Objective. To investigate the validity, reproducibility, and responsiveness of a simplified power Doppler ultrasound (PDUS) assessment of joint inflammation compared with a comprehensive 44-joint PDUS assessment in patients with rheumatoid arthritis (RA) who started therapy with a biologic agent. Methods. A total of 160 patients with active RA who started a biologic agent were prospectively recruited in 18 Spanish centers. The patients underwent clinical and laboratory assessment and blinded PDUS examination at baseline and 6 months. A PDUS examination of 128 synovial sites in 44 joints was performed. US synovitis and PD signal were semiquantitatively graded from 1 to 3 in all synovial sites. US count and index for synovitis and PD signal were obtained. PDUS intraobserver and interobserver reliability were evaluated. A process of data reduction based on the frequency of involvement of synovial sites by both synovitis and PD signal was conducted. Construct and discriminant validity of a simplified PDUS assessment was investigated. Results. A PDUS simplified assessment including 24 synovial sites from 12 joints detected 100% of patients with synovitis and 91% of patients with PD signal. There was a highly significant correlation between the 44-joint count and index for synovitis and PD signal and the 12-joint count and index for synovitis and PD signal at baseline and 6 months (r ‫؍‬ 0.84 -0.90, P < 0.0005). The smallest detectable difference was lower than the mean change in simplified PDUS variables. Conclusion. A 12-joint PDUS assessment of RA joint inflammation may be a valid, feasible method for multicenter monitoring of therapeutic response to biologic agents.

Entheseal morphologic abnormalities, PD signal, and bursitis were US abnormalities that were responsive to anti-TNF therapy in SpA. PDUS can be a reproducible method for multicenter monitoring of therapeutic response in enthesitis of SpA.

Some current dietary habits, food preparation methods and foods consumed by Kuwaiti citizens are described based on data collected from 500 adults of different education and income levels. The data show that while some traditional food habits are adhered to, others are giving way to western influences.Wheat is the main staple, followed by rice; mutton and lamb are preferred over beef; but chicken and fish are also consumed. Diluted yogurt (roob) is traditionally ingested during lunch, which is the main meal. Fresh fruits and vegetables are readily available, but their consumption is limited by purchasing power. Carbonated beverages, coffee and tea are consumed frequently and sugar utilization is high. Some food preparation practices have different implications on nutrient values of food. In cooking, rice is soaked in warm water for a few hours and then the water is discarded; meat and vegetable mixtures may be boiled for a long time. Such food preparation methods tend to destroy valuable nutrients; but partially boiled vegetable, or not well cooked meat, are not popular.Although abundant food is available and considerable amounts are wasted, an analysis of nutrient intakes show that dietary vitamin A, thiamin, riboflavin and calcium intakes are below that of the U.S. RDA for adult men and women. Iron and magnesium intakes of women are also unsatisfactory.

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The zinc, copper, and selenium status of 90 noninstitutionalized Canadian elderly women (M age = 70.3 years) in a university community and consuming self-selected diets was assessed using hair and serum trace element levels and dietary trace element intakes. Mean (+/- SD) serum zinc and copper levels (analyzed via atomic absorption spectrophotometry, AA) were 1.09 +/- 0.13 and 1.22 +/- 0.29 micrograms/ml, respectively. Mean serum selenium (+/- SD) (analyzed via instrumental neutron activation analysis (INAA) was 0.115 +/- 0.03 micrograms/ml. Median hair trace element values, analyzed via INAA, were 156 for zinc, 12.8 for copper, and 0.63 micrograms/g for selenium. Mean (+/- SD) daily dietary intakes determined via chemical analysis of 1-day diet duplicates were 1.2 +/- .06 mg/d for copper (via AA), 7.6 +/- 3.3 mg/d and 77.6 +/- 44.5 micrograms/d for zinc and selenium (via INAA), respectively, whereas mean copper and zinc intakes (+/- SD) calculated from 3-day records were 1.6 +/- 0.7 and 10.1 +/- 3.5 mg/day, respectively. Median hair and serum trace element values were above the levels associated with deficiencies. Thus the zinc, copper and selenium status of these elderly women appeared adequate.