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

Pirprofen is a non-steroidal anti-inflammatory drug, related structurally to drugs such as ibuprofen, ketoprofen and naproxen. Published clinical trials indicate that pirprofen 600 to 1200 mg/day as 2 or 3 divided doses is a suitable alternative to usual therapeutic dosages of aspirin, flurbiprofen, ibuprofen, indomethacin, ketoprofen, naproxen, piroxicam and sulindac in the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, musculoskeletal disorders and non-articular rheumatism. More studies are required to evaluate its potential relative to other commonly used drugs in the treatment of gout, juvenile rheumatoid arthritis and dysmenorrhoea. In patients with acute postsurgical, trauma or cancer pain, single oral or intramuscular doses of pirprofen 200 to 400mg provide equivalent analgesic activity to usual therapeutic doses of aspirin, diflunisal, ketoprofen, noramidopyrine, paracetamol and pentazocine. As with other non-steroidal anti-inflammatory drugs, gastrointestinal complaints are the most frequently reported side effects. At equivalent analgesic or anti-inflammatory dosages, pirprofen probably causes fewer side effects than aspirin and appears to be as well tolerated as the other agents with which it has been compared. Long term tolerability, particularly compared with some of the newer, purportedly less gastrotoxic agents or formulations, needs to be investigated further. Pirprofen does not appear likely to offer any particular advantage with respect to efficacy and tolerability over other non-steroidal anti-inflammatory drugs, except aspirin. However, as no one agent is the most suitable drug for all patients requiring such therapy, pirprofen may be considered along with other drugs of this type in the therapy of arthritic conditions and acute pain states.
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PMID:Pirprofen. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. 353 73

We reviewed crystal-proved gouty arthritis in 23 women. Twenty-one (91%) developed gout after menopause onset. Tophaceous gout occurred in six (26%), polyarticular involvement in 13 (57%); 70% manifested an underlying arthropathy, usually osteoarthritis. We studied 75 men with crystal-proved gout for comparison. Women developed gout significantly later compared with men, more often were receiving diuretics before gout onset, and more frequently manifested renal insufficiency and monoarticular involvement. These differences were significant when controlled for the women's later age at onset. Significantly more men than women had alcoholism and an identifiable precipitating event for acute attacks. There were no significant differences in race, age, family history of gout, disease duration, hypertension, distribution of joint involvement, tophi, or mean serum urate concentration. Gout in women is overwhelmingly postmenopausal, apparently associated with diuretic therapy and renal insufficiency independent of the effects of age. Articular characteristics in men and women are remarkably similar.
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PMID:The clinical spectrum of gouty arthritis in women. 377 53

We analyzed the relationship between the mucin clot test and the synovial fluid (SF) leukocyte count in osteoarthritis, rheumatoid arthritis (RA), gout, and calcium pyrophosphate dihydrate crystal deposition disease. Except for RA there was no statistically significant relationship between white count and a tight mucin determination within the disease categories. For low (2 X 10(9) cells/l or less) leukocyte counts, the crystal induced arthropathies had a significantly greater proportion showing a tight reaction than found in the osteoarthritic and rheumatoid fluids. We propose that mucin clot determinations may reflect synovial membrane activity rather than SF leukocyte counts.
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PMID:Synovial fluid analysis--another look at the mucin clot test. 387 19

An attempt is made to see if any correlation exists between the prevalence of 13 selected rheumatic diseases and the number of literature entries concerning these disorders in 1974 and 1983. Entries on systemic lupus are broken down in detail. It is concluded that interest in autoimmune diseases, especially their immunology, appears healthy. Lower morbidity disorders with a large prevalence (osteoarthritis, fibrositis, gout) may be disproportionately under-investigated. Whether any correlation between funding levels and literature entries can be made is speculative.
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PMID:Systemic lupus erythematosus, rheumatology and medical literature: current trends. 391 Aug 33

This report describes six elderly patients with previously undiagnosed and untreated chronic polyarticular gout, five of whom were seen at a Geriatric Rehabilitation and Assessment Unit within a 3-month period. All were on long-term diuretic therapy. Four patients had coexisting osteoarthritis. Three patients were unable to recall any prior history of attacks of acute arthritis and four patients were significantly disabled from gout. Chronic polyarticular gout in these patients was previously misdiagnosed and inadequately treated, resulting in otherwise preventable disability.
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PMID:Chronic polyarticular gout in the elderly: a report of six cases. 395 33

Osteoarthritis or 'Joint Failure' is a multi-factorial disease with a final common pathway of cartilage degeneration and bone eburnation. The association of arthritic disease and joint degeneration with the deposition of sodium urate crystals in gout and calcium pyrophosphate crystals in pseudogout (chondrocalcinosis) is clinically well established. Electron microscopy coupled with electron probe analysis has revealed the presence of various other calcium phosphate crystals in joint tissues and fluids. We have found three new morphological types of apatite crystals in human articular cartilage which are too small to be detected by X-rays of human joints or even by light microscopy of joint tissues. Two morphologically distinct types of apatite crystals in articular cartilage are associated with extracellular matrix vesicles formed from the cell processes of chondrocytes. 'Cuboid' crystals, which are found in the pericellular regions near the surface zone of articular cartilage, appear to be a variant of apatite and may even be 'Whitlockite' because there are traces of magnesium present. There are increased numbers of these microscopic 'cuboid' crystals (Type II) and Mineral Nodules (Type I) in arthritic cartilage and this is coupled with increased numbers of matrix vesicles and alkaline phosphatase activity. Clusters of fine needle-shaped apatite crystals (Type III) found on the surface of articular cartilage are not associated with matrix vesicles. Thus some forms of osteoarthritis are closely associated with apatite type crystal deposition and may imply abnormal mineral formation in articular cartilage as a pathogenic mechanism.
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PMID:Apatite-type crystal deposition in arthritic cartilage. 409 1

Neutral protease, collagenase and elastase activities were high in synovial fluids from inflammatory arthritic diseases such as gout, active rheumatoid arthritis and ankylosing spondylitis. The activities correlated well with biochemical parameters such as CRP, ESR and total protein. Values were much lower in a non-inflammatory fluid from a patient with osteoarthrosis. Treatment of fluids with trypsin released both collagenase and elastase. The fluids possessed reserve inhibitory action against these enzymes presumably due to plasma antiproteases being present. The collagenase present was found to possess a MW of 32,700 daltons.
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PMID:Neutral protease, collagenase and elastase activities in synovial fluids from arthritic patients. 609 75

A simple, rapid screening method using alizarin red S stain and ordinary light microscopy to detect microcrystalline or noncrystalline calcium phosphate salts was used on wet drop preparations of synovial fluids. This proved to be helpful in detecting apatite crystal clumps and small calcium pyrophosphate dihydrate (CPPD) crystals missed by polarized light. The staining was positive in 100% of synovial fluids from patients later proven to have apatite and/or CPPD deposition diseases. Apatite and CPPD crystals were commonly found together in the same fluids. In addition, some synovial fluids from patients with osteoarthritis, renal failure dialysis, rheumatoid arthritis, and gout also exhibited positive staining. The correlation of positive alizarin red S staining with radiologic evidence of osteoarthritis suggests that apatite crystals might be related to articular cartilage degeneration in different rheumatic diseases.
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PMID:Alizarin red S staining as a screening test to detect calcium compounds in synovial fluid. 618 60

Recent recognition of the importance of inflammation and the efficacy of anti-inflammatory drugs in osteoarthritis has increased their importance in the routine management of the disease. Anti-inflammatory drugs do more than just relieving pain; they reduce the duration of morning stiffness, stiffness after sitting and the number of tender joints. Patients usually prefer them to simple analgesics. The choice of anti-inflammatory drugs is determined largely by individual variation in response so that it may be necessary to try a number of different compounds before finding one which suits a particular patient. Intra-articular steroids are disappointing in that though effective, their action is very brief. Intra-articular orgotein may have a useful role in the treatment of osteoarthritis. Simple analgesics are useful for patients with mild or intermittent pain when regular treatment is inappropriate. Specific therapy, like penicillamine for rheumatoid arthritis or allopurinol for gout, is urgently required. Better understanding of the pathogenesis of the disease may make this possible.
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PMID:The drug treatment of osteoarthritis. 621 63

Degenerative arthritis in the aged includes two major disease categories--osteoarthritis and the crystal-associated arthropathics. The crystals chiefly involved are monosodium urate (gout) and calcium pyrophosphate dihydrate (CPPD), although several others (e.g., cholesterol, brushite and apatite) have been implicated. This report illustrates how the newer diagnostic techniques such as polarized-light microscopy, analytical electron microscopy and x-ray microdiffraction have augmented knowledge concerning diseases associated with articular crystal deposition. For example, diffraction techniques are required for accurate identification of the apatite crystals found in synovial fluid effusions and in the matrix vesicles of degenerate cartilage. According to ultrastructural studies, monosodium urate crystals found in tophi, joint surfaces and effusions show a distinct morphology. Present in inactive joints, the crystal surfaces are bare; in acute gout, the crystals are covered with mucin, confirming the observation that protein binding to crystals is necessary for inflammation to proceed. CPPD disease is by far the most common crystal-associated arthropathy affeting the aged. The incidence of CPPD deposits in articular tissues increases with age but, in contrast to gout, affects both men and women. The pathogenesis of CPPD disease is a mystery, but factors under investigation include matrix abnormalities, ionic imbalances, and enzyme disorders.
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PMID:Crystal-associated arthropathies: what's new in old joints. 625 59


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