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Gout: HELP
Articles from Miscellaneous institutions in Singapore
Based on 8 articles published since 2010

These are the 8 published articles about Gout that originated from Miscellaneous institutions in Singapore during 2010-2020.
+ Citations + Abstracts
1 Review Dual-energy CT in gout - A review of current concepts and applications. 2017

Chou, Hong / Chin, Teck Yew / Peh, Wilfred C G. ·Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Alexandra Health, Singapore, Singapore. ·J Med Radiat Sci · Pubmed #28238226.

ABSTRACT: Dual-energy computed tomography (DECT) is a relatively recent development in the imaging of gouty arthritis. Its availability and usage have become increasingly widespread in recent years. DECT is a non-invasive method for the visualisation, characterisation and quantification of monosodium urate crystal deposits which aids the clinician in the early diagnosis, treatment and follow-up of this condition. This article aims to give an up to date review and summary of existing literature on the role and accuracy of DECT in the imaging of gout. Techniques in image acquisition, processing and interpretation will be discussed along with pitfalls, artefacts and clinical applications.

2 Article Is HLA-B*58:01 genotyping cost effective in guiding allopurinol use in gout patients with chronic kidney disease? 2020

Teng, Gim Gee / Tan-Koi, Wei-Chuen / Dong, Di / Sung, Cynthia. ·Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore, 119228. · Chronic Program, Alexandra Hospital, National University Health System, Singapore, 159964. · Vigilance & Compliance Branch, Health Sciences Authority, Singapore, 138667. · Global Health Research Center, Duke Kunshan University, China, 215316. · Health Services & Systems Research, Duke-NUS Medical School, Singapore, 169857. ·Pharmacogenomics · Pubmed #32180492.


3 Article Clinics in diagnostic imaging (200). Intra-articular chronic tophaceous gout of the knee. 2019

Lee, Yee Wah Margaret / Kok, Shi Xian Shawn / Wong, Li Weng / Wong, Bak Siew Steven. ·Department of Radiology, Sengkang General Hospital, Singapore. ·Singapore Med J · Pubmed #31663097.

ABSTRACT: A 39-year-old man presented with acute left knee pain and swelling. There was limitation of movement of the knee joint. His past medical history was significant for gout. Computed radiography showed bony erosions that were not typical of chronic tophaceous gout. Magnetic resonance (MR) imaging showed focal deposits within the knee joint, which demonstrated isointense signal to muscle on T1-weighted sequence and intermediate signal on proton density (PD) and PD fat-saturated sequences. There was extensive, similar signal abnormality in the cruciate ligaments, popliteus tendon and lateral meniscus. These findings were in keeping with an intra-articular manifestation of chronic tophaceous gout. The clinical presentation and imaging features are herein discussed, with an emphasis on MR imaging.

4 Article Gout and risk of knee replacement for severe knee osteoarthritis in the Singapore Chinese Health Study. 2017

Teng, G G / Leung, Y Y / Ang, L-W / Yuan, J-M / Koh, W-P. ·University Medicine Cluster, Division of Rheumatology, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore. Electronic address: gim_gee_teng@nuhs.edu.sg. · Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; Duke-NUS Medical School Singapore, Singapore. Electronic address: katy.leung.y.y@singhealth.com.sg. · Epidemiology & Disease Control Division, Ministry of Health, Singapore. Electronic address: ANG_Li_Wei@moh.gov.sg. · Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA. Electronic address: yuanj@upmc.edu. · Duke-NUS Medical School Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. Electronic address: woonpuay.koh@duke-nus.edu.sg. ·Osteoarthritis Cartilage · Pubmed #28757187.

ABSTRACT: OBJECTIVE: While cross-sectional and retrospective case-control studies suggest that gout is associated with knee osteoarthritis (KOA), no prospective study has evaluated the risk of total knee replacement (TKR) for KOA in association with gout. We prospectively evaluated the association between gout and the risk of TKR due to severe KOA. DESIGN: We used data from the Singapore Chinese Health Study (SCHS), a prospective cohort with 63,257 Chinese adults aged 45-74 years at recruitment (1993-1998). Self-report of physician-diagnosed gout was enquired at follow-up I interview (1999-2004) from 52,322 subjects. TKR cases for KOA after follow-up I were identified via linkage with nationwide hospital discharge database through 31 December 2011. Multivariable Cox proportional hazards regression model was applied with adjustment for potential risk factors of KOA. RESULTS: Among 51,858 subjects (22,180 men and 29,678 women) included in this analysis, after average 9.7 follow-up years, there were 1,435 cases of TKR. Gout was associated with 39% higher risk of TKR in women [hazard ratio (HR) 1.39; 95% confidence interval (CI) 1.08-1.79] but not in men (HR 0.78; 95% CI 0.49-1.23). The positive gout-TKR association in women remained after excluding participants with self-reported history of arthritis (HR 1.57; 95% CI 1.04-2.37). This association was stronger in women who were lean (body mass index [BMI] < 23 kg/m CONCLUSION: Gout is associated with risk of severe KOA, especially in lean women, suggesting the crystal arthritis may play a role in the pathogenesis or progression of OA.

5 Article Psoriasis and uric acid: a population-based cross-sectional study. 2016

Lai, Y C / Yew, Y W. ·Harvard TH Chan School of Public Health, Boston, MA, USA. · Department of Dermatology, National Skin Centre, Singapore. ·Clin Exp Dermatol · Pubmed #26643816.

ABSTRACT: BACKGROUND: Psoriasis has been reported to be associated with raised serum uric acid levels and gout, and uric acid has been demonstrated to mediate inflammatory pathways via secretion of pro-inflammatory chemokines. AIM: To evaluate the association between psoriasis, serum uric acid levels and gout in a cross-sectional study using the US National Health and Nutrition Examination Survey (NHANES) database. METHODS: Data on clinical history of psoriasis, gout and other relevant medical conditions from the questionnaire as well as laboratory parameters for serum uric acid and lipid levels in the periods 2003-2006 and 2011-2012 were analysed. Multivariate analysis with logistic regression modelling was performed, with hyperuricaemia as the dependent variable, and age, sex, ethnicity, body mass index, metabolic syndrome, current smoking status, alcohol consumption and history of psoriasis as the independent variables. RESULTS: Of the 11 282 study participants, 297 (2.6%) reported a history of psoriasis and 1493 (13.2%) were found to have hyperuricaemia. Patients with psoriasis were at increased risk of having hyperuricaemia, compared with those without psoriasis (OR = 1.37; P = 0.04). They were also more likely to report a history of gout (OR = 1.83; P < 0.05). However, neither association was significant after adjusting for potential confounders with multivariate logistic regression. CONCLUSION: In conclusion, there was insufficient evidence to show that psoriasis is an independent risk factor of hyperuricaemia or gout. A raised serum uric acid level may be a consequence of metabolic syndrome, which in turn is associated with psoriasis.

6 Article Cost-effectiveness analysis of genotyping for HLA-B*5801 and an enhanced safety program in gout patients starting allopurinol in Singapore. 2015

Dong, Di / Tan-Koi, Wei-Chuen / Teng, Gim Gee / Finkelstein, Eric / Sung, Cynthia. ·Health Services & Systems Research Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore. · Vigilance & Compliance Branch, Health Sciences Authority, 11 Biopolis Way, #11-01, Helios, Singapore 138667, Singapore. · Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore 117549, Singapore. · Division of Rheumatology, National University Health System, University Medicine Cluster, Singapore. · Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Emerging Infectious Diseases Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore. ·Pharmacogenomics · Pubmed #26554739.

ABSTRACT: AIMS: Allopurinol is an efficacious urate-lowering therapy (ULT), but is associated with rare serious adverse drug reactions of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), with higher risk among HLA-B*5801 carriers. We assessed the cost-effectiveness of HLA-B*5801 testing, an enhanced safety program or strategies with both components. METHODS: The analysis adopted a health systems perspective and considered Singaporean patients with chronic gout, over a lifetime horizon, using allopurinol or probenecid. The model incorporated SJS/TEN and gout treatment outcomes, allele frequencies, drug prices and other medical costs. RESULTS: Based on cost-effectiveness threshold of US$50,000 per quality-adjusted life year, HLA-B*5801-guided ULT selection or enhanced safety program was not cost effective. Avoidance of ULTs was the least preferred strategy as uncontrolled gout leads to lower quality-adjusted life years and higher costs. CONCLUSION: The analysis underscores the need for biomarkers with higher positive predictive value for SJS/TEN, less expensive genetic tests or safety programs, or more effective gout drugs. .

7 Article Tophaceous gouty arthropathy of the lumbar spine. 2014

Saripalli, Kundan / Baskar, Sangeetha. ·Yong Loo Lin School of Medicine, Singapore kundan.reddy.saripalli@nus.edu.sg. · Khoo Teck Puat Hospital, Singapore. ·Clin Med (Lond) · Pubmed #25468860.

ABSTRACT: Gout, classically affecting the first metatarsal joints, knees, fingers and ears, is seldom thrown out as a differential when a patient complains of lower back pain. Symptoms presented by patients with spinal gout may be non-specific and varied; at times, the only clue being that the patient has a previous history of gout. Prompt treatment with anti-inflammatory medication once diagnosis is reached helps to alleviate pain and improves the prognosis of the disease. Therefore, it is vital for the treating physician to keep an open mind and consider spinal gout as a diagnosis once other sinister causes such as osteomyelitis have been ruled out. This greatly reduces the morbidity associated with late treatment of spinal gout.

8 Article Problem based review: The patient with acute monoarthritis. 2013

Suresh, Ernest. ·Department of Medicine Alexandra Hospital, Jurong Health, 378 Alexandra Road, Singapore 159964. dr_esuresh@hotmail.com ·Acute Med · Pubmed #23732137.

ABSTRACT: Acute monoarthritis is a common medical emergency with wide differential diagnosis. Common underlying causes include trauma, septic arthritis, crystal induced arthritis (gout and pseudogout), and reactive arthritis. Of these, septic arthritis is the diagnosis not to miss because of its association with significant morbidity and mortality. Precise diagnosis of the underlying cause of monoarthritis relies on a good history, physical examination findings, and results of focussed investigations. In this article, a practical approach to diagnosis and initial management of patients presenting with acute monoarthritis is described with the aid of a case vignette.