The effect of initiation of urate-lowering treatment during a gout flare on the current episode: a meta-analysis of randomized controlled trials

Abstract Objective: The objective was to evaluate whether initiation of urate-lowering treatment (ULT) during an acute gout flare prolonged the current episode. Methods: A comprehensive search of MEDLINE and Web of Science databases was conducted from their inception to 15 March 2021. Five randomized controlled trials (RCTs) with 381 patients met the inclusion criteria. Standardized mean difference (SMD), odds ratio (OR), and 95% confidence interval (CI) were used for estimating the clinical efficacy of ULT in acute gout. Results: There was no statistical difference in days to resolution (intent-to-treat analysis) (SMD, 0.68; 95% CI — 0.42 to 1.78; I2, 49%; p = 0.22), the pain visual analogue score (VAS) by day 10 (SMD, — 0.07; 95% CI — 0.30 to 0.16; I2, 0%; p = 0.53), C-reactive protein (CRP) from day 7 to 10 (SMD, — 1.14; 95% CI — 5.63 to 3.36; I2, 55%; p = 0.62), erythrocyte sedimentation rate (ESR) from day 7 to 10 (SMD, — 2.51; 95% CI — 5.46 to 0.45; I2, 0%; p = 0.10) and the recurrence of gout flares within 28-30 days (OR 0.78; 95% CI 0.29 to 2.09; I2, 0%; p = 0.62). Conclusion: Initiation of ULT during an acute gout flare did not prolong the duration of the flare. However, larger sample size studies are needed to confirm this finding. Trial registration number PROSPERO (CRD42021234581).

Effect of pregnancy related anxiety on executive function of preschool children and gender difference / 中国学校卫生

Objective@#To understand the effect of pregnancyrelated anxiety on preschool childrens executive functions(EFs) and gender difference in order to optimize the early development environment of offspring life.@*Methods@#This study was based on the ChinaAnhui Birth Cohort Study. Pregnant women from Maternal and Child Health Care Hospital in Maanshan, Anhui province between October 2008 and October 2010 were recruited. The general information of pregnant women and the pregnancyrelated anxiety were collected prospectively in the first trimester of pregnancy. A cohort of 3 556 children aged 3-5 were followed up and their basic characteristics were collected. Executive function of preschool children was assessed by Behavior Rating Inventory of Executive FunctionPreschool Version(BRIEF) (parent version).@*Results@#In boys, compared with the control group, pregnancyrelated anxiety in the first trimester of pregnancy was associated with the risk of abnormality in working memory, planning/organization and GEC[OR(95%CI)=1.40(1.06-1.85), 1.64(1.06-2.54), 1.89(1.27-2.82)]. Anxiety in the both trimesters of pregnancy was associated with the risk of abnormality in inhibition, working memory, planning/organization and GEC[OR(95%CI)=2.60(1.45-4.67), 2.45(1.69-3.57), 2.23(1.28-3.88), 3.27(2.03-5.28)]. In girls, pregnancyrelated anxiety in the first trimester of pregnancy was associated with the risk of abnormality in inhibition and working memory[OR(95%CI)=1.79(1.13-2.83), 1.45(1.07-1.98)]. Anxiety in the third trimester of pregnancy was associated with the risk of abnormality in inhibition[OR(95%CI)=2.26(1.17-4.38)]. Anxiety in both trimesters of pregnancy was associated with the risk of abnormality in inhibition and working memory[OR(95%CI)=2.45(1.40-4.28), 2.02(1.35-3.01)].@*Conclusion@#Pregnancyrelated anxiety significantly affected the executive function of preschool children, and there was a significant doseresponse relationship. Pregnancyrelated anxiety primarily affects working memory, planning/organization and GEC function in boys, and the working memory, inhibition function in girls.