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)

Piroxicam is a chemically unique, long-acting, potent antiinflammatory/analgesic agent now available for the treatment of arthritis and other inflammatory diseases in over 80 countries around the world. The literature of the last 2 years on preclinical and clinical results with piroxicam has been reviewed. Recent laboratory experiments have given insights into additional actions of piroxicam which may play a role in its broad spectrum of antiinflammatory activity. In various animal models, piroxicam inhibits cell migration into an inflamed site. In vitro, piroxicam inhibits both superoxide anion production and lysosomal enzyme release from human neutrophils and also inhibits IgM-rheumatoid factor production by human lymphocytes. The safety and excellent toleration of piroxicam in animals has been reconfirmed. Extensive clinical trials in over 66,000 patients have demonstrated the high efficacy and excellent toleration of piroxicam in rheumatoid arthritis, osteoarthritis, gout, various musculoskeletal disorders and pain of varied etiology. Patient preference and compliance has consistently been higher for patients on piroxicam therapy. A single 20 mg, daily oral dose produces 24 hour control of symptoms. Piroxicam has been shown to be a useful addition to the physicians armamentarium.
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PMID:Piroxicam--a literature review of new results from laboratory and clinical studies. 634 66

Synovial fluids from patients with osteoarthritis contain a chemotactic inhibitor that acts by antagonizing the complement-derived chemotactic anaphylotoxin, C5a. The activity of this inhibitor in synovial fluids from patients with several forms of inflammatory arthritis (rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, and gout) were comparable to the activity present in osteoarthritic synovial fluids. In contrast, levels of inhibitory activity in synovial fluids from 9 patients with familial Mediterranean fever were decreased to less than 20% of those found in osteoarthritis fluids. The possibility was considered that the diminished inhibitory activity in fluids from patients with familial Mediterranean fever plays a part in the pathogenesis of the inflammatory attacks characteristic of this disease.
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PMID:Diminished activity of a chemotactic inhibitor in synovial fluids from patients with familial Mediterranean fever. 636 3

Aspirin (acetylsalicylic acid), the first of the NSAIDs (introduced in 1899), was initially never referred to as an anti-inflammatory agent. It was the advent of cortisone in 1949 that demonstrated dramatically that corticosteroids had anti-inflammatory properties and the term 'non-steroidal anti-inflammatory drug' was first used when phenylbutazone was introduced 3 years later. Since then, the NSAIDs have proliferated. There is to date no good evidence that they halt progression of rheumatoid disease, but by easing pain and diminishing swelling they make life much easier in osteoarthrosis, rheumatoid arthritis and many other types of arthritis, and are the drugs of first choice in acute gout. Their mode (or modes) of action are obscure and though inhibition of cyclo-oxygenase (prostaglandin synthetase) is clearly important, other mechanisms are also involved. The assessment of the anti-inflammatory action of these agents has received considerable attention in clinical trials because, whatever their action may be in experimental animal models, their action in inflamed joints in human patients must be ascertained, since there may be little parallel between the two. Different experimental animal models give different results with various agents and often bear little relation to their therapeutic action in man. No attempt has been made here to review in depth all the NSAIDs that have appeared since 1952. All have anti-inflammatory and analgesic activity and all can cause gastrointestinal side effects, though effectiveness and toxicity vary from drug to drug and patient to patient, there being very great interpatient variability. Non-reactors, patients who apparently fail to respond to certain agents, need further study, for it seems that these subjects may metabolise these agents differently from others. Considerable ingenuity has been shown not only in evolving new NSAIDs but in finding new ways of administering them. The number and variety of NSAIDs in their various forms varies greatly from country to country, depending largely on the regulatory bodies of those countries. In the meantime, the search for a better, less toxic compound continues with the hope that one may be found which has a deeper and more basic action on the underlying disease process.
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PMID:Non-steroidal anti-inflammatory drugs. Current status and rational therapeutic use. 636 85

The pattern of arthritis in Roman Britain was investigated by examining the skeletons of 416 adults from the Roman cemetery at Poundbury Camp near Dorchester, Dorset. The mean height of the people was not much less than that of the current British population, and the prevalence of right handedness was similar to our own. There was a high prevalence of osteoarthritis for such a relatively young community, with particularly severe changes in the vertebral column. The pattern of joints affected by osteoarthritis was different from that seen now, but the prevalence of vertebral ankylosing hyperostosis was much the same. Rheumatoid arthritis was seen as often as the expected rat would indicate, given that the population died young, but it was rare. Other forms of arthritis, including gout and ankylosing spondylitis, were not seen.
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PMID:Arthritis in Roman Britain. 641 69

A review of 290 patients with Paget's disease of bone revealed 83% had one or more rheumatic syndromes. The most common finding was back pain (37%), most often related to an independent osteoarthritic process or Paget's disease precipitating or complicating spinal osteoarthritis. Paget's disease as a sole source of back pain was distinctly uncommon (2%). Osteoarthritis related to Paget's disease was present in the hip (30%) and knee (11%). Paget's disease in spondylitis was present in 4 patients and in ankylosing hyperostosis in 4 patients. The latter group had very active Paget's disease. Rheumatoid arthritis (1%), hyperuricemia (20%), and gout (4%) did not appear increased in this group.
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PMID:Musculoskeletal manifestations of Paget's disease of bone. 644 3

Rheumatic pain is usually generalized, but in a variety of conditions it may present as localized and often remain so. These conditions include palindromic rheumatism, osteoarthritis, gout or pseudogout, seronegative spondyloarthropathy, septic arthritis, tendinitis and bursitis, radiculopathy and nerve entrapment, nodular growth, and tendon enlargement. When the presenting feature is focal pain in muscles, joints, or fibrous tissue, the differential diagnosis should include these considerations.
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PMID:Localized rheumatologic diseases. Common diagnostic challenges. 660 May 15

Interleukin-1 (IL-1) is a macrophage derived mediator whose properties suggest that it could play a role in the pathology of arthritis. To test this hypothesis, joint fluids from patients with serveral different arthritides were tested. Small amounts of IL-1-like activity were recovered from many of these joint fluids after affinity chromatography over a column of rabbit anti-human IL-1. Positive fluids were obtained from patients with rheumatoid arthritis, psoriatic arthritis, Reiter's syndrome, osteoarthritis, gout, and traumatic arthritis. Upon gel filtration, the joint derived factor displayed a molecular weight distribution similar to that of IL-1 derived from human monocytes stimulated in vitro. These results suggest that IL-1 is present in joint effusions and, therefore, might contribute to joint destruction.
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PMID:Isolation of an interleukin-1-like factor from human joint effusions. 660 52

Serum uric acid levels were investigated in a series of 1715 subjects. Of these 596 were patients suffering from inflammatory rheumatic disorders, 162 patients with gout, 236 with osteoarthrosis and 79 with systemic lupus erythematosus or diffuse scleroderma. 642 healthy subjects completed the series. On analyzing the results, very high uricemia values were found in patients with gout. Increased average uricemia values were observed in patients with psoriatic arthritis and diffuse connective tissue disorders (systemic lupus erythematosus and diffuse scleroderma). Hyperuricemia was found in psoriatic arthritis, rheumatoid arthritis, and in nosologic units classified under diffuse connective tissue disorders in 5.6 to 10.1% of patients. In the healthy subjects examined, hyperuricemia was recorded in 3.8% of cases.
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PMID:[Serum uric acid levels in disorders of the rheumatic type]. 661 Feb 59

Examination of 400 Saxon, Romano-British, and mediaeval skeletons from seven archaeological excavations in the west of England showed an unexpectedly high incidence of osteoarthritis and osteophytosis. Three skeletons had evidence of an erosive peripheral arthritis-one with probable gout, one probable psoriatic arthropathy, and one with possible rheumatoid arthritis. The pattern and types of rheumatic disease, and the resultant disability, were apparently different. An exuberant form of large joint osteoarthritis was common and rheumatoid arthritis and similar diseases rare.
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PMID:Arthritis in Saxon and mediaeval skeletons. 679 6

We report here on 41 male patients with acute polyarticular gout seen in 3 years. Acute polyarticular gout continues to masquerade as other commoner rheumatological disorders such as septic arthritis, rheumatoid arthritis, degenerative joint disease, and even hemiparesis. Almost all of these patients had clues to the diagnosis of acute gout in their medical history. These clues included a past history of intermittent acute gout, prior attacks of polyarticular arthritis, previous hyperuricaemia, and/or obvious tophi. The patients all responded promptly to nonsteroidal anti-inflammatory drugs. We observed serious toxic drug reactions in 8 patients.
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PMID:Acute polyarticular gout. 684 58


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