[Quality of life in multiple sclerosis and other chronic autoimmune and non-autoimmune diseases]. / Calidad de vida en esclerosis multiple y otras enfermedades cronicas autoinmunes y no autoinmunes.

INTRODUCTION: Diseases that involve the nervous system and the musculoskeletal system are particularly likely to produce different limitations and deficits, and to affect the individual conception of quality of life. AIM: To determine the impact on quality of life generated by chronic autoimmune diseases like multiple sclerosis (MS), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), ankylosing spondylitis (AS) and chronic musculotendinous diseases like osteoarthritis (OA) and fibromyalgia (FM), using the Short Form 36-item (SF-36) health questionnaire. PATIENTS AND METHODS: A descriptive cross-sectional study was conducted between January 2004 and June 2006 and included 509 individuals, of whom 56 had MS, 36 SS, 24 AS, 200 RA, 65 SLE, 54 OA and 74 FM. Guided interviews were conducted to evaluate each sphere of the SF-36 health questionnaire. The statistical analysis was performed using the general lineal model, with means differences according to each diagnosis. RESULTS: Compared to patients with RA, those with MS showed significant differences in the physical functioning and social functioning dimensions. The lowest score was recorded in those with FM, except in physical functioning, where MS had the lowest mean. No differences were found in the mean scores on general conception of the state of health in each condition analysed. CONCLUSIONS: Different neurological functions deteriorate progressively in MS, which has repercussions on the musculoskeletal system; this leads to a poorer quality of life, mainly in the physical and social functions. The disability generated is not only defined by deficit but also by the degrees of functional limitation within the context of personal health. Quality of life thus becomes a global biopsychosocial phenomenon.

Democracy, authoritarianism, and health in Argentina.

The democracy-participation-better health versus authoritarianism-repression-worse health polarity is illustrated by the case of health policy in Argentina. At the turn of the century, Argentina's health levels were among the highest in the world. The subsequent deterioration can be correlated with disruptions of the country's democratic process. The participation of the military in Argentinian political life has produced a lowering of the standard of living of the majority of the population, with a consequent increase in mortality and morbidity, and the appearance of elitist, commodity-centered health policies. the anti-health policies of the military are contrasted with those pursued by democratically elected Argentinian governments, as well as the principles set forth in recent declarations of human rights.

Starting from year one: the politics of health in Nicaragua.

The triumphant Sandinista revolution inherited a health situation characterized by high mortality, low life expectancy, widespread malnutrition, and a medical system limited in scope. The extent of these problems can only be estimated as a result of the somocista government's failure to develop an accurate system of vital statistics. While there are many options available for rapidly decreasing the high levels of mortality and morbidity in Nicaragua, the revolutionary government has chosen a strategy which fuses public health and politics. A health network based on popular participation and control is being formed which should not only decrease the high rates of malnutrition and infectious diseases in a cost-efficient manner, but should increase the strength of the revolution as well.

Health in Argentina under the Military Junta.

The socioeconomic policies of Argentina's Military Junta, in power since March 1976, have led to a sharp impoverishment of the vast majority of the population. In the health sector, facilities which previously were public are being transferred to the private sector, and public hospitals formerly providing free services to the population now charge patients for the care received. As a necessary counterpart to these unpopular measures, a regime of terror has been waged against members of the health team--both those politically active and those considered potentially subversive, particularly the psychiatrists and workers in community health. Differences between the Argentinian situation and previous European fascist patterns are noted, and the possibility of use of the "Argentinian model" in other capitalist countries in crisis is discussed.