Investigation and management of gout in the young and elderly

Article Abstract:

Arthritis and severe joint pain are common features of gout. Gout can be caused by an enzyme defect that causes excessive production of uric acid in the body, and is associated with high blood pressure, obesity, high fat content in the blood, excessive alcohol consumption and heart disease. This condition is more common in the elderly and is uncommon among men under 30 years of age and among premenopausal women. When it occurs in a younger patient, the most likely cause is excessive production of uric acid or an inability of the kidney to remove uric acid from the body. The uric acid can accumulate or deposit in joints and can cause kidney damage. Early diagnosis is important and is done by analyzing a sample (aspirate) of joint fluid. A diet low in purine, caffeine and alcohol is recommended for these patients. The typical case of gout occurring in a middle-aged man is easy to recognize, as the patient will likely consume large amounts of food and alcohol, have exaggerated facial coloring and suffer very severe toe pain. In such cases, gout is most likely to be caused by obesity, alcohol, high blood pressure or preventable heart disease. In the elderly, kidney disease and long-term use of diuretics (for treating a heart condition) are commonly associated with the development of gout. Gout in these cases is more common among women and can be recognized by the presence of lumps on or within the joints of the fingers and toes. These lumps are called tophi and are composed of uric acid deposits. Treatment of the elderly patient can be difficult because of the side effects of certain drugs. In many cases, drug treatment is not necessary. The nonsteroidal anti-inflammatory drugs, such as aspirin, may cause gastrointestinal symptoms and liver damage. Treatment with allopurinol can reduce blood levels of uric acid, and colchicine reduces the severity of a gout attack. However, these drugs have toxic side effects that become worse with increasing age of the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Uric acid metabolism

---

Levels of insulin related growth factor 1 in osteoarthritis of the knee

Article Abstract:

Low blood levels of insulin related growth factor 1 (IGF1) may not contribute to the development of osteoarthritis (OA) of the knee. OA is a noninflammatory degenerative joint disease that occurs mainly in elderly individuals. A study compared blood levels of IGF1 in 78 elderly patients with symptomatic OA of the knee to levels in 78 elderly individuals without OA of the knee. The average blood level of IGF1 was not significantly higher in patients with OA of the knee than in the healthy individuals. Blood levels of IGF1 dropped significantly with age but were not affected by other factors. One of the main complications of OA is cartilage loss associated with a disruption of the balance between cartilage synthesis and cartilage degradation. IGF1 plays an important role in maintaining this balance.

Measurement, Physiological aspects, Osteoarthritis, Joint diseases, Insulin-like growth factor 1, Insulin-like growth factor I

---

Gout is on the increase in New Zealand

Article Abstract:

The incidence of gout among both the native and European populations in New Zealand appears to be growing. The percentage of persons with gout or hyperuricemia was analyzed among 315 European and 342 Maori people in New Zealand and compared with previous population studies. There were more Maoris with gout and hyperuricemia than those of European descent particularly among men. There were a greater percentage of people in both populations with either condition than in previous years.

Health aspects, Maoris, New Zealanders

Similar abstracts:

• Abstracts: Diagnosis and management of HIV-associated periodontal lesions. Clinical management of HIV-related periodontitis: report of case
• Abstracts: Diagnosis and management of subglottic stenosis after neonatal ventilation. Multicentre randomised controlled trial of high against low frequency positive pressure ventilation
• Abstracts: Nutrition and bronchopulmonary dysplasia. The use of plasma in the neonatal period. Evaluation of paediatric intensive care in a regional centre
• Abstracts: Cross-national changes in the effects of peptic ulcer disease. Alternative management strategies for patients with suspected peptic ulcer disease
• Abstracts: Influenza vaccination in the prevention of acute otitis media in children. The causes of hospital-treated acute lower respiratory tract infection in children

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.