The Role of Advanced Imaging in Gout Management

Gout is a common form of inflammatory arthritis where urate crystals deposit in joints and surrounding tissues. With the high prevalence of gout, the standardized and effective treatment of gout is very important, but the long-term treatment effect of gout is not satisfied because of the poor adherence in patients to the medicines. Recently, advanced imaging modalities, including ultrasonography (US), dual-energy computed tomography (DECT), and magnetic resonance imaging (MRI), attracted more and more attention for their role on gout as intuitive and non-invasive tools for early gout diagnosis and evaluation of therapeutic effect. This review summarized the role of US, DECT, and MRI in the management of gout from four perspectives: hyperuricemia, gout attacks, chronic gout, and gout complications described the scoring systems currently used to quantify disease severity and discussed the challenges and limitations of using these imaging tools to assess response to the gout treatment.

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The Role of Arthroscopy in the Treatment of Gouty Arthritis of the Knee Case presentation

Revista de Chimie ◽

10.37358/rc.18.8.6507 ◽

2018 ◽

Vol 69 (8) ◽

pp. 2236-2239

Author(s):

Marius Moga ◽

Mark Edward Pogarasteanu ◽

Dumitru Ferechide ◽

Antoine Edu ◽

Chen Feng Ifrim

Keyword(s):

Gouty Arthritis ◽

Surgical Techniques ◽

Term Treatment ◽

Clinical Aspects ◽

Associated Lesions ◽

Number Of Patients ◽

Long Term Treatment ◽

Functional Scores ◽

Urate Crystals

Gout is a metabolic disease involving the impregnation of joints and other tissues with urate crystals. The onset is often brutal, and it manifests itself with pain and inflammation in the affected joint. The treatment usually involves rest, ice, NSAIDs and anti-gout medication. The long-term treatment involves medication and dietary changes. In the joint, urate crystals are deposited in the synovial, in the cartilage and in the menisci. In the arthroscopic practice, the gouty knee is a rare occurrence. We present a relevant case, that of a 57 years old patient without a prior gout diagnosis where we found urate crystal deposits covering the synovium, cartilage and meniscus, and we discuss the current and recent year Pub Med indexed literature in order to evaluate the possibilities for arthroscopic treatment of this pathology. We looked at the number of patients involved, their characteristics, and the surgical techniques used. We also looked at the temporal relation of the arthroscopic intervention to the recent gout attacks, and at the described lesions that were found. Also, we evaluated the papers for joint liquid analysis, gout drug treatment, and description of clinical aspects involved and associated lesions. Finally, we looked at the follow-up, at the functional scores used to monitor the patient�s evolution, at the associated medication and at the long-term outcomes, if described. We have found opinions to vary. In the end, we draw conclusions pertaining to the practical short-term and long-term use of knee arthroscopy in the treatment of gout.

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Cognitive Treatment for OCD

10.1093/oxfordhb/9780195376210.013.0076 ◽

2012 ◽

Author(s):

Maureen L. Whittal ◽

Melisa Robichaud

Keyword(s):

Term Treatment ◽

Future Directions ◽

Cognitive Treatment ◽

Long Term Treatment ◽

Inflated Responsibility ◽

And Control ◽

The Relationship ◽

Control Of Thoughts

The cornerstone of cognitive treatment (CT) for OCD is based upon the knowledge that unwanted intrusions are essentially a universal experience. As such, it is not the presence of the intrusion that is problematic but rather the associated meaning or interpretation. Treatment is flexible, depending upon the nature of the appraisals and beliefs, but can include strategies focused on inflated responsibility and overestimation of threat, importance and control of thoughts, and the need for perfectionism and certainty. The role of concealment and the relationship to personal values are important maintaining and etiological factors. The short-term and long-term treatment outcome is reviewed, along with predictors of treatment response and mechanisms of action, and the chapter concludes with future directions regarding CT for OCD.

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Defining the role of SGAs in the long-term treatment of bipolar disorder

Bipolar Disorders ◽

10.1111/bdi.12472 ◽

2017 ◽

Vol 19 (1) ◽

pp. 65-67 ◽

Cited By ~ 4

Author(s):

Gin S Malhi ◽

Grace Morris ◽

Amber Hamilton ◽

Tim Outhred ◽

Pritha Das

Keyword(s):

Bipolar Disorder ◽

Term Treatment ◽

Long Term Treatment

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The relevance of prescribing triple neurohormonal blockade in real clinical practice: the role of mineralocorticoid receptor antagonists

Consilium Medicum ◽

10.26442/20751753.2021.6.200889 ◽

2021 ◽

Vol 23 (6) ◽

pp. 491-497

Author(s):

Igor V. Zhirov ◽

◽

Igor V. Zhirov ◽

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Mineralocorticoid Receptor ◽

Systolic Dysfunction ◽

Term Treatment ◽

Mineralocorticoid Receptor Antagonists ◽

Long Term Treatment ◽

Real Clinical Practice

In the article is outlined the main concepts use of the mineralocorticoids receptors antagonists in the treatment of congestive heart failure and systolic dysfunction after acute myocardial infarction. Claimed the pivotal role of eplerenone in the long-term treatment strategy due to decrease of mortality and improving the clinical outcomes.

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Long-term clinical use of mirabegron in patients with overactive bladder syndrome

Medycyna Faktów ◽

10.24292/01.mf.0420.12 ◽

2020 ◽

Vol 13 (4) ◽

pp. 460-464

Author(s):

Tomasz Wiatr ◽

Piotr Chłosta

Keyword(s):

Overactive Bladder ◽

Term Treatment ◽

Overactive Bladder Syndrome ◽

Invasive Treatment ◽

Treatment Development ◽

Non Invasive ◽

Antimuscarinic Drugs ◽

Adrenoceptor Agonist ◽

Long Term Treatment

Overactive bladder syndrome (OAB) is defined by the International Continence Society (ICS) as urinary urgency with increased daytime frequency and nocturia in the absence of proven infection or any other pathology, usually with or without urgency incontinence. Pharmacotherapy with antimuscarinic drugs is highly effective, but more than 60% of patients discontinue the treatment. Development of mirabegron, a β3-adrenoceptor agonist (β3-AR), has become an expected pharmacotherapy option for the non-invasive treatment of overactive bladder. The available studies show that long-term treatment with 50 mg mirabegron in patients with OAB is associated with reducing the severity of symptoms. Data from clinical trials show that mirabegron provides efficacy similar to antimuscarinic drugs, but with a better tolerance profile.

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Neuropharmacology of the Neuropsychiatric Symptoms of Dementia and Role of Pain: Essential Oil of Bergamot as a Novel Therapeutic Approach

International Journal of Molecular Sciences ◽

10.3390/ijms20133327 ◽

2019 ◽

Vol 20 (13) ◽

pp. 3327 ◽

Cited By ~ 6

Author(s):

Damiana Scuteri ◽

Laura Rombolà ◽

Luigi Antonio Morrone ◽

Giacinto Bagetta ◽

Shinobu Sakurada ◽

...

Keyword(s):

Essential Oil ◽

Psychological Symptoms ◽

Neuropsychiatric Symptoms ◽

Term Treatment ◽

Long Term Treatment ◽

Anxiety Depression ◽

Cognitive Disturbance

Aging of the population makes of dementia a challenge for health systems worldwide. The cognitive disturbance is a serious but not the only issue in dementia; behavioral and psychological syndromes known as neuropsychiatric symptoms of dementia remarkably reduce the quality of life. The cluster of symptoms includes anxiety, depression, wandering, delusions, hallucinations, misidentifications, agitation and aggression. The pathophysiology of these symptoms implicates all the neurotransmitter systems, with a pivotal role for the glutamatergic neurotransmission. Imbalanced glutamatergic and GABAergic neurotransmissions, over-activation of the extrasynaptic N-methyl-D-aspartate (NMDA) receptors and alterations of the latter have been linked to the development of neuropsychiatric symptoms experienced by almost the entire demented population. Drugs with efficacy and safety for prevention or long term treatment of these disorders are not available yet. Aromatherapy provides the best evidence for positive outcomes in the control of agitation, the most resistant symptom. Demented patients often cannot verbalize pain, resulting in unrelieved symptoms and contributing to agitation. Bergamot essential oil provides extensive preclinical evidence of analgesic properties. Incidentally, the essential oil of bergamot induces anxyolitic-like effects devoid of sedation, typical of benzodiazepines, with a noteworthy advantage for demented patients. These data, together with the reported safety profile, form the rational basis for bergamot as a neurotherapeutic to be trialed for the control of behavioral and psychological symptoms of dementia.

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Serum lysophosphatidylcholines to phosphatidylcholines ratio is associated with symptomatic responders to symptomatic drugs in knee osteoarthritis patients

Arthritis Research & Therapy ◽

10.1186/s13075-019-2006-8 ◽

2019 ◽

Vol 21 (1) ◽

Cited By ~ 2

Author(s):

Guangju Zhai ◽

Jean-Pierre Pelletier ◽

Ming Liu ◽

Edward W. Randell ◽

Proton Rahman ◽

...

Keyword(s):

Term Treatment ◽

Serum Samples ◽

Optimal Cutoff ◽

Knee Oa ◽

Symptomatic Knee ◽

Long Term Treatment ◽

High Prevalence ◽

The Difference ◽

Total Concentrations

Abstract Background Identification of the optimal treatment for a given patient is of paramount importance. This is of particular relevance in osteoarthritis (OA) because of the high prevalence of the disease, extensive heterogeneity of the disease, and need for long-term treatment. The aim of the study was to examine whether serum lysophosphatidylcholines (lysoPCs) to phosphatidylcholines (PCs) ratio can predict clinical response to licofelone and naproxen treatments in symptomatic knee OA patients. Methods One hundred fifty-eight OA patients who completed the study according to protocol (ATP) of a previous 24-month clinical trial cohort comparing the effect of licofelone vs. naproxen in symptomatic knee OA patients were included. Symptomatic responses to either treatments were classified according to the OARSI-OMERACT criteria based on the WOMAC scores at 24 months. Total concentrations of PCs and lysoPCs were measured in the serum samples collected before the initiation of the treatments, and the lysoPCs to PCs ratio was calculated. Student’s t test was utilized to compare the difference in the ratio of lysoPCs to PCs between the symptomatic responders and non-responders. Logistic regression was utilized to adjust for the potential confounders. Receiver operating characteristic (ROC) analysis was performed to identify the optimal cutoff of the ratio for prediction. Results Data showed that 61.4% of the patients symptomatically responded to licofelone and naproxen and 38.6% were deemed as therapeutic failures (non-responders). There was no difference in responders between licofelone and naproxen (p = 0.87). Responders had a significantly higher lysoPCs to PCs ratio than non-responders (0.097 ± 0.003 vs. 0.085 ± 0.003; p = 0.006). Patients with a ratio greater than the optimal cutoff of 0.088 had 2.93 times more likely to respond to licofelone and naproxen (p = 0.002). Conclusions Serum lysoPCs to PCs ratio is a marker for response to licofelone and naproxen and may aid in the personalized treatment to knee OA.

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Aluminium Bone Deposits in Normal Renal Function Patients after Long-Term Treatment by Plasma Exchange

The International Journal of Artificial Organs ◽

10.1177/039139888901201012 ◽

1989 ◽

Vol 12 (10) ◽

pp. 664-667 ◽

Cited By ~ 6

Author(s):

C. Mousson ◽

S.A. Charhon ◽

M. Ammar ◽

M. Accominotti ◽

G. Rifle

Keyword(s):

Renal Function ◽

Bone Formation ◽

Plasma Exchange ◽

Normal Renal Function ◽

Bone Biopsy ◽

Term Treatment ◽

Normal Range ◽

Non Invasive ◽

Long Term Treatment

The accumulation of aluminium (AI) can cause AI bone deposits, osteomalacia and encephalopathy. As albumin solutions used as replacement fluid in plasma exchange (PE) are contaminated with AI, we studied AI overload in two symptomless patients with normal renal function, treated by long-term plasma exchange (PE). Total AI loading was calculated at 1750 μmol in patient 1 (178 PE sessions) and 2100 μmol in patient 2 (153 PE sessions). Bone biopsy showed AI deposits and low bone formation without osteomalacia in patient 1 and only osteoporosis in patient 2. Plasma AI levels were useless in detecting early AI overload, because the remained in the normal range, even after PE in both patients. Bone biopsy was the best means of recognizing AI intoxication, but cannot be recommended for frequent evaluations. However, the desferrioxamine mobilization test can be proposed as a repetitive non-invasive investigation method.

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