scholarly journals Hyperuricaemia and gout

2020 ◽  
pp. 95-100
Author(s):  
A Kopke ◽  
OBW Greeff
Keyword(s):  
Uric Acid ◽  
Side Effects ◽  
Treatment Options ◽  
The Body ◽  
Acute Gout ◽  
Tophaceous Gout ◽  
Life Threatening ◽  
Inflammatory Drugs ◽  
Urate Crystals

Gout is a painful, inflammatory disease that affects more men than women. The incidence of gout has increased substantially over the past few decades, as evidenced by information from the Rochester project. Some of the risk factors for the development of gout include: increased ethanol intake, high dietary purine consumption, obesity and the use of certain drugs, such as diuretics. Another important risk factor for the development of gout is hyperuricaemia. Hyperuricaemia results from an imbalance between the rate of production and excretion of uric acid in the body. An excess of uric acid thus builds up in the body, supersaturating body fluids and leading to the formation of monosodium urate crystals. These crystals accumulate in tissue and around joints, leading to an acute gout attack. Gout can be divided into four phases, namely asymptomatic hyperuricaemia, acute gout attacks or recurrent gout, intercritical gout and chronic tophaceous gout. Various treatment options are available for gout, and the treatment for each gout patient is determined by the stage of the disease. Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, corticotropin and colchicine are used for the treatment of acute gout attacks. Allopurinol and probenecid are used for long-term hypouricaemic therapy, while NSAIDs and colchicine are prescribed for the prophylaxis of future gout attacks. All of these treatments have side-effects, ranging from mild to life-threatening in nature. There is a need for novel gout therapies that have fewer side-effects but are still as effective.

scholarly journals Hyperuricemia and Gout – Ins and Out

2020 ◽  
Vol 15 (2) ◽  
pp. 227-234
Author(s):  
Md Abdur Razzak ◽  
Quazi Audry Arafat Rahman ◽  
Fahtiha Nasreen
Keyword(s):  
Gouty Arthritis ◽  
Polarized Light ◽  
Acute Gout ◽  
Women Patients ◽  
Monosodium Urate ◽  
Tophaceous Gout ◽  
First Metatarsal ◽  
Birefringent Crystals ◽  
Inflammatory Drugs ◽  
Urate Crystals

Gout is a condition characterized by the deposition of monosodium urate crystals in the joints or soft tissue. The four phases of gout include asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout and chronic tophaceous gout. The peak incidence occurs in patients 30 to 50 years old, and the condition is much more common in men than in women. Patients with asymptomatic hyperuricemia do not require treatment, but efforts should be made to lower their urate levels by encouraging them to make changes in diet or lifestyle. Acute gout most commonly affects the first metatarsal joint of the foot, but other joints are also commonly involved. Definitive diagnosis requires joint aspiration with demonstration of birefringent crystals in the synovial fluid under a polarized light microscope. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, corticosteroids and analgesics. In patients without complications, NSAID therapy is preferred. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 227-234

scholarly journals Pharmacotherapy for gout

2021 ◽  
Vol 64 (11) ◽  
pp. 772-777
Author(s):  
Chang-Nam Son
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Serum Urate ◽  
Treat To Target ◽  
Common Disease ◽  
Uric Acid Concentration ◽  
Acute Gout ◽  
Serum Uric Acid Concentration ◽  
Inflammatory Drugs

Background: Gout is a common disease that is mainly caused by hyperuricemia. Although it is relatively easy to treat, adherence to drug treatment and the rate at which treatment targets are met is low.Current Concepts: For the treatment of acute gout attack, colchicine, nonsteroidal anti-inflammatory drugs, and glucocorticoids can be used alone or in combination depending on the severity of symptoms. To prevent gout attacks, patients are started on colchicine prior to or concurrent with treatment with uric acid–lowering drugs. The treatment is maintained until serum uric acid levels have returned to normal, and the patient has had no acute attacks for three to six months. Ultimately, the symptoms of gout are controlled in the long term by treating the patient’s hyperuricemia. For this purpose, allopurinol, febuxostat, and benzbromarone are used, and the side effects and contraindications for each drug should be checked. The goal for the treatment of chronic gout is to maintain a serum uric acid concentration below 6.0 mg/dL.Discussion and Conclusion: Patients visit the emergency departments of hospitals for sudden gout attacks. However, gout is a chronic disease that requires the lifelong use of uric acid–lowering agents. Therefore, it is necessary to educate patients on a serum urate-based treat-to-target approach.

Natural inhibitors against potential targets of cyclooxygenase, lipoxygenase and leukotrienes

2021 ◽  
Vol 25 ◽  
Author(s):  
Rishita Dey ◽  
Sudatta Dey ◽  
Asmita Samadder ◽  
Anil Saxena ◽  
Sisir Nandi
Keyword(s):  
Rheumatoid Arthritis ◽  
Arachidonic Acid ◽  
Side Effects ◽  
Extensive Study ◽  
Alternative Medicines ◽  
Great Acceptance ◽  
Inflammatory Drugs ◽  
Lox Inhibitors ◽  
Natural Inhibitors

Background: The cyclooxygenase (COX) and lipoxygenase (LOX) enzymes catalyze the production of pain mediators like prostaglandins (PGs) and leukotrienes (LTs) respectively from arachidonic acid. Introduction: The COX and LOX enzyme modulators are responsible for the major PGs and LTs mediated complications like asthma, osteoarthritis, rheumatoid arthritis, cancer, Alzheimer’s disease, neuropathy and cardiovascular syndromes (CVS). Many synthetic nonsteroidal anti-inflammatory drugs (NSAIDs) used in the treatment have serious side effects like nausea, vomiting, hyperacidity, gastrointestinal ulcers, CVS, etc. Methods: The natural inhibitors of pain mediators have great acceptance worldwide due to fewer side effects on long-term uses. The present review is an extensive study of the advantages of plant-based vs synthetic inhibitors. Results: These natural COX and LOX inhibitors control inflammatory response without causing side-effect-related complicacy. Conclusion: Therefore, the natural COX and LOX inhibitors may be used as alternative medicines for the management of pain and inflammation due to their less toxicity and resistivity.

Gastroprotection during long-term NSAID use – what we know after 120 years of observations?

2021 ◽  
Vol 14 (2) ◽  
pp. 132-137
Author(s):  
Michał Lipiński
Keyword(s):  
Side Effects ◽  
Risk Stratification ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Broad Spectrum ◽  
Nsaid Therapy ◽  
Gastrointestinal Complications ◽  
Gastrointestinal Side Effects ◽  
Inflammatory Drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed classes of medications. The broad spectrum of side effects following long-term NSAID therapy includes mainly, but not only, gastrointestinal complications. Risk stratification of the gastrointestinal complications events is an important element of planning NSAIDs therapy, which allows to determine the indications for the use of proton pump inhibitors. This article presents the criteria for assessment and the method of adequate prevention of gastrointestinal side effects in patients receiving long-term NSAID therapy.

Serum Urate During Acute Gout

2009 ◽  
Vol 36 (6) ◽  
pp. 1287-1289 ◽  
Author(s):  
NAOMI SCHLESINGER ◽  
JOSEPHINE M. NORQUIST ◽  
DOUGLAS J. WATSON
Keyword(s):  
Uric Acid ◽  
Serum Urate ◽  
Acute Attack ◽  
Normal Serum ◽  
The Body ◽  
Acute Gout ◽  
Acid Pool ◽  
Randomized Controlled Clinical Trials ◽  
Acute Gout Treatment ◽  
The Relationship

Objective.To study the frequency of normal serum urate (SU) levels during acute gout in the largest studies of acute gout treatment to date.Methods.Data collected from 2 randomized controlled clinical trials assessing the efficacy of etoricoxib or indomethacin for 7 days in acute gout were used to assess SU levels during acute gouty attacks. Efficacy was similar with both agents, so both groups were combined for analysis.Results.A total of 339 patients were enrolled in the 2 studies; 94% were male; mean age was 50.5 years. At baseline, 14% of patients had a “true” normal SU (≤ 6 mg/dl) and 32% had SU ≤ 8 mg/dl during acute gout. Baseline mean SU was 7.1 versus 8.5 mg/dl (p < 0.001) in those taking allopurinol versus nonusers. Patients taking chronic allopurinol were more likely to have lower SU at baseline compared to those not taking chronic allopurinol (p < 0.001) during the acute attack.Conclusion.A normal SU level at presentation does not exclude an acute gouty attack. In the largest studies of acute gout to date, attacks still occurred despite SU levels being below 6.8 mg/dl, the saturation level for urate. This may be attributed to persistence of tophi and an increased body uric acid pool. Additional studies are needed to determine the correlation between SU and the body uric acid pool as well as the relationship to timing of changes during acute gout.

Non-steroidal Anti-inflammatory Drugs in Orthopaedic and Perioperative Practice

2009 ◽  
Vol 19 (9) ◽  
pp. 287-290 ◽  
Author(s):  
Wasim Khan ◽  
Mamun Al-Rashid ◽  
David R Marsh
Keyword(s):  
Side Effects ◽  
Bone Formation ◽  
Bone Remodelling ◽  
Life Threatening ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Non-steroidal anti-inflammatory drugs are powerful and effective anti-inflammatory, analgesic and anti-pyretic drugs. They are routinely used in orthopaedic conditions and in the perioperative setting. They are however associated with potentially life-threatening side-effects and it is important to appreciate these before these medicines are administered. There is evidence suggesting that these drugs adversely affect bone formation, and this has implications for their use in patients with fractures and other pathologies that involve bone remodelling.

Information needs of hematologic cancer survivors

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18547-18547 ◽  
Author(s):  
C. Soloe ◽  
K. Bandel ◽  
M. Jarblum ◽  
E. Willacy ◽  
S. Squire ◽  
...  
Keyword(s):  
Side Effects ◽  
Diagnostic Tests ◽  
Information Needs ◽  
Treatment Options ◽  
Structured Interviews ◽  
Cancer Centers ◽  
Cancer Types ◽  
Cancer Experience ◽  
Financial Issues

18547 Background: Little is known about how information needs of cancer survivors/patients (S/P), caregivers (CG), and non-caregiver relatives (NCG) evolve during the cancer experience. Methods: We conducted structured interviews of 21 leukemia, lymphoma, and multiple myeloma S/P, 13 CG, and 19 NCG, and asked them to prioritize information needs during the 4 cancer experience phases from a list of 13 topics. This research was supported by the Division of Cancer Prevention and Control of the Centers for Disease Control and Prevention. Results: Information preferences varied (Friedman’s test, P < 0.0001) by phase of the cancer experience. Topics ranked highest (median rank in parentheses) before treatment, during treatment, after treatment, and at relapse, respectively, were diagnostic tests (2), cancer/ cancer types (2.5), treatment options (3.4), hospitals/cancer centers (3.5), and insurance/financial issues (4); coping with treatment side effects (3), insurance/financial issues (4.5), treatment options (5), hospitals/cancer centers (5), and long term side effects (5); long term side effects (2), tests to detect recurrence (2), risk factors (3), diagnostic tests (4), and support groups (5); and tests to detect recurrence (3), insurance/financial issues (3), cancer/cancer types (4), diagnostic tests (5), and treatment options (5). Across the cancer experience, the highest priority topics for S/P, CG, and NCG, were cancer/ cancer types (4), treatment options (4), long term side effects (5), and risk factors (5); diagnostic tests (4.5), coping with side effects of treatment (5), and treatment options (5); and treatment options (3), diagnostic tests (4), and 5 other topics tied for 3rd place (6). In-depth, semi-structured interviews conducted with the surveys provided additional detail regarding responses collected in the prioritization exercise. Conclusions: Clinicians can help S/P, CG, and NCG by offering role- and cancer continuum-targeted information. No significant financial relationships to disclose.

Spaying-related urinary incontinence and oestrogen therapy in the bitch

2009 ◽  
Vol 57 (1) ◽  
pp. 171-182 ◽  
Author(s):  
Maria Veronesi ◽  
Alessandro Rota ◽  
Massimiliano Battocchio ◽  
Massimo Faustini ◽  
Antonio Mollo
Keyword(s):  
Urinary Incontinence ◽  
Side Effects ◽  
Replacement Therapy ◽  
The Body ◽  
Oestrogen Therapy ◽  
Oestrogen Replacement Therapy ◽  
Tail Docking ◽  
Age At Surgery ◽  
Type Of Surgery

Some aspects of spaying-related urinary incontinence in the bitch still remain incompletely clarified. Therefore, the aims of the present study were to evaluate the prevalence of the disease among spayed dogs, to detect differences in risk related to the type of surgery, to describe the characteristics of incontinent bitches, to assess the influence of age at surgery on the onset of incontinence occurrence, and to assess the effectiveness and long-term side effects of oestrogen therapy in affected bitches. Among 750 bitches submitted to ovariectomy or ovariohysterectomy, those showing spaying-related urinary incontinence were evaluated. Oestrogen replacement therapy consisted of administering an effective dose followed by an individual maintenance dose. The results showed that the disease occurred in 5% of neutered bitches, the type of surgery did not affect the disease occurrence, affected bitches frequently represented large or giant breeds or large-size mongrels, the body weight of the affected bitches at surgery was often ≥ 20 kg, the disease seems to be associated with tail docking, the age at surgery influences the onset of incontinence, with earlier occurrence in older bitches, and that a strong co-operation between owners and veterinarians is necessary to achieve successful response to oestrogen replacement therapy. Long-term administration seems to be unrelated to oestrogenic side effects.

scholarly journals A REVIEW ON COVID-19 PANDEMIC A GLOBAL THREAT-CURRENT STATUS AND CHALLENGES AND PREVENTIVE STRATEGIES

2021 ◽  
pp. 10-14
Author(s):  
SUNITHA SUKUMARAN ◽  
S. SATHIANARAYANAN
Keyword(s):  
Immune System ◽  
Side Effects ◽  
Current Treatment ◽  
The Body ◽  
Current Status ◽  
Plasma Therapy ◽  
Angiotensin Converting Enzyme 2 ◽  
Life Threatening ◽  
Health Organization ◽  
Global Threat

Covid19 (Coronavirus) is a life-threatening virus that mainly affects our respiratory system, kidney, and GIT tract. People with a low immune system in their body fall prey to it. This virus (2019-nCoV) spreads easily from one person to another. As there is no treatment to kill the virus, the only way to stop this pandemic is through precautions and reduce the viral load in the body. This review reveals the main types of coronaviruses, history, pathophysiology, current treatment, drawbacks of current treatment, targets for drug development against Covid-19, vaccines discovered for covid-19, side effects of the currently available vaccines, and current status of this situation. The main mechanism of action of the virus easily enters to bind with the Angiotensin-Converting Enzyme 2 (ACE2) in the human body cells. Management of the virus several approaches will be taken mainly isolation of the patients and contacts the contacts, oxygen therapy for respiratory failure patients based on the severity Remdesivir, Lopinavir/ritonavir, Chloroquine, and Hydroxychloroquine, Alpha-interferon and plasma therapy can be used to control the infections. In India, AYUSH is also recommended to enhance the immune system through herbal-based products, Vaccination is also recommended by most of the countries, but many side effects and drug-drug interactions were reported for the above treatments. So that in future a new way of approach should be developed by our health organization as soon as possible.

scholarly journals More allopurinol is needed to get gout patients <0.36 mmol/L: a gout audit in the form of a before–after trial

2009 ◽  
Vol 1 (4) ◽  
pp. 315 ◽  
Author(s):  
Bruce Arroll ◽  
Merran Bennett ◽  
Nicola Dalbeth ◽  
Dilanka Hettiarachchi ◽  
Ben Cribben ◽  
...  
Keyword(s):  
Uric Acid ◽  
Clinical Audit ◽  
First Language ◽  
Acute Gout ◽  
Diagnosis And Management ◽  
Preventive Medication ◽  
English Speaking ◽  
The Difference ◽  
Language Strategies

AIM: To establish a benchmark for gout control using the proportion of patients with serum uric acid (SUA)<0.36 mmol/L, assess patients’ understanding of their preventive medication and trial a mail and phone intervention to improve gout control. METHODS: Patients clinically diagnosed with gout and baseline SUAs were identified in two South Auckland practices. A mail and phone intervention was introduced aimed at improving the control of gout. Intervention #1 took place in one practice over three months. Intervention #2 occurred in the other practice four to 16 months following baseline. RESULTS: No significant change in SUA from intervention #1 after three months. The second intervention by mail and phone resulted in improvement in SUA levels with a greater proportion of those with SUA <0.36 mmol/L and the difference in means statistically significant (p=0.039 two-tailed paired t-test). Benchmarking for usual care was established at 38–43% SUA <0.36 level. It was possible to increase from 38% to 50%. Issues relating to gout identified included lack of understanding of the need for long-term allopurinol and diagnosis and management for patients for whom English is not their first language. STRATEGIES FOR IMPROVEMENT: (1) Community workers who speak Pacific languages may assist GPs in communicating to non-English speaking patients. (2) Alternative diagnoses should be considered in symptomatic patients with prolonged normouricaemia. (3) GPs should gradually introduce allopurinol after acute gout attacks, emphasising importance of prophylaxis. (4) A campaign to inform patients about benefits of allopurinol should be considered. (5) A simple one keystroke audit is needed for gout audit and benchmarking. (6) GP guidelines for gout diagnosis and management should be available. KEYWORDS: Gout; uric acid; clinical audit; benchmarking; family practice

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