Gout Attack Research Paper

Gout Attack Research Paper
Many people find gout symptoms to be unbearable. Gout attacks often occur without warning, but
there are many things you can do to reduce your risk of one. Below are some of the ways you can
reduce your risk of a gout attack:
Take Your Medication
Medication is one of the standard treatments for gout. Taking your medication as prescribed will
greatly reduce your chance of having a gout attack. Colchine is one of the medications that can be
used to treat gout. It works by preventing excess uric acid crystals from accumulating in the joints.
The accumulation of uric acid crystals in the joints is what leads to gout.
Change Your Diet
Lifestyle changes can make it easier for you to manage gout. Uric acid is created when the body
breaks down ... Show more content on Helpwriting.net ...
Excessive alcohol consumption is one of the possible causes of gout attacks. Many types of alcohol,
such as beer, are rich in purines. That is why alcohol can increase the production of uric acid in the
body. It can also reduce the effectiveness of some gout medications.
Furthermore, beverages that have been sweetened with high fructose corn syrup may increase the
risk of a gout attack. Limit your intake of those beverages and drink more water. Water can reduce
the risk of a gout attack by flushing out uric acid crystals.
Regular Exercise
Gout is such a painful condition, which is why many people who suffer from it avoid exercise.
However, you can actually reduce the risk of a gout attack by getting more physical activity in your
day. It is easier for you to maintain a healthy body weight when you exercise. People who are a
healthy body weight are less likely to develop gout.
Apply Ice
You may want to consider applying some ice to the affected joints. The ice can help reduce the
inflammation and swelling. Make sure that you wrap the ice in a dish cloth or paper towel and then
apply it to the affected area. Apply the ice to the area for 20 to 30 minutes at a time, several times
during the

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Gout Research Paper
Abstract
Gout is a common form of arthritis that is caused by the formation of crystals of uric acid in a joint.
An acute gout attack usually consists of the rapid onset of pain in the affected joint. Gout can affect
the quality of life of the individual during an acute attack as well as the long–term effects it causes.
Gouty arthritis is increasing in its popularity. The outlook for gout is good if diagnosed and treated
within the early stages of the disease progression. Although it is non–life threatening, gout can cause
severe pain, and it has been known to be linked to depression. Keywords: Gout, joint, disease,
Gout; What It Is and How to Prevent It
Gout is a common disease that is composed of a metabolic defect in the breakdown and excretion of
uric acid. This excess of uric acid is what causes gouty arthritis. Uric acid crystallizes due to the
improper breakdown of ... Show more content on Helpwriting.net ...
The prevalence of gout in the U.S. has risen over the last twenty years and now affects 8.3 million
Americans. Since it is found on all continents, gout might be regarded as a metabolic disease
(McCormick). Gout is more common in men than it is in women. It is also more common in African
American men than white men. The chance of having gout rises with age, with the peak age being
seventy–five. In women, gout attacks usually occur after menopause. If your parents have gout, then
you have a twenty–percent
chance of developing it, as a genetic predisposition. Gout is strongly linked to obesity, high blood
pressure, high cholesterol, and even diabetes. All studies have consistently shown that gout
predominantly affects older men. Monogenic disorders that result in overproduction of uric acid via
enzyme defects in purine metabolism are extremely rare but common primary gout in men often
shows strong familial predisposition, although the genetic basis remains unknown

Gout Case Study
Introduction Along with the development of modern society and lifestyle activities, gout is formed
by the impact of the environment and daily activities, is becoming many people's fears, so the
understanding of the disease to early preventive measures, effective treatments play an extremely
important role. Gout is a metabolic disease uric acid, leading to deposition of monosodium crystals
in the organization (synovium and organizations around the joints, kidneys and kidney tissue tube),
the contributory factors can find in some certain common medication, alcohol, and dietary foods
(Gout 2016). The frequency of occurrence of gout increased significantly with age, and correlated
with the increase of serum uric acid concentrations. The pathogenesis ... Show more content on
Helpwriting.net ...
These crystals are usually formed in and around the joints, possibly because the temperature in the
area is slightly lower than the rest of the body. If it into the space between the joints, these crystals
can cause arthritis and painful. There are many outstanding risk urate salt if high levels of uric acid
in the body. However, increased uric acid syndrome and gout is necessary to distinguish two issues,
although they are closely related to each other. Uric acid is a waste product formed by the natural
destruction of purines in the body. People whose drinking habits, dietary habits unreasonable not
only to increase the amount of purine metabolism, but also a source of countless unfinished generate
free radicals, hike cycle in the body and are ready to mount at any risk gene variation. Frequent gout
by patients with underlying medical history and other diseases including obesity, family history of
kidney disease, hypertension, metabolic syndrome, alcoholism and use of certain medications. There
are some factors can cause of gout disease: Age and gender can cause of gout by middle–aged men
or postmenopausal women, drink more alcohol, obesity, metabolic syndrome, prolonged
hyperuricemia, family history of gout, long–term use of medications that increase blood uric acid.
The cause increased blood uric acid production

Values Are Expressed As Means ± Standard Error
Values are expressed as means ± standard Error. Means with similar superscript (a, b c, d) letters in
columns indicate non–significant difference (P< 0.05).
DISCUSION
The results of the current study shown that high fructose (10%) lead to increment in weight gain,
hyperglycemia, hyperinsulinemia oxidative stress and dyslipidemia. These findings are similar with
that of Stanhope & Havel20 who showed that "fructose rich diet induced the development of
phathophysiological characteristics associated with metabolic syndrome". "The high fructose flux
leads to enhanced accumulation of hepatic triglycerides and resulting in impairment of glucose and
lipid metabolism"21 .
FOOD + BODY
In the current study high fructose diet for 6 weeks increased body weight.
This finding is in accordance with those of Xolalpa–Molina27 who reported that "studies in humans
and animal models suggest that dietary components such as high fat and fructose can affect fatty
infiltration and lipid peroxidation".
There was a significant decrease in food intake in group 2 fed high fructose diet which may be due
to high caloric and water intake and the sweet taste. On the other hand supplementation with
Tamarindus indica L. Seeds Extract and Crocus Sativus Aqueous (CSE) Extract had no significant
effect on food or water intake.
Thus, no reduction of appetite was accompanied by Tamarindus indica L. Seeds Extract and Crocus
Sativus Aqueous (CSE) Extract –induced weight loss in F–T rats.

Gout Research Paper
Degenerative Diseases in Asian Indian Americans – Gout There are many degenerative diseases that
occur with a higher frequency in Asian–Indian Americas compared to the general population. One of
these is gout. The prevalence of gout in the general population of the U.S. is 1–3% (Fuerst, 2015),
whereas prevalence in Indo–Americans is 2–3% (Salgal & Agrawal, 2015). This prevalence is for
recent immigrant but rises with acculturation. Gout is an inflammatory arthritis that develops as a
result of the accumulation of too much uric acid in your body. It is considered a metabolic disease –
either a person's body makes too much uric acid or they don't eliminate it properly. When too much
accumulates in the blood it then begins to deposit in ... Show more content on Helpwriting.net ...
The first is preventative. Gout is a metabolic disease that is predetermined by out genetics or
brought on by certain medical conditions mentioned above. Controlling these medical conditions
will help reduce the chance of getting gout. In addition, if one has gout through heredity there are
some things that can be done to decrease like frequency of attacks. Diet is a primary way to control
it. There are many foods that can increase the level of uric acid in the body and subsequently results
in gout attacks. Foods with high amounts of uric acid include red meats, organ meat, shell fish,
turkey, sardines, and anchovies (CDC, 2018). In addition alcohol can increase the level of uric acid
in the blood by inhibiting the elimination of uric acid through the kidneys. Also foods or liquids high
in fructose increase uric acid (CDC 2018). There are foods that help or are protective against gout
and high blood levels of uric acid: vitamin C, Bing cherries, coffee, and low–fat dairy products (Paul
& James, 2017) in addition to staying well hydrated. The other arm of treatment is biochemical.
There are medicines that treat the acute symptoms of a gout attack including colchicine, non–
steroidal anti–inflammatory medicines such as motrin, and prednisone; and there are medicines that
are used long term to decrease the uric acid level in the body, these include medicines such as
allopurinol and febuxostat (CDC, 2018). It is important to

Vertebrate Adaptions for Terrestrial Life Essay
Vertebrate Adaptions For Terrestrial Life
AP–Biology Essay on vertebrate structural adaptations for terrestrial life.
The problems of survival of animals on land are very different from those of survival of animals in
aquatic environment. Describe four problems associated with animal survival in terrestrial
environments but not in aquatic environments. For each problem, explain a physiological of
structural solution.
Four problems faced by animals on land are breathing (respiration), water conservation in
excretions, successful reproduction, and the producing an egg which can survive outside of the
water.
All animals need to respire, but I have no idea why. Maybe you would like to answer that? Aquatic
... Show more content on Helpwriting.net ...
One way we do this is through our excretions.
Nitrogen forms a major waste product in animals. When amino acids and nucleic acids are broken
down, they release toxic ammonia (NH3). To rid the body of this toxin, several mechanisms have
evolved, each appropriate to the habitat or survival of the animal. Aquatic animals secrete NH3
directly into the surrounding water. Land animals cannot do this because of the toxicity of NH3.
Instead, NH3 is converted into urea in our livers. Urea is significantly less toxic than NH3, and thus
requires less water to excrete in the urine. The reason we need the water to excrete this is because
the water is needed to dilute the urea (or NH3 if we did excrete it in that form), in order to make it
less toxic.
Birds excrete ammonia in the form of uric acid, that's what they're always dropping on our heads.
Those mangy little rats with wings... have you ever wondered why we let those little pests run free
in the cities, but we wont let dogs and cats free, even though most people consider the birds more of
a nuisance? I didn't think so, anyways:
A third adaptation to terrestrial life is internal fertilization. In aquatic animals, many eggs are laid,
usually allowing the water, and chance to fertilize the eggs. We can't do this on land, because the
eggs and sperm would dry out, and would stay in the same place, unless they could walk (he he he).
To solve this problem, we have developed a system of internal fertilization.

Chronic Effects Of Chronic Water Intake
Introduction
Water is crucial for life. Most biological processes require water to be present for it to occur.
Without water there is no medium for these processes to occur, therefore we must fully understand
the consequences of dehydration. Dehydration is a condition that is caused by excessive loss of body
water. It has been known that dehydration is associated with acute renal dysfunction, and it has been
considered reversible with no long–term effects on the kidney. However, there has been an
increasing number of epidemiological studies suggesting that irregular water intake, leading to
recurrent events of dehydration, is a risk factor for developing and progressing the conditions of
chronic kidney disease (CKD). Due to the high prevalence in both the initial and final stages of
CKD, it has become a global health burden. Although there have been many studies linking
recurrent dehydration with the development and progression of CKD, only a handful of studies
looked into the long–term impacts of chronic water restriction on the progression of CKD and the
core mechanisms associated with it. Apart from water regulation, the kidney also affects the
cardiovascular system, with many studies associating CKD with cardiovascular diseases (CVS).
Therefore, it is important to understand the causes of CKD to prevent the risk of developing CVS in
CKD. In this review we will look at how recurrent dehydration causes CKD. Firstly, the role of how
the kidney regulates water balance is

Gout Research Paper
6 Million Americans over the age of 20 have confided having a condition known as "The Disease of
Kings." Also known as gout or gouty arthritis and nicknamed for the relationship between the
disease, rich foods & alcohol consumption, gout is one of the oldest known cases of arthritis. This
form of arthritis commonly affects men over the age of 40; the attacks come on suddenly, and the
discomfort is severe. Symptoms of inflammation, swelling and tenderness originating in the great
toe and progressing joint by joint are classic signs of gouty arthritis. Thomas Sydenham (1989)
describes an acute gout attack in excruciating detail; "The victim goes to bed and sleeps in good
health. About two o'clock in the morning he is awakened by a severe pain in the ... Show more
content on Helpwriting.net ...
The fluid is examined under a microscope for uric acid crystals. However, not finding the crystals
doesn't always mean that [it isn't] gout. The crystals may also be around the joints, so [the] doctor
may search for them there as well. Also, gout attacks may look like joint infections. So the joint
fluid may also be cultured to see if a bacterium grows from it." (2012) Due to the somewhat difficult
task of diagnosing gout, many clients will not have a definitive diagnosis for a relatively large
amount of time.
The initial flare up of gouty arthritis is usually managed with NSAIDS to control swelling and assist
in pain management while long term treatment is determined by the provider in charge of the clients
care. Long term treatment options can include corticosteroids (prednisone) taken orally or injected
directly into the joint, as well as diet restrictions. Colchicine is usually a last resort given only after
initial treatment has failed. Unfortunately, it is also only effective when it is taken within the first 12
hours after the initial symptoms of an attack

Summary Of The Great Bird Poop
In the articles "The Great Bird Poop Disaster" and "How to Solve the Problem of Bird Poop" both
by Anna Starecheski. It talks about how there is a huge problem with birds coating our cities and
streets is gooey, slippery piles of white and black poop, but is there a solution of some of the maney
problems caused by this epidemic. In the article "The Great Bird Poop Disaster" it talks about how
there are a lot of problems that are caused by bird poop, one is that it has acid in it so it is corrosive.
In the article, it says "At the center of a bird dropping is a black substance; that is poop. The white,
gloppy stuff is the urine, which consists mainly of uric acid. Uric acid is corrosive. That means it
can eat away at the surfaces of buildings and bridges. Bird poop can also ruin everything from the
paint on your mom's car to your favorite T–shirt. In the U.S., pigeons cause about $1.1 billion in
damages every year." (Starecheski 18). This shows that this isn't just a little inconveniences, no it's a
big deal that if it is not fixed soon the U.S will be deeper in debt than bird poop. This is why
squinted across the world are trying to find a solution to this problem that spreads across the world.
In the article "How to Solve the Problem of Bird Poop" It talks about some of the solutions that we
have tried and some that we still use to try to get some of the birds to leave. In the article, it says
"Placing spikes on window ledges, bridges, fences, and other areas where birds

Otherwise Called Nyhan 's Syndrome
Lesch–Nyhan Syndrome, otherwise called Nyhan's syndrome, hypoxanthine–guanine
phosphoribosyltransferase (HPRT) deficiency or juvenile gout, is a rare hereditary disorder that
affects almost exclusively males at a very young age. Thereby, they develop neurological and
behavioral abnormalities–physical handicaps, mental retardation and abnormal involuntary muscle
movements– and the overproduction of uric acid. This paper will outline the Lesch–Nyhan
syndromes genetic and metabolic components, symptoms and signs, how and when a patient should
present to a physician, what makes the physician think that a patient has the disease, how it is
diagnosed, the treatment and/or cure, and its longevity. The history of Lesch–Nyhan syndrome
began first when it was discovered or recognized by Michael Lesch and William Nyhan. Michael
Lesch and William Nyhan supplied the first detailed clinical characterization of Lesch–Nyhan
disease in the year 1964 (H A Jinnah, 2015). Additionally, the deficiency of the enzyme
hypoxanthine–guanine phosphoribosyl transferase was observed by Seegmiller and associates in
1967 (H A Jinnah, 2015). Lesch–Nyhan Syndrome is genetically caused due to the deficiency of
hypoxanthine–guanine phosphoribosyl transferase or the HPRT1 gene mutation. The complete or
acute deficiency of HRPT leads to this Lesch–Nyhan syndrome. The gene mutation is located in the
X chromosome. The HPRT gene is found on the long arm of the X chromosome and the amino acid
coding for HPRT is

Research Paper On Gout
2.4 ASSOCIATED HEALTH CONDITIONS OF GOUT
Gout is associated with a host of health conditions and diseases. Majority of patients have at least
one associated health condition and disease. The most common one are obesity, high blood pressure,
kidney disease and heart disease.
2.4.1 OBESITY AND GOUT
Obesity is a condition that exists when a person carries extra body fat that is severely out of
proportion to his or her height. Gout is highly common in obese people. Research shows that a large
percentage of gout patients are overweight. Weight gain plays a role in the development of gout. An
obese person is four times more likely to develop gout compared to someone with a normal body
weight.
People with high BMI readings also have higher ... Show more content on Helpwriting.net ...
Kidney stones form when your urine contains more crystal–forming substances – such as calcium,
oxalate and uric acid – than the fluid in your urine can dilute. At the same time, your urine may lack
substances that prevent crystals from sticking together, creating an ideal environment for kidney
stones to form.
Uric acid crystals deposited in the kidneys can become large kidney stones. These are also known as
uric acid stones. These stones are formed in people who don't drink enough fluids or who lose too
much fluid, those who eat a high–protein diet, and those who have gout.
Uric acid stones are very painful and can cause permanent kidney damage. The stones can form
obstructions which prevent your kidneys from removing wastes and causing infection. They can also
scar the kidneys with rough or sharp edges. These problems can lead to chronic kidney disease and
even kidney failure where kidney dialysis or kidneys transplant to treat complications that could
lead to more illnesses and even death.
It is important to monitor your kidney function. Drink at least 64 ounces of water a day (8 cups) to
help reduce the risk for stone

A Brief Note On The Care Of Annie
The essay is going to describe about the care of Annie, aged forty four years and came to the
emergency department because of extreme and increasing pain in her right big toe for the last couple
of days. Annie has a female partner who is working in the mines and she is away and also she have
three year old son. She is worried about him because there is no one else to look after as both pairs
of grandparents are unavailable. Health care providers conduct the interview to find subjective data
and objective data, make the necessary observations of the patient, and assemble the information on
concurrent and previous disorders, the family history, the patient 's social and medication
background, and the results of laboratory studies and diagnostic procedures., her vital sign are: Her
vital signs are: T38, P100, R20 and BP 140/90. During the examination, her toe looks red and
swollen, she could not sleep for couple of days and also have excruciating and increasing pain. Her
liver function test did not demonstrate any defects but serum electrolytes test indicate higher uric
acid levels. Her medical diagnosis is "Gout. Gout is a kind of arthritis. It can cause an attack of
sudden burning pain, stiffness, and swelling in a joint, usually a big toe (Neogi, 2011).she is given
Allopurinol, 600mg daily and Ibuprofen, 200–400mg, 4/24. Health care provider decide to admit her
for observation and more examination. The aim of cure relieves pain and inflammation and also
prevent from coming

A Short Note On Diabetes And Its Effect On The Patient...
Gout is a condition of the joint that causes the patient severe pain. It is characterized by an increase
of uric acid in the blood that lasts for some time. This elevation of uric acid in the blood is called
hyperuricemia. In normal development, uric acid is chemical that is produced in the body. This
chemical is created when the body breaks down substances called purines. Normally, uric acid
dissolves in the blood and is excreted by the kidneys and passes through the urine. If the patient's
body produces an excess of uric acid or doesn 't remove enough if it, they can get sick. However, not
all patients that have elevated uric acid levels will develop gout (Edwards, 2013). Under–excretion
or over–production of uric acid by the ... Show more content on Helpwriting.net ...
Patients can also have an increased risk related to other diseases that they have like hypertension,
some renal and cardiovascular diseases, and diabetes. Some medications can also affect a gouty flare
ups like Vitamin B3, diuretics, niacin, medications used to treat tuberculosis, and cyclosporine.
Surgical procedures and trauma to the joints can also cause a gouty flare–up (Finney, 2014). Gout
presents itself in four different stages. In stage one, the patient will experiences a gouty flare up but
then will have symptoms free periods of time even though the uric acid levels in the blood continue
to be elevated. Some patients can also present with no symptoms at all. In the second stage, the
patient will start to experience acute arthritis that has a sudden onset usually within six to twelve
hours. The flare ups of gout tend to be located in the small joints like the fingers, wrists, elbows, and
knees. The most common flare up symptoms can usually be found in the patient's great toe. If the
patient doesn't treat seek treatment the flare–ups can last anywhere from seven to ten days.
Symptoms that the patient can experience besides painful, swollen joints are chills, headaches, and
weakness. At this point the patient can still experience symptom free periods and this is stage three,
or interval gout. However if the gout continues to be left untreated, the time in between will be
decreased. The body will also start to

Describe About Care Plan For Annie Who Is Diagnose With ``...
This essay is going to describe about care plan for Annie who is diagnose with "gout". The interview
has been conducted by the nurse to find subjective data and objective data, make the necessary
observations of her, and assemble the information on concurrent and previous disorders, the family
history, her social and medication background, purpose and effects of the medications, the results of
laboratory studies and diagnostic procedures.
Annie, aged forty four years who has arrived to the emergency department because of extreme and
increasing pain in her right big toe for the last couple of days. Her vital signs were : T38, P100, R20
and BP 140/90. During the examination, her toe looks red and swollen, she could not sleep for
couple of days due to excruciating pain. Her liver function test did not show any defects whereas
serum electrolytes test indicates higher uric acid levels. Her medical diagnosis is gout. Gout is a
kind of arthritis. Which can cause an attack of sudden burning pain, stiffness, and swelling in a joint,
usually a big toe (Neogi, 2011). She is given Allopurinol, 600mg daily and Ibuprofen, 200–400mg,
4/24. Medical Officer decided to admit her for observation and more examination. The aim of care
is to relief pain and inflammation and also prevent from gout attacks leading to stable joint harm.
Her female partner is away for work in the mines. Also, due to unavailability of her grandparents,
she is worried about her three year old son as there is no one

Gout Is A Complex Metabolic Disease
Gout is a complex metabolic disease that presents itself in a form of arthritis that causes unexpected,
severe attacks of pain. In addition, men are more likely to get gout, but women become increasingly
susceptible to gout after menopause (Mayo Clinic Staff, n.d.). Generally, gout affects one joint at a
time and causes tenderness, redness, warmth, and swelling of the joint. However, it can be in several
joints. The big toe is most often affected, but gout can also affect other joints in the leg – such as the
knee, ankle and foot – and less often, the hand, wrist, fingers and elbow ("Arthritis and Gout," n.d.).
An attack of gout can occur suddenly, often waking you up in the middle of the night with the
sensation that the big toe is on fire. In fact, the joint is so tender that the mere weight of the sheet
upon the affected joint may seem intolerable. The prevalence of gout appears to be increasing. It is
currently estimated to affect over 6 million Americans (Shiel, Jr., M.D., FACP, FACR, 2015). There
are three different types of medical appearances of gout that vary in symptoms and treatment, they
being hyperuricemia, acute gout, and tophus gout. Hyperuricemia is an overproduction of uric acid
and is seen in the beginning stage of gout. In addition, peak incidences occur in patients 30 to 50
years old. Patients with asymptomatic hyperuricemia do not require treatment, but efforts should be
made to lower their urate levels by encouraging them to make changes in

Hyperuricaemia Research Paper
Hyperuricaemia which is distinguished by abnormal high levels of uric acid is present in 5–30% of
the general population and appears to be increasing worldwide (1). It has been considered as an
important risk factor for gout and may be associated with development of several oxidative stress
diseases such as cancer and cardiovascular diseases (2, 3). The control of uric acid production has
been widely regarded as a key factor in the prevention and treatment of hyperuricaemia (4). Liver
xanthine Oxidoreductase is the key enzyme in the catabolism of purines, and catalyses the oxidation
of hypoxanthine to xanthine and xanthine to uric acid. This enzyme occurs in two distinct forms.
Xanthine dehydrogenase (XDH) is the frequent active form under physiological conditions. Under
... Show more content on Helpwriting.net ...
However, some severe adverse effects such as hepatitis, nephropathy and allergic reactions limit the
clinical use of allopurinol (3). Several in–vitro observations confirmed the XO inhibitory activity of
some phytochemicals such as flavonoids (7–10). Flavonoids are non–nutrient polyphenolic
compounds that occur in plants and consist of six major classes based on specific structural
differences: flavonols,flavones, flavanones, catechins, anthocyanidins, and isoflavones (11).
Therefore, a promising approach for hyperuricemia and its complications might be a combination
therapy utilizing dietary flavonoids and hypouricemic pharmaceuticals at a suboptimal dosage to
minimize any potential adverse side effects. The present study was designed to screen natural
compounds for their xanthine oxidase inhibitory potential. Xanthine oxidase inhibitors (XOI) are
used in the treatment of gout. Gout is a common worldwide health problem. It arises due to elevated
serum levels of uric acid. Xanthine oxidase inhibitors block the production of uric

Arthritis, Rheumatoid, And Rheumatoid Arthritis
Gout, Osteoarthritis, and Rheumatoid Arthritis
More than 6.1 million people in Australia suffer from arthritis. Arthritis is a disease characterized by
pain, swelling and stiffness in the joints. There are more than 100 types of disease which is one of
the most chronic in the world. It impacts on a person's basic daily tasks causing joint weakness,
uncertainty, and distortion. It affects community, both economic and personal resulting the need for
more hospitals and primary health care services. The number of people with arthritis is higher at old
ages, however there are more people who are suffering from this disease are between 35 to 64 years
group. Arthritis is not yet curable and treatments vary depending on the type of arthritis. To ... Show
more content on Helpwriting.net ...
(National Rural Health Alliance Inc, Aug 2014)
Gout
Gout is an inflammation disease in which urate crystals deposit into joints resulting in high levels of
uric acid in the blood (hyperuricaemia). Urate crystals are deposited in the connective tissues of the
body causing gout disorder. Gout affects the first metatarsal joint of the foot where the base of the
big toes and this condition makes the person wake up at night feeling like their big toes are on fire
and pain is most severe in hours immediately following the attack. Urate crystals are deposited in
various other connective tissues causing more inflammation as it progresses. gout can occur due to
primary or secondary hyperuricemia and is treatable. Gout occurs must often in men usually after 30
years of age where as women are expected to get after menopause. (Flynn &Johnson, 2005, pp
1447–1448)
Symptoms
Intense joint pain – gout affects the joint of the foot of the big toe and can occur in feet, ankles,
knees, hands, and wrists.
Lingering discomfort – discomfort lasts from a few days to a few weeks and the attacks are likely to
last longer and affects more joints.
Inflammation and redness – joints become red, hot, tender and swollen.
Range of motion is limited – mobility of joint

AIHW Austrila Burden Of Disease Study
Why Arthritis and other Musculoskeletal Conditions, such as Gout, should remain on the list of
National Priority in Australia Gout is one of the most common inflammatory arthritis in Australia.
As a type of hyperuricaemia, gout is a metabolic disorder form of inflammation when blood
contains excess uric acid, causing deposits of uric acid crystals in joints. Gout is non–fatal disease
with common symptoms are pain and swelling. Risk factor includes dietary factors, genetic factors,
alcohol consumption, obesity, hypertension, renal disease and diuretic use. (Chandratre P, Roddy E,
2010)
Gout is a chronic disease has a serious influence on the quality of life of Australians, because it is a
non–fatal condition, but can cost serious burden on ... Show more content on Helpwriting.net ...
The huge amount of risk factors for the impact of gout in male and female has now been published
in epidemiological studies. Therefore, gout has a strong association with many common morbid risk
factors, and directly increases the prevalence and incidence; cause mortality beyond that expected.
According to AIHW study, the incidence of gout was 4 times higher in male than in female and
increased with age. In concluding, Arthritis and other Musculoskeletal Conditions, such as Gout,
should remain on the list of National Priority in

Effects Of Pregnancy On Women And Babies
Subtle or acute changes in pregnancy can threaten the successful journey to motherhood resulting in
devastating consequences for women and babies (Lunau, 2014). Pre–eclampsia is the focus of this
essay, a high risk condition experienced by a woman under my care. Her medical treatment will be
contrasted with evidence–based information found in the reviewed literature. Risk assessment
definition will be critiqued along with impact of this term on pregnant women. I will reflect on the
care I provided and strategies that can enhance more sensible care. A pseudonym will be used to de–
identify the woman complying with the code of professional conduct for midwives (2008).
Discussion
Maria was an 18 year old Aboriginal primigravida who at 36 ... Show more content on
Helpwriting.net ...
(2014) argue that while understanding of pre–eclampsia has improve over the years the only
effective treatment is the birth of the fetus and the placenta. However, immediate stabilization of the
woman prior to termination of pregnancy is essential (Friedlander, 2008; Pennington, et al., 2012;
Berzan, et al., 2014).
Maria arrived at Alice Springs maternity unit complaining of headache; her blood pressure was
160/120mmhg measured manually. She had peripheral pitting oedema in her legs, proteinuria 4+,
oliguria and elevated uric acid. Lisonkova and Joseph (2013) make a strong case that late–onset
preeclampsia is associated with younger maternal age and nulliparity which correlated with the
background of the woman under my care. While pre–eclampsia is generally diagnosed on the basis
of hypertension and proteinuria (Pettit & Brown, 2012), Lewis (2011) classify these parameters as
inaccurate and non specific markers. The reasons come from two directions. First they are only
present in 15–20% of all pregnant women (Lewis, 2011). Second, they are just two signs of
progressive circulatory malfunction and inflammation of the placenta (Lewis, 2011).
There seems to be general agreement that proteinuria and uric acid are poor predictors of maternal
and fetal complication and they should not guide management (Steegers,

Gout Research Paper
Relieving the Symptoms of Gout
Gout can affect men and women, but men are more likely to have the condition. The signs of the
condition are pain and tenderness in the joints. Women are more likely to develop the condition after
menopause. Gout symptoms can happen anytime of day or night, but most people have attacks at
night. The attack is similar to arthritis, and it causes a burning sensation in the toes. Fortunately,
there are several medical and natural ways to treat the condition.
What Causes Gout?
A diet high in sugar, seafood and meat increases uric acid levels. Alcohol and being overweight can
also raise your risk of developing gout. Kidney disease and high blood pressure can also cause gout.
The condition can be hereditary. Gout occurs

Effects Of Renal Intoxication
Renal injury due to KBrO3 intoxication could be evaluated by assessment of serum urea, creatinine,
and uric acid, which were used as early indicators of renal dysfunction [39].The significant increase
in serum urea, creatinine and uric acid in the KBrO3 –treated rats indicate the development of renal
dysfunction and reduced glomerular filtration rate. The increase in uric acid level also may be due to
degradation of purines and pyrimidines which strongly related to the significant increase in xanthine
oxidase activity resulted in overproduction of uric acid. The increase in xanthine oxidase activity
does not only catalyze the formation of uric acid but also generate ROS. Therefore, the elevated
xanthine oxidase activity could explain the ... Show more content on Helpwriting.net ...
Pro–inflammatory cytokines, including tumor necrosis factor α (TNF–α) and IL–6, are thought to
act as a central factor in the pathophysiology of chronic kidney disorders [43]. Oxidative stress is
also involved in the inflammatory response. ROS can induce inflammatory processes by activation
of transcription factors, which induce secretion of pro–inflammatory cytokines, including TNF–α
and IL–6 [44]. In this study, results illustrated that KBrO3 induced an inflammatory reaction
indicated by increasing renal TNF–α and IL–6 levels . However, treatment with taurine and /or
vanillin prior KBrO3 administration suppressed the overproduction of TNF–α and IL–6 in renal
tissue provided a protective effect against kidney pathological changes. Interestingly, the observed
results show that pretreatment of rats with vanillin also caused the apparent reduction in levels of
proinflammatory cytokines such as interleukin (IL)–1β, IL–6, and tumor necrosis factor–alpha . This
is in accordance with the previous results obtained [45] reported that pre–treatment with vanillin
resulted in a normalization

What Causes Joint Pain
Joint pain and other musculoskeletal conditions are the most prevalent causes of chronic pain
worldwide, affecting over 50 million people in the USA alone. The most common form of joint pain
is Arthritis – which is a disease that causes pain, swelling and restricted movement in joints. There
are various types of arthritis such as Osteoarthritis, Rheumatoid arthritis and Gout.
Arthritis (along with other rheumatic conditions) has been the leading cause of disability among US
adults for the past 15 years. According to Dr Vijay Vad, (Dr Vijay Vad, 2009), arthritis is one of the
oldest and most chronic diseases in the world. The origins of rheumatic conditions such as arthritis
date back to ancient times. Evidence of this include ancient skeletons ... Show more content on
Helpwriting.net ...
However there are various treatments (both conventional to mainstream medicine, and alternate
treatments) for RA. The most important thing is to begin treatment early, before the joints undergo
permanent damage. The most important and successful treatment is that of starting treatment with
DMARDs (disease modifying ant–rheumatic drugs) that not only relieve the symptoms of RA, but
also slow down the progression of the disease itself. Anti–inflammatory drugs have also proven to
be successful in managing symptoms of RA. (Eric Ruderman, 2013).. Physical and occupational
therapy as well as low–impact exercise also have beneficial effects on the symptoms of RA due to
them strengthening the joint and improving mobility. For severe RA that cannot be helped by other
treatments, surgery has proven to be beneficial as well. There are also a number of alternative
treatments for RA. According to The Rheumatoid Arthritis Support Network (RASN), Organic
turmeric is very successful in terms of its benefits to relieving symptoms of RA. This is due to the
fact that it is a natural antioxidant and anti–inflammatory agent that also has bone protective
properties (a study by the US National Institute of Health in 2012 on rats has proved this)
(Kamarudin TA,

Gout Research Paper
Gout is an extremely painful inflammation of the joint caused by a buildup of need–sharp uric–acid
crystals. The big toe is the most common target but gout can attack the feet, ankles, knees, and
hands as well. Gout is caused when uric acid is produced in the body of purines specific chemical
compounds that are found in high amounts in certain foods such as meat, poultry, and seafood.
People with gout either produce too much uric acid , or more commonly, their bodies have a
problem in removing it. Symptoms of gout include severe pain, redness and tenderness in the joints,
usually in the big toe. Attacks come suddenly and without warning often at night. Pain can occur at
night in the joint, ankle, foot, knee, or toe the pain can be mild or server. ... Show more content on
Helpwriting.net ...
Drink plenty of fluids, (No alcohol or sweet sodas) , ice and elevate the joint , relax stress can
aggravate gout call your doctor and make an appointment, and ask friends and family to help you
with daily tasks. Gout may remit for long periods, followed by flares for days to weeks or can
become chronic. The gold standard for diagnosing gout is aspiration and microscopic analysis for
urate crystals in joint fluid or a tophus. Urate crystals are negatively birefringent under polarized
light. Infection must be ruled out gouty patients are, generally either old men or men who have worn
themselves out in youth as to have brought on a premature old age– of such dissolute habits. The
victim goes to bed and sleeps in good health. About 2am in the morning he is awakening by a severe
pain in his toe, heel, ankle or instep. The pain feels like a dislocation also parts feel as if cold water
were poured over them. Then comes chills and shivers and a little fever. The night is passed in
torture sleeplessness turning the part affected and perpetual change of posture the tossing body
being as incessant as the pain of the tortured joint, and begins worse as the fit comes

Uric Acid Crystals
Many gout victims want to discover how to reduce uric acid crystals. Here, you'll discover how to
do this using 5 herbal remedies. And you'll also discover how diet plays a vital role in reducing uric
acid crystals and preventing gout attacks.
In order to reduce uric acid crystals you need to reduce their acid levels in your blood. And in order
to reduce uric acid in your bloodstream, you first need to understand how it is formed...
Formation of Uric Acid Leading to Gout Attacks
When chemical compounds called "purines" in your body and food breaks down as part of the
process that results in producing your protein and energy requirements, uric acid is formed as a
byproduct.
Normally your kidneys take excess acid out of your blood, process ... Show more content on
Helpwriting.net ...
4 – Celery and celery seeds have been shown to lower acid levels.
5 – Devils claw has been known to reduce acid levels too.
Of course this only scratches the surface of what is available. And you need also to address other
issues like diet, weight, family history, medications, medical conditions, even lifestyle issues.
Importance of Diet in Reducing Uric Acid
Diet itself is so important. The typical Western diet contains lots of animal protein which can be
high or very high in purines. So eating these high–purine foods only increases the risk of uric acid
crystals forming and causing gout. As a gout sufferer you should avoid high–purine foods.
You're in luck though. There's a gout report available online [see below] that has all the info. you
need. It is what thousands of ex–gout victims worldwide have successfully used to prevent their
gout returning. It also contains a special 2 hour gout pain relief program.
And it uses fully–researched, totally natural methods. So that you benefit two ways: (1) you get rid
of your excruciating pain very fast, and, (2) you prevent your gout returning, so that you reduce the
risk of permanent

Gout Essay
What is Gout and How it is treated
Kyle C. Cupp
DuBois Area High School
Abstract
What is Gout and How is it Treated Gout is a semi common form of Arthritis that can cause a lot of
pain and discomfort. As it stands there is no known cure for gout as it is a deposit of crystal
structures deposited in the joins. Medicine for gout is mostly tries to stop flare ups to help people be
more comfortable. Gout is very painful and crippling affliction that can cause a lot of damage to
joints and connective tissue and in the medical world there is not a definite cure for gout. LIving
with someone with gout INdomethacin and allopurinol have the best ability to treat and prevent flare
ups in gout patients.
Gout is a disease that is caused by a metabolic disorder known as Hyperuricemia. ... Show more
content on Helpwriting.net ...
Its main objective is to get rid of gout from the kidneys. This type of treatment is given by syringe at
your doctor's office it isn't a pill like many of the other types of treatments. (Pegloticase 2017)
Ketorolac is a very powerful drug that is even compared to opioids and morphine. To have the anti
inflammatory effect it has to higher doses and a patient is usually only kept on it for about 5 days.
While it can be an anti inflammatory it still has the effects of a drugs such as opioids and morphine.
It is only considered in extreme cases and would not make a very good long term effective drug
(Non–Steroidal Anti–inflammatory drugs 2017).
Meloxicam is another type of drug used to treat gout. It is a selective cox 2 inhibitor. It inhibits
prostaglandins. "Prostaglandins also protect the lining of the stomach and intestines from the
damaging effects of acid, promote blood clotting by activating platelets, and also affect kidney
function (Ogbru, A, 2016)." It is extremely selective even with prostaglandins so that it is more
thorough (Non–Steroidal Anti–inflammatory drugs

Gout Research Paper
Oly Salunga
MED 2047
VNPT031
Gout
Brittany Hallett
August 18, 2015
GOUT According to Rosdahl (2010), "The body produces substances called purines during
metabolism. If the body is unable to metabolize these substances, uric acid accumulates in the
bloodstream and forms crystal deposits in the joints" (p.1236). This arthritic condition called gout is
a condition of hyperuricemia wherein these uric acid accumulates and form hard crystals deposited
in your joints. It can harm your joints, tendons, and other tissues. It can cause an attack of sudden
blistering joint pain, stiffness, and joint swelling. It often affects the joints of the big toe, instep,
ankle or knee but it may appear in any joint. Primary gout ... Show more content on Helpwriting.net
...
Take analgesics and anti–inflammatory drugs for pain and inflammation. Take pain medication as
soon as the patient feels the pain and not to wait until it get worse. Colchicines may interact with
grapefruit juice and CNS depressants. Allopurinol can be taken together with uricosuric agents to
get an additive effect. Uricosuric agents such as probenecid or sulfinpyrazone should be taken with
milk, food or antacids to minimize GI distress. Notify prescriber if nausea, vomiting or stomach pain
persists, chills, fever and chest pain. Report immediately if patients noticed darkening of the

Is There A Role For Primary Prevention For Patients With...
Is there a role for primary prevention for patients with asymptomatic hyperuricaemia?
Indrajeet Mandal
Gout is a very common disease in the UK, with 1 in 40 adults being affected by the condition (The
Gout Society UK 2014). The prevalence of the condition has increased in the past few decades, and
there is a greater disease burden in the more economically–developed countries (Kuo et al. 2015).
Uric Acid & Gout: Physiology
Gout is an arthropathy that involves the deposition of urate crystals into a joint. An acute gout attack
involves deposition of joints into a joint, resulting in a painful, swollen joint that classically affects
the first metatarsophalangeal joint, although can involve other joints as well. Figure 1: the natural ...
Show more content on Helpwriting.net ...
2011), and these have been shown to be independent risk factors (Lin et al. 2000).
Hyperuricaemia is associated with higher all–cause mortality
The classical hypothesis is that high uric acid levels lead to increased chance of crystals forming,
which then deposit in the joints. However, recent evidence has started to suggest that
hyperuricaemia itself is a risk factor for increased mortality from causes other than gout. A study
carried out on Japanese men has shown that high serum uric acid has been linked with an increased
relative risk of mortality from all causes in a study carried out on Japanese male workers (Tomita et
al. 2000). An increased mortality raises the question of whether we should routinely prescribe
primary prevention interventions in patients who are in the stage of asymptomatic hyperuricaemia.
Early studies have shown that there is no significant increase in mortality from renal failure. A
prospective study followed a cohort of 2046 initially healthy men and measured urate levels and the
incidence of a raised serum creatinine (Campion et al. 1987). They concluded that there wasn't a
significant rise in the creatinine level, and that there was no significant renal impairment caused
hyperuricaemia, supporting a conservative treatment regimen.
However, it is worth nothing that this measurement was done by correlation urate levels and creatine
levels – as the baseline creatinine varies from person to person, it could be argued that this is not

A Short Note On What It Is?
Gout; What It Is and How to Prevent It
Gout is a common disease which consists of the defective metabolism of uric acid causing arthritis.
Gout is caused by the formation of crystallizing uric acid, and that comes from the breakdown of
substances called purines. Purines are prevalent in all body's tissues. Purines are also found in many
foods. Uric acid dissolves in the blood, is filtered by the kidneys, and excreted out of the body in
urine. As the uric acid level elevates, if not excreted properly, the saturation of the uric acid can
cause the formation and deposition of monosodium urate crystals to form in and around the joints.
Acute gout attacks usually consist of rapid onset of pain in the affected joint, followed by redness,
warmth, swelling, and at times, decreased range of motion has been reported in the affected joint. It
is one of the most debilitating forms of arthritis. Inflammation and pain occur when too much uric
acid crystallizes and gets deposited within the joints.
Discussion
Cause
Uric acid comes from the breakdown of substances called purines. Purines are found in all body
tissues. These purines are also found in many foods, such as liver, dried beans, peas, anchovies, red
meat, fructose, and even beer (Katz). Uric acid dissolves in the blood, filters through the kidneys,
and exits the body via urine excretion. This bodily function can be affected if the body increases the
amount of uric acid it makes or intakes, and if the kidneys

Gout Case Study
Gout is a commonly occurring disease within the elderly population. Essentially, gout is identified
as being a rather severe type of arthritis caused by formation of monosodium urate (MSU) crystals
in joints and other tissues (Buttaro et al., 2013). This form of severe arthritis is generally classified
as a type of rheumatic disease where too much uric acid is produced or built up within the body,
which subsequently crystallizes, and result in hyperuricemia (Jin et al., 2012). Gout is a medical
condition that can be extremely painful for any human being but especially the elderly patient. Gout
tends to affect the cold joints such as the big toe.
However, it may affect the kidneys as well in which the patient develops what are commonly
referred

A Brief Note On Pain, Hypertension, Gout, And Diabetes...
Subjective Data: Chief Complaint: Right ankle pain for two days, routine visit for osteoarthritis,
hypertension, gout, and diabetes mellitus (DM) evaluation. History of present illness: Mrs. V. J. a 68
year–old–African American female presented in the clinic complaining of a burning pain, stiffness,
swelling right ankle, which radiates to the right metatarsophalangeal joint for two days, pain scale
seven out of ten. She denied falling or hitting her right ankle against an object, just woke up around
three that morning to use the bathroom and could barely walk. She also stated that right ankle edema
has increased more in the past two days due to cold weather. She takes Norco 10/325mg two tablets
orally every six hours and apply warm ... Show more content on Helpwriting.net ...
She had three siblings, one sister and twin brothers, sister is 60 years old, newly diagnosed with DM
and twin brothers are 58 years old alive and well. Review of System (ROS) General: Neat Skin:
Reports swelling right ankle and right big toe pain. Eyes: She wears reading glasses Ears: Denies
ringing in the ear, pain, discharge, or hearing impairment. Nose: Denies nasal discharge, Congestion,
or problems with smell. Throat: Denies problems with her gum and mouth. Swallows without any
difficulty. Neck: Denies any edema or bruises around the neck. Respiration: Denies labored
breathing. Cardiovascular: Denies chest pain, bilateral ankle edema, but severely increased on the
right with burning pain. Gastrointestinal: Denies anorexia, nausea and vomiting, heartburn,
abdominal pain, or constipation. Endocrine: History of Type two DM Objective Data: Vital signs:
Temperature 98.7 Fahrenheit, Blood pressure 128/82, Respiration 16, weight194, height 5feet 8
inches, body mass index (BMI) 28. Generalized appearance well–kept wore a decent outfit,
overweight, ambulates with a walker. Skin: Warm to touch, dry and intact Head: Normocephalic,
atraumatic. Ear: No discharge or cerumen noted bilaterally, tympanic membrane normal without
redness or edema. Nose: Nares patent without any obstruction. No frontal or maxillary tenderness
during palpation of the sinus cavities. Pharynx: Oral mucosa moist, no dental cavities or plague

Patient Suffering From An Inflammation Of The Big Toe That...
Introduction This is a case study on a patient suffering from an inflammation of the big toe that has
caused severe pain. According to the provisional test conducted, the patient is suffering from gout.
The purpose of the study is to determine the additional procedures that will be conducted on her.
The steps followed are informed by the personal details provided and the test that have already been
conducted on the patient. This will be followed by the clarifying the all the symptoms; this will
ensure that the rest of the procedures are in line with the previous tests conducted. Finally, an
assessment of the problem will be conducted to give a confirmation on the illness. Domains of
health such as physical, social and psychological will be analyzed for any probable cause of the
problem. Identification of the patient The patient is a female by the name Annie. She is married to a
female partner who is away working at a mining site. Her case was presented as an emergency due
to the excruciating pain that she was undergoing. According to her, the pain has been there for two
days where she could not sleep due to the pain intensity. Also, she was unable to cover herself as the
warmth provided by the bed sheet amplified the pain. According to her, she had to raise the affected
foot using a pillow to ease the pain. Her toe appears red in color with an evident swelling. Also, the
toe under the pain is experiencing higher temperature than the rest of her body. According to Anne,
she

A Brief Note On Arthritis And Its Effects On The Body
Jacob Hunnicutt
MED 2047
Gouty Arthritis
Instructor: Michelle Earixson–Lamothe
3/16/15
VNFT031
Gouty arthritis, more commonly known as gout, is a very painful condition that primarily affects the
joints especially those of the great toe, ankles, wrist, and fingers. "Gout is most commonly seen in
men, particularly those between the ages of 40 and 50" (Bradford, 2014 ). Gout is not a disease that
is new to society; it has been around for centuries. The first recorded incidence of gout was in Egypt
in 2640 BC, to the Egyptians gout was called podagra (Nuki, 2006). Gout is highly linked to one's
diet and in history gout was known to affect the affluent population more than any other. Humans
are the only living organisms that seem to have the problem of gout. The reason this is so is most
likely due to the fact that in other organisms, such as reptiles, fish, dogs, have an enzyme, uricase,
that is responsible for the breakdown of uric acid. The leading cause of gout is due to the ineffective
metabolism of purines. When purines are ingested in the body it is converted into urate. Gout leads
to hyperuricemia, which is high blood uric acid levels. For a person who ingests a normal and
balanced amount of purines, the body is able to handle it and filter it out of the body via the kidneys.
If a person has a decreased function of their kidneys their chances of getting gout, alongside many
other things, significantly increases. The kidneys are responsible for

Symptoms And Symptoms Of Arthritis
The pain and associated symptoms related to gout can be quite severe although mild at the outset.
The following characteristics of the disease are utilized in the diagnosis and development of a
treatment strategy in the patient (Roberts, 2010; De Miguel et al., 2012):
1. Onset: pain and swelling can occur rapidly with little prior indication but mostly in the middle of
the night
2. Location: the pain and swelling associated with gout occurs most often in the hallux or big toe
(podagra) but also commonly appears in the ankle areas, knees, elbows and wrists
3. Duration: the flare–ups of acute pain associated with gout may last hours, days or weeks in
advanced cases
4. Characteristics: pain is usually acute and sharp in character
5. Aggravating factors: cold weather, comorbidities such as rheumatoid arthritis
6. Relieving factors: application of heat pads, changes in diet
7. Treatment: NSAIDS, corticosteroids, colchicine, uricosurics, xanthine oxidase inhibitors,
pegloticase
Differential Diagnosis Multiple different diagnoses can be mistaken for gout disease or,
alternatively, that can complicate the diagnosis of gout. The most common of these differential
diagnoses involve the development of crystallization in the patient's articulated areas or joints. These
various differential diagnoses are detailed in the next section:
1. Pseudo gout disease: this occurs when calcium pyrophosphate dehydrates (CPPD) accumulates in
the patient's blood serum which leads to crystallization in

Febuxostat Case Study
A review on febuxostat : chemistry and therapeutic profile
Abstract:
Febuxostat is a novel, orally administered, non–purine analogue & selective inhibitor of oxidized
and reduced forms of xanthine oxidase, approved in February 2009 by the Us FDA for the cure,
management and long term treatment of chronic hyperurecemia and gout even in patients with
intolerance/hypersenstivity to allopurinol .If given at a daily dose of 80 mg or 120mg it is reported
more effective than allupurinol . Febuxostat does not require any dosage adjustments in patients
with mild to moderate renal impairment . In the reported clinical trials, it is found to be well
tolerated and superior to conventional drugs for treatment of gout. The purpose of this review is ...
Show more content on Helpwriting.net ...
Lead compound for development of high affinity inhibitors
b.Preliminary modification of the lead compound revealed that the introduction of an electron–
withdrawing substituent and hydrogen bond acceptor such as NO2 or CF3 at the 3'–position of the
phenyl ring or an electron–donating substituent such as OR or COOH at the 4'–position led to an
increase of the inhibitory activity. Attempts to replace the nitro group with other electron–
withdrawing substituents at the 3–position resulted in identification of the cyano group as the best
substituent among other substituents examined. The final structure proposed was found to be
febuxustat with high inhibitory activity.
c.The` CN 'group of febuxostat is necessary for potent enzyme inhibitory activity. When the 3–
cyano moiety of febuxostat is replaced by hydrogen, the binding affinity was significantly decreased
.
d.When the cyano group of the inhibitor was substituted with a nitro ligand, which is also capable of
accepting a hydrogen bond, the resulting derivative showed a binding affinity very similar to that of

Uloric Case Study Summary
Uloric (Febuxostat) is a xanthine oxidase inhibitor used to control hyperuricemia in patients with
gout. Xanthine oxidase inhibitors inhibit the activity of xanthine oxidase, an enzyme involved in the
metabolism of purines. This medication should not be used for the treatment of asymptomatic
hyperuricemia. Uloric was first FDA approved on February 13th, 2009 for chronic management of
hyperuricemia. Given that this medication is fairly new to the market, it is more expensive then the
other prescription medication in the same pharmaceutical categories, allopurinol. Uloric comes in
two strengths, 40 mg, and 100 mg tablets. Bothe the 40 mg and the 80 mg tablets costs $310.39 for a
30–day supply (quantity of 30). Allopurinol also comes in 2 strengths, 100 mg, and 300 mg tablets.
The cost of 100 allopurinol 100 mg tablets is $37.69 and $76.14 for ... Show more content on
Helpwriting.net ...
Studies have shown that 80 mg of Uloric was able to get 30% more patients than 300 mg of
allopurinol to a healthy uric acid level (<6 mg/dL). Even though in the study Uloric seems to be
more effective in managing hyperuricemia, I believe that this is not a fair comparison because 300
mg daily of allopurinol is only given in patients with mild gout. When comparing 40 mg Uloric with
300 mg allopurinol, the number of patients who reached a healthy uric acid level was equal. It is
shown that patients with mild to moderate kidney problems do not have to take a lower dose which
seems like a major advantage for using Uloric, but in the study only a small number of patients with
severe kidney problems were studied. Patients with kidney problems have to take a lower dose of
allopurinol; the dose of allopurinol is only decreased in patients with a creatinine clearance (CrCl)
of less than 20 mL/minute, which to me seems that the patient is experience severe kidney

Gout Disease Research Paper
Gout disease was known over 4000 year by the Egyptians, Romans and the Greeks. It was named
the "rich man disease" or "disease of kings" for it was related to the standard of living that only
wealthy people can afford in that time. The first time the Egyptians documented the gout disease
was in 2600 BC as arthritis of the big toe. Originally, the name Gout is from Latin Gutta which
means "drop" (Copeman WSC, 1964). Gout disease, also called gouty arthritis, is an inflammatory
arthritis that is very painful. It occurs when there is an excess of uric acid in the bloodstream. The
acid forms crystals in joints, causing sudden and severe pain, swelling, redness and tenderness. Most
people at first experience gout at the base of the big toe. Gout can also affect others movable joints
like your ankles, knees, wrists, fingers and elbows or others. According to the Arthritis National
Research Foundation, gout affects in 8.3 million Americans. The same research institute states that it
is rare in children or young people but men are ... Show more content on Helpwriting.net ...
Most current treatments of gout are Oral corticosteroids, intravenous corticosteroids, NSAIDs (non–
steroid anti–inflammatory drugs), and colchicine. Indomethacin (Indocin) has also been the
preferred choice but, there is no evidence that shows that it is more effective than any other
medications. Oral NSAID can be prescribed to the patient for one to two days after the symptoms
disappear. Treatment can also be done through diet with a strict control of the patient food with only
free uric acid. Therefore, patient must stop eating a high–purine diet ( like Frequent consumption of
red meat and shellfish), and high–fructose foods and beverages, This was confirmed by Haig in a
series of clinical experiments he conducted on himself from 1894 to 1897, and more recently in
clinical physiological studies on patients given purine–free formula

Gout
The Disease of Kings
Gout, a disease commonly referred to as "The Disease of Kings or as "Rich Man's Disease is
considered a chronic and progressive disease. Chronic gout can also lead to crystal deposits (sodium
orate) of uric acid (a normal byproduct of purines) in the tissues, particularly in and around the
joints. Gout can cause sudden severe arthritis and may cause joint destruction, decreased kidney
function, and kidney (nephrolithiasis). Gout has the unique distinction of being one of the most
frequently recorded medical illnesses throughout history
When our body has too much of uric acid (commonly known as "hyperuricema"), some of the
needle–shaped crystals tend to deposit outside the bloodstream, most commonly around the ... Show
A healthy diet and proper medication, and catching the disease in its initial stages, are the only ways
to stay healthy and miles away from

Symptoms And Treatment Of Gout
1. Gout (Acute, Active)
a) Differentials: Gout, Rheumatoid Arthitis, Plantar Fasciitis
b) Plan: Prescribed Colchicine (Colcrys) 0.6 mg tablet for 10 days, to reduce joint inflammation
related to gout flares.
c) Education: A preventive gout flare diet includes one that is low–purine, low protein, alcohol–
restricted diet. Gout is influenced by dietary factors that lead to an increase in purines, such as red
meat and shellfish, alcohol, and caffeinated beverages. Avoidance of these dietary factors may
reduce gouty flares. An alcohol–restricted diet is imperative because alcohol consumption closely
correlates with hyperuricemia leading to a gout attack. B.B. should be made aware that excessive
joint movement might increase inflammation, whereas rest of affected joints may support resolution
of pain. Cold compresses may also be beneficial to treatment of gout attacks. Patient should be
recommended to exercise regularly and drink plenty of water, leading to lower the concentration of
uric acid.
d) Referral: None at this time. Patient directed to follow–up if symptoms have not resolved in 10
days.
Gout is an arthritic disease caused by buildup of uric acid in the body. Normally, the liver processes
purines. When purines are destroyed by the liver, uric acid, a waste product is produced. Normally,
the body disposes uric acid through the kidneys where it is removed from the blood. When too much
uric acid is produced by the liver or the kidneys do not eliminate properly from the

Gout Research Paper
MT: foods that causes gout
MD: what is gout? What causes gout flare–ups? List of foods that causes gout flare ups
Foods That Causes Gout
Gouts are a very painful form of arthritis, caused by the accumulation of uric acid crystals in the
joint space, and inflame the joints. These crystals only form when there is excess amount of uric
acid in the blood; uric acid (a waste product that is usually filtered from the blood by the kidneys
and expelled from the body through the urine) is formed when the body breaks down some
compounds called purine. Purine has always been a part of your body, your body cells contain
purine, and it can also be found in a lot of the foods you eat. In other words, when your diet contains
too much purine, you have a very high level of uric acid, which eventually leads to gout. ... Show
Seafood: oysters, lobsters, shrimps, salmons, tuna, sardines, oily fish etc are notorious for worsening
gout symptoms, they also trigger them, staying away from them is very important if you want to
recover, but if you must eat them, then it must not be more than 5 ounces a day, it doesn't matter the
type of seafood you choose to eat.
Meat: animal foods contain very high quantity of purines it doesn't matter the type of meat you
enjoy, whether it is beef, pork, chicken etc just ensure that you do not take them, because such foods
causes gout attacks, it is best to reduce the
Beans and legumes: beans peas and legumes also have high purine contents, which is not good for

Gout Attack Research Paper

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