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)

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

In the management of rheumatic diseases, the use of corticosteroids should be reserved for active arthritis. Phenylbutazone (Butazolidin) is probably the drug of choice for acute gout and is also effective in ankylosing spondylitis, Reiter's syndrome, and psoriatic arthritis. Indomethacin (Indocin) also is useful in these conditions. Ibuprofen (Motrin) is only slightly more efficacious than aspirin. Aspirin is still the preferred treatment for rheumatoid arthritis and should be tried before ibuprofen. Osteoarthritis of the cervical or lumbar spine calls for a full program of physical therapy. Experimental procedures for total replacement of joints other than hip and knee show promise.
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PMID:Rheumatic diseases. 2. Therapeutic considerations. 108 14

Sixty-six hip arthroplasties in 55 patients were reviewed to specifically study cemented versus noncemented procedures, as related to heterotopic bone formation (HBF). Other factors considered included the type of arthroplasty, surgical approaches, preoperative and postoperative medicines, preoperative predisposing diagnoses, range of motion, and pain. The overall percentage of heterotopic ossification was 64%. There was no significant difference between cemented (67%) and noncemented (55%) procedures. Except for an increased percentage (80%) of ossification after a trochanteric osteotomy, there were no significant differences between the three reviewed surgical approaches. Male osteoarthritics had the highest overall HBF. Eighty percent of patients who previously had developed HBF also did so with a contralateral hip surgery. Surprisingly, all patients with gout (100%) developed HBF. Acetylsalicylic acid used prophylactically for anticoagulation had no significant effect. Resurfacing arthroplasty procedures accounted for half of the severe grades of HBF. A decreased range of motion occurred with more severe grades of HBF.
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PMID:Heterotopic bone in hip arthroplasties. Cemented versus noncemented. 151 5

In the past 20 years treatment appears to have had a major impact on all forms of cerebral vascular disease. Morbidity and mortality from strokes have declined nearly 50% in developed countries. Modern imaging techniques, methodology, and biostatistics have identified risk factors and refined clinical trials such that we question all previous studies of stroke management. Control of moderate and severe hypertension has significantly lowered stroke rates. In borderline and mild hypertension the decision to treat is influenced by other stroke risk factors including diabetes mellitus, cigarette smoking, ischaemic heart disease, plasma lipid levels, gout, haematocrit, and body weight. Current data indicate that anticoagulants are of no value, or hazardous, in atherothrombotic strokes; of unknown value in transient ischaemic attacks; of dubious value in evolving strokes; and beneficial in cardiac embolism. The cardiac causes, including mural thrombus, unstable arrhythmias, and mitral valve prolapse should be actively sought. Aspirin, as the prototype anti-platelet agent, holds promise in transient ischemic attacks and minor strokes at both small and moderate dosages. Ticlopine is now being critically evaluated in America. Use of cerebral vasodilators should be abandoned. Enthusiasm in the use of streptokinase and urokinase has been dampened by the conversion of ischemic infarcts into haemorrhagic infarcts. In subarachnoid haemorrhage epsilon-aminocaprioc acid is useful although hazardous, in preventing rebleeding. Certain calcium ion channel blockers are promising in the reduction of vasopasm. Since the November 1985 article in the new England Journal of Medicine on the failure of external-to-internal carotid arterial bypass to reduce the risk of ischemic stroke, the swing is back to conservative management.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Advances in the medical management of cerebral vascular disease. 331 47

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 aim of this study was to analyse the frequency of aspirin and NSAID usage in 400 unselected patients admitted to the general medical wards through the Accident and Emergency Department. One hundred and twenty patients (30%) reported using NSAIDs (n = 27) or aspirin (n = 99) prior to admission. The median age was 70.5 years (IQR 54-80). Most aspirin use was low dose for cardiovascular prophylaxis and headache. The reported indications for NSAID use were osteoarthritis (n = 12), rheumatoid arthritis (n = 9), gout (n = 3) and psoriatic arthritis (n = 2) and headache (n = 1). Only 23 (19%) patients were aware of the potential side effects of these agents. Co-prescribing with an H2 antagonist (n = 10), proton pump inhibitor (n = 11) or misoprostol (n = 5) was noted in 21.6%. Approximately one third of patients admitted to general medical wards in this study were receiving NSAIDs or Aspirin. The indications for prescribing were appropriate for aspirin. NSAID use was more symptom based and may have been better managed using an analgesic in some cases. Despite the high prevalence of upper gastrointestinal symptoms, co-prescribing of ulcer healing drugs was relatively uncommon.
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PMID:Prospective evaluation of the utilization of aspirin and non-steroidal anti-inflammatory drugs in acute medical admissions. 961 32