Tophi reduction: ultrasound imaging and correlation with plasma levels of uric acid in patients undergoing treatment for tophaceous gout.

The objective was to determine the reduction of tophi in patients undergoing drug therapy in correlation with urate serum levels through ultrasound examination. A total of 31 male patients, between the ages of 33 to 77 years, with tophaceous gout were evaluated between 2005 and 2009, 11 of which were selected. Ultrasound examinations of visible tophi and evaluations of serum uric acids levels were performed annually on each patient. There was a statistically significant difference between measurements 1, 2, 3 and measurement 4 and between measurements 4 and 5. A strong significant positive association was seen between variation of tophus size and the reduction of serum uric acid levels.

Involvement of the thoracic spine in tophaceous gout. A case report.

The presence of tophi involving the spine is an atypical complication of tophaceous gout and its diagnosis may be difficult. The authors present a case of tophaceous gout involving the thoracic spine and discuss the topic.

Determinaçäo dos níveis séricos de ácido úrico em uma amostra populacional da regiäo de Marília-SP e suas correlaçöes com algumas variáveis demográficas e bioquímicas / Serum uric acid levels in a populational sample in Marília county - Säo Paulo State and correlation with some biochemical and demographic parameters

Este trabalho é um estudo epidemiológico que procura estabelecer correlaçöes entre a concentraçäo sérica de ácido úrico e outros fatores, como localizaçäo geográfica, etnia, idade, sexo e obesidade. Foram estudados 958 indivíduos da regiäo da Alta Paulista, no Estado de Säo Paulo, Brasil, submetidos a anamnese, exames clínicos, reumatológico e laboratoriais. Encontraram-se níveis de ácido úrico sérico significantemente mais elevados na populaçäo urbana quando comparados com a populaçäo rural. Nas duas populaçöes, tanto urbana quanto rural, os níveis séricos de ácido úrico foram significantemente mais elevados no grupo masculino que no feminino. Näo houve correlaçäo entre níveis séricos de ácido úrico e idade, embora entre as mulheres se observasse aumento significante da urecemia a partir dos 40 anos. Näo houve diferença quanto à urecemia entre as raças branca e näo branca. Indivíduos obesos apresentaram níveis maiores de urecemia em relaçäo aos näo obesos, embora essa diferença tenha sido estatisticamente significante apenas na amostra de origem urbana. Näo houve correlaçäo entre os níveis séricos de ácido úrico e trigliceridemia, colesterolemia e glicemia

Nonsteroidal Anti-Inflammatory Drugs and Prostaglandins: Their Interactions and Effects on the Particulate-Induced Inflammatory Process Implicated in Joint Implant-Loosening and on Monosodium Urate Crystal-Induced Inflammation.

The objective of this study was to determine the effects of orally administered misoprostol and diclofenac on inflammation caused by particulates in the rat subcutaneous air-pouch model. Subcutaneous air pouches were formed in male Sprague-Dawley rats. The animals were premedicated by gavage with either saline, diclofenac, misoprostol, or both diclofenac and misoprostol. The air pouches were injected with either polymethyl methacrylate particles or monosodium urate crystals, and the pouch fluids were obtained at 1, 6, 24, 48, and 72 h. Leukocyte influx, tumor necrosis factor, neutral metalloprotease activity, and prostaglandin E(2) levels were measured. It was determined that leukocyte influx was inhibited by diclofenac in the acute inflammation caused by monosodium urate crystals only. In all animals receiving diclofenac, prostaglandin E(2) (PGE(2)) levels were reduced, whereas tumor necrosis factor levels were elevated. The elevation of tumor necrosis factor was prevented by the addition of misoprostol. It is concluded that the oral administration of diclofenac or misoprostol can affect levels of specific mediators involved in particulate-induced inflammation in the subcutaneous air pouch.