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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In most patients with primary gout hyperuricaemia results from a renal defect in tubular uric acid secretion. An increased endogenous purine biosynthesis is observed in only 2% of all patients with gout. Secondary hyperuricaemai results either from an increased breakdown of endogenous nucleic acids as in polycythaemia or from a decreased renal excretion of uric acid due to drug treatment, renal insufficiency or metabolic disturbances. Hyperuricaemia may be defined either in statistical terms from epidemiological studies of normal and gouty populations or from physicochemical properties of urate. Monosodium urate and uric acid are soluble in water to the extent of 6.32 mmol/l and 0.39 mmol/l respectively. In human plasma saturation of monosodium urate occurs at a concentration of about 0.42 mmol/l. The solubility of uric acid and urate in urine is more complicated as it is affected by changes in pH and salt concentration. Uricosuric drugs decrease serum uric acid concentration by enhancing the renal excretion of uric acid. Effects and side effects of uricosuric therapy are discussed.
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PMID:Uricosuric therapy and urate solubility in blood and urine. 50 37

Tienilic acid, a diuretic agent effective at the cortical diluting segment of the distal tubule, has been found to have equivalent antihypertensive action in a dose of 250 mg twice daily to hydrochlorothiazide in a dose of 50 mg twice daily. Tienilic acid reduced arterial pressure without diminishing renal plasma flow or endogenous creatinine clearance; moreover, it did so whilst achieving hypouricaemia through a uricosuric effect. Hypokalaemia was observed but corrected by supplemental potassium. A transient but reversible, slight elevation in serum creatinine concentration and significant hypertriglyceridaemia were also observed. In conclusion, tienilic acid seems to be a novel diuretic, well-suited for the patient with hypertension, particularly if there is coincidental gout or coexisting hyperuricaemia.
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PMID:Antihypertensive and renal effects of tienilic acid. 50 45

The ability of potential anti-thrombotic agents to modify platelet-thrombus formation in injured cerebral arteries in the rabbit was tested. Low doses of heparin were without effect, while higher doses produced variable suppression of white body formation but at the expense of bleeding. Aspirin did not inhibit white body formation but another non-steroid anti-inflammatory agent, flurbiprofen was able to do so, as was the anti-gout agent, sulphinpyrazone. Magnesium salts both topically and parenterally, suppressed thrombus formation and increased the concentration of ADP which was required to initiate thrombus production at minor injury sites.
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PMID:The effect of agents which modify platelet behaviour and of magnesium ions on thrombus formation in vivo. 50 67

An abnormal fibrinogen was found in a patient associated with disabling recurrent phlebitis and pulmonary emboli, pseudotumor cerebri, gout and endometriosis. The fibrinogen is characterized by (1) abnormal side-to-side and end-to-end polymerization, (2) abnormal fibrinopeptide release, (3) a delayed gamma-gamma dimerization of the non cross-linked fibrin, (4) a pH optimum of 7--7.8, and (5) a deviation from normal amino acid composition with regard to lysine, aspartic acid, glutamic acid and serine. Since no defect has been found in any of her three children, and since the prothromin and partial thromboplastin times vary from time to time, it is assumed that the defect is acquired. Liver disease, usually associated with acquired abnormal fibrinogen, has been excluded as an etiological cause since liver function tests and biopsy are completely normal.
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PMID:An acquired abnormal fibrinogen associated with thromboembolic disease and pseudotumor cerebri. 50 12

Renal hemodynamics as measured by inulin clearance (Cinulin) and para-aminohippurate clearance (CPAH) was evaluated in 149 patients with primary gout over intervals of two to 22 years. In over 30 per cent of the patients plasma urate was greater than 10 mg/dl and urinary uric acid greater than 800 mg/min. A linear trend in decreasing frequency of hyperuricemia and excessive uricosuria is significantly related to the patient's age at the onset of gout. Group I consisted of 84 patients with uncomplicated gout in both clearance studies. Cinulin and CPAH were somewhat lower in patients larger than or equal to 50 years of age with longer duration of gout. Further reduction in clearances was minimal at the second clearance study in intervals of approximately 10 years. Group II included 27 patients who had no associated disease at the time of the first clearance study but in whom associated disease had developed by the time of the second clearance study. A striking reduction in Cinulin and CPAH was noted, especially in those 50 years old or above. There were 38 patients in group III with associated diseases at the time of both clearance studies. They had lower Cinulin and CPAH at the time of the first study, particularly the older patients. Further reduction during the second study was less striking than that in group II. Analyses of variance suggest that various coexisting vascular diseases with associated nephropathy have the most significant impact on the status of renal function in gout, with aging the second most important and duration of gout, the third.
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PMID:Renal function in gout. V. Factors influencing the renal hemodynamics. 50 87

Of 30 cases of olecranon and prepatellar bursitis, ten were septic. Fever, tenderness, peribursal cellulitis, and skin involvement over the bursa were more common in the septic cases. A high leukocyte count, low bursal-to-serum glucose ratio, and positive Gram-stained smear of the bursal fluid distinguished septic from nonseptic bursitis. Rheumatoid arthritis and gout may be accompanied by nonseptic bursitis. Septic bursitis may be associated with a sympathetic sterile effusion in a neighboring joint or adjacent fascial space. The duration of antibiotic treatment necessary to sterilize bursal fluid was proportional to the length of time infection had been present. A prospective antibiotic program disclosed an average of 12 days for successful therapy. A bactericidal agent against penicillin-resistant Staphylococcus aureus is the drug of choice.
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PMID:Comparison of nonseptic and septic bursitis. Further observations on the treatment of septic bursitis. 50 24

Ticrynafen is an orally administered diuretic that is similar to the thiazides in its therapeutic actions, but unlike the thiazides, it increases urate excretion and lowers serum uric acid levels. Ticrynafen is useful in the treatment of hypertension and in selected cases of chronic congestive heart failure. At present, it appears to be indicated primarily in patients with these disorders who have a history of gout. Patients who are currently receiving a thiazide should not have their therapy arbitrarily changed to ticrynafen because of asymptomatic hyperuricemia.
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PMID:Evaluation of a new uricosuric diuretic--ticrynafen. 51 60

Although microscopic studies have shown similarities between bursal and joint membranes, little is known about bursae and their response to disease states. Eighty-six cases of superficial bursitis due to trauma, bacterial infection, or gout were reviewed and compared with cases of joint inflammation due to the same etiologies. In traumatic bursitis the bursal fluid mucin test was more abnormal and the viscosity lower than that of joint fluid in traumatic arthritis. The bursal fluid total leukocyte count of septic bursitis was less than 20,000/mm3 in 8 of 13 cases but in only 1 of 21 synovial fluids from cases of septic arthritis (P = 0.005). In gouty bursitis the mean total leukocyte count of bursal fluid was 2800/mm3, compared with a mean synovial fluid total leukocyte count of 28,700 in gouty arthritis (P less than 0.02). These findings indicate that superficial bursae react less intensely than diarthrodial joints to specific disease stimuli and that a relatively low bursal fluid leukocyte count is often present in cases of septic and gouty bursitis.
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PMID:Reaction of superficial bursae in response to specific disease stimuli. 51 17

Twenty-nine patients with acute gout were treated with piroxicam (40 mg daily for 5 days) in a multicentre general practitioner study. Pain relief was noticeable within 4 hours of the first dose and thereafter proceeded steadily, together with the early relief of other symptoms associated with acute gout. The prompt relief of symptoms was accompanied by a fall in serum uric acid. Piroxicam was well tolerated, eight experiencing side-effects that were mainly mild and gastro-intestinal in nature. The drug seems to be highly effective and safe in the treatment of acute gout.
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PMID:Piroxicam in the treatment of acute gout: a multicentre open study in general practice. 52 Jun 53

The anti-hyperuricemic effect of a daily doses of 100 mg of the normurat (Benzbromaron) was studied in 25 patients with gout. This agent leads to a rapid decrease to normal values of the elevated serum uric acid level. Within one week of discontinuation of the drug the serum urate levels rose to the initial pathological value. For some of the patients it was possible to keep the uric acid level within the normal range by administration of 50 mg of Benzbromaron daily or 100 mg every second day. The tolerance of the preparation was good and during the 4--6 months' long therapeutic trial there were no severe side effects.
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PMID:[Normurat (benzbromaron) in the treatment of gout]. 52 67


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