How To Treat Fibromyalgia Effectively

By Nathan Wei

Fibromyalgia is a multisystem disease characterized by various and diffuse symptoms including sleep disturbance, fatigue, headache, dizziness, reduction in short term memory, hypersensitivity to environmental stimuli, morning stiffness, irritable bowel and irritable bladder, numbness and tingling, premenstrual syndrome, restless leg syndrome, temporomandibular joint pain, noncardiac chest pain, Raynaud’s phenomenon, sicca syndrome, and anxiety.

Prevalence in the United States is 3.4% in women and 0.5% in men, with increasing prevalence to age 80 years and women being affected 10 times more frequently than men and familial clustering suggesting a genetic etiology.

It is chronic and, because the symptoms do not follow strict anatomic pathways, is often misdiagnosed and poorly treated.

Functional MRI studies have demonstrated that the brains of patients with fibromyalgia react differently to pain stimuli than the brains of patients without fibromyalgia. Thus, the problem appears to be that the brains of fibromyalgia patients have different functional, electrical, and chemical differences than the brains of people without the disorder. In other words, patients with fibromyalgia handle brain inputs and outputs of different stimuli in an abnormal fashion.

Triggers for symptoms include emotional stress, illness, surgery, and trauma.

Criteria for diagnosis of fibromyalgia were formulated by the American College of Rheumatology (ACR) in 1990. ACR criteria include 2 components: widespread pain above and below the waist including the axial skeleton and presence of 11 tender points among 18 specified points.

A careful history, physical examination, and laboratory testing are helpful in defining the diagnosis.

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The Fibromyalgia Impact Questionnaire is a self-administered instrument that is useful in assessing functional abilities in daily life and outcomes of treatment.

Conditions that should be considered in the differential diagnosis of fibromyalgia include chronic fatigue syndrome, Lyme disease, rheumatoid arthritis, systemic lupus erythematosus, Sjogren’s disease, polymyalgia rheumatica, and hypothyroidism. Furthermore, these conditions may also be present in patients with fibromyalgia, which renders the diagnosis more difficult.

In recent years, recognition, understanding, and diagnosis of fibromyalgia have improved. It appears from multiple well controlled studies that a multidimensional approach is probably the most effective approach.

Specific treatment recommendations are:

— Patient education

— Cognitive behavioral therapy

— Non impact aerobic exercise

— Physical therapy may be beneficial for some patients.

— Drugs including tricyclic medications, selective serotonin reuptake inhibitors, selective serotonin and nor-epinephrine uptake inhibitors may alleviate pain and improve sleep quality and global well-being in patients with fibromyalgia.

— Cyclobenzaprine (Flexeril) at bedtime, may decrease pain and improve sleep quality in patients with fibromyalgia.

— GABA pathway drugs such as gabapentin (Neurontin) and pregabalin (Lyrica) are helpful for reducing pain.

— Nonnarcotic analgesics and mu antagonists such as tramadol (Ultram) may help with pain.

— Modafinil (Provigil) can help with fatigue. Low grade amphetamines such as phentermine can also help with fatigue but may aggravate hypertension.

Nonpharmacologic therapies with moderate evidence of effectiveness in fibromyalgia are balneotherapy, biofeedback, hypnotherapy, and strength training.

Evidence to support the use of chiropractic therapy, electrotherapy, manual and massage therapy, or ultrasound, in patients with fibromyalgia is weak, but worth trying in selected individuals.

Acupuncture has been used successfully. Serum levels of substance P and serotonin have been found to be significantly elevated after acupuncture treatment, suggesting possible mechanisms in pain relief. Although their effectiveness has not been proven by controlled trials, other treatment modalities employed include chiropractic therapy, yoga, Tai Chi, massage therapy, magnetic therapy, and tender-point injections.

Opioids (narcotics), as a rule, are not indicated in the management of fibromyalgia.

Conclusion: Fibromyalgia is a real disease manifested by abnormal sensory processing of environmental stimuli. It is quite clear that a multi-faceted approach to the management of this disorder is required for optimal response. The primary components should consist of patient education, cognitive behavioral therapy, non impact aerobic exercise, and individualized medications. The addition of alternative/complementary therapies should also be considered.

About the Author: Nathan Wei, MD FACP FACR is a Rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info:

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Athletes prepare for 2012 Summer Paralympics at the Paralympic Fitness Centre

Monday, August 27, 2012

London, England — As Paralympians ready for the Games which are set to open later this week, they have access to a world class fitness center inside the Paralympic Village which is designed to maximise their pre-Game preparations.

According to volunteers staffing the center, instead of being a single large room, as in Beijing, the building has numerous rooms. It, along with the adjacent Village Services Centre, is designed to be converted into a school after the games conclude. Rooms have been structured as a gym, an auditorium, and science laboratories.

Gym equipment is supplied by Technogym, an Italian firm that has supplied gym equipment for the Olympics since 2000. Equipment has been provided not just for for the Fitness Centre, but for gyms at all the Olympic venues. The newest equipment is oriented toward maximum flexibility, allowing athletes to exercise the particular muscles that they most require for their sport.

In addition to the equipment, the Fitness Centre also provides instructors trained in the use of the equipment, the likes of which athletes from many countries have never seen before. There are also a number of instructors available to provide motivational training.

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Restrictions imposed in China textile trade with U.S.

Saturday, May 21, 2005

In an effort to ease complaints by the U.S. and Europe about a heavy influx of low priced Chinese goods, China will raise export tariffs on 74 categories of textile products in June. This follows plans from the U.S. to impose quotas on Chinese textiles and clothing.

Products likely to see an increase from the Chinese move include synthetic fiber shirts, trousers, knit shirts and blouses, cotton shirts, and combined cotton yarn. Last week, similar restrictions were imposed by the U.S. on cotton trousers, knit shirts, and underwear. Currently, a 2.5 cent charge per item is imposed; the new tariff will raise this to the equivalent of 12 cents per piece now. While this is a fourfold increase, it is not expected to affect consumer prices. Because of this, some doubt the tariff will have any effect on correcting the trade imbalance.

This move is in response to U.S. trade quotas imposed due to concerns that increased Chinese goods would put U.S. textile manufacturers out of business. According to Auggie Tantillo, executive director of the American Manufacturing Trade Action Coalition, a textile industry group in the U.S., the move will preserve 10,000 U.S. jobs. The new U.S. trade quota will limit the growth of Chinese textile imports to 7.5 percent compared with shipments over the past year.

Prior to January 1, a global quota system helped regulate the trade. With the quota system gone, fears have arisen that a flood of Chinese goods could undercut U.S. competitiveness in the market. China is able to market its goods cheaply due to an artificially weak yuan. The U.S. Treasury criticized the China yuan policy as “highly distortionary”, posing a major risk to China’s economy itself and to global economic growth. They challenged China to revalue its currency to bring it to a level they believe will allow fairer competition between global manufacturers.

China has disputed the charges of the U.S. Treasury. Chinese Commerce Minister Bo Xilai said, “I believe they are not reasonable”.

Laura Jones, a representative of large retailers, also criticized the move, saying “These restrictions on imports from China will do absolutely nothing to help the U.S. textile industry — and the government knows it.”

China has seen a boom in economic growth in recent years due to growing trade surpluses with the West, but economists worry that the trade gap will cause longer term global economic problems. China’s textile and apparel exports are the most noteworthy example, with exports up over 1,000 percent in some categories this year and the rapid loss of marketshare and jobs by U.S. textile manufacturers.

Beginning in 1978, the Chinese economy has been transforming from a Soviet-style centrally planned economy to more of a free market style system, under the rigid political control of Communist Party of China.

To this end, the government has leveraged foreign trade to stimulate economic growth. The result has been a fourfold increase in GDP, making China the sixth largest economy in the world. By 2012 the People’s Republic of China may have the highest GDP in the world.

According to U.S. statistics, from 1999 to 2004 China’s trade surplus with the U.S. doubled to $170 billion. Wal-Mart is China’s seventh largest export partner, just ahead of the United Kingdom.

However, the gains from their “socialist market economy” have not been without problems. The Chinese leadership has often experienced the worst results of socialism and capitalism: bureaucracy, lassitude, corruption, and inflation. Inflation rates have been an on-going challenge, reaching as high as 17% in 1995.

Environmental deterioration is a longer-term threat to economic growth. In 1998, the World Health Organization reported that China had seven of the 10 most-polluted cities on Earth. Another concern among some economists is that China’s economy is over-heating, and due to its global economic expansion this could have major repercussions among other nations.

Typically, wages have been low and working conditions poor, with workers living in restrictive dormitories and working at boring factory jobs. However, recent labor shortages have started improving conditions, and raising the minimum wage towards the equivalent of 100-150 US dollars per month. The labor shortages are in part a result of a demographic trend caused by strict family planning.

  • “Economy of the People’s Republic of China” — Wikipedia, May 22, 2005
  • “China raises tariffs on textile exports. Beijing hoping to counter criticism from U.S., Europe.” — CNN, May 21, 2005
  • “China to increase export tariffs” — CNN, May 19, 2005
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20-horse field for Derby dash

Saturday, May 7, 2005

The 131st run for the roses in Louisville, KY is set for Saturday at Churchill Downs. Post time is 6:04pm EDT under what should be partly sunny skies and a fast track. The 20-horse field contains 10 strong contenders in what promises to be a fast pace out front in the Kentucky Derby.

Trainer Nick Zito, the 2-time derby winner boasts 5 stable horses running the race, and has the odds-on favorite Bellamy Road. The George Steinbrenner owned horse won convincingly in 4 of its last 5 trips. At its #16 post position, it will have to get out quickly, or be on the outside going into the first turn where it would have to fight for position. Given the early starting speed of Spanish Chestnut, it seems unlikely that any horse will easily set the pace.

Showing strong closing in its last 4 races is Bandini, ridden by top New York jockey John Velazquez, a 6-time Breeder’s Cup winner. If this horse can hold onto the pace, watch for him at the finish line.

For today’s 1 ¼ mile race, Jeremy Rose on Afleet Alex looks dangerous, where both horse and jockey are experienced. But it was Wilko who prevailed in their meeting at the Breeders’ Cup Juvenile last October.

A Chicago Tribune computer analysis predicts a win for High Fly, based on its “lack of flaws”. In that prediction they note criteria on which it was calculated, but nothing accounts for the race day excitement of roaring crowds in these 3-year-old thoroughbreds.

Last year the jammed Churchill Downs drew 140,000 people on a rainy Saturday to watch Smarty Jones win. The Derby run is the first leg in USA horse racing’s Triple Crown. The last horse to win the triple crown was Affirmed in 1978.

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Portable Gps Units, Key To Finding Your Way

By Jim Kesel

The early handheld or portable GPS units were designed for military personnel. They tended to be bulkier and somewhat cumbersome to use. Now that GPS technology has been made available to civilians, the GPS units themselves have improved in one essential area of design: portability. The new portable GPS units allow consumers to have as much GPS power as soldiers have and in some cases have more features. This article will discuss the three types of portable GPS units available on the market: GPS units used exclusively for tracking purposes, GPS units designed for navigation and portable GPS units which can be used for both.

Portable GPS units designed for tracking are available in a variety of forms. The first are known as GPS auto trackers. The portable version of GPS auto trackers are usually battery-operated and can be conveniently put in the car’s glove compartment. The next type of portable GPS unit with tracking capabilities are personal GPS systems. They can be a small device that looks like a cell-phone, (which can be placed in one’s pocket, purse or backpack), built in special GPS watches or even in tennis shoes. These systems can be used to track loved ones, (especially children), or for exercise performance purposes. The latter is done by allowing a person to track how far and fast they might have walked or jogged. Finally, there are GPS units that can track expensive personal belongings, such as laptops. These types of portable GPS units can be placed in a USB or flash card slot.

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On the other end of the spectrum are portable GPS units designed for navigation, also known as GPS navigators. GPS navigators can either be handheld or designed for use in a car. Handheld GPS navigators look similar to a cell phone. The graphics can either be in color or in black or white. GPS navigators designed for the car are generally rectangular and can be connected to the windshield by suction cups. Both types of GPS navigators allow a person to obtain directions and maps as they are on the road. Sophisticated portable GPS navigators communicate directions through a computer-generated voice.

Combination portable GPS units are designed for both navigational and tracking capabilities. An example can be seen through GPS-enabled cell phones. The downside to these at least in comparison to GPS navigators is that they only work in areas that have that particular cell phone company’s coverage. If the area does not have coverage, the cell phone GPS won’t work well. However the portable GPS units navigation capabilities are not affected by poor cell phone coverage.

Portable GPS units can be used for tracking, navigation or a combination of the two. Indeed, these GPS units offer quite a bit of GPS power, considering their reduced size. With a device that is small enough to fit in one’s pocket, people are offered two things: the ability to get to their chosen destination on time or the ability to keep a ‘virtual’ eye on expensive possessions or loved ones. Price-wise portable GPS units with the tracking capability will be a bit more expensive, but in the long run when one is ensured that everything and everyone most dear to them is where they are supposed to be, it won’t take long to realize the money would be well-spent.

About the Author: James Kesel, MS is the Publisher of

GPS Auto Tracker

providing information on

Portable GPS

and the latest GPS Tracking and Navigation systems.

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Thailand forces registration of prepaid phones to thwart insurgency

Tuesday, November 15, 2005

In a move aimed at hampering the near-daily bombing attacks in southern Thailand, all owners of prepaid phones are required to register by midnight local time today or face being blocked.

Originally scheduled for implementation at the end of last year, the move was deferred to allow people more time to register their phones. The policy only applies to the three southernmost provinces that border MalaysiaPattani, Narathiwat, and Yala — formerly the Malay Pattani kingdom.

Thais from other parts of the country with prepaid phones will also be required to register should they wish to visit the region. When doing so their calls will be treated as roaming, a feature of GSM which allows a user to make and receive calls on a network other than that of their service provider.

Many of the bombs used in the south are believed to be detonated by mobile phone, although most of the more than one thousand casualties in the region have been from drive-by shootings and stabbings.

It is reported that 65% of the near half-million prepaid phones in the region that this would impact have been registered. Prepaid phones are commonplace throughout Thailand and estimates put the number in use throughout the whole country at approximately ten million.

Other efforts to deal with the insurgency in the predominantly Muslim area include an announcement yesterday that approximately 20,000 local villagers will be given training and small arms to help defend their villages. Both men and women will be eligible, and those accepted into the programme will be put onto the government payroll.

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Triple limb-reattachment fails – boy loses foot

Tuesday, April 5, 2005Terry Vo, the 10-year old Australian boy who had two hands and a foot reattached by surgeons after losing them in an accident, has had to have the foot re-amputated. He will be given a prosthetic foot in its place.

The operation to re-attach three limbs was thought to have been a first – but was ultimately unsuccessful, with the foot having died inside, and receiving insufficient blood supply following the surgery to reattach it.

“That would lead to the small muscles in the foot actually constricting, the toes bending over and a deformed …. foot that is sort of clawed over and doesn’t have good sensation,” said plastic surgeon, Mr Robert Love today, on Australia’s ABC Radio.

“Even if you can get all of that to survive, he [would be] worse off than having had an amputation.”

“What is very disappointing is that for the first two days after [the operation] the foot looked absolutely magnificent,” he said.

Terry’s hands were healing well, said the surgeon. The prosthetic foot would allow him to walk normally, since his knee was intact.

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Finding The Weight Loss Programs That Really Work

By Joe R. Maldonado

Finding the weight loss programs that really work can be like searching for a needle in a haystack that is the size of mount Everest. There are a number of reasons for this, from weight loss programs that do not actually work for anyone to ones that work for some people and just not you to your failure to stick with the program. Even though it can be so difficult many people still keep trying to find something that will work for them, and truth be told, they should. There is no reason not to try, so long as you are doing so safely. Weight loss programs are not a game and you need to take some precautions when deciding which ones you want to try.

Each program is designed a specific way, and anyone and their mother can and is designing weight loss programs because it is the In thing to do. But how do you know that the program that you cousins, boyfriends, sister told you to try is actually safe? There is a big difference between effective weight loss programs and dangerous crash courses, and if you are going to be trying different weight loss programs then you are going to know how to spot the fakes before you get into them and risk your own health in the process.

First thing to look for is how they structure the diet. A crash course will ask you to cut out foods entirely. This is not only dangerous to your health it is a good way to end up putting on more weight then you originally had. This is because when you come off the diet, your body will pack on the weight as a precaution in case it happens again. You want to avoid crash courses and stick with weight loss programs that ask you to eat specific foods in moderation and to cut back on the amount of food you eat in one sitting.

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Secondly any weight loss program that tells you that you are not going to have to do any form of physical activity is misguided at best. You will have to always do some form of exercise. When we exercise our metabolism increases which is what controls the amount of calories that we burn, and the more calories that we burn, the faster we will lose weight. Weight loss programs that ask you to perform some form of daily exercise are programs that actually give you a shot at losing weight.

We are a group of health and fitness professionals that have gone over each and every diet and weight loss program that is available and took the time to compose a list of the weight loss programs that are going to be the safest to use while still giving you results. While these are the weight loss programs that we deem to be the best, not everyone will work for you and you are going to have to stick with the one you choose for a while to accurately judge it.

About the Author: To know more about

weight loss programs

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diets that work

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weight loss plans

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Monster.com aquires Yahoo’s HotJobs service for $225 million

Thursday, February 4, 2010

Yahoo announced plans to sell its HotJobs employment search service to Monster Worldwide for $225m, the companies said yesterday. Monster currently controls one third of online jobs postings in the United States. The two companies also struck a three-year agreement under which Monster will provide career and job content for the Internet giant’s homepage in the U.S. and Canada.

Terms of the deal include Monster being paid for providing job-related postings for Yahoo’s homepage in the US and Canada for three years and other expressions of interest. Yahoo, who bought HotJobs in 2001 for $436 million, last month agreed to sell email provider Zimbra to VMWare Inc. for an undisclosed amount, having it acquired for $350 million two years ago.

“HotJobs with its significant customer base plus the traffic agreement are an ideal complement to Monster’s innovative recruitment solutions and global reach,”

“HotJobs with its significant customer base plus the traffic agreement are an ideal complement to Monster’s innovative recruitment solutions and global reach,” said Sal Iannuzzi, chairman, CEO and president of Monster Worldwide. “Monster will be able to offer its employers a significantly larger pool of candidates across diverse geographies and industries,” the company said in a statement.

Buying Yahoo out of the online recruitment business leaves Monster with only one major competitor, Careerbuilder.com. “We have substantially added quality traffic, while substantially increasing our customer base,” he added.

HotJobs averaged 12.6 million unique visitors a month, according to Media Metrics comScore. HotJobs generates annual revenue of about $100 million while Monster’s revenue totalled $905 million in 2009. Alexa.com rates HotJobs at rank 3 while Monster.com at rank 531.

== Sources ==

*Mike Swift. “Yahoo to sell HotJobs employment service to Monster for $225 million” — Mercury News, 3 February, 2010

*Nick Zieminski and Alexei Oreskovic. “Monster to pay $225 million for Yahoo’s HotJobs site” — Reuters, 3 February, 2010

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Apple to hold media event on September 1, may update iPods and Apple TV

Friday, August 27, 2010

Apple Inc. will hold a music-centered event in San Francisco, California on September 1. It has been widely speculated that the company will introduce an updated line of iPod portable music players and a new Apple TV.

The company e-mailed invitations for the event to various media organizations on Wednesday. The message included a picture of a guitar and the time of the event. Apple did not release any information about what products would be involved.

Apple has released new iPods through previous similar events in September in anticipation of the holiday shopping season. This year, Apple may unveil a new iPod Touch with two cameras, similar to their recent iPhone 4 design. It will likely also update the iTunes music store and software.

Speculation about a new Apple TV is mixed. While many blogs are reporting that a refresh of the device will be announced, analysts say that it is unlikely to happen during next Wednesday’s event. According to Reuters, sources are saying that Apple is negotiating with major television networks, including ABC and NBC, in order to provide shows for purchase on iTunes. However, they also reported that the deal has not been completed, and none of the companies involved have commented on the rumors.

It has also been rumored that Apple will introduce a new online music service. In 2009, Apple took over a company that allowed users to stream music online rather than download individual songs. Apple has not confirmed the rumors.

Last September’s media event saw the return of Apple CEO Steve Jobs after he took a break to undergo a liver transplant. This year, the event will be held in San Francisco’s Yerba Buena Center for the Arts, previously used by Apple in April for the unveiling of the iPad.

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