Hagit Cohen, PhD, Lily Neumann, PhD, Moshe Kotler, MD and Dan Buskila, MD
Fibromyalgia syndrome is a chronic, painful musculoskeletal disorder of unknown etiology and/or pathophysiology. During the last decade many studies have suggested autonomic nervous system involvement in this syndrome, although contradictory results have been reported. This review focuses on studies of the autonomic nervous system in fibromyalgia syndrome and related disorders, such as chronic fatigue syndrome and irritable bowel syndrome on the one hand and anxiety disorder on the other, and highlights techniques of dynamic assessment of heart rate variability, It raises the potentially important prognostic implications of protracted autonomic dysfunction in patient populations with fibromyalgia and related disorders, especially for cardiovascular morbidity and mortality.
Michalis Voulgarelis, MD and Haralampos M. Moutsopoulos, MD, FACP, FRCP (Edin)
Sjogren’s syndrome is a chronic inflammatory process involving primarily the exocrine glands. Its association with lymphoma is well documented. A low grade marginal-zone lymphoma related to mucosa-associated lymphoid tissue is the commonest lymphoid neoplasia in Sjogren’s syndrome. We review the literature and comment on the molecular, clinical, histopathologic and therapeutic aspects of these tumors in Sjogrens syndrome.
Dvora Aharoni, MD, Sergey Mekhmandarov, MD, Menachem Itzchaki, MD, Nurith Hiller, MD and Deborah Elstein, PhD
Leonid feldman, MD, Amalia Kleiner-Baumgarten, MD and Maximo Maislos, MD
Lotan Shilo, MD, Dania Hirsch, MD, Martin Ellis, MD and Louis Shenkman, MD
Imad Kasis, MD, Lea Lak, MD, Jakov Adler, MD, Rinat Choni, MD, Gila Shazberg, MD, Tewade-Doron Fekede, MD, Ehud Shoshani, MD, Douglas Miller, MD and Samuel Heyman, MD
Background: Following the recent drought in Ethiopia, the Jewish Agency, aided by the Israel Ministry of Foreign Affairs, launched a medical relief mission to a rural district in Ethiopia in May-August 2000.
Objectives: To present the current medical needs and deficiencies in this representative region of Central Africa, to describe the mission’s mode of operation, and to propose alternative operative modes.
Methods: We critically evaluate the current local needs and existing medical system, retrospectively analyze the mission’s work and the patients’ characteristics, and summarize a panel discussion of all participants and organizers regarding potential alternative operative modes.
Results: An ongoing medical disaster exists in Ethiopia, resulting from the burden of morbidity, an inadequate health budget, and insufficient medical personnel, facilities and supplies. The mission operated a mobile outreach clinic for 3 months, providing primary care to 2,500 patients at an estimated cost of $48 per patient. Frequent clinical diagnoses included gastrointestinal and respiratory tract infections, skin and ocular diseases (particularly trachoma), sexually transmitted diseases, AIDS, tuberculosis, intestinal parasitosis, malnutrition and malaria.
Conclusions: This type of operation is feasible but its overall impact is marginal and temporary. Potential alternative models of providing medical support under such circumstances are outlined.
Rivka Zissin, MD and Myra Shapiro-Feinberg, MD
Galya Rozen, MD, David R. Samuels, MD and Annat Blank, MD
Gustawa Stendig-Linberg, MD LRCPI, FRSM
George Habib, MD and Walid R Saliba, MD
by Jonathan Grunfeld, MD and Colin Klein, MD