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Gout: HELP
Articles from Beth Israel Deaconess
Based on 10 articles published since 2010
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These are the 10 published articles about Gout that originated from Beth Israel Deaconess during 2010-2020.
 
+ Citations + Abstracts
1 Guideline Autosomal dominant tubulointerstitial kidney disease: diagnosis, classification, and management--A KDIGO consensus report. 2015

Eckardt, Kai-Uwe / Alper, Seth L / Antignac, Corinne / Bleyer, Anthony J / Chauveau, Dominique / Dahan, Karin / Deltas, Constantinos / Hosking, Andrew / Kmoch, Stanislav / Rampoldi, Luca / Wiesener, Michael / Wolf, Matthias T / Devuyst, Olivier / Anonymous4640822. ·Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany. · Divisions of Nephrology and Molecular and Vascular Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. · INSERM U1163, Laboratory of Hereditary Kidney Diseases, Paris, France. · Paris Descartes University, Imagine Institute, Paris, France. · Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. · Département de Néphrologie et Transplantation d'organes, CHU Rangueil, Toulouse, France. · Centre de Génétique Humaine, Institut de Pathologie et de Génétique, Gosselies, Belgium. · Department of Biological Sciences, Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus. · UKD Foundation, New York, New York, USA. · Institute for Inherited Metabolic Disorders, Charles University in Prague, Prague, Czech Republic. · Molecular Genetics of Renal Disorders Unit, Division of Genetics and Cell Biology, Dulbecco Telethon Institute c/o IRCCS San Raffaele Scientific Institute, Milan, Italy. · Division of Pediatric Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. · Institute of Physiology, University of Zurich, Zurich, Switzerland. ·Kidney Int · Pubmed #25738250.

ABSTRACT: Rare autosomal dominant tubulointerstitial kidney disease is caused by mutations in the genes encoding uromodulin (UMOD), hepatocyte nuclear factor-1β (HNF1B), renin (REN), and mucin-1 (MUC1). Multiple names have been proposed for these disorders, including 'Medullary Cystic Kidney Disease (MCKD) type 2', 'Familial Juvenile Hyperuricemic Nephropathy (FJHN)', or 'Uromodulin-Associated Kidney Disease (UAKD)' for UMOD-related diseases and 'MCKD type 1' for the disease caused by MUC1 mutations. The multiplicity of these terms, and the fact that cysts are not pathognomonic, creates confusion. Kidney Disease: Improving Global Outcomes (KDIGO) proposes adoption of a new terminology for this group of diseases using the term 'Autosomal Dominant Tubulointerstitial Kidney Disease' (ADTKD) appended by a gene-based subclassification, and suggests diagnostic criteria. Implementation of these recommendations is anticipated to facilitate recognition and characterization of these monogenic diseases. A better understanding of these rare disorders may be relevant for the tubulointerstitial fibrosis component in many forms of chronic kidney disease.

2 Editorial Editorial: The Ethics of Recent Gout Trials. 2016

Shmerling, Robert H. ·Beth Israel Deaconess Medical Center, Boston, Massachusetts; Chair, American College of Rheumatology Committee on Ethics and Conflicts of Interest. ·Arthritis Rheumatol · Pubmed #27110864.

ABSTRACT: -- No abstract --

3 Review Injection Techniques for Common Chronic Pain Conditions of the Foot: A Comprehensive Review. 2020

Urits, Ivan / Smoots, Daniel / Franscioni, Henry / Patel, Anjana / Fackler, Nathan / Wiley, Seth / Berger, Amnon A / Kassem, Hisham / Urman, Richard D / Manchikanti, Laxmaiah / Abd-Elsayed, Alaa / Kaye, Alan D / Viswanath, Omar. ·Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. iurits@bidmc.harvard.edu. · Creighton University School of Medicine, Phoenix Regional Campus, Phoenix, AZ, USA. · Georgetown University School of Medicine, Washington, DC, USA. · Arizona State University, Tempe, AZ, USA. · Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. · Department of Anesthesiology, Mount Sinai Medical Center, Miami Beach, FL, USA. · Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA. · Pain Management Centers of America, Paducah, KY, USA. · Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA. · Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA, USA. · Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ, USA. · Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA. ·Pain Ther · Pubmed #32107725.

ABSTRACT: PURPOSE OF REVIEW: This is a comprehensive literature review of the available evidence and techniques of foot injections for chronic pain conditions. It briefly describes common foot chronic pain syndromes and then reviews available injection techniques for each of these syndromes, weighing the available evidence and comparing the available approaches. RECENT FINDINGS: Foot and ankle pain affects 20% of the population over 50 and significantly impairs mobility and ability to participate in activities of daily living (ADLs), as well as increases fall risk. It is commonly treated with costly surgery, at times with questionable efficacy. Injection therapy is challenging when the etiology is anatomical or compressive. Morton's neuroma is a budging of the interdigital nerve. Steroid, alcohol, and capsaicin injections provide some benefit, but it is short lived. Hyaluronic acid (HA) injection provided long-term relief and could prove to be a viable treatment option. Achilles tendinopathy (AT) is most likely secondary to repeat tendon stress-platelet-rich-plasma (PRP) and prolotherapy have been trialed for this condition, but more evidence is required to show efficacy. Similar injections were trials for plantar fasciitis and achieved only short-term relief; however, some evidence suggests that PRP injections reduce the frequency of required therapy. Tarsal tunnel syndrome, a compressive neuropathy carries a risk of permanent neural injury if left untreated. Injection therapy can provide a bridge to surgery; however, surgical decompression remains the definitive therapy. When the etiology is inflammatory, steroid injection is more likely to provide benefit. This has been shown in several studies for gout, as well as osteoarthritis of the foot and ankle and treatment-refractory rheumatoid arthritis. HA showed similar benefit, possibly due to anti-inflammatory effects. Stem cell injections may provide the additional benefit of structure restoration. Chronic foot pain is common in the general population and has significant associated morbidity and disability. Traditionally treated with surgery, these are costly and only somewhat effective. Injections provide an effective alternative financially and some evidence exists that they are effective in pain alleviation. However, current evidence is limited and the benefit described from injection therapy has been short-lived in most cases. Further studies in larger populations are required to evaluate the long-term effects of these treatments.

4 Review Injection Techniques for Common Chronic Pain Conditions of the Hand: A Comprehensive Review. 2020

Urits, Ivan / Smoots, Daniel / Anantuni, Lekha / Bandi, Prudhvi / Bring, Katie / Berger, Amnon A / Kassem, Hisham / Ngo, Anh L / Abd-Elsayed, Alaa / Manchikanti, Laxmaiah / Urman, Richard / Kaye, Alan / Viswanath, Omar. ·Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. iurits@bidmc.harvard.edu. · Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA. · Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. · Department of Anesthesiology, Mount Sinai Medical Center, Miami Beach, FL, USA. · Department of Pain Medicine, Pain Specialty Group, Newington, NH, USA. · Harvard Medical School, Boston, MA, USA. · Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. · Pain Management Centers of America, Paducah, KY, USA. · Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA. · Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA. · Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ, USA. · Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA. ·Pain Ther · Pubmed #32100225.

ABSTRACT: INTRODUCTION: This compilation presents a comprehensive review of the literature on common chronic pain conditions of the hand. It briefly presents these common conditions with their biological background, diagnosis, and common management options. It then presents and compares the latest literature available for injection techniques to treat these diagnoses and compares the available evidence. METHODS: A comprehensive literature review was performed in MEDLINE, PubMed, and Cochrane databases from 1996 to 2019 using the terms "hand pain", "injection techniques", "steroid injection", "chronic pain", "osteoarthritis", "rheumatoid arthritis", "carpal tunnel syndrome", "De Quervain's tenosynovitis", "ganglion cyst", "gout", "Raynaud's", and "stenosing tenosynovitis". RESULTS: Hand pain is a common condition with 9.7% prevalence in men and 21.6% in women and can cause significant morbidity and disability. It also carries a significant cost to the individuals and the healthcare system, totaling in $4 billion dollars in 2003. Injection therapy is an alternative when conservative treatment fails. Osteoarthritis is the most common chronic hand pain syndrome and affects about 16% of the population. Its mechanism is largely mechanic, and as such, there is controversy if steroid injections are of benefit. Hyaluronic acid (HA) appears to provide substantial relief of pain and may increase functionality. More studies of HA are required to make a definite judgment on its efficacy. Similarly, steroid ganglion cyst injection may confer little benefit. Carpal tunnel syndrome is a compressive neuropathy, and only temporarily relieved with injection therapy. US-guidance provides significant improvement and, while severe cases may still require surgery, can provide a valuable bridge therapy to surgery when conservative treatment fails. Similar bridging treatments and increased efficacy under US-guidance are effective for stenosing tenosynovitis ("trigger finger"), though, interestingly, inflammatory background is associated with decreased effect in this case. When the etiology of the pain is inflammatory, such as in RA, corticosteroid (CS) injections provide significant pain relief and increased functionality. They do not, however, change the course of disease (unlike DMARDs). Another such example is De-Quervain tenosynovitis that sees good benefit from CS injections, and an increased efficacy with US-guidance, and similarly are CS injections for gout. For Raynaud's phenomenon, Botox injections have encouraging results, but more studies are needed to determine safety and efficacy, as well as the possible difference in effect between primary and secondary Raynaud's. CONCLUSIONS: Chronic hand pain is a prevalent and serious condition and can cause significant morbidity and disability and interferes with independence and activities of daily living. Conservative treatment remains the first line of treatment; however, when first-line treatments fail, steroid injections can usually provide benefit. In some cases, HA or Botox may also be beneficial. US-guidance is increasing in hand injection and almost ubiquitously provides safer, more effective injections. Hand surgery remains the alternative for refractory pain.

5 Review Treatment of tophaceous gout: When medication is not enough. 2016

Kasper, Isaac R / Juriga, Matthew D / Giurini, John M / Shmerling, Robert H. ·Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. Electronic address: ikasper@bidmc.harvard.edu. · Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA. · Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. ·Semin Arthritis Rheum · Pubmed #26947439.

ABSTRACT: OBJECTIVES: To review the literature concerning surgical intervention of tophaeceous gout and propose clinical circumstances for when it may be considered. INTRODUCTION: Tophi develop in approximately 12-35% of patients with gout. Tophaceous disease is usually preventable given the availability of effective urate lowering therapies (ULT) including allopurinol, febuxostat, probenecid, lesinurad, and pegloticase. Despite medical therapy, there remains a subset of patients who develop significant complications of tophi including infection, ulceration, and entrapment neuropathy. Tophi in close proximity to joints can cause joint instability, severely limited range of motion, and significant functional impairment. For the rare circumstance when a tophus is causing an urgent complication or if a patient has a contraindication to all available ULTs, surgery may be an appropriate option. This review summarizes the published experience with surgical interventions for tophaceous gout and offers recommendations for its consideration. METHODS: Using Medline and Google Scholar, all available series of surgery for tophaceous gout were reviewed. RESULTS: Overall, 7 published surgical series were identified. In all, 6 of these 7 series were published between 2002 and 2014. The reported outcomes of surgical interventions for tophaceous gout were generally positive without major post-surgical complications. CONCLUSION: Although medical therapy with ULTs should be the first-line approach to tophaceous gout, surgery should be considered for the rare patient with impending or severe, debilitating complications including infections, entrapment neuropathy or those at risk for permanent joint destruction. In these selected clinical circumstances, surgical intervention for tophaceous gout may be appropriate.

6 Clinical Conference How Would You Manage This Patient With Gout?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. 2018

Burns, Risa B / Smith, C Christopher / Shmerling, Robert H / Tess, Anjala. ·Beth Israel Deaconess Medical Center, Boston, Massachusetts (R.B.B., C.C.S., R.H.S., A.T.). ·Ann Intern Med · Pubmed #30508444.

ABSTRACT: Gout is the most common form of inflammatory arthritis. In 2012, the American College of Rheumatology (ACR) issued a guideline, which was followed in 2017 by one from the American College of Physicians (ACP). The guidelines agree on treating acute gout with a corticosteroid, nonsteroidal anti-inflammatory drug, or colchicine and on not initiating long-term urate-lowering therapy (ULT) for most patients after a first gout attack and in those whose attacks are infrequent (<2 per year). However, they differ on treatment of both recurrent gout and problematic gout. The ACR advocates a "treat-to-target" approach, and the ACP did not find enough evidence to support this approach and offered an alternative strategy that bases intensity of ULT on the goal of avoiding recurrent gout attacks ("treat-to-avoid-symptoms") with no monitoring of urate levels. They also disagree on the role of a gout-specific diet. Here, a general internist and a rheumatologist discuss these guidelines; they debate how they would manage an acute attack of gout, if and when to initiate ULT, and the goals for ULT. Lastly, they offer specific advice for a patient who is uncertain about whether to begin this therapy.

7 Clinical Conference Management of gout: a 57-year-old man with a history of podagra, hyperuricemia, and mild renal insufficiency. 2012

Shmerling, Robert H. ·Division of Rheumatology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. rshmerli@bidmc.harvard.edu ·JAMA · Pubmed #23188030.

ABSTRACT: Gout is an ancient disease. Despite significant advances in the understanding of its risk factors, etiology, pathogenesis, prevention, and treatment, millions of people with gout experience repeated attacks of acute arthritis and other complications. The incidence of gout is increasing, most likely reflecting increasing rates of obesity and other lifestyle factors, including diet. Comorbid conditions that often accompany gout, including chronic kidney disease and diabetes mellitus, present challenges for the management of gout. Using the case of Mr R, a 57-year-old man with a history of podagra, hyperuricemia, and mild renal insufficiency, the diagnosis and treatment of gout are discussed. For those with moderate to severe gout, urate-lowering treatment can eliminate acute attacks of arthritis and prevent complications. In the near future, it is likely that new risk factors for gout will be identified and new ways of preventing and managing this common disease will become available.

8 Article Odontoid cervical gout causing atlantoaxial instability: case report. 2019

Slavin, Justin / DiStasio, Marcello / Dellaripa, Paul F / Groff, Michael. ·Departments of1Neurosurgery and. · 2Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. · 3Rheumatology, Brigham and Women's Hospital; and. ·J Neurosurg Spine · Pubmed #30684938.

ABSTRACT: The authors present a case report of a patient discovered to have a rotatory subluxation of the C1-2 joint and a large retroodontoid pannus with an enhancing lesion in the odontoid process eventually proving to be caused by gout. This patient represented a diagnostic conundrum as she had known prior diagnoses of not only gout but also sarcoidosis and possible rheumatoid arthritis, and was in the demographic range where concern for an oncological process cannot fully be ruled out. Because she presented with signs and symptoms of atlantoaxial instability, she required posterior stabilization to reduce the rotatory subluxation and to stabilize the C1-2 instability. However, despite the presence of a large retroodontoid pannus, she had no evidence of spinal cord compression on physical examination or imaging and did not require an anterior procedure to decompress the pannus. To confirm the diagnosis but avoid additional procedures and morbidity, the authors proceeded with the fusion as well as a posterior biopsy to the retroodontoid pannus and confirmed a diagnosis of gout.

9 Article Uricosuric targets of tranilast. 2017

Mandal, Asim K / Mercado, Adriana / Foster, Andria / Zandi-Nejad, Kambiz / Mount, David B. ·Renal Divisions VA Boston Healthcare System and Brigham and Women's Hospital Boston Massachusetts. · Renal Divisions Departamento de Nefrología Instituto Nacional de Cardiología Ignacio Chávez Mexico City Mexico. · Renal Division Beth Israel Deaconess Medical Center Boston Massachusetts. ·Pharmacol Res Perspect · Pubmed #28357121.

ABSTRACT: Uric acid, generated from the metabolism of purines, has both proven and emerging roles in human disease. Serum uric acid in humans is determined by production and by the net balance of reabsorption and secretion in kidney and intestine. In the human kidney, epithelial reabsorption dominates over secretion, such that in normal subjects there is at least 90% net reabsorption of filtered urate resulting in a fractional excretion of <10%. Tranilast, an anti-inflammatory drug with pleiotropic effects

10 Minor Crystal-induced oligoarthritis triggered by pembrolizumab, an immune checkpoint inhibitor. 2018

Corominas, Hèctor / Badlissi, Fadi / Shmerling, Robert H. ·Division of rheumatology, Beth Israel Deaconess medical center, Harvard medical school, Boston, MA 02215, United States; Unitat territorial de reumatologia. hospital de Santa-Creu-i-Sant-Pau, universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: vancor@yahoo.com. · Division of rheumatology, Beth Israel Deaconess medical center, Harvard medical school, Boston, MA 02215, United States; Unitat territorial de reumatologia. hospital de Santa-Creu-i-Sant-Pau, universitat Autònoma de Barcelona, Barcelona, Spain. · Division of rheumatology, Beth Israel Deaconess medical center, Harvard medical school, Boston, MA 02215, United States. ·Joint Bone Spine · Pubmed #29414722.

ABSTRACT: -- No abstract --