دانلود کتاب شوگرن (بیماری مرموز چشمی)

One American in 83 has a mysterious condition known as Sjögren’s. Named after a Swedish ophthalmologist who described its salient features nearly 80 years ago, Sjögren’s, until recently, resided in a nosologic purgatory, with its manifestations misunderstood, underappreciated, and ignored. An inter-national consensus has finally been derived regarding what the term Sjögren’s means. Now that organized science has finally come to terms (literally) with the disease, a number of insights elucidated by Sjogrenologists have been rap-idly forthcoming. The collective wisdom of these investigators has continued to result in the publication of prescient findings that serve to emphasize the importance of research into this area and will have implications far beyond Sjögren’s itself. It is our hope that researchers, clinicians, physicians, and allied health professionals as well as patients and their families will be able to use this resource.
Why should we write a book on Sjögren’s? It is an autoimmune condi-tion that affects the whole body, especially musculoskeletal and glandular tissues. It can exist as a primary condition or concomitantly with rheuma-toid arthritis, systemic lupus erythematosus, scleroderma, or other rheumatic disorders. According to the most recent report from the National Institutes of Health, 14.7 to 23.5 million people in the United States have an autoimmune condition, and 150 such conditions have been identified to date. Up to 4 mil-lion of these individuals have conditions related to Sjögren’s according to the National Arthritis Data Workshop estimates, which would make the percep-tion that it is uncommon incorrect. Its prevalence varies internationally from 0.1% to 4.8% of a general population. Sjögren’s does not have a strong focus in medical education. Its symptoms are subtle and can be intermittent or non-specific. It has been estimated that symptoms are present for a mean of nearly 3 years before it is properly diagnosed. While this is an improvement from where we were a decade ago, this is unfortunate because a delayed diagnosis drastically alters quality of life. For example:
•Patients report greater fatigue, pain, and depression and diminished cog-nitive function compared with their peers.
•A survey showed that Sjögren’s impacts patients in the following ways: 97% experience physical symptoms; 59% experience an impact on their sex life; work life is impacted for 54%; 71% experience an impact on daily life, and; 63% experience a negative impact on relationships with family and friends.
•The majority have serious dental complications (e.g., caries) as well as fa-tigue and significant musculoskeletal impairments.