Author Interviews, Gout, NIH, OBGYNE / 04.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48366" align="alignleft" width="160"]Jack A. Yanovski, MD, PhDSenior InvestigatorSection on Growth and Obesity, DIR, NICHDNational Institutes of HealthHatfield Clinical Research CenterBethesda, MD 20892‐1103 Dr. Yanovski[/caption] Jack A. Yanovski, MD, PhD Senior Investigator Section on Growth and Obesity, DIR, NICHD National Institutes of Health Hatfield Clinical Research Center Bethesda, MD 20892‐1103 MedicalResearch.com: What is the background for this study? Response: Studies of both mouse models and people suggest that obesity induced inflammation may promote insulin resistance and progression to diabetes. Others have proposed that suppressing this chronic, low level inflammation may slow the onset of diabetes. Nod-like Receptor Family Pyrin Domain Containing 3 (NLRP3) has recently been shown to play a strong role in promoting the inflammatory state in obesity. Colchicine, traditionally used to suppress or prevent inflammation in gout and other disorders is believed to inhibit formation of the NLRP3 inflammasome. Our group hypothesized that colchicine would improve obesity associated inflammation in adults with metabolic syndrome who had not yet developed type 2 diabetes.
Author Interviews, Gout, Obstructive Sleep Apnea, Rheumatology / 30.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44241" align="alignleft" width="200"]Dr M Blagojevic-Bucknal Senior Lecturer in Statistics Arthritis Research UK Primary Care Centre Research Institute for Primary Care & Health Sciences  Keele University Staffordshire UK Dr. Blagojevic-Bucknal[/caption] Dr M Blagojevic-Bucknal Senior Lecturer in Statistics Arthritis Research UK Primary Care Centre Research Institute for Primary Care & Health Sciences Keele University Staffordshire UK  MedicalResearch.com: What is the background for this study? Response: Evidence suggests that elevated serum uric acid levels, the cause of gout, are also frequently identified in patients with sleep apnoea However, despite prevalent hyperuricaemia in patients with sleep apnoea, shared risk factors with gout of obesity and alcohol consumption, and research identifying the associations between gout and other co-morbidities, few studies have considered the possibility of an association between sleep apnoea and gout in short and long term.
Author Interviews, Erectile Dysfunction, Gout / 27.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29648" align="alignleft" width="200"]Dr Edward Roddy Clinical Senior Lecturer in Rheumatology and Honorary Consultant Rheumatologist Arthritis Research UK Primary Care Centre Research Institute for Primary Care & Health Sciences Keele University Staffordshire UK Dr. Edward Roddy[/caption] Dr Edward Roddy Clinical Senior Lecturer in Rheumatology and Honorary Consultant Rheumatologist Arthritis Research UK Primary Care Centre Research Institute for Primary Care & Health Sciences Keele University Staffordshire UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Both gout and erectile dysfunction (ED) are prevalent in the general population, and share some common risk factors such as obesity, alcohol consumption and comorbidity (vascular disease, renal disease etc). We undertook a retrospective cohort study in UK Clinical Practice Research Database, a large longitudinal UK database of UK computerised primary care records, to quantify the risk of incident ED in men with gout. We found that men with gout had 30% greater risk of developing erectile dysfunction than men without gout, after adjusting for confounding variables such as lifestyle factors and comorbidity, although the absolute increased risk was small (0.6%). We did a further analyses including men who already had ED when they were diagnosed with gout, finding that they were also at increased risk of being diagnosed with ED in the year before they developed gout, suggesting that hyperuricaemia, which people can have for decades before developing gout, may be a key reason to explain the increased risk of erectile dysfunction in people with gout. Apparently, some people who make use of content on websites similar to sex-hd.xxx to aid in alleviating their ED.
Author Interviews, Colon Cancer, Gout, NYU, Rheumatology / 20.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29599" align="alignleft" width="150"]Michael Pillinger, MD Professor of Medicine and Biochemistry and Molecular Pharmacology NYU School of Medicine Dr. Michael Pillinger[/caption] Michael Pillinger, MD Professor of Medicine and Biochemistry and Molecular Pharmacology NYU School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: We are interested in the co-morbidities of gout and the fact that gout is accompanied by multiple cardiovascular, renal and other events. The implications of gout for cancer are less clear, but the basic biology suggests that either: 1) the acute and chronic inflammation of gout could contribute to a pro-cancer environment; 2) the anti-oxidant effects of urate could have anti-cancer properties; 3) the ability of uric acid to serve as a "danger signal" released from dying cells (potentially including cancer cells" could promote anti-cancer immunity. The clinical literature is murky at best.
Author Interviews, Gout, Kidney Disease / 19.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29815" align="alignleft" width="140"]Gerald D. Levy MD Internal Medicine/Rheumatology Southern California Kaiser Permanente Downey, CA Dr. Gerald Levy[/caption] Gerald D. Levy MD Internal Medicine/Rheumatology Southern California Kaiser Permanente Downey, CA  MedicalResearch.com: What are the main findings of your study? Patients with hyperuricemia and chronic kidney disease (CKD)  improve when serum Uric Acid (sUA) is brought below 6mg/dl with urate lowering therapy. We found a 6% improvement in this group compared to patients not at goal. More importantly the stage of CKD appears to be important with CKD II showing approximately 3% who improve with nearly 10% of patients improving in the CKD III group. We did not see benefit in those patients who are stage 4 CKD.
Author Interviews, Gout, Kidney Disease, Pharmacology / 19.11.2016

MedicalResearch.com Interview with: Dr. Ana Beatriz Vargas dos Santos Médica do Serviço de Reumatologia Universidade do Estado do Rio de Janeiro MedicalResearch.com: What is the background for this study? Response: Gout is the most common inflammatory arthritis worldwide and, despite available treatment, the management of gout remains suboptimal. One of the reasons for this suboptimal management of gout is the hesitant use of urate-lowering therapy, including a common reduction in dose or discontinuation of allopurinol in patients with gout who have kidney dysfunction based on the assumption that allopurinol may be worsening kidney function. However, there is no evidence that allopurinol is toxic for the kidneys, and this dose reduction or discontinuation results in more difficult-to-treat gout. Chronic kidney disease (CKD) stage 3 or above occurs in approximately 20% of people with gout, and there is emerging evidence that urate-lowering therapy may improve kidney function in patients with both gout and CKD. Although CKD is common, most people with gout start out with normal kidney function. Yet, there are limited data regarding the effects of allopurinol on kidney function in such individuals. We, therefore, undertook this study to assess whether people with newly diagnosed gout who are starting allopurinol are at increased risk for developing CKD stage 3 or worse.
Author Interviews, Blood Pressure - Hypertension, Gout, Johns Hopkins, Nutrition, Rheumatology / 16.08.2016

MedicalResearch.com Interview with: [caption id="attachment_27021" align="alignleft" width="155"]Stephen P. Juraschek, MD, PhD Fellow, Division of General Internal Medicine Johns Hopkins Hospital Dr. Stephen Juraschek[/caption] Stephen P. Juraschek, MD, PhD Fellow, Division of General Internal Medicine Johns Hopkins Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diet has long been viewed as an important way to lower uric acid levels to prevent gout attacks; however, there is little evidence about whether a particular dietary pattern might be effective for lowering uric acid. For the first time we show that the DASH diet, an effective diet for lowering blood pressure, it lowers uric acid levels substantially in people with abnormally high uric acid levels.
Annals Internal Medicine, Author Interviews, Emergency Care, Gout, Pharmacology / 23.02.2016

MedicalResearch.com Interview with: [caption id="attachment_21670" align="alignleft" width="120"]Professor Timothy H Rainer MD MBBCh Director, Accident & Emergency Medicine Academic Unit The Chinese University of Hong Kong Prof. Timothy Rainer[/caption] Professor Timothy H Rainer  MD MBBCh Director, Accident & Emergency Medicine Academic Unit The Chinese University of Hong Kong  Medical Research: What is the background for this study? What are the main findings? Prof. Rainer: Gout is a type of arthritis characterised by periodic attacks of acute joint swelling and severe pain, and  often treated with colchicine or nonsteroidal anti-inflammatory drugs (NSAIDs).  Two recent randomized, controlled trials showed that oral prednisolone, a corticosteroid, was as effective as NSAIDs in the treatment of acute gout, but these studies involved small numbers of patients.  The researchers investigatedwhether oral prednisolone was as effective and safe as indomethacin (a NSAID) in a larger sample of patients who had acute gout symptoms and who were seen in the emergency department (ED) setting. Patients in both the prednisolone and indomethacin groups had clinically meaningful decreases in their pain levels during the 2 hours they were observed in the ED as well as during the 14-day follow-up period. Both groups had a similar decrease in pain levels. No major adverse events were reported in either group although there were more minor adverse events in the indomethacin group.
Author Interviews, Gout, Rheumatology / 10.11.2015

MedicalResearch.com Interview with: Paras Karmacharya, MD Internal Medicine Reading Health System West Reading, PA 19611 Co-Authors: Ranjan Pathak MD, Madan Raj Aryal MD, Smith Giri MD, Anthony A Donato MD MHPE Medical Research: What is the background for this study? Response: Studies describing seasonal variations in acute gouty arthritis note a seasonal trend, but disagree on timing, with most showing a peak in spring months while others showing peaks later in the year. However, serum uric acid (SUA) levels seem to peak in the summer months. This disparity has led to the hypothesis that the flares might be related to factors other than elevated serum uric acid levels. Various theories on the effects of weather and immune system changes on the chronobiology of the equilibrium and precipitation of monosodium urate crystals have been proposed. We aimed to shed light on this question by examining the seasonal variation in the incidence of acute gouty arthritis in the US using a large inpatient database. Medical Research: What are the main findings? Response: We used the Nationwide Inpatient Sample (NIS) database, a large national database that represents 20% of all hospital admissions, to identify adult patients with a primary diagnosis of acute gouty arthritis from 2009-2011 during their hospitalization. A total of 28,172 hospitalizations with primary diagnosis of acute gouty arthritis were reported from 2009-11. The peak incidence of acute gout was seen in the month of November (peak/low ratio 1.34, 95% CI 1.29-1.38, p<0.05) (Figure 1). The highest number of hospitalizations was observed in autumn months, while the lowest incidence was observed in spring (28.12% vs. 23.13%, p<0.001). Medical Research: What should clinicians and patients take away from your report? Response: Unlike previous studies, our analysis found the peak incidence of acute gout in the fall with its peak in the month of November. Various environmental (temperature, humidity, diet, physical activity) and biochemical factors (low cortisol levels, high absolute neutrophil counts and plasminogen activator inhibitor-1) have been implicated for the seasonal variation, but the data on this is conflicting. Whether our findings are reflective of purine and alcohol intake over the US holidays in November and December is a hypothesis that requires further testing.
Author Interviews, Gout, Mayo Clinic, Rheumatology / 26.03.2014

Tim Bongartz, M.D. Associate Professor of Medicine Department of Rheumatology Mayo Clinic, MinnesotaMedicalResearch.com Interview with: Tim Bongartz, M.D. Associate Professor of Medicine Department of Rheumatology Mayo Clinic, Minnesota MedicalResearch.com: What are the main study findings? Dr. Bongartz:  Dual-energy computed tomography (DECT) is an imaging methods that has been in use for many years to classify the material of renal stones. Our study demonstrates that this technology can be useful in identifying monosodium urate deposits in and around joint, allowing to diagnose patients with gout with overall high sensitivity and specificity. Importantly, a stratified analysis of patient subgroups revealed that DECT is less accurate in diagnosing patients with a first flare of gout, emphasizing the importance of careful patient selection when using this new technology. In a "diagnostic-yield" substudy, we explored the question how much DECT could contribute to correctly diagnose patients where clinicians did have a high level of suspicion for gout, but synovial fluid aspiration results came back negative. In about a third of these patients with negative routine testing, we could confirm a diagnosis of gout through use of DECT.
General Medicine / 16.01.2014

MedicalResearch.com Interview with: Weiya Zhang, BPH, MEpi, PhD Associate Professor & Reader Division of Rheumatology, Orthopaedics and Dermatology The University of Nottingham Clinical Sciences Building City Hospital Nottingham NG5 1PB MedicalResearch.com: What are the main findings of the study? Dr. Zhang: We found the prevalence and incidence of gout keep rising from 1997 to 2012, but the management (percentage of patients treated with the recommended effective drugs) remains poor.