Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Gout: HELP
Articles from Latin America
Based on 86 articles published since 2008
||||

These are the 86 published articles about Gout that originated from Latin America during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial Assessing qualitatively the impact of gout on sleep: any sleep was a dream far away until the gout flare resolved. 2018

Augusto Ferreira de Andrade, Carlos. ·Department of Epidemiology and Quantitative Methods in Health, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. · School of Medicine, Severino Sombra University, Rio de Janeiro, Brazil. ·Rheumatology (Oxford) · Pubmed #29947811.

ABSTRACT: -- No abstract --

2 Review Xanthine oxidase inhibitors for prevention of cardiovascular events: a systematic review and meta-analysis of randomized controlled trials. 2018

Bredemeier, Markus / Lopes, Lediane Moreira / Eisenreich, Matheus Augusto / Hickmann, Sheila / Bongiorno, Guilherme Kopik / d'Avila, Rui / Morsch, André Luis Bittencourt / da Silva Stein, Fernando / Campos, Guilherme Gomes Dias. ·Rheumatology Service at Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil. markbred@terra.com.br. · Serviço de Reumatologia do Hospital Nossa Senhora da Conceição, Avenida Francisco Trein, 596, sala 2048, Porto Alegre, RS, 91350-200, Brazil. markbred@terra.com.br. · Rheumatology Service at Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil. ·BMC Cardiovasc Disord · Pubmed #29415653.

ABSTRACT: BACKGROUND: Xanthine oxidase inhibitors (XOI), classified as purine-like (allopurinol and oxypurinol) and non-purine (febuxostat and topiroxostat) XOI, present antioxidant properties by reducing the production of reactive oxygen species derived from purine metabolism. Oxidative stress is an important factor related to endothelial dysfunction and ischemia-reperfusion injury, and may be implicated in the pathogenesis of heart failure, hypertension, and ischemic heart disease. However, there is contradictory evidence regarding the possible cardiovascular (CV) protective effect exerted by XOI. Our objective is to compare the incidence of major adverse cardiovascular events (MACE), mortality, total (TCE) and specific CV events in randomized controlled trials (RCTs) testing XOI against placebo or no treatment. METHODS: PubMed, EMBASE, Web of Science, Cochrane Central, Lilacs databases were searched from inception to Dec 30 2016, along with hand searching. RCTs including exclusively adult individuals, lasting ≥ 4 weeks, with no language restriction, were eligible. Independent paired researchers selected studies and extracted data. Considering the expected rarity of events, Peto and DerSimonian/Laird odds ratios (OR), the latter in case of heterogeneity, were used for analysis. Random-effects meta-regression was used to explore heterogeneity. RESULTS: The analysis of MACE included 81 articles (10,684 patients, 6434 patient-years). XOI did not significantly reduce risk of MACE (OR CONCLUSIONS: Purine-like XOI may reduce the incidence of adverse CV outcomes. However, higher doses of allopurinol (> 300 mg/day) may be associated with loss of CV protection.

3 Review Severe gout: Strategies and innovations for effective management. 2017

Pascual, Eliseo / Andrés, Mariano / Vázquez-Mellado, Janitzia / Dalbeth, Nicola. ·Sección de Reumatología, Hospital General Universitario de Alicante, Av. Pintor Baeza 12, 03010 Alicante, Spain; Departamento de Medicina Clínica (Reumatología), Universidad Miguel Hernández, Carretera Nacional 332 S/N, 03550, San Juan de Alicante, 03010 Alicante, Spain. Electronic address: pascual_eli@gva.es. · Sección de Reumatología, Hospital General Universitario de Alicante, Av. Pintor Baeza 12, 03010 Alicante, Spain; Departamento de Medicina Clínica (Reumatología), Universidad Miguel Hernández, Carretera Nacional 332 S/N, 03550, San Juan de Alicante, 03010 Alicante, Spain. · Servicio de Reumatología, Hospital General de México, Dr. Balmis 148, Cuauhtémoc, Doctores, 06726 Ciudad de México, D.F., Mexico. · Department of Rheumatology, Auckland District Health Board and Department of Medicine, University of Auckland, Auckland 1010, New Zealand. ·Joint Bone Spine · Pubmed #27932279.

ABSTRACT: Severe gout is characterised by frequent polyarticular flares, numerous tophi, joint damage, and musculoskeletal disability. This is a preventable condition and in many cases, represents a disease that has been insufficiently managed for years. Standard management recommendations may be insufficient for patients with severe gout; these patients frequently require intensive individualised pharmacological management with combinations of urate-lowering therapy and anti-inflammatory agents. In this article, we aim to integrate recent therapeutic advances to provide a practical framework for optimal management of severe gout.

4 Review Male fertility potential alteration in rheumatic diseases: a systematic review. 2016

Tiseo, Bruno Camargo / Cocuzza, Marcello / Bonfa, Eloisa / Srougi, Miguel / Silva, Clovis A. ·Departamento de Urologia da Faculdade de Medicina da Universidade de São Paulo, Brasil. · Divisão de Reumatologia da Faculdade de Medicina da Universidade de São Paulo, Brasil. · Unidade de Reumatologia Pediátrica do Departamento de Pediatria da Faculdade de Medicina da Universidade de São Paulo, Brasil. ·Int Braz J Urol · Pubmed #27120778.

ABSTRACT: BACKGROUND: Improved targeted therapies for rheumatic diseases were developed recently resulting in a better prognosis for affected patients. Nowadays, patients are living longer and with improved quality of life, including fertility potential. These patients are affected by impaired reproductive function and the causes are often multifactorial related to particularities of each disease. This review highlights how rheumatic diseases and their management affect testicular function and male fertility. MATERIALS AND METHODS: A systematic review of literature of all published data after 1970 was conducted. Data was collected about fertility abnormalities in male patients with systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis, ankylosing spondylitis, Behçet disease and gout. Two independent researchers carried out the search in online databases. RESULTS: A total of 19 articles were included addressing the following diseases: 7 systemic lupus erythematosus, 6 Behçet disease, 4 ankylosing spondylitis, 2 rheumatoid arthritis, 2 dermatomyositis and one gout. Systemic lupus erythematosus clearly affects gonadal function impairing spermatogenesis mainly due to antisperm antibodies and cyclophosphamide therapy. Behçet disease, gout and ankylosing spondylitis patients, including those under anti-TNF therapy in the latter disease, do not seem to have reduced fertility whereas in dermatomyositis, the fertility potential is hampered by disease activity and by alkylating agents. Data regarding rheumatoid arthritis is scarce, gonadal dysfunction observed as consequence of disease activity and antisperm antibodies. CONCLUSIONS: Reduced fertility potential is not uncommon. Its frequency and severity vary among the different rheumatic diseases. Permanent infertility is rare and often associated with alkylating agent therapy.

5 Review The eye and the skin in nonendocrine metabolic disorders. 2016

Urrets-Zavalía, Julio A / Espósito, Evangelina / Garay, Iliana / Monti, Rodolfo / Ruiz-Lascano, Alejandro / Correa, Leandro / Serra, Horacio M / Grzybowski, Andrzej. ·Department of Ophthalmology, University Clinic Reina Fabiola, Catholic University of Córdoba, Oncativo 1248, Córdoba (5000), Argentina. Electronic address: julioaurrets@gmail.com. · Department of Ophthalmology, University Clinic Reina Fabiola, Catholic University of Córdoba, Oncativo 1248, Córdoba (5000), Argentina. Electronic address: gely_esposito@hotmail.com. · Department of Dermatology, Hospital Privado Centro Médico de Córdoba, Naciones Unidas 346, Córdoba (5016), Argentina. Electronic address: ilianastella@hotmail.com. · Department of Ophthalmology, University Clinic Reina Fabiola, Catholic University of Córdoba, Oncativo 1248, Córdoba (5000), Argentina. Electronic address: fitomonti@hotmail.com. · Department of Dermatology, Hospital Privado Centro Médico de Córdoba, Naciones Unidas 346, Córdoba (5016), Argentina. Electronic address: aruizlascano@hospitalprivadosa.com.ar. · Department of Ophthalmology, University Clinic Reina Fabiola, Catholic University of Córdoba, Oncativo 1248, Córdoba (5000), Argentina. Electronic address: leandrocorrea50@hotmail.com. · CIBICI-CONICET, Faculty of Chemical Sciences, National University of Córdoba, Haya de la Torre esquina Medina Allende sin número, Ciudad Universitaria, Córdoba (5000), Argentina. Electronic address: hserra@fcq.unc.edu.ar. · Department of Ophthalmology, Poznań City Hospital, ul. Szwajcarska 3, 61-285 Poznań, Poland; Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland. Electronic address: ae.grzybowski@gmail.com. ·Clin Dermatol · Pubmed #26903184.

ABSTRACT: As metabolism is controlled by the input of genes and the environment, metabolic disorders result from some disturbance in the interaction between genes and environmental factors. Many metabolic disorders consist in congenital enzyme deficiencies, also known as "inborn errors of metabolism," that may be disabling or cause severe illness and death and are predominantly inherited in an autosomal recessive fashion. The deposit in cells and tissues of storage substances from errors in metabolic processes may produce a wide variety of disorders affecting different organs and functions, with different degrees of severity, and often present around the time of birth or early childhood. Distinctive ocular and skin manifestations accompany many metabolic diseases and may provide clues for their diagnosis and evolution.

6 Review Molecular basis of oxidative stress in gouty arthropathy. 2015

Zamudio-Cuevas, Yessica / Hernández-Díaz, Cristina / Pineda, Carlos / Reginato, Anthony M / Cerna-Cortés, Jorge Francisco / Ventura-Ríos, Lucio / López-Reyes, Alberto. ·Molecular Synovioanalysis and Musculoskeletal Ultrasound Laboratories, Instituto Nacional de Rehabilitación, Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Delegación Tlalpan, 14389, Mexico, D.F, Mexico. · Molecular Microbiology Laboratory, Department of Microbiology, Escuela Nacional de Ciencias Biológicas (ENCB), Instituto Politécnico Nacional (IPN), Prolongación de Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomás, Delegación Miguel Hidalgo, 11340, Mexico, D.F, Mexico. · Rheumatology Division, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02903, USA. · Molecular Synovioanalysis and Musculoskeletal Ultrasound Laboratories, Instituto Nacional de Rehabilitación, Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Delegación Tlalpan, 14389, Mexico, D.F, Mexico. allorey@yahoo.com. ·Clin Rheumatol · Pubmed #25854697.

ABSTRACT: Gout is a disorder of urate metabolism in which persistent high urate levels in the extracellular fluids result in the deposition of monosodium urate (MSU) crystal in joints and periarticular tissues. In recent years, this disease represents an increasingly common health problem, so the pace of investigation in the field has accelerated tremendously. New research advances in the pathogenesis of hyperuricemia and in the understanding of how MSU crystals induce an acute gouty attack have been focused in this review on the processes of inflammation and involvement of the innate immune response; in addition, we discuss new knowledge about the role of the reactive oxygen species in establishing oxidative stress in MSU crystal-induced arthritis.

7 Clinical Trial Validation of the Health Assessment Questionnaire disability index in patients with gout. 2008

Alvarez-Hernández, Everardo / Peláez-Ballestas, Ingris / Vázquez-Mellado, Janitzia / Terán-Estrada, Leobardo / Bernard-Medina, Ana Guishlaine / Espinoza, Jesús / Aceves-Avila, Francisco J / Goycochea-Robles, María V / Garza, Mario / Ventura, Lucio / Burgos-Vargas, Rubén / Anonymous6550597. ·Department of Rheumatology, Hospital General de México, México City, México. ·Arthritis Rheum · Pubmed #18438898.

ABSTRACT: OBJECTIVE: To assess the psychometric properties of the Health Assessment Questionnaire (HAQ) disability index (DI) in patients with gout. METHODS: This study was conducted in a multicenter cohort of patients with gout whose data were collected at baseline (time 0) and 6 months later (time 6). Reliability was assessed by test-retest reliability (intraclass correlation coefficient [ICC]) and internal consistency (Cronbach's alpha coefficient). Construct validity was assessed with convergent validity (HAQ DI correlation with Short Form 36 [SF-36]) and discriminative validity (HAQ DI correlation with clinical features). Sensitivity to change was determined by comparing HAQ DI time 0 versus HAQ DI time 6 (percentage of change, effect size, smallest real difference [SRD], and Guyatt's responsiveness index [GRI]). RESULTS: We included 206 patients (96.6% men, mean +/- SD age and disease duration 56.3 +/- 12.4 years and 9.3 +/- 8.5 years, respectively). Of these, 52.4% had joint pain, 22.8% swelling, 32.5% reduced joint mobility, and 36.9% tophi. The mean HAQ DI score was 0.59 +/- 0.77 (95% confidence interval [95% CI] 0.49-0.70). ICC (n = 36, evaluations at baseline and 5 days later) was 0.76. Cronbach's alphas were 0.91 (95% CI 0.88-0.92, P = 0.000) for the 20 HAQ DI items and 0.93 (95% CI 0.92-0.94, P = 0.000) for the 8 HAQ DI categories. The HAQ DI correlated in predictable ways with SF-36 subscales and clinical variables, and discriminated between subgroups with and without any joint pain, swelling, and tophi. Concerning sensitivity to change (n = 167), the difference between HAQ DI time 0 and HAQ DI time 6 was 0.31 +/- 0.58 (effect size 0.62, SRD 0.59, and GRI 1.91). DeltaHAQ DI correlated with Deltapain (r = 0.349, P = 0.000). CONCLUSION: The HAQ DI is a valid and reliable measure of functioning in patients with gout.

8 Article Hesperidin Methylchalcone Suppresses Experimental Gout Arthritis in Mice by Inhibiting NF-κB Activation. 2018

Ruiz-Miyazawa, Kenji W / Pinho-Ribeiro, Felipe A / Borghi, Sergio M / Staurengo-Ferrari, Larissa / Fattori, Victor / Amaral, Flavio A / Teixeira, Mauro M / Alves-Filho, Jose C / Cunha, Thiago M / Cunha, Fernando Q / Casagrande, Rubia / Verri, Waldiceu A. ·Departamento de Ciências Patológicas , Universidade Estadual de Londrina-UEL , Rod. Celso Garcia Cid, Km 380, PR445, Cx. Postal 10.011 , 86057-970 Londrina , Paraná , Brazil. · Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Laboratório de Imunofarmacologia , Universidade Federal de Minas Gerais , 31270-567 Belo Horizonte , Minas Gerais , Brazil. · Department of Pharmacology, Ribeirão Preto Medical School , University of São Paulo , Avenida Bandeirantes s/n , 14050-490 Ribeirão Preto , São Paulo , Brazil. · Departamento de Ciências Farmacêuticas , Universidade Estadual de Londrina-UEL , Avenida Robert Koch, 60, Hospital Universitário , 86038-350 Londrina , Paraná , Brazil. ·J Agric Food Chem · Pubmed #29852732.

ABSTRACT: Gout arthritis is a painful inflammatory disease induced by monosodium urate (MSU) crystals. We evaluate the therapeutic potential of the flavonoid hesperidin methylchalcone (HMC) in a mouse model of gout arthritis induced by intra-articular injection of MSU (100 μg/10 μL). Orally given HMC (3-30 mg/kg, 100 μL) reduced in a dose-dependent manner the MSU-induced hyperalgesia (44%, p < 0.05), edema (54%, p < 0.05), and leukocyte infiltration (70%, p < 0.05). HMC (30 mg/kg) inhibited MSU-induced infiltration of LysM-eGFP

9 Article Improvement in OMERACT domains and renal function with regular treatment for gout: a 12-month follow-up cohort study. 2018

Vazquez-Mellado, Janitzia / Peláez-Ballestas, Ingris / Burgos-Vargas, Rubén / Alvarez-Hernández, Everardo / García-Méndez, Sergio / Pascual-Ramos, Virginia / Rull-Gabayet, Marina. ·Rheumatology Department, Hospital General de México Eduardo Liceaga México City, México City, Mexico. jvazquezmellado@prodigy.net.mx. · Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico. jvazquezmellado@prodigy.net.mx. · Rheumatology Department, Hospital General de México Eduardo Liceaga México City, México City, Mexico. · Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico. · Immunology and Rheumatology Department, Instituto Nacional de Ciencias Médicas y de la Nutrición Salvador Zubirán, Mexico City, Mexico. ·Clin Rheumatol · Pubmed #29546696.

ABSTRACT: OMERACT proposed a set of mandatory and discretionary domains to evaluate the effect of treatment in patients with gout. To determine the percentage of improvement and the effect size 6 and 12 months after starting a proper treatment in patients with gout from our cohort (GRESGO) based on the OMERACT proposal for chronic gout. GRESGO is a cohort of consecutive, new patients with gout attending either of two dedicated clinics. This report includes 141 patients evaluated at baseline and 6 months plus 101 of them completing a 12-month follow-up in 2012. Clinical data including the OMERACT domains for chronic gout were collected at baseline and every 6 months. Treatment was prescribed by their attending physician with the purpose of getting < 6 mg/dL of seric uric acid (sUA). Most patients were males (96%) with inappropriate treatment (95%); 66% had tophi, 30% metabolic syndrome, and 32% low renal function. Mean dose of allopurinol at baseline and throughout the study went from 344 ± 168 mg/day to 453 ± 198 at 12 months. Most OMERACT domains and renal function improved significantly; 73% improved > 20% from 6 to 12 months. Greater improvement was observed in the domains: flares, index tophus size, pain, general health assessment, and HAQ score, all of them associated to lower sUA values. Chronic gout patients improve significantly in most OMERACT domains when conventional and regular treatment is indicated. sUA < 6 mg/dL is associated with greater improvement.

10 Article Brief Report: Validation of a Definition of Flare in Patients With Established Gout. 2018

Gaffo, Angelo L / Dalbeth, Nicola / Saag, Kenneth G / Singh, Jasvinder A / Rahn, Elizabeth J / Mudano, Amy S / Chen, Yi-Hsing / Lin, Ching-Tsai / Bourke, Sandra / Louthrenoo, Worawit / Vazquez-Mellado, Janitzia / Hernández-Llinas, Hansel / Neogi, Tuhina / Vargas-Santos, Ana Beatriz / da Rocha Castelar-Pinheiro, Geraldo / Amorim, Rodrigo B C / Uhlig, Till / Hammer, Hilde B / Eliseev, Maxim / Perez-Ruiz, Fernando / Cavagna, Lorenzo / McCarthy, Geraldine M / Stamp, Lisa K / Gerritsen, Martijn / Fana, Viktoria / Sivera, Francisca / Taylor, William. ·University of Alabama at Birmingham and Birmingham VA Medical Center, Birmingham, Alabama. · University of Auckland, Auckland, New Zealand. · University of Alabama at Birmingham. · Taichung Veterans General Hospital, Taichung, Taiwan. · Chiang Mai University, Chiang Mai, Thailand. · Hospital General de Mexico, Mexico City, Mexico. · Boston University School of Medicine, Boston, Massachusetts. · Boston University School of Medicine, Boston, Massachusetts, and Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Diakonhjemmet Hospital, Oslo, Norway. · Research Institute of Rheumatology of Russia, Moscow, Russia. · University of the Basque Country, Cruces University Hospital, and Biocruces Health Research Institute, Vizcaya, Spain. · University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. · Mater Misericordiae University Hospital, Dublin, Ireland. · University of Otago, Christchurch, New Zealand. · Westfries Gasthuis, Hoorn, The Netherlands. · Rigshospitalet Glostrup, Copenhagen, Denmark. · Hospital General Universitario Elda, Elda, Spain. · University of Wellington, Wellington, New Zealand. ·Arthritis Rheumatol · Pubmed #29161469.

ABSTRACT: OBJECTIVE: To perform external validation of a provisional definition of disease flare in patients with gout. METHODS: Five hundred nine patients with gout were enrolled in a cross-sectional study during a routine clinical care visit at 17 international sites. Data were collected to classify patients as experiencing or not experiencing a gout flare, according to a provisional definition. A local expert rheumatologist performed the final independent adjudication of gout flare status. Sensitivity, specificity, predictive values, and receiver operating characteristic (ROC) curves were used to determine the diagnostic performance of gout flare definitions. RESULTS: The mean ± SD age of the patients was 57.5 ± 13.9 years, and 89% were male. The definition requiring fulfillment of at least 3 of 4 criteria (patient-defined gout flare, pain at rest score of >3 on a 0-10-point numerical rating scale, presence of at least 1 swollen joint, and presence of at least 1 warm joint) was 85% sensitive and 95% specific in confirming the presence of a gout flare, with an accuracy of 92%. The ROC area under the curve was 0.97. The definition based on a classification and regression tree algorithm (entry point, pain at rest score >3, followed by patient-defined flare "yes") was 73% sensitive and 96% specific. CONCLUSION: The definition of gout flare that requires fulfillment of at least 3 of 4 patient-reported criteria is now validated to be sensitive, specific, and accurate for gout flares, as demonstrated using an independent large international patient sample. The availability of a validated gout flare definition will improve the ascertainment of an important clinical outcome in studies of gout.

11 Article Arctium minus crude extract presents antinociceptive effect in a mice acute gout attack model. 2018

Fischer, Susana Paula Moreira / Brusco, Indiara / Camponogara, Camila / Piana, Mariana / Faccin, Henrique / Gobo, Luciana Assis / de Carvalho, Leandro Machado / Oliveira, Sara Marchesan. ·Neurotoxicity and Psychopharmacology Laboratory, Center of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil. · Graduate Program in Biological Sciences: Biochemistry Toxicology, Federal University of Santa Maria, Santa Maria, RS, Brazil. · Graduate Program in Pharmaceutical Sciences, Center of Health Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil. · Department of Chemistry, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil. · Neurotoxicity and Psychopharmacology Laboratory, Center of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil. saramarchesan@hotmail.com. · Graduate Program in Biological Sciences: Biochemistry Toxicology, Federal University of Santa Maria, Santa Maria, RS, Brazil. saramarchesan@hotmail.com. · Department of Biochemistry and Molecular Biology, Federal University of Santa Maria, Av. Roraima 1000, Camobi, Santa Maria, RS, Zip Code: 97105-900, Brazil. saramarchesan@hotmail.com. ·Inflammopharmacology · Pubmed #28801728.

ABSTRACT: Gout is a disorder that triggers a severe inflammatory reaction which generates episodes of intense pain and discomfort to the patient. Arctium minus (Hill) Bernh. (Asteraceae) is known as "burdock" and displays anti-inflammatory, antinociceptive, against rheumatic pain and radical-scavenging activities. Species of the genus Arctium have been used in assistant therapy of gout and other inflammatory processes. We investigated the antinociceptive and anti-edematogenic effects of the crude extract of A. minus seeds in an acute gout attack model induced by intra-articular injection of monosodium urate (MSU) crystals in adult male Swiss mice (25-30 g). The crude extract of A. minus (100 mg/kg, p.o.) reduced the mechanical allodynia induced by the injection of MSU (1.25 mg/site, i.a.) from 4 until 8 h after its administration. A. minus seeds crude extract prevented mechanical allodynia at doses of 30 and 100 mg/kg, but not 10 mg/kg. Allopurinol (10 µg/mL) and A. minus crude extract (10-300 µg/mL) inhibited the xanthine oxidase activity in vitro. The A. minus seeds crude extract did not cause adverse effects since did not change the toxicological parameters evaluated. A. minus crude extract can be used as an assistant therapy of gout pain, supporting its traditional use, without causing adverse effects.

12 Article A 52-year-old man with gouty arthritis and erosive lesion in the hip. 2017

Dos Santos, Vitorino Modesto / Passini Soares, Viviane Vieira / de Faria, Priscilla Souza / Borges Viana, Francisca Germanya Morais / Duarte, Mayza Lemes. ·Department of Internal Medicine, Armed Forces Hospital, Cruzeiro Novo, Brasilia, Distrito Federal, Brazil; vitorinomodesto@gmail.com. ·Rom J Morphol Embryol · Pubmed #28730243.

ABSTRACT: The case study of peripheral and axial gouty arthritis is described in a 52-year-old man without concomitant clinical evidence of tophaceus gout on physical evaluation on admission. Gout is a metabolic disorder related to excess of uric acid in the extracellular compartment, and deposition of monosodium urate crystals in the joints and other sites. Arthritis and tophi are major manifestations, which more often involve the peripheral joints asymmetrically. Chronic tophaceous gout commonly develops after a decade of recurrent polyarticular gout. With lower frequency, the axial skeleton (spine and sacroiliac region) may be affected, condition sometimes associated with additional concerns, diagnostic challenges and pitfalls. Higher suspicion index and utilization of novel radiographic tools can settle these matters. Radiographic imaging exams include plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy to show bone erosion and joint lesions characterizing the spectrum of gouty osteoarthropathy.

13 Article Management of Gout and Hyperuricemia in CKD. 2017

Vargas-Santos, Ana Beatriz / Neogi, Tuhina. ·Rheumatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA. Electronic address: tneogi@bu.edu. ·Am J Kidney Dis · Pubmed #28456346.

ABSTRACT: Hyperuricemia and gout, the clinical manifestation of monosodium urate crystal deposition, are common in patients with chronic kidney disease (CKD). Although the presence of CKD poses additional challenges in gout management, effective urate lowering is possible for most patients with CKD. Initial doses of urate-lowering therapy are lower than in the non-CKD population, whereas incremental dose escalation is guided by regular monitoring of serum urate levels to reach the target level of <6mg/dL (or <5mg/dL for patients with tophi). Management of gout flares with presently available agents can be more challenging due to potential nephrotoxicity and/or contraindications in the setting of other common comorbid conditions. At present, asymptomatic hyperuricemia is not an indication for urate-lowering therapy, though emerging data may support a potential renoprotective effect.

14 Article Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990-2013: findings from the Global Burden of Disease Study 2013. 2017

Moradi-Lakeh, Maziar / Forouzanfar, Mohammad H / Vollset, Stein Emil / El Bcheraoui, Charbel / Daoud, Farah / Afshin, Ashkan / Charara, Raghid / Khalil, Ibrahim / Higashi, Hideki / Abd El Razek, Mohamed Magdy / Kiadaliri, Aliasghar Ahmad / Alam, Khurshid / Akseer, Nadia / Al-Hamad, Nawal / Ali, Raghib / AlMazroa, Mohammad AbdulAziz / Alomari, Mahmoud A / Al-Rabeeah, Abdullah A / Alsharif, Ubai / Altirkawi, Khalid A / Atique, Suleman / Badawi, Alaa / Barrero, Lope H / Basulaiman, Mohammed / Bazargan-Hejazi, Shahrzad / Bedi, Neeraj / Bensenor, Isabela M / Buchbinder, Rachelle / Danawi, Hadi / Dharmaratne, Samath D / Zannad, Faiez / Farvid, Maryam S / Fereshtehnejad, Seyed-Mohammad / Farzadfar, Farshad / Fischer, Florian / Gupta, Rahul / Hamadeh, Randah Ribhi / Hamidi, Samer / Horino, Masako / Hoy, Damian G / Hsairi, Mohamed / Husseini, Abdullatif / Javanbakht, Mehdi / Jonas, Jost B / Kasaeian, Amir / Khan, Ejaz Ahmad / Khubchandani, Jagdish / Knudsen, Ann Kristin / Kopec, Jacek A / Lunevicius, Raimundas / Abd El Razek, Hassan Magdy / Majeed, Azeem / Malekzadeh, Reza / Mate, Kedar / Mehari, Alem / Meltzer, Michele / Memish, Ziad A / Mirarefin, Mojde / Mohammed, Shafiu / Naheed, Aliya / Obermeyer, Carla Makhlouf / Oh, In-Hwan / Park, Eun-Kee / Peprah, Emmanuel Kwame / Pourmalek, Farshad / Qorbani, Mostafa / Rafay, Anwar / Rahimi-Movaghar, Vafa / Shiri, Rahman / Rahman, Sajjad Ur / Rai, Rajesh Kumar / Rana, Saleem M / Sepanlou, Sadaf G / Shaikh, Masood Ali / Shiue, Ivy / Sibai, Abla Mehio / Silva, Diego Augusto Santos / Singh, Jasvinder A / Skogen, Jens Christoffer / Terkawi, Abdullah Sulieman / Ukwaja, Kingsley N / Westerman, Ronny / Yonemoto, Naohiro / Yoon, Seok-Jun / Younis, Mustafa Z / Zaidi, Zoubida / Zaki, Maysaa El Sayed / Lim, Stephen S / Wang, Haidong / Vos, Theo / Naghavi, Mohsen / Lopez, Alan D / Murray, Christopher J L / Mokdad, Ali H. ·Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA. · Department of Community Medicine, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran. · Norwegian Institute of Public Health, Bergen, Norway. · Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. · Japan International Cooperation Agency, Lusaka, Zambia. · Ophthalmology resident in Aswan University Hospital, Aswan, Egypt. · Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden. · Murdoch Childrens Research Institute, Melbourne, Victoria, Australia. · The University of Melbourne, Melbourne, Victoria, Australia. · The University of Sydney, Sydney, New South Wales, Australia. · Hospital for Sick Children, Toronto, Ontario, Canada. · University of Toronto, Toronto, Ontario, Canada. · Food and Nutrition Administration, Ministry of Health, Safat, Kuwait. · University of Oxford, Oxford, UK. · Saudi Ministry of Health, Riyadh, Saudi Arabia. · Division of Physical Therapy, Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan. · Charité Universitätsmedizin, Berlin, Germany. · King Saud University, Riyadh, Saudi Arabia. · Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan. · Public Health Agency of Canada, Toronto, Ontario, Canada. · Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogota, Colombia. · Charles R. Drew University of Medicine and Science, Los Angeles, California, USA. · David Geffen School of Medicine, University of California at Los Angeles (UCLA), California, USA. · College of Public Health and Tropical Medicine, Jazan, Saudi Arabia. · University of São Paulo, São Paulo, Brazil. · Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Victoria, Australia. · Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. · Walden University, Minneapolis, Minnesota, USA. · Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. · Clinical Investigation Centre INSERM (the National Institute for Health and Medical Research), Université de Lorraine, Vandoeuvre les Nancy, France. · Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. · Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA. · Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Stockholm, Sweden. · Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran, Iran. · Bielefeld University, Bielefeld, Germany. · West Virginia Bureau for Public Health, Charleston, West Virginia, USA. · Arabian Gulf University, Manama, Bahrain. · Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates. · Nevada Division of Behavior and Public Health, Carson City, Nevada, USA. · Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA. · Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia. · Salah Azaiz Institute, Tunis, Tunisia. · Institute of Community and Public Health, Birzeit University, Birzeit, Palestine. · Health Economics Research Unit, University of Aberdeen, Aberdeen, UK. · Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany. · Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran. · Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. · Health Services Academy, Islamabad, Pakistan. · Ball State University, Muncie, Indiana, USA. · Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway. · University of British Columbia, Vancouver, British Columbia, Canada. · Aintree University Hospital National Health Service Foundation Trust, Liverpool, UK. · School of Medicine, University of Liverpool, Liverpool, UK. · Mansoura Faculty of Medicine, Mansoura, Egypt. · Imperial College London, London, UK. · Digestive Disease Research Institute, Tehran Universities of Medical Sciences, Tehran, Iran. · McGill University, Montreal, Quebec, Canada. · College of Medicine, Howard University, Washington DC, USA. · Thomas Jefferson University, Philadelphia, Pennsylvania, USA. · College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. · Hunger Action Los Angeles, Los Angeles, California, USA. · Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria. · Institute of Public Health, Heidelberg University, Heidelberg, Germany. · International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh. · Faculty of Health Sciences, Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon. · Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea. · Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea. · National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA. · Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran. · Contech International Health Consultants, Lahore, Pakistan. · Contech School of Public Health, Lahore, Pakistan. · Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. · Finnish Institute of Occupational Health, Helsinki, Finland. · Sweidi Hospital, Riyadh, Saudi Arabia. · Society for Health and Demographic Surveillance, Suri, India. · Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. · Independent Consultant, Karachi, Pakistan. · Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK. · Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK. · Department of Epidemiology & Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon. · Federal University of Santa Catarina, Florianópolis, Brazil. · University of Alabama at Birmingham, and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA. · Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway. · Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA. · Outcomes Research Consortium, Cleveland Clinic, Cleveland, Ohio, USA. · Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia. · Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria. · Federal Institute for Population Research, Wiesbaden, Germany. · German National Cohort Consortium, Heidelberg, Germany. · Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan. · Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea. · Jackson State University, Jackson, Mississippi, USA. · University Hospital, Setif, Algeria. · Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. ·Ann Rheum Dis · Pubmed #28209629.

ABSTRACT: OBJECTIVES: We used findings from the Global Burden of Disease Study 2013 to report the burden of musculoskeletal disorders in the Eastern Mediterranean Region (EMR). METHODS: The burden of musculoskeletal disorders was calculated for the EMR's 22 countries between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, death, years of live lost, years lived with disability and disability-adjusted life years (DALYs). RESULTS: For musculoskeletal disorders, the crude DALYs rate per 100 000 increased from 1297.1 (95% uncertainty interval (UI) 924.3-1703.4) in 1990 to 1606.0 (95% UI 1141.2-2130.4) in 2013. During 1990-2013, the total DALYs of musculoskeletal disorders increased by 105.2% in the EMR compared with a 58.0% increase in the rest of the world. The burden of musculoskeletal disorders as a proportion of total DALYs increased from 2.4% (95% UI 1.7-3.0) in 1990 to 4.7% (95% UI 3.6-5.8) in 2013. The range of point prevalence (per 1000) among the EMR countries was 28.2-136.0 for low back pain, 27.3-49.7 for neck pain, 9.7-37.3 for osteoarthritis (OA), 0.6-2.2 for rheumatoid arthritis and 0.1-0.8 for gout. Low back pain and neck pain had the highest burden in EMR countries. CONCLUSIONS: This study shows a high burden of musculoskeletal disorders, with a faster increase in EMR compared with the rest of the world. The reasons for this faster increase need to be explored. Our findings call for incorporating prevention and control programmes that should include improving health data, addressing risk factors, providing evidence-based care and community programmes to increase awareness.

15 Article Gout treatment: survey of Brazilian rheumatology residents. 2017

Amorim, Rodrigo Balbino Chaves / Vargas-Santos, Ana Beatriz / Pereira, Leticia Rocha / Coutinho, Evandro Silva Freire / da Rocha Castelar-Pinheiro, Geraldo. ·Division of Rheumatology, Internal Medicine Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. rodrigo_b_c_amorim@yahoo.com.br. · Division of Rheumatology, Internal Medicine Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. · Epidemiology Department, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil. ·Clin Rheumatol · Pubmed #28101833.

ABSTRACT: To assess the current practices in gout management among Brazilian rheumatology residents. We performed a cross-sectional online survey among all the rheumatology residents and those rheumatologists who had just completed their training (post-residency (PR)) regarding their approach to gout management. Results were compared with the 2012 American College of Rheumatology (ACR) gout guidelines and with the responses of a previous survey with a representative sample of practicing Brazilian rheumatologists (RHE). We received 224 responses (83%) from 271 subjects. Among all respondents, the first-choice treatment for gout flares was the combination of a nonsteroidal anti-inflammatory drug + colchicine for otherwise healthy patients. A target serum urate <6 mg/dL for patients without tophi was reported by >75%. Less than 70% reported starting allopurinol at low doses (≤100 mg/day) for patients with normal renal function and <50% reported maintaining urate-lowering therapy indefinitely for patients without tophi. Among residents and PR, the residency stage was the main predictor of concordance with the ACR guidelines, with PR achieving the greatest rates. Reported practices were commonly concordant with the 2012 ACR gout guidelines, especially among PR. However, some important aspects of gout management need improvement. These results will guide the development of a physician education program to improve the management of gout patients in Brazil.

16 Article The influence of seasonality on the content of goyazensolide and on anti-inflammatory and anti-hyperuricemic effects of the ethanolic extract of Lychnophora passerina (Brazilian arnica). 2017

de Albuquerque Ugoline, Bruno César / de Souza, Jacqueline / Ferrari, Fernanda Cristina / Ferraz-Filha, Zilma Schimith / Coelho, Grazielle Brandão / Saúde-Guimarães, Dênia Antunes. ·Laboratório de Plantas Medicinais (LAPLAMED), CiPharma, Escola de Farmácia, Campus da Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil. · Laboratório de Controle de Qualidade, CiPharma, Escola de Farmácia, Campus da Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil. · Laboratório de Plantas Medicinais (LAPLAMED), CiPharma, Escola de Farmácia, Campus da Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil; Departamento de Química, Instituto Federal de Minas Gerais-Campus Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil. · Laboratório de Plantas Medicinais (LAPLAMED), CiPharma, Escola de Farmácia, Campus da Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil. Electronic address: saudeguima@gmail.com. ·J Ethnopharmacol · Pubmed #28089739.

ABSTRACT: ETHNOPHARMACOLOGICAL RELEVANCE: Lychnophora passerina (Mart ex DC) Gardn (Asteraceae), popularly known as Brazilian arnica, is used in Brazilian folk medicine to treat pain, rheumatism, bruises, inflammatory diseases and insect bites. AIM OF THE STUDY: Investigate the influence of the seasons on the anti-inflammatory and anti-hyperuricemic activities of ethanolic extract of L. passerina and the ratio of the goyazensolide content, main chemical constituent of the ethanolic extract, with these activities. MATERIALS AND METHODS: Ethanolic extracts of aerial parts of L. passerina were obtained from seasons: summer (ES), autumn (EA), winter (EW) and spring (EP). The sesquiterpene lactone goyazensolide, major metabolite, was quantified in ES, EA, EW and EP by a developed and validated HPLC-DAD method. The in vivo anti-hyperuricemic and anti-inflammatory effects of the ethanolic extracts from L. passerina and goyazensolide were assayed on experimental model of oxonate-induced hyperuricemia in mice, liver xanthine oxidase (XOD) inhibition and on carrageenan-induced paw edema in mice. RESULTS: HPLC method using aqueous solution of acetic acid 0.01% (v/v) and acetonitrile with acetic acid 0.01% (v/v) as a mobile phase in a gradient system, with coumarin as an internal standard and DAD detection at 270nm was developed. The validation parameters showed linearity in a range within 10.0-150.0µg/ml, with intraday and interday precisions a range of 0.61-3.82. The accuracy values of intraday and interday analysis within 87.58-100.95%. EA showed the highest goyazensolide content. From the third to the sixth hour after injection of carrageenan, treatments with all extracts at the dose of 125mg/kg were able to reduce edema. Goyazensolide (10mg/kg) showed significant reduction of paw swelling from the second hour assay. This sesquiterpene lactone was more active than extracts and presented similar effect to indomethacin. Treatments with ES, EA and EP (125mg/kg) and goyazensolide (10mg/kg) reduced serum urate levels compared to hyperuricemic control group and were able to inhibit liver XOD activity. One of the mechanisms by which ES, EA, EP and goyazensolide exercise their anti-hyperuricemic effect is by the inhibition of liver XOD activity. Goyazensolide was identified as the main compound present in ES, EA, EW and EP and it is shown to be one of the chemical constituents responsible for the anti-inflammatory and anti-hyperuricemic effects of the ethanolic extracts. CONCLUSION: The anti-inflammatory and anti-hyperuricemic activities of the ethanolic extracts from L. passerina were not proportionally influenced by the variation of goyazensolide content throughout the seasons. The involvement of goyazensolide on in vivo anti-inflammatory and anti-hyperuricemic activities of L.passerina extracts was confirmed, as well as the possibility of participation of other constituents on these effects. This study demonstrated that the aerial parts of L. passerina may be collected in any season for use as anti-inflammatory agent. For use in hyperuricemia, the best seasons for the collection are summer, autumn and spring. The ethanolic extract of L. passerina and goyazensolide can be considered promising agents in the therapeutic of inflammation, hyperuricemia and gout.

17 Article Annexin A1 promotes timely resolution of inflammation in murine gout. 2017

Galvão, Izabela / Vago, Juliana P / Barroso, Livia C / Tavares, Luciana P / Queiroz-Junior, Celso M / Costa, Vivian V / Carneiro, Fernanda S / Ferreira, Tatiana P / Silva, Patricia M R / Amaral, Flávio A / Sousa, Lirlândia P / Teixeira, Mauro M. ·Imunofarmacologia, Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Departamento de Morfologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Laboratório de Inflamação, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Brazil. ·Eur J Immunol · Pubmed #27995621.

ABSTRACT: Gout is a self-limited inflammatory disease caused by deposition of monosodium urate (MSU) crystals in the joints. Resolution of inflammation is an active process leading to restoration of tissue homeostasis. Here, we studied the role of Annexin A1 (AnxA1), a glucocorticoid-regulated protein that has anti-inflammatory and proresolving actions, in resolution of acute gouty inflammation. Injection of MSU crystals in the knee joint of mice induced inflammation that was associated with expression of AnxA1 during the resolving phase of inflammation. Neutralization of AnxA1 with antiserum or blockade of its receptor with BOC-1 (nonselective) or WRW

18 Article Performance of Ultrasound in the Diagnosis of Gout in a Multicenter Study: Comparison With Monosodium Urate Monohydrate Crystal Analysis as the Gold Standard. 2017

Ogdie, Alexis / Taylor, William J / Neogi, Tuhina / Fransen, Jaap / Jansen, Tim L / Schumacher, H Ralph / Louthrenoo, Worawit / Vazquez-Mellado, Janitzia / Eliseev, Maxim / McCarthy, Geraldine / Stamp, Lisa K / Perez-Ruiz, Fernando / Sivera, Francisca / Ea, Hang-Korng / Gerritsen, Martijn / Cagnotto, Giovanni / Cavagna, Lorenzo / Lin, Chingtsai / Chou, Yin-Yi / Tausche, Anne-Kathrin / Lima Gomes Ochtrop, Manuella / Janssen, Matthijs / Chen, Jiunn-Horng / Slot, Ole / Lazovskis, Juris / White, Douglas / Cimmino, Marco A / Uhlig, Till / Dalbeth, Nicola. ·University of Pennsylvania, Philadelphia. · University of Otago, Wellington, New Zealand. · Boston University School of Medicine, Boston, Massachusetts. · VieCuri Medical Centre, Venlo, The Netherlands, and Scientific IQ HealthCare, Radboud University Medical Center, Nijmegen, The Netherlands. · Chiang Mai University, Chiang Mai, Thailand. · Hospital General de México, Mexico City, Mexico. · Nasonova Research Institute of Rheumatology of Russia, Moscow, Russia. · University College Dublin and Mater Misericordiae University Hospital, Dublin, Ireland. · University of Otago Christchurch, Christchurch, New Zealand. · Hospital Universitario Cruces, BioCruces Health Research Institute, and Basque Country University, Barakaldo, Spain. · Hospital General Universitario de Elda, Alicante, Spain. · Université Paris Diderot, INSERM UMR 1132 and Service de Rhumatologie, Hôpital Lariboisière, AP-HP, Paris, France. · Westfries Gasthuis, Hoorn, The Netherlands. · University of Pavia and IRCCS Policlinico San Matteo Foundation, Pavia, Italy, and Skane University Hospital Malmö/Lund, Lund, Sweden. · University of Pavia and IRCCS Policlinico San Matteo Foundation, Pavia, Italy. · Taichung Veterans' General Hospital, Taichung, Taiwan, Republic of China. · University Hospital Carl Gustav Carus, Dresden, Germany. · Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Rijnstate Hospital, Arnhem, The Netherlands. · China Medical University Hospital, Taichung, Taiwan, Republic of China. · Copenhagen University Hospital Glostrup, Glostrup, Denmark. · Riverside Professional Centre, Sydney, Nova Scotia, Canada. · Waikato District Health Board and Waikato Clinical School, Hamilton, New Zealand. · University of Genoa, Genoa, Italy. · Diakonhjemmet Hospital, Oslo, Norway. · University of Auckland, Auckland, New Zealand. ·Arthritis Rheumatol · Pubmed #27748084.

ABSTRACT: OBJECTIVE: To examine the performance of ultrasound (US) for the diagnosis of gout using the presence of monosodium urate monohydrate (MSU) crystals as the gold standard. METHODS: We analyzed data from the Study for Updated Gout Classification Criteria (SUGAR), a large, multicenter observational cross-sectional study of consecutive subjects with at least 1 swollen joint who conceivably may have gout. All subjects underwent arthrocentesis; cases were subjects with confirmed MSU crystals. Rheumatologists or radiologists who were blinded with regard to the results of the MSU crystal analysis performed US on 1 or more clinically affected joints. US findings of interest were double contour sign, tophus, and snowstorm appearance. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Multivariable logistic regression models were used to examine factors associated with positive US results among subjects with gout. RESULTS: US was performed in 824 subjects (416 cases and 408 controls). The sensitivity, specificity, PPV, and NPV for the presence of any 1 of the features were 76.9%, 84.3%, 83.3%, and 78.2%, respectively. Sensitivity was higher among subjects with a disease duration of ≥2 years and among subjects with subcutaneous nodules on examination (suspected tophus). Associations with a positive US finding included suspected clinical tophus (odds ratio [OR] 4.77 [95% confidence interval (95% CI) 2.23-10.21]), any abnormality on plain radiography (OR 4.68 [95% CI 2.68-8.17]), and serum urate level (OR 1.31 [95% CI 1.06-1.62]). CONCLUSION: US features of MSU crystal deposition had high specificity and high PPV but more limited sensitivity for early gout. The specificity remained high in subjects with early disease and without clinical signs of tophi.

19 Article Treat-to-target (T2T) recommendations for gout. 2017

Kiltz, U / Smolen, J / Bardin, T / Cohen Solal, A / Dalbeth, N / Doherty, M / Engel, B / Flader, C / Kay, J / Matsuoka, M / Perez-Ruiz, F / da Rocha Castelar-Pinheiro, G / Saag, K / So, A / Vazquez Mellado, J / Weisman, M / Westhoff, T H / Yamanaka, H / Braun, J. ·Rheumazentrum Ruhrgebiet, and Ruhr University Bochum, Herne, Germany. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria. · Assisitance Publique Hôpitaux de Paris Rheumatology Department, Lariboisière Hospital, University Paris Diderot, Sorbonne Paris-Cité and INSERM, UMR 1132, Paris, France. · Research Medical Unit INSERM, Université Paris VII-Denis Diderot Assistance Publique-Hôpitaux de Paris, Service de Cardiologie, Hôpital Lariboisière, Paris, France. · University of Auckland and Auckland District Health Board, Auckland, New Zealand. · University of Nottingham, Nottingham, UK. · Medical Faculty, Institute of General Practice and Family Medicine, University Bonn, Bonn, Germany. · UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester, Massachusetts, USA. · Carnegie Mellon University, Pittsburgh, Pennsylvania, USA. · Rheumatology Division, Hospital de Cruces, Baracaldo, Vizcaya, Spain. · Discipline of Rheumatology, Rio de Janeiro State University, Rio de Janeiro, Brazil. · University of Alabama at Birmingham, Birmingham, Alabama, USA. · Service de Rhumatologie, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. · Servicio de Reumatología, Hospital General de México, México City, México. · Division of Rheumatology, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, USA. · Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Herne, Germany. · Tokyo Women's Medical University, Tokyo, Japan. ·Ann Rheum Dis · Pubmed #27658678.

ABSTRACT: OBJECTIVES: The treat-to-target (T2T) concept has been applied successfully in several inflammatory rheumatic diseases. Gout is a chronic disease with a high burden of pain and inflammation. Because the pathogenesis of gout is strongly related to serum urate levels, gout may be an ideal disease in which to apply a T2T approach. Our aim was to develop international T2T recommendations for patients with gout. METHODS: A committee of experts with experience in gout agreed upon potential targets and outcomes, which was the basis for the systematic literature search. Eleven rheumatologists, one cardiologist, one nephrologist, one general practitioner and one patient met in October 2015 to develop T2T recommendations based on the available scientific evidence. Levels of evidence, strength of recommendations and levels of agreement were derived. RESULTS: Although no randomised trial was identified in which a comparison with standard treatment or an evaluation of a T2T approach had been performed in patients with gout, indirect evidence was provided to focus on targets such as normalisation of serum urate levels. The expert group developed four overarching principles and nine T2T recommendations. They considered dissolution of crystals and prevention of flares to be fundamental; patient education, ensuring adherence to medications and monitoring of serum urate levels were also considered to be of major importance. CONCLUSIONS: This is the first application of the T2T approach developed for gout. Since no publication reports a trial comparing treatment strategies for gout, highly credible overarching principles and level D expert recommendations were created and agreed upon.

20 Article Severe tophaceous gout and disability: changes in the past 15 years. 2017

López López, Carlos Omar / Lugo, Everardo Fuentes / Alvarez-Hernández, Everardo / Peláez-Ballestas, Ingris / Burgos-Vargas, Rubén / Vázquez-Mellado, Janitzia. ·Servicio de Medicina Física y Rehabilitación, Unidad 402, Hospital General de México, Dr. Balmis 148, Col. Doctores, 06720, Mexico D.F., Mexico. · Servicio de Reumatología, Unidad 404, Hospital General de México, Dr. Balmis 148, Col. Doctores, 06720, Mexico D.F., Mexico. · Servicio de Reumatología, Unidad 404, Hospital General de México, Dr. Balmis 148, Col. Doctores, 06720, Mexico D.F., Mexico. jvazquezmellado@prodigy.net.mx. ·Clin Rheumatol · Pubmed #27631961.

ABSTRACT: Epidemiologic data from recent decades show a significant increase in the prevalence and incidence of gout worldwide, in addition to changes in its clinical expression. Our objective was to compare the frequency of the severity of gout and disability in two patient groups at our clinic during different periods. We included and compared data of two groups: group A (1995-2000), patients from previous report, and group B (2010-2014), the baseline data of current patients participating in a cohort (GRESGO). This evaluation included data of socioeconomic and educational levels, demographics, associated diseases, previous treatment, clinical and biochemical data, and disability evaluated using the Health Assessment Questionnaire (HAQ). We included data of 564 gout patients. Participants were 35.7 ± 12.7 years old at onset and had 12.0 ± 9.2-years disease duration at their first evaluation in our department. Group B patients were younger, had higher educational and socioeconomic levels, and had more severe disease. However, this group had less frequency of some associated diseases and significantly higher HAQ scores. With increased HAQ score, a higher number of acute flares and tender, limited-to-motion, and swollen joints were seen. The spectrum of gout has changed over the past decade. A higher percentage of our patients had a severe form of disease, were younger, had earlier disease onset, and had more disability reflected in higher HAQ scores. In our current patient group, the variable most associated with disability was limited-to-motion joints; however, the number of acute flares and tender and swollen joints was also higher in patients with greater disability.

21 Article Dietary fiber and the short-chain fatty acid acetate promote resolution of neutrophilic inflammation in a model of gout in mice. 2017

Vieira, Angélica T / Galvão, Izabela / Macia, Laurence M / Sernaglia, Érica M / Vinolo, Marco Aurélio R / Garcia, Cristiana C / Tavares, Luciana P / Amaral, Flávio A / Sousa, Lirlândia P / Martins, Flaviano S / Mackay, Charles R / Teixeira, Mauro M. ·Immunopharmacology Group, Department of Biochemistry and Immunology, Federal University of Minas Gerais, Minas Gerais, Brazil. · Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais (UFMG), Minas Gerais, Brazil. · Department of Immunology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; and. · Department of Genetics, Evolution and Bioagents, Institute of Biology, University of Campinas, São Paulo, Brazil. · Immunopharmacology Group, Department of Biochemistry and Immunology, Federal University of Minas Gerais, Minas Gerais, Brazil; mmtex@icb.ufmg.br. ·J Leukoc Biol · Pubmed #27496979.

ABSTRACT: Gout is a disease characterized by the deposition of monosodium urate (MSU) crystals in the joints. Continuous gout episodes may lead to unresolved inflammatory responses and tissue damage. We investigated the effects of a high-fiber diet and acetate, a short-chain fatty acid (SCFA) resulting from the metabolism of fiber by gut microbiota, on the inflammatory response in an experimental model of gout in mice. Injection of MSU crystals into the knee joint of mice induced neutrophil influx and inflammatory hypernociception. The onset of inflammatory response induced by MSU crystals was not altered in animals given a high-fiber diet, but the high-fiber diet induced faster resolution of the inflammatory response. Similar results were obtained in animals given the SCFA acetate. Acetate was effective, even when given after injection of MSU crystals at the peak of the inflammatory response and induced caspase-dependent apoptosis of neutrophils that accounted for the resolution of inflammation. Resolution of neutrophilic inflammation was associated with decreased NF-κB activity and enhanced production of anti-inflammatory mediators, including IL-10, TGF-β, and annexin A1. Acetate treatment or intake of a high-fiber diet enhanced efferocytosis, an effect also observed in vitro with neutrophils treated with acetate. In conclusion, a high-fiber diet or one of its metabolic products, acetate, controls the inflammatory response to MSU crystals by favoring the resolution of the inflammatory response. Our studies suggest that what we eat plays a determinant role in our capacity to fine tune the inflammatory response.

22 Article Hydroxyapatite and calcium pyrophosphate crystals mimicking gout in systemic sclerosis. 2017

Ventura-Ríos, Lucio / Ferrusquia-Toriz, Diana / Saldarriaga, Lina María. ·Laboratorio de Ultrasonido Musculoesquelético y Articular, Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra», Ciudad de México, México. Electronic address: venturarioslucio@gmail.com. · Laboratorio de Ultrasonido Musculoesquelético y Articular, Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra», Ciudad de México, México. ·Reumatol Clin · Pubmed #27247113.

ABSTRACT: -- No abstract --

23 Article A descriptive, cross-sectional study characterizing bone erosions in rheumatoid arthritis and gout by ultrasound. 2016

Ventura-Ríos, Lucio / Hernández-Díaz, Cristina / Sanchez-Bringas, Guadalupe / Madrigal-Santillán, Eduardo / Morales-González, José Antonio / Pineda, Carlos. ·Laboratorio de Ultrasonido Musculoesquelético y Articular, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, México City, México. venturarioslucio@gmail.com. · Laboratorio de Ultrasonido Musculoesquelético y Articular, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, México City, México. · Servicio de Cirugía de Columna. Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, México City, México. · Laboratorio de Medicina de Conservación. Escuela Superior de Medicina. Instituto Politécnico Nacional, México City, México. · Dirección de Investigación, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, México City, México. ·Clin Rheumatol · Pubmed #27393079.

ABSTRACT: The aim of this study is to characterize bone erosions in metatarsal heads (MTH) in rheumatoid arthritis (RA) and gout by grayscale ultrasound. In a descriptive, cross-sectional study, we evaluated 40 patients with RA and 40 with gout, both diagnosed according to the American College of Rheumatology/European League Against Rheumatism criteria, respectively. All patients had bone erosion demonstrated by ultrasound, which was used, following OMERACT criteria, to describe the shape, size, number, border definition, overhanging margin, topography (intra- or extra-articular), and distribution (over dorsal, medial, lateral, or plantar aspect) of the lesions in the MTH. Descriptive statistics were used and a concordance exercise between two ultrasonographers blinded to the diagnosis was performed. Bone erosions in RA were observed most frequently at the plantar and lateral aspect of the fifth MTH, round in 96 %, small-sized (2.43 ± 0.9 mm), intra-articular (100 %), and single (75 %). Few bone erosions had a well-defined border an overhanging margin while in gout were found most frequently in the medial and dorsal aspect of the first MTH, single in 71 %, intra-articular in 100 %, and of median size (4.0 ± 2.3). For shape, 51 % was round and 49 % was oval. A well-defined border was present in 39 %, and an overhanging margin in 62 %. Inter-rater reliability kappa was excellent (0.81, 95 % CI 0.56-1.00). Some characteristics of bone erosions in RA, including shape, size, ill-defined border, and localization in the fifth MTH could distinguish the lesions from gout. Grayscale US has excellent reliability to describe bone erosions in RA and gout.

24 Article Antinociceptive Effect of Racemic Flurbiprofen and Caffeine Co-Administration in an Arthritic Gout-Type Pain in Rats. 2016

Liévano-Reyes, Ricardo / Pérez-Méndez, Hermínia Ines / Solís-Oba, Aida / Jaramillo-Morales, Osmar Antonio / Espinosa-Juárez, Josué Vidal / López-Muñoz, Francisco Javier. ·Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Unidad Xochimilco, CDMX, 04960, México. · Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana, Unidad Xochimilco, CDMX, 04960, México. · Laboratorio No.7 "Dolor y Analgesia" del Departamento de Farmacobiología, Cinvestav-Sede Sur, Calz. de los Tenorios No. 235, Col., Granjas Coapa, CDMX, 14330, México. ·Drug Dev Res · Pubmed #27241234.

ABSTRACT: Preclinical Research Drug combinations are routinely used in the treatment of pain. In drug associations, adjuvants such as caffeine, are employed with different non-steroidal anti-inflammatories drugs (NSAIDs), however, at present does not exist studies showing the effect of the combination of racemic flurbiprofen (rac-Flur) in association with caffeine. The objective of this work was to evaluate the combination of rac-Flur + caffeine oral in arthritic gout-type pain in rats. The antinociceptive effects of the rac-Flur alone and in combination with caffeine were analyzed on a pain-induced functional impairment model in rat. rac-Flur induced a dose-dependent antinociceptive effect and caffeine did not present any effect. The combination of rac-Flur and caffeine achieve a higher percentage of antinociceptive effect compared with the individual administration of rac-Flur. The dose-response curve (DRCs) shows that the combination of rac-Flur (31.6 mg/kg) + caffeine (17.8 mg/kg) exhibited the maximal antinociceptive efficacy (294.0 ± 21.2 area units), while rac-Flur alone (31.6 mg/kg) showed 207.2 ± 35.2 au, thus indicating an increase in efficacy (potentiation). Furthermore, the DRCs of the combinations presented a displacement to the left, indicating a change in the potency. Caffeine is able to increase the effect of rac-Flur in the arthritic gout-type pain in rats. Drug Dev Res 77 : 192-198, 2016.   © 2016 Wiley Periodicals, Inc.

25 Article Tendon involvement in patients with gout: an ultrasound study of prevalence. 2016

Ventura-Ríos, Lucio / Sánchez-Bringas, Guadalupe / Pineda, Carlos / Hernández-Díaz, Cristina / Reginato, Anthony / Alva, Magaly / Audisio, Marcelo / Bertoli, Ana / Cazenave, Tomas / Gutiérrez, Marwin / Mora, Claudia / Py, Guillermo / Sedano, Oscar / Solano, Carla / de Miguel, Eugenio. ·Musculoskeletal Ultrasound Laboratory, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, México City, México. venturarioslucio@gmail.com. · Spine Surgery Service, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, Mexico City, Mexico. · Research Direction, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, México City, México. · Musculoskeletal Ultrasound Laboratory, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, México City, México. · Rheumatology Research and Musculoskeletal Ultrasound, Brown University, Providence VAMC, University Medicine Foundation/RIH, Providence, RI, USA. · Rheumatology Unit, Hospital Edgardo Rebagliati Martins, Lima, Perú. · Rheumatology Unit, Facultad de Ciencias Médicas, Hospital Nacional de Clínicas, Córdoba, Argentina. · Rheumatology Unit, Instituto Reumatológico Strusberg, Córdoba, Argentina. · Rheumatology Unit, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina. · División de Enfermedades Musculoesqueléticas y Reumáticas, Instituto Nacional de Rehabilitación, Luis Guillermo Ibarra Ibarra, México City, México. · Rheumatology Lima, Hospital Marino Molina Scippa ESSALUD, Lima, Peru. · Rheumatology Unit, Hospital Nacional Rosales, San Salvador, El Salvador. · Rheumatology Unit, Hospital Universitario La Paz, Madrid, Spain. ·Clin Rheumatol · Pubmed #27236513.

ABSTRACT: The objective of the present study is to evaluate, by ultrasonography (US), the prevalence in the quadriceps, patellar, and Achilles tendon involvement of gout compared to that of patients with osteoarthritis and asymptomatic marathon runners. This is a multicenter, multinational, transverse cross-sectional, and comparative study comprising 80 patients with the diagnosis of gout according to the American College of Rheumatology (ACR) criteria, compared with two control groups: 35 patients with generalized osteoarthritis according to the ACR criteria and 35 subjects who were healthy marathon runners. Demographics and clinical characteristics, such as age, gender, comorbidity, disease duration, pain at the enthesis in the knee and ankle, frequency of disease exacerbations, uric acid level more than 7.2 mg at the time of evaluation, and type of treatment, were recorded. All participants were examined by ultrasound at the quadriceps, the patellar at its proximal and distal insertion, and the Achilles tendon to detect intra-tendinous tophus or aggregates according to the OMERACT definitions. Descriptive statistics and differences between groups were analyzed by chi-square test. Sensitivity and specificity by US were calculated. The prevalence of intra-tendinous aggregates and tophi in gout was significant compared with the other groups. Both lesions were the most frequent at the distal patellar insertion, followed by the quadriceps, Achilles, and proximal patellar insertion ones. In patients with osteoarthritis (OA), intra-tendinous hyperechoic aggregates were observed in 20 % of quadriceps tendons and in 11 % of patellar tendons at its proximal insertion, while in the healthy marathon runner group, the Achilles tendon had this kind of lesion in 17 % of the subjects. Neither the OA nor the healthy marathon runners had intra-tendinous tophi. The sensitivity and specificity of US to detect tophi or aggregates were 69.6 and 92 %, respectively, tendon involvement at the lower limbs in gout is very frequent, particularly in the patellar tendon, and US possesses good sensitivity and specificity for detecting intra-tendinous tophi.

Next