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Gout
Classification and external resources

A 1799 cartoon depicting gout.
ICD-10 M10.
ICD-9 274.00 274.1 274.8 274.9
OMIM 138900 300323
DiseasesDB 29031
eMedicine emerg/221 med/924 med/1112 oph/506 orthoped/124 radio/313
MeSH D006073
.Gout is a medical condition that usually presents with recurrent attacks of acute inflammatory arthritis (red, tender, hot, swollen joint).^ Gout is a disease involving inflammation of the joints and usually it occurs recurrently.
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

^ The joint becomes red, hot, swollen and extremely painful.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

^ Recurrent Gouty Arthritis The frequency of subsequent acute attacks of gout usually increases over time.
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 9 October 2009 4:56 UTC www.aafp.org [Source type: Academic]
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 20 November 2009 6:13 UTC newcms.aafp.org [Source type: Academic]

.It is caused by elevated levels of uric acid in the blood.^ Gout is caused by a chemical in the blood called uric acid (urate).
  • Gout | Health | Patient UK 27 January 2010 23:57 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ Chronic elevated blood urate levels .
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

^ Hyperuricemia – the presence of elevated levels of uric acid in the blood.

.The uric acid crystallizes and deposits in joints, tendons, and surrounding tissues.^ Uric acid crystals will cause inflammation and tissue damage where they deposit.
  • Gout - Kosmix : Reference, Videos, Images, News, Shopping and more... 27 January 2010 23:57 UTC health.kosmix.com [Source type: FILTERED WITH BAYES]

^ Uric acid can only crystallize in acid environments.
  • Gout Resource 27 January 2010 23:57 UTC goutresource.com [Source type: FILTERED WITH BAYES]

^ The accumulation of uric acid can crystallize and deposit in joints.
  • The Best Natural Solution For Any Type Of Gout 27 January 2010 23:57 UTC www.goutcurepatch.com [Source type: General]

.Gout affects 1% of Western populations at some point in their lives.^ PR: 6 Back pain affects 80% of Americans at some time in their lives.
  • Disease | Human-Diseases.Com - Worldwide Database of Medical Resources 9 October 2009 4:56 UTC www.human-diseases.com [Source type: Academic]

^ Several other conditions may at some point in their course resemble gout.

^ For these reasons, men over 40 years old account for about 90% of the population affected by gout .

[1]
.Treatment with NSAIDs, steroids, or colchicine improves symptoms.^ Low doses of NSAIDs and/or colchicine may be used for several months after introducing uric acid-reduction treatment to prevent another attack.
  • Gout - Uric Acid, Secondary Gout, Primary Gout - Life Extension Health Concern 27 January 2010 23:57 UTC www.lef.org [Source type: Academic]

^ The options available for the treatment of acute attacks of gout are NSAIDs, colchicine, corticosteroids, corticotropin and intra-articular corticosteroids.
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

^ Prophylactic agents (colchicine, NSAIDs, or systemic steroids) should be initiated concurrently with hypouricemic drugs to decrease the risk of an acute gouty attack.

.Once the acute attack has subsided, levels of uric acid are usually lowered via lifestyle changes and long term prevention with allopurinol.^ Allopurinol: to decrease production of uric acid .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Allopurinol is used to prevent gout attacks .
  • Gout | Health | Patient UK 27 January 2010 23:57 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ Medicines to lower uric acid levels are not given until a gout attack is over.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1]
Historically, it was known as "the disease of kings"[2] or "rich man's disease".[3]

Contents

Signs and symptoms

Tophi of the knee.
.Gout usually presents as recurrent attacks of acute inflammatory arthritis (a red, tender, hot, swollen joint).^ Gout is a disease involving inflammation of the joints and usually it occurs recurrently.
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

^ The joint becomes red, hot, swollen and extremely painful.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

^ Recurrent Gouty Arthritis The frequency of subsequent acute attacks of gout usually increases over time.
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 9 October 2009 4:56 UTC www.aafp.org [Source type: Academic]
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 20 November 2009 6:13 UTC newcms.aafp.org [Source type: Academic]

[1] .The joint that is most commonly affected is the first metatarsalphalangeal joint at the base of the big toe (approximately 75 percent of first attacks) and when this occurs it is known as podagra.^ This is why most gout attacks first occur in the big toe.

^ The joint most commonly affected is the big toe.
  • Gout Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 27 January 2010 23:57 UTC wrongdiagnosis.com [Source type: Academic]

^ Gout is characterized by swelling and intense pain in an affected joint - commonly the big toe).
  • Lisa McDowell - EzineArticles.com Expert Author 27 January 2010 23:57 UTC ezinearticles.com [Source type: FILTERED WITH BAYES]

.The reason gout usually presents in the feet is in part due to their lower temperature.^ However, following a kidney transplant, people are vulnerable to gout (which has an atypical upper limb and polyarticular presentation due to the effects of immunosuppressant drug regimens).
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Gout tends to attack joints in the feet and hands because the temperature in these joints is usually lower than in the rest of the body.
  • Patient information leaflet - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: General]
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Acute gout most often presents as attacks of pain, erythema, and swelling of one or a few joints in the lower extremities.
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

[1]
.People with long-standing hyperuricemia can form tophi (uric acid crystal deposits) in tissues.^ Uric acid crystals will cause inflammation and tissue damage where they deposit.
  • Gout - Kosmix : Reference, Videos, Images, News, Shopping and more... 27 January 2010 23:57 UTC health.kosmix.com [Source type: FILTERED WITH BAYES]

^ Uric acid can only crystallize in acid environments.
  • Gout Resource 27 January 2010 23:57 UTC goutresource.com [Source type: FILTERED WITH BAYES]

^ The accumulation of uric acid can crystallize and deposit in joints.
  • The Best Natural Solution For Any Type Of Gout 27 January 2010 23:57 UTC www.goutcurepatch.com [Source type: General]

.These are usually hard, non-painful deposits.^ These deposits give rise to inflammation of the joints, causing pain, swelling, redness and tenderness of the area.
  • gout 27 January 2010 23:57 UTC www.arthritis.ca [Source type: FILTERED WITH BAYES]

^ When located just under the surface of the skin, these deposits are usually firm and movable.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Ineffective processing of the uric acid leads to development of deposits of hard lumps in and around the joints and these humps lead to arthritis, a common occurrence among aged people.
  • Gout Home Remedies - Gout Treatment - Natural Remedies & Cure for Gout 27 January 2010 23:57 UTC www.natural-homeremedies.org [Source type: FILTERED WITH BAYES]

.Extensive tophi that invade bone are associated with arthritis due to bone erosion.^ Arthritis next remecade due arthritus knee bone spur fragments arthritis and sleep deprivation.
  • For more information about the changes please go to the Better Super website. 9 October 2009 4:56 UTC im.bluekapk.waw.pl [Source type: FILTERED WITH BAYES]

^ Classic radiologic features of gout include tophi, an overhanging edge of cortex and a "punched-out" erosion of bone with sclerotic borders 18 (Figure 4) .
  • Diagnosis and Management of Gout - April 1, 1999 - American Academy ofFamily Physicians 20 November 2009 6:13 UTC www.aafp.org [Source type: Academic]

^ Tophi could destroy bone and cartilage in the joints, similar to rheumatoid arthritis.

.Elevated levels of urine uric acid can lead to uric-acid crystals precipitating in the kidneys which may form kidney stones and lead to urate nephropathy.^ Uric acid can only crystallize in acid environments.
  • Gout Resource 27 January 2010 23:57 UTC goutresource.com [Source type: FILTERED WITH BAYES]

^ Urate can also form small, plate-like crystals in the kidneys, where they may aggregate to form gravel or stones.
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

^ Collection of urate crystals in the kidneys can lead to kidney stones.
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

[4]

Causes

.Hyperuricemia is the underlying cause of gout.^ Since gout is caused due to hyperuricemia, i.e.
  • What is Gout, Symptoms, Treatment & Causes 27 January 2010 23:57 UTC www.ayushveda.com [Source type: FILTERED WITH BAYES]

^ This is gout that is predominantly due to a specific underlying cause.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

^ In secondary gout , hyperuricemia is caused by drug therapy or by medical conditions other than an inborn metabolic disorder.

.This can occur for a number of reasons including dietary, genetic, or underexcretion of urate.^ This inability may occur for a number of reasons.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Like allopurinol, an increased number of gout attacks can occur when probenecid is started, and for this reason colchicine is often given for the first 6 months of therapy.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

[1] .About 10% of people with hyperuricemia develop gout.^ About 10 to 20% of gout sufferers develop kidney stones.
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

^ About 1 in 100 people develop gout.

^ The presence of urate does not itself lead to gout, and even people with higher-than-usual levels of urate may never go on to develop gout.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

[5]

Lifestyle

.About 12% of gout is attributed to dietary causes.^ The reason for this is that it takes a build up of about twenty years to cause a first gout attack.
  • Lisa McDowell - EzineArticles.com Expert Author 27 January 2010 23:57 UTC ezinearticles.com [Source type: FILTERED WITH BAYES]

^ I know someone who has suffered from gout who isn't a drinker and doesn't have an unhealthy diet, so I looked it up and only 12% of cases of gout are dietary in origin.
  • Dealing with half a drummer - alt.guitar.bass | Google Groups 27 January 2010 23:57 UTC groups.google.com [Source type: FILTERED WITH BAYES]

^ They are appropriate when gout is caused by under-excretion of uric acid, which occurs in about 80% of gout cases.

[1] .This includes a strong association with the consumption of alcohol,[6] sugar,[7] and meat and seafood.^ There is a proven and direct association between alcohol consumption and the presence of Gout.

^ While meat and certain types of seafood and shellfish do produce high levels of purines in the blood, research has suggested that not all purine-rich foods are associated with gout.

^ Modifiable risk factors for gout attacks include alcohol consumption, obesity, hypertension and occupational and environmental exposure to lead.
  • Diagnosis and Management of Gout - April 1, 1999 - American Academy ofFamily Physicians 20 November 2009 6:13 UTC www.aafp.org [Source type: Academic]

[8] .The intake of dairy products, vegetables, and the total protein intake do not affect the occurrence of gout.^ A series of epidemiological studies has shown that meat, fish and beer intake and obesity increase the risk of gout, while dairy products 10-12 decrease the risk.
  • Buy allopurinol online 9 October 2009 4:56 UTC get.xs8.org [Source type: Academic]

^ The study found that high levels of consumption of dairy products were associated with a decreased risk of gout.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Generally foods that are high in fats cause gout; likewise high level purines found in proteins, some beans and vegetables also cause gout.
  • Lisa McDowell - EzineArticles.com Expert Author 27 January 2010 23:57 UTC ezinearticles.com [Source type: FILTERED WITH BAYES]

[9]
.A sedentary lifestyle also increases the risk of developing the disease.^ This dangerous "mystery disease" increases the risk of heart disease, stroke, high blood pressure, diabetes, and sudden death!
  • Gout Diet | Gout Treatment | Natural Gout Remedies Cure 27 January 2010 23:57 UTC www.cureyourgout.com [Source type: General]
  • Gout Diet | Gout Treatment | Natural Gout Remedies Cure 27 January 2010 23:57 UTC www.cureyourgout.com [Source type: General]
  • Natural Gout Cures - How To Cure Gout Pain Naturally 27 January 2010 23:57 UTC www.getoutgout.com [Source type: General]

^ A 2004 study suggests that animal flesh sources of purine (such as beef and seafood) greatly increase the risk of developing gout.
  • Gout encyclopedia topics | Reference.com 27 January 2010 23:57 UTC www.reference.com [Source type: Academic]

^ However, after menopause the uricosuric effect is lost and risk of developing gout is increased.

[10]

Medical conditions

.Gout may present as a complication of other medical conditions.^ Hyperuricaemia may be present without gout.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Gout may be present without hyperuricaemia.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ It can be a result of some other medical condition.

.Gout also can develop as a co-morbidity of other diseases, including polycythaemia, intake of cytotoxics, obesity, diabetes, hypertension, renal disorders, and hemolytic anemia.^ Gout also can develop as co-morbidity of other diseases, including polycythaemia , leukaemia , intake of cytotoxics , obesity , diabetes , hypertension , renal disorders, and hemolytic anemia .
  • Gout encyclopedia topics | Reference.com 27 January 2010 23:57 UTC www.reference.com [Source type: Academic]

^ Gout is strongly associated with obesity, hypertension, hyperlipidemia and diabetes ...

^ Gout is strongly associated with obesity, hypertension, hyperlipidemia and diabetes.

.Gout is an important complication in a minority of solid organ transplants.^ The procedure itself poses a risk of gout, as does the medication (cyclosporine) used to prevent rejection of the transplanted organ.

[12]
.Gout may occur as a result of renal failure.^ Occur primarily in patients with renal failure.
  • Gout: Crystal-Induced Arthritides: Merck Manual Professional 27 January 2010 23:57 UTC www.merck.com [Source type: Academic]

^ May precipitate acute gout, nephrolithiasis, gastrointestinal upset, or rash; modifies renal handling of other drugs; use cautiously with heparin .
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]

^ Although gout most commonly occurs as an attack in a single big toe, other joints – the knee, the elbow or the wrist, for example – may be affected.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

[13] .An example of this is a condition known as Chronic Urate Nephropathy in which crystal deposits form in the renal tubules, interstitium and glomeruli.^ ARTICULAR GOUT: Conditions in which urate crystals deposit are seen in joints.
  • Visceral and Articular Gout 27 January 2010 23:57 UTC www.avianweb.com [Source type: FILTERED WITH BAYES]

^ Long-term deposition of crystals in the renal parenchyma can cause chronic urate nephropathy.
  • Diagnosis and Management of Gout - April 1, 1999 - American Academy ofFamily Physicians 20 November 2009 6:13 UTC www.aafp.org [Source type: Academic]

^ If the concentration of uric acid in the blood rises above normal levels, sodium urate crystals may form in the tendons, ligaments, and cartilage of the joints.
  • Gout Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 27 January 2010 23:57 UTC wrongdiagnosis.com [Source type: Academic]

.This results in elevated serum creatinine, urinary sediments, and hyperuricemia disproportionate to the degree of renal insufficiency.^ This process is characterized by hyperuricemia that is disproportional to the degree of renal impairment and is associated with a benign urinary sediment.

^ Diuretics result of hyperuricemia or not the treatment of urinary tract stones, the withdrawal will gradually disappear.
  • Gout - Blog Toplist 27 January 2010 23:57 UTC www.blogtoplist.com [Source type: FILTERED WITH BAYES]

^ Lead intoxication can damage the renal tubules, leading to impaired proximal tubular function with resultant hyperuricemia and gout.

.Renal impairment is common in patients with gout but usually occurs secondary to other conditions.^ Gout may occur alone (primary gout) or may be associated with other medical conditions or medications (secondary gout).

^ A number of other conditions can cause gout.

^ Secondary gout is caused by medications or medical conditions ...

.
Some studies have established a statistical connection between gout and lead poisoning,[14] and a significant correlation between levels of lead in the body, urate excretion and gout.
^ Lin, et al have statistical evidence linking gout to lead poisoning, and lead level in the body is significantly correlated with urate excretion and gout.
  • Gout encyclopedia topics | Reference.com 27 January 2010 23:57 UTC www.reference.com [Source type: Academic]

^ As a result, gout was common from lead poisoning.
  • Gout Remedies Questions 27 January 2010 23:57 UTC www.earthclinic.com [Source type: FILTERED WITH BAYES]

^ Studies have found an association between coffee drinking — both regular and decaffeinated coffee — and lower uric acid levels, though no study has demonstrated how or why coffee may have an influence on uric acid in your body.

[15] .It is known that lead sugar was formerly used to sweeten wine.^ It is known that lead sugar was used to sweeten wine, and that chronic lead poisoning is a cause of gout, which condition is then known as saturnine gout, because of its association with alcohol and excess.

^ It is known that lead sugar was used to sweeten wine, and that chronic lead poisoning is a cause of gout, and condition is then known as saturnine gout, because of its association with lead (Saturnus was the alchemists' term for the metal lead ).
  • Gout encyclopedia topics | Reference.com 27 January 2010 23:57 UTC www.reference.com [Source type: Academic]

^ Formerly, port wine was sweetened with litharge, causing lead poisoning, of which gout is a complication.

[16][17] .This condition is then known as saturnine gout, as saturnus is the alchemical term for metallic lead.^ It is known that lead sugar was used to sweeten wine, and that chronic lead poisoning is a cause of gout, and condition is then known as saturnine gout, because of its association with lead (Saturnus was the alchemists' term for the metal lead ).
  • Gout encyclopedia topics | Reference.com 27 January 2010 23:57 UTC www.reference.com [Source type: Academic]

^ Gout is one of the few rheumatological conditions that can be diagnosed with certainty, has a known cause and can be cured with appropriate therapy.
  • Gout Clinical Trials 27 January 2010 23:57 UTC www.clinicalconnection.com [Source type: Academic]
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

^ Gout especially favors the bunion joint, known as the 1st metatarso-phalangeal joint, which is the first joint involved in 75% of patients and is ultimately involved in over 90% of those with this condition.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

[18]

Pharmaceuticals

.Diuretics have been associated with attacks of gout; low doses of hydrochlorothiazide (HCTZ), however, do not seem to increase the risk.^ And some of the agents used for hypertension can increase the risk for gout attacks.

^ Erratic use will increase gout attacks.
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

^ Travel is an example of an activity that increases the risk of gout attacks.

[19]

Pathophysiology

.Gout occurs when crystals of uric acid, in the form of monosodium urate, precipitate on the articular cartilage of joints, on tendons, and in the surrounding tissues.^ The accumulation of uric acid can crystallize and deposit in joints.
  • The Best Natural Solution For Any Type Of Gout 27 January 2010 23:57 UTC www.goutcurepatch.com [Source type: General]

^ Gout is caused by an accumulation of urate crystals in the joints, inflaming the joint.
  • Gout Home Remedies for Natural Pain Relief 27 January 2010 23:57 UTC www.ayurvediccure.com [Source type: FILTERED WITH BAYES]

^ The overabundance of this uric acid will crystallize and settle in that joint and be pretty painful.
  • Lisa McDowell - EzineArticles.com Expert Author 27 January 2010 23:57 UTC ezinearticles.com [Source type: FILTERED WITH BAYES]

.Uric acid is a normal component of blood serum.^ I also checked my blood for uric acid levels and it was normal.
  • Natural Gout Treatment, Remedies | Cure Gouty Symptoms, Causes | Arthritis Gout Diet | Pain Relief Remedy | Herbal Home Therapy, Medicine 27 January 2010 23:57 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

^ Serum uric acid .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Uric acid elevation on blood testing .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

.Uric acid is more likely to form into crystals when there is hyperuricemia, although hyperuricemia is 10 times more common without clinical gout than with it.^ Uric acid stones can also form when you do not have gout or hyperuricemia.

^ Asymptomatic hyperuricemia is common and usually does not progress to clinical gout.
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

^ Gout , however, is more likely to be caused by kidney problems than is hyperuricemia the cause of kidney abnormalities.

[20] .Gout can also occur when serum uric acid is normal, and when it is abnormally low (hypouricemia).^ Gout is a condition with abnormally high levels of uric acid in the ...

^ Serum uric acid .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Gout occurs when too much uric acid builds up in the body.

.Paradoxically, acute attacks of gout can occur together with a sudden decrease in serum uric acid, such as due to use of drugs (uricosurics, xanthine oxidase inhibitors), or total parenteral nutrition.^ Allopurinol: to decrease production of uric acid .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Allopurinol is used to prevent gout attacks .
  • Gout | Health | Patient UK 27 January 2010 23:57 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ Treatment with allopurinol decreases the number of acute gout attacks despite persistently elevated serum uric acid levels.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

[21] .However, the sudden decrease may be a consequence of abrupt formation of crystals (removing uric acid from the serum), rather than a cause.^ Allopurinol: to decrease production of uric acid .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ It also may reduce excretion of uric acid.

^ Serum uric acid concentrations may be reduced with nonpharmacologic therapy.
  • Diagnosis and Management of Gout - April 1, 1999 - American Academy ofFamily Physicians 20 November 2009 6:13 UTC www.aafp.org [Source type: Academic]

.Regardless of the serum concentration of uric acid, precipitation of uric acid is markedly enhanced when the blood pH is low (acidosis).^ Serum uric acid concentrations may be reduced with nonpharmacologic therapy.
  • Diagnosis and Management of Gout - April 1, 1999 - American Academy ofFamily Physicians 20 November 2009 6:13 UTC www.aafp.org [Source type: Academic]

^ Serum uric acid .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ In either case, concentrations of uric acid increase in the blood.

.A similar pH-sensitive effect occurs in urine,[22] contributing to uric acid nephrolithiasis (kidney stones).^ Have one or more kidney stone made from uric acid.
  • Gout | Health | Patient UK 27 January 2010 23:57 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ Defective uric acid excretion also occurs when the kidneys are functioning poorly.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Elevated blood levels of uric acid can also result in uric kidney stones.

.Uric acid is a product of purine metabolism, and in humans is normally excreted in the urine.^ Allopurinol: to decrease production of uric acid .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Uric acid, the end product of purine metabolism, is a waste product that has no physiologic role.
  • Diagnosis and Management of Gout - April 1, 1999 - American Academy ofFamily Physicians 20 November 2009 6:13 UTC www.aafp.org [Source type: Academic]

^ Hypoxanthine is metabolized to xanthine and xanthine to uric acid.

.Purines are generated by the body via breakdown of cells in normal cellular turnover, and also are ingested as part of a normal diet.^ Purines can be generated by the body itself (via the breakdown of cells in normal cellular turnover) or can be ingested in purine-rich foods (e.g.

^ Urate is a normally harmless waste product which is formed when the body breaks down substances known as purines.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ In orthodox medicine, type-I diabetes is believed to be an autoimmune disease, in which something causes the body’s immune system to destroy normal insulin-producing cells of the pancreas.
  • Natural Health Society of Australia - Ask Roger a Question 9 October 2009 4:56 UTC www.health.org.au [Source type: FILTERED WITH BAYES]

.The kidneys are responsible for approximately two-thirds of uric acid excretion, with the liver responsible for the rest.^ It also may reduce excretion of uric acid.

^ We expect that approximately two-thirds of the Uric Acid to be removed from the body through the kidneys and urinary system.

^ Defective uric acid excretion also occurs when the kidneys are functioning poorly.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

Chemical crystallization

.An acute attack occurs as a result of an inflammatory reaction to crystals of sodium urate that are deposited in the joint tissue.^ This provokes an inflammatory reaction of these tissues.
  • Gout Remedies like apple cider vinegar on Earth Clinic, Your Source for Natural Cures. 27 January 2010 23:57 UTC www.earthclinic.com [Source type: General]
  • Gout Clinical Trials 27 January 2010 23:57 UTC www.clinicalconnection.com [Source type: Academic]

^ Cross-section of a joint, showing urate crystals deposited in the cartilage.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

^ As discussed earlier, gout is characterized by the acute or subacute attacks of joint or soft tissue inflammation resulting from MSU crystal deposition.

.The inflammatory response involves the local infiltration of granulocytes which phagocytise the urate crystals.^ The recently defined role of the NALP3 inflammasome in the inflammatory phase of gout suggests a potential role for interleukin-1 inhibition in urate crystal-induced inflammation.
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

^ In time, MSU crystals can provoke an inflammatory response that produces the symptoms characteristic of gout .

^ Chronic urate nephropathy in patients with chronic tophaceous gout can result from the deposition of urate crystals in the medullary interstitium and pyramids, resulting in an inflammatory reaction that can lead to fibrotic changes.

.Lactate is high in synovial tissues and in the leucocytes that associated with the inflammatory process which also favours the deposition of uric acid.^ It is a disorder associated with metabolism of uric acid.
  • Natural Gout Treatment, Remedies | Cure Gouty Symptoms, Causes | Arthritis Gout Diet | Pain Relief Remedy | Herbal Home Therapy, Medicine 27 January 2010 23:57 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

^ Whenever possible, synovial fluid should be aspirated and examined under polarizing light for uric acid crystals.
  • Natural Gout Treatment, Remedies | Cure Gouty Symptoms, Causes | Arthritis Gout Diet | Pain Relief Remedy | Herbal Home Therapy, Medicine 27 January 2010 23:57 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

^ In this condition, monosodium urate or uric acid crystals are deposited on the articular cartilage of joints, tendons and surrounding tissues due to elevated concentrations of uric acid in the blood stream.
  • Gout Remedies like apple cider vinegar on Earth Clinic, Your Source for Natural Cures. 27 January 2010 23:57 UTC www.earthclinic.com [Source type: General]

[23]

Kamikaze leukocytes

Self Perpetuating Fatal Phagocytosis
.KT Rajan studied phagocytosis of urate crystals by polymorphonuclear leucocytes.^ No randomized controlled trial (RCT) has studied the effect on clinical outcomes of testing for urate crystals in synovial fluid or tophi.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ After urate crystals deposit in soft tissues and joints, monocytes and macrophages are activated in an attempt to clear the crystals by phagocytosis.

.From his investigations with specific reference to phagocytosis of urate crystals by polymorphonuclear leucocytes he proposed a sequence of events that may initiate the inflammatory reaction in acute gout.^ Acute attacks may be indistinguishable from acute gout.

^ A definitive diagnosis of gout is from light microscopy of joint fluid aspirated from the joint (this test may be difficult to perform) to demonstrate intracellular monosodium urate crystals in synovial fluid polymorphonuclear leukocytes.

^ High levels of uric acid in the blood can lead to urate crystal formation and it's the accumulation of these crystals around joints that causes gout.

He concluded that :
(1) that neutrophil leucocytes avidly ingest microcrystals of sodium monourate
(2) that this causes the rapid degranulation and disintegration of the leucocytes
.(3) that fresh leucocytes ingest the debris and crystals liberated by the dead cells, and in their turn degranulate and die, thus possibly establishing a vicious circle in the system.^ CPPD crystals might not be as evident and thus possibly missed, especially if the analysis is not done by a trained examiner.

In support of his theory Rajan quoted research in the 1960’s where McCarty demonstrated that:
.The severity of the inflammatory reaction is dependent on the number of neutrophils that are available at the time of invasion by the bacteria or toxic agent.^ A number of effective antihyperuricemic agents are available.

^ The time it takes serum urate to reach target level will depend on the severity of the gout, and the number of joints affected.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ The celery seeds are believed to contain several anti-inflammatory agents that are supposed to be beneficial in reducing the swelling of the joints.
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

.In agranulocytosis the reaction to bacterial invaders by the host is functionally deficient and acute gouty effusions provoked by injecting crystals of uric acid into joints can be abolished by pretreating the host with drugs like vinblastine which reduce the total number of leucocytes available.^ The accumulation of uric acid can crystallize and deposit in joints.
  • The Best Natural Solution For Any Type Of Gout 27 January 2010 23:57 UTC www.goutcurepatch.com [Source type: General]

^ The overabundance of this uric acid will crystallize and settle in that joint and be pretty painful.
  • Lisa McDowell - EzineArticles.com Expert Author 27 January 2010 23:57 UTC ezinearticles.com [Source type: FILTERED WITH BAYES]

^ Gouty arthritis (acute joint inflammation) is caused by uric acid (urate) crystals that are deposited in joint tissue.
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

(McCarty, 1965). [24].

The wild fire

(A Gradual Fuel Increase Resulting in an Uncontrolled Burn)
Theodore Fields Director, Rheumatology Faculty Practice Plan, Hospital for Special Surgery New York suggests that
.Whatever the cause of elevated uric acid levels, the key event in gout is the movement of uric acid crystals into the joint fluid.^ Gout is medical condition characterized by abnormally elevated levels of uric acid in ...

^ The biologic precursor to gout is elevated serum uric acid levels (i.e., hyperuricemia).
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

^ The accumulation of uric acid can crystallize and deposit in joints.
  • The Best Natural Solution For Any Type Of Gout 27 January 2010 23:57 UTC www.goutcurepatch.com [Source type: General]

.Inflammatory chemicals are released when the body’s defense mechanisms, engulf the uric acid crystals.^ Spiked rods are uric acid crystals.
  • The Best Natural Solution For Any Type Of Gout 27 January 2010 23:57 UTC www.goutcurepatch.com [Source type: General]

^ The production of uric acid can be decreased in the body (e.g.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ By intensifying the body’s production of uric acid.

.All the signs of inflammation, including heat, redness, swelling and pain are caused by these chemicals.^ It is these crystals that cause the pain, swelling and inflammation associated with gout.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ They are also one of the chemicals responsible for causing pain and inflammation.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ These are not usually painful and generally cause no problems at all.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

.(cytokines) The inflammation attracts more white blood cells to the joint, which increases the inflammation.^ WBC = white blood cell .
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]

^ Intense joint inflammation occurs when white blood cells engulf the crystals.
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

^ This cycle also recruits more white blood cells to the joint which accelerates the inflammatory process.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

Matchstick model
Theodore stated
“When thinking of gout, a useful model has been proposed by Wortmann. .Uric acid crystals can be thought of like matches, which can sit quietly or can be ignited.^ Uric acid crystals can be thought of like matches, which can sit quietly or can be ignited.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Spiked rods are uric acid crystals.
  • The Best Natural Solution For Any Type Of Gout 27 January 2010 23:57 UTC www.goutcurepatch.com [Source type: General]

^ In this condition, monosodium urate or uric acid crystals are deposited on the articular cartilage of joints, tendons and surrounding tissues due to elevated concentrations of uric acid in the blood stream.
  • Gout Remedies like apple cider vinegar on Earth Clinic, Your Source for Natural Cures. 27 January 2010 23:57 UTC www.earthclinic.com [Source type: General]

.Crystals can be present for years in the cartilage, or even in the joint fluid, without causing inflammation.^ Pain and inflammation in joints which is caused due to the crystal deposits.
  • Gout Home Remedies - Gout Treatment - Natural Remedies & Cure for Gout 27 January 2010 23:57 UTC www.natural-homeremedies.org [Source type: FILTERED WITH BAYES]

^ Crystals can be present for years in the cartilage, or even in the joint fluid, without causing inflammation.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ In this condition, monosodium urate or uric acid crystals are deposited on the articular cartilage of joints, tendons and surrounding tissues due to elevated concentrations of uric acid in the blood stream.
  • Gout Remedies like apple cider vinegar on Earth Clinic, Your Source for Natural Cures. 27 January 2010 23:57 UTC www.earthclinic.com [Source type: General]

.Then, at some point, due to increasing number of crystals or other inciting factor, the matches are “struck” and the inflammation begins.^ Crystallization is governed by other factors as well.

^ Then, at some point, due to increasing number of crystals or other inciting factor, the matches are “struck” and the inflammation begins.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ This analogy is important both for conceptualizing the uric acid crystals in the joint and for understanding the various types of gout treatment (see below) – some of which attack the inflammation (pour water on the flaming matches) and some of which remove the uric acid crystals (take away the matches).
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

This analogy is important both for conceptualizing the uric acid crystals in the joint and for understanding the various types of gout treatment (see below) – some of which attack the inflammation (pour water on the flaming matches) and some of which remove the uric acid crystals (take away the matches).” [25]

Diagnosis

.
Spiked rods of uric acid (MSU) crystals photographed under a microscope with polarized light from a synovial fluid sample.
^ Whenever possible, synovial fluid should be aspirated and examined under polarizing light for uric acid crystals.
  • Natural Gout Treatment, Remedies | Cure Gouty Symptoms, Causes | Arthritis Gout Diet | Pain Relief Remedy | Herbal Home Therapy, Medicine 27 January 2010 23:57 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

^ The joint inflammation is precipitated by deposits of uric acid crystals in the joint fluid (synovial fluid) and joint lining (synovial lining).
  • The Best Natural Solution For Any Type Of Gout 27 January 2010 23:57 UTC www.goutcurepatch.com [Source type: General]

^ Crystal analysis is done with compensated polarized light.

Formation of uric acid crystals in the joints are associated with gout.

Synovial fluid

.A definitive diagnosis of gout is based upon the identification of monosodium urate (MSU) crystals in the synovial fluid.^ A definitive diagnosis requires aspiration and examination of synovial fluid to confirm the presence of monosodium urate crystals.
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 9 October 2009 4:56 UTC www.aafp.org [Source type: Academic]
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 20 November 2009 6:13 UTC newcms.aafp.org [Source type: Academic]

^ Testing can reveal the presence of monosodium urate (MSU) crystals, which will nearly always confirm a diagnosis of gout.

^ Monosodium urate crystals in synovial fluid 16 , 17 .
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]

[1] .They have a needle-like morphology and strong negative birefringence under polarized light.^ MSU crystals are birefringent, with strong negative elongation when viewed under compensated polarized light.

^ They are weakly birefringent under polarized light and have a rhomboid or rod-shaped appearance.

^ Needle shaped, negative birefringence .
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]

This test is difficult to perform and often requires a trained observer.[26]

Blood tests

.Hyperuricemia is a common feature of gout, so its presence supports a diagnosis of gout.^ The presence of podagra or tophi strongly supports a gout diagnosis.
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]

^ This special light will reveal the presence of monosodium urate (MSU) crystals, which will nearly always confirm a diagnosis of gout.

^ Blood tests may support the diagnosis by showing high urate levels, but these levels are also sometimes elevated in the absence of gout.
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

.However, gout can occur without hyperuricemia.^ McCarty DJ. Gout without hyperuricemia.
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]

^ More than 99% of primary gout cases, however, are idiopathic, meaning that the cause of the hyperuricemia cannot be determined.

^ Gout , however, is more likely to be caused by kidney problems than is hyperuricemia the cause of kidney abnormalities.

[27] .Hyperuricemia is defined as a plasma urate (uric acid) level greater than 420 μmol/L (7.0 mg/dL) in males, or 380 μmol/L in females.^ Hyperuricemia is defined as a plasma urate (uric acid) level greater than 420 μmol/L (7.0 mg/dL) in males (or 380 μmol/L in females); however, high uric acid level does not necessarily mean a person will develop gout.

^ The solubility threshold for uric acid is approximately 6.7 mg/dl.

^ Note: plasma urate level is interchnageable with serum uric acid level (SUA).
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

.However, a high uric acid level does not necessarily mean a person will develop gout.^ High levels of uric acid are associated with a number of conditions, including gout.

^ If a person has a very high level of SUA (e.g.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ The path leading to high concentrations of uric acid and gout is the following: .

.Urate is within the normal range in up to two-thirds of cases.^ Additionally, urate is within the normal range in up to two-thirds of cases.

^ At least two-thirds of cases affects more than one joint during a first attack.

^ Once the urate level has fallen to well within the normal range, you should continue on that dose of allopurinol.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

[28] .If gout was suspected, the serum urate test should be repeated once the attack has subsided.^ If gout is suspected, the serum urate test should be repeated once the attack has subsided.

^ Diagnosis Gout should be suspected in any case of acute monoarticular arthritis .
  • Natural Gout Treatment, Remedies | Cure Gouty Symptoms, Causes | Arthritis Gout Diet | Pain Relief Remedy | Herbal Home Therapy, Medicine 27 January 2010 23:57 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

^ The main goal of treatment is to decrease urate levels to less than the level of precipitation, which is 6.8 mg/dL. The therapeutic target level should be less than 6 mg/dL, at which level risk of gout attack is decreased and so is the formation of tophi (for which urate levels of <5 mg/dL are preferred).

.Other blood tests commonly performed are full blood count, electrolytes, renal function, thyroid function tests and erythrocyte sedimentation rate (ESR).^ Other blood tests commonly performed are full blood count, electrolytes, renal function and erythrocyte sedimentation rate (ESR).

^ Renal function (urea and electrolyte levels).
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ If uric acid in the urine exceeds a particular value, further tests for an enzyme defect or other identifiable cause of gout should be performed.

.This helps to exclude other causes of arthritis, most notably septic arthritis, and to investigate any underlying cause for the hyperuricaemia.^ But X-rays may help to rule out other causes of arthritis.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ This stage of gout is frequently confused with other forms of arthritis , most commonly osteoarthritis .
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Nevertheless, reviewing the diagnosis is vital to exclude any other underlying pathology.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

Differential

.A critical differential diagnosis in gout is septic arthritis.^ Diagnosis Gout should be suspected in any case of acute monoarticular arthritis .
  • Natural Gout Treatment, Remedies | Cure Gouty Symptoms, Causes | Arthritis Gout Diet | Pain Relief Remedy | Herbal Home Therapy, Medicine 27 January 2010 23:57 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

^ It is possible to have concomitant gout and septic arthritis at one time.

^ The severity of the fever and a high white-blood cell count in the joint fluid helps differentiate septic arthritis from gout, but at times it is difficult to tell the conditions apart.

.The only way to definitively rule out this diagnosis is via a joint aspiration and culture.^ Ruling Out Other Disorders As part of the diagnosis, other disorders that produce gout-like symptoms or cause hyperuricemia should be ruled out.

^ A definite diagnosis can be made if the needle-shaped urate crystals are found in tissue or joint fluid.
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

^ Joint aspiration should be considered in acute swollen joints if possible, and fluid should be analyzed for cell count, cultures, and crystals.

.Clinically, gout can be hard to distinguish from several other conditions, including chondrocalcinosis.^ A number of other conditions can cause gout.

^ Gout must be distinguished from conditions that can cause similar symptoms, such as pseudogout, a condition caused by calcium pyrophosphate crystals, septic arthritis (caused by an infection in a joint), and rheumatoid arthritis (an autoimmune arthritis).

^ In secondary gout , hyperuricemia is caused by drug therapy or by medical conditions other than an inborn metabolic disorder.

.Chondrocalcinosis is a very similar disease, caused by deposition of calcium pyrophosphate rather than uric acid.^ It is very similar to gout, but is caused by deposits of calcium pyrophosphate dihydrate crystals in and around the joints.

^ It is caused by deposits of calcium pyrophosphate dihydrate crystals in and around the joints.

^ Pseudogout (calcium pyrophosphate deposition disease) .
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]

.Gouty tophi, particularly when not located in a joint, can be mistaken for basal cell carcinoma[29] or other neoplasm.^ Gouty tophi involving the proximal interphalangeal joint with erythema of the overlying skin.
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 9 October 2009 4:56 UTC www.aafp.org [Source type: Academic]
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 20 November 2009 6:13 UTC newcms.aafp.org [Source type: Academic]

[30]

Prevention

.Both lifestyle modifications and medication can decrease uric acid levels.^ Allopurinol: to decrease production of uric acid .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ The production of uric acid can be decreased in the body (e.g.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Antihyperuricemic medications reduce levels of uric acid in the body.

.Medications however are not usually started until one to two weeks after an acute attack has resolved due to theoretical concerns of worsening the attack.^ Start allopurinol after two or more attacks of gout within a year or after the first attack in people with one or more tophi, or radiological features of gouty arthritis, or renal impairment, or known uric acid stones, or long-term diuretic medication needs: Start allopurinol 1–2 weeks after the inflammation has settled and titrate the dose every few weeks until the serum uric acid level is below 300 micromol/L. Use a low dose of nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose colchicine to prevent acute attacks of gout when starting allopurinol.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Start allopurinol after two or more attacks of gout within a year or after the first attack in people with one or more tophi, or radiological features of gouty arthritis, or renal impairment, or uric acid stones, or long-term diuretic medication needs: Start allopurinol 1–2 weeks after the inflammation has settled and titrate the dose every few weeks until the serum uric acid level is below 300 micromol/L. Use a low dose of nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose colchicine to prevent acute attacks of gout when starting allopurinol.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ There is a risk of precipitating acute attacks of gout for approximately 12 months after starting allopurinol [ Jordan et al, 2007 ] .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

[1] .They are often not recommended until after a second attack of gout has occurred,[1] unless destructive joint changes, tophi, or urate nephropathy exists.^ It is difficult to predict when an attack of gout will occur.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Gout attacks are sudden and often occur at night.
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

^ To enable the person to understand the nature of the condition, and the risks and benefits of the various drug and dietary treatment options To relieve the pain and inflammation of an acute attack of gout promptly To reduce the risk of recurrent attacks of gout — if not outweighed by the risks of treatment To minimize the risks of developing new tophi, and to resolve existing tophi To minimize the risks of developing joint damage, renal stones, and urate nephropathy To identify and modify risk factors for gout that may have other adverse effects on the person's health Outcome measures .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

[4] .It is not until this point that medications have been found to be cost effective.^ You Can Find Effective Hyperhidrosis Treatment Jonny Andrews used to suffer from excessive sweating until he found an effective Hyperhidrosis Treatment .
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

^ Jonny Andrews used to suffer from excessive sweating until he found an effective Hyperhidrosis Treatment .
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

[1] .Urate lowering measures should be titrated to decrease serum uric acid levels below 360 µmol/L (6 mg/dL).^ Allopurinol: to decrease production of uric acid .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ The target serum uric acid level is less than 6 mg per dL (355 μmol per L), 29 and doses of the urate-lowering therapy should be titrated upward until this target is reached.
  • Gout: An Update - September 15, 2007 - American Family Physician 27 January 2010 23:57 UTC www.aafp.org [Source type: Academic]

^ During urate-lowering therapy, the dose should be titrated upward until the serum uric acid level is less than 6 mg per dL (355 micromol per L).
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

[1]

Lifestyle

.Dietary and lifestyle choices may decrease the risk of gout.^ A series of epidemiological studies has shown that meat, fish and beer intake and obesity increase the risk of gout, while dairy products 10-12 decrease the risk.
  • Buy allopurinol online 9 October 2009 4:56 UTC get.xs8.org [Source type: Academic]

^ The study found that high levels of consumption of dairy products were associated with a decreased risk of gout.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Lifestyle and food choices to reverse your Gout fast, naturally, and for good.
  • "How To REVERSE GOUT NOW!" - The Gout-Reversing Breakthrough 27 January 2010 23:57 UTC cure-gout.com [Source type: General]

.Lowering intake of meat and seafood, consuming adequate vitamin C, limiting alcohol and fructose ingestion, and avoiding obesity have all been shown to be effective in preventing gout.^ Limit meat and seafood.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Avoid a diet rich in meat and seafood.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Avoid regular daily intake of meat, seafood, and alcohol (especially beer).
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[1] .Any lifestyle change that reduces blood pressure will have a favorable effect, but there are concerns that medications for hypertension may aggravate gout.^ Hypertension - persistently high blood pressure.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ High blood pressure (hypertension) - causes, treatments and medication .
  • Disease | Human-Diseases.Com - Worldwide Database of Medical Resources 9 October 2009 4:56 UTC www.human-diseases.com [Source type: Academic]

^ Avoid aspirin because it may abruptly change uric acid levels in the blood and may make symptoms worse.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[31]
.A low-calorie diet in obese men decreased uric acid levels by 100 µmol/L.[19] Vitamin C intake of 1,500 mg per day decreases the risk of gout by 45% compared to 250 mg per day.^ Allopurinol: to decrease production of uric acid .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Very low-calorie diets.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Alcohol intake and risk of incident gout in men: a prospective study.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]
  • Gout Remedies Questions 27 January 2010 23:57 UTC www.earthclinic.com [Source type: FILTERED WITH BAYES]

[32] .Coffee but not tea consumption is associated with a lower risk of gout.^ The study found that high levels of consumption of dairy products were associated with a decreased risk of gout.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ There is a proven and direct association between alcohol consumption and the presence of Gout.

^ Moderate consumption of wine (two glasses per day) was not associated with a significant increased risk [ Choi, 2005 ] .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

[33]

Allopurinol

.Allopurinol blocks uric acid production and is the most commonly used hypourecemic agent.^ Allopurinol: to decrease production of uric acid .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Drugs such as allopurinol to decrease production of uric acid by the body.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Uric acid, in humans, is the final product.

[1] .Chronic therapy is safe and well tolerated and can be used in people with renal impairment or urate stones.^ In elderly people, and in people with moderate renal impairment, use colchicine 500 micrograms once a day.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ If the 24-hour urine levels are abnormally elevated, then uricosuric agents should not be used to avoid an increased risk of urate stones.

^ Acute attacks of gout are relatively rare in people with renal impairment, due to the anti-inflammatory effects of uraemia.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

.Hypersensitivity occurs in a small number of people.^ In elderly people, symptoms are more likely to occur in a number of joints in the upper extremities, particularly the fingers.

[1]

Probenecid

.Probenecid is effective for treating hyperuricemia but has been found to be less effective than allopurinol.^ Confirmation of the presence of monosodium urate crystals is imperative so that patients with coincidental hyperuricemia and osteoarthritis are not incorrectly diagnosed with gout and unnecessarily treated with allopurinol (Zyloprim).
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 9 October 2009 4:56 UTC www.aafp.org [Source type: Academic]
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 20 November 2009 6:13 UTC newcms.aafp.org [Source type: Academic]

^ The 80mg dose of febuxostat brought more patients to less than 6mg/dL of uric acid than 300mg of allopurinol, the dose of allopurinol most commonly used.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ These agents may prove to be as effective and less harmful to the GI tract than NSAIDs.

[1]

Others

.Febuxostat, a non-purine inhibitor of xanthine oxidase, may be an alternative to allopurinol with equivalent effectiveness at reducing attacks of gout.^ CONCLUSIONS: Febuxostat is a promising alternative to allopurinol for the treatment of gout and hyperuricemia.
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

^ Febuxostat: a selective xanthine oxidase inhibitor for the treatment of hyperuricemia and gout.
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

^ Allopurinol gout attacks .
  • Buy allopurinol online 9 October 2009 4:56 UTC get.xs8.org [Source type: Academic]

The drug was approved by European Medicines Agency in 2008[34] and by the FDA in 2009.[35]
.EDTA, a chelating agent, has successfully increased uric acid excretion.^ Uricosuric agents increase elimination of uric acid by the kidneys.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Probenecid: to increase the excretion of uric acid .
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Hyperuricemia in primary gout arises or is presumed to arise from a genetic or other inborn disorders that cause metabolic problem resulting in overproduction of uric acid or reduced excretion of uric acid.

[36] .In rare cases, gout may be secondary to untreated sleep apnea via the release of purines as a by-product of the breakdown of oxygen-starved cells.^ If so, you may be suffering from sleep apnea.
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

^ To avoid Gout or hasten the process of curing Gout avoid Purine rich foods and beverages such as organ meats, poultry, seafood and products containing yeast.

^ A purine-rich diet rarely causes hyperuricemia, although it may precipitate an attack in some people with existing gout .

.Treatment for apnea can therefore be effective in lessening incidence of acute gout attacks.^ Algorithm for treatment of acute gout.
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 9 October 2009 4:56 UTC www.aafp.org [Source type: Academic]
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 20 November 2009 6:13 UTC newcms.aafp.org [Source type: Academic]

^ What if treatment fails in acute gout?
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Acute attacks may be indistinguishable from acute gout.

[37]

Management

.Treatment objectives include managing the symptoms of an acute attacks and preventing further attacks via reducing serum uric acid levels.^ The goal of treatment is to prevent future attacks, to reduce high levels of uric acid (hyperuricemia), and to identify and treat the causes of your hyperuricemia.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Treatment with allopurinol decreases the number of acute gout attacks despite persistently elevated serum uric acid levels.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ The management of an acute attack of gout is very different from the prevention of subsequent attacks.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

[38] .Options for treatment include application of cold, nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and colchicine.^ Manage an acute attack of gout by prescribing a nonsteroidal anti-inflammatory drug (NSAID) (e.g.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Non-steriodal anti-inflammatory drugs (NSAIDs) .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective for treating inflammation and pain from pseudogout.

[1]

Conservative

.Ice applied for 20 to 30 minutes several times a day decreases pain.^ To raise metabolic rate (and burn calories faster), it is necessary at least three days a week to have 20 – 30 minutes of vigorous activity or every day walk briskly for 30 minutes.
  • Natural Health Society of Australia - Ask Roger a Question 9 October 2009 4:56 UTC www.health.org.au [Source type: FILTERED WITH BAYES]

^ Until the growth of the new nail is complete, apply apple cider vinegar 2 or 3 times a day.
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

^ However, do not apply ice directly to your skin and never apply ice for more than 20 minutes at a time.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

[39][1]

NSAIDs

.NSAIDS are the usual first line treatment for gout with no significant difference between agents in effectiveness.^ There was no significant difference between treatments in any of the secondary efficacy variables.
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

^ However, gout typically strikes after 20 - 40 years of persistent hyperuricemia, so men who develop it usually experience their first attack between the ages of 30 and 50.

^ There was no difference in pain scores between the groups, but less adverse effects were seen with prednisolone than indometacin [ Man et al, 2007 ] .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

[1] .Improvement may be seen within 4 hours.^ Colchicine may be given to a healthy adult within 48 hours of an attack.

[1] .They however are not recommended in those with certain other health problems such as gastrointestinal bleeding, renal failure, or heart failure.^ They may also be given to people who cannot take NSAIDs for other reasons, such as those with chronic kidney failure, heart failure, gastrointestinal bleeding or those using a blood-thinner, such as warfarin.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Those at high risk for NSAID-related bleeding include the elderly, anyone with a history of an ulcer or gastrointestinal bleeding, patients with serious heart conditions, those who drink too much alcohol, and persons on certain medications, such anticoagulants (blood thinners), corticosteroids, or bisphosphonates (drugs used for osteoporosis).

^ To such I suppose the book may seem empty in the centre; to the others it is a room, a house of life, into which they themselves enter, and are tortured and purified.
  • Free Ebooks - The Letters of Robert Louis Stevenson, Volume II 9 October 2009 4:56 UTC www.bored.com [Source type: Original source]

[40] .While indomethacin is historically the most commonly used NSAID, due to concerns of side effects and no evidence of greater benefit, an alternative like ibuprofen may be preferred.^ Unfortunately, the use of NSAIDs is limited by side effects.
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 9 October 2009 4:56 UTC www.aafp.org [Source type: Academic]
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 20 November 2009 6:13 UTC newcms.aafp.org [Source type: Academic]

^ Common side effects of long-term use of NSAIDs can include: .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Some of the side effects that can be caused by NSAIDs are outlined below.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

[19] .For those at risk of gastric irritation from NSAIDs, an additional proton pump inhibitor may be given.^ Prevacid is the first proton-pump inhibitor specifically approved for protecting against ulcers in chronic NSAID users.

^ Note: some people who get dyspepsia from taking an NSAID may also be given gastroprotective medication.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Combining nitric oxide with NSAIDs may provide benefits similar to the COX-2 inhibitors.

[41]

Steroids

.Glucocorticoids have been found to be equally effective to NSAIDs[42] and may be used if contraindications exist for NSAIDs.^ All NSAIDs appear equally effective.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ NSAIDs should be avoided in patients who are intolerant of such medications or have other comorbid conditions contraindicating their use.

^ Low doses of colchicine or NSAIDs may be used to during this period for prevention of another attack.

[1] .Intra-articular steroids have also been found to be effective however the risk of concurrent joint infection must be ruled out.^ Gout must be distinguished from conditions that can cause similar symptoms, such as pseudogout, a condition caused by calcium pyrophosphate crystals, septic arthritis (caused by an infection in a joint), and rheumatoid arthritis (an autoimmune arthritis).

^ However, an X-ray may be used to help rule out other conditions which affect the joints, such as chondrocalcinosis (build up of calcium crystals in the joints).
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ It has been found to be effective, when combined with other herbs, to assist in relieving the inflammation that contributes to joint pain.
  • Natural Health Society of Australia - Ask Roger a Question 9 October 2009 4:56 UTC www.health.org.au [Source type: FILTERED WITH BAYES]

[1]

Colchicine

.Colchicine is an alternative for those unable to tolerate NSAIDs.^ Switching to an alternative NSAID or colchicine may be worth trying providing there are no contraindications.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Younger, otherwise healthy patients who can tolerate NSAIDs or colchicine may be treated with either.

^ If NSAIDs are contraindicated, or not tolerated, consider low-dose colchicine for a minimum of 6 weeks (often up to 6 months).
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

[1] .Its side effects (primarily gastrointestinal upset) has decreased its usage.^ Regular use of even over-the-counter NSAIDs may be hazardous for anyone and has been are associated with the following side effects: Ulcers and gastrointestinal bleeding.

^ The drug can cause gastrointestinal side effects at high dose, including nausea, vomiting, diarrhea, and abdominal cramps.

^ The possible side effects of probenecid and sulfinpyrazone include skin rashes, gastrointestinal problems, anemia, and kidney stone formation.

[43][44] .Gastrointestinal upset however depends on the dose and the risk can be decreased by using smaller yet still effective doses.^ They may be effective for gout, although there is no data on the use of these agents for gout patients as yet.

^ The doses used in trials were 40, 80, and 120 mg orally daily; however the dose to be used in clinical practice may be closer to 80 mg.

^ However, the relative frequency of use of these medications ibuprofen available in Germany since 1989 ; , the risk of varies among nations.
  • Buy allopurinol online 9 October 2009 4:56 UTC get.xs8.org [Source type: Academic]

[19] .Colchicine may interact with other commonly prescribed drugs such as atorvastatin and erythromycin among others.^ Allopurinol interacts with certain other drugs, such as azathioprine.

^ To such I suppose the book may seem empty in the centre; to the others it is a room, a house of life, into which they themselves enter, and are tortured and purified.
  • Free Ebooks - The Letters of Robert Louis Stevenson, Volume II 9 October 2009 4:56 UTC www.bored.com [Source type: Original source]

^ Treatment should be initiated while taking into consideration other comorbid conditions, such as renal disease, gastric disease, organ transplant, drug interactions, and others, because these will dictate the choice of therapy.

[44]

Epidemiology

.Gout affects 1% of the Western population at some point in their lifetime and is increasing in prevalence.^ There are some factors which can increase the level of urate in your blood, and therefore also increase your chances of developing gout.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ The following is a list of some conditions that can increase the chances of developing gout:- .
  • Gout Home Remedies - Gout Treatment - Natural Remedies & Cure for Gout 27 January 2010 23:57 UTC www.natural-homeremedies.org [Source type: FILTERED WITH BAYES]

^ Uric acid and other kidney stones are present in 10% to 25% of patients with primary gout, a prevalence more than 1,000 times that of the general population.

[1] This increases to 2% in men over the age of 30 and women over the age of 50.[40]
Different populations have different propensities to develop gout. .In the United States, gout is twice as prevalent in African American males as it is in European-Americans.^ It has been estimated that there may be as many as 5 million gout sufferers in the United States.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ In one study that followed male medical students for 28 years, the prevalence of gout was 5.8% in Caucasian men and 10.9% in African American men.

[45] .It is high among the peoples of the Pacific Islands, and the Māori of New Zealand, but rare in Australian aborigines despite the latter's higher mean concentration of serum uric acid.^ Serum uric acid .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ The path leading to high concentrations of uric acid and gout is the following: .

^ In this condition, monosodium urate or uric acid crystals are deposited on the articular cartilage of joints, tendons and surrounding tissues due to elevated concentrations of uric acid in the blood stream.
  • Gout Remedies like apple cider vinegar on Earth Clinic, Your Source for Natural Cures. 27 January 2010 23:57 UTC www.earthclinic.com [Source type: General]

[46]
.In the United States and Italy, attacks of gout occur more frequently in the spring.^ Pseudogout is more likely to occur in the autumn while gout attacks are most common in the spring.

^ It is difficult to predict when an attack of gout will occur.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Some experts recommend a 24-hour collection sample in patients with frequent gout attacks to determine with they are over-producers or under-execretors of uric acid.

[47][48]

History

Anton van Leeuwenhoek described the microscopic appearance of uric acid crystals in 1679.[49]
.The first written description of gout dates from 2,600 BC, when Egyptians noted gouty arthritis of the big toe.^ For example, gout is more likely if arthritis first appears in the big toe.

^ Acute gouty arthritis occurs when the first symptoms of gout appear.

^ Arthritis of big toe arthritis foods that agravate.
  • We show you how to find the cheapest....... 9 October 2009 4:56 UTC odd.beljacob.waw.pl [Source type: News]

Around 400 BC, the Greek physician Hippocrates also commented on gout.[49] Writing ca. 30 AD, Aulus Cornelius Celsus appeared to recognize many of the features of gout, including its link with a urinary solute, late onset in women, linkage with alcohol, and perhaps even prevention by dairy products:
."Again thick urine, the sediment from which is white, indicates that pain and disease are to be apprehended in the region of joints or viscera.^ At this stage, you tend to feel pain in joints and kidneys at each movement; with a complete treatment, the disease will eventually lead to kidney failure.

^ The following diseases also cause joint and muscle pain: .

^ Gout , an inflammatory joint disease causing acute pain and swelling, usually develops after a number of years of buildup of uric acid crystals in the joints and surrounding tissue.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

.Joint troubles in the hands and feet are very frequent and persistent, such as occur in cases of podagra and cheiragra.^ Joint troubles 80 in the hands and feet are very frequent and persistent, such as occur in cases of podagra and cheiragra.
  • LacusCurtius • Celsus — On Medicine — Book IV 9 October 2009 4:56 UTC penelope.uchicago.edu [Source type: Original source]

^ In polyarticular gout, the joints of the foot, ankle, knee, wrist, elbow, and hand are the most frequently affected.

^ Gout tends to attack joints in the feet and hands because the temperature in these joints is usually lower than in the rest of the body.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

.These seldom attack eunuchs or boys before coition with a woman, or women except those in whom the menses have become suppressed.^ Before starting one of these drugs, any previous acute attack should be completely controlled and the joints should not be inflamed.

^ Also, before starting one of these drugs, any previous acute attack should be completely controlled and the joints should not be inflamed.

^ Often women, in whom the blood is not being given out through the menses, expectorate blood.
  • LacusCurtius • Celsus — On Medicine — Book IV 9 October 2009 4:56 UTC penelope.uchicago.edu [Source type: Original source]

.Upon the commencement of pain blood should be let; for when this is carried out at once in the first stages it ensures health, often for a year, sometimes for always.^ Upon the commencement of pain blood should be let; for when this is carried out at once in the first stages it ensures health, often for a year, sometimes for always.
  • LacusCurtius • Celsus — On Medicine — Book IV 9 October 2009 4:56 UTC penelope.uchicago.edu [Source type: Original source]

^ I am speaking first-hand here, as it was my stay at Hopewood 41 years ago that completely changed my health from poor to very good.
  • Natural Health Society of Australia - Ask Roger a Question 9 October 2009 4:56 UTC www.health.org.au [Source type: FILTERED WITH BAYES]

^ First thing you can do is find out what is causing the pain.

.Some also, when they have washed themselves out by drinking asses' milk, evade this disease in perpetuity; some have obtained lifelong security by refraining from wine, mead and venery for a whole year; indeed this course should be adopted especially after the primary attack, even although it has subsided."^ I should not care for a whole year.
  • The Letters of Robert Louis Stevenson (12) 9 October 2009 4:56 UTC ebooks.adelaide.edu.au [Source type: Original source]

^ Some also, when they have washed themselves out by drinking asses' milk, evade this disease in perpetuity; some have obtained lifelong p457 security by refraining from wine, mead and venery for a whole year; indeed this course should be adopted especially after the primary attack, even although it has subsided.
  • LacusCurtius • Celsus — On Medicine — Book IV 9 October 2009 4:56 UTC penelope.uchicago.edu [Source type: Original source]

^ Some experts recommend a 24-hour collection sample in patients with frequent gout attacks to determine with they are over-producers or under-execretors of uric acid.

[50]
Colchicum was described for treatment of rheumatism and swelling in the Ebers Papyrus, ca. .1500 B.C.[51] The use of Colchicum corm for gout probably traces back to ca.^ The most widely used drugs for acute gout were colchicine, n = 42 (53%), and nonsteroidal antiinflammatory drugs (NSAID), n = 40 (51%).
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

550 A.D., as the "hermodactyl" recommended by Alexander of Tralles. .Colchicum corm was used by ibn Sina Persian physician and other Islamic physicians, was recommended by Ambroise Pare in the sixteenth century, and appeared in the London Pharmacopoeia of 1618.[52] In 1833 P.L. Geiger purified an active ingredient, which he named colchicine.^ Some physicians would start colchicine after one very severe or two moderately severe attacks of gout, and beyond that use allopurinol.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ These two, and other active ingredients in ginger, provide antiseptic, lymph-cleansing, circulation, and constipation relief qualities.
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

^ OBJECTIVES: To assess the efficacy and safety of systemic corticosteroids in the treatment of acute gout in comparison with placebo, NSAIDs, colchicine, other active drugs, other therapies, or no therapy.
  • Gout: Free Medical and Health Information on Gout Research and Treatment 27 January 2010 23:57 UTC www.lifestages.com [Source type: Academic]

[53] .Colchicum was brought to America by Benjamin Franklin; Franklin suffered from gout himself and had written humorous doggerel about the disease during his stint as Envoy to France.^ The most significant point is that the inflammation is not the disease; inflammation is the healing process brought about by the body to deal with some underlying irritant/s (or toxin/s).
  • Natural Health Society of Australia - Ask Roger a Question 9 October 2009 4:56 UTC www.health.org.au [Source type: FILTERED WITH BAYES]

^ Gout typically affects the first metatarsophalangeal joint (big toe) — this is the case in 70% of people at first presentation, and in 90% of people at some time during the disease.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Remember that the inflammation is not the disease; inflammation is the healing process brought about by the body to deal with some underlying irritant/s (toxins).
  • Natural Health Society of Australia - Ask Roger a Question 9 October 2009 4:56 UTC www.health.org.au [Source type: FILTERED WITH BAYES]

[54] .As a drug predating the FDA, colchicine was sold as a generic in the United States for many years.^ Gastrointestinal complications from the use of NSAIDs account for almost 100,000 hospitalizations and at least 16,000 deaths a year in the United States.

^ It has been estimated that there may be as many as 5 million gout sufferers in the United States.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

.In 2009 the FDA approved colchicine for gout flares, awarding Colcrys a three year term of market exclusivity, prohibiting generic sales, and increasing the price of the drug from $9 to $485 per bottle.^ Age from 16 years onwards Allopurinol tablets: 100mg once a day, increase every 2 weeks Allopurinol 100mg tablets Take one tablet once a day for 2 weeks, then take two tablets once a day for 2 weeks, then take three tablets once a day.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Over the long term (about 10 to 20 years) gout becomes a chronic disorder characterized by constant low-grade pain and mild or acute inflammation.

^ Possible side-effects: Elevation of blood pressure, ankle swelling, upset stomach, ulcer (long-term use may have an increased risk of heart attack or stroke, but gout use is generally very short-term).
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

[55][56]
.Around 200 AD, the Roman gladiatorial surgeon Galen described gout as a discharge of the four humors of the body in unbalanced amounts into the joints.^ Gout is often divided into four stages: .

^ Hyperuricemia is the underlying metabolic aberrancy in gout and is defined as the serum urate level, in body fluids, above which urate precipitates into monosodium urate crystals.

^ Gout is often divided into four symptomatic stages: Asymptomatic hyperuricemia.

.The word "gout" was initially used by Randolphus of Bocking, around 1200 AD. It is derived from the Latin word "gutta", meaning "a drop" (of liquid).^ Colchicine, a derivative of the autumn crocus (also called the meadow saffron), has been used against gout attacks for centuries.

^ The word asbestos is derived from Greek and means inextinguishable, and asbestos is a group of naturally occurring, heat-resistant fibrous silicates.
  • Disease | Human-Diseases.Com - Worldwide Database of Medical Resources 9 October 2009 4:56 UTC www.human-diseases.com [Source type: Academic]

^ The term ankylosing is derived from the Greek word ankylos, meaning stiffening of a joint, whi ankylosing spondylitis, .
  • Disease | Human-Diseases.Com - Worldwide Database of Medical Resources 9 October 2009 4:56 UTC www.human-diseases.com [Source type: Academic]

[49]
.The Dutch scientist Antonie van Leeuwenhoek described the microscopic appearance of urate crystals in 1679.[49] In 1848 English physician Alfred Baring Garrod realised that excess uric acid in the blood was the cause of gout.^ Gout is caused by too much uric acid in the blood.
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Colchicine: to decrease the ability of uric acid crystals to cause inflammation.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

^ Gout is caused by too much uric acid in the blood (hyperuricemia).
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

[57]
The Tyrannosaurus rex specimen known as "Sue" appears to have suffered from gout.[58]
.Historical treatments for gout include gin and numerous medications that have since been found to be not effective.^ Medications used in the treatment of gout include: .

^ Historically, lower prednisolone doses have been used for the treatment of acute gout in UK clinical practice.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Since gout attacks are usually quite painful, and often make walking difficult, most gout sufferers will request specific treatment for their painful condition.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

.Sodium bicarbonate (baking soda) is a traditional remedy,[59] thought to work by raising blood pH (lowering blood acidity).^ The intake of a few teaspoonful of baking soda in water increases the blood pH and helps lower the possibility of crystallization of uric acid the primary cause of gout.
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

^ Most of the cleaning tips work very well and keep you from using chemical cleaners....so go green and clean your coffeepot with some bicarbonate of baking soda.
  • 200 Amazing Secrets 9 October 2009 4:56 UTC www.anvari.org [Source type: General]

^ If you have water retention, half of the baking soda should be replaced with potassium bicarbonate or potassium citrate.
  • Gout Remedies like apple cider vinegar on Earth Clinic, Your Source for Natural Cures. 27 January 2010 23:57 UTC www.earthclinic.com [Source type: General]

.However, the added sodium may be inappropriate for some people.^ However, some people may be more at risk than others.
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ Most gout episodes are acute and last a few days, but the severity and frequency of attacks can increase, and some people may develop a chronic form of gout.

^ For people who need to take NSAIDs regularly, some agents are available that may protect against bleeding and ulcers.

Etymology

The word gout comes from the Latin word gutta (a drop).[1]

See also

References

  1. ^ a b c d e f g h i j k l m n o p q r s t u v w x Chen LX, Schumacher HR (October 2008). "Gout: an evidence-based review". J Clin Rheumatol 14 (5 Suppl): S55–62. doi:10.1097/RHU.0b013e3181896921. PMID 18830092. 
  2. ^ Kubitz possibly has gout."The Disease Of Kings - Forbes.com". Forbes. http://www.forbes.com/2003/04/01/cx_cd_0401feat.html. 
  3. ^ "Rich Man's Disease - definition of Rich Man's Disease in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia.". http://medical-dictionary.thefreedictionary.com/Rich+Man%27s+Disease. 
  4. ^ a b Tausche AK, Jansen TL, Schröder HE, Bornstein SR, Aringer M, Müller-Ladner U (August 2009). "Gout--current diagnosis and treatment". Dtsch Arztebl Int 106 (34-35): 549–55. doi:10.3238/arztebl.2009.0549. PMID 19795010. 
  5. ^ Vitart V, Rudan I, Hayward C, et al. (April 2008). "SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout". Nat. Genet. 40 (4): 437–42. doi:10.1038/ng.106. PMID 18327257. 
  6. ^ Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G (April 2004). "Alcohol intake and risk of incident gout in men: a prospective study". Lancet 363 (9417): 1277–81. doi:10.1016/S0140-6736(04)16000-5. PMID 15094272. 
  7. ^ Choi HK, Curhan G (February 2008). "Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study". BMJ 336 (7639): 309–12. doi:10.1136/bmj.39449.819271.BE. PMID 18244959. 
  8. ^ Choi HK, Liu S, Curhan G (January 2005). "Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey". Arthritis Rheum. 52 (1): 283–9. doi:10.1002/art.20761. PMID 15641075. 
  9. ^ Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G (March 2004). "Purine-rich foods, dairy and protein intake, and the risk of gout in men". N. Engl. J. Med. 350 (11): 1093–103. doi:10.1056/NEJMoa035700. PMID 15014182. 
  10. ^ http://www.the-family-doctor.com/the-family-doctor/g/gout.htm
  11. ^ http://www.ajmc.com/media/pdf/A141_Epidemiology.pdf
  12. ^ Stamp L, Searle M, O'Donnell J, Chapman P (2005). "Gout in solid organ transplantation: a challenging clinical problem". Drugs 65 (18): 2593–611. PMID 16392875. 
  13. ^ Trivieri, Larry; Ivker, Robert S.; Anderson, Robert H. (1999). The complete self-care guide to holistic medicine: treating our most common ailments. New York, N.Y: J.P. Tarcher/Putnam. ISBN 0-87477-986-3. OCLC 41211414. 
  14. ^ Lin JL, Tan DT, Ho HH, Yu CC (November 2002). "Environmental lead exposure and urate excretion in the general population". Am. J. Med. 113 (7): 563–8. doi:10.1016/S0002-9343(02)01296-2. PMID 12459402. 
  15. ^ Wright LF, Saylor RP, Cecere FA (August 1984). "Occult lead intoxication in patients with gout and kidney disease". J. Rheumatol. 11 (4): 517–20. PMID 6434739. 
  16. ^ Lin JL, Huang PT (April 1994). "Body lead stores and urate excretion in men with chronic renal disease". J. Rheumatol. 21 (4): 705–9. PMID 8035397. 
  17. ^ Shadick NA, Kim R, Weiss S, Liang MH, Sparrow D, Hu H (July 2000). "Effect of low level lead exposure on hyperuricemia and gout among middle aged and elderly men: the normative aging study". J. Rheumatol. 27 (7): 1708–12. PMID 10914856. 
  18. ^ Ball GV (1971). "Two epidemics of gout". Bull Hist Med 45 (5): 401–8. PMID 4947583. 
  19. ^ a b c d Laubscher T, Dumont Z, Regier L, Jensen B (December 2009). "Taking the stress out of managing gout". Can Fam Physician 55 (12): 1209–12. PMID 20008601. 
  20. ^ Virsaladze DK, Tetradze LO, Dzhavashvili LV, Esaliia NG, Tananashvili DE (May 2007). "[Levels of uric acid in serum in patients with metabolic syndrome] [Levels of uric acid in serum in patients with metabolic syndrome]" (in Russian). Georgian Med News (146): 35–7. PMID 17595458. 
  21. ^ Moyer RA, John DS (April 2003). "Acute gout precipitated by total parenteral nutrition". The Journal of rheumatology 30 (4): 849–50. PMID 12672211. 
  22. ^ Halabe A, Sperling O (1994). "Uric acid nephrolithiasis". Mineral and electrolyte metabolism 20 (6): 424–31. PMID 7783706. 
  23. ^ Drug Houses of Australia Pty Ltd 1989 MIMS Annual p. 234
  24. ^ Observations on phagocytosis of urate crystals by polymorphonuclear leucocytes [1] K. T. RAJAN Oxford Regional Rheumatic Diseases Research Centre, Stoke Mandeville Hospital, Aylesbury, Bucks. Rajan, K. T. (1975). Annals of the Rheumatic Diseases, 34, 54
  25. ^ Theodore Fields Director, Rheumatology Faculty Practice Plan, Hospital for Special Surgery New York, NY [[2] "The Gout Knol"]. [3]. 
  26. ^ PMID 18299687
  27. ^ Sturrock R (2000). "Gout. Easy to misdiagnose". BMJ 320 (7228): 132–3. doi:10.1136/bmj.320.7228.132. PMID 10634714. PMC 1128728. http://bmj.bmjjournals.com/cgi/content/full/320/7228/132. 
  28. ^ Siva C, Velazquez C, Mody A, Brasington R (2003). "Diagnosing acute monoarthritis in adults: a practical approach for the family physician". Am Fam Pghysician 68 (1): 83–90. PMID 12887114. 
  29. ^ Jordan DR, Belliveau MJ, Brownstein S, McEachren T, Kyrollos M (2008). "Medial canthal tophus". Ophthal Plast Reconstr Surg 24 (5): 403–4. doi:10.1097/IOP.0b013e3181837a31. PMID 18806664. 
  30. ^ Sano K, Kohakura Y, Kimura K, Ozeki S (March 2009). "Atypical Triggering at the Wrist due to Intratendinous Infiltration of Tophaceous Gout". Hand (N Y) 4 (1): 78–80. doi:10.1007/s11552-008-9120-4. PMID 18780009. 
  31. ^ Emkey GR and Reginato AM (2009). "All about gout and pseudogout". Journal of Musculoskeletal Medicine 26 (10). http://www.musculoskeletalnetwork.com/display/article/1145622/1476306. 
  32. ^ Choi HK, Gao X, Curhan G (March 2009). "Vitamin C intake and the risk of gout in men: a prospective study". Arch. Intern. Med. 169 (5): 502–7. doi:10.1001/archinternmed.2008.606. PMID 19273781. 
  33. ^ Choi HK, Curhan G (June 2007). "Coffee, tea, and caffeine consumption and serum uric acid level: the third national health and nutrition examination survey". Arthritis Rheum. 57 (5): 816–21. doi:10.1002/art.22762. PMID 17530681. 
  34. ^ "Adenuric (febuxostat) receives marketing authorisation in the European Union" (PDF). http://www.ipsen.com/articles/mediacentre/pressreleases/20080505___autorisation_adenuric_eu_10.pdf. Retrieved 2008-05-28. 
  35. ^ "FDA Okays New Treatment for Gout-Related Hyperuricemia". http://www.medpagetoday.com/ProductAlert/Prescriptions/12902. Retrieved 2009-05-25. 
  36. ^ Lin JL, Yu CC, Lin-Tan DT, Ho HH (July 2001). "Lead chelation therapy and urate excretion in patients with chronic renal diseases and gout". Kidney Int. 60 (1): 266–71. doi:10.1046/j.1523-1755.2001.00795.x. PMID 11422760. 
  37. ^ Abrams B (February 2005). "Gout is an indicator of sleep apnea". Sleep 28 (2): 275. PMID 16171252. 
  38. ^ Zhang W, Doherty M, Bardin T, et al. (October 2006). "EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)". Ann. Rheum. Dis. 65 (10): 1312–24. doi:10.1136/ard.2006.055269. PMID 16707532. 
  39. ^ Schlesinger N et al. (2002). "Local ice therapy during bouts of acute gouty arthritis". J. Rheumatol. 29 (2): 331–4. doi:10.1093/rheumatology/29.5.331. PMID 11838852. 
  40. ^ a b Winzenberg T, Buchbinder R (July 2009). "Cochrane Musculoskeletal Group review: acute gout. Steroids or NSAIDs? Let this overview from the Cochrane Group help you decide what's best for your patient". J Fam Pract 58 (7): E1–4. PMID 19607767. 
  41. ^ Clinical Knowledge Summaries. "Gout - Management -- What treatment is recommended in acute gout?". National Library for Health. http://cks.library.nhs.uk/gout/management/detailed_answers/managing_acute_gout/treatment. Retrieved 2008-10-26. 
  42. ^ Man CY, Cheung IT, Cameron PA, Rainer TH (2007). "Comparison of oral prednisolone/paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute goutlike arthritis: a double-blind, randomized, controlled trial". Annals of emergency medicine 49 (5): 670–7. doi:10.1016/j.annemergmed.2006.11.014. PMID 17276548. 
  43. ^ Gout~Medication at eMedicine
  44. ^ a b "Information for Healthcare Professionals: New Safety Information for Colchicine (marketed as Colcrys)". U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm174315.htm. 
  45. ^ Rheumatology Therapeutics Medical Center. "What Are the Risk Factors for Gout?". http://www.arthritisconsult.com/gout.html#risk. Retrieved 2007-01-26. 
  46. ^ Roberts-Thomson RA, Roberts-Thomson PJ (May 1999). "Rheumatic disease and the Australian aborigine". Ann. Rheum. Dis. 58 (5): 266–70. doi:10.1136/ard.58.5.266. PMID 10225809. PMC 1752880. http://ard.bmjjournals.com/cgi/content/full/58/5/266. 
  47. ^ Schlesinger N, Gowin KM, Baker DG, Beutler AM, Hoffman BI, Schumacher HR (February 1998). "Acute gouty arthritis is seasonal". J. Rheumatol. 25 (2): 342–4. PMID 9489831. 
  48. ^ Gallerani M, Govoni M, Mucinelli M, Bigoni M, Trotta F, Manfredini R (October 1999). "Seasonal variation in the onset of acute microcrystalline arthritis". Rheumatology (Oxford) 38 (10): 1003–6. doi:10.1093/rheumatology/38.10.1003. PMID 10534553. http://rheumatology.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=10534553. 
  49. ^ a b c d Pillinger, MH; Rosenthal P, Abeles AM (2007). "Hyperuricemia and gout: new insights into pathogenesis and treatment". Bulletin of the NYU Hospital for Joint Diseases 65 (3): 215–221. PMID 17922673. http://www.nyuhjdbulletin.org/Permalink.aspx?permalinkId=0c3ec9d1-8cc8-49d5-850d-4c5a55cb0669. 
  50. ^ Celsus, Bill Thayer's edition at LacusCurtius
  51. ^ Wallace Graham and James B. Roberts (1953). "Intravenous colchicine in the treatment of gouty arthritis". Ann Rheum Dis 12 (1): 16–19. doi:10.1136/ard.12.1.16. PMID 13031443. PMC 1030428. http://ard.bmj.com/content/12/1/16.full.pdf. 
  52. ^ Edward F. Hartung (1954). "History of the Use of Colchicum and related Medicaments in Gout". pp. 190–200. doi:doi: 10.1136/ard.13.3.190. http://ard.bmj.com/content/13/3/190.full.pdf.  (free BMJ registration required)
  53. ^ 81. Geiger, P. L. Ann. Chem. Pharm. (later, Liebigs .Vnn.) 7:274. 1833.
  54. ^ Manuchair S. Ebadi. "Pharmacodynamic basis of herbal medicine". http://books.google.com/books?id=CMJKgfhCKzIC&pg=PA275&lpg=PA275. 
  55. ^ Kurt R. Karst (2009-10-21). "California Court Denies Preliminary Injunction in Lanham Act Case Concerning Unapproved Colchicine Drugs". http://www.fdalawblog.net/fda_law_blog_hyman_phelps/2009/10/california-court-denies-preliminary-injunction-in-lanham-act-case-concerning-unapproved-colchicine-d.html. 
  56. ^ Harris Meyer (2009-12-29). "The High Price of FDA Approval". Kaiser Health News and the Philadelphia Inquirer. http://www.kaiserhealthnews.org/Stories/2009/December/29/FDA-approval.aspx. 
  57. ^ Storey GD (October 2001). "Alfred Baring Garrod (1819-1907)". Rheumatology (Oxford, England) 40 (10): 1189–90. doi:10.1093/rheumatology/40.10.1189. PMID 11600751. http://rheumatology.oxfordjournals.org/cgi/content/full/40/10/1189. 
  58. ^ Rothschild, BM; Tanke D, Carpenter K (1997). "Tyrannosaurs suffered from gout". Nature 387 (6631): 357. doi:10.1038/387357a0. PMID 9163417. http://www.nature.com/nature/journal/v387/n6631/abs/387357a0.html. 
  59. ^ The British Pharmaceutical Codex. Published by direction of the Council of the Pharmaceutical Society of Great Britain, 1911. Sodium

External links

.
  • Gout: Medline Plus
  • Saag KG, Choi H (2006).^ Gradual weight loss may improve uric acid levels and reduce the frequency of gout attacks [ Saag and Choi, 2006 ] .
    • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

    ^ Saag KG and Choi H: Epidemiology, risk factors, and lifestyle modifications for gout.
    • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

    ^ Abstract ] [ Free Full-text ] Saag, K.G. and Choi, H. (2006 ) Epidemiology, risk factors, and lifestyle modifications for gout.
    • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

    ."Epidemiology, risk factors, and lifestyle modifications for gout". Arthritis Res.^ What are the causes and risk factors for gout?
    • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

    ^ Being overweight is a risk factor for gout.
    • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

    ^ What are the risk factors for gout?

    .Ther.
    8 Suppl 1: S2. doi:10.1186/ar1907.^ Arthritis Res Ther 8 Suppl 1:S2, 2006.
    • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

    PMID 16820041. 

1911 encyclopedia

Up to date as of January 14, 2010

From LoveToKnow 1911

.Medical warning!
This article is from the 1911 Encyclopaedia Britannica.^ This article is from the 1911 Encyclopaedia Britannica.

.Medical science has made many leaps forward since it has been written.^ Medical science has made many leaps forward since it has been written.

^ And I think this will be the next great step forward for medical science.
  • Questions Being Raised About the Importance of Diet on Gout 27 January 2010 23:57 UTC www.beatinggout.com [Source type: FILTERED WITH BAYES]

^ Gout is a disease that medical science obsessed over for, well, since medical science came into being.
  • Uloric | Beating Gout 27 January 2010 23:57 UTC www.beatinggout.com [Source type: General]
  • Questions Being Raised About the Importance of Diet on Gout 27 January 2010 23:57 UTC www.beatinggout.com [Source type: FILTERED WITH BAYES]

.This is not a site for medical advice, when you need information on a medical condition, consult a professional instead.^ Medical advice If you need medical help now ...
  • Gout - Treatment 27 January 2010 23:57 UTC www.nhs.uk [Source type: General]

^ If you have, or suspect to have any medical condition, you are urged to consult your ...

^ Need more information about medication you've been prescribed?

.GOUT, the name rather vaguely given, in medicine, to a constitutional disorder which manifests itself by inflammation of the joints, with sometimes deposition of urates of soda, and also by morbid changes in various important organs.^ ARTICULAR GOUT: Conditions in which urate crystals deposit are seen in joints.
  • Visceral and Articular Gout 27 January 2010 23:57 UTC www.avianweb.com [Source type: FILTERED WITH BAYES]

^ Visceral gout (Visceral urate deposition) .
  • Visceral and Articular Gout 27 January 2010 23:57 UTC www.avianweb.com [Source type: FILTERED WITH BAYES]

^ Gout symptoms develop when monosodium urate crystals develop and deposit in the joints.
  • Gout: causes, symptoms, food & diet, remedy, treatment, cures 9 October 2009 4:56 UTC clddufjord.ca [Source type: FILTERED WITH BAYES]

.The term gout, which was first used about the end of the 13th century, is derived through the Fr.^ It has been used against gout attacks for centuries.

^ The term gout, which was first used about the end of the 13th century, is derived through the Fr.

^ If you have a remedy you would like to try, talk to your doctor about the gout remedies in terms of using them with your medication to understand if it is safe, and how to use it.
  • Gout Remedies 27 January 2010 23:57 UTC gout-remedies.net [Source type: FILTERED WITH BAYES]

goutte from the Lat. .gotta, a drop, in allusion to the old pathological doctrine of the dropping of a morbid material from the blood within the joints.^ The level of uric acid in your blood usually begins to drop within 24 hours after the first dose of allopurinol.

.The disease was known and described by the ancient Greek physicians under various terms, which, however, appear to have been applied by them alike to rheumatism and gout.^ Gout is an ancient disease.
  • AllAbout Gout & How to Fight Back... The Facts Put Simply 27 January 2010 23:57 UTC www.joint-pain-forum.com [Source type: FILTERED WITH BAYES]

^ Gout is a painful rheumatic disease.

^ It was first described by the ancient Greeks.
  • Drug InfoNet Doctors' Answers to Frequently Asked Questions - Gout 27 January 2010 23:57 UTC www.druginfonet.com [Source type: FILTERED WITH BAYES]

.The general term arthritis (iipOpov, a joint) was employed when many joints were the seat of inflammation; while in those instances where the disease was limited to one part the terms used bore reference to such locality; hence podagra *Sawa, from 7roin, the foot, and eypa, a seizure), chiragra (Xelp, the hand), gonagra (-Oyu, the knee), &c.^ Arthritis is a general term for a group of more than 100 diseases.
  • Gout Treatment, Gout Remedies, Supplements, Gout Cure 27 January 2010 23:57 UTC www.morphemeremedies.com [Source type: FILTERED WITH BAYES]

^ The term "gout" commonly is used to refer to the painful arthritis attacks.

^ Steroid injections are sometimes used for large joints (such as the knee).
  • Gout - information, symptoms and treatments 27 January 2010 23:57 UTC hcd2.bupa.co.uk [Source type: FILTERED WITH BAYES]

.Hippocrates in his Aphorisms speaks of gout as occurring most commonly in spring and autumn, and mentions the fact that women are less liable to it than men.^ Less than 5% of patients with gout are female.

^ Pseudogout is more likely to occur in the autumn while gout attacks are most common in the spring.
  • Channel Management System- Washington, DC 27 January 2010 23:57 UTC www.georgetownuniversityhospital.org [Source type: Academic]
  • Gout - Chronic Diagnosis - Gout - Chronic Health Information - NY Times Health 27 January 2010 23:57 UTC health.nytimes.com [Source type: FILTERED WITH BAYES]
  • Gout 27 January 2010 23:57 UTC preventdisease.com [Source type: Academic]

^ Gout occurs most often in older men.
  • Gout Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 27 January 2010 23:57 UTC wrongdiagnosis.com [Source type: Academic]

.He also gives directions as to treatment.^ He also gives directions as to treatment.

.Celsus gives a similar account of the disease.^ Celsus gives a similar account of the disease.

.Galen regarded gout as an unnatural accumulation of humours in a part, and the chalk-stones as the concretions of these, and he attributed the disease to over-indulgence and luxury.^ Galen regarded gout as an unnatural accumulation of humours in a part, and the chalk -stones as the concretions of these, and he attributed the disease to over- indulgence and luxury.

^ IT'S KNOWN as the disease of kings and regarded as an inevitable consequence of a lifetime of rich food and over-indulgence.
  • Gout News - Topix 27 January 2010 23:57 UTC www.topix.com [Source type: General]
  • Gout News - Topix 27 January 2010 23:57 UTC www.topix.net [Source type: General]

^ As regards the kidneys, 55 these when they have become affected, continue diseased for a long while.
  • LacusCurtius • Celsus — On Medicine — Book IV 9 October 2009 4:56 UTC penelope.uchicago.edu [Source type: Original source]

.Gout is alluded to in the works of Ovid and Pliny, and Seneca, in his 95t h epistle, mentions the prevalence of gout among the Roman ladies of his day as one of the results of their high living and debauchery.^ This one has worked for a lot of gout patients within a few days.
  • http://gout-smashers-guide.com/ 27 January 2010 23:57 UTC gout-smashers-guide.com [Source type: FILTERED WITH BAYES]

^ Gout is alluded to in the works of Ovid and Pliny , and Seneca , in his 95t h epistle , mentions the prevalence of gout among the Roman ladies of his day as one of the results of their high living and debauchery.

^ About one in five (21 percent) employed gout patients say that they have missed work in the last year due to a gout flare, with 23 percent saying they missed seven work days or more.
  • Uricelax Gout Treatment - Alleviate Gout Symptoms Naturally 27 January 2010 23:57 UTC www.uricelax.com [Source type: FILTERED WITH BAYES]

.Lucian, in his Tragopodagra, gives an amusing account of the remedies employed for the cure of gout.^ What is the natural cures gout remedy ?
  • natural cures gout - Natural Cures Gout- Stop Taking Pain Killers and Finally Treat Gout 27 January 2010 23:57 UTC www.ideamarketers.com [Source type: General]

^ Have another natural cure for Gout Remedies ?
  • Gout Remedies Questions 27 January 2010 23:57 UTC www.earthclinic.com [Source type: FILTERED WITH BAYES]

^ Filed under Gout Cures , Gout Remedies .

.In all times this disease has engaged a large share of the attention of physicians, from its wide prevalence and from the amount of suffering which it entails.^ In all times this disease has engaged a large share of the attention of physicians, from its wide prevalence and from the amount of suffering which it entails.

^ Keep a small amount of baking soda in ashtrays at all times.
  • Tips 9 October 2009 4:56 UTC www.lonnieworld.com:11888 [Source type: General]
  • Print Page - 200 excellent tips on how to do anything 9 October 2009 4:56 UTC www.caliopes-corner.co.uk [Source type: General]
  • Toronto Website Designs - Mississauga , Brampton, Toronto Graphics Design, Website, Video Production Company - 200 Problem Solving Tips - Mississauga, Toronto 9 October 2009 4:56 UTC lgvisiondesigns.com [Source type: General]

^ Old age is a time when you suffer from all kinds of medical conditions.

.Sydenham, the famous English physician of the 17th century, wrote an important treatise on the subject, and his description of the gouty paroxysm, all the more vivid from his having himself been afflicted with the disease for thirty-four years, is still quoted by writers as the most graphic and exhaustive account of the symptomatology of gout.^ Sydenham , the famous English physician of the 17th century, wrote an important treatise on the subject, and his description of the gouty paroxysm , all the more vivid from his having himself been afflicted with the disease for thirty-four years, is still quoted by writers as the most graphic and exhaustive account of the symptomatology of gout.

^ Gout is one of the most painful diseases a person can be afflicted with.

^ Often quoted, the English physician Thomas Sydenham's classic description of his own gouty sufferings is as true today as it was in the 17th century: .
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 9 October 2009 4:56 UTC www.aafp.org [Source type: Academic]
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 20 November 2009 6:13 UTC newcms.aafp.org [Source type: Academic]

.Subsequently Cullen, recognizing gout as capable of manifesting itself in various ways, divided the disease into regular gout, which affects the joints only, and irregular gout, where the gouty disposition exhibits itself in other forms; and the latter variety he subdivided into atonic gout, where the most prominent symptoms are throughout referable to the stomach and alimentary canal; retrocedent gout, where the inflammatory attack suddenly disappears from an affected joint and serious disturbance takes place in some internal organ, generally the stomach or heart; and misplaced gout, where from the first the disease does not appear externally, but reveals itself by an inflammatory attack of some internal part.^ This is why most gout attacks first occur in the big toe.

^ Diseases with similar symptoms to gout.

^ To prevent gout attacks take with bromelain.

.Dr Garrod, one of the most eminent authorities on gout, adopted a division somewhat similar to, though simpler than that of Cullen, namely, regular gout, which affects the joints alone, and is either acute or chronic, and irregular gout, affecting non-articular tissues, or disturbing the functions of various organs.^ If more than one joint is affected, it is known as polyarticular gout .

^ Attacks are unusually severe or affect more than one joint.

^ Gout can affect different joints of the body.
  • Ankle Gout 27 January 2010 23:57 UTC www.goutcures.org [Source type: FILTERED WITH BAYES]

.It is often stated that the attack of gout comes on without any previous warning; but, while this is true in many instances, the reverse is probably as frequently the case, and the premonitory symptoms, especially in those who have previously suffered from the disease, may be sufficiently precise to indicate the impending seizure.^ Attacks of gout are readily excited in those predisposed to the disease.

^ You may be suffering with gout.
  • baking soda gout | Is Red Clover A Good Gout Herbal Medicine? 9 October 2009 4:56 UTC symptomsofgout.info [Source type: FILTERED WITH BAYES]
  • side effects of allopurinol | A Natural Remedy For Gout. Why You Should Make Strawberries Part Of Your Gout Diet 9 October 2009 4:56 UTC symptomsofgout.info [Source type: FILTERED WITH BAYES]

^ Gout is a condition that usually attacks immediately and without many warning signs.
  • Ankle Gout 27 January 2010 23:57 UTC www.goutcures.org [Source type: FILTERED WITH BAYES]

.Among the more common of these may be mentioned marked disorders of the digestive organs, with a feeble and capricious appetite, flatulence and pain after eating, and uneasiness in the right side in the region of the liver.^ A weak and unpredictable appetite Digestive disorders Feelings of uneasiness in the region of the liver.

^ Among the more common of these may be mentioned marked disorders of the digestive organs , with a feeble and capricious appetite, flatulence and pain after eating, and uneasiness in the right side in the region of the liver .

^ In the joints, these uric acid crystals cause inflammatory arthritis, which in turn leads to intermittent swelling, redness, heat, pain, and stiffness in the joints.It may be sudden.
  • If you have gouty arthritis drink coffee to lower uric acid levels. Gout is a painful condition that occurs when the bodily 20 November 2009 6:13 UTC www.ndri.com [Source type: Academic]

.A remarkable tendency to gnashing of the teeth is sometimes observed.^ A remarkable tendency to gnashing of the teeth is sometimes observed.

.This symptom was first noticed.^ This symptom was first noticed.

^ The connection was first noticed when sleep apnea patients received treatment for their disorder and they noticed their gout symptoms simultaneously improved.
  • Lisa McDowell - EzineArticles.com Expert Author 27 January 2010 23:57 UTC ezinearticles.com [Source type: FILTERED WITH BAYES]

^ Severe joint pain, fatigue fever, and inflammation are the first symptoms most people notice.
  • are kidney stones dangerous | 7 Secret Weapons to Win the War of Arthritis Inflammation and 9 October 2009 4:56 UTC naturaltreatmentforgout.info [Source type: FILTERED WITH BAYES]

by .Dr Graves, who connected it with irritation in the urinary organs, which also is present as one of the premonitory indications of the gouty attack.^ Flatulence Irritation in urinary organs.

^ Dr Graves, who connected it with irritation in the urinary organs, which also is present as one of the premonitory indications of the gouty attack.

^ An attack of gout may appear without warning or there may be premonitory symptoms like flatulence, uneasiness, irritation in the urinary organs, numbness and coldness in the limbs.At midnight the patients is awakened by a painful feeling in the foot.
  • GOUT(VATARAKTA) Treatment, Ayurvedic Natural Treatment for GOUT(VATARAKTA) Disease, Herbal Medicine & Remedies For Gout Disease 27 January 2010 23:57 UTC www.herbal-clinic.com [Source type: Academic]

.Various forms of nervous disturbance also present themselves in the form of general discomfort, extreme irritability of temper, and various perverted sensations, such as that of numbness and coldness in the limbs.^ Various forms of nervous disturbance also present themselves in the form of general discomfort, extreme irritability of temper , and various perverted sensations, such as that of numbness and coldness in the limbs.

^ The patient is restless and extremely irritable, and suffers from cramp in the limbs and from dyspepsia , thirst and constipation .

^ These manifest themselves in the form of inflammation and swelling of the joints, tenderness in the affected area, burning sensation and a feeling of excessive pain while touching or moving the joints.
  • Gout, Ayurveda treatments Gout, Consult Ayurveda Doctor, Ayurveda Curative treatments, Book Ayurveda package, Ayurveda hospitals, Chronic Diseases, Gout Symptoms, Gout Treatment Ayurveda, Ayurveda Treatments, Ayurveda Treatment plan Gout, Curative Treatments Gout, Ayurveda Spas, Ayurveda Doctors, Consult Ayurveda Doctor Online 27 January 2010 23:57 UTC www.ayurport.com [Source type: Academic]

.These symptoms may persist for many days and then undergo amelioration immediately before the impending paroxysm.^ The symptoms may last for days to weeks.
  • Adult Health Advisor 2009.1: Gout 27 January 2010 23:57 UTC www.med.umich.edu [Source type: FILTERED WITH BAYES]

^ These symptoms may persist for many days and then undergo amelioration immediately before the impending paroxysm.

^ Symptoms may initially disappear within three to 10 days, but if left untreated, gout can lead to increasing pain and joint damage.

.On the night of the attack the patient retires to rest apparently well, but about two or three o'clock in the morning awakes with a painful feeling in the foot, most commonly in the ball of the great toe, but it may be in the instep or heel, or in the thumb.^ On the night of the attack the patient retires to rest apparently well, but about two or three o'clock in the morning awakes with a painful feeling in the foot, most commonly in the ball of the great toe, but it may be in the instep or heel , or in the thumb.

^ Gout: Painful joints, most commonly the big toe.
  • Gout Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 27 January 2010 23:57 UTC wrongdiagnosis.com [Source type: Academic]

^ The Rt great toe is the joint most commonly affected by gout.
  • Hyperuricemia And Gout 27 January 2010 23:57 UTC www.uic.edu [Source type: Academic]

.With the pain there often occurs a distinct shivering followed by feverishness.^ With the pain there often occurs a distinct shivering followed by feverishness.

^ Often the drug provides relief quickly but there are some side effects such as nausea, vomiting and abdominal pain.
  • AllAbout Gout & How to Fight Back... The Facts Put Simply 27 January 2010 23:57 UTC www.joint-pain-forum.com [Source type: FILTERED WITH BAYES]

^ There is severe pain in the right part under the praecordia, which spreads to the right side, to the clavicle and arm of that side; 47 at times there is also pain in the right hand, there is hot shivering.
  • LacusCurtius • Celsus — On Medicine — Book IV 9 October 2009 4:56 UTC penelope.uchicago.edu [Source type: Original source]

The pain soon becomes of the most agonizing character: in the words of Sydenham, "now it is a violent stretching and tearing of the ligaments, now it is a gnawing pain, and now a pressure and tightening; so exquisite and lively meanwhile is the part affected that it cannot bear the weight of the bedclothes, nor the jar of a person walking in the room." When the affected part is examined it is found to be swollen and of a deep red hue. .The superjacent skin is tense and glistening, and the surrounding veins are more or less distended.^ The superjacent skin is tense and glistening, and the surrounding veins are more or less distended.

.After a few hours there is a remission of the pain, slight perspiration takes place, and the patient may fall asleep.^ After a few hours there is a remission of the pain, slight perspiration takes place, and the patient may fall asleep.

^ Without treatment the attack subsides in a week or so and when patients first develop gout there may be intervals of many months or even years between attacks.
  • ::NZRA - New Zealand Rheumatology Association - Patient Information 27 January 2010 23:57 UTC www.rheumatology.org.nz [Source type: FILTERED WITH BAYES]

^ Typical descriptions of this symptom include a patient who goes to bed and awakens by severe pain in the big toe but may also be experienced in the heel, instep or ankle.

.The pain may continue moderate during the day but returns as night advances, and the patient goes through a similar experience of suffering to that of the previous night, followed with a like abatement towards morning.^ The pain may continue moderate during the day but returns as night advances, and the patient goes through a similar experience of suffering to that of the previous night, followed with a like abatement towards morning.

^ And it must follow, as the night the day..
  • Can I experience muscle growth in my late 40's? - Bodybuilding.com Forums 9 October 2009 4:56 UTC forum.bodybuilding.com [Source type: FILTERED WITH BAYES]

^ Gout's throbbing pain often hits at night, turning the skin red-hot and leaving the affected joint swollen and tender for 5 to 10 days.

.These nocturnal exacerbations occur with greater or less severity during the continuance of the attack, which generally lasts for a week or ten days.^ Acute attacks commonly occur at night and without treatment can last for several weeks.
  • Gout Cleanse for GOUTCURE 27 January 2010 23:57 UTC www.merc-buyers.com [Source type: Academic]

^ Attacks tend to last a few days to a few weeks.
  • Herbal Medicine: Gout 27 January 2010 23:57 UTC www.healthy.net [Source type: FILTERED WITH BAYES]

^ Without immediate attention, an attack can last days or weeks, so its not surprisin ...
  • Search Results: gout: page: 27 January 2010 23:57 UTC curezone.com [Source type: General]

.As the symptoms decline the swelling and tenderness of the affected joint abate, but the skin over it pits on pressure for a time, and with this there is often associated slight desquamation of the cuticle.^ Inflammation, warmth, swelling, redness, and marked tenderness in the affected joint.
  • The Best Natural Solution For Any Type Of Gout 27 January 2010 23:57 UTC www.goutcurepatch.com [Source type: General]

^ The affected joint will feel warm and the skin often looks shiny.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

^ The most common symptoms of gout are inflammation, swelling, and tenderness in a joint.
  • Gout: causes, symptoms, food & diet, remedy, treatment, cures 9 October 2009 4:56 UTC clddufjord.ca [Source type: FILTERED WITH BAYES]

.During the attacks there is much constitutional disturbance.^ During the attacks there is much constitutional disturbance.

^ During an attack of gout, it is best to try and rest the affected joint as much as possible.
  • Patient information leaflet - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: General]
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

^ There is no permanent cure for gout , but much can be done to manage the pain of an acute attack, lessen the duration of an attack, and prevent future attacks.
  • gout symptoms, causes, diagnosis, foods that cause gout and treatments 27 January 2010 23:57 UTC www.seekwellness.com [Source type: FILTERED WITH BAYES]

.The patient is restless and extremely irritable, and suffers from cramp in the limbs and from dyspepsia, thirst and constipation.^ The patient is restless and extremely irritable, and suffers from cramp in the limbs and from dyspepsia , thirst and constipation .

^ Various forms of nervous disturbance also present themselves in the form of general discomfort, extreme irritability of temper , and various perverted sensations, such as that of numbness and coldness in the limbs.

^ EXTREMELY PAINFUL to anybody that has it, so be patient with him if he is irritable when he has a gout attack.
  • Gout: What vitamins to take, what foods to eat, and what foods to stay away from.? - Yahoo! Answers 27 January 2010 23:57 UTC answers.yahoo.com [Source type: General]

.The urine is scanty and high-coloured, with a copious deposit, consisting chiefly of urates.^ The urine is scanty and high-coloured, with a copious deposit , consisting chiefly of urates.

^ You didn't know it, but your uric acid levels have been high for years, and now urate crystals have deposited in the joint of your big toe causing inflammation.
  • The Acute Gouty Arthritis Attack - Clivir - How to Lessons, Tips & Tutorials 20 November 2009 6:13 UTC www.clivir.com [Source type: Original source]

^ These crystals come from body fluids that contain markedly high concentrations of uric acid (urate), a waste product of digestion that is normally excreted in urine.
  • Health24 - Medical - Head 2 Toe 27 January 2010 23:57 UTC www.health24.com [Source type: FILTERED WITH BAYES]

.During the continuance of the symptoms the inflammation may leave the one foot and affect the other, or both may suffer at the same time.^ During the continuance of the symptoms the inflammation may leave the one foot and affect the other, or both may suffer at the same time.

^ Other symptoms may include: .
  • CIGNA - Gout 27 January 2010 23:57 UTC www.cigna.com [Source type: FILTERED WITH BAYES]

^ Other joints may also be affected.
  • If you have gouty arthritis drink coffee to lower uric acid levels. Gout is a painful condition that occurs when the bodily 20 November 2009 6:13 UTC www.ndri.com [Source type: Academic]

.After the attack is over the patient feels quite well and fancies himself better than he had been for a long time before; hence the once popular notion that a fit of the gout was capable of removing all other ailments.^ I’ve been dealing with gout for a long, long time.
  • How a few small diet changes got me off crutches permanently – with no drugs! « Ken’s Gout Cure 20 November 2009 6:13 UTC kensgoutcure.com [Source type: General]

^ Gout attacks affect more than one joint at a time.

^ Have you been experiencing gout for a long time?
  • Gout Remedies like apple cider vinegar on Earth Clinic, Your Source for Natural Cures. 27 January 2010 23:57 UTC www.earthclinic.com [Source type: General]

.Any such idea, however, is sadly belied in the experience of most sufferers from this disease.^ Any such idea, however, is sadly belied in the experience of most sufferers from this disease.

^ Gout is one of the most painful types of arthritis, with a pain level equivalent to childbirth or the fracture of long bones, such as the femur, according to gout sufferers .
  • Uricinex | Gout Treatment | Uricinex Gout Treatment 27 January 2010 23:57 UTC www.4uricinex.com [Source type: General]

^ If you've had this experience, or something similar, you are most likely suffering from the affects of gout.
  • Gout Treatment & Gout Pain Relief Remedy | Flexcin with CM8 27 January 2010 23:57 UTC gout-pain-remedy.com [Source type: General]

.It is rare that the first is the only attack of gout, and another is apt to occur within a year, although by care and treatment it may be warded off.^ A second attack may occur, but usually not for 6 months to 2 years.
  • Adult Health Advisor 2009.1: Gout 27 January 2010 23:57 UTC www.med.umich.edu [Source type: FILTERED WITH BAYES]

^ It is rare that the first is the only attack of gout, and another is apt to occur within a year, although by care and treatment it may be warded off.

^ This is why most gout attacks first occur in the big toe.

.The disease, however, undoubtedly tends to take a firmer hold on the constitution and to return.^ The disease, however, undoubtedly tends to take a firmer hold on the constitution and to return.

^ However, if your doctor has prescribed low-dose aspirin to protect against heart disease or similar serious conditions then you should continue to take it.
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

.In the earlier recurrences the same joints as were formerly the seat of the gouty inflammation suffer again, but in course of time others become implicated, until in advanced cases scarcely any articulation escapes, and the disease thus becomes chronic.^ Gout is a disease involving inflammation of the joints and usually it occurs recurrently.
  • Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com 9 October 2009 4:56 UTC www.feedage.com [Source type: General]

^ In the earlier recurrences the same joints as were formerly the seat of the gouty inflammation suffer again, but in course of time others become implicated, until in advanced cases scarcely any articulation escapes, and the disease thus becomes chronic.

^ Joint inflammation can become chronic and deforming after repeated attacks.
  • Highlands Orthopaedics and Sports Medicine ~ Gout 27 January 2010 23:57 UTC www.highlands-ortho.com [Source type: FILTERED WITH BAYES]

.It is to be noticed that when gout assumes this form the frequently recurring attacks are usually attended with less pain than the earlier ones, but their disastrous effects are evidenced alike by the disturbance of various important organs, especially the stomach, liver, kidneys and heart, and by the remarkable changes which take place in the joints from the formation of the so-called chalkstones or tophi.^ Gout attacks can recur from time to time in the same joint.

^ Less than 5% of patients with gout are female.

^ With recurrent gout, tophi can form.

.These deposits, which are highly characteristic of gout, appear at first to take place in the form of a semifluid material, consisting for the most part of urate of soda, which gradually becomes more dense, and ultimately quite hard.^ Visceral gout (Visceral urate deposition) .
  • Visceral and Articular Gout 27 January 2010 23:57 UTC www.avianweb.com [Source type: FILTERED WITH BAYES]

^ These deposits, which are highly characteristic of gout, appear at first to take place in the form of a semifluid material, consisting for the most part of urate of soda, which gradually becomes more dense, and ultimately quite hard.

^ Gout is a common disease and appears to be becoming more common over time.
  • Gout - a knol by Theodore Fields 27 January 2010 23:57 UTC knol.google.com [Source type: FILTERED WITH BAYES]

.When any quantity of this is deposited in the structures of a joint the effect is to produce stiffening, and, as deposits appear to take place to a greater or less amount in connexion with every attack, permanent thickening and deformity of the parts is apt to be the consequence.^ When any quantity of this is deposited in the structures of a joint the effect is to produce stiffening, and, as deposits appear to take place to a greater or less amount in connexion with every attack, permanent thickening and deformity of the parts is apt to be the consequence.

^ These deposits, which are highly characteristic of gout, appear at first to take place in the form of a semifluid material, consisting for the most part of urate of soda, which gradually becomes more dense, and ultimately quite hard.

^ In addition to taking pain medications as prescribed by their doctors, people having gout attacks are encouraged to rest and to increase the amount of fluids that they drink.
  • Gout: Encyclopedia of Nursing & Allied Health 27 January 2010 23:57 UTC www.enotes.com [Source type: Academic]

.The extent of this depends, of course, on the amount of the deposits, which, however, would seem to be in no necessary relation to the severity of the attack, being in some cases even of chronic gout so slight as to be barely appreciable externally, but on the other hand occasionally causing great enlargement of the joints, and fixing them in a flexed or extended position which renders them entirely useless.^ The pain of a gout attack can be severe.
  • Gout | Health | Patient UK 27 January 2010 23:57 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ This will keep the joints mobile and will lessen the frequency and severity of gout attacks.

^ Can gout cause serious joint disease?
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

.Dr Garrod describes the appearance of a hand in an extreme case of this kind, and likens its shape to a bundle of French carrots with their heads forward, the nails corresponding to the stalks.^ Dr Garrod describes the appearance of a hand in an extreme case of this kind, and likens its shape to a bundle of French carrots with their heads forward, the nails corresponding to the stalks.

.Any of the joints may be thus affected, but most commonly those of the hands and feet.^ The most common sites include the joints of the hands or feet.
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 9 October 2009 4:56 UTC www.aafp.org [Source type: Academic]
  • Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians 20 November 2009 6:13 UTC newcms.aafp.org [Source type: Academic]

^ Knee and ankle joints are the next most commonly affected, but any joints are susceptible.

^ Affected joints may include: .
  • Clinical topic - Gout 27 January 2010 23:57 UTC www.cks.nhs.uk [Source type: Academic]

.The deposits take place in other structures besides those of joints, such as along the course of tendons, underneath the skin and periosteum, in the sclerotic coat of the eye, and especially on the cartilages of the external ear.^ The deposits take place in other structures besides those of joints, such as along the course of tendons, underneath the skin and periosteum, in the sclerotic coat of the eye, and especially on the cartilages of the external ear .

^ Tophi are lumps below the skin around joints or in other places.
  • Gout Medical Information 27 January 2010 23:57 UTC www.drugs.com [Source type: FILTERED WITH BAYES]
  • Gout - MMCI 27 January 2010 23:57 UTC mmci2.adam.com [Source type: FILTERED WITH BAYES]

^ Is urate deposited at places other than in joints?
  • arc :: Gout 27 January 2010 23:57 UTC www.arc.org.uk [Source type: FILTERED WITH BAYES]

.When largely deposited in joints an abscess sometimes forms, the skin gives way, and the concretion is exposed.^ When largely deposited in joints an abscess sometimes forms, the skin gives way, and the concretion is exposed.

^ Uric acid sometimes forms crystals that are deposited in the joints.
  • Gout Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 27 January 2010 23:57 UTC wrongdiagnosis.com [Source type: Academic]

^ Sometimes the deposits can break through the skin.
  • Gout -->Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.arthritis.ca/types%20of%20arthritis/gout/default.asp?s=1&province=on">www.arthritis.ca</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__6" class="citable__local-anchor">.</a><span class='citationPopup' rel="6">Sir <a href="/Thomas_Watson" title="Thomas Watson">Thomas Watson</a> quotes a case of this kind where the patient when playing at cards was accustomed to chalk the <a href="/Score" title="Score">score</a> of the game upon the table with his gouty knuckles.</span><span class="citable__li" citable_id="6"><a href="#citable__6"><strong>^</strong></a> <c_txt>Sir Thomas Watson quotes a case of this kind where the patient when playing at cards was accustomed to chalk the score of the game upon the table with his gouty knuckles.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> </div> <div style="margin: 1.12em 0; display:block"><a name="citable__76" class="citable__local-anchor">.</a><span class='citationPopup' rel="76">The recognition of what is termed irregular gout is less easy than that form above described, where the disease gives abundant external evidence of its presence; but that other parts than joints suffer from gouty attacks is beyond question.</span><span class="citable__li" citable_id="76"><a href="#citable__76"><strong>^</strong></a> <c_txt>Less than 5% of patients with gout are female.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.podlink.com/pathology/gout.htm">www.podlink.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="76"><a href="#citable__76"><strong>^</strong></a> <c_txt>Intercritical gout is the term used to describe the periods between attacks.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Acute Gouty Arthritis Symptoms - Acute Gouty Arthritis Health Information - NY Times Health</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://health.nytimes.com/health/guides/disease/acute-gouty-arthritis/symptoms.html">health.nytimes.com</a> [Source type: FILTERED WITH BAYES]</li><li> <em><c_title>Channel Management System- Washington, DC</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.georgetownuniversityhospital.org/body.cfm?id=555563&action=articleDetail&AEProductID=Adam2004_5010&AEArticleID=000093&crawl=false">www.georgetownuniversityhospital.org</a> [Source type: Academic]</li><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.podlink.com/pathology/gout.htm">www.podlink.com</a> [Source type: Academic]</li><li> <em><c_title>Gout - Symptoms</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.umm.edu/patiented/articles/what_causes_gout_000093_2.htm">www.umm.edu</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="76"><a href="#citable__76"><strong>^</strong></a> <c_txt>The recognition of what is termed irregular gout is less easy than that form above described, where the disease gives abundant external evidence of its presence; but that other parts than joints suffer from gouty attacks is beyond question.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__218" class="citable__local-anchor">.</a><span class='citationPopup' rel="218">The diagnosis may often be made in cases where in an attack of ordinary gout the disease suddenly leaves the affected joints and some new series of symptoms arises.</span><span class="citable__li" citable_id="218"><a href="#citable__218"><strong>^</strong></a> <c_txt>Some people may never experience gout signs and symptoms again.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - MayoClinic.com</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.mayoclinic.com/health/gout/DS00090/METHOD=print">www.mayoclinic.com</a> [Source type: General]</li><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cnn.com/HEALTH/library/gout/DS00090.html">www.cnn.com</a> [Source type: General]</li><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.studentnews.cnn.com/HEALTH/library/gout/DS00090.html">www.studentnews.cnn.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="218"><a href="#citable__218"><strong>^</strong></a> <c_txt>Can gout cause serious joint disease?</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>arc :: Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.arc.org.uk/arthinfo/patpubs/6015/6015.asp">www.arc.org.uk</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="218"><a href="#citable__218"><strong>^</strong></a> <c_txt>Affected joints may include: .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Patient information leaflet - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/patient_information_leaflet/gout">www.cks.nhs.uk</a> [Source type: General]</li><li> <em><c_title> Clinical topic - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/gout">www.cks.nhs.uk</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__35" class="citable__local-anchor">.</a><span class='citationPopup' rel="35">It has been often observed when cold has been applied to an inflamed joint that the pain and inflammation in the part ceased, but that some sudden and alarming seizure referable to the stomach, <a href="/Brain" title="Brain">brain</a>, heart or lungs supervened.</span><span class="citable__li" citable_id="35"><a href="#citable__35"><strong>^</strong></a> <c_txt>It leads to sudden, severe attacks of pain and inflammation in joints.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout: An In-Depth Overview - Conditions and Treatments - HSS</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.hss.edu/conditions_gout-in-depth-overview.asp">www.hss.edu</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="35"><a href="#citable__35"><strong>^</strong></a> <c_txt>The pain stems from the inflammation surrounding the joint.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.feedage.com/feeds/301241/home-remedies--health--fitness--articleproscom">www.feedage.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="35"><a href="#citable__35"><strong>^</strong></a> <c_txt>This results in excruciating pain and inflammation of the joints.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.buzzle.com/articles/gout/">www.buzzle.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__151" class="citable__local-anchor">.</a><span class='citationPopup' rel="151">Such attacks, which correspond to what is termed by Cullen retrocedent gout, often terminate favourably, more especially if the disease again returns to the joints.</span><span class="citable__li" citable_id="151"><a href="#citable__151"><strong>^</strong></a> <c_txt>Gout often attacks as quickly as overnight.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://life-enthusiast.com/index/Concerns/Gout">life-enthusiast.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="151"><a href="#citable__151"><strong>^</strong></a> <c_txt>Gout tophi are lumps that are often noticed on the joint that is attacked by the gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Relief Made Easy - Natural Remedies For Gout Revealed</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.goutremoval.com/">www.goutremoval.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="151"><a href="#citable__151"><strong>^</strong></a> <c_txt>Gout can also attack joints such as the knees and the elbows (as shown here).</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Slideshow: Watch & Learn About Gout on RxList.com</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.rxlist.com/gout_slideshow_watch_and_learn_about_gout/article.htm">www.rxlist.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__19" class="citable__local-anchor">.</a><span class='citationPopup' rel="19">Further, the gouty nature of some long-continued internal or cutaneous disorder may be rendered apparent by its disappearance on the outbreak of the paroxysm in the joints.</span><span class="citable__li" citable_id="19"><a href="#citable__19"><strong>^</strong></a> <c_txt>Joint damage may render the joint nonfunctional.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout: eMedicine Orthopedic Surgery</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://emedicine.medscape.com/article/1267449-overview">emedicine.medscape.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="19"><a href="#citable__19"><strong>^</strong></a> <c_txt>Further, the gouty nature of some long-continued internal or cutaneous disorder may be rendered apparent by its disappearance on the outbreak of the paroxysm in the joints.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="19"><a href="#citable__19"><strong>^</strong></a> <c_txt>Untreated cases may develop chronic gouty arthritis in which multiple joints are involved by a long-term destructive process.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Herbal Medicine: Gout </c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.healthy.net/library/books/hoffman/musculoskeletal/gout.htm">www.healthy.net</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__133" class="citable__local-anchor">.</a><span class='citationPopup' rel="133">Gout, when of long standing, is often found associated with degenerative changes in the heart and large <a href="/Arteries" title="Arteries">arteries</a>, the liver, and especially the kidneys, which are apt to assume the contracted granular condition characteristic of one of the forms of <a href="/Bright%27s_disease" title="Bright's disease">Bright's disease</a>.</span><span class="citable__li" citable_id="133"><a href="#citable__133"><strong>^</strong></a> <c_txt>Gout, when of long standing, is often found associated with degenerative changes in the heart and large arteries , the liver, and especially the kidneys, which are apt to assume the contracted granular condition characteristic of one of the forms of Bright's disease .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="133"><a href="#citable__133"><strong>^</strong></a> <c_txt>Gout is an ancient disease associated with deposits of uric acid, especially in the joints and kidneys.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - a knol by Theodore Fields</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://knol.google.com/k/gout?collectionId=14dmp09oqdm08.34">knol.google.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="133"><a href="#citable__133"><strong>^</strong></a> <c_txt>One form of arthritis often confused with gout is called pseudogout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Q&A About Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.niams.nih.gov/Health_Info/Gout/default.asp">www.niams.nih.gov</a> [Source type: Academic]</li><li> <em><c_title>Gout | Fitness and Freebies</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.fitnessandfreebies.com/health/gout.html">www.fitnessandfreebies.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__130" class="citable__local-anchor">.</a><span class='citationPopup' rel="130">A variety of urinary calculus - the <a href="/Uric_acid" title="Uric acid">uric acid</a> - formed by concretions of this substance in the kidneys is a not unfrequent occurrence in connexion with gout; hence the well-known association of this disease and <a href="/Gravel" title="Gravel">gravel</a>.</span><span class="citable__li" citable_id="130"><a href="#citable__130"><strong>^</strong></a> <c_txt>Uric acid stones can also form when you do not have gout or hyperuricemia.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Channel Management System- Washington, DC</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.georgetownuniversityhospital.org/body.cfm?id=555563&action=articleDetail&AEProductID=Adam2004_5010&AEArticleID=000093&crawl=false">www.georgetownuniversityhospital.org</a> [Source type: Academic]</li><li> <em><c_title>Gout - Symptoms</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.umm.edu/patiented/articles/what_causes_gout_000093_2.htm">www.umm.edu</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="130"><a href="#citable__130"><strong>^</strong></a> <c_txt>Gout is an ancient disease associated with deposits of uric acid, especially in the joints and kidneys.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - a knol by Theodore Fields</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://knol.google.com/k/gout?collectionId=14dmp09oqdm08.34">knol.google.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="130"><a href="#citable__130"><strong>^</strong></a> <c_txt>Gout is associated with high blood pressure , kidney disease , diabetes , atherosclerosis , and uric acid kidney stones .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Remedies - Health 911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.health911.com/remedies/rem_gout.htm">www.health911.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> </div> <div style="margin: 1.12em 0; display:block"><a name="citable__220" class="citable__local-anchor">.</a><span class='citationPopup' rel="220">The <a href="/Pathology" title="Pathology">pathology</a> of gout is discussed in the article on <a href="/Metabolic_Diseases" title="Metabolic Diseases">Metabolic Diseases</a>.</span><span class="citable__li" citable_id="220"><a href="#citable__220"><strong>^</strong></a> <c_txt>Metabolic diseases: gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout: Free Medical and Health Information on Gout Research and Treatment</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.lifestages.com/health/gout.html">www.lifestages.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="220"><a href="#citable__220"><strong>^</strong></a> <c_txt>Falasca GF. Metabolic diseases: gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.umm.edu/altmed/articles/gout-000070.htm">www.umm.edu</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="220"><a href="#citable__220"><strong>^</strong></a> <c_txt>The pathology of gout is discussed in the article on Metabolic Diseases .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__3" class="citable__local-anchor">.</a><span class='citationPopup' rel="3">Many points, however, still remain unexplained.</span><span class="citable__li" citable_id="3"><a href="#citable__3"><strong>^</strong></a> <c_txt>Many points, however, still remain unexplained.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> As remarked by Trousseau, "the production in excess of uric <a href="/Acid" title="Acid">acid</a> and urates is a pathological <a href="/Phenomenon" title="Phenomenon">phenomenon</a> inherent like all others in the disease; and like all the others it is dominated by a specific cause, which we know only by its effects, and which we term the gouty diathesis." This subject of diathesis (habit, or organic predisposition of individuals), which is regarded as an essential element in the pathology of gout, naturally suggests the question as to whether, besides being inherited, such a peculiarity may also be acquired, and this leads to a consideration of the causes which are recognized as influential in favouring the occurrence of this disease.</div> <div style="margin: 1.12em 0; display:block"><a name="citable__65" class="citable__local-anchor">.</a><span class='citationPopup' rel="65">It is beyond dispute that gout is in a marked degree hereditary, fully more than half the number of cases being, according to Sir C. Scudamore and Dr Garrod, of this character.</span><span class="citable__li" citable_id="65"><a href="#citable__65"><strong>^</strong></a> <c_txt>It is beyond dispute that gout is in a marked degree hereditary, fully more than half the number of cases being, according to Sir C. Scudamore and Dr Garrod, of this character.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="65"><a href="#citable__65"><strong>^</strong></a> <c_txt>Gout : more than just pain?</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> gout Facts, information, pictures | Encyclopedia.com articles about gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.encyclopedia.com/topic/gout.aspx">www.encyclopedia.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="65"><a href="#citable__65"><strong>^</strong></a> <c_txt>Dr Garrod describes the appearance of a hand in an extreme case of this kind, and likens its shape to a bundle of French carrots with their heads forward, the nails corresponding to the stalks.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__205" class="citable__local-anchor">.</a><span class='citationPopup' rel="205">But it is no less certain that there are habits and modes of life the observance of which may induce the disease even where no hereditary tendencies can be traced, and the <a href="/Avoidance" title="Avoidance">avoidance</a> of which may, on the other hand, go far towards weakening or neutralizing the influence of inherited liability.</span><span class="citable__li" citable_id="205"><a href="#citable__205"><strong>^</strong></a> <c_txt>But it is no less certain that there are habits and modes of life the observance of which may induce the disease even where no hereditary tendencies can be traced, and the avoidance of which may, on the other hand, go far towards weakening or neutralizing the influence of inherited liability.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="205"><a href="#citable__205"><strong>^</strong></a> <c_txt>It may, notwithstanding, be affirmed as generally true that those who lead regular lives, and are moderate in the use of animal food and alcoholic drinks, or still better abstain from the latter altogether, are less likely to be the victims of gout even where an undoubted inherited tendency exists.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="205"><a href="#citable__205"><strong>^</strong></a> <c_txt>The comparative absence of gout in countries where spirituous liquors are chiefly used, such as Scotland , is cited as showing their relatively slight effect in encouraging that disease; but it is to be noticed that in such countries there is on the whole a less marked tendency to excess in the other pleasures of the table, which in no degree less than alcohol are chargeable with inducing the gouty habit.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__91" class="citable__local-anchor">.</a><span class='citationPopup' rel="91">Gout is said to affect the sedentary more readily than the active.</span><span class="citable__li" citable_id="91"><a href="#citable__91"><strong>^</strong></a> <c_txt>If more than one joint is affected, it is known as polyarticular gout .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Rheumatology Therapeutics Medical Center</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.arthritisconsult.com/gout.html">www.arthritisconsult.com</a> [Source type: Academic]</li><li> <em><c_title> Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://preventdisease.com/diseases/gout.html">preventdisease.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="91"><a href="#citable__91"><strong>^</strong></a> <c_txt>He has also said that it affects men more than women.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Best Gout Home Remedies</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.bestgoutremedies.com/">www.bestgoutremedies.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="91"><a href="#citable__91"><strong>^</strong></a> <c_txt>Men are affected more than woman.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Treatment | LIVESTRONG.COM</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.livestrong.com/gout-treatment/">www.livestrong.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <a name="citable__194" class="citable__local-anchor">.</a><span class='citationPopup' rel="194">If, however, inadequate exercise be combined with a luxurious manner of living, with habitual over-indulgence in animal food and rich dishes, and especially in alcoholic beverages, then undoubtedly the chief factors in the production of the disease are present.</span><span class="citable__li" citable_id="194"><a href="#citable__194"><strong>^</strong></a> <c_txt>However this has to be combined with other factors.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.feedage.com/feeds/301241/home-remedies--health--fitness--articleproscom">www.feedage.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="194"><a href="#citable__194"><strong>^</strong></a> <c_txt>If, however, inadequate exercise be combined with a luxurious manner of living, with habitual over-indulgence in animal food and rich dishes, and especially in alcoholic beverages, then undoubtedly the chief factors in the production of the disease are present.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="194"><a href="#citable__194"><strong>^</strong></a> <c_txt>Overindulgence in alcohol or purine-rich foods.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Rheumatology Therapeutics Medical Center</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.arthritisconsult.com/gout.html">www.arthritisconsult.com</a> [Source type: Academic]</li><li> <em><c_title> Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://preventdisease.com/diseases/gout.html">preventdisease.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> </div> <div style="margin: 1.12em 0; display:block"><a name="citable__254" class="citable__local-anchor">.</a><span class='citationPopup' rel="254">Much has been written upon the relative influence of various forms of alcoholic drinks in promoting the development of gout.</span><span class="citable__li" citable_id="254"><a href="#citable__254"><strong>^</strong></a> <c_txt>Much has been written upon the relative influence of various forms of alcoholic drinks in promoting the development of gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="254"><a href="#citable__254"><strong>^</strong></a> <c_txt>Do not eat too much food or drink too much alcohol.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>CIGNA - Gout: Changing your diet</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cigna.com/healthinfo/za1144.html">www.cigna.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="254"><a href="#citable__254"><strong>^</strong></a> <c_txt>Most gout episodes are acute and last a few days, but the severity and frequency of attacks can increase, and some people may develop a chronic form of gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.labtestsonline.org/understanding/conditions/gout.html">www.labtestsonline.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__40" class="citable__local-anchor">.</a><span class='citationPopup' rel="40">It is generally stated that fermented are more injurious than distilled liquors, and that, in particular, the stronger wines, such as port, <a href="/Sherry" title="Sherry">sherry</a> and <a href="/Madeira" title="Madeira">madeira</a>, are much more potent in their gout-producing action than the lighter class of wines, such as hock, moselle, &c., while <a href="/Malt" title="Malt">malt</a> liquors are fully as hurtful as strong wines.</span><span class="citable__li" citable_id="40"><a href="#citable__40"><strong>^</strong></a> <c_txt>Gout : more than just pain?</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> gout Facts, information, pictures | Encyclopedia.com articles about gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.encyclopedia.com/topic/gout.aspx">www.encyclopedia.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="40"><a href="#citable__40"><strong>^</strong></a> <c_txt>It is generally stated that fermented are more injurious than distilled liquors, and that, in particular, the stronger wines, such as port, sherry and madeira , are much more potent in their gout-producing action than the lighter class of wines, such as hock, moselle, &c., while malt liquors are fully as hurtful as strong wines.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="40"><a href="#citable__40"><strong>^</strong></a> <c_txt>It is beyond dispute that gout is in a marked degree hereditary, fully more than half the number of cases being, according to Sir C. Scudamore and Dr Garrod, of this character.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__110" class="citable__local-anchor">.</a><span class='citationPopup' rel="110">It seems quite as probable, however,that over-indulgence in any form of <a href="/Alcohol" title="Alcohol">alcohol</a>, when associated with the other conditions already adverted to, will have very much the same effect in developing gout.</span><span class="citable__li" citable_id="110"><a href="#citable__110"><strong>^</strong></a> <c_txt>However, not all hyperuricemics develop gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Highlands Orthopaedics and Sports Medicine ~ Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.highlands-ortho.com/gout.html">www.highlands-ortho.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="110"><a href="#citable__110"><strong>^</strong></a> <c_txt>These conditions are associated with gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout & Aspirin by MedicineNet.com</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.myonlinemedical.com/medical-condition-gout/">www.myonlinemedical.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="110"><a href="#citable__110"><strong>^</strong></a> <c_txt>However, other effects from gout are uncommon.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout | Health | Patient UK</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.patient.co.uk/showdoc/23068747/">www.patient.co.uk</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__213" class="citable__local-anchor">.</a><span class='citationPopup' rel="213">The comparative absence of gout in countries where spirituous liquors are chiefly used, such as <a href="/Scotland" title="Scotland">Scotland</a>, is cited as showing their relatively slight effect in encouraging that disease; but it is to be noticed that in such countries there is on the whole a less marked tendency to excess in the other pleasures of the table, which in no degree less than alcohol are chargeable with inducing the gouty habit.</span><span class="citable__li" citable_id="213"><a href="#citable__213"><strong>^</strong></a> <c_txt>There is one other therapy that I have used and the effects were no less remarkable.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Arthritis Remedies on Earth Clinic, Your Source for natural cures!</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.earthclinic.com/CURES/arthritis.html">www.earthclinic.com</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="213"><a href="#citable__213"><strong>^</strong></a> <c_txt>Less than 5% of patients with gout are female.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.podlink.com/pathology/gout.htm">www.podlink.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="213"><a href="#citable__213"><strong>^</strong></a> <c_txt>The comparative absence of gout in countries where spirituous liquors are chiefly used, such as Scotland , is cited as showing their relatively slight effect in encouraging that disease; but it is to be noticed that in such countries there is on the whole a less marked tendency to excess in the other pleasures of the table, which in no degree less than alcohol are chargeable with inducing the gouty habit.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__61" class="citable__local-anchor">.</a><span class='citationPopup' rel="61">Gout is not a common disease among the poor and labouring classes, and when it does occur may often be connected even in them with errors in living.</span><span class="citable__li" citable_id="61"><a href="#citable__61"><strong>^</strong></a> <c_txt>Gout is a common disease.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - a knol by Theodore Fields</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://knol.google.com/k/gout?collectionId=14dmp09oqdm08.34">knol.google.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="61"><a href="#citable__61"><strong>^</strong></a> <c_txt>Gout is not a common disease among the poor and labouring classes, and when it does occur may often be connected even in them with errors in living.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="61"><a href="#citable__61"><strong>^</strong></a> <c_txt>It is rare that the first is the only attack of gout, and another is apt to occur within a year, although by care and treatment it may be warded off.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__45" class="citable__local-anchor">.</a><span class='citationPopup' rel="45">It is not very rare to meet gout in butlers, coachmen, &c., who are apt to live luxuriously while leading comparatively easy lives.</span><span class="citable__li" citable_id="45"><a href="#citable__45"><strong>^</strong></a> <c_txt>Men, particularly those between the ages of 40 and 50, are more likely to develop gout than women, who rarely develop the disorder before menopause .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - Medpedia</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://wiki.medpedia.com/Gout">wiki.medpedia.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="45"><a href="#citable__45"><strong>^</strong></a> <c_txt>Men, particularly those between the ages of 40 and 50, are more likely to develop gout than women, who rarely develop the disorder before menopause.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Q&A About Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.niams.nih.gov/Health_Info/Gout/default.asp">www.niams.nih.gov</a> [Source type: Academic]</li><li> <em><c_title>Gout | Fitness and Freebies</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.fitnessandfreebies.com/health/gout.html">www.fitnessandfreebies.com</a> [Source type: FILTERED WITH BAYES]</li><li> <em><c_title>Health and Self-care: Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://siakhenn.tripod.com/gout.html">siakhenn.tripod.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="45"><a href="#citable__45"><strong>^</strong></a> <c_txt>The shoulder joint is very rarely involved by gout, and the hip essentially never.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - a knol by Theodore Fields</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://knol.google.com/k/gout?collectionId=14dmp09oqdm08.34">knol.google.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__21" class="citable__local-anchor">.</a><span class='citationPopup' rel="21">Gout, it must ever be borne in mind, may also affect persons who observe the strictest <a href="/Temperance" title="Temperance">temperance</a> in living, and whose only excesses are in the direction of over-work, either physical or intellectual.</span><span class="citable__li" citable_id="21"><a href="#citable__21"><strong>^</strong></a> <c_txt>Who is affected by gout?</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://my.clevelandclinic.org/disorders/Gout/hic_Gout.aspx">my.clevelandclinic.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="21"><a href="#citable__21"><strong>^</strong></a> <c_txt>Gout, it must ever be borne in mind, may also affect persons who observe the strictest temperance in living, and whose only excesses are in the direction of over-work, either physical or intellectual.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="21"><a href="#citable__21"><strong>^</strong></a> <c_txt>While any adult can fall prey to gout, the typical victim is a middle-aged male, who may be overweight and have a family history of the disease.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout | Home Remedies</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://homeremedies.prevention.com/gout-remedies?limit=50">homeremedies.prevention.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <a name="citable__47" class="citable__local-anchor">.</a><span class='citationPopup' rel="47">Many of the great names in history in all times have had their existence embittered by this malady, and have died from its effects.</span><span class="citable__li" citable_id="47"><a href="#citable__47"><strong>^</strong></a> <c_txt>Another great side effect is that my adult acne has all but disappeared, and my skin is much softer, wrinkles less prominent, my nails are stronger, too.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Arthritis Remedies on Earth Clinic, Your Source for natural cures!</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.earthclinic.com/CURES/arthritis.html">www.earthclinic.com</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="47"><a href="#citable__47"><strong>^</strong></a> <c_txt>In times of crisis, and in particular that we are living now, all possible resources to mitigate the effects of the crisis must be sought and evaluated.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Best Gout Treatment</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://bestgouttreatment.com/">bestgouttreatment.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="47"><a href="#citable__47"><strong>^</strong></a> <c_txt>We just added Gout Hater's Cookbook II and III to our kitchen reference library and we now have three times as many great recipes to use.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Amazon.com: Gout Hater's Cookbook I (9781888141740): Jodi Schneiter: Books</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.amazon.com/Gout-Haters-Cookbook-Jodi-Schneiter/dp/1888141743">www.amazon.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <a name="citable__144" class="citable__local-anchor">.</a><span class='citationPopup' rel="144">The influence of hereditary tendency may often be traced in such instances, and is doubtless called into activity by the depressing consequences of over-work.</span><span class="citable__li" citable_id="144"><a href="#citable__144"><strong>^</strong></a> <c_txt>To such I suppose the book may seem empty in the centre; to the others it is a room, a house of life, into which they themselves enter, and are tortured and purified.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Free Ebooks - The Letters of Robert Louis Stevenson, Volume II</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.bored.com/ebooks/British_Literature_New/stevenson%20robert%20louis/letters%20volume2.html">www.bored.com</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="144"><a href="#citable__144"><strong>^</strong></a> <c_txt>When it follows as a consequence of other health conditions such as renal failure , it is often regardless of the person's lifestyle.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout encyclopedia topics | Reference.com</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.reference.com/browse/gout">www.reference.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="144"><a href="#citable__144"><strong>^</strong></a> <c_txt>As in the case of any abdominal flux, so in this, it is particularly necessary that the patient should go to stool, not as often as inclined, but as often as compelled, so that by such delay the intestines may be got into the habit of holding up their contents.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>LacusCurtius • Celsus — On Medicine — Book IV </c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Celsus/4*.html">penelope.uchicago.edu</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <a name="citable__267" class="citable__local-anchor">.</a><span class='citationPopup' rel="267">It may, notwithstanding, be affirmed as generally true that those who <a href="/Lead" title="Lead">lead</a> regular lives, and are moderate in the use of animal food and alcoholic drinks, or still better abstain from the latter altogether, are less likely to be the victims of gout even where an undoubted inherited tendency exists.</span><span class="citable__li" citable_id="267"><a href="#citable__267"><strong>^</strong></a> <c_txt>Drink alcohol in moderation or not at all.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Gout | AHealthyMe.com</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.ahealthyme.com/topic/gout">www.ahealthyme.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="267"><a href="#citable__267"><strong>^</strong></a> <c_txt>It may, notwithstanding, be affirmed as generally true that those who lead regular lives, and are moderate in the use of animal food and alcoholic drinks, or still better abstain from the latter altogether, are less likely to be the victims of gout even where an undoubted inherited tendency exists.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="267"><a href="#citable__267"><strong>^</strong></a> <c_txt>Who is likely to develop gout?</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>FAQs | Gout & Uric Acid Education Society</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.gouteducation.org/gout/faqs.aspx">www.gouteducation.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> </div> <div style="margin: 1.12em 0; display:block"><a name="citable__5" class="citable__local-anchor">.</a><span class='citationPopup' rel="5">Gout is more common in mature age than in the earlier years of life, the greatest number of cases in one decennial period being between the ages of thirty and forty, next between twenty and thirty, and thirdly between forty and fifty.</span><span class="citable__li" citable_id="5"><a href="#citable__5"><strong>^</strong></a> <c_txt>They approved the first new gout drug in more than forty years.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Questions Being Raised About the Importance of Diet on Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.beatinggout.com/">www.beatinggout.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="5"><a href="#citable__5"><strong>^</strong></a> <c_txt>Gout is more common among men than women.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Gout: Crystal-Induced Arthritides: Merck Manual Professional </c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.merck.com/mmpe/sec04/ch035/ch035b.html">www.merck.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="5"><a href="#citable__5"><strong>^</strong></a> <c_txt>Gout is more common in men.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout natural treatment, food, diet, supplement herbs and vitamins by Ray Sahelian, M.D., Gout research</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.raysahelian.com/gout.html">www.raysahelian.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__167" class="citable__local-anchor">.</a><span class='citationPopup' rel="167">It may occasionally affect very young persons; such cases are generally regarded as hereditary, but, so far as diet is concerned, it has to be remembered that their home life has probably been a predisposing cause.</span><span class="citable__li" citable_id="167"><a href="#citable__167"><strong>^</strong></a> <c_txt>It may cause disability, in case it affects the entire body.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>My Gout Adventure</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.mygoutadventure.com/">www.mygoutadventure.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="167"><a href="#citable__167"><strong>^</strong></a> <c_txt>It may occasionally affect very young persons; such cases are generally regarded as hereditary, but, so far as diet is concerned, it has to be remembered that their home life has probably been a predisposing cause.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="167"><a href="#citable__167"><strong>^</strong></a> <c_txt>Hyperuricemia also may result when a person eats too many high-purine foods, such as liver, dried beans and peas, anchovies, and gravies.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Q&A About Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.niams.nih.gov/Health_Info/Gout/default.asp">www.niams.nih.gov</a> [Source type: Academic]</li><li> <em><c_title>Gout | Fitness and Freebies</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.fitnessandfreebies.com/health/gout.html">www.fitnessandfreebies.com</a> [Source type: FILTERED WITH BAYES]</li><li> <em><c_title>Health and Self-care: Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://siakhenn.tripod.com/gout.html">siakhenn.tripod.com</a> [Source type: FILTERED WITH BAYES]</li><li> <em><c_title>Gout | The Flexcin Blog</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.flexcin.com/blog/?tag=gout">www.flexcin.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__60" class="citable__local-anchor">.</a><span class='citationPopup' rel="60">After middle life gout rarely appears for the first time.</span><span class="citable__li" citable_id="60"><a href="#citable__60"><strong>^</strong></a> <c_txt>After middle life gout rarely appears for the first time.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="60"><a href="#citable__60"><strong>^</strong></a> <c_txt>It is rare that the first is the only attack of gout, and another is apt to occur within a year, although by care and treatment it may be warded off.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="60"><a href="#citable__60"><strong>^</strong></a> <c_txt>For example, gout is more likely if arthritis first appears in the big toe.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Channel Management System- Washington, DC</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.georgetownuniversityhospital.org/body.cfm?id=555563&action=articleDetail&AEProductID=Adam2004_5010&AEArticleID=000093&crawl=false">www.georgetownuniversityhospital.org</a> [Source type: Academic]</li><li> <em><c_title>Gout - Chronic Diagnosis - Gout - Chronic Health Information - NY Times Health</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://health.nytimes.com/health/guides/disease/gout-chronic/diagnosis.html">health.nytimes.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__227" class="citable__local-anchor">.</a><span class='citationPopup' rel="227">Women are much less the subjects of gout than men, apparently from their less exposure to the influences (excepting, of course, that of heredity) which tend to develop the disease, and doubtless also from the differing circumstances of their physical constitution.</span><span class="citable__li" citable_id="227"><a href="#citable__227"><strong>^</strong></a> <c_txt>Gout is a fairly common disease, more common in men than women, and rare in premenopausal women.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout and Pseudogout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/gout-and-pseudogout/">www.clevelandclinicmeded.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="227"><a href="#citable__227"><strong>^</strong></a> <c_txt>More men develop gout than women.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>gout symptoms, causes, diagnosis, foods that cause gout and treatments</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.seekwellness.com/gout/what_is_gout.htm">www.seekwellness.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="227"><a href="#citable__227"><strong>^</strong></a> <c_txt>Gout is more common among men than women.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Gout: Crystal-Induced Arthritides: Merck Manual Professional </c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.merck.com/mmpe/sec04/ch035/ch035b.html">www.merck.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__63" class="citable__local-anchor">.</a><span class='citationPopup' rel="63">It most frequently appears in females after the cessation of the menses.</span><span class="citable__li" citable_id="63"><a href="#citable__63"><strong>^</strong></a> <c_txt>It most frequently appears in females after the cessation of the menses.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - LoveToKnow 1911</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.1911encyclopedia.org/Gout">www.1911encyclopedia.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__39" class="citable__local-anchor">.</a><span class='citationPopup' rel="39">Persons exposed to the influence of <a href="/Lead_Poisoning" title="Lead Poisoning">lead poisoning</a>, such as plumbers, painters, &c., are apt to suffer from gout; and it would seem that impregnation of the system with this <a href="/Metal" title="Metal">metal</a> markedly interferes with the uric acid excreting function of the kidneys.</span><span class="citable__li" citable_id="39"><a href="#citable__39"><strong>^</strong></a> <c_txt>Designed specifically for persons suffering from gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Amazon.com: Gout Hater's Cookbook I (9781888141740): Jodi Schneiter: Books</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.amazon.com/Gout-Haters-Cookbook-Jodi-Schneiter/dp/1888141743">www.amazon.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="39"><a href="#citable__39"><strong>^</strong></a> <c_txt>By interfering with the kidneys' ability to excrete uric acid.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://preventdisease.com/diseases/gout.html">preventdisease.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="39"><a href="#citable__39"><strong>^</strong></a> <c_txt>Serum uric acid is also significantly influenced by the ability of the kidney to excrete uric acid.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout information at MyFootShop.com!</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.myfootshop.com/detail.asp?Condition=Gout">www.myfootshop.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> </div> <div style="margin: 1.12em 0; display:block"><a name="citable__174" class="citable__local-anchor">.</a><span class='citationPopup' rel="174">Attacks of gout are readily excited in those predisposed to the disease.</span><span class="citable__li" citable_id="174"><a href="#citable__174"><strong>^</strong></a> <c_txt>Those with gout should see their doctor to see if there are any medications that may prevent or help with the pain in case of another attack.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Avoid Foods That Cause Gout</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.squidoo.com/Avoid-Foods-That-Cause-Gout">www.squidoo.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="174"><a href="#citable__174"><strong>^</strong></a> <c_txt>Patients with recurrent attacks of gout have a longer duration of illness and are more likely to have polyarthric disease.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Diagnosis and Management of Gout - April 1, 1999 - American Academy ofFamily Physicians</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.aafp.org/afp/990401ap/1799.html">www.aafp.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="174"><a href="#citable__174"><strong>^</strong></a> <c_txt>Recommended for those whove had their first gout attack.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Resource</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://goutresource.com/">goutresource.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__26" class="citable__local-anchor">.</a><span class='citationPopup' rel="26">Exposure to cold, disorders of digestion, fatigue, and irritation or injuries of particular joints will often precipitate the gouty paroxysm.</span><span class="citable__li" citable_id="26"><a href="#citable__26"><strong>^</strong></a> <c_txt>However, the disorder is often associated with an injury or surgical procedure, periods of stress, or reactions to alcohol (malt liquors and wines) and certain drugs, including antibiotics.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Special Edition Newsletter</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.theolivebranch.com/news/gout.htm">www.theolivebranch.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="26"><a href="#citable__26"><strong>^</strong></a> <c_txt>A history of intermittent inflammatory arthritis, in which the joints return to normal between attacks, is typically caused by crystalline disorders and is characteristic of gouty arthritis early in its course.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout: eMedicine Rheumatology</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://emedicine.medscape.com/article/329958-overview">emedicine.medscape.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="26"><a href="#citable__26"><strong>^</strong></a> <c_txt>Acute gouty arthritis often is precipitated by trauma, infection, surgery, etc.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://wrongdiagnosis.com/g/gout/intro.htm">wrongdiagnosis.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> </div> <div style="margin: 1.12em 0; display:block"><a name="citable__34" class="citable__local-anchor">.</a><span class='citationPopup' rel="34">With respect to the treatment of gout the greatest variety of opinion has prevailed and practice been pursued, from the numerous <a href="/Quaint" title="Quaint">quaint</a> nostrums detailed by Lucian to the "expectant" or do-nothing system recommended by Sydenham.</span><span class="citable__li" citable_id="34"><a href="#citable__34"><strong>^</strong></a> <c_txt>It is recommended with both drug medication and natural remedy for gout treatments.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.buzzle.com/articles/gout/">www.buzzle.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="34"><a href="#citable__34"><strong>^</strong></a> <c_txt>SELECTION CRITERIA: Randomized controlled trials and controlled clinical trials investigating the use of systemic corticosteroids in the treatment of acute gout were included.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout: Free Medical and Health Information on Gout Research and Treatment</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.lifestages.com/health/gout.html">www.lifestages.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="34"><a href="#citable__34"><strong>^</strong></a> <c_txt>OBJECTIVES: To assess the efficacy and safety of systemic corticosteroids in the treatment of acute gout in comparison with placebo, NSAIDs, colchicine, other active drugs, other therapies, or no therapy.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout: Free Medical and Health Information on Gout Research and Treatment</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.lifestages.com/health/gout.html">www.lifestages.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__179" class="citable__local-anchor">.</a><span class='citationPopup' rel="179">But gout, although, as has been shown, a malady of a most severe and intractable character, may nevertheless be successfully dealt with by appropriate medicinal and hygienic measures.</span><span class="citable__li" citable_id="179"><a href="#citable__179"><strong>^</strong></a> <c_txt>The most common inflammatory arthritis in men over the age of 40, gout is characterized by sudden and severe episodes of pain, tenderness, redness, stiffness and swelling of joints.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Gout News, Video and Description</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.news-medical.net/?tag=/Gout">www.news-medical.net</a> [Source type: News]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="179"><a href="#citable__179"><strong>^</strong></a> <c_txt>Primary-care doctors treat most of the gout cases, but severe cases may be referred to a rheumatologist, who specializes in arthritic diseases.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout: Sufferers know to toe the line with a proper diet </c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.post-gazette.com/food/20011104gout1104fnp3.asp">www.post-gazette.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="179"><a href="#citable__179"><strong>^</strong></a> <c_txt>If left untreated, a gout attack may last several days, but usually goes completely within 7-10 days.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout | Health | Patient UK</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.patient.co.uk/showdoc/23068747/">www.patient.co.uk</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> The general plan of treatment can be here only briefly indicated. <a name="citable__195" class="citable__local-anchor">.</a><span class='citationPopup' rel="195">During the acute attack the affected part should be kept at perfect rest, and have applied to it warm opiate fomentations or poultices, or, what answers quite as well, be enveloped in <a href="/Cotton" title="Cotton">cotton</a> <a href="/Wool%2C_worsted_and_woollen_manufactures" title="Wool, worsted and woollen manufactures">wool</a> covered in with oil <a href="/Silk" title="Silk">silk</a>.</span><span class="citable__li" citable_id="195"><a href="#citable__195"><strong>^</strong></a> <c_txt>Healthcare practitioners recommend resting the affected joint during acute gout attacks.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Harris Teeter - Herbal Remedies</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.harristeeter.com/healthnotes.aspx?org=harristeeter&pgpid=368&ContentID=1023001">www.harristeeter.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="195"><a href="#citable__195"><strong>^</strong></a> <c_txt>Gout usually begins with an acute attack of pain, inflammation, extreme tenderness, and redness in the affected joint—often the big toe and sometimes the ankle or knee.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> gout Facts, information, pictures | Encyclopedia.com articles about gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.encyclopedia.com/topic/gout.aspx">www.encyclopedia.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="195"><a href="#citable__195"><strong>^</strong></a> <c_txt>This occurs commonly in men in their toes but can appear in other parts of the body and affects women as well.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout encyclopedia topics | Reference.com</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.reference.com/browse/gout">www.reference.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__155" class="citable__local-anchor">.</a><span class='citationPopup' rel="155">The diet of the patient should be light, without animal food or stimulants.</span><span class="citable__li" citable_id="155"><a href="#citable__155"><strong>^</strong></a> <c_txt>Without question, foods for a gout diet should contain lots of antioxidants.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout remedies, The best available natural and drug remedies.</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.best-gout-remedies.com/">www.best-gout-remedies.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="155"><a href="#citable__155"><strong>^</strong></a> <c_txt>Avoid crash dieting (7) Best foods that should help heal: celery, cherries or cherry juice, bananas, and pineapples.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout: What vitamins to take, what foods to eat, and what foods to stay away from.? - Yahoo! Answers</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://answers.yahoo.com/question/index?qid=20070729132842AA3u6rx">answers.yahoo.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="155"><a href="#citable__155"><strong>^</strong></a> <c_txt>Patients should avoid low-carbohydrate diets that are designed for quick weight loss.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - Medpedia</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://wiki.medpedia.com/Gout">wiki.medpedia.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__142" class="citable__local-anchor">.</a><span class='citationPopup' rel="142">The administration of some simple laxative will be of service, as well as the free use of alkaline <a href="/Diuretics" title="Diuretics">diuretics</a>, such as the bicarbonate or acetate of potash.</span><span class="citable__li" citable_id="142"><a href="#citable__142"><strong>^</strong></a> <c_txt>Natural gout treatment involves the use of vitamins and minerals such as calcium, potassium, fish oils, quercetin and sometimes some others.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.buzzle.com/articles/gout/">www.buzzle.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="142"><a href="#citable__142"><strong>^</strong></a> <c_txt>For example, diuretics ('water tablets') such as bendroflumethiazide, aspirin (at full painkiller dose - not low dose aspirin used to prevent blood clots), and some chemotherapy medicines.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout | Health | Patient UK</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.patient.co.uk/showdoc/23068747/">www.patient.co.uk</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="142"><a href="#citable__142"><strong>^</strong></a> <c_txt>Gout patients with hypertension treatment can be used in addition to diuretics than any antihypertensive drugs such as calcium antagonist (nifedipine sustained-release tablets, ammonia ...</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - Blog Toplist</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.blogtoplist.com/rss/gout.html">www.blogtoplist.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__117" class="citable__local-anchor">.</a><span class='citationPopup' rel="117">The medicinal <a href="/Agent" title="Agent">agent</a> most relied on for the relief of pain is <a href="/Colchicum" title="Colchicum">colchicum</a>, which manifestly exercises a powerful action on the disease.</span><span class="citable__li" citable_id="117"><a href="#citable__117"><strong>^</strong></a> <c_txt>Gout is often said to be the most painful of all the rheumatic diseases.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>arc :: Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.arc.org.uk/arthinfo/patpubs/6015/6015.asp">www.arc.org.uk</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="117"><a href="#citable__117"><strong>^</strong></a> <c_txt>Medicines such as arthritis pain relief and anti inflammatory drugs can be taken in addition to exercise and life changes.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Get Rid Of Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://get-rid-of-gout.com/">get-rid-of-gout.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="117"><a href="#citable__117"><strong>^</strong></a> <c_txt>Simply Flower Power Pain Relief & Moisturising Cream has helped many skin problems to become at least more tolerable.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Natural Health Society of Australia - Ask Roger a Question</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.health.org.au/index.cfm/page/265">www.health.org.au</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> This <a href="/Drug" title="Drug">drug</a> (<em>Colchicum autumnale</em>), which is believed to correspond to the hermodactyl of the ancients, has proved of such efficacy in modifying the attacks that, as observed by Dr Garrod, "we may safely assert that colchicum possesses as specific a control over the gouty inflammation as <a href="/Cinchona" title="Cinchona">cinchona</a> barks or their alkaloids over intermittent <a href="/Fever" title="Fever">fever</a>." It is usually administered in the form of the <a href="/Wine" title="Wine">wine</a> in doses of 10 to 30 drops every four or six hours, or in pill as the acetous <a href="/Extract" title="Extract">extract</a> (gr. 2-gr. i.). <a name="citable__75" class="citable__local-anchor">.</a><span class='citationPopup' rel="75">The effect of colchicum in subduing the pain of gout is generally so prompt and marked that it is unnecessary to have recourse to opiates; but its action requires to be carefully watched by the physician from its well-known nauseating and depressing consequences, which, should they appear, render the suspension of the drug necessary.</span><span class="citable__li" citable_id="75"><a href="#citable__75"><strong>^</strong></a> <c_txt>However one should keep the side effects of NSAIDs in mind, and they can include formation of stomach ulcers as well as high blood pressure.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Best Gout Home Remedies</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.bestgoutremedies.com/">www.bestgoutremedies.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="75"><a href="#citable__75"><strong>^</strong></a> <c_txt>Those with gout should see their doctor to see if there are any medications that may prevent or help with the pain in case of another attack.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Avoid Foods That Cause Gout</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.squidoo.com/Avoid-Foods-That-Cause-Gout">www.squidoo.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="75"><a href="#citable__75"><strong>^</strong></a> <c_txt>It has been a result of several medical researches and studies that uric acid foods are major contributing factors in causing a painful arthritic disease known as gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Relief Made Easy - Natural Remedies For Gout Revealed</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.goutremoval.com/">www.goutremoval.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <a name="citable__38" class="citable__local-anchor">.</a><span class='citationPopup' rel="38">Otherwise the remedy may be continued in gradually diminishing doses for some days after the disappearance of the gouty inflammation.</span><span class="citable__li" citable_id="38"><a href="#citable__38"><strong>^</strong></a> <c_txt>Dosing: 50mg bid-400mg/day, may go up to 800mg/day .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Hyperuricemia And Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.uic.edu/classes/pmpr/pmpr652/Final/stevens/gout.html">www.uic.edu</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="38"><a href="#citable__38"><strong>^</strong></a> <c_txt>Some essences, like Rescue Remedy, are blended to have an effect regarding a recent (minutes, hours, days) traumatic event.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.feedage.com/feeds/301241/home-remedies--health--fitness--articleproscom">www.feedage.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="38"><a href="#citable__38"><strong>^</strong></a> <c_txt>However, I may find some inspiration some day.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Free Ebooks - The Letters of Robert Louis Stevenson, Volume II</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.bored.com/ebooks/British_Literature_New/stevenson%20robert%20louis/letters%20volume2.html">www.bored.com</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <a name="citable__95" class="citable__local-anchor">.</a><span class='citationPopup' rel="95">Should gout give evidence of its presence in an irregular form by attacking internal organs, besides the medicinal treatment above mentioned, the use of frictions and <a href="/Mustard" title="Mustard">mustard</a> applications to the joints is indicated with the view of exciting its appearance there.</span><span class="citable__li" citable_id="95"><a href="#citable__95"><strong>^</strong></a> <c_txt>So, it is a medication widely used for gout treatment.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.buzzle.com/articles/gout/">www.buzzle.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="95"><a href="#citable__95"><strong>^</strong></a> <c_txt>Evidence supporting the use of colchicine to prevent recurrent attacks of gout .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Clinical topic - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/gout">www.cks.nhs.uk</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="95"><a href="#citable__95"><strong>^</strong></a> <c_txt>Evidence supporting the use of corticosteroids for an acute attack of gout .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Clinical topic - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/gout">www.cks.nhs.uk</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__241" class="citable__local-anchor">.</a><span class='citationPopup' rel="241">When gout has become chronic, colchicum, although of less service than in acute gout, is yet valuable, particularly when the inflammatory attacks recur.</span><span class="citable__li" citable_id="241"><a href="#citable__241"><strong>^</strong></a> <c_txt>Acute attacks may be indistinguishable from acute gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout and Pseudogout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/gout-and-pseudogout/">www.clevelandclinicmeded.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="241"><a href="#citable__241"><strong>^</strong></a> <c_txt>An acute attack of gout is very painful.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://wrongdiagnosis.com/g/gout/intro.htm">wrongdiagnosis.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="241"><a href="#citable__241"><strong>^</strong></a> <c_txt>Less than 5% of patients with gout are female.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.podlink.com/pathology/gout.htm">www.podlink.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__89" class="citable__local-anchor">.</a><span class='citationPopup' rel="89">More benefit, however, appears to be derived from <a href="/Potassium" title="Potassium">potassium</a> iodide, <a href="/Guaiacum" title="Guaiacum">guaiacum</a>, the alkalis potash and lithia, and from the administration of aspirin and <a href="/Sodium" title="Sodium">sodium</a> salicylate.</span><span class="citable__li" citable_id="89"><a href="#citable__89"><strong>^</strong></a> <c_txt>However, aspirin and closely related drugs (salicylates) should be avoided because they can ultimately worsen gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout | Encyclopedia of Medicine | Find Articles at BNET</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://findarticles.com/p/articles/mi_g2601/is_0006/ai_2601000603/">findarticles.com</a> [Source type: News]</li></ul></c_src></small></div><br></span> Salicylate of menthol is an effective local application, painted on and covered with a <a href="/Gutta_Percha" title="Gutta Percha">gutta-percha</a> bandage. Lithia was strongly recommended by Dr Garrod from its solvent action upon the urates. It is usually administered in the form of the carbonate (gr. v., freely diluted).</div> <div style="margin: 1.12em 0; display:block"><a name="citable__214" class="citable__local-anchor">.</a><span class='citationPopup' rel="214">The treatment and regimen to be employed in the intervals of the gouty attacks are of the highest importance.</span><span class="citable__li" citable_id="214"><a href="#citable__214"><strong>^</strong></a> <c_txt>Acute Gouty Arthritis Three treatments currently available for acute gouty arthritis attacks are nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine and corticosteroids.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Diagnosis and Management of Gout - April 1, 1999 - American Academy ofFamily Physicians</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.aafp.org/afp/990401ap/1799.html">www.aafp.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="214"><a href="#citable__214"><strong>^</strong></a> <c_txt>Without treatment the attack subsides in a week or so, and when patients first develop gout, there may be intervals of many months or even years between attacks.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>The Best Natural Solution For Any Type Of Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.goutcurepatch.com/">www.goutcurepatch.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="214"><a href="#citable__214"><strong>^</strong></a> <c_txt>Acute Gout The four treatment options available for the acute gouty attack are NSAIDs, colchicine, corticosteroids and analgesics (Table 3 and Figure 4).</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.aafp.org/afp/990215ap/925.html">www.aafp.org</a> [Source type: Academic]</li><li> <em><c_title>Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://newcms.aafp.org/afp/990215ap/925.html">newcms.aafp.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__48" class="citable__local-anchor">.</a><span class='citationPopup' rel="48">These bear reference for the most part to the habits and mode of life of the patient.</span><span class="citable__li" citable_id="48"><a href="#citable__48"><strong>^</strong></a> <c_txt>For most of these patients we suggest one of the alkaline calciums such as calcium lactate, calcium gluconate, or egg-shell compounds.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Arthitis Natural Treatment</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.healing.org/only-21.html">www.healing.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="48"><a href="#citable__48"><strong>^</strong></a> <c_txt>Most of these overseas patients have never had a personal meeting with him.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout clinic with homeopathy, acupressure, diet, nutrition, home remedies, herbal, etc.</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.homeopathictreatment4u.com/gout.html">www.homeopathictreatment4u.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="48"><a href="#citable__48"><strong>^</strong></a> <c_txt>It isn't as restricted as most, but it does take a certain amount of diligence and resignation on the part of the patient to follow it correctly.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Arthitis Natural Treatment</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.healing.org/only-21.html">www.healing.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__136" class="citable__local-anchor">.</a><span class='citationPopup' rel="136">Restriction must be laid upon the amount and quality of the food, and equally, or still more, upon the alcoholic stimulants.</span><span class="citable__li" citable_id="136"><a href="#citable__136"><strong>^</strong></a> <c_txt>Obviously we can not ignore also the food, which must be of good quality, including vegetables, legumes and fruits, especially citrus and those with large amounts of vitamin C, such as cherry, kiwi, cashew, etc..</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Best Gout Treatment</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://bestgouttreatment.com/">bestgouttreatment.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="136"><a href="#citable__136"><strong>^</strong></a> <c_txt>Martial, perchance, - but he is dead, And Herrick now must rhyme no more; Still burning with the muse, they tread (And arm in arm) the shadowy shore.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Free Ebooks - The Letters of Robert Louis Stevenson, Volume II</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.bored.com/ebooks/British_Literature_New/stevenson%20robert%20louis/letters%20volume2.html">www.bored.com</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="136"><a href="#citable__136"><strong>^</strong></a> <c_txt>It is true that if you over-indulge in alcohol (especially beer and wine) or food, attacks of gout are more likely, but that is not the whole story.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>arc :: Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.arc.org.uk/arthinfo/patpubs/6015/6015.asp">www.arc.org.uk</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> "The instances," says Sir Thomas Watson, "are not few of men of good sense, and masters of themselves, who, being warned by one <a href="/Visitation" title="Visitation">visitation</a> of the gout, have thenceforward resolutely abstained from rich living and from wine and strong drinks of all kinds, and who have been rewarded for their prudence and self-denial by complete <a href="/Immunity" title="Immunity">immunity</a> from any return of the disease, or upon whom, at any rate, its future assaults have been few and feeble." The same eminent authority adds: "I am sure it is worth any <em>young</em> man's while, who has had the gout, to become a teetotaller." <a name="citable__123" class="citable__local-anchor">.</a><span class='citationPopup' rel="123">By those more advanced in life who, from long continued habit, are unable entirely to relinquish the use of stimulants, the strictest possible temperance must be observed.</span><span class="citable__li" citable_id="123"><a href="#citable__123"><strong>^</strong></a> <c_txt>Men, particularly those between the ages of 40 and 50, are more likely to develop gout than women, who rarely develop the disorder before menopause.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Q&A About Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.niams.nih.gov/Health_Info/Gout/default.asp">www.niams.nih.gov</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="123"><a href="#citable__123"><strong>^</strong></a> <c_txt>From a congenital defect, I must suppose, I am unable to write the word OR - wherever I write it the printer unerringly puts AS - and those who read for me had better, wherever it is possible, substitute OR for AS. This the more so since many writers have a habit of using AS which is death to my temper and confusion to my face.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Free Ebooks - The Letters of Robert Louis Stevenson, Volume II</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.bored.com/ebooks/British_Literature_New/stevenson%20robert%20louis/letters%20volume2.html">www.bored.com</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="123"><a href="#citable__123"><strong>^</strong></a> <c_txt>Rare and life-threatening hypersensitivity reactions are possible with allopurinol use.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout natural treatment, food, diet, supplement herbs and vitamins by Ray Sahelian, M.D., Gout research</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.raysahelian.com/gout.html">www.raysahelian.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__108" class="citable__local-anchor">.</a><span class='citationPopup' rel="108">Regular but moderate exercise in the form of walking or <a href="/Riding" title="Riding">riding</a>, in the case of those who lead sedentary lives, is of great advantage, and all over-work, either physical or mental, should be avoided.</span><span class="citable__li" citable_id="108"><a href="#citable__108"><strong>^</strong></a> <c_txt>Who should avoid taking colchicine?</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Clinical topic - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/gout">www.cks.nhs.uk</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="108"><a href="#citable__108"><strong>^</strong></a> <c_txt>Eighth, have regular, moderate physical activity.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Natural Health Society of Australia - Ask Roger a Question</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.health.org.au/index.cfm/page/265">www.health.org.au</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="108"><a href="#citable__108"><strong>^</strong></a> <c_txt>Ulcerations either do not heal at all, or at any rate form a scar with difficulty: there is also pain and some difficulty in walking fast or running.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>LacusCurtius • Celsus — On Medicine — Book IV </c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Celsus/4*.html">penelope.uchicago.edu</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <em>Fatiguez la bete, et reposez la tete</em> is the maxim of an experienced French <a href="/Doctor" title="Doctor">doctor</a> (Dr Debout d'Estrees of <a href="/Contrexeville" title="Contrexeville">Contrexeville</a>). <a name="citable__160" class="citable__local-anchor">.</a><span class='citationPopup' rel="160">Unfortunately the complete carrying out of such directions, even by those who feel their importance, is too often rendered difficult or impossible by circumstances of occupation and otherwise, and at most only an approximation can be made.</span><span class="citable__li" citable_id="160"><a href="#citable__160"><strong>^</strong></a> <c_txt>Upon the commencement of pain blood should be let; for when this is carried out at once in the first stages it ensures health, often for a year, sometimes for always.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>LacusCurtius • Celsus — On Medicine — Book IV </c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Celsus/4*.html">penelope.uchicago.edu</a> [Source type: Original source]</li><li> <em><c_title>Gout encyclopedia topics | Reference.com</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.reference.com/browse/gout">www.reference.com</a> [Source type: Academic]</li><li> <em><c_title> Gout Clinical Trials </c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.clinicalconnection.com/Clinical_Trials/Condition/gout.aspx">www.clinicalconnection.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="160"><a href="#citable__160"><strong>^</strong></a> <c_txt>Astragalus root is often recommended for boosting the immune system, in those who get sick easily or already have a serious illness.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Home Remedies // Health & Fitness // ArticlePros.com 301241 Feedage.com</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.feedage.com/feeds/301241/home-remedies--health--fitness--articleproscom">www.feedage.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="160"><a href="#citable__160"><strong>^</strong></a> <c_txt>Most of the symptoms are common to those of the adults, but there are others to be added such as rashes and fever .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>My Gout Adventure</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.mygoutadventure.com/">www.mygoutadventure.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <a name="citable__197" class="citable__local-anchor">.</a><span class='citationPopup' rel="197">Certain <a href="/Mineral_Waters" title="Mineral Waters">mineral waters</a> and <a href="/Baths" title="Baths">baths</a> (such as those of <a href="/Vichy" title="Vichy">Vichy</a>, <a href="/Royat" title="Royat">Royat</a>, Contrexeville, &c.</span><span class="citable__li" citable_id="197"><a href="#citable__197"><strong>^</strong></a> <c_txt>Use of alcohol or some medications, such as certain diuretics (also known as water pills), particularly those used to treat high blood pressure, can set off a gout attack.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout --><title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.arthritis.ca/types%20of%20arthritis/gout/default.asp?s=1&province=on">www.arthritis.ca</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="197"><a href="#citable__197"><strong>^</strong></a> <c_txt>Certain people, such as those who are receiving cyclosporine after a transplant, have a high risk of developing tophi.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Channel Management System- Washington, DC</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.georgetownuniversityhospital.org/body.cfm?id=555563&action=articleDetail&AEProductID=Adam2004_5010&AEArticleID=000093&crawl=false">www.georgetownuniversityhospital.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> ) are of undoubted value in cases of gout and arthritis. <a name="citable__262" class="citable__local-anchor">.</a><span class='citationPopup' rel="262">The particular place must in each case be determined by the physician, and special caution must be observed in recommending this plan of treatment in persons whose gout is complicated by organic disease of any kind.</span><span class="citable__li" citable_id="262"><a href="#citable__262"><strong>^</strong></a> <c_txt>Treatment of associated diseases is recommended.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout and Pseudogout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/gout-and-pseudogout/">www.clevelandclinicmeded.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="262"><a href="#citable__262"><strong>^</strong></a> <c_txt>What treatment is recommended in acute gout?</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Clinical topic - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/gout">www.cks.nhs.uk</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="262"><a href="#citable__262"><strong>^</strong></a> <c_txt>Fewer than one in five people with elevated levels of uric acid in the blood actually develop gout, and unless a persons uric acid level in the blood is very high (in which case it can lead to kidney complications) it on its own does not require treatment.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout --><title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.arthritis.ca/types%20of%20arthritis/gout/default.asp?s=1&province=on">www.arthritis.ca</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> </div> <div style="margin: 1.12em 0; display:block"><a name="citable__104" class="citable__local-anchor">.</a><span class='citationPopup' rel="104">Dr Alexander Haig's "uric acid free diet" has found many adherents.</span><span class="citable__li" citable_id="104"><a href="#citable__104"><strong>^</strong></a> <c_txt>Avoid diet sodas (these act as diuretics in many people, causing uric acid to concentrate in the blood which can then easily precipitate).</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Gout Clinical Trials </c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.clinicalconnection.com/Clinical_Trials/Condition/gout.aspx">www.clinicalconnection.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="104"><a href="#citable__104"><strong>^</strong></a> <c_txt>Because uric acid levels are only mildly affected by diet, dietary therapy does not play a large role in the prevention of gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Channel Management System- Washington, DC</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.georgetownuniversityhospital.org/body.cfm?id=555563&action=articleDetail&AEProductID=Adam2004_5010&AEArticleID=000093&crawl=false">www.georgetownuniversityhospital.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="104"><a href="#citable__104"><strong>^</strong></a> <c_txt>Diets high in protein, particularly animal protein, increase uric acid.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.podlink.com/pathology/gout.htm">www.podlink.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <a name="citable__28" class="citable__local-anchor">.</a><span class='citationPopup' rel="28">His view as regards the pathology is that in gouty persons the blood is less alkaline than in normal, and therefore less able to hold in solution uric acid or its salts, which are retained in the joints.</span><span class="citable__li" citable_id="28"><a href="#citable__28"><strong>^</strong></a> <c_txt>I also checked my blood for uric acid levels and it was normal.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Natural Gout Treatment, Remedies | Cure Gouty Symptoms, Causes | Arthritis Gout Diet | Pain Relief Remedy | Herbal Home Therapy, Medicine</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.biogetica.com/cure-gout.php">www.biogetica.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="28"><a href="#citable__28"><strong>^</strong></a> <c_txt>Uric acid elevation on blood testing .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout - a knol by Theodore Fields</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://knol.google.com/k/gout?collectionId=14dmp09oqdm08.34">knol.google.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="28"><a href="#citable__28"><strong>^</strong></a> <c_txt>A disturbance in chemical balance of the body, in which chronic excess uric acid in the blood leads to deposition of needle-shaped urate crystal in and around joints and tendons, where they cause inflammation (gout is a form of arthritis).</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout clinic with homeopathy, acupressure, diet, nutrition, home remedies, herbal, etc.</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.homeopathictreatment4u.com/gout.html">www.homeopathictreatment4u.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__46" class="citable__local-anchor">.</a><span class='citationPopup' rel="46">Assuming gout to be a poisoning by animal food (meat, <a href="/Fish" title="Fish">fish</a>, eggs), and by <a href="/Tea" title="Tea">tea</a>, <a href="/Coffee" title="Coffee">coffee</a>, <a href="/Cocoa" title="Cocoa">cocoa</a> and other <a href="/Vegetable" title="Vegetable">vegetable</a> <a href="/Alkaloid" title="Alkaloid">alkaloid</a>-containing substances, he recommends an average daily diet excluding these, and containing 24 oz.</span><span class="citable__li" citable_id="46"><a href="#citable__46"><strong>^</strong></a> <c_txt>Other - foods containing yeast extract.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Patient information leaflet - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/patient_information_leaflet/gout">www.cks.nhs.uk</a> [Source type: General]</li><li> <em><c_title> Clinical topic - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/gout">www.cks.nhs.uk</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="46"><a href="#citable__46"><strong>^</strong></a> <c_txt>Sea foods, especially shell fish, scallops, prawns, crabs, sardines and anchovies Offal meats such as livers, hearts, gizzards, tongues and kidneys Coffee and cocoa Tea Extracts of meats Vegetables such as spinach, peas and beans Sweetbreads Alcohols, especially beer Tofu The following foods must be increased in the diet as they can lower the content of uric acid:- .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>What is Gout, Symptoms, Treatment & Causes</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.ayushveda.com/health/gout.htm">www.ayushveda.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="46"><a href="#citable__46"><strong>^</strong></a> <c_txt>The uric acid is derived chiefly from nucleoproteins, which are found in nearly all foods of animal origin except eggs and milk, but these proteins are more common in the glandular organs such as sweetbreads, kidneys, and liver.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Arthitis Natural Treatment</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.healing.org/only-21.html">www.healing.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> of breadstuffs (t04st, <a href="/Bread" title="Bread">bread</a>, biscuits and puddings) together with 24 oz. of <a name="citable__85" class="citable__local-anchor">.</a><span class='citationPopup' rel="85"><a href="/Fruit" title="Fruit">fruit</a> and vegetables (excluding peas, beans, lentils, mushrooms and asparagus); 8 oz.</span><span class="citable__li" citable_id="85"><a href="#citable__85"><strong>^</strong></a> <c_txt>Vegetables - asparagus, kidney beans, lima beans, lentils and spinach.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Patient information leaflet - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/patient_information_leaflet/gout">www.cks.nhs.uk</a> [Source type: General]</li><li> <em><c_title> Clinical topic - Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.cks.nhs.uk/gout">www.cks.nhs.uk</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="85"><a href="#citable__85"><strong>^</strong></a> <c_txt>Other foods which are very rich in purines include liver, kidneys, red meat, yeast extracts, seafood (herring, sardines, and shellfish) and asparagus, beans, cauliflower, lentils, mushrooms, oatmeal and spinach.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Prophylaxis | Doctor | Patient UK</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.patient.co.uk/showdoc/40024972/">www.patient.co.uk</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="85"><a href="#citable__85"><strong>^</strong></a> <c_txt>There is no evidence to support a reduction in purine-rich vegetables such as peas, beans, mushrooms or cauliflower, unless intake is extreme.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout Prophylaxis | Doctor | Patient UK</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.patient.co.uk/showdoc/40024972/">www.patient.co.uk</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> of the breadstuffs may be replaced by 21 oz. of <a href="/Milk" title="Milk">milk</a> or 2 oz. of <a name="citable__78" class="citable__local-anchor">.</a><span class='citationPopup' rel="78"><a href="/Cheese" title="Cheese">cheese</a>, <a href="/Butter" title="Butter">butter</a> and oil being taken as required, so that it is not strictly a vegetarian diet.</span><span class="citable__li" citable_id="78"><a href="#citable__78"><strong>^</strong></a> <c_txt>Protein foods in a lacto-ovo-vegetarian diet are legumes, seeds (sunflower, sesame, pepitas and flax), nuts, free-range eggs and/or soft cheese.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Natural Health Society of Australia - Ask Roger a Question</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.health.org.au/index.cfm/page/265">www.health.org.au</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="78"><a href="#citable__78"><strong>^</strong></a> <c_txt>In a lacto-ovo-vegetarian diet (also containing eggs and cheese), there is a wider variety of protein foods with the addition of vitamin B 12 which does not occur in plant foods.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Natural Health Society of Australia - Ask Roger a Question</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.health.org.au/index.cfm/page/265">www.health.org.au</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="78"><a href="#citable__78"><strong>^</strong></a> <c_txt>Essential fatty acids are required for fat absorption, so if saturated fats are high in the diet and omega-3s and polyunsaturated oils are deficient, there can be malabsorption.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Natural Health Society of Australia - Ask Roger a Question</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.health.org.au/index.cfm/page/265">www.health.org.au</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> </div> <div style="margin: 1.12em 0; display:block"><a name="citable__153" class="citable__local-anchor">.</a><span class='citationPopup' rel="153">Precisely the opposite view as to diet has recently been put forward by Professor A. Robin of the Hbpital Beaujon, who says serious mistakes are made in ordering patients to abstain from red meats and take light food, fish, eggs, &c.</span><span class="citable__li" citable_id="153"><a href="#citable__153"><strong>^</strong></a> <c_txt>Excess intake of protein rich diet like red meat, pulses and cheese Natural Home Remedies for Gout Following are some of the effective home remedies for gout : 1.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Home Remedies for Gout, Causes, Symptoms | Gout Pain Relief</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.natural-cure-guide.com/home-remedies/gout.htm">www.natural-cure-guide.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="153"><a href="#citable__153"><strong>^</strong></a> <c_txt>Some foods contain large amounts of uric acid, especially red meats and internal organs (such as liver and kidneys), some shellfish, and anchovies.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://my.clevelandclinic.org/disorders/Gout/hic_Gout.aspx">my.clevelandclinic.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="153"><a href="#citable__153"><strong>^</strong></a> <c_txt>Try to reduce the intake of food that has a high purine content: eggs, duck meat, chicken, spinach, mushrooms, sardines, dried peas, beans and mussels.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Avoid Foods That Cause Gout</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.squidoo.com/Avoid-Foods-That-Cause-Gout">www.squidoo.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <a name="citable__166" class="citable__local-anchor">.</a><span class='citationPopup' rel="166">The common object in view is the diminished output of uric acid.</span><span class="citable__li" citable_id="166"><a href="#citable__166"><strong>^</strong></a> <c_txt>Increase output of uric acid .</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout encyclopedia topics | Reference.com</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.reference.com/browse/gout">www.reference.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="166"><a href="#citable__166"><strong>^</strong></a> <c_txt>Overproduction of Uric Acid Purines, which are later metabolized to uric acid, enter a common metabolic pathway by which either nucleic acid or uric acid is produced.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title> Diagnosis and Management of Gout - April 1, 1999 - American Academy ofFamily Physicians</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.aafp.org/afp/990401ap/1799.html">www.aafp.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="166"><a href="#citable__166"><strong>^</strong></a> <c_txt>Toxaemia of pregnancydue to diminished excretion of uric acid.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout clinic with homeopathy, acupressure, diet, nutrition, home remedies, herbal, etc.</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.homeopathictreatment4u.com/gout.html">www.homeopathictreatment4u.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__55" class="citable__local-anchor">.</a><span class='citationPopup' rel="55">This output is chiefly obtained from food rich in nucleins and in collagenous matters, <em>i.e.</em> young white meats, eggs, &c.</span><span class="citable__li" citable_id="55"><a href="#citable__55"><strong>^</strong></a> <c_txt>Try to reduce the intake of food that has a high purine content: eggs, duck meat, chicken, spinach, mushrooms, sardines, dried peas, beans and mussels.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Avoid Foods That Cause Gout</c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://www.squidoo.com/Avoid-Foods-That-Cause-Gout">www.squidoo.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="55"><a href="#citable__55"><strong>^</strong></a> <c_txt>While meat and certain types of seafood and shellfish do produce high levels of purines in the blood, research has suggested that not all purine-rich foods are associated with gout.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Channel Management System- Washington, DC</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.georgetownuniversityhospital.org/body.cfm?id=555563&action=articleDetail&AEProductID=Adam2004_5010&AEArticleID=000093&crawl=false">www.georgetownuniversityhospital.org</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="55"><a href="#citable__55"><strong>^</strong></a> <c_txt>To avoid Gout or hasten the process of curing Gout avoid Purine rich foods and beverages such as organ meats, poultry, seafood and products containing yeast.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout and Cherries</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.goutandcherries.com/">www.goutandcherries.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <a name="citable__103" class="citable__local-anchor">.</a><span class='citationPopup' rel="103">Consequently the gouty subject ought to restrict himself to the <a href="/Consumption" title="Consumption">consumption</a> of red <a href="/Meat" title="Meat">meat</a>, <a href="/Beef" title="Beef">beef</a> and mutton, and leave out of his <a href="/Dietary" title="Dietary">dietary</a> all white meat and internal organs.</span><span class="citable__li" citable_id="103"><a href="#citable__103"><strong>^</strong></a> <c_txt>In former days, kings and other royalty became gouty from an overuse of red meats, wines, liquors and an insufficient supply of fresh leafy vegetables.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Arthitis Natural Treatment</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.healing.org/only-21.html">www.healing.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="103"><a href="#citable__103"><strong>^</strong></a> <c_txt>Diets rich in red meats, internal organs, yeast, and oily fish.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>The Best Natural Solution For Any Type Of Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.goutcurepatch.com/">www.goutcurepatch.com</a> [Source type: General]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="103"><a href="#citable__103"><strong>^</strong></a> <c_txt>All glandular meats, red meat and meat extracts such as bouillon and gravies; organ meats such as liver, sweet breads, and kidney.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout clinic with homeopathy, acupressure, diet, nutrition, home remedies, herbal, etc.</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.homeopathictreatment4u.com/gout.html">www.homeopathictreatment4u.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__162" class="citable__local-anchor">.</a><span class='citationPopup' rel="162">He should take little hydrocarbons and sugars, and be moderate in fats.</span><span class="citable__li" citable_id="162"><a href="#citable__162"><strong>^</strong></a> <c_txt>If gout runs in the family, one should moderate their intake of alcohol, fats and high-purine food, and should keep their weight under control.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout clinic with homeopathy, acupressure, diet, nutrition, home remedies, herbal, etc.</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.homeopathictreatment4u.com/gout.html">www.homeopathictreatment4u.com</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="162"><a href="#citable__162"><strong>^</strong></a> <c_txt>If it stops of itself, the patient should make use of the bath, and take a little food; if it persists, he should abstain, not only from for, but even from drink.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>LacusCurtius • Celsus — On Medicine — Book IV </c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Celsus/4*.html">penelope.uchicago.edu</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="162"><a href="#citable__162"><strong>^</strong></a> <c_txt>If on the day following, in spite of all, the stool is still liquid, he should rest as before and take a little astringent food.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>LacusCurtius • Celsus — On Medicine — Book IV </c_title></em> <c_date>9 October 2009 4:56 UTC</c_date> <a href="http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Celsus/4*.html">penelope.uchicago.edu</a> [Source type: Original source]</li></ul></c_src></small></div><br></span> <a name="citable__212" class="citable__local-anchor">.</a><span class='citationPopup' rel="212">Vegetarian diet he regards as a mistake, likewise milk diet, as they tend to weaken the patient.</span><span class="citable__li" citable_id="212"><a href="#citable__212"><strong>^</strong></a> <c_txt>Specific diets don't seem as remedial for the rheumatoid arthritis patient as they are in osteoarthritis.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Arthitis Natural Treatment</c_title></em> <c_date>20 November 2009 6:13 UTC</c_date> <a href="http://www.healing.org/only-21.html">www.healing.org</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> <a name="citable__222" class="citable__local-anchor">.</a><span class='citationPopup' rel="222">To prevent the formation of uric acid Robin prescribes quinic acid combined with formine or urotropine.</span><span class="citable__li" citable_id="222"><a href="#citable__222"><strong>^</strong></a> <c_txt>Allopurinol (Alloprim®, Zyloprim®) works by preventing the formation of uric acid.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.uptodate.com/patients/content/topic.do?topicKey=~uX2uh.W.v1Wv3y">www.uptodate.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="222"><a href="#citable__222"><strong>^</strong></a> <c_txt>Seen above in Figure 3 is the formation of uric acid.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.jeffreywarber.com/hc%20pages/gout.html">www.jeffreywarber.com</a> [Source type: Academic]</li></ul></c_src></small></div><br></span> <span class="citable__li" citable_id="222"><a href="#citable__222"><strong>^</strong></a> <c_txt>Drink fluids (At least 4-5 cups a day) to prevent kidney stones and to help eliminate uric acid.</c_txt><div style="padding-left: 10px"><small><c_src><ul><li> <em><c_title>Gout: An In-Depth Overview - Conditions and Treatments - HSS</c_title></em> <c_date>27 January 2010 23:57 UTC</c_date> <a href="http://www.hss.edu/conditions_gout-in-depth-overview.asp">www.hss.edu</a> [Source type: FILTERED WITH BAYES]</li></ul></c_src></small></div><br></span> </div> <br clear="all" /> <div style='text-align:left'> <script language='javascript' type='text/javascript'> ServeSecondCustomGoogleAd(); </script> </div> <table width="100%" align="center" border="0"> <tr> <td width="50%" align="left"> <div style="margin: 1.12em 0; display:block"><< <a href="/Jean_Herauld_Gourville" title="Jean Herauld Gourville">Jean Herauld Gourville</a></div> </td> <td width="50%" align="right"> <div style="margin: 1.12em 0; display:block"><a href="/Pierre_Gouthiere" title="Pierre Gouthiere">Pierre Gouthiere</a> >></div> </td> </tr> </table> </div> <div id="1911encyclopedia_catlinks"> <p class='catlinks'>Categories: <a href="/Category:GOS-GRA" title="Category:GOS-GRA">GOS-GRA</a> | <a href="/Category:Health_and_medicine" title="Category:Health and medicine">Health and medicine</a></div> </div> </div> <div style="display:table-cell;clear:both;"></div> </div> </div><br/> </div> <div class="section-delimeter"></div> <div class="section" id="simple_wikipedia"> <h1 class="section-title"> <a name="simple_wikipedia">Simple English</a> </h1> <div style="float:right"> </div> <div class="fragment"> <div id="simple_wikipedia_fragments"> <table class="infobox" width="200" cellspacing="0" style="font-size: 95%; text-align:left"> <tr> <td style="text-align: center; background: lightgrey; font-size: 95%;" colspan="2"> <b>Gout</b><br /><i>Classification and other resource links</i> </td></tr> <tr style="line-height: 1;"> <td colspan="2" style="text-align:center;"> <small>Uric acid</small> </td></tr> <tr> <th> <a href="/ICD" title="ICD">ICD</a>-<a href="/List_of_ICD-10_codes" title="List of ICD-10 codes">10</a> </th><td> M<a href="http://www.who.int/classifications/apps/icd/icd10online/?gm05.htm+m10" class="external text" title="http://www.who.int/classifications/apps/icd/icd10online/?gm05.htm+m10" rel="nofollow">10.</a> </td></tr> <tr> <th> <a href="/ICD" title="ICD">ICD</a>-<a href="/List_of_ICD-9_codes" title="List of ICD-9 codes">9</a> </th><td> <a href="http://www.icd9data.com/getICD9Code.ashx?icd9=274.0" class="external text" title="http://www.icd9data.com/getICD9Code.ashx?icd9=274.0" rel="nofollow">274.0</a> <a href="http://www.icd9data.com/getICD9Code.ashx?icd9=274.1" class="external text" title="http://www.icd9data.com/getICD9Code.ashx?icd9=274.1" rel="nofollow">274.1</a> <a href="http://www.icd9data.com/getICD9Code.ashx?icd9=274.8" class="external text" title="http://www.icd9data.com/getICD9Code.ashx?icd9=274.8" rel="nofollow">274.8</a> <a href="http://www.icd9data.com/getICD9Code.ashx?icd9=274.9" class="external text" title="http://www.icd9data.com/getICD9Code.ashx?icd9=274.9" rel="nofollow">274.9</a> </td></tr> <tr> <th> OMIM </th><td> <a href="http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=138900" class="external text" title="http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=138900" rel="nofollow">138900</a> <a href="http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=300323" class="external text" title="http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=300323" rel="nofollow">300323</a> </td></tr> <tr> <th> <a href="http://en.wikipedia.org/wiki/Diseases_Database" class="extiw" title="en:Diseases Database">DiseasesDB</a> </th><td> <a href="http://www.diseasesdatabase.com/ddb29031.htm" class="external text" title="http://www.diseasesdatabase.com/ddb29031.htm" rel="nofollow">29031</a> </td></tr> <tr> <th> <a href="http://en.wikipedia.org/wiki/eMedicine" class="extiw" title="en:eMedicine">eMedicine</a> </th><td> <a href="http://www.emedicine.com/med/topic924.htm" class="external text" title="http://www.emedicine.com/med/topic924.htm" rel="nofollow">med/924</a>  <a href="http://www.emedicine.com/orthoped/topic124.htm" class="external text" title="http://www.emedicine.com/orthoped/topic124.htm" rel="nofollow">orthoped/124</a> <a href="http://www.emedicine.com/emerg/topic221.htm" class="external text" title="http://www.emedicine.com/emerg/topic221.htm" rel="nofollow">emerg/221</a> <a href="http://www.emedicine.com/med/topic1112.htm" class="external text" title="http://www.emedicine.com/med/topic1112.htm" rel="nofollow">med/1112</a> <a href="http://www.emedicine.com/oph/topic506.htm" class="external text" title="http://www.emedicine.com/oph/topic506.htm" rel="nofollow">oph/506</a> <a href="http://www.emedicine.com/radio/topic313.htm" class="external text" title="http://www.emedicine.com/radio/topic313.htm" rel="nofollow">radio/313</a> </td></tr> <tr> <th> <b><a href="http://en.wikipedia.org/wiki/Medical_Subject_Headings" class="extiw" title="en:Medical Subject Headings">MeSH</a></b> </th><td> <a href="http://www.nlm.nih.gov/cgi/mesh/2008/MB_cgi?field=uid&term=D006073" class="external text" title="http://www.nlm.nih.gov/cgi/mesh/2008/MB_cgi?field=uid&term=D006073" rel="nofollow">D006073</a> </td></tr> </table> <p><b>Gout</b> (also called <i><b>metabolic arthritis</b></i>) is a <a href="/Disease" title="Disease">disease</a> created by a buildup of uric acid. </p> <a name="Other_websites" id="Other_websites"></a><h2> <span class="mw-headline"> Other websites </span></h2> <p> </p> <ul><li> <a href="http://www.rheumatology.org/public/factsheets/gout.asp?aud=pat|" class="external text" title="http://www.rheumatology.org/public/factsheets/gout.asp?aud=pat|" rel="nofollow">American College of Rheumatology</a> - (ACR Fact Sheet on Gout) </li><li> <a href="http://my.webmd.com/hw/health_guide_atoz/ty2036.asp?navbar=hw69013" class="external text" title="http://my.webmd.com/hw/health_guide_atoz/ty2036.asp?navbar=hw69013" rel="nofollow">Diet and gout</a> - From webMD.com </li><li> <a href="http://www.thepatientconnections.com/blog.asp?uid=z0nsrl" class="external text" title="http://www.thepatientconnections.com/blog.asp?uid=z0nsrl" rel="nofollow">Online discussion of patients' experience of gout</a> </li></ul> <div class="notice metadata plainlinks" id="stub"><a href="/index.php?title=Special:Upload&wpDestFile=Wiki_letter_w.svg" class="new" title="File:Wiki letter w.svg"></a> <i>This <a href="/Category:Stubs" title="Category:Stubs">short article</a> can be made longer. You can help Wikipedia by <span class="plainlinks"><a href="http://yak.rapint.com/index.php?title=Gout&action=edit" class="external text" title="http://yak.rapint.com/index.php?title=Gout&action=edit" rel="nofollow">adding to it</a>. </i></div> <p><br /> </span> </p> </div> <div class="printfooter"> Retrieved from "<a href="http://yak.rapint.com/wiki/Gout">http://yak.rapint.com/wiki/Gout</a>"</div> <div class="contents"> <div id='catlinks' class='catlinks'><div id="mw-normal-catlinks"><a href="/Special:Categories" title="Special:Categories">Categories</a>: <span dir='ltr'><a href="/Category:Stubs" title="Category:Stubs">Stubs</a></span> | <span dir='ltr'><a href="/Category:Diseases" title="Category:Diseases">Diseases</a></span> | <span dir='ltr'><a href="/Category:Arthritis" class="new" title="Category:Arthritis (not yet started)">Arthritis</a></span> | <span dir='ltr'><a href="/Category:Rheumatology" class="new" title="Category:Rheumatology (not yet started)">Rheumatology</a></span></div></div> <div class="bottom"></div> </div> </div> </div><br/> </div> <div class="section-delimeter"></div> </div> <div id="core_panel_main" > <div class="section" id="citable_sentences"> <h1 class="section-title"> <a name="citable_sentences">Citable sentences</a> </h1> <div style="float:right"> <span class="core-uptodate">Up to date as of December 10, 2010</span> <br> </div> <div class="fragment"> <div id="citable_fragments"> <div id="citableSentencesList"> <p> Here are sentences from other pages on Gout, which are similar to those in the above article. <div id="citable__sentence_list"> </div> </p> </div> </div> </div><br/> </div> <div class="section-delimeter"></div> <div id="external_links_revision_history_tooltip"> </div> <script> $(document).ready(function() { $("#external_links_revision_history_fragments a[title]").tooltip({tip: '#external_links_revision_history_tooltip', effect: 'toggle', position: 'bottom right', offset: [-1,2], lazy: true, delay: 100}); $("#external_links_revision_history_fragments img[title]").tooltip({tip: '#external_links_revision_history_tooltip', position: 'bottom right', offset: [-1,0], lazy: true, effect: 'toggle'}); }); </script> <div class="section" id="related_links"> <h1 class="section-title"> <a name="related_links">Related links</a> </h1> <span class="core-uptodate">Up to date as of November 16, 2009</span> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/tick-green-8x11.gif" align="bottom" title = "This page is marked authoritative because it has been included for <B>98%</B> of the life of the Wikipedia article."> </nobr></td><td><a href="http://ard.bmjjournals.com/cgi/content/full/62/6/497" title=". PMID 12759281.<br><br><A HREF=http://ard.bmjjournals.com/cgi/content/full/62/6/497>http://ard.bmjjournals.com/cgi/content/full/62/6/497</A>">Fenofibrate and losartan</a> - Ann Rheum Dis -- Sign In Page</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/tick-green-8x11.gif" align="bottom" title = "This page is marked authoritative because it has been included for <B>96%</B> of the life of the Wikipedia article."> </nobr></td><td><a href="http://www.britishdalmatianclub.org.uk/downloads/Purine%20Table%202003_files/sheet001.htm" title="<A HREF=http://www.britishdalmatianclub.org.uk/downloads/Purine%20Table%202003_files/sheet001.htm>http://www.britishdalmatianclub.org.uk/downloads/Purine%20Table%202003_files/sheet001.htm</A>">Purine content in food</a></td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/tick-green-8x11.gif" align="bottom" title = "This page is marked authoritative because it has been included for <B>79%</B> of the life of the Wikipedia article."> </nobr></td><td><a href="http://bmj.bmjjournals.com/cgi/content/full/320/7228/132" title=". PMID 10634714.<br><br><A HREF=http://bmj.bmjjournals.com/cgi/content/full/320/7228/132>http://bmj.bmjjournals.com/cgi/content/full/320/7228/132</A>">Gout. Easy to misdiagnose</a> - bmj.com Sign In Page</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/tick-green-8x11.gif" align="bottom" title = "This page is marked authoritative because it has been included for <B>79%</B> of the life of the Wikipedia article."> </nobr></td><td><a href="http://ard.bmjjournals.com/cgi/content/full/58/5/266" title=". PMID: 10225809<br><br><A HREF=http://ard.bmjjournals.com/cgi/content/full/58/5/266>http://ard.bmjjournals.com/cgi/content/full/58/5/266</A>">Rheumatic disease and the Australian aborigine</a> - Ann Rheum Dis -- Sign In Page</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/tick-green-8x11.gif" align="bottom" title = "This page is marked authoritative because it has been included for <B>74%</B> of the life of the Wikipedia article."> </nobr></td><td><a href="http://my.webmd.com/hw/health_guide_atoz/ty2036.asp?navbar=hw69013" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>A diet rich in purines from certain sources can raise uric acid levels in the body, which sometimes leads to <B>gout</B>.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Meat and seafood may increase your risk of <B>gout</B>, while dairy products may lower your risk.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Foods to eat occasionally (moderately high in purines, but may not raise your risk of <B>gout</B>):</TD></TR></TABLE><BR><A HREF=http://my.webmd.com/hw/health_guide_atoz/ty2036.asp?navbar=hw69013>http://my.webmd.com/hw/health_guide_atoz/ty2036.asp?navbar=hw69013</A>">Diet and gout</a></td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.arthritisconsult.com/gout.html#risk" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>What are the general guidelines for treating <B>gout</B>?</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD><B>Gout</B> is a type of arthritis (inflammation of the joints) that mostly affects men age 40 and older.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>The process leading to hyperuricemia and <B>gout</B> begins with the metabolism of purines, nitrogen-containing compounds that are important for energy.</TD></TR></TABLE><BR><A HREF=http://www.arthritisconsult.com/gout.html#risk>http://www.arthritisconsult.com/gout.html#risk</A>">What Are the Risk Factors for Gout?</a> - Rheumatology Therapeutics Medical Center</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.ajcn.org/cgi/reprint/2/4/276" title="<A HREF=http://www.ajcn.org/cgi/reprint/2/4/276>http://www.ajcn.org/cgi/reprint/2/4/276</A>">The low purine diet</a> - THE LOW PURINE DIET -- ROBINSON 2 (4): 276 -- American Journal of Clinical Nutrition</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://newcms.aafp.org/afp/990215ap/925.html" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD><B>Gout</B> is a condition characterized by the deposition of monosodium urate crystals in the joints or soft tissue.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>The four phases of <B>gout</B> include asymptomatic hyperuricemia, acute <B>gout</B>y arthritis, intercritical <B>gout</B> and chronic tophaceous <B>gout</B>.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Acute <B>gout</B> most commonly affects the first metatarsal joint of the foot, but other joints are also commonly involved.</TD></TR></TABLE><BR><A HREF=http://newcms.aafp.org/afp/990215ap/925.html>http://newcms.aafp.org/afp/990215ap/925.html</A>">Gout and hyperuricemia</a> - Gout and Hyperuricemia - February 15, 1999 - American Academy of Family Physicians</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.rheumatology.org/public/factsheets/gout_new.asp?aud=pat" title="- (ACR Fact Sheet on <B>Gout</B>)<br><br><A HREF=http://www.rheumatology.org/public/factsheets/gout_new.asp?aud=pat>http://www.rheumatology.org/public/factsheets/gout_new.asp?aud=pat</A>">American College of Rheumatology</a> - American College of Rheumatology</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://arthritis-research.com/content/8/S1/S2" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>Arthritis Research & Therapy | Full text | Epidemiology, risk factors, and lifestyle modifications for <B>gout</B></TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Epidemiology, risk factors, and lifestyle modifications for <B>gout</B></TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD><B>Gout</B> affects more than 1% of adults in the USA, and it is the most common form of inflammatory arthritis among men.</TD></TR></TABLE><BR><A HREF=http://arthritis-research.com/content/8/S1/S2>http://arthritis-research.com/content/8/S1/S2</A>">Epidemiology, risk factors, and lifestyle modifications for gout</a> - Arthritis Research & Therapy | Full text | Epidemiology, risk factors, and lifestyle modifications for gout</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.medsafe.govt.nz/Profs/PUarticles/azathioprine.htm" title="The patient should be warned that azathioprine interacts with allopurinol, a treatment for <B>gout</B>.<br><br><A HREF=http://www.medsafe.govt.nz/Profs/PUarticles/azathioprine.htm>http://www.medsafe.govt.nz/Profs/PUarticles/azathioprine.htm</A>">Azathioprine-Allopurinol Interaction: Danger!</a> - Azathioprine_Allopurinol Interaction:  Danager</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.henriettesherbal.com/eclectic/bpc1911/sodium.html" title="<A HREF=http://www.henriettesherbal.com/eclectic/bpc1911/sodium.html>http://www.henriettesherbal.com/eclectic/bpc1911/sodium.html</A>">Sodium</a> - Sodii Benzoas, B.P. Sodium Benzoate. | Henriette's Herbal Homepage</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=17530645" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>Coffee consumption and risk of incident <B>gout</B> in men: a prospective study.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>OBJECTIVE: Coffee is one of the most widely consumed beverages in the world and may affect the risk of <B>gout</B> via various mechanisms.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>We prospectively evaluated the relationship between coffee intake and the risk of incident <B>gout</B> in a large cohort of men.</TD></TR></TABLE><BR><A HREF=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=17530645>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=17530645</A>">Coffee Consumption and Reduced Gout Risk</a> - Coffee consumption and risk of incident gout in me...[Arthritis Rheum. 2007] - PubMed Result</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=9489831&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>OBJECTIVE: Information regarding effect of weather conditions on <B>gout</B> is sparse.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>We conducted a study in the USA to examine whether <B>gout</B> is seasonal.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Retrospective chart review of all patients was performed to confirm a clinical picture of acute <B>gout</B>.</TD></TR></TABLE><BR><A HREF=http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=9489831&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus>http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=9489831&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus</A>">Acute gouty arthritis is seasonal.</a> - Acute gouty arthritis is seasonal. [J Rheumatol. 1998] - PubMed Result</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10534553&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>RESULTS: During the period considered, 210 episodes of acute <B>gout</B> were observed [196 in males (93.3%) and 14 in females (6.7%)] in 179 different subjects, and 179 episodes of acute pseudo<B>gout</B> [58 in males (32.4%) and 121 in females (67.6%)] in 165 different subjects.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Analysis of the seasonal distribution of <B>gout</B> or pseudo<B>gout</B> events was significantly different (chi(2) 15.7, P=0.001).</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Chronobiological evaluation by means of Fourier analysis showed a circannual pattern for <B>gout</B> attacks, both for the total sample (P=0.006) and the male subgroup (P=0.003), characterized by a peak in April and a trough in October.</TD></TR></TABLE><BR><A HREF=http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10534553&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus>http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10534553&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus</A>">Seasonal variation in the onset of acute microcrystalline arthritis.</a> - Seasonal variation in the onset of acute microcrys...[Rheumatology (Oxford). 1999] - PubMed Result</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.niams.nih.gov/Health_Info/Gout/default.asp" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>It describes what <B>gout</B> is and how it develops.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>It also explains how <B>gout</B> is diagnosed and treated.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD><B>Gout</B> is a painful condition that occurs when the bodily waste product uric acid is deposited as needle-like crystals in the joints and/or soft tissues.</TD></TR></TABLE><BR><A HREF=http://www.niams.nih.gov/Health_Info/Gout/default.asp>http://www.niams.nih.gov/Health_Info/Gout/default.asp</A>">Answers and Questions on Gout</a> - Q&A About Gout</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://arthritismd.com/gout.html" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD><B>Gout</B> is a common form of arthritis in which uric acid crystals become deposited within the joint, causing an inflammatory reaction.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>People who develop <B>gout</B> often have increased levels of circulating uric acid.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>However, some people with <B>gout</B> have normal levels of uric acid in their blood and some people with increased uric acid levels do not develop <B>gout</B>.</TD></TR></TABLE><BR><A HREF=http://arthritismd.com/gout.html>http://arthritismd.com/gout.html</A>">Gout</a></td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://health.howstuffworks.com/gout-in-depth.htm" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD><B>Gout</B> is a painful and common type of arthritis.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>The rate of <B>gout</B> has increased in recent decades, not only in America but also in other developed countries.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Click the icon to see an animation about <B>gout</B>.</TD></TR></TABLE><BR><A HREF=http://health.howstuffworks.com/gout-in-depth.htm>http://health.howstuffworks.com/gout-in-depth.htm</A>">Gout in Depth - How Stuff Works</a> - HowStuffWorks "Gout In-Depth"</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://news.bbc.co.uk/2/hi/health/7219473.stm" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD><B>Gout</B> was once a common complaint in men as this 1799 cartoon shows.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Copyright Wellcome Trust Medical Photographic Library Sugary drinks have been blamed for a surge in cases of the painful joint disease <B>gout</B>.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Men who consume two or more sugary soft drinks a day have an 85% higher risk of <B>gout</B> compared with those who drink less than one a month, a study suggests.</TD></TR></TABLE><BR><A HREF=http://news.bbc.co.uk/2/hi/health/7219473.stm>http://news.bbc.co.uk/2/hi/health/7219473.stm</A>">BBC NEWS | Health | Gout surge blamed on sweet drinks</a></td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.bmj.com/cgi/eletters/332/7553/1315#135610" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>Some of my patients with <B>gout</B> have a significantly higher creatinene than this.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Underwood for his excellent review of Diagnosis & management of <B>Gout</B> [1].</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD><B>Gout</B> is considered a disease associated with abundance and overindulgence like old Roman ways.</TD></TR></TABLE><BR><A HREF=http://www.bmj.com/cgi/eletters/332/7553/1315#135610>http://www.bmj.com/cgi/eletters/332/7553/1315#135610</A>">bmj.com Rapid Responses for Underwood, 332 (7553) 1315-1319</a></td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.podiatrychannel.com/gout/naturalmedicine.shtml" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>Naturopathic and conventional medicine agree on their recommendations for diet and lifestyle changes in treating <B>gout</B>.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>It should be noted that the primary drug used to treat <B>gout</B>, colchicine, has no direct effect on uric acid levels;</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>Cherries lower uric acid levels and can prevent <B>gout</B> attack.</TD></TR></TABLE><BR><A HREF=http://www.podiatrychannel.com/gout/naturalmedicine.shtml>http://www.podiatrychannel.com/gout/naturalmedicine.shtml</A>">Gout: Natural Treatments</a> - Gout - Natural Treatment, Diet, Supplements - podiatrychannel</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.bartleby.com/109/3.html" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>You know my sedentary state, and on that account, it would seem, Madam <B>Gout</B>, as if you might spare me a little, seeing it is not altogether my own fault.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>What can be expected from such a course of living, but a body replete with stagnant humors, ready to fall prey to all kinds of dangerous maladies, if I, the <B>Gout</B>, did not occasionally bring you relief by agitating those humors, and so purifying or dissipating them?</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>As much instruction as you please, Madam <B>Gout</B>, and as many reproaches;</TD></TR></TABLE><BR><A HREF=http://www.bartleby.com/109/3.html>http://www.bartleby.com/109/3.html</A>">3. Dialogue Between Franklin and the Gout by Benjamin Franklin. Matthews, Brander, ed. 1914. The Oxford Book of American Essays</a></td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.niams.nih.gov/hi/topics/gout/gout.htm" title="<TABLE STYLE='font-size: 12;'><TR><TD VALIGN='TOP'>•</TD><TD>It describes what <B>gout</B> is and how it develops.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD>It also explains how <B>gout</B> is diagnosed and treated.</TD></TR><TR><TD VALIGN='TOP'>&bull</TD><TD><B>Gout</B> is a painful condition that occurs when the bodily waste product uric acid is deposited as needle-like crystals in the joints and/or soft tissues.</TD></TR></TABLE><BR><A HREF=http://www.niams.nih.gov/hi/topics/gout/gout.htm>http://www.niams.nih.gov/hi/topics/gout/gout.htm</A>">Answers and Questions on Gout</a> - Q&A About Gout</td></tr></table> </div> </span><br/> <span class="fragment"> <div id="external_links_revision_history_fragments"> <table border="0" cellpadding="0" cellspacing="0" hspace="0" vspace="0"><tr><td valign="top" nowrap bgcolor="white"><nobr><img src="images/external_links_revision_history/spacer.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"><img src="images/external_links_revision_history/square2-8x11.gif" align="bottom" width="8" height="11"> </nobr></td><td><a href="http://www.icuredmygout.org" title="- (site claiming that <B>gout</B> is cured by<br><br><A HREF=http://www.icuredmygout.org>http://www.icuredmygout.org</A>">I Cured My Gout</a> - I Cured My Gout</td></tr></table> </div> </span><br/> </div> <div class="section-delimeter"></div> <div class="section" id="related_topics"> <h1 class="section-title"> <a name="related_topics">Related topics</a> </h1> <span class="core-uptodate">Up to date as of August 19, 2010</span> <ul> <span class="fragment"> <li> <a href="/Rheumatoid_arthritis">Rheumatoid arthritis</a> </li> </span> <span class="fragment"> <li> <a href="/Osteoarthritis">Osteoarthritis</a> </li> </span> <span class="fragment"> <li> <a href="/Ankylosing_spondylitis">Ankylosing spondylitis</a> </li> </span> <span class="fragment"> <li> <a href="/Arthritis">Arthritis</a> </li> </span> <span class="fragment"> <li> <a href="/Chondrocalcinosis">Chondrocalcinosis</a> </li> </span> <span class="fragment"> <li> <a href="/Reactive_arthritis">Reactive arthritis</a> </li> </span> <span class="fragment"> <li> <a href="/Septic_arthritis">Septic arthritis</a> </li> </span> <span class="fragment"> <li> <a href="/Juvenile_idiopathic_arthritis">Juvenile idiopathic arthritis</a> </li> </span> <span class="fragment"> <li> <a href="/Adult-onset_Still's_disease">Adult-onset Still's disease</a> </li> </span> <span class="fragment"> <li> <a href="/Psoriatic_arthritis">Psoriatic arthritis</a> </li> </span> </ul> </div> <div class="section-delimeter"></div></div> </div> <br/><br/><br/> <script type="text/javascript" language="javascript"><!-- function checkEmail(myForm) { if (/^\w+([\.-]?\w+)*@\w+([\.-]?\w+)*(\.\w{2,3})+$/.test(myForm.str_email.value)){ return (true); } alert("Invalid E-mail Address! 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