : '.._Precisely which bacteria are involved in the emergence of multiple sclerosis remains unclear. Possible candidates are clostridiums_, which can have direct contact with the intestinal wall…" Another study published in the National academy of Science [6] showed that _Segmented Filament Bacteria_, would also be implicated in triggering Experimental Autoimmune Encephalomyelitis (EAE) in mice. EAE is an MS like disease used as a research model.

On the other hand , the "good" bacteria of study [8] is "a mixture of the three lactobacilli strains".

A Dutch study on the effects of probiotics on EAE [8] confirms this approach "…We suggest that conclusions on probiotics are limited to specific strains and models and not generalised…".

Keep also in mind that the industry's record on precise identification of which bacteria are in the probiotic product has been shown to be less than perfect by a study [9] published in the international journal of food microbiology.Quoting [9]

"…Five products were mislabelled with respect to the numbers and three with respect to species of lactobacilli. In four cases, the specified strains were not detected. Four fermented milks sold under three trademarks contained the same strain, which was named differently on each label. As safety and functionality of probiotics are strain dependent, these results demonstrated the need to control lactobacilli present in commercially probiotic human food products, not only at the species but also at the strain level, to ensure their quality and protect the consumer…"

Another study published in Gut Microbes [11] presents a list of substantial risks of using probiotics with scant known properties:

* Infectivity or in situ toxin production.
* Genetic stability of the probiotic over time,
* Deleterious metabolic activities,
* Potential for pathogenicity or toxicogenicity
* _**Immunological effects must be considered, especially in certain vulnerable populations**_
* All of the above "..must be assessed depending on the characteristics of the genus and species of the microbe being used…"

Keep in mind that probiotics recommendation for Multiple Sclerosis food supplementation are already out, and not just in "far out" blogs, but posted on the respectable _University of Maryland Complementary Medicine site_ [12].

Quoting the U. Of Maryland : "…Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health…"

They were probably relying on the Swedish work we mentioned in [8]. The only problem is that if you dig more into [8], you find that they used a cocktail of three specific strains of Lactobacillus: L. paracasei DSM 13434, L. plantarum DSM 15312 and DSM 15313. Even more the study alaso showed that: "…_**each monostrain probiotic failed to be therapeutic**_ in diseased mice, _**while a mixture of the three lactobacilli strains suppressed the progression and reversed the clinical and histological signs of EAE.**_.."

Leaving the MS issue, but staying  in the immune system impact of probiotics,_** some studies have targetted the use of probiotics to alleviate allergies**_ [13]. Here to the conclusion is that "…the probiotic performance of strains differs; each probiotic strain is a unique organism itself with specific properties that cannot be extrapolated from other, even closely related, strains…"

So much for broad, simple, advice?

Coming back to the consumption of probiotics and their effect on commensal bacteria,_** the assumption that all commensal bacteria are good for all individuals without regards to the genetic make up and disease susceptibilities of the consumer is probably too simplistic**_. Then again how far does the consumer self knowledge have to go so that he can buy of the shelf shotgun probiotics without anxiety?

_**A start to this answer is that consumer has to back the FDA in their insistence for a pedigree of the species an strain of the probiotics on the open market. **_

_Of course this is an expensive proposition and the food industry vehemently opposes it…..**

_I am not usually a fan of stifling regulation and red tape, but here, a cautionary slowing down of putting probiotic bacteria on the market might be in order._


What do we know about probiotics live cultures?

1. [MediNewsDigest ][1]; "Are Probiotics Gut Bacteria Good or Bad For Multiple Sclerosis Or Other Autoimmune Diseases?"; Oct 30, 2011
2. [MediNewsDigest][4] ; "Food industry and the FDA are involved in a tussle over the safety of new probiotic bacteria" ; Dec 17, 2011
3. [NutraIngredients][5] ; "Harvard Professor: NDI draft guidance does not go far enough" ; Jan 27, 2012
4. [New England Journal Of Medicine's Perspectives][6] ; "Assessing Supplement Safety — The FDA's Controversial Proposal
5. [ ScienceNews][7] ; "Gut bacteria linked to MS " ; Dec 3rd, 2011
6. [Proceeding of the National Academy of Science USA][8] ; "Proinflammatory T-cell responses to gut microbiota promote experimental autoimmune encephalomyelitis." March 15 2011
7.  [MediNewsDigest][9] ; "Multiple Sclerosis: Unusual Probiotics Alternative Therapy" ; April 15, 2011
8.  [MediNewsDigest][10] ; "Study Shows Probiotics Show Promise Against Multiple Sclerosis" ; Oct 5, 2010
9. [Vaccine ][11]; "Strain-dependent effects of probiotic lactobacilli on EAE autoimmunity." ; April 16, 2008
10.  [International Journal of Food Microbiology ][12]; "Numbers and strains of lactobacilli in some probiotic products." ; Dec 15, 2004
11. [ Gut Microbes][13] ; "Safety assessment of probiotics for human use" ; May-June 2010
12. [Univ. Maryland Medical Center ][14]; Complementary Medicine : Multiple Sclerosis
13. [ Journal of Clinical Gastroenterology][15] ; "Probiotics: use in allergic disorders: a Nutrition, Allergy, Mucosal Immunology, and Intestinal Microbiota (NAMI) Research Group Report. " ; July 2008


[1]: http://www.medinewsdigest.com/?p=3074
[2]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Greek_Yoghurts-e1327821676491.png (Greek_Yoghurts)
[3]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Greek_Yoghurts.png
[4]: http://www.medinewsdigest.com/?p=3306
[5]: http://www.nutraingredients-usa.com/Regulation/Harvard-professor-NDI-draft-guidance-doesn-t-go-far-enough
[6]: http://www.nejm.org/doi/full/10.1056/NEJMp1113325
[7]: http://www.sciencenews.org/view/generic/id/335561/title/Gut_bacteria_linked_to_MS
[8]: http://www.ncbi.nlm.nih.gov/pubmed/20660719
[9]: http://www.medinewsdigest.com/?p=2343
[10]: http://www.medinewsdigest.com/?p=886
[11]: http://www.ncbi.nlm.nih.gov/pubmed/18378048
[12]: http://www.ncbi.nlm.nih.gov/pubmed/15541801
[13]: http://www.ncbi.nlm.nih.gov/pubmed/21327023
[14]: http://www.umm.edu/altmed/articles/multiple-sclerosis-000111.htm
[15]: http://www.ncbi.nlm.nih.gov/pubmed/18542035
[16]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/email.png
[17]: http://www.addtoany.com/add_to/email?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3715&linkname=Probiotics%2C%20Multiple%20Sclerosis%2C%20and%20Immune%20System%20Disorders%3A%20Caution (Email)
[18]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/twitter.png
[19]: http://www.addtoany.com/add_to/twitter?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3715&linkname=Probiotics%2C%20Multiple%20Sclerosis%2C%20and%20Immune%20System%20Disorders%3A%20Caution (Twitter)
[20]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/linkedin.png
[21]: http://www.addtoany.com/add_to/linkedin?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3715&linkname=Probiotics%2C%20Multiple%20Sclerosis%2C%20and%20Immune%20System%20Disorders%3A%20Caution (LinkedIn)
[22]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/facebook.png
[23]: http://www.addtoany.com/add_to/facebook?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3715&linkname=Probiotics%2C%20Multiple%20Sclerosis%2C%20and%20Immune%20System%20Disorders%3A%20Caution (Facebook)
[24]: http://www.addtoany.com/share_save#url=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3715&title=Probiotics%2C%20Multiple%20Sclerosis%2C%20and%20Immune%20System%20Disorders%3A%20Caution

URL: http://www.medinewsdigest.com/?p=3715

Halos and Starbursts After LASIK Eye Surgery

How Long Do Starbursts and Halos Last After LASIK Surgery?

URL: http://www.disabled-world.com/disability/types/vision/starbursts.php

Sunday, January 29, 2012

[RA & Humor] Things you can use Biofreeze for but probably shouldn’t..

Things  you can use Biofreeze for but probably shouldn't…. by Niki Wyre  If you have followed our group on Facebook or are a regular visitor on our blogs, here at rachicks.com, you've probably heard us mention Biofreeze a time or two or a thousand times.  While Biofreeze [...]

URL: http://rachicks.com/ra-humor-things-you-can-use-biofreeze-for-but-probably-shouldnt/

Saturday, January 28, 2012

ADA Amendments Act - Department of Education

Department of Education Issues ADA Amendments Act Dear Colleague Letter to Provide Guidance Under Amended Legal Standards - The Department of Education's Office for Civil Rights has issued a Dear Colleague letter concerning the Americans with Disabilities Act Amendments Act.

URL: http://www.disabled-world.com/disability/ada/amendments-act.php

2012 Cost of Living Adjustment for Veterans and Beneficiaries

Veterans, their families, and survivors receiving benefits from the Department of Veterans Affairs saw a 3.6 percent increase in their compensation and pension benefits beginning January 1.

URL: http://www.disabled-world.com/news/america/adustment.php

Friday, January 27, 2012

National ADA Symposium - March 12 - 14 & May 30 - June 1

Two symposiums will be held on changes in the updated 2010 Americans with Disabilities Act (ADA) Standards for Accessible Design and Title II Regulations, along with the [ADA Amendments Act][1]. Learn about the newest standards and regulations and how these changes affect businesses, local governments and employers. The Orlando, FL session will be held **March 12 - 14, 2012**. Check the [**schedule**][2] and [**register**][3] online. The Indianapolis, IN symposium will be **May 30 - June 1, 2012**. Check the [**schedule**][4] and [**register**][5] online.

[1]: http://www.ada.gov/pubs/ada.htm
[2]: http://www.adasymposium.org/OrlandoSchedule.html
[3]: http://www.regonline.com/Register/Checkin.aspx?EventID=1035466
[4]: http://www.adasymposium.org/IndianapolisSchedule.html
[5]: http://www.regonline.com/Register/Checkin.aspx?EventID=1036929

URL: http://www.adasymposium.org/

National Report Finds One-in-Five Americans Had Mental Illness in 2010

This [report][1] shows that 45.9 million American adults aged 18 or older experienced mental illness in 2010. The rate of mental illness was more than twice as high among those aged 18 to 25 than among those aged 50 and older. Adult women were also more likely than men to have experienced mental illness. Mental illness among adults aged 18 or older is defined as having had a diagnosable mental, behavioral or emotional disorder.

[1]: http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/

URL: http://www.samhsa.gov/newsroom/advisories/1201185326.aspx

National Council on Disability to Meet on February 1

Members of the National Council on Disability (NCD) will meet by phone on **February 1, 2012** from 3 - 4:00 p.m. Eastern Time to discuss disability forums. Interested parties may join the meeting at the NCD office in Washington, DC or join the call in a listening-only capacity by calling **1-888-466-4440**.

URL: http://www.ncd.gov/events

Secretary of Labor & OPM Director Provide Guidance to Federal Agencies on Increasing Federal Employment of People with Disabilities

U.S. Secretary of Labor Hilda L. Solis and the Director of the U.S. Office of Personnel Management (OPM), John Berry, have sent a letter to the heads of federal departments and agencies reminding them of their roles in implementing [Executive Order 13548, Increasing Federal Employment of Individuals with Disabilities][1]. The letter describes several tools that can be used by federal departments and agencies to recruit and hire qualified individuals with disabilities into the federal workforce. These resources include [eFedLink.org][2], the [Workforce Recruitment Program][3] and the shared list of people with disabilities hosted on the [MAX Federal Community][4].

[1]: http://www.dol.gov/odep/federal-hire/
[2]: https://efedlink.org/login/index.cfm
[3]: https://wrp.gov/AboutPre.do
[4]: https://login.max.gov/cas/login?service=https%3A%2F%2Fmax.omb.gov%2Fmaxportal%2Fj_spring_cas_security_check&ioGroupName=AGY-OPM.DISABILITIESHIRING

URL: http://www.dol.gov/odep/wrp/DOLOPM.pdf

HHS Releases More than $863 Million to Help Low-Income Households with Energy Costs

The U.S. Department of Health and Human Services (HHS) is releasing more than $863 million to grantees to help low-income households with their heating and other home energy costs under the [Low Income Home Energy Assistance Program][1] (LIHEAP). LIHEAP assists qualified families with their home energy needs such as heating in the winter and cooling in the summer. Individuals interested in applying for energy assistance should contact their [local/state LIHEAP agency][2].

[1]: http://www.acf.hhs.gov/programs/ocs/liheap/brochure/brochure.html
[2]: http://www.acf.hhs.gov/programs/ocs/liheap/grantees/grantee_contacts.html

URL: http://www.hhs.gov/news/press/2012pres/01/20120119a.html

District of Columbia to Have Reserved Parking Meters for Persons with Disabilities

The District Department of Transportation will start a new program to improve access for persons with disabilities to businesses and services in the city. Beginning in late January, the District will have reserved metered parking spaces for persons with disabilities with distinctive "red top" meters. This new program sets aside curbside parking spaces for the exclusive use by persons with disabilities and eliminates the free parking in metered spaces.

URL: http://www.dc.gov/DC/DDOT/About+DDOT/News+Room/Press+Releases/DDOT+to+Implement+Reserved+Parking+Meters+for+Persons+with+Disabilities

Sallie Mae Insurance Services for College Students

Sallie Mae Insurance Services Now Available to College Students - Families Now Have Options to Protect the Investment in Higher Education.

URL: http://www.disabled-world.com/disability/education/sallie-mae-insurance.php

Adenoviruses - Viruses that Affect Children and Adults

Adenoviruses are common and can cause illness in both children and adults. While the majority of the illnesses people experience are not serious, adenoviruses cause respiratory illness most of the time. The viruses can also cause diarrhea, fever, bladder infection, rash illness, and pink eye.

URL: http://www.disabled-world.com/health/influenza/adenoviruses.php

Thursday, January 26, 2012

DOJ Obtains Comprehensive ADA Agreement with Virginia's Developmental Disabilities System

The U.S. Department of Justice (DOJ) has reached a detailed settlement agreement that will change the [Commonwealth of Virginia's][1] system for serving people with developmental disabilities, including intellectual disabilities, and resolve violations of the [Americans with Disabilities Act][2] (ADA). The agreement expands community-based services so that Virginia can serve people with developmental disabilities in their own homes, their family's homes or other integrated community settings. Over the next 10 years, Virginia will expand community services by providing [home and community-based Medicaid waivers][3] to nearly 4,200 individuals.

[1]: http://www.dbhds.virginia.gov/Settlement.htm
[2]: http://www.ada.gov/olmstead/
[3]: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Support/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html

URL: http://www.justice.gov/opa/pr/2012/January/12-crt-111.html

EEOC Receives Record Number of Discrimination Charges

The U.S. Equal Employment Opportunity Commission (EEOC) received a record 99,947 charges of employment discrimination in Fiscal Year 2011. Charges claiming "retaliation" under all the statutes the EEOC enforces were the most numerous at 37,334 charges. Charges involving claims of race discrimination at 35,395 charges followed behind. Charges with three other most frequently-cited allegations increased, including sex discrimination, disability discrimination and age discrimination, respectively. The agency's enforcement of Americans with Disabilities Act produced the highest increase in monetary relief among all of the statutes.

URL: http://www1.eeoc.gov/eeoc/newsroom/release/1-24-12a.cfm

Viral Meningitis Facts and Information

Meningitis involves an inflammation of the membranes or, "meninges," that cover a person's spinal cord and brain. Viral infections are the most common cause of meningitis, with bacterial infections being the second most common cause. Additional and more rare causes of meningitis include parasites, fungi, and causes that are non-infectious such as ones related to drugs.

URL: http://www.disabled-world.com/health/neurology/viral-meningitis.php

Wednesday, January 25, 2012

BraunAbility Dealer Steps Up for Rehab Profiessional

[![Braun wheelchair van dealer volunteer event][1]][2]

BraunAbility Sales Manager Tim Hargis (third from left) poses with United Access volunteers Bobby Bryson, Laura Klaus and Sam Brenner.

[BraunAbility][3] dealers have incredibly close relationships with the professionals who help wheelchair users find the [mobility products][4] they deserve and the resources to purchase that equipment. A terrific example of that was shared earlier this month when the crew at United Access in Dallas helped the Texas Rehab ACTion Network organize a fundraiser for a woman named Belinda Kirkland.

Belinda had worked as a DARS (Department of Assistive and Rehabilitative Services) counselor out of Arlington, Texas for years. She worked tirelessly to help families find a way to overcome all types of disabilities and improve their quality of life. Aside from her work as a counselor, she also served as a secretary of TRAN (Texas RehabACTion Network), where she led several committees and actively worked to advance programs in the workplace for persons with disabilities.

Belinda was diagnosed with a form of t-cell cancer, and the single mother was consequently out of work for several months as she fought the aggressive disease.

Laura Klaus, a member of the [United Access ][5]team in Dallas, had never met Belinda in person, but through their work with TRAN and planning the fundraiser, Laura felt like Belinda was a friend she'd known for years. As a newcomer to the state in the last year, that friendship was especially helpful to Laura. "Belinda gave so much to me in my short seven months here in Texas," said Laura. "She guided me through DARS, brought me to TRAN, and always had such positive things to say about how to find my way here."

Laura and her team of coworkers at United Access planned a very successful fundraiser, an event called "A Benefit for Belinda - a TRAN Chili Cook-Off" held at the world-class Cowboys Stadium. Over 20 teams participated, and well over 200 tasters paid to enjoy the work of the chili chefs and participate in a silent auction. United Access also used the opportunity to train DARS counselors on mobility equipment, from new wheelchair vans to driving equipment.

In total nearly $7,000 was raised to help Belinda and her family with medical bills and the cost of living. The family and friends were incredibly grateful for all the work that went into the event, and most of all, for the showing of support for such a beloved woman.

Unfortunately, as much as all the prayers and the love from her friends and colleagues helped her spirit and her finances, they could not change the course of her disease. Belinda passed away last weekend, and the disability and rehabilitation community lost a tireless advocate and friend.

"The impact she had on so many lives is tremendous – especially for this new Texan," said Laura. "Our thoughts and prayers are with all of those who were touched by the grace of Belinda and her family."

We sincerely and deeply appreciate the work and the relationships that Belinda helped build over the course of her career. If you are interested in contributing to her fund, you can contact Laura Klaus at United Access ([lklaus@unitedaccess.com][6], 972.240.8839).

[1]: http://www.braunability.com/abilityvoice/wp-content/uploads/2012/01/Screen-shot-2012-01-24-at-4.19.30-PM-300x209.png (Screen shot 2012-01-24 at 4.19.30 PM)
[2]: http://www.braunability.com/abilityvoice/2012/01/braunability-dealer-steps-up-for-rehab-profiessional/screen-shot-2012-01-24-at-4-19-30-pm/
[3]: http://www.braunability.com/
[4]: http://www.braunability.com/wheelchair-minivans.cfm
[5]: http://www.unitedaccess.com/
[6]: mailto:lklaus@unitedaccess.com

URL: http://www.braunability.com/abilityvoice/2012/01/braunability-dealer-steps-up-for-rehab-profiessional/

Tuesday, January 24, 2012

Overview of Fibromyalgia And Its Treatments (January 2012)

The Fibromyalgia syndrome (FMS)  is one of the diseases that were reputed to be all in your head.  Not any more, at least not  in the "imaginary" sense. This was particularly,  aggravating because it could be so painful. Actually, even though the pain is primarily at the sensitive points of the figure below ( uploaded from Wikipedia Commons), it does have something to do with your brain. It has do do with a loss of gray matter in the FMS afflicted brain. Gray matter is a critical component that  contains neuronal cell bodies, as the other component, white matter,  contains mostly the axons or nerve connections. The photograph below is a lateral view of a real brain, not a sketch. Nine times more women than men are afflicted.


Fig (1): Lateral View of Dissected Brain (John A Beal, Wikipedia)

_ For the fun of  it, here is the key to the numbers on Fig (1) identifying the main brain  brain regions..Skip if you are in a hurry…

1. entriculus lateralis, Cornu frontale
2. Ventriculus lateralis, Pars centralis
3. Calcar avis
4. Ventriculus lateralis, Cornu occipitale
5. Trigonum collaterale
6. Eminentia collateralis
7. Hippocampusduloxetine, milnacipran
8. Ventriculus lateralis, Cornu temporale
9. Capsula interna
10. Nucleus caudatus

_As you can see a lot  of the grey matter is at the surface of the brain._ Loss of gray matter is associated with chronic pain [3] aging [4] or trauma [5]. So, maybe, gray matter loss is not the hallmark of necessarily degenerative process. That is if aging is not a degenerative, but I digress…

_**In terms of manifestations, FMS is mostly pain without an apparent cause **_ [6], and particularly focused on tender points such as shown in Fig (2) below . But it also can include: fatigue, sleep disturbance, and joint stiffness. bowel and bladder abnormalities, numbness and tingling and cognitive dysfunction.


Fig (2) : Skeletal muscles and Some Fibromyalgia Tender Points

_**So, are there a treatment for FM**_ ? The answer is qualified yes

Academia classifies the overall pain reduction as : "..full response (at least a 50% change), response (30-49% change), and no response (less than a 30% change.[8]". This is the kind of pain reduction you can expect from the drugs on the market. Let us do the math:  a 40% reduction means 60% remains. Hmmm….

The most common are:

1. Drugs like (Lyrica/Pregablin) [9] or Gabapentin / Neurontin [9] succeed in decreasing the pain level by 30% to 50% in many people, 30% being more likely [10]. They both are anticonvulsants and were used initially against epilepsy, and are used commonly against neuropathic pain
2. Duloxetine (Cymbalta) is an antidepressant serotonin-noradrenaline reuptake inhibitor (SNRI)
3. Milnacipran (Savella) also an SNRI, but interestingly approved in the US only for FMS

More drugs against FMS can be found in [11]. Since FMS is a syndrome, every patient can respond substantially differently to the drugs, hence the variety. But again,  in most cases the 30% to 50 % pain reduction is the goal. I have not seen a study claiming 75% or better. FMS also usually affects sleep and sometimes cognition, so your _doctor has to balance all your needs and your tolerance to the  side effects. For example use of Lyrica can bring about dizziness, sleepiness, blurred vision, dry mouth, swelling of the hands and feet, weight gain._

_**So many have turned to alternative medicine for help. These complementary or alternative medical (CAM) include three categories:**_

1. Nutrition, herbs and supplements
2. Massage
3. Mind Body techniques and Tai-Chi

_**Nutrition, herbs and supplements: **_

Cathy Wong, in about.com [12]  has a excellent article on this.

* _**Magnesium:**_ "…Magnesium, along with malic acid (a fruit acid found naturally in apples) are often suggested for people with fibromyalgia because they are both needed for the generation of energy in cells in the form of adenosine triphosphate (ATP)…"

* Note:  The FMS benefits seem to be strongly dose dependent, up to 300 mg magnesium and 1200 mg malic acid per day) for 6 months.
* A study [13] of people with poor sleep shows lower Magnesium levels that can be remediated by supplementation. FMS patients do suffer from poor sleep patterns

* _**Vitamin D**_ : While there is a vitamin D deficiency both in women with FMS and and  in men with musculoskeletal problem, the benefits of this vitamin D supplementation need to be shown.[14,15]
* 5-HTP (Triptophan): Thought to work like serotonin antidepressants, possibly with less side effects. [16]
* Vitamin B-12 : From [17], homocysteine has been found in the cerebrospinal fluid  of FMS patients, indicating low B-12
* Capsaicin ; From Cathy Wong, [12] , there is a FMS study validating the use of capsaicin for FMS.  Could not find it.


There are some indication that massage-_**myofascial release therapy **_can improve the quality of life of FMS people [18]. You need a masseur seriously trained in this particular discipline. The technique involves "..Relaxing contracted muscles, increasing circulation and lymphatic drainage, and stimulating the stretch reflex of muscles and overlying fascia…" (Wikipedia) .

The " Trigger Point Therapy Workbook" [19] , though not a book on massage, is a good introduction to the myofascial concepts and all around a resource for FMS patients.

_**Mind Body techniques and Tai-Chi:**_

Last , but not least, Tai-Chi [20] and Mind Body techniques have been shown to be of help against FMS [21]. Both claim some success. Interestingly the Mind Body study's cohort were all women, but the Tai-Chi study did not mention gender. [21] claims benefit in  "coping with pain, anxiety, depression and somatic complaint" as well as sustainability of the benefits 3 years later…

The Tai-Chi claims are broad :"..components may influence neuroendocrine and immune function as well as neurochemical and analgesic pathways that lead to enhanced physical, psychological, and psychosocial well-being and overall quality of life in patients with fibromyalgia.."

_**Hope this helps,**_

_**Talk to your Doctor**_


[1] [Journal of Neuroscience][5] ; "Accelerated Brain Gray Matter Loss in Fibromyalgia Patients: Premature Aging of the Brain?"  ;April 11, 2007

[2][ Journal of Pain ][5]; "Changes in gray matter density in fibromyalgia: correlation with dopamine metabolism." ; 2009

[3] [Current Rheumatology Report ;][6] ":Variations in brain gray matter associated with chronic pain." ;

[4][ American Journal of Neuroradiology ][7]; "Age-related total gray matter and white matter changes in normal adult brain. Part I: volumetric MR imaging analysis." ; 2002

[5] [Journal of Neurotrauma][8] ; "Selective metabolic reduction in gray matter acutely following human traumatic brain injury."; 2004

[6] [Wikipedia ; Fibromyalgia][9]

[7] [Cochrane Summaries:][10] "Gabapentin for fibromyalgia" ; 2011

[8][ Journal of Medical Economics][11] ; "Cost effectiveness of duloxetine in the treatment of fibromyalgia in the United States" ; 2011

[9] [Arthritis and Rheumatism ][12]; "Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial." 2005

[10][ Journal of Pain][13] ; "Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome." ; 2010

[11] [Drug Class Reviews ][14]; "Drug Class Review: Drugs for Fibromyalgia: Final Original Report [Internet]" ; Oregon Health and Sciences U.; 2011

[12] [About.com ; Cathy Wong ][15]; "Herbs and Supplements for Fibromyalgia";2007

[13] [Magnesium Research ][16]; "Magnesium supplementation improves indicators of low magnesium status and inflammatory stress in adults older than 51 years with poor quality sleep."

[14] [Annals of Rheumatic Disease][17] ; "Musculoskeletal pain is associated with very low levels of vitamin D in men: results from the European Male Ageing Study."; 2010

[15] [Saudi Medical Journal ][18]; "The relation between vitamin D deficiency and fibromyalgia syndrome in women" ; 2011

[16][ Rheumatism Disease Clinic Of North America ][19]; " Neuroendocrine perturbations in fibromyalgia and chronic fatigue syndrome." ; 2000

[17] [Scandinavian  Journal Of Rheumatology][20] ; "Increased concentrations of homocysteine in the cerebrospinal fluid in patients with fibromyalgia and chronic fatigue syndrome." ; 1997

[18] [Evidence based Complementary and Alternative Medicine][21] ; "Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia." ; 2010

[19] [The Trigger Point Therapy Work Book"][22]; Clair and Amber Davies ; New Harbinger Publications ; 2004

[20] [New England Journal Of Medicine ][23]; " A Randomized Trial of Tai Chi for Fibromyalgia" ; 2010

[21] [Psychotherapy and Psychosomatics][24] ; "Mindfulness training as an intervention for fibromyalgia: evidence of postintervention and 3-year follow-up " ;2007


[1]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Dissected-Brain-lateral-view-John-Beal-Wiki-e1327356762852.png (Dissected Brain lateral view John Beal Wiki)
[2]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Dissected-Brain-lateral-view-John-Beal-Wiki.png
[3]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Skeletal-Muscles-Wikipedia-Commons-2-e1327346641522.png (Skeletal Muscles (Wikipedia Commons)-2)
[4]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Skeletal-Muscles-Wikipedia-Commons-2.png
[5]: http://www.jneurosci.org/content/27/15/4004.full.pdf
[6]: http://www.ncbi.nlm.nih.gov/pubmed?term=Variations%20in%20brain%20gray%20matter%20associated%20with%20chronic%20pain.
[7]: http://www.ncbi.nlm.nih.gov/pubmed/12223373
[8]: http://www.medinewsdigest.com/Age-related total gray matter and white matter changes in normal adult brain. Part I: volumetric MR imaging analysis.
[9]: http://en.wikipedia.org/wiki/Fibromyalgia
[10]: http://summaries.cochrane.org/CD007938/gabapentin-for-chronic-neuropathic-pain-and-fibromyalgia-in-adults
[11]: http://www.ncbi.nlm.nih.gov/pubmed/21651426
[12]: http://www.ncbi.nlm.nih.gov/pubmed/15818684
[13]: http://www.ncbi.nlm.nih.gov/pubmed/20418173
[14]: http://www.ncbi.nlm.nih.gov/pubmed/21678632
[15]: http://altmedicine.about.com/cs/conditionsetoh/a/Fibromyalgia.htm
[16]: http://www.ncbi.nlm.nih.gov/pubmed/21199787
[17]: http://www.ncbi.nlm.nih.gov/pubmed/20498201
[18]: http://www.ncbi.nlm.nih.gov/pubmed/21894355
[19]: http://www.ncbi.nlm.nih.gov/pubmed/11084955
[20]: http://www.ncbi.nlm.nih.gov/pubmed/9310111
[21]: http://www.ncbi.nlm.nih.gov/pubmed/21234327
[22]: http://www.newharbinger.com/bookstore/productdetails.cfm?PC=298
[23]: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3023168/?tool=pmcentrez
[24]: http://www.ncbi.nlm.nih.gov/pubmed/17570961
[25]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/email.png
[26]: http://www.addtoany.com/add_to/email?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3639&linkname=Overview%20of%20Fibromyalgia%20And%20Its%20Treatments%20%28January%202012%29 (Email)
[27]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/twitter.png
[28]: http://www.addtoany.com/add_to/twitter?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3639&linkname=Overview%20of%20Fibromyalgia%20And%20Its%20Treatments%20%28January%202012%29 (Twitter)
[29]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/linkedin.png
[30]: http://www.addtoany.com/add_to/linkedin?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3639&linkname=Overview%20of%20Fibromyalgia%20And%20Its%20Treatments%20%28January%202012%29 (LinkedIn)
[31]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/facebook.png
[32]: http://www.addtoany.com/add_to/facebook?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3639&linkname=Overview%20of%20Fibromyalgia%20And%20Its%20Treatments%20%28January%202012%29 (Facebook)
[33]: http://www.addtoany.com/share_save#url=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3639&title=Overview%20of%20Fibromyalgia%20And%20Its%20Treatments%20%28January%202012%29

URL: http://www.medinewsdigest.com/?p=3639

An End to Transfers for this Texas Family

[![A new wheelchair van for Jason][1]][2]

Dawn Fornier and Mike Shipka deliver a BraunAbility Entervan to Jason Philips. A customer donated the van to the nonprofit Camp Craig Allen and asked that it be given to another family in need of mobility.

Like so many of our customers, getting from Point A to Point B was never easy for Jason Roberts and his mother, Phyllis. Jason was diagnosed with Duchenne muscular dystrophy at the age of five and began using a wheelchair at nine. Since day one his mother, Phyllis, has been his primary caregiver, and after their many other medical expenses, they've never been able to afford an [accessible vehicle][3].

While their mobility was limited, they never let that slow them down completely. It hasn't been easy, but for decades Phyllis has transferred her son into and out of a vehicle. And while Jason has never been heavy, it's still work to get him in and out of a car….a LOT of work. Every trip involves Phyllis lifting up Jason, transferring him into the car, and then stowing his power chair. The transfer process can be very stressful on Jason's body, so once he's secured, she'll give him a breathing treatment to help him regain his strength and help him breathe on his own again. The whole process can take up to 45 minutes each way.

That was life, for Jason and Phyllis, and while it wasn't easy, they made it work. They've taken some remarkable trips in recent years, including a drive out to Las Vegas and a visit to Bob Marley's burial site in Jamaica. But trips like this will become much, much easier after the surprise they received this past October, all thanks to a customer of [Advanced Mobility Systems][4] in Texas who had contacted the dealership and informed them that he no longer had a need for his accessible van. His wife had recently passed away from ALS, and he wanted to donate the [Entervan][3] to a family in need. With the help of Advanced Mobility, the customer was able to donate the [wheelchair van][3] to the nonprofit [Camp Craig Allen][5] (a camp for adults with physical disabilities), who in turn surprised Jason and his parents with the new vehicle.

The family was overjoyed. Not only would simple trips become easier, but now Jason had an added peace of mind knowing that his mother, who had suffered two heart attacks, would not have to exert so much of her energy just to take him into town. "The ease of getting into and out of the vehicle is so much simpler for them now," said Jennifer Satery of Advanced Mobility. "What took two hours before takes just two minutes."

With the BraunAbility van - and the big hearts of everyone involved - Phyllis and Jason have freedom they've never experienced before. They can do more, go more places and enjoy life more with a little less worry…and that's exactly what you get with the BraunAbility brand on your van and a BraunAbility dealer there to keep you on the road!

[1]: http://www.braunability.com/abilityvoice/wp-content/uploads/2012/01/Jason1-300x191.jpg (Jason1)
[2]: http://www.braunability.com/abilityvoice/2012/01/an-end-to-transfers-for-this-texas-family/jason1-2/
[3]: http://www.braunability.com/wheelchair-minivans.cfm
[4]: http://www.advancedmobility.net/Express2.0/index.php
[5]: http://www.campcraigallen.org/

URL: http://www.braunability.com/abilityvoice/2012/01/an-end-to-transfers-for-this-texas-family/

Hemiplegia Definition and Information

Hemiplegia is a condition which affects one side of the body only - hemi comes from the Greek word meaning half.

URL: http://www.disabled-world.com/definitions/hemiplegia.php

Monday, January 23, 2012

Your Key to Hiring Student Interns & Employees with Disabilities - February 7

The Workforce Recruitment Program and the U.S. Department of Agriculture invite you to join them on **February 7, 2012** from 10 - 11:30 a.m. in Washington, DC to learn how to access more than 2,600 pre-screened and rated job candidates with disabilities. These job candidates are enrolled in over 270 college and university campuses nationwide. They represent all majors and range from college freshmen to graduate and law students. Schedule A eligible candidates and Veterans with disabilities are also included. To attend send an [email][1] by January 31, 2012.

[1]: mailto:WRPmarketing@dol.gov

URL: http://www.dol.gov/odep/wrp/20120207.htm

U.S. Department of Education Reminds School Districts of Their Obligations Under the ADA & the Rehabilitation Act

The U.S. Department of Education has issued a "Dear Colleague" [letter][1] and a Frequently Asked Questions [document][2] on the Americans with Disabilities Act (ADA) Amendments Act. These documents provide guidance on the new requirements of the ADA and Section 504 of the Rehabilitation Act in elementary and secondary schools. It emphasizes the obligations of school districts and their responsibilities made by the law.

[1]: http://www2.ed.gov/about/offices/list/ocr/letters/colleague-201109.html
[2]: http://www2.ed.gov/about/offices/list/ocr/docs/dcl-504faq-201109.html

URL: http://www.ed.gov/news/press-releases/department-education-issues-ada-amendments-act-dear-colleague-letter-provide-gui

Presidential Memorandum - Federal Support for the Randolph-Sheppard Vending Facility Program

President Barack Obama has released a memorandum for the heads of Executive Departments and Agencies in support of the [Randolph-Sheppard Vending Facility Program][1]. The program is run by the U.S. Department of Education and provides management training and business skills to individuals who are blind. The Randolph-Sheppard Act created the Vending Facility Program requiring qualified individuals who are blind to be given a priority to operate vending facilities on federal properties. The program today provides opportunities for over 2,500 individuals who are blind.

[1]: http://www2.ed.gov/programs/rsarsp/index.html

URL: http://www.whitehouse.gov/the-press-office/2012/01/20/presidential-memorandum-federal-support-randolph-sheppard-vending-facili

United Insurance Company of America Pays $37, 500 to Settle EEOC Disability Discrimination Lawsuit

The U.S. Equal Employment Opportunity Commission (EEOC) charged United Insurance Company of America (UICA) with discriminating against an employee with a disability. The company offered the individual, who is a recovering drug addict, a job conditioned upon his passing a drug test. When he failed the test and submitted a letter from his treatment provider explaining that he was in a treatment program, UICA withdrew its job offer. It violates the [Americans with Disabilities Act][1] to discriminate against an employee because an employer thinks the individual has a disability.

[1]: http://www.eeoc.gov/laws/types/disability.cfm

URL: http://www.eeoc.gov/eeoc/newsroom/release/1-23-12.cfm

Researchers Temporarily Halt Research on H5N1 Avian Influenza

A Georgetown University Medical Center professor says the voluntary action taken by two research teams to temporarily halt work involving the highly pathogenic avian influenza H5N1 is laudable.

URL: http://www.disabled-world.com/health/influenza/birdflu/h5n1.php

High Levels of MRSA Bacteria in Meat Products

Retail pork products in the United States. have a higher prevalence of methicillin-resistant Staphylococcus aureus bacteria (MRSA) than previously identified, according to new research by the University of Iowa College of Public Health and the Institute for Agriculture and Trade Policy.

URL: http://www.disabled-world.com/health/mrsa/bacteria.php

Reducing Deaths from Prostate Cancer

Dr. David Samadi, top robotic prostatectomy surgeon, redirects prostate cancer emphasis to treatment decisions following diagnosis.

URL: http://www.disabled-world.com/health/cancer/prostate/reducing.php

Smoking After being Diagnosed with Cancer

Many people continue to smoke after being diagnosed with cancer - A new analysis has found that a substantial number of lung and colorectal cancer patients continue to smoke after being diagnosed.

URL: http://www.disabled-world.com/health/cancer/diagnosed.php

Will an Increase in Wheelchair Users Lead to More Parking Spaces?

According to recent statistics, it's going to get even harder for me to find a handicap parking space for my [wheelchair van][1]!

The [San Francisco Chronicle][2] recently noted that life expectancy has increased to 78.7 years…especially in the disability community. People with middle age disease-related disabilities are living longer – thus increasing their population. Current government statistics indicate the number of people with a disability (broadly defined as impairments, activity limitations, or participation restrictions) now reaches 40 to 50 million.

What usually coincides with good news? Bad news! Because of this growing population, handicap parking spaces, accessible bathrooms and other technologies catering to disabilities are quickly filling up. The Americans with Disabilities Act (ADA) of 1991 strives to provide solutions for this growing populace.

> Ralph asked the owner why he didn't have a ramp, and the owner replied, "Because people in wheelchairs don't come here to eat." Ralph just rolled away in wonder.

Promoting the ADA can be essential in creating more accessible surroundings for those with disabilities. For instance, if enough people have difficulty entering a movie theater because of uneven pavement, difficult ramps, etc., the ADA will support the change to make the venue safe and easily accessible. Because there are an increasing number of people with disabilities, there will be an increasing outcry to address these needs.

Ralph Braun tells the story of a popular local restaurant that did not have a ramp leading into its front entrance. Ralph asked the owner why he didn't have a ramp, and the owner replied, "Because people in wheelchairs don't come here to eat." Ralph just rolled away in wonder.

With the ADA in force and a larger population of wheelchair users in the country, hopefully the close-mindedness of business owners like this one will continue to be a think of the past. Until then, it's important to be aware and vocal – kindly letting venues know when they lack handicap parking spaces, accessible bathrooms and other handicap user-friendly technologies! The future will hold many more assistive tools as the demand increases, but it's never too early to update the everyday stuff that helps us stay active in our everyday lives!

[1]: http://www.braunability.com/wheelchair-minivans.cfm
[2]: http://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2012/01/11/bloomberg_articlesLXNMM11A1I4H.DTL

URL: http://www.braunability.com/abilityvoice/2012/01/will-an-increase-in-wheelchair-users-lead-to-more-parking-spaces/

2012 National Transition Conference (NTC): College & Careers for Youth with Disabilities - May 30 - June 1

The NTC conference will take place from **May 30 - June 1, 2012** in Washington, DC. This conference will bring together partners in the transition community to exchange ideas and approaches. You'll be able to access the latest information that can be used to improve the transition from school to adult life for young adults with disabilities. Registration will be available online beginning in March.

URL: http://www.transition2012.org/

Sunday, January 22, 2012

2012 National Transition Conference (NTC): College & Careers for Youth with Disabilities - May 30 - June 1

The NTC conference will take place from **May 30 - June 1, 2012** in Washington, DC. This conference will bring together partners in the transition community to exchange ideas and approaches. You'll be able to access the latest information that can be used to improve the transition from school to adult life for young adults with disabilities. Registration will be available online beginning in March.

URL: http://www.transition2012.org/

Saturday, January 21, 2012

Autism Redefined - Harder to get Autism Diagnosis in 2013 as Revised Definition Goes into Effect

Autism redefined: Yale researchers study impact of proposed diagnostic criteria - Getting an autism diagnosis could be more difficult in 2013 when a revised diagnostic definition goes into effect.

URL: http://www.disabled-world.com/health/neurology/autism/redefined.php

Friday, January 20, 2012

The Mystery of Autism - Another Clue

Another Clue in the Mystery of Autism - New research suggests birth weight plays a role in autism spectrum disorder.

URL: http://www.disabled-world.com/health/neurology/autism/mystery.php

Laws Protecting Students with Disabilities

Students with disabilities might experience difficulties in school that range from issues with learning, concentration, language, or perhaps issues related to making friends or behavior.

URL: http://www.disabled-world.com/disability/education/protection-laws.php

Bringing More Doctors and Nurses to Saskatchewan Canada

The Canadian Harper Government and Saskatchewan Partner to Bring More Doctors and Nurses to Province.

URL: http://www.disabled-world.com/news/canada/saskatchewan/doctors-nurses.php

State Implementation Grants for Services for Children & Youth with Special Health Care Needs (CYSHCN) - Application Deadline March 1, 2012

The U.S. Department of Health and Human Services is accepting applications for six [awards][1] to improve access to comprehensive, coordinated community-based systems of services for CYSHCN and their families. The programs must be family-centered and culturally competent. Applicants must show previous experience working with state and family partners to develop services for CYSHCN and their families. [Application][2] deadline is **March 1, 2012 **(Catalog of Federal Domestic Assistance number 93.110).

[1]: https://grants.hrsa.gov/webExternal/DisplayAttachment.asp?ID=4FCC0AAC-E405-464F-95DE-BC63B13F6297
[2]: http://www.grants.gov/applicants/apply_for_grants.jsp

URL: http://www07.grants.gov/search/search.do?&mode=VIEW&oppId=135154

Job Accommodation Network (JAN) Training Modules on Workplace Accommodations

JAN has released the first in a series of fully-accessible online training modules. The first module is "JAN's Interactive Process." This 23 minute training has a downloadable transcript and handout, and describes a step-by-step process that employers can use to help successfully accommodate job applicants or employees. The next module in the series will be "ADA Amendments Act".

URL: http://askjan.org/training/library.htm

FCC Releases New Closed Captioning Rules

The Federal Communications Commission (FCC) has released rules to implement certain closed captioning provisions of the [Twenty-First Century Communications and Video Accessibility Act of 2010][1]. The rules require video programming that is shown on television with closed captions to be closed captioned when delivered using Internet protocol. The Commission also adopted rules that require equipment designed to receive or play back video programming to be equipped to display closed-captioned video programming. This link opens a PDF document. This information is also in [text][2] format.

[1]: http://www.fcc.gov/guides/21st-century-communications-and-video-accessibility-act-2010
[2]: http://transition.fcc.gov/Daily_Releases/Daily_Business/2012/db0113/FCC-12-9A1.txt

URL: http://transition.fcc.gov/Daily_Releases/Daily_Business/2012/db0113/FCC-12-9A1.pdf

U.S. Supreme Court Rules in Favor of Church in Disability Employment Discrimination Case

In an opinion titled _Hosanna-Tabor Evangelical Lutheran Church and School v. Equal Employment Opportunity Commission_, the U.S. Supreme Court has ruled that employees of a church cannot sue for employment discrimination. A teacher, who was a commissioned minister at a Lutheran School, was asked to resign after taking a leave of absence due to a disability. The teacher had filed a disability discrimination claim with the EEOC under the [Americans with Disabilities Act][1].

[1]: http://www.eeoc.gov/laws/types/disability.cfm

URL: http://www.supremecourt.gov/opinions/11pdf/10-553.pdf

Wednesday, January 18, 2012

Cognitive Rehabilitation Techniques Have Some Success For Multiple Sclerosis Impairments

Many MS patients undergo some cognitive impairment. Such impairments are common for many neurological diseases whether from a disease (Parkinson), a stroke or a trauma. Cognitive Rehabilitation Techniques (CRT) have been applied to cases , and it is comforting to the Multiple Sclerosis community to know that a recent study by the Kessler Foundation [1] showed  some success in applying CRTs to MS patients.

How did they measure cognitive improvements? Through the use a technique called fMRI or Functional Magnetic Resonance Imaging (fMRI). That technique consists in imaging the change in blood flow (hemodynamic response) related to energy use by neurons (Wikipedia). We have blogged about the use of  fMRIs before [2]


fMRI showing brain activity

Quoting the press release from the Kessler Foundation : " After treatment, greater activation was evident on fMRI in the treatment group during performance of a memory task; no change was seen in the placebo group". This greater activation was associated with memory improvement.

CRT is mostly associated with TBI (Traumatic Brain Injury) and the study in [3] describes the areas of intervention as "  attention, visual perception and constructional abilities, language and communication, memory, problem solving and executive functioning, multi-modal interventions, and comprehensive-holistic cognitive rehabilitation. But what do CRTs consist of? A good description can be found in the the Learnet tutorial on Cognitive Intervention [4].

The areas of intervention in Multiple sclerosis cases are based on the modified Story Memory Technique. Although details on what the Technique entails are scant, the main news as far as we are concerned is that this does not involve drugs. That is because drugs , in addition to their usual contingent of side effects seem to have very limited efficacy. Take Donepezil [5], or others [6] as study found them no better than a placebo.

So Cognitive Therapy looks promising.

Hope this helps,

_**Talk to your Doctor**_


[1] [ ScienceBlog][3] ; "Greater brain activation after cognitive rehabilitation for MS" ; 2012

[2] [MediNewsDigest][4]; "Coma Consciousness: Not an Oxymoron Anymore"  ; December 30, 2011

[3] [Archive Of Physical Medical Rehabilitation ][5]; " Evidence-based cognitive rehabilitation: recommendations for clinical practice." ;

[4] [Learnet Tutorial][6]; "Tutorial: Cognitive Intervention / Rehabilitation" ;2006

[5][ Neurologist ][7]; "Is Donepezil Effective for Multiple Sclerosis-related Cognitive Dysfunction?: A Critically Appraised Topic." ; 2012

[6] [Cochrane Data Base of systematic reviews ][8]; "Pharmacologic treatment for memory disorder in multiple sclerosis." ; 2011


[1]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/fMRI-of-Brain.png (fMRI of Brain)
[2]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/fMRI-of-Brain.png
[3]: http://scienceblog.com/51645/greater-brain-activation-after-cognitive-rehabilitation-for-ms/
[4]: http://www.medinewsdigest.com/?p=3403
[5]: http://www.ncbi.nlm.nih.gov/pubmed/11128897
[6]: http://www.projectlearnet.org/tutorials/cognitive_intervention.html
[7]: http://www.ncbi.nlm.nih.gov/pubmed/22217618
[8]: http://www.ncbi.nlm.nih.gov/pubmed/21975787
[9]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/email.png
[10]: http://www.addtoany.com/add_to/email?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3617&linkname=Cognitive%20Rehabilitation%20Techniques%20Have%20Some%20Success%20For%20Multiple%20Sclerosis%20Impairments (Email)
[11]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/twitter.png
[12]: http://www.addtoany.com/add_to/twitter?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3617&linkname=Cognitive%20Rehabilitation%20Techniques%20Have%20Some%20Success%20For%20Multiple%20Sclerosis%20Impairments (Twitter)
[13]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/linkedin.png
[14]: http://www.addtoany.com/add_to/linkedin?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3617&linkname=Cognitive%20Rehabilitation%20Techniques%20Have%20Some%20Success%20For%20Multiple%20Sclerosis%20Impairments (LinkedIn)
[15]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/facebook.png
[16]: http://www.addtoany.com/add_to/facebook?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3617&linkname=Cognitive%20Rehabilitation%20Techniques%20Have%20Some%20Success%20For%20Multiple%20Sclerosis%20Impairments (Facebook)
[17]: http://www.addtoany.com/share_save#url=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3617&title=Cognitive%20Rehabilitation%20Techniques%20Have%20Some%20Success%20For%20Multiple%20Sclerosis%20Impairments

URL: http://www.medinewsdigest.com/?p=3617

Federal Internship & Job Opportunities for Youth with Disabilities Conference Call - January 17

The White House Office of Public Engagement invites you to a nationwide conference call on federal internship, fellowship and employment opportunities for young people with disabilities on **January 17, 2012** at 3 p.m. Eastern Time. To receive the dial-in number be sure to fill out the requested information on the bottom of the page and hit Submit.

URL: http://www.whitehouse.gov/webform/federal-internships-and-jobs-persons-disabilities-call

Wheelchair Basketball - Inclusion of Able-bodied Players on the Team has Advantages

A University of Alberta study has found that women wheelchair basketball athletes say the inclusion of able-bodied athletes on the team had many different types of advantages.

URL: http://www.disabled-world.com/sports/wheelchair/able-bodied.php

Tuesday, January 17, 2012

Antibiotics Can DamageYour Digestive Tract: Can Probiotics Help?

Most everybody has had to take antibiotics for infections or other. Antibiotics kill bacteria, that's what they do. Unfortunately,  there are in your gut good, benign and beneficial bacteria as well as the noxious bacteria you took the antibiotics against. Usually the person's digestive system will be resettled by the beneficial bacteria, but not always. sometimes the damage can be more serious. Take for example this study posted on Medscape  about infection from the nasty bacteria Clostridium Difficile [1]. The Medscape entry describes the Clostridium infection  as being sometimes caused by antibiotics destroying the normal checks and balances of the coexisting bacteria before their use. In the words of Medscape : "..Normal gut flora resists colonization and overgrowth with C Difficile. Antibiotic use, which suppresses the normal flora, allows proliferation of C Difficile…"


Clostridium Difficile Bacteria (Wikipedia Commons)


I am not not sure why many in the scientific community put  bacteria in the category of "Flora" which is reserved for plants, and microbiota is more appropriate, but be it as it may, this is one example of serious damage that can be caused by antibiotic treatment

Studies with a conclusion of nasty side antibiotics effects abound. Another example, more general is in [3] , which has found that antibiotics damage the host body 's defenses by ravaging the pre-existing microbiata. The sphere of influence of gut microbiata goes well beyond the gastro-intestinal tract. See the figure below extracted from [3]


Gut Microbiata's Sphere of Influence (Physiol. Review)

Then again, needless to say, sometimes the administration of antibiotics is not optional. So , can we repair the damage after the indiscriminate carpet bombing?

Livestrong [4] gives some guidelines as how to proceed:

* _**Yogurt**_ with active cultures [Greek style yogurt has more bacteria strains, usually 5 instead of three for regular yogurt]
* _**Probiotic**_ nutritional supplements

* _**Miso Soup**_ : "Miso is made from naturally fermented soybeans and the unpasteurized type contains plenty of helpful Lactobacillus bacteria that can help replenish good bacteria"

Hope this helps,

_**Talk to your Doctor**_


[1] [Medscape Reference][5]   ; Clostridium Difficile Colitis

[2][ Livestrong][6] ; "How to Replace Good Bacteria After Antibiotics" ; 2011

[3][ Physiological Review ][7]; Gut Microbiata in health an Disease" "2010

[4][ Livestrong ][6]; "How to Replace Good Bacteria After Antibiotics" ; 2011


[1]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Clostridium-Difficile-Wiki-e1326781871899.png (Clostridium Difficile Wiki)
[2]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Clostridium-Difficile-Wiki.png
[3]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Gut-Microbiata-Health-Influence-Physiol.-Review.png (Gut Microbiata Health Influence Physiol. Review)
[4]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Gut-Microbiata-Health-Influence-Physiol.-Review.png
[5]: http://emedicine.medscape.com/article/186458-overview#a0104
[6]: http://www.livestrong.com/article/329964-how-to-replace-good-bacteria-after-antibiotics/
[7]: http://physrev.physiology.org/content/90/3/859.full
[8]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/email.png
[9]: http://www.addtoany.com/add_to/email?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3590&linkname=Antibiotics%20Can%20DamageYour%20Digestive%20Tract%3A%20Can%20Probiotics%20Help%3F (Email)
[10]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/twitter.png
[11]: http://www.addtoany.com/add_to/twitter?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3590&linkname=Antibiotics%20Can%20DamageYour%20Digestive%20Tract%3A%20Can%20Probiotics%20Help%3F (Twitter)
[12]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/linkedin.png
[13]: http://www.addtoany.com/add_to/linkedin?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3590&linkname=Antibiotics%20Can%20DamageYour%20Digestive%20Tract%3A%20Can%20Probiotics%20Help%3F (LinkedIn)
[14]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/facebook.png
[15]: http://www.addtoany.com/add_to/facebook?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3590&linkname=Antibiotics%20Can%20DamageYour%20Digestive%20Tract%3A%20Can%20Probiotics%20Help%3F (Facebook)
[16]: http://www.addtoany.com/share_save#url=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3590&title=Antibiotics%20Can%20DamageYour%20Digestive%20Tract%3A%20Can%20Probiotics%20Help%3F

URL: http://www.medinewsdigest.com/?p=3590

Exergames Provide Cognitive Benefits for Seniors

Exergames may provide cognitive benefit for older adults - New findings reported in American Journal of Preventive Medicine.

URL: http://www.disabled-world.com/fitness/exercise/exergames.php

Headphone Wearing Pedestrians Struck by Cars and Trains More Than Triple

Injuries to Headphone-Wearing Pedestrians Struck by Cars and Trains More Than Triple Since 2004, According to University of Maryland Researchers - Teens, Young Adult Males Predominantly Affected; Nearly Three Quarters of Injuries Are Fatal.

URL: http://www.disabled-world.com/disability/accidents/headphone-safety.php

Monday, January 16, 2012

Funding Your Education: The 2012-13 Guide to Federal Student Aid

A guide for students who are preparing to or who already attend college or a post-secondary education program. It explains all the federal aid programs available for students who are eligible and how to apply. There is a section that explains how students with intellectual disabilities can be eligible for federal student aid and how they can apply. Students should apply right away for 2012-2013 school year. This link opens a PDF document.

URL: http://studentaid.ed.gov/students/attachments/siteresources/12-13_Guide.pdf

NASA Summer Internships - Application Deadline February 1

NASA is looking to increase the number of students with disabilities pursuing science, technology, engineering and math careers in their internship programs. Eligible students can apply for a NASA summer internship now. The application deadline is **February 1, 2012**. For more information contact Kenneth Silberman by phone at** 301-286-9281** or by **[email][1]**.

[1]: mailto:Kenneth.a.silberman@nasa.gov

URL: https://intern.nasa.gov/solar/web/public/main/index.cfm?solarAction=view&subAction=content&contentCode=HOME_PAGE_INTERNSHIPS

Video Programming Accessibility Advisory Committee (VPAAC) Meeting - February 9

The VPAAC, an advisory Committee required by the [Twenty-First Century Communications and Video Accessibility Act of 2010][1], will hold a meeting on **February 9, 2012** from 9 a.m. - 5 p.m. Eastern Time in Washington, DC. The meeting will be open to the public and will be [webcast][2] live. This information is also in [text][3] format. This link opens a PDF document.

[1]: http://www.fcc.gov/guides/21st-century-communications-and-video-accessibility-act-2010
[2]: http://www.fcc.gov/live
[3]: http://transition.fcc.gov/Daily_Releases/Daily_Business/2012/db0106/DA-12-15A1.txt

URL: http://transition.fcc.gov/Daily_Releases/Daily_Business/2012/db0106/DA-12-15A1.pdf

Disability Newsletters List

Many disability organizations publish online newsletters, or magazines, often e-mailed to subscribers. This is a list of newsletters regarding disability issues and news that can be read online or subscribed to via email.

URL: http://www.disabled-world.com/news/disabilitycommunity/newsletters.php

Making the Most of Your Health Care Dollars

You can help lower your out-of-pocket health care costs by understanding what your health plan covers, what it does not cover and how to make the most of every dollar spent on health care and health insurance.

URL: http://www.disabled-world.com/medical/healthcare/most.php

What are Mattresses Made of? - Guide to the Chemicals in Your Mattress

What's Really In Your Mattress? - A Comprehensive Guide on the Usage of Chemicals in Your Mattress - Conventional mattresses are very likely to contain chemicals, some potentially toxic to humans and/or harmful to the environment.

URL: http://www.disabled-world.com/disability/blogs/mattress-material.php

Education, Schools and Students with Neurological Impairments

College, high school, and grade school students have the potential to experience a variety of forms of neurological disorders that may affect their academic functioning while they are in school.

URL: http://www.disabled-world.com/disability/education/student-conditions.php

Sunday, January 15, 2012

Marijuana Not Associated with Adverse Lung Function

Marijuana use not associated with adverse effects on lung function - In a study in which participants had repeated measurements of lung function over 20 years, occasional and low cumulative marijuana use was not associated with adverse effects on pulmonary function, according to a study in the January 11 issue of JAMA.

URL: http://www.disabled-world.com/medical/pharmaceutical/marijuana/adverse-lung-function.php

Walnuts Contain Highest Antioxidant Content Among Nuts

Walnuts go to the Head of the Class: New Research Finds Walnuts Rank Highest in Antioxidant Content Among Nuts.

URL: http://www.disabled-world.com/fitness/nutrition/nuts-seeds/healthy-walnuts.php

Saturday, January 14, 2012

Overview of Incontinence Problems in Multiple Sclerosis

The British site[ MSTrust][1] came to our attention with a post  "Uro-Neurologist Professor Clare Fowler receives Honor. " According to that site,  Prof Fowler is managing continence problems in people with neurological problems, particularly people with MS. A quick way to get familiar with her work is to go to a Pdf  on line titled "A UK consensus on the management of the bladder in multiple sclerosis"

This is a nice work and in it is the chart below that we have extracted from the [MSTrust Pdf][2]


MS progression and Incontinence (From MSTrust)

The chart is a bit scary because it almost implies that all MS patients will end up bed ridden, never mind the wheelchair. But it is a summary that draws all MS cases on the same time scale.  **_We have to be aware that the time scale is very different for all the gamut of MS types_** (Relapsing remitting, secondary progressive, primary progressive, and progressive relapsing, and probably more…)

Key advice from the leaflet is that patients who have more persistent  urine retention than 100 ml should be suggested self catheterization.  See our previous post, though, on the risk of Urinary Tract Infections [1]  associated with the use of catheters. See [2] for more details of this common problem.  If catheters are not not enough Professor Clare Fowler advises   _**antimuscarinics**_  drugs. Antimuscarinics are drugs acting on the central nervous system to control overactive bladder [3,4]. These drugs are also used against Parkinson's. Dr A. Athanasopoulos in [2] is see _antimuscarinics_ as a safe cornerstone of overactive bladder issues. Others see possible risks for men and advise caution [5]

_**Hope this helps in your talk to your Doctor.**_


[1] [MediNewsDigest][5] ; "Status of treatments for Urinary Tract Infections With Emphasis On Wheelchair Users" ; 2011

[2] [Current Opinion of Infectious Disease][6] ; "Management of Catheter-Associated Urinary Tract Infection (CAUTI);  2010

[3] [British Journal of Pharmacology ][7]; "Muscarinic receptors: their distribution and function in body systems, and the implications for treating overactive bladder." 2006

[4][ Advanced Urology ][8]; "An Overview of the Clinical Use of Antimuscarinics in the Treatment of Overactive Bladder";  2011

[5] [Nature Reviews Urology][9] ; "Should an antimuscarinic agent be used for persistent LUTS after treatment with an α1-blocker?" 2009


[1]: http://www.mstrust.org.uk/news/article.jsp?id=5194
[2]: http://www.mstrust.org.uk/downloads/bladder_consensus.pdf
[3]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/MS-Progression-and-Incontinence.png (MS Progression and Incontinence)
[4]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/MS-Progression-and-Incontinence.png
[5]: http://www.medinewsdigest.com/?p=3524
[6]: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865895/
[7]: http://www.ncbi.nlm.nih.gov/pubmed/16398909
[8]: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114080/
[9]: http://www.nature.com/nrurol/journal/v6/n2/full/ncpuro1288.html
[10]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/email.png
[11]: http://www.addtoany.com/add_to/email?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3574&linkname=Overview%20of%20Incontinence%20Problems%20in%20Multiple%20Sclerosis (Email)
[12]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/twitter.png
[13]: http://www.addtoany.com/add_to/twitter?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3574&linkname=Overview%20of%20Incontinence%20Problems%20in%20Multiple%20Sclerosis (Twitter)
[14]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/linkedin.png
[15]: http://www.addtoany.com/add_to/linkedin?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3574&linkname=Overview%20of%20Incontinence%20Problems%20in%20Multiple%20Sclerosis (LinkedIn)
[16]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/facebook.png
[17]: http://www.addtoany.com/add_to/facebook?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3574&linkname=Overview%20of%20Incontinence%20Problems%20in%20Multiple%20Sclerosis (Facebook)
[18]: http://www.addtoany.com/share_save#url=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3574&title=Overview%20of%20Incontinence%20Problems%20in%20Multiple%20Sclerosis

URL: http://www.medinewsdigest.com/?p=3574

$5, 000 Scholarship for Students Dedicated to Helping Prevent Nursing Home Abuse

Nursing Home Abuse.net Announces $5,000 Scholarship Available Exclusively to Students Dedicated to Helping Prevent Nursing Home Abuse.

URL: http://www.disabled-world.com/disability/education/5000-scholarship.php

Lee Abramson - Independent Candidate for 2012 Presidential Election

Lee Abramson has announced that he is an independent candidate for the Presidential election in 2012.

URL: http://www.disabled-world.com/editorials/political/presidency.php

Down Syndrome Education Website

The Down syndrome Education Online website is one that offers people a very comprehensive and reliable source of updated information and resources.

URL: http://www.disabled-world.com/communication/community/education-site.php

Friday, January 13, 2012

Preventing Shocks from Static Electricity

Information on how to stop getting shocked from electrostatic discharges in the home, car, and from synthetic clothing.

URL: http://www.disabled-world.com/disability/blogs/sparks.php

Thursday, January 12, 2012

Disability, Mobility Impairments and Students with Disabilities

Students with disabilities may experience a range of different mobility impairments that might require accommodations in school or university settings. The mobility impairments can range from ones related to a person's stamina to ones associated with paralysis.

URL: http://www.disabled-world.com/disability/education/students.php

YOOLA Travel Service for Persons with Disability - Accessible Tourism in France and World Sports Packages

YOOLA, travel agency dedicated to disabled travelers:
fully accessible tourism in France and sports packages all around the world!

URL: http://www.disabled-world.com/travel/yoola.php

RIM-AU Wheelchair Basketball Tournament

This year's tournament will be twice as big as in years past with 17 teams participating - fantastic growth over the years!

URL: http://www.disabled-world.com/sports/news/tournament.php

Wednesday, January 11, 2012

Status of treatments for Urinary Tract Infections With Emphasis On Wheelchair Users

Many Urinary Tract Infections  (UTI) are fairly common, particularly for people with conditions or diseases that keep them in a wheelchair such as Spinal cord Injuries or Multiple Sclerosis because individuals may have bladder storage and/or voiding dysfunction [1]. Many times the infections are associated with the use of catheters. Diabetes is also often associated with UTIs.  [2,3] Since many UTIs recur, the questions your doctor has to struggle with, and you to be thinking about, usually boil down to:

1. How many times can the the usual antibiotics be prescribed and maintain efficacy as well as keeping possible side effects at bay.
2. Is this a "simple" or a "complicated" UTI?

_This post is not meant to alarm you, but on the contrary to describe the arsenal your Doctor has to deal with UTIs, should the need arise._

* Antibiotics are probably the most common treatment:

> * Quinolones have been extensively prescribed  but there are some safety issues [2] : "Fluoroquinolone toxicity[190][191] or quinolone toxicity is the long term  or serious physical and mental ADRs that can occur from use of fluoroquinolones."  An example is  ciprofloxacin [3], which is a fluoroquinolone  and is often  prescribed for UTIs
> * Other studies sometimes recommend  substitutes for the quinolones [4] "Uncomplicated UTI is classified as either uncomplicated cystitis (UC) or uncomplicated pyelonephritis (UP)….co-trimoxazole/trimethoprim and fluoroquinolones can no longer be recommended as first-line empirical treatment for UC. Rather, the new recommended treatment of first choice consists of fosfomycin-trometamol, nitrofurantoin, or pivmecillinam…High-dose fluoroquinolones are still recommended, however, as first-line oral treatment for UP."  _So you should find out from your Doctor which type of UTI you have: UC or UP._


UTI are often a side effect of constant wheelchair use

Then other approaches are currently studied:

* Botulinum toxin type A [5] : this treatment aims at better control  of the urine flow by the  Detrusor urinae muscle:   "…A (Botox) for injection for the treatment of urinary incontinence as a result of neurogenic detrusor overactivity (e.g. spinal cord injury, multiple sclerosis) in adults…". This probably assumes that the patient still has a modicum of detrusor control and is meant to treat mainly muscular hypercontraction. Since a lot of the UTIs have to do with inadequate urinary flow, some improvement of the UTIs concomitant with the better detruser control could be expected.

* Bacterial interference [7] is an approach which reminds us of the current probiotic craze in nutrition: "benign bacterial strains were studied with the objective of offering some protection against invasion by uropathogenic strains."

Note: According to [3] "The increased incidence, prevalence and severity of urinary tract infection in patients with diabetes argue for aggressive antibacterial chemotherapy" Keeping in mind that "…Studies have reported rates of diabetes from 13% to 22% in persons with an SCI.." [10]

Are there some natural therapies against UTIs, most of us have heard of Cranberries and cranberry juice. Are there any proofs? We provide references to two studies that think so [11,12]. The principle is that  cranberry uses physics to decrease the adherence of the bacteria the the bladder wall. Seems that it works but is certainly less efficacious than antibiotics. Then again , since the accent is on prevention, might be worth a try.

_**Talk to  your Doctor**_


[1] [British Journal Of Community Nursing][3] ; "Lower urinary tract dysfunction in MS: management in the community.";  2009

[2][ American Journal of Medicine][4] ;  "Pathogenesis of bacteriuria and infection in the spinal cord injured patient"; 2002

[3][ Journal of Urology][5] ; "Diabetes mellitus and urinary tract infection: epidemiology, pathogenesis and proposed studies"; 2009

[4] [Wikipedia/quinolones][6]

[5] [Wikipedia/ciprofloxacin][7]

[6] [Dtsch Arztebl Int.;][8]  2011 Jun ; "Uncomplicated urinary tract infections." ; 2011

[7][ International Journal Of Urology ;][9] "Botulinum toxin type A for the treatment of lower urinary tract disorders." ; 2012

[8] [Journal Of Spinal cord Medicine ; ][10]"Bacterial interference for prevention of urinary tract infection: an overview"

[9] [American Journal of Medicine][4] ; "Pathogenesis of bacteriuria and infection in the spinal cord injured patient."

[10] [Journal of Spinal Cord Injury][11]  ; "Diabetes Mellitus in Individuals With Spinal Cord Injury or Disorder "; 2006

[11] [Archive of Internal Medicine][12] ;"Cranberries vs antibiotics to prevent urinary tract infections: a randomized double-blind noninferiority trial in premenopausal women.

[12] [Journal of Medicinal Food ][13];" Role of cranberry on bacterial adhesion forces and implications for Escherichia coli-uroepithelial cell attachment."


[1]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Women_in_wheelchair-e1326313345595.jpg (Women_in_wheelchair)
[2]: http://www.medinewsdigest.com/wp-content/uploads/2012/01/Women_in_wheelchair.jpg
[3]: http://www.ncbi.nlm.nih.gov/pubmed/20166471
[4]: http://www.ncbi.nlm.nih.gov/pubmed/12113873
[5]: http://www.ncbi.nlm.nih.gov/pubmed/19846134
[6]: http://en.wikipedia.org/wiki/Quinolone#Antibiotic_misuse_and_bacterial_resistance
[7]: http://en.wikipedia.org/wiki/Ciprofloxacin
[8]: http://www.ncbi.nlm.nih.gov/pubmed/21776311
[9]: http://www.ncbi.nlm.nih.gov/pubmed/22220916
[10]: http://www.ncbi.nlm.nih.gov/pubmed/10914355
[11]: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1864854/
[12]: http://www.ncbi.nlm.nih.gov/pubmed/21788542
[13]: http://www.ncbi.nlm.nih.gov/pubmed/19257836
[14]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/email.png
[15]: http://www.addtoany.com/add_to/email?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3524&linkname=Status%20of%20treatments%20for%20Urinary%20Tract%20Infections%20With%20Emphasis%20On%20Wheelchair%20Users (Email)
[16]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/twitter.png
[17]: http://www.addtoany.com/add_to/twitter?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3524&linkname=Status%20of%20treatments%20for%20Urinary%20Tract%20Infections%20With%20Emphasis%20On%20Wheelchair%20Users (Twitter)
[18]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/linkedin.png
[19]: http://www.addtoany.com/add_to/linkedin?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3524&linkname=Status%20of%20treatments%20for%20Urinary%20Tract%20Infections%20With%20Emphasis%20On%20Wheelchair%20Users (LinkedIn)
[20]: http://www.medinewsdigest.com/wp-content/plugins/add-to-any/icons/facebook.png
[21]: http://www.addtoany.com/add_to/facebook?linkurl=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3524&linkname=Status%20of%20treatments%20for%20Urinary%20Tract%20Infections%20With%20Emphasis%20On%20Wheelchair%20Users (Facebook)
[22]: http://www.addtoany.com/share_save#url=http%3A%2F%2Fwww.medinewsdigest.com%2F%3Fp%3D3524&title=Status%20of%20treatments%20for%20Urinary%20Tract%20Infections%20With%20Emphasis%20On%20Wheelchair%20Users

URL: http://www.medinewsdigest.com/?p=3524