ABSTRACT
No disponible
Subject(s)
Humans , Hyperuricemia/diagnosis , Gout/diagnosis , Febuxostat/therapeutic use , Asymptomatic Diseases , Antihypertensive Agents/therapeutic useABSTRACT
Sonography has detected urate deposits in 34%-42% of the patients with asymptomatic hyperuricemia. This may prompt reclassification of asymptomatic hyperuricemia into "asymptomatic gout" and consideration of urate lowering therapy (ULT) to resolve urate deposits. In patients with gout and no visible tophi, sonography has detected urate deposits in half of the patients. This may allow diagnosing "tophaceous gout" and influencing the serum urate target level, prophylaxis to avoid acute gout flares during ULT, and clinical follow-up. Current accessibility to sonography may better classify patients with hyperuricemia and gout and contribute to delineate therapeutic objectives and clinical guidance.
Subject(s)
Gout/diagnostic imaging , Uric Acid/metabolism , Gout/metabolism , Humans , Hyperuricemia/diagnostic imaging , Hyperuricemia/metabolism , UltrasonographyABSTRACT
El aumento de la concentración sérica de uratos (hiperuricemia, mayor o igual a 7,0mg/dL) ocasiona cristales que promueven inflamación y lesión articular. La ecografía puede poner de manifiesto estos depósitos de urato. Su presencia obliga a considerar que un paciente con hiperuricemia en realidad padece gota asintomática, y que un enfermo con gota sin tofos subcutáneos puede tener gota tofácea. La información que ofrece la ecografía (signo del «doble contorno» y de concreciones hiperecogénicas simulando nubes) posibilita una clasificación de la hiperuricemia y de la gota más precisas. Además, esta información puede dar lugar a modificaciones relevantes en cuanto al proceder diagnóstico y terapéutico en los enfermos con hiperuricemia y gota (AU)
The increase in serum urate concentrations (hyperuricaemia, ≥7.0mg/dL) creates crystals, which promote inflammation and joint lesions. Ultrasonography can reveal these urate deposits. The presence of crystals suggests that a patient with hyperuricaemia is actually experiencing asymptomatic gout, and that a patient with gout without subcutaneous tophi could experience tophaceous gout. The information offered by ultrasound (double contour sign and hyperechoic concretions mimicking clouds) enables a more specific classification of hyperuricaemia and gout. Additionally, this information can lead to relevant changes in terms of the diagnosis and therapeutic approach for patients with hyperuricaemia and gout (AU)
Subject(s)
Humans , Male , Female , Hyperuricemia/complications , Hyperuricemia , Gout/complications , Gout , Ultrasonography/instrumentation , Ultrasonography/methods , Ultrasonography , Sensitivity and Specificity , Urate Oxidase/analysisABSTRACT
The increase in serum urate concentrations (hyperuricaemia, ≥7.0mg/dL) creates crystals, which promote inflammation and joint lesions. Ultrasonography can reveal these urate deposits. The presence of crystals suggests that a patient with hyperuricaemia is actually experiencing asymptomatic gout, and that a patient with gout without subcutaneous tophi could experience tophaceous gout. The information offered by ultrasound (double contour sign and hyperechoic concretions mimicking clouds) enables a more specific classification of hyperuricaemia and gout. Additionally, this information can lead to relevant changes in terms of the diagnosis and therapeutic approach for patients with hyperuricaemia and gout.
ABSTRACT
Pulmonary arterial hypertension is a rare and progressive disease that mainly affects the pulmonary arterioles (precapillary), regardless of the triggering aetiology. The prevalence of pulmonary hypertension and pulmonary arterial hypertension in Spain is estimated at 19.2 and 16 cases per million inhabitants, respectively. The diagnosis of pulmonary arterial hypertension is based on haemodynamic criteria (mean pulmonary artery pressure ≥25mmHg, pulmonary capillary wedge pressure ≤15mmHg and pulmonary vascular resistance >3 Wood units) and therefore requires the implementation of right cardiac catheterisation. Sequential therapy with a single drug has been used in clinical practice. However, recent European guidelines recommend combined initial therapy in some situations. This review conducts a critical update of our knowledge of this disease according to the latest guidelines and recommendations.
