Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Experience with chemodissolution of uric acid stones in 30 patients is presented. Chemodissolution was achieved either with infusion of 0.16 M i.v. lactate or oral sodium bicarbonate, in addition to liberal fluid intake and allopurinol wherever indicated. In some cases direct chemodissolution by in situ irrigation with sodium bicarbonate solution was done after an initial percutaneous nephrostomy. Seven patients presented with acute obstructive anuria. In this group, 5 of them had bilateral obstructive calculi, while 2 had unilateral obstruction in a solitary kidney. The latter 2 had complete recovery following intravenous lactate therapy. Of the 5 presenting with bilateral obstruction, 2 patients had complete response to chemodissolution, whereas the remaining 3 had only a partial response requiring surgery for ultimate salvage. In this group I, 6 patients are doing well with a normal serum creatinine at 3 months to 4 years follow-up, while 1 patient has a serum creatinine, stabilised at 3.2 mg%. In the second group, 23 patients presented with non-obstructing urinary stones. Flank pain was the commonest complaint and a concomitant history of gout was present in 6 patients. Hyperuricaemia was detected in 12 and hyperuricosuria in 19. All cases were managed by high fluid intake and oral sodium bicarbonate, with self-monitoring of urine pH, which was kept between 6.5 and 7.0. Allopurinol was administered in cases having hyperuricaemia and/or hyperuricosuria. Systemic alkali therapy in the form of intravenous molar lactate or sodium bicarbonate is effective and safe both in obstructive anuria and non-obstructive urinary uric acid stones.
 ...
PMID:Chemodissolution of urinary uric acid stones by alkali therapy. 131 80

In the Chilandar monastery (Mount Athos, Greece) library, a collection of medical texts written in the Old Serbian Slavonic language was discovered in 1952. Because of its size and comprehensiveness, this manuscript was named the Chilandar Medical Codex. The Collection contains several manuscripts, which according to modern medical terminology, the manuscripts can be classified as texts on Internal Medicine, Infectious diseases, Toxicology, Pediatrics, Pharmacology and Surgery, belonging to different time periods. The oldest part, Text on uroscopy, is considered to have been written in 13th or 14th century and consists of 35 text pages divided into 62 paragraphs. Following the popular uroscopy methodology of macroscopic examination of urine, this text contains detailed descriptions of urine characteristics (color, consistency, sediment, odor), as well as a convincing Hippocratic description of urine formation from the filtration of metabolic and waste materials (involving the four humors) rather than blood and fumes (toxic metabolites) according to the theory of Theophilus Protospatharius and Isaac Israeli. Precise descriptions of normal and pathological urine characteristics are provided. Although kidney anatomy and function is unclear, the urinary bladder is very undoubtedly described as an organ for urine collection. In the Chilandar Medical Codex, there are about one hundred descriptions of kidney and urinary tract diseases and disorders. Many symptoms and syndromes such as hematuria, dysuria, pyuria, renal colic, anuria, polyuria, edema and dropsy, urine retention and fever, are incorporated in the broader clinical pictures of lithiasis of the kidney and/or bladder, pyelonephritis, cystitis, necrotic renal disease indicative of renal tuberculosis and tumors, acute and chronic nephritis, renal failure, and gout. Specific pharmacological prescriptions, mostly simple or compound herbal medicines, are given for each of those renal ailments.
 ...
PMID:Kidney disease in medieval Serbian manuscripts from the Chilandar monastery (Mount Athos, Greece). 1687 11

Allopurinol is a xanthine oxidase inhibitor used in management of chronic gout. It acts by reducing the amount of uric acid by inhibiting purine metabolism. A middle-aged hypertensive female who was on allopurinol for 7 months presented with generalized weakness and exertional dyspnea. Investigations revealed pancytopenia: normocytic normochromic anemia (Hb-3.2g/dL, TLC-3400/mm3) and severe thrombocytopenia (Platelets-1000/mm3) with mild hepatosplenomegaly and grade 2 medico renal disease with normal cardiac status. Nutritional, hemolytic and infective causes were ruled out. She was transfused with fresh whole blood, platelets, administered empirical antibiotics and started on steroids. Initially, she responded to treatment but later developed an episode of convulsions with anuria and succumbed to leukopenic sepsis secondary to hypo/aplastic anemia probably due to allopurinol. Allopurinol is used extensively in the management of chronic gout and is well tolerated due to its safety profile. But we here report a case of allopurinol induced aplastic anemia leading to the demise of a patient. Allopurinol though safe needs careful monitoring.
 ...
PMID:Allopurinol: Sorrow to the marrow. 3275 32