Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies

Objectives. To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR). Methods. An English-language questionnaire, containing questions on demographics, clinical and practical aspects of UGAJ, training options in UGAJ for rheumatologists, UGAJ education in the rheumatology training curriculum and other structured education programmes in UGAJ was sent to three different groups: (i) all national rheumatology societies of EULAR; (ii) all national societies of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB); and (iii) 22 senior rheumatologists involved in EULAR musculoskeletal US training from 14 European countries, who were also asked to circulate the questionnaire among relevant colleagues. Results. Thirty-three (75%) of 44 countries responded to the questionnaire (61.3% of national rheumatology societies, 25% of the national US societies and 100% of expert ultrasonographers). In the majority of countries (85%) 80%) rate of rheumatologists performing conventional joint injection in most of the surveyed countries. The reported variations in practice and the lack of available structured training programmes for trainees in most countries indicates the need for standardization in areas including training guideline

A Systematic Literature Review Analysis of Ultrasound Joint Count and Scoring Systems to Assess Synovitis in Rheumatoid Arthritis According to the OMERACT Filter

Objective. The OMERACT Ultrasound Task Force is currently developing a global synovitis score (GLOSS) with the objective of feasibly measuring global disease activity in patients with rheumatoid arthritis (RA). In order to determine the minimal number of joints to be included in such a scoring system, and to analyze the metric properties of proposed global (i.e., patient level) ultrasound (US) scoring systems of synovitis in RA, a systematic analysis of the literature was performed. Methods. A systematic literature search of Pubmecl and Embase was performed (January 1, 1984, to March 31, 2010). Original research reports written in English including RA, ultrasound, Doppler, and scoring systems were included. The design, subjects, methods, imaging protocols, and performance characteristics studied were analyzed, as well as the ultrasound definition of synovitis. Results. Of 3004 reports identified, 14 articles were included in the review. We found a lack of clear definition of synovitis as well as varying validity data with respect to the proposed scores. Scoring systems included a wide range and number of joints. All analyzed studies assessed construct validity and responsiveness by using clinical examination, laboratory findings, and other imaging modalities as comparators. Both construct validity and responsiveness varied according to the number and size of joints examined and according to the component of synovitis measured [i.e., gray-scale (GS) or power Doppler (PD) alone or in combination]. With regard to feasibility, time of evaluation varied from 15 to 60 min and increased with the number of joints involved in the examination. Conclusions. Ultrasound can be regarded as a valuable tool for globally examining the extent of synovitis in RA. However, it is presently difficult to determine a minimal number of joints to be included in a global ultrasound score. Further validation of proposed scores is needed. (J Rheumatol 2011; 38:2055-62; doi:10.3899/jrheum.110424

Estratégias alimentares do cardinal-tetra (Paracheirodon axelrodi, Characidae) em seu ambiente natural

The cardinal tetra (Paracheirodon axelrodi) is the most intensively commercialized ornamental fish from the Rio Negro Basin (Amazonas State, Brasil). Analysis of the stomach and gut contents of fish caught in their natural habitats show conclusively that the cardinal is essentially a predator, feeding on the mesofauna that adheres to submerged litter, roots and waterplants. Microcrustacea and chironomid larvae (Diptera) were the most frequently ingested prey, while algae intake was relatively infrequent. It is argued that the relatively small size of the cardinals captured in their natural habitat is due to the annual migrations imposed by the inundation cycles, rather than to resource limitation, because it is known from earlier investigations of similar habitats, that these plant substrates are densely colonized by the aquatic mesofauna. Cardinals raised in captivity are larger and have higher rates of growth.O cardinal (Paracheirodon axelrodi) é o peixe ornamental comercializado com maior intensidade na Bacia do Rio Negro (Estado do Amazonas, Brasil). Análise do conteúdo estomacal de peixes capturados nos seus habitats naturais mostra, que o cardinal é essencialmente um predador, alimentando-se da mesofauna que está colonizando a liteira submersa, arbustos submersos, raízes flutuantes e plantas aquáticas. As presas principais são microcrustáceos e larvas de quironomídeos (Chironomidae, Diptera), enquanto ingestão de algas é pouco freqüente. Considera-se que o tamanho relativamente pequeno de cardinais capturados nos ambientes naturais é devido as migrações anuais que acompanham os ciclos anuais de enchente e vazante, e não à falta de recursos; já que é conhecido de ambientes parecidos de outros rios da região, que estes substratos aquáticos são densamente colonizados pela mesofauna. Cardinais criados em cativeiros tem taxas de crescimento mais altas e são de tamanho maiores

Fruit production, migrant bird visitation, and seed dispersal of Guarea glabra in Panama

The relationship between bird visitation and the size of the available fruit crop was studied at an understory tree ( Guarea glabra Vahl, Meliaceae) in the tropical wet forest of Barro Colorado Island, Panama Canal Zone. Twelve resident species and seven North American migrant species fed on the Bright orange arilloids (seeds with arils), which were not depleted during the normal fruiting period. The number of individual visitors, the number of visiting species, and the number of seeds removed increased linearly with the size of the available fruit crop. The proportion of seeds removed did not increase with the size of the available fruit crop, indicating that dispersal is a function of the number of fruit available and not a disproportionate function of large fruit displays. Four species of North American migrants ( Myiarchus crinitus, Catharus ustulatus, Vireo olivaceus , and Vermivora peregrina ) accounted for 70% of the visits and 60% of the seeds removed from the trees. No resident species visited Guarea as frequently as any one of these migrants. There was no indication that any single visitor was dependent on this tree for nutrition, nor that the tree was dependent upon any single species for dispersal. We hypothesize that the fruiting season of G. glabra is adaptively synchronized with northward migration of opportunistically frugivorous North American birds.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47724/1/442_2004_Article_BF00348067.pd