108 LETTERS

of Health, National Institute of Allergy and Infectious Diseases, Washington DC, 1974, p 20

6. Ronald AR, Harding GKM, Mathias R, Wong CK, Muir P: Prophylaxis of recurring urinary tract infection in fe- males: a comparison of nitrofurantoin with trimethoprim- sulfamethoxazole. Can Med Assoc J 112(suppl):13-16, 1975

7. Edwards PR, Ewing WH: Identification of Enterobacte- riaceae. Third edition. Minneapolis, Minnesota, Burgess Publishing Company, 1972, pp 21-47

8. Skirrow MB: Campylobacter enteritis: a “new” disease. Br Med J 2:9-11, 1977

9. Pai CH, Sorger S, Lafleur L, Lackman L, Marks MI: Effi- cacy of cold enrichment techniques for recovery of Yer- sinia enterocolitica from human stools. J Clin Microbiol 9:712-715, 1979

10. Cowling P, Ebringer R, Cawdell D, Ishii M, Ebringer A: C-reactive protein, ESR, and Klebsiella in ankylosing spondylitis. Ann Rheum Dis 39:4549, 1980

11. Eastmond CJ, Cooke EM, Wright V: Klebsiella pneu- moniae (letter). Ann Rheum Dis 37:298-299, 1978

12. Warren RE, Brewerton DA: Faecal carriage of Klebsiella by patients with ankylosing spondylitis and rheumatoid arthritis. Ann Rheum Dis 39 :374 , 1980

13. Eastmond CJ, Willshaw HE, Burgess EP, Shinebaum R, Cooke EM, Wright V: Frequency of faecal Klebsiella aerogenes in patients with ankylosing spondylitis and con- trols with respect to individual features of the disease. Ann Rheum Dis 39:118-123, 1980

14. Seager K, Bashir HV, Geczy AF, Edmonds J, De Vere- Tyndall A: Evidence for a specific B27-associated cell sur- face marker on lymphocytes of patients with ankylosing spondylitis. Nature 277:68-70, 1979

15. Geczy AF, Alexander K, Bashir HV, Edmonds J: A fac- tors(s) in Klebsiella culture filtrates specifically modifies an HLA B27-associated cell surface component. Nature 283:782-784, 1980

International year of disabled persons, 1981 To the Editor:

The United Nations (UN) and its specialized agencies (WHO, UNICEF, UNESCO) have proclaimed 1981 as the International Year of Disabled Persons (IYDP). The logo represents 2 human beings holding hands, one handicapped and the other able-bodied in their development, they soar upward in equality (Figure 1).

The UN General Assembly at its December 1979 session adopted a resolution stating that the IYDP should promote the realization of the right of disabled persons to participate fully in the social life and devel- opment of the societies in which they live, and their

right to enjoy living conditions equal to those of other citizens. The year should increase awareness of the con- tributions disabled persons can make as full members of society and result in better social response to the special difficulties which disabled persons encounter in devel- oping their human potential.

An important objective of the IYDP will be to increase public understanding of what disability is and awareness of the problems it may bring. Recognition that disability is a functional restriction due to an im- pairment and that handicaps are the social con- sequences of disability will be important.

Another objective of the IYDP will be encourag- ing disabled persons to organize and express their views effectively. The experience acquired in the course of the IYDP should lead to the adoption of a long-term pro- gram of action.

The participation not only of member-nations of the UN but also of non-governmental international or- ganizations of disabled persons, professional societies, and social agencies concerned with disabled people must be secured. One such non-governmental organiza- tion is the International League Against Rheumatism (ILAR) which, as a federation of 3 Regional Leagues (EULAR, PANLAR, SEAPAL), has a membership of national professional rheumatism societies and social agencies from approximately 60 countries. The Execu- tive Committee of ILAR at its meeting in January 1980

Figure 1. International Year of Disabled Persons logo.

LETTERS 109

formed an Ad Hoc Committee for IYDP chaired by Prof. Veikko Laine of Finland.

The goals of the ILAR Committee for the IYDP are: to adopt and implement the general objectives of the UN plan for the IYDP, and to stress in its recom- mendations rheumatic disease as a cause of disability and the special nature of this disability, characterized by pain, chronicity, and the need for prolonged care and rehabilitative procedures.

All the activities assumed by the ILAR Com- mittee and all the activities planned and recommended by the Committee for implementation by regional, na- tional, and international societies and agencies will be coordinated with the UN plan for the IYDP.

On the national level, the Committee is encour- aging professional societies and voluntary agencies to cooperate in the planning and implementation of a na- tional program for the IYDP as follows:

1.

2.

3.

4.

To stress the problems of disabled persons in con- nection with their own activities, and to provide relevant material for distribution to all concerned with disability caused by arthritis. To organize special groups of disabled sufferers from different rheumatic diseases to express their views effectively and to secure the right to partici- pate actively in the work of policy-making bodies in the management of their disability. To direct information systems in the form of health education to different target populations, particularly those of schools and industry. To cooperate on national and local levels with other organizations and officials representing dis- abled persons in order to assemble and strengthen their forces in joint programs.

On the regional level, the establishment of social and community agencies to fight rheumatic disease and disability will be encouraged in countries which at pres- ent have no such agencies.

On the international level, the ILAR Ad Hoc Committee will stress the importance of rheumatic dis- orders as effectors of disability, as well as the defi- ciencies existing in the prevention of such disabilities. It will influence the plans of the UN and WHO to include the recognition of impairment caused by rheumatic dis- ease among the disabilities defined by the UN Assem- bly. It will maintain cooperation with WHO by present- ing well-defined joint projects designed to improve the prevention of disabilities from arthritis.

In the United States, activities for the IYDP have been initiated by a Federal Interagency Com- mittee. The private sector is represented by the U.S.

Council for the IYDP, formed to promote through com- munity commitment full participation in all aspects of society by persons with disabilities. This Council has es- tablished long-term goals not only to increase public awareness of the unmet needs of persons with dis- abilities, but also to improve the quality of their lives. In support of the work of the IYDP, it has adopted the slo- gan, “Meeting the Challenge through Partnerships.”

The Arthritis Foundation has joined the U.S. Council as a partner to “support the world-wide objec- tive of the UN to establish goals and programs that will enrich the lives of citizens with disabilities, support the aims of the U.S. council both to fully integrate such people into the community life, and to sharpen public awareness of the problems and needs of persons with disabilities.”

EMMANUEL RUDD, MD Co-Chair, Committee on Education and

International League Against

Member, ILAR Ad Hoe Committee

Publications

Rheumatism

for I YDP

Huge knee effusion: A record? To the Editor:

Since the amount of fluid aspirated from a joint is rarely reported, even if the volume is unusually large, the record for large effusions is not definitely known. However, an informal inquiry among a number of rheu- matologists revealed that none had aspirated or known of a joint effusion greater than 250 cc. Following is the report of a case of psoriatic arthritis with a huge knee effusion yielding 363 cc of fluid.

A 50-year-old white man with a 17-year history of swollen and painful joints affecting the knees, wrists, and hands was seen in consultation at a rheumatology clinic. Four years earlier the patient had undergone a rheumatologic evaluation and was diagnosed as having seronegative active rheumatoid arthritis with an erythrocyte sedimentation rate (ESR) of 88 mm/hour. Treatment with aspirin and gold therapy was beneficial. Eighteen months prior to the visit under discussion, he developed psoriatic skin lesions and was treated by a dermatologist. His symptoms at the time of consultation were pain and swelling, primarily in the knees, which did not significantly interfere with his job as a salesman.

Physical examination revealed widespread patches of psoriasis and pitting of the nails. No subcuta-