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Gout: HELP
Articles from Nebraska
Based on 15 articles published since 2008
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These are the 15 published articles about Gout that originated from Nebraska during 2008-2019.
 
+ Citations + Abstracts
1 Editorial To Treat or Not to Treat (to Target) in Gout. 2017

Neogi, Tuhina / Mikuls, Ted R. ·From Boston University School of Medicine, Boston, Massachusetts; University of Nebraska Medical Center, Omaha, Nebraska. ·Ann Intern Med · Pubmed #27802507.

ABSTRACT: -- No abstract --

2 Editorial The Problem with Gout Is That It's Still Such a Problem. 2016

Coburn, Brian W / Mikuls, Ted R. ·Department of Internal Medicine, Division of Rheumatology, University of Nebraska Medical Center and the Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA; · Umbach Professor of Rheumatology, Department of Internal Medicine, Division of Rheumatology, University of Nebraska Medical Center and the Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA tmikuls@unmc.edu. ·J Rheumatol · Pubmed #27481987.

ABSTRACT: -- No abstract --

3 Review Epidemiology of gout. 2008

Weaver, Arthur L. ·Department of Internal Medicine, Division of Rheumatology, University of Nebraska Medical Center, Omaha, NE, USA. Weaver2aj@tds.net ·Cleve Clin J Med · Pubmed #18819329.

ABSTRACT: The incidence and prevalence of gout are rising, likely as a result of a changing pattern of risk factors. At-risk populations are growing, due to the fact that people are living longer. Longevity and current dietary and lifestyle choices have also contributed to increased rates of comorbidities associated with hyperuricemia and gout. The use of medications to treat such comorbidities also plays a role in some cases of gout. While dietary and lifestyle modification may be useful as adjunctive measures, such changes do not replace pharmacologic treatments for gout or associated comorbidities.

4 Article Antioxidant properties of citric acid interfere with the uricase-based measurement of circulating uric acid. 2019

Ryan, Evan M / Duryee, Michael J / Hollins, Andrew / Dover, Susan K / Pirruccello, Samuel / Sayles, Harlan / Real, Kevin D / Hunter, Carlos D / Thiele, Geoffrey M / Mikuls, Ted R. ·Department of Internal Medicine, Division of Rheumatology, University of Nebraska Medical Center, Omaha, NE, USA. · Department of Internal Medicine, Division of Rheumatology, University of Nebraska Medical Center, Omaha, NE, USA; Veteran Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA. Electronic address: mduryee@unmc.edu. · Department of Clinical Sciences, Surgery, Duke University, Durham, NC, USA. · Veteran Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA. · Department of Clinical Pathology, University of Nebraska Medical Center, Omaha, NE, USA. · Department of Internal Medicine, Division of Rheumatology, University of Nebraska Medical Center, Omaha, NE, USA; Veteran Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA. ·J Pharm Biomed Anal · Pubmed #30447534.

ABSTRACT: BACKGROUND: Circulating uric acid (UA) is an important biomarker, not only in the detection and management of gout, but also in assessing the risk of related comorbidity. The impact of collection methods on clinical UA measurements has been the subject of limited study. After observing significant differences between UA concentrations of blood samples obtained by different collection tubes, we began examining the effects of exogenous tube components on measured UA concentrations. We aimed to: (1) demonstrate the variability in uricase-based UA measurements attributable to different collection methods and (2) identify factors influencing this variability. METHODS: Blood samples from human subjects were collected using Serum Separator Tubes (SST tubes), Acid Citrate Dextrose (ACD) tubes, and Sodium Citrate (SC) tubes. Circulating UA concentrations were measured by chemistry analyzers utilizing the uricase method. Absorbance assays were run in order to determine the effects of citric acid, sodium citrate, and dextrose on measured absorbance in the presence of leuco crystal violet dye, hydrogen peroxide, and peroxidase. Statistical analyses-including Student's T tests and ANOVA-were used to compare results. RESULTS: UA concentrations of blood samples collected in ACD tubes were significantly lower than those collected in SST tubes (P < 0.01). Samples collected in SC tubes trended towards lower UA measurements than samples collected in SST tubes, although this difference did not reach statistical significance (P = 0.06). Blood samples spiked with separate concentrations of sodium citrate (3.2 and 22.0 g/L), citric acid (8.0 g/L), and dextrose (24.5 g/L) demonstrated significantly lower UA measurements compared to controls (P < 0.01). Absorbance assays demonstrated that increasing concentrations of citric acid and sodium citrate-in the presence of leuco crystal violet, hydrogen peroxide, and peroxidase-decreased the amount of oxidized dye in the uricase method of UA measurement in a dose-dependent manner (P < 0.01). In contrast, dextrose did not significantly alter the amount of oxidized dye available. DISCUSSION: Our results indicate that citric acid obstructs accurate uricase-based UA measurement, providing falsely low values. Citric acid, a known antioxidant, scavenges hydrogen peroxide, a key intermediate using the uricase method. By scavenging hydrogen peroxide, citric acid decreases the amount of oxidized leuco dye leading to falsely low UA measurements. Therefore, collection tubes, like ACD and SC tubes, which contain concentrations of citric acid or its conjugate base sodium citrate should not be used to measure circulating UA levels when utilizing uricase-based measurement methods.

5 Article Allopurinol Medication Adherence as a Mediator of Optimal Outcomes in Gout Management. 2017

Coburn, Brian W / Bendlin, Kayli A / Sayles, Harlan / Meza, Jane / Russell, Cynthia L / Mikuls, Ted R. ·From the *Medicine Service, Veterans Affairs Nebraska-Western Iowa Health Care System; †Division of Rheumatology, University of Nebraska Medical Center; ‡Pharmacy Service, Veterans Affairs Nebraska-Western Iowa Health Care System; and §Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE; and ∥School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO. ·J Clin Rheumatol · Pubmed #28816767.

ABSTRACT: BACKGROUND: Patient and provider factors, including allopurinol medication adherence, affect gout treatment outcomes. OBJECTIVES: The aim of this study was to examine associations of patient and provider factors with optimal gout management. METHODS: Linking longitudinal health and pharmacy dispensing records to questionnaire data, we assessed patient and provider factors among 612 patients with gout receiving allopurinol during a recent 1-year period. Associations of patient (medication adherence and patient activation) and provider factors (dose escalation, low-dose initiation, and anti-inflammatory prophylaxis) with serum urate (SU) goal achievement of less than 6.0 mg/dL were examined using multivariable logistic regression. Medication adherence was assessed as a mediator of these factors with goal achievement. RESULTS: A majority of patients (63%) were adherent, whereas a minority received dose escalation (31%). Medication adherence was associated with initiation of daily allopurinol doses of 100 mg/d or less (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.20-2.76). In adjusted models, adherence (OR, 2.35; 95% CI, 1.50-3.68) and dose escalation (OR, 2.48; 95% CI, 2.48-4.25) were strongly associated with SU goal attainment. Low starting allopurinol dose was positively associated with SU goal attainment (OR, 1.11; 95% CI, 1.02-1.20) indirectly through early adherence, but also had a negative direct association with SU goal attainment (OR, 0.21; 95% CI, 0.12-0.37). CONCLUSIONS: Medication adherence and low starting dose combined with dose escalation represent promising targets for future gout quality improvement efforts. Low starting dose is associated with better SU goal attainment through increased medication adherence, but may be beneficial only in settings where appropriate dose escalation is implemented.

6 Article Rationale and design of the randomized evaluation of an Ambulatory Care Pharmacist-Led Intervention to Optimize Urate Lowering Pathways (RAmP-UP) Study. 2016

Coburn, Brian W / Cheetham, T Craig / Rashid, Nazia / Chang, John M / Levy, Gerald D / Kerimian, Artak / Low, Kimberly J / Redden, David T / Bridges, S Louis / Saag, Kenneth G / Curtis, Jeffrey R / Mikuls, Ted R. ·Division of Rheumatology, University of Nebraska Medical Center, Omaha, NE, United States. · Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States. · Drug Information Services, Kaiser Permanente Southern California, Downey, CA, United States. · Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States. · Division of Rheumatology, University of Alabama at Birmingham, Birmingham, AL, United States. · Division of Rheumatology, University of Nebraska Medical Center, Omaha, NE, United States; Medicine, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, United States. Electronic address: tmikuls@unmc.edu. ·Contemp Clin Trials · Pubmed #27449546.

ABSTRACT: BACKGROUND: Despite the availability of effective therapies, most gout patients achieve suboptimal treatment outcomes. Current best practices suggest gradual dose-escalation of urate lowering therapy and serial serum urate (sUA) measurement to achieve sUA<6.0mg/dl. However, this strategy is not routinely used. Here we present the study design rationale and development for a pharmacist-led intervention to promote sUA goal attainment. METHODS: To overcome barriers in achieving optimal outcomes, we planned and implemented the Randomized Evaluation of an Ambulatory Care Pharmacist-Led Intervention to Optimize Urate Lowering Pathways (RAmP-UP) study. This is a large pragmatic cluster-randomized trial designed to assess a highly automated, pharmacist-led intervention to optimize allopurinol treatment in gout. Ambulatory clinics (n=101) from a large health system were randomized to deliver either the pharmacist-led intervention or usual care to gout patients over the age of 18years newly initiating allopurinol. All participants received educational materials and could opt-out of the study. For intervention sites, pharmacists conducted outreach primarily via an automated telephone interactive voice recognition system. The outreach, guided by a gout care algorithm developed for this study, systematically promoted adherence assessment, facilitated sUA testing, provided education, and adjusted allopurinol dosing. The primary study outcomes are achievement of sUA<6.0mg/dl and treatment adherence determined after one year. With follow-up ongoing, study results will be reported subsequently. CONCLUSION: Ambulatory care pharmacists and automated calling technology represent potentially important, underutilized resources for improving health outcomes for gout patients.

7 Article Target Serum Urate: Do Gout Patients Know Their Goal? 2016

Coburn, Brian W / Bendlin, Kayli A / Sayles, Harlan / Hentzen, Kathryn S / Hrdy, Michaela M / Mikuls, Ted R. ·Veterans Affairs Nebraska, Western Iowa Health Care System, and University of Nebraska Medical Center, Omaha, Nebraska. · Veterans Affairs Nebraska, Western Iowa Health Care System, Omaha, Nebraska. ·Arthritis Care Res (Hoboken) · Pubmed #26784147.

ABSTRACT: OBJECTIVE: To examine gout patients' knowledge of their condition, including the central role of achieving and maintaining the serum urate (SU) goal with the use of urate-lowering therapy (ULT). METHODS: This study of 612 gout patients was conducted at a Veterans Affairs medical center. Gout patients were included based on administrative diagnostic codes and receipt of at least 1 allopurinol prescription over a 1-year period. Questionnaires were mailed to patients and linked to medical records data. The questionnaire included gout-specific knowledge questions, the Patient Activation Measure, and self-reported health outcomes. Knowledge was assessed descriptively. Multivariable logistic regression was used to determine predictors of SU goal knowledge. Associations of knowledge with health outcomes were examined in exploratory analyses. RESULTS: The questionnaire had a 62% response rate. Only 14% of patients knew their SU goal, while the majority answered correctly for the other 5 gout-specific knowledge questions. In adjusted analyses, having a rheumatologist as initial prescriber (odds ratio [OR] 3.0 [95% confidence interval (95% CI) 1.4-6.2]) and knowing all of the other 5 gout-specific knowledge questions (OR 2.1 [95% CI 1.3-3.4]) were associated with greater odds of knowing the SU goal. SU goal knowledge was associated with self-reported global health status, but not with self-reported health-related quality of life or gout-specific health status. CONCLUSION: There is a knowledge deficit regarding the SU treatment goal among gout patients receiving ULT, despite generally high levels of other gout-specific knowledge. SU goal information may be an important and underutilized concept among providers treating gout patients.

8 Article Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds Consensus Exercises. 2016

de Lautour, Hugh / Taylor, William J / Adebajo, Ade / Alten, Rieke / Burgos-Vargas, Ruben / Chapman, Peter / Cimmino, Marco A / da Rocha Castelar Pinheiro, Geraldo / Day, Ric / Harrold, Leslie R / Helliwell, Philip / Janssen, Matthijs / Kerr, Gail / Kavanaugh, Arthur / Khanna, Dinesh / Khanna, Puja P / Lin, Chingtsai / Louthrenoo, Worawit / McCarthy, Geraldine / Vazquez-Mellado, Janitzia / Mikuls, Ted R / Neogi, Tuhina / Ogdie, Alexis / Perez-Ruiz, Fernando / Schlesinger, Naomi / Ralph Schumacher, H / Scirè, Carlo A / Singh, Jasvinder A / Sivera, Francisca / Slot, Ole / Stamp, Lisa K / Tausche, Anne-Kathrin / Terkeltaub, Robert / Uhlig, Till / van de Laar, Mart / White, Douglas / Yamanaka, Hisashi / Zeng, Xuejun / Dalbeth, Nicola. ·Auckland District Health Board, Auckland, New Zealand. · University of Otago, Wellington, New Zealand. · University of Sheffield, Sheffield, UK. · Schlosspark-Klinik, Charité, University Medicine Berlin, Berlin, Germany. · Hospital General de México, Mexico City, Mexico. · Christchurch Hospital, Christchurch, New Zealand. · Università di Genova, Genova, Italy. · Pedro Ernesto University Hospital, Rio de Janeiro, Brazil. · University of New South Wales and St Vincent's Hospital, Sydney, Australia. · University of Massachusetts Medical School, Worcester, and Corrona, LLC, Southborough. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK. · Rijnstate Hospital, Arnhem, The Netherlands. · Veterans Affairs Medical Center, Georgetown and Howard University Hospitals, Washington, DC. · University of California School of Medicine, San Diego. · University of Michigan, Ann Arbor. · University of Michigan and Ann Arbor VA Medical Center, Ann Arbor. · Taichung Veteran's General Hospital, Taichung, Taiwan. · Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. · Mater Misericordiae University Hospital and University College, Dublin, Ireland. · Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha. · Boston University School of Medicine, Boston, Massachusetts. · University of Pennsylvania, Philadelphia. · Hospital Universitario Cruces, OSI-EEC, and Biocruces Health Research Institute, Biscay, Spain. · Rutgers University Robert Wood Johnson Medical School, New Brunswick, New Jersey. · IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy. · University of Alabama at Birmingham and the Birmingham VA Medical Center, Birmingham. · Hospital General Universitario Elda, Elda, Spain. · Copenhagen University Hospital Glostrup, Glostrup, Denmark. · University of Otago, Christchurch, New Zealand. · University Hospital Carl Gustav Carus, Dresden, Germany. · University of California San Diego VA Medical Center, La Jolla. · National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Universiteit Twente, Erschede, The Netherlands. · Waikato DHB and Waikato Clinical School, University of Auckland, Hamilton, New Zealand. · Tokyo Women's Medical University, Tokyo, Japan. · Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China. · University of Auckland and Auckland District Health Board, Auckland, New Zealand. ·Arthritis Care Res (Hoboken) · Pubmed #26414176.

ABSTRACT: OBJECTIVE: To establish consensus for potential remission criteria to use in clinical trials of gout. METHODS: Experts (n = 88) in gout from multiple countries were invited to participate in a web-based questionnaire study. Three rounds of Delphi consensus exercises were conducted using SurveyMonkey, followed by a discrete-choice experiment using 1000Minds software. The exercises focused on identifying domains, definitions for each domain, and the timeframe over which remission should be defined. RESULTS: There were 49 respondents (56% response) to the initial survey, with subsequent response rates ranging from 57% to 90%. Consensus was reached for the inclusion of serum urate (98% agreement), flares (96%), tophi (92%), pain (83%), and patient global assessment of disease activity (93%) as measurement domains in remission criteria. Consensus was also reached for domain definitions, including serum urate (<0.36 mm), pain (<2 on a 10-point scale), and patient global assessment (<2 on a 10-point scale), all of which should be measured at least twice over a set time interval. Consensus was not achieved in the Delphi exercise for the timeframe for remission, with equal responses for 6 months (51%) and 1 year (49%). In the discrete-choice experiment, there was a preference towards 12 months as a timeframe for remission. CONCLUSION: These consensus exercises have identified domains and provisional definitions for gout remission criteria. Based on the results of these exercises, preliminary remission criteria are proposed with domains of serum urate, acute flares, tophus, pain, and patient global assessment. These preliminary criteria now require testing in clinical data sets.

9 Article Modifiable factors associated with allopurinol adherence and outcomes among patients with gout in an integrated healthcare system. 2015

Rashid, Nazia / Coburn, Brian W / Wu, Yi-Lin / Cheetham, T Craig / Curtis, Jeffrey R / Saag, Kenneth G / Mikuls, Ted R. ·From the Drug Information Services, Kaiser Permanente Southern California Region, Downey; Department of Research and Evaluation, Kaiser Permanente, Pasadena, California; University of Nebraska Medical Center, and the Division of Rheumatology, Omaha VA, Omaha, Nebraska; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.N. Rashid, PharmD, MS, Research Scientist, Drug Information Services, Kaiser Permanente; B.W. Coburn, BS, University of Nebraska Medical Center; Y-L. Wu, MS; T.C. Cheetham, PharmD, MS, Department of Research and Evaluation, Kaiser Permanente; J.R. Curtis, MD, MS, MPH; K.G. Saag, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; T.R. Mikuls, MD, MSPH, Division of Rheumatology, Omaha VA and University of Nebraska Medical Center. ·J Rheumatol · Pubmed #25512479.

ABSTRACT: OBJECTIVE: To identify modifiable patient and provider factors associated with allopurinol adherence and the achievement of a serum urate acid (SUA) goal in gout. METHODS: We identified a retrospective cohort of patients with gout, newly treated with allopurinol. All patient data came from administrative datasets at a large integrated health delivery system. Patients were ≥ 18 years old at time of initial allopurinol dispensing, and had 12 months or more of membership and drug eligibility prior to the index date. Allopurinol adherence was defined as a proportion of days covered ≥ 0.80, evaluated during the first 12 months of observation after the initial dispensing. Multivariable logistic regression was used to examine factors associated with allopurinol nonadherence and attaining an SUA concentration < 6.0 mg/dl. RESULTS: We identified 13,341 patients with gout with incident allopurinol use (mean age 60 yrs, 78% men). Of these, 9581 patients (72%) had SUA measured both at baseline and during followup. Only 3078 patients (32%) attained an SUA target of < 6.0 mg/dl during followup. Potentially modifiable factors associated with treatment adherence and obtaining the SUA goal in the multivariable analysis included concomitant diuretic use, prescriber specialty, and allopurinol dosing practices. Adherent patients were 2.5-fold more likely than nonadherent patients to achieve an SUA < 6.0 mg/dl during observation. CONCLUSION: Among patients with gout initiating allopurinol in our study, 68% did not reach the SUA goal and 57% of patients were nonadherent. Modifiable factors, including allopurinol dose escalation, treatment adherence, rheumatology referral, and concomitant medication use, could be important factors to consider in efforts aimed at optimizing gout treatment outcomes.

10 Article Gout as a manifestation of familial juvenile hyperuricemic nephropathy. 2014

Spain, Heather / Plumb, Troy / Mikuls, Ted R. ·From the *Department of Medicine, University of Nebraska Medical Center; and †Omaha Veterans Affairs Medical Center, Omaha, NE. ·J Clin Rheumatol · Pubmed #25417683.

ABSTRACT: We report 2 cases of familial juvenile hyperuricemic nephropathy, a rare autosomal dominant disorder characterized by uromodulin gene mutations leading to hyperuricemia secondary to profound renal uric acid underexcretion, gout, and chronic renal disease. Case 1 involves a 56-year-old woman who underwent a kidney transplant after steady decline in kidney function since the age of 19 years. Her gout had been successfully controlled with varying doses of daily allopurinol. Case 2, the son of case 1, presented with already progressive and debilitating arthritis at the age of 34 years with relatively stable chronic renal failure that was also subsequently managed with daily allopurinol and judicious anti-inflammatory prophylaxis.

11 Article Gout-related health care utilization in US emergency departments, 2006 through 2008. 2013

Garg, Rohini / Sayles, Harlan R / Yu, Fang / Michaud, Kaleb / Singh, Jasvinder / Saag, Kenneth G / Mikuls, Ted R. ·Creighton University, Omaha, Nebraska. ·Arthritis Care Res (Hoboken) · Pubmed #22949176.

ABSTRACT: OBJECTIVE: To characterize gout-related emergency department (ED) utilization using a nationally representative sample and to examine factors associated with the frequency and charges of gout-related ED visits. METHODS: Using the National Emergency Department Sample data from 2006-2008, the weighted national frequency of gout visits was calculated along with the median ED charge and total national ED-related charges. Associations of several patient- and facility-level factors were examined with the occurrence of gout visits using multivariable logistic regression and with ED-related charges using multivariable linear regression. RESULTS: Gout was the primary indication for 168,410 ED visits in 2006, 171,743 visits in 2007, and 174,823 visits in 2008, accounting for ∼0.2% of all visits annually and generating ED charges of more than $128 million in 2006, $144 million in 2007, and $166 million in 2008. Age, male sex, household income <$39,000, private insurance, and hospital locations in nonmetropolitan areas and the southern US were associated with an increased propensity for ED utilization in gout. Higher ED-related charges for gout were associated with female sex, age, a higher number of coded diagnoses, and a metropolitan residence. CONCLUSION: Gout accounts for a substantial proportion of ED visits, leading to significant health care charges. Effective strategies to reduce gout burden in EDs could potentially benefit by targeting groups characterized by factors demonstrated to be related to a higher ED utilization in gout as identified by our study.

12 Article How PCP education can impact gout management: the gout essentials. 2008

Weaver, Arthur L / Cheh, Michelle A / Kennison, Richard H. ·Department of Rheumatology, University of Nebraska Medical Center, Omaha, Nebraska, USA. weaver2aj@tds.net ·J Clin Rheumatol · Pubmed #18830090.

ABSTRACT: -- No abstract --

13 Minor Renal dosing of allopurinol results in suboptimal gout care. 2017

Neogi, Tuhina / Dalbeth, Nicola / Stamp, Lisa / Castelar, Geraldo / Fitzgerald, John / Gaffo, Angelo / Mikuls, Ted R / Singh, Jasvinder / Vázquez-Mellado, Janitzia / Edwards, N Lawrence. ·Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA. · Department of Immunology, University of Auckland, Auckland, New Zealand. · Department of Medicine, Otago University, Christchurch, Canterbury, New Zealand. · Department of Rheumatology, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil. · Medicine/Rheumatology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA. · Department of Medicine, Birmingham VA Medical Center, Birmingham, Alabama, USA. · Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. · Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA. · Servicio de Reumatologia, Hospital General de Mexico, Mexico City, Mexico. · Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA. ·Ann Rheum Dis · Pubmed #27582422.

ABSTRACT: -- No abstract --

14 Minor Allopurinol Dose Reductions Based on Creatinine Alert Redesign System. 2016

Gaffo, Angelo L / Mikuls, Ted R / Stamp, Lisa K / Neogi, Tuhina. ·Department of Medicine, University of Alabama at Birmingham, Birmingham Veterans Affairs Medical Center. · Division of Rheumatology, University of Nebraska Medical Center, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha. · Department of Medicine, University of Otago, Christchurch, New Zealand. · Department of Medicine, Boston University School of Medicine, Mass. ·Am J Med · Pubmed #27320718.

ABSTRACT: -- No abstract --

15 Unspecified Introduction: professionals in dialogue: sharing insights and knowledge into gout management. 2008

Weaver, Arthur L. ·From the Department of Rheumatology, University of Nebraska Medical Center, Omaha, Nebraska. ·J Clin Rheumatol · Pubmed #18830089.

ABSTRACT: -- No abstract --