The editorial on page 1 of this issue asks for financial support for DVMB members who lost their property in the floods which devastated some valleys in Germany in August of this year.

 In pages 3–7, the disappointing reply of the German federal ministry of health on a letter of DVMB chairman Franz GADENZ (published in our September issue) on health care for people with chronic diseases is published.

Wolfgang MIEHLE in his article on reactive arthritides describes not only the HLA-B27 associated reactive spondyloarthritides like Reiter’s syndrome, but gives also very helpful information concerning the Lyme borreliosis which is spread by ticks also in parts of central Europe. 

Dennis MCGONAGLE et al. present an enthesitis based model for the pathogenesis of spondyloarthropathies. They argue that all symptom sites observed in spondyloarthropathies are characterised by biomechanical stress which may lead to microfractures. Subsequent healing may then be associated with inflammation processes and may thus contribute (in combination with bacteria) to the disease. Their original article published in the Journal of Rheumatology was transformed into a patient-adapted German version.

The cartoons in pages 22 and 65 have again been drawn by cartoonist Christian BORN.

As part of the results of a survey in the year 2000 among patient members of the German and the Austrian AS societies, I present some differences found between HLA-B27 positive and HLA-B27 negative AS patients. The difference in the average age at disease onset is larger than that between AS patients with and without associated diseases. It has also been found that iritis attacks are found in a larger percentage of B27 positive AS patients than in B27 negative AS patients. A scientific version of this article has been prepared in cooperation with M. A. KHAN, S. VAN DER LINDEN, D. VAN DER HEIJDE, and J. BRAUN and has been accepted by Rheumatology International. 

Francis GUILLEMIN et al. investigated the long-term disability and prolonged sick leaves as outcome measurements in ankylosing spondylitis and found that work connected with carrying heavy loads and work involving exposure to cold conditions and prolonged standing postures are unfavourable for patients with AS while sedentary work and formal vocational rehabilitation programs seem to protect against long-term disability. The original paper was published in 1990 in Arthritis and Rheumatism.

The “Heilstollen” in Bad Gastein celebrated its 50th anniversary with a symposium and an evening ceremony. Our report on the Heilstollen history is based on a book which appeared on the occasion of this anniversary.

Albrecht FALKENBACH asked AS patients which factors mainly influenced the course of their disease. Negative influences indicated were physical overstrain at work, weather conditions, after-effects of war and captivity, and previous infections. The original of this article has been published in Arthritis Care & Research.

Under the title “4000 years AS therapy”, I contribute a report on what may be the oldest document on the treatment of ankylosing spondylitis: a papyrus written in the 19th century BC which contains recipes “to ease what is stiff and straighten what is warped“. The papyrus has been excavated in 1896, was preserved by Hugo IBSCHER in Berlin. It was deciphered by John BARNS and is now stored in the British Museum.

Helmut W. MINNE gave a review on what everyone should know about vitamin D. A lack of this vitamin can lead to rachitis in children and to osteomalacia in adults. The skin can produce vitamin D with the help of sunlight. Additional amounts are contained in some food or in drugs. Risk factors for a vitamin D deficit are listed. The article is reprinted from the journal of Deutsche Rheuma-Liga.

A book on ankylosing spondylitis edited by Jürgen BRAUN and Joachim SIEPER is reviewed. Many AS researchers in Germany and abroad have contributed to this important book. 

International cooperation:
The 6th ASIF Council meeting took place in October 2002 in Portorose, Slovenia. AS societies from 12 countries were represented. Seoirse SMITH from Ireland was elected as new ASIF president. Details on all AS societies existing world-wide may be found in the ASIF website under www.asif.rheumanet.org.