Population genetics of 30 insertion/deletion polymorphisms in the Kuwaiti population.

This study evaluates the forensic utility of the 30 insertion and deletion (indel) markers contained in the Qiagen Investigator® DIPplex kit in the Kuwaiti population (n = 150). All but one of the 30 markers were shown to conform to the expectations of the Hardy-Weinberg Equilibrium. Linkage disequilibrium tests showed no statistically significant deviation from independence. The high combined power of discrimination (CPD > 99.999%) and low combined match probability (CMP) of 2.736 × 10-13 provide a satisfactory level of discrimination, allowing the DIPplex loci to be used as forensic markers for individual identification in Kuwait. The paternity indices indicate the usefulness of the DIPplex kit as a supplementary typing system for challenging paternity cases in Kuwait.

Assessment of coding region variants in Kuwaiti population: implications for medical genetics and population genomics.

Consanguineous populations of the Arabian Peninsula have been underrepresented in global efforts that catalogue human exome variability. We sequenced 291 whole exomes of unrelated, healthy native Arab individuals from Kuwait to a median coverage of 45X and characterised 170,508 single-nucleotide variants (SNVs), of which 21.7% were 'personal'. Up to 12% of the SNVs were novel and 36% were population-specific. Half of the SNVs were rare and 54% were missense variants. The study complemented the Greater Middle East Variome by way of reporting many additional Arabian exome variants. The study corroborated Kuwaiti population genetic substructures previously derived using genome-wide genotype data and illustrated the genetic relatedness among Kuwaiti population subgroups, Middle Eastern, European and Ashkenazi Jewish populations. The study mapped 112 rare and frequent functional variants relating to pharmacogenomics and disorders (recessive and common) to the phenotypic characteristics of Arab population. Comparative allele frequency data and carrier distributions of known Arab mutations for 23 disorders seen among Arabs, of putative OMIM-listed causal mutations for 12 disorders observed among Arabs but not yet characterized for genetic basis in Arabs, and of 17 additional putative mutations for disorders characterized for genetic basis in Arab populations are presented for testing in future Arab studies.

A cross-cultural study on perceived health-related quality of life in children and adolescents with type 1 diabetes mellitus.

OBJECTIVE: This study investigated whether culture can affect self- and proxy-reports of perceived diabetes-specific health-related quality of life of children and adolescents with type 1 diabetes when taking into account glycemic control, gender and age. METHODS: A total of 416 patients aged between 8 and 18 years--84 (Greece), 135 (Hungary) and 197 (Kuwait)--and their parents completed the Pediatric Quality of Life Inventory 3.0. Diabetes Module. RESULTS: Gender and age did not have any effect on perceived diabetes-specific health-related quality of life. Significant differences were detected among countries in self- and proxy-reports of diabetes-specific health-related quality of life when controlling for glycemic control. More specifically, Greek patients with type 1 diabetes and their parents reported significantly worse disease-specific health-related quality of life than their peers from Kuwait and Hungary. Moreover, culture affected the level of agreement between self- and proxy-reports with parents from Kuwait underestimating their children's diabetes-specific health-related quality of life. CONCLUSION: The impact of culture on self- and proxy-reports of diabetes-specific health-related quality of life warrants further investigation, since it might suggest the need for differential psychosocial treatment.

SELF-REPORTED RELIGIOSITY IN KUWAITI AND AMERICAN COLLEGE STUDENTS.

In previous research, Kuwaiti students obtained higher scores than American students on a religiosity scale. For the present study, the self-reported religiosity of Kuwaiti and American students was assessed using a single item. The respondents were 154 Kuwaiti students (M age = 20.8 yr., SD = 2.4) and 154 American college students (M age = 21.8 yr., SD = 5.0; 82% women in both samples). The Kuwaiti students responded in Arabic and the American students in English to the question: "What is your level of religiosity in general?" using an 11-point Likert format anchored by 0 and 10. The high score indicates high religiosity. The Kuwaiti students obtained a significantly higher mean score for religiosity than did their American counterparts (6.5 vs 4.5), indicating that religiosity is more important in the lives of the present sample of Kuwaiti students than in their American counterparts. A single-item self-rating scale may be useful in brief surveys such as epidemiological studies.

Profile of subjective quality of life and its correlates in a nation-wide sample of high school students in an Arab setting using the WHOQOL-Bref.

BACKGROUND: The upsurge of interest in the quality of life (QOL) of children is in line with the 1989 Convention on the Rights of the Child, which stressed the child's right to adequate circumstances for physical, mental, and social development. The study's objectives were to: (i) highlight how satisfied Kuwaiti high school students were with life circumstances as in the WHOQOL-Bref; (ii) assess the prevalence of at risk status for impaired QOL and establish the QOL domain normative values; and (iii) examine the relationship of QOL with personal, parental, and socio-environmental factors. METHOD: A nation-wide sample of students in senior classes in government high schools (N = 4467, 48.6% boys; aged 14-23 years) completed questionnaires that included the WHOQOL-Bref. RESULTS: Using Cummins' norm of 70% - 80%, we found that, as a group, they barely achieved the well-being threshold score for physical health (70%), social relations (72.8%), environment (70.8%) and general facet (70.2%), but not for psychological health (61.9%). These scores were lower than those reported from other countries. Using the recommended cut-off of <1SD of population mean, the prevalence of at risk status for impaired QOL was 12.9% - 18.8% (population age-adjusted: 15.9% - 21.1%). In all domains, boys had significantly higher QOL than girls, mediated by anxiety/depression; while the younger ones had significantly higher QOL (p < 0.001), mediated by difficulty with studies and social relations. Although poorer QOL was significantly associated with parental divorce and father's low socio-economic status, the most important predictors of poorer QOL were perception of poor emotional relationship between the parents, poor self-esteem and difficulty with studies. CONCLUSION: Poorer QOL seemed to reflect a circumstance of social disadvantage and poor psychosocial well-being in which girls fared worse than boys. The findings indicate that programs that address parental harmony and school programs that promote study-friendly atmospheres could help to improve psychosocial well-being. The application of QOL as a school population health measure may facilitate risk assessment and the tracking of health status.

Race differences in the prevalence of the factor V Leiden mutation in Kuwaiti nationals.

Factor V Leiden mutation (FVL; G1691A) is an established risk factor for venous thromboembolic disorders. FVL was reported with high prevalence in Caucasians (1-15%) but was absent in non-Caucasians like Africans and Asians. Studies reported FVL in 5-27% of Arabs and non-Arabs living in the Middle Eastern countries northern to the Arabian Peninsula, but was almost absent in Arabs in the Arabian Peninsula itself. Kuwait is an Arabic country present on the northern border of the Arabian Peninsula, and Kuwaitis are originally from Saudi Arabia (Southern to Kuwait and within the Arabian Peninsula) or from Iran and Iraq (northern to Kuwait and the Arabian Peninsula). This study was conducted to study FVL in Kuwaitis in relation to their origin. Real-time PCR was performed on DNA samples of 285 apparently healthy Kuwaitis using specially designed primers and probes for FVL. There were 109 Kuwaitis of Iranian origin, 71 of Iraqi origin and 105 of Saudi origin. FVL was present in 7 and 5 Kuwaitis of Iranian and Iraqi origin, respectively. None of the Kuwaitis of Saudi origin had the mutation. Prevalence of FVL in Kuwaitis of Iranian (6.42%) and Iraqi (7.04%) origin were statistically different from prevalence in Kuwaitis of Saudi (0%) origin (P-value<0.05). No difference was found between females and males (P-value>0.6). In conclusion, FVL is present in Kuwaitis of Iranian or Iraqi origin only. Therefore, testing and providing genetic consultation for FVL may be needed in those Kuwaitis only which should save time, cost and efforts. However, this assumption should be confirmed by other studies and on larger number of cases.

Validity and reliability of the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (EORTC QLQ): experience from Kuwait using a sample of women with breast cancer.

BACKGROUND AND OBJECTIVES: Although the EORTC QLQ-C30 and its breast-specific module (BR-23) are widely used instruments, the few reports on their psychometric characteristics from Arab and neighboring countries involved limited analyses. Our objective was to assess the psychometric characteristics of both questionnaires using the responses of a larger sample of Arab women. METHODS: Participants were consecutive clinic attendees at the Kuwait Cancer Control Center. The indices assessed were alpha coefficients, item-internal consistency (IIC), item-discriminant validity (IDV), and known-groups validity. RESULTS: The 348 women were aged 48.3 (10.3) years. The intra-class correlation for the test-retest statistic and the internal consistency values for the multi-item scales were >0.7 alpha. With the exception of the pain subscale, all items met the IIC criterion of >0.4 correlation with the corresponding scale. For IDV, the BR-23 performed better than the QLQ-C30. The scale scores discriminated between patients at different disease stages, and between sick and well populations. CONCLUSION: With the exception of the pain subscale, the Arabic version of the questionnaires is psychometrically sound.

Dimensional and hierarchical models of depression using the Beck Depression Inventory-II in an Arab college student sample.

BACKGROUND: An understanding of depressive symptomatology from the perspective of confirmatory factor analysis (CFA) could facilitate valid and interpretable comparisons across cultures. The objectives of the study were: (i) using the responses of a sample of Arab college students to the Beck Depression Inventory (BDI-II) in CFA, to compare the "goodness of fit" indices of the original dimensional three-and two-factor first-order models, and their modifications, with the corresponding hierarchical models (i.e., higher - order and bifactor models); (ii) to assess the psychometric characteristics of the BDI-II, including convergent/discriminant validity with the Hopkins Symptom Checklist (HSCL-25). METHOD: Participants (N = 624) were Kuwaiti national college students, who completed the questionnaires in class. CFA was done by AMOS, version 16. Eleven models were compared using eight "fit" indices. RESULTS: In CFA, all the models met most "fit" criteria. While the higher-order model did not provide improved fit over the dimensional first - order factor models, the bifactor model (BFM) had the best fit indices (CMNI/DF = 1.73; GFI = 0.96; RMSEA = 0.034). All regression weights of the dimensional models were significantly different from zero (P < 0.001). Standardized regression weights were mostly 0.27-0.60, and all covariance paths were significantly different from zero. The regression weights of the BFM showed that the variance related to the specific factors was mostly accounted for by the general depression factor, indicating that the general depression score is an adequate representation of severity. The BDI-II had adequate internal consistency and convergent/discriminant validity. The mean BDI score (15.5, SD = 8.5) was significantly higher than those of students from other countries (P < 0.001). CONCLUSION: The broadly adequate fit of the various models indicates that they have some merit and implies that the relationship between the domains of depression probably contains hierarchical and dimensional elements. The bifactor model is emerging as the best way to account for the clinical heterogeneity of depression. The psychometric characteristics of the BDI-II lend support to our CFA results.

Correlates of quality of life in an Arab schizophrenia sample.

OBJECTIVES: We focused on the subjective quality of life (QOL) indicators of the Lancashire quality of life profile, European version (LQoLP-EU) in a Kuwaiti schizophrenia sample. The objectives were: First, to assess the reliability and validity of the questionnaire. Second, to highlight the patients' QOL profile, in comparison with the results of the European five-nation study. Third, to examine the association of perceived needs for care, caregiver burden, service satisfaction, self-esteem and psychopathology, with three indices of global QOL: total life satisfaction or perceived QOL (PQOL) score; general wellbeing (GW) and Cantril's ladder (CL). METHOD: Consecutive outpatients in stable condition and their family caregivers were interviewed with the LQoLP, and measures of needs for care, service satisfaction, caregiver burden and psychopathology. RESULTS: There were 130 patients (66.1%m, mean age 36.8). Majority of the patients (56%) felt satisfied with the nine domains of life investigated, and 44.6% felt "averagely" happy. Their clinical severity was moderate (BPRS-18 = 44.4). In exploratory factor analysis (FA), the original domains were mostly replicated. Reliability indices were significant (>0.7). In stepwise regression analyses, the associations of PQOL were more in number and mostly different from those of GW and CL. The correlates of PQOL included, social unmet need (8.1% of variance), staff perception of unmet need (10.3%), general satisfaction with services (11.3%), burden of caregiver supervision (3.7%), self-esteem (2.9%) and positive symptoms (2.6%). Of the nine life domains, health was the most important correlate of GW and CL, indicating the centrality of health status in judgments of subjective QOL. In secondary FA, GW and CL loaded together, but separately from life domains, implying that these are separable parts of the subjective wellbeing construct. CONCLUSION: The profile of QOL scores was mostly similar to European data. The significant multivariate association with patients/staff perceptions of unmet need for care and service satisfaction indicate the usefulness of staff professional development and service improvement in outcome; and imply that promotion of QOL should be an institutional objective. Our finding about the relationship between the three global measures of QOL has added support to the emerging QOL theory.

The prevalence of self-reported chronic conditions among Arab, Chaldean, and African Americans in southeast Michigan.

OBJECTIVES: While there is a plethora of research on the prevalence of individual chronic conditions, studies that examine the clustering of these conditions are lacking, especially among immigrant, minority groups. DESIGN: Cross-sectional, convenience sample. SETTING: A self-administered survey was distributed at churches, mosques, and small businesses. PARTICIPANTS: Arabs (n = 1383), Chaldeans (n = 868), Blacks (n = 809) and Whites (n = 220) in southeast Michigan. MAIN OUTCOME MEASURES: We estimated the prevalence of hypertension, high cholesterol, heart disease, diabetes, asthma, and depression. Using a logistic regression model, we estimated odds ratios and 95% confidence intervals for the association between ethnicity and reporting one or more chronic conditions before and after adjusting for demographic, socioeconomic status, health care, chronic conditions, and health behavior variables. RESULTS: The overall age and sex-adjusted prevalence of having one or more chronic conditions was 44%. Estimates were lower for Chaldeans (32%) compared to Arabs (44%), Whites and Blacks (50% for each group). In the fully adjusted model, Chaldeans were less likely (OR = 0.62; 95% CI = 0.43-0.89) to report having one more chronic conditions compared to Whites. CONCLUSIONS: Future studies should employ probability samples, and should collect more detailed sociodemographic and acculturation data, which influence the relationship between race/ethnicity and the prevalence of chronic conditions.

Religiosity and death anxiety: no association in Kuwait.

In a sample of 162 Kuwaiti college students (33 men, 129 women; M age = 20.1 yr., SD = 1.9), the mean scores on the death anxiety scales by Templer, Abdel-Khalek, and the Collett-Lester were higher than that in an American sample, except for one subscale of the Collett-Lester Scale, i.e., Dying of Self. Based on the relatively collectivistic culture, it seems that the present participants did not differentiate between the "self" and the "other" in death anxiety, in which all scales were rated high in general. The scores on these scales were not significantly correlated with those on the Hoge Intrinsic Religious Motivation Scale, or single-item self-rating measures of religiosity and strength of religious belief.

Association of blood levels of C-reactive protein with clinical phenotypes in Arab schizophrenic patients.

Schizophrenia may be associated with inflammatory reactions and C-reactive protein (CRP) is a nonspecific serum protein marker for persisting inflammatory states. This study aimed to assess concentrations of high sensitivity CRP (hsCRP) in schizophrenic Arab patients and evaluate the relationships of hsCRP levels with aspects of clinical phenotypes of the disease. Two age-matched groups of subjects were studied: (1) healthy controls, HC, n=165; (2) patients with schizophrenia, SZ: n=207. Each subject was evaluated with a standard questionnaire for age at disease onset, family history, disease severity and outcome. Serum hsCRP levels were measured by immunoassay. The two groups of subjects were similar in age, ethnic composition and socioeconomic status. Those with SZ had significantly greater serum concentrations of hsCRP. There were significant associations between hsCRP and (i) age in both groups; (ii) body mass index (BMI) in HC but not in SZ. In the latter, hsCRP levels were: (a) marginally higher in women with later age of disease onset; (ii) highest with remission and with catatonic features; and (iii) lower with family history of psychosis. The study concludes that serum levels of hsCRP are increased in clinically stable Arab patients with schizophrenia and appear related to the disorder's clinical expression. It is suggested that there may be an inflammatory component to schizophrenia which is associated with aspects of its clinical phenotype.

Subjective quality of life in a nationwide sample of Kuwaiti subjects using the short version of the WHO quality of life instrument.

OBJECTIVES: The usefulness of quality of life (QOL) as an outcome measure in medicine has inspired general population studies to establish normative values. The objectives of the study were to: (1) highlight the pattern of satisfaction with aspects of life circumstances among a nationwide sample of Kuwaiti subjects, using the 26-item WHOQOL Instrument (WHOQOL-Bref); (2) establish the QOL domain normative values; (3) highlight the relationship of QOL with socio-demographic variables and scores on scales for anxiety and depression; and (4) assess the relationship between domains of QOL. METHOD: A one-in-three systematic random proportionate sample of consenting Kuwaiti nationals attending the large cooperative stores and municipal government offices in the six governorates, were requested to complete the questionnaires anonymously. RESULTS: There were 3,303 participants (44.8% m, 55.2% f, mean age 35.4, SD 11.9; range, 16-87). As a group, they were only moderately satisfied with their life circumstances. The domain scores for physical health (14.6 or 66.2%) and psychological health (14.2 or 63.9%) were at the middle of the range for the WHO 23-country report, while the social relations (15.0 or 68.8%) and environment (14.5 or 65.4%) domains were at the upper end of the WHO range. The general facet (GF) score (15.5 or 71.6%) was significantly higher than all domains. Diminished QOL was significantly associated with female gender, older age, social disadvantage, and high scores on anxiety/depression. Depression was the most important predictor of QOL, accounting for over 77% of total variance. CONCLUSION: QOL was sensitive to distressing and unfulfilled life circumstances. Hence, coupled with the difficulty of conducting house-to-house surveys in such a conservative society, a cost effective way of tracking societal distress is by including a brief and responsive measure of QOL during national census exercises. Clinicians need to be aware of QOL issues because QOL is associated with clinical and social variables. The differences between GF (representing subjective well-being) and the domains, has implications for QOL theory.

Public knowledge and attitudes toward epilepsy in Kuwait.

PURPOSE: The study was conducted to determine the familiarity with, knowledge of, misunderstandings, and attitudes toward epilepsy among the Kuwaiti population. METHODS: A pretested questionnaire was used to collect data from a sample of 784 Kuwaiti individuals, selected from five governorates in Kuwait using a multistage stratified clustered sampling. RESULTS: Seven hundred fifty-five subjects were interviewed, and 97.6% reported their awareness about epilepsy. Of these, 51.8% knew someone who had epilepsy, 56.4% had witnessed an epileptic seizure, 45.9% believed that epilepsy is a hereditary disease, 60.4% reported that "all epileptic fits manifest symptoms of generalized tonic-clonic seizure," 88.3% indicated that putting an object into the patient's mouth to prevent tongue biting during a seizure is appropriate, and 57.1% stated that drug therapy was the only treatment available for epilepsy. Objections to shake hands with, working with, marrying, and employing epileptic patients were reported by 16.0%, 24.8%, 71.6%, and 45.2%, respectively. Childbirth by epileptic women and allowing children to play with an epileptic child were opposed by 56.3% and 27.7%, respectively. A total of 370 (50.2%) agreed that epilepsy is equivalent to psychiatric disorder. DISCUSSION: The present findings have demonstrated that epilepsy is a well-known disease in Kuwait, and that negative attitudes toward epilepsy do prevail in Kuwait. The majority of the negative attitudes were significantly associated with the misunderstanding of epilepsy. Continuing effective educational interventions would be needed in order to improve the appropriate understanding of epilepsy, and to ameliorate the social discrimination and misconceptions against epileptic patients.

Emotional intelligence and psychological health in a sample of Kuwaiti college students.

This summary investigated correlations between emotional intelligence and psychological health amongst 191 Kuwaiti undergraduate students in psychology, 98 men and 93 women (M age=20.6 yr., SD=2.8). There were two measures of emotional intelligence, one based on the ability model, the Arabic Test for Emotional Intelligence, and the other on the mixed model, the Emotional Intelligence Questionnaire. Participants' psychological health was assessed using scales from the Personality Assessment Inventory. A weak relationship between the two types of emotional intelligence was found. A correlation for scores on the Emotional Intelligence Questionnaire with the Personality Assessment Inventory was found but not with those of the Arabic Test for Emotional Intelligence. Regression analysis indicated scores on Managing Emotions and Self-awareness accounted for most of the variance in the association with the Personality Assessment Inventory. Significant sex differences were found only on the Arabic Test for Emotional Intelligence; women scored higher than men. On Emotional Intelligence Questionnaire measures, men had significantly higher means on Managing Emotions and Self-motivation. However, no significant differences were found between the sexes on the Total Emotional Intelligence Questionnaire scores.

Serum prostate-specific antigen levels in Middle Eastern men with subclinical prostatitis.

OBJECTIVE: To investigate the influence of subclinical or histologically diagnosed prostatitis on serum prostate-specific antigen (PSA) in patients investigated for prostatic disease in Kuwait. MATERIALS AND METHODS: Serum PSA was assayed in patients investigated for prostatic disease in Mubarak Al-Kabeer Hospital, Kuwait, between December 2002 and December 2004. These included patients undergoing transrectal ultrasound with needle biopsy of the prostate gland and those who were treated with transurethral resection of the prostate or retropubic prostatectomy. The tissue was evaluated for prostatitis as well as the underlying disease, and the type and severity of prostatitis were compared with levels of serum PSA. RESULTS: Of the 331 tissue specimens, 18 (5.4%) did not show prostatitis, while 233 (70.4%) with benign prostate and 80 (24.2%) with malignant prostate disease showed prostatitis. Of 270 men with known serum PSA levels, 198 and 72 had benign and malignant prostate disease, respectively. Of the 198, 77 (41%) with benign prostate disease and prostatitis and of the 72, 52 (76%) with malignant prostate disease and prostatitis had serum PSA levels >10 ng/ml. CONCLUSION: The data showed that although raised serum PSA is more commonly associated with prostate cancer, subclinical prostatitis is a significant source of high serum PSA in over 40% of men in Kuwait. That local factors may obscure the usefulness of serum PSA as a screening tool suggests the need for a locally applicable paradigm to identify prostate cancer.

High prevalence and level of resistance to metronidazole, but lack of resistance to other antimicrobials in Helicobacter pylori, isolated from a multiracial population in Kuwait.

BACKGROUND: The primary treatment regimen for Helicobacter pylori infection for Kuwaitis does not contain metronidazole, but that for expatriates does. There is also increasing failure of antimicrobial therapy. AIM: To determine the susceptibility of H. pylori from upper gastrointestinal biopsies of Kuwaitis and non-Kuwaitis to find out if differences existed in the susceptibilities of the isolates from the two different populations. METHODS: The susceptibilities of 96 H. pylori isolates were tested against metronidazole, amoxicillin, clarithromycin and tetracycline by the E test. The rdxA gene was analysed from selected metronidazole-susceptible and metronidazole-resistant strains to find out polymorphism and the basis of metronidazole resistance. RESULTS: Approximately, 70% of isolates from both populations were metronidazole resistant with 65% isolates showing high minimum inhibitory concentration values of >256 mug/mL. No resistance to the other three antimicrobials was found. There were novel nonsense and missense mutations with no deletion in the rdxA gene by insertion of mini-IS605. CONCLUSIONS: The prevalence and level of metronidazole resistance in H. pylori in the two populations was high with no difference, in spite of different treatment regimens. Metronidazole resistance in this transitional country appeared to be independent of prior metronidazole use for treatment of H. pylori infection.

Long term prognosis of sarcoidosis in Arabs and Asians: predictors of good outcome.

BACKGROUND: The prognosis of sarcoidosis is variable and often difficult to predict. Our aim was to identify predictors of good prognosis in Arabs and Asians with sarcoidosis. METHODS: Data on patients with sarcoidosis followed up for at least 3 years in two major hospitals in Kuwait were collected retrospectively for the period 1983 to 1995 and prospectively from 1995. RESULTS: Of the total 115 patients, 60% were females and 80% were Arabs. Majority, 86.9%, of the patients had either Stage I or II disease. Forty-five (43.7%) were followed up for 3 to 5 years, 43 (41.7%) for 5 to 9 and 15 (14.6%) for 10 or more years while 12 were lost to follow up. Good prognosis was seen in 53 (51%), intermediate in 33(32%) and poor in 17 (17%) patients. Two patients (1.9%) died. Good prognosis was observed in 74.4% of patients with Stage I, 40% of patients with Stage II and 16.7% with stage III disease, p = 0.001. In addition, presence of arthralgia predicted a good prognosis, p = 0.014. Hypercalcemia was noted only in patients with poor or intermediate outcome. Gender, ethnicity, and presence of erythema nodosum were not predictors of prognosis in our patients. Multivariate logistic regression analysis confirmed that early stage of the disease [OR (95 %CI), 6.1 (2.3-15.7), p = 0.001] and presence of arthralgia, [OR (95%CI), 4.5 (1.3-15.4), p = 0.02] were predictors of good prognosis. CONCLUSION: Presence of arthralgia and early stage of the disease were the most important predictors of good prognosis. Sex, age, ethnicity and presence of erythema nodosum did not influence the prognosis.

Age-specific reference levels of serum prostate-specific antigen and prostate volume in healthy Arab men.

UNLABELLED: OBJECTIVE; To determine age-specific reference ranges for serum prostate-specific antigen (PSA) concentration and prostate volumes in a population of healthy Arab men. SUBJECTS AND METHODS: Blood samples were taken from 396 healthy Arab men (from Kuwait and Oman) aged 15-79 years and from across the social spectrum. Men aged >40 years had a digital rectal examination and transrectal ultrasonography of the prostate to determine prostate volume. The serum PSA level was measured using commercial kits, and age-specific ranges for PSA levels and prostate volume determined. RESULTS: The serum PSA ranges (ng/mL) for each age range in Arab men were: 40-49 years, 0-0.9; 60-69, 0-2.7; 70-79, 0-5.5 ng/mL; the respective prostate volumes were 8-22, 9-30 and 10-33 mL. The serum PSA level and prostate volume correlated with age (P < 0.001). Arab men had lower serum PSA levels and prostate volumes than those reported for Caucasians, but similar to those reported for Asians (Japanese and Chinese). CONCLUSION: These results indicate that Arab men have lower PSA levels and prostate volumes than Caucasians. The levels are slightly lower than those reported in the Japanese and, as in the Japanese, low PSA levels and small prostate volumes might be related to the low incidence of clinical prostate cancer in Arab men.