Gout - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. P ARKER , ...

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A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Gout: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83622-1 1. Gout-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on gout. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON GOUT......................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Gout .............................................................................................. 9 E-Journals: PubMed Central ....................................................................................................... 17 The National Library of Medicine: PubMed ................................................................................ 17 CHAPTER 2. NUTRITION AND GOUT ............................................................................................. 121 Overview.................................................................................................................................... 121 Finding Nutrition Studies on Gout ........................................................................................... 121 Federal Resources on Nutrition ................................................................................................. 124 Additional Web Resources ......................................................................................................... 125 CHAPTER 3. ALTERNATIVE MEDICINE AND GOUT ...................................................................... 129 Overview.................................................................................................................................... 129 National Center for Complementary and Alternative Medicine................................................ 129 Additional Web Resources ......................................................................................................... 133 General References ..................................................................................................................... 138 CHAPTER 4. PATENTS ON GOUT ................................................................................................... 139 Overview.................................................................................................................................... 139 Patents on Gout ......................................................................................................................... 139 Patent Applications on Gout ..................................................................................................... 145 Keeping Current ........................................................................................................................ 147 CHAPTER 5. BOOKS ON GOUT ....................................................................................................... 149 Overview.................................................................................................................................... 149 Book Summaries: Federal Agencies............................................................................................ 149 Book Summaries: Online Booksellers......................................................................................... 152 The National Library of Medicine Book Index ........................................................................... 154 Chapters on Gout ....................................................................................................................... 155 CHAPTER 6. MULTIMEDIA ON GOUT ............................................................................................ 157 Overview.................................................................................................................................... 157 Bibliography: Multimedia on Gout............................................................................................ 157 CHAPTER 7. PERIODICALS AND NEWS ON GOUT ......................................................................... 159 Overview.................................................................................................................................... 159 News Services and Press Releases.............................................................................................. 159 Newsletter Articles .................................................................................................................... 162 Academic Periodicals covering Gout.......................................................................................... 163 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................. 165 Overview.................................................................................................................................... 165 U.S. Pharmacopeia..................................................................................................................... 165 Commercial Databases ............................................................................................................... 167 Researching Orphan Drugs ....................................................................................................... 168 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 171 Overview.................................................................................................................................... 171 NIH Guidelines.......................................................................................................................... 171 NIH Databases........................................................................................................................... 173 Other Commercial Databases..................................................................................................... 176 The Genome Project and Gout ................................................................................................... 176 APPENDIX B. PATIENT RESOURCES ............................................................................................... 181 Overview.................................................................................................................................... 181 Patient Guideline Sources.......................................................................................................... 181 Associations and Gout ............................................................................................................... 188

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Finding Associations.................................................................................................................. 189 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 191 Overview.................................................................................................................................... 191 Preparation................................................................................................................................. 191 Finding a Local Medical Library................................................................................................ 191 Medical Libraries in the U.S. and Canada ................................................................................. 191 ONLINE GLOSSARIES................................................................................................................ 197 Online Dictionary Directories ................................................................................................... 198 GOUT DICTIONARY ................................................................................................................... 201 INDEX .............................................................................................................................................. 265

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with gout is indexed in search engines, such as www.google.com or others, a nonsystematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about gout, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to gout, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on gout. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to gout, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on gout. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON GOUT Overview In this chapter, we will show you how to locate peer-reviewed references and studies on gout.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and gout, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “gout” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Intricacies in the Diagnosis and Treatment of Gout Source: Patient Care. 35(13): 33-36,38,43,47. July 15, 2001. Summary: This journal article provides health professionals with information on the pathogenesis, diagnosis, and treatment of gout. Gout results from the deposit of urate crystals in a joint, which causes an acute inflammatory response. The risk of gout increases with the degree and duration of hyperuricemia. Gout usually affects men older than 25 and women after menopause. The initial presentation is typically a painful attack of monarthritis, followed by recurrent flares and, if untreated, chronic polyarticular gout. Factors that may trigger a gout attack include trauma, alcohol consumption, surgery, dietary imbalances, infection, radiation therapy, and drugs. The probable clinical stages of gout are acute, intercritical, and chronic. Many conditions cause symptoms similar to gout, including pseudogout, osteoarthritis, rheumatoid

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arthritis, hydroxyapatite induced arthritis, and other diseases. The diagnosis of gout is established by finding monosodium urate monohydrate crystals in the aspiration fluid of a joint or tophus. Radiographic findings in the early stage of gout are normal except for acute soft tissue swelling. As the disease progresses, the typical radiographic finding is a punched out erosion away from the joint surface with overhanging margins of bone. Treatment depends on the stage of the disease. Acute attacks may be treated with high dose nonsteroidal antiinflammatory drugs, colchicine, and systemic or intraarticular corticosteroids. Although lifestyle changes, including dietary modifications and exercise, can reduce serum urate levels, the practicality of this approach is questionable. Purine diet restriction combined with exercise may lower the serum urate level just below the threshold for gout attacks. Drugs that are currently used for lowering serum urate are uricosuric agents and xanthine oxidase inhibitors. Uricosuric agents such as probenecid and sulfinpyrazone are typically used for patients with low urate clearance, and xanthine oxidase inhibitors such as allopurinol are used for patients with increased urate production. Gout and hyperuricemia are common complications among solid organ transplant recipients. Management of these conditions involves achieving a low serum urate level while maintaining adequate immunosuppression to avoid allograft rejection. 4 figures, 2 tables, and 7 references. •

Arthrocentesis To Diagnose and Treat Acute Gouty Arthritis in the Great Toe Source: JAAPA: Official Journal of the American Academy of Physician Assistants. 13(10): 93-94,96. October 2000. Summary: This journal article provides health professionals with information on the use of arthrocentesis to diagnose and treat acute gouty arthritis. Although a high level of uric acid in the blood suggests gout, it can be confirmed only by identification of urate crystals in fluid aspirated from the joint. Arthrocentesis with fluid aspiration may relieve the pain of acute gouty arthritis, but the clinician may find it necessary to inject a corticosteroid directly into the joint space before removing the aspiration needle. The article explains how arthrocentesis is performed, presents postoperative instructions the physician should give the patient, and identifies contraindications and complications. 1 figure, 2 tables, and 5 references.

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Diagnosis and Management of Gout Source: American Family Physician. 59(7): 1799-1806. April 1, 1999. Contact: American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail: [email protected]. Website: www.aafp.org. Summary: This journal article provides health professionals with information on diagnosing and managing gout. This disease, which results from the deposition of urate crystals in synovial fluid and other tissues or the formation of uric acid stones in the kidneys, typically occurs during middle age. Gout is often, but not always, associated with elevated serum uric acid levels. Clinical manifestations include acute or chronic arthritis, tophi, interstitial renal disease, and uric acid nephrolithiasis. Diagnosis is based on the identification of uric acid crystals in joints, tissues, or body fluids. Treatment goals include terminating the acute attack, preventing recurrent attacks, and preventing the complications associated with the deposition of urate crystals in tissues. Pharmacologic management remains the mainstay of treatment. Acute attacks may be terminated by using nonsteroidal anti-inflammatory agents, colchicine, or intra-articular injections of corticosteroids. Probenecid, sulfinpyrazone, and allopurinol can be used to

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prevent recurrent attacks. Potentially exacerbating factors such as obesity, alcohol intake, and certain foods and medications can contribute to hyperuricemia. These should be identified and modified. 6 figures, 2 tables, and 24 references. (AA-M). •

Arthritis 101: Gout Source: Arthritis Today. 13(1): 26-27. January-February 1999. Summary: This journal article provides people who have gout with information on this painful form of arthritis. Gout, which is caused by the deposition of uric acid crystals in the joint, usually appears suddenly. If allowed to progress, the pain and inflammation of gout can resemble that of rheumatoid arthritis. The article explains why uric acid may accumulate in bodily tissues and who is most susceptible to getting gout. It also lists factors that can aggravate gout: use of diuretic medications, obesity, use of alcohol, kidney failure, and a diet rich in purines. Other topics are how gout is diagnosed using a patient's medical history, a physical examination, and laboratory tests; what joints are affected by gout; and how it is treated, namely, with anti-inflammatory medications, nonsteroidal anti-inflammatory drugs, and glucocorticoid medications. 5 figures.

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Acute Gouty Arthritis: Diagnosis and Treatment Source: Physician Assistant. 23(11): 32-42. November 1999. Summary: This journal article, which is part of the continuing medical education (CME) series, provides health professionals with information on the pathology, clinical presentation, signs and symptoms, diagnosis, and treatment of acute gouty arthritis. Gout is the most common cause of inflammatory arthritis in men older than 30. It is a disorder of purine metabolism resulting in the deposition of monosodium urate crystals in various tissues. The first metatarsophalangeal (MTP) joint is most commonly involved; however, gout can occur almost anywhere. The onset is acute, typically nocturnal, and usually monoarticular. Most patients who have gout are hyperuricemic, although only a few patients with hyperuricemia develop gout. In 90 percent of the cases, underexcretion of uric acid is the cause of hyperuricemia. The remaining 10 percent of cases are caused by overproduction or a combination of both. The four phases of gout are asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout, and chronic tophaceous gout. The diagnosis of acute gouty arthritis may be suspected from the presence of urate crystals, clinical findings, hyperuricemia, and rapid resolution after colchicine treatment. Medications used to treat acute gout attacks include nonsteroidal anti-inflammatory drugs, colchicine, corticosteroids and adrenocorticotropic hormones, and narcotic analgesics. Between attacks, the patient should follow a low purine and high flavonoid diet, consume a lot of fluids, take high potency vitamin and mineral supplements, and use colchicine and indomethacin as prophylactic agents. Antihyperuricemic medications, such as allopurinol and the uricosuric agents probenecid and sulfinpyrazone, are better suited for people who suffer frequent, acute gouty arthritis not controlled by colchicine prophylaxis or those who have tophaceous deposits or renal impairment. The article includes a case study, a study guide, and a CME test. 1 figure, 2 tables, and 8 references. (AA-M).

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Practical Approach to Gout, A Source: Postgraduate Medicine. 106(4): 115-116,119-123. October 1, 1999. Summary: This journal article provides health professionals with information on the diagnosis, management, and prevention of gout, a clinical syndrome that is caused by a group of heterogeneous disorders and mainly affects men between 40 and 60 years old.

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The first metatarsophalangeal joint, the ankle, and the soft tissue of the midfoot are most commonly affected. Gout is characterized by deposition of monosodium urate monohydrate crystals, leading to neutrophil activation and synovial inflammation. Mechanisms of hyperuricemia include uric acid overproduction and impaired renal clearance of uric acid. Two X-linked enzyme disorders cause increased rates of uric acid production. Diagnosis involves aspirating the joint and identifying the characteristic needle shaped, negatively birefringent monosodium urate crystals under compensated polarized light microscopy. Gram's stain and culture of the aspirated fluid are often performed concomitantly. The goals of therapy are resolving inflammation, preventing recurrent attacks, and reversing complications arising from deposition of urate crystals in joints, kidneys, and tophi. Therapy involves treating the acute attack, preventing future attacks, and lowering uric acid levels. Conservative therapeutic measures include advising patients to lose weight, moderate their use of alcohol, avoid dehydration and repetitive trauma, and control hypertension and hyperlipidemia. Current pharmacologic options for reducing inflammation and pain include nonsteroidal antiinflammatory drugs (NSAIDs), colchicine, glucocorticoids, and corticotropin. Low doses of either colchicine or an NSAID may be effective in preventing acute attacks of gout. When attacks occur despite conservative measures, treatment with urate lowering agents is indicated. The classes of medications available for reducing serum urate levels are uricosuric agents and xanthine oxidase inhibitors. Common uricosuric agents are probenecid and sulfinpyrazone. Xanthine oxidase inhibitors include allopurinol. Most patients who have gout need long term treatment with either uricosuric agents or xanthine oxidase inhibitors. 3 tables and 13 references. •

Gout: Applying Current Knowledge Source: Patient Care. 32(10): 125-131, 135-136, 139. May 30, 1998. Summary: This journal article for health professionals focuses on the diagnosis and treatment of gout. Although gout has a long history, there are still significant clinical unknowns. It is characterized by acute pain and swelling in the first metatarsophalangeal joint. Peripheral joints are most commonly involved, while joints in the hand are frequently affected as well. Diagnosis is based on the medical history, a physical examination, evaluation of the serum uric acid level, and aspiration and examination of synovial fluid. Radiographs may also be used to detect intraosseous tophi. There are risks to both overdiagnosing and underdiagnosing this disease. Management depends on the stage of the disease. Acute attacks should be treated with antiinflammatory agents, but long-term treatment may involve the using allopurinol, probenecid, or sulfinpyrazone to reduce the concentrations of serum uric acid. Although diet therapy is not usually totally effective, patients should try to avoid alcohol and foods high in purine and should be followed carefully to ensure their compliance with treatment. 5 figures, 1 table, and 4 references.

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Gout: Effective Strategies for Acute and Long-Term Control Source: Journal of Musculoskeletal Medicine. 15(8): 45-53. August 1998. Summary: This journal article provides health professionals with information on the clinical features, diagnosis, and treatment of gout. The incidence of gout increases with advancing age and elevations in serum urate levels. Although gout is most common in men, its incidence appears to be increasing in postmenopausal women. The prevalence of tophaceous gout is declining. The natural history of gout follows a transition through the stages of asymptomatic hyperuricemia, acute gouty arthritis with intercritical periods, and chronic tophaceous gout. The initial attack begins suddenly and is typically

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monarticular. Exquisite pain and inflammation are characteristic. Response to colchicine supports the presumptive clinical diagnosis, but confirmation of the diagnosis depends on identification of urate crystals in tophaceous material. Adequate control of blood pressure is essential in patients who have gout and hypertension and is probably the most important intervention in preventing progression of renal disease. Prompt therapy with colchicine, nonsteroidal anti-inflammatory drugs, or corticotropin is the cornerstone of acute care. Once the acute attack has resolved, colchicine, allopurinol, or a uricosuric agent such as probenecid or sulfinpyrazone should be prescribed to prevent recurrent attacks. Serum urate levels need not be lowered unless symptoms occur. Compliance with lifelong therapy is necessary to avoid recurrence. Weight reduction and alcohol restriction are also helpful. 4 figures, 3 tables, and 15 references. (AA-M). •

Gout: Diagnosis and Treatment Source: Cortlandt Forum. 219-225. August 1996. Summary: This journal article for physicians examines the diagnosis and treatment of gout, including tests useful in diagnosis, the best treatment for an acute attack, management of chronic recurrent gout, medication considerations, and the management options for patients with asymptomatic hyperuricemia. Tables list the diagnostic clues to gout, options for the treatment of acute gout, urate-lowering strategies, and the causes of hyperuricemia. The article suggests that, among all the diagnostic clues that may appear, the critical laboratory finding is phagocytosed urate crystals in polymorphonuclear leukocytes in synovial fluid. Of the agents best to reduce serum urate, allopurinol is the most effective with rarely occurring serious side effects. While urate-lowering drugs can be eventually discontinued, there is no clinically available method to determine when, therefore, in actual practice, medication is maintained for life. While patients with asymptomatic hyperuricemia require no treatment, it is recommended that they be observed on follow-up examinations. For such patients, an alteration in lifestyle would be required that may involve dietary modification, reduction in weight and alcohol consumption, and avoidance of diuretics. 5 tables.

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Radiologic Features of Gout Source: American Family Physician. 54(4):1232-1238. September 15, 1996. Contact: American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail: [email protected]. Website: www.aafp.org. Summary: This journal article for health professionals describes the phases and radiologic features of gout, a common rheumatologic disease characterized by the deposition of monosodium urate crystals in tissue from supersaturated extracellular fluid. The deposition of crystals in the joints and periarticular soft tissue can lead to arthritis and bone destruction. Four phases can occur in the evolution of gout: asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout, and chronic tophaceous gout. The radiologic features include swelling of soft tissues, tophi, normal mineralization, preservation of joint space until the later stages of disease, punched-out erosions with overhanging edge of cortex and sclerotic borders, and an asymmetric polyarticular distribution. The lower extremity joints are most often affected, but the small joints of the hands, wrists, and elbows may also be involved. Gout rarely occurs in the shoulders, hips, sacroiliac joints, or spine. The article also discusses the use of radiographs in the differential diagnosis of gout. 17 references, 10 figures, and 2 tables. (AA-M).

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Renal Transplant-Associated Hyperuricemia and Gout Source: JASN. Journal of the American Society of Nephrology. 11(5): 974-979. May 2000. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-6423. Summary: Gout (a disorder of uric acid metabolism) is a common problem among renal transplant patients with a prevalence of 2 to 13 percent. Hyperuricemia (extra uric acid in the blood) is even more common. This article explores the metabolic basis of gout in allograft recipients. The author examines the currently available methods for treating gout, with a particular emphasis on drug interactions and specific needs of the transplant patient. The author notes that gout is a disabling disease, and may cloud the outcome of a patient for whom rehabilitation has been particularly hard fought. In addition, the treatment of gout in renal allograft recipients poses more potential pitfalls than in the general population. The prevalence of these conditions in transplant patients is attributable to cyclosporine use, although individual patients may have other risk factors as well. Cyclosporine lowers urinary clearance of uric acid; the specific mechanism for this is unknown but may involve alterations in tubular transport. Barring specific contraindications, patients with an established history of hyperuricemia or gout at the time of their transplantation should be on uric acid lowering therapy at the same time cyclosporine treatment is initiated. 1 figure. 2 tables. 65 references.

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Drugs to Lower Uric Acid Levels: How to Avoid Misuse in Gouty Arthritis Source: Postgraduate Medicine. 89(2): 111-113, 116. February 1, 1991. Summary: This article discusses ways to avoid misuse of drugs to lower uric acid levels in patients with gouty arthritis. Topics include the characteristics of gout, drug therapy for gouty arthritis, and when to use drugs to lower uric acid levels. The author stresses that the latter agents are not useful in the management of acute gout and must be initiated at low doses with gradual increments. Due in part to the fact that these uricosuric agents tend to interact with a number of drugs, careful and frequent monitoring is needed during the first several months of therapy with these drugs. 2 tables. 6 references. (AA-M).

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Cyclosporine Causes Gout in Kidney Transplant Patients Source: Research Resources Reporter. 14(3): 1-4. March 1990. Contact: Available from Superintendent of Documents. U.S. Government Printing Office, Washington, DC 20402. (202) 783-3238 (for charge orders). Summary: This article describes research demonstrating the increased incidence of gout in kidney transplant patients receiving cyclosporine for immunosuppression. The prevalence and cause of hyperuricemia and gout was studied in two group of patients: one treated with cyclosporine and prednisone (A) and the other treated with prednisone and azathioprine (B). Uric acid clearance was lower in patients in group A. The data suggest that hyperuricemia and gout develop as a result of the diminished uric acid clearance. The researchers also found that patients taking cyclosporin frequently develop hypertension.

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Uric Acid Nephrolithiasis: Current Concepts and Controversies Source: Journal of Urology. 168(4 Part 1): 1307-1314. October 2002.

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Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2334. Fax (301) 824-7290. Summary: Uric acid calculi (stones) with or without a calcium component comprise a significant proportion of urinary stones. Knowledge of the pathophysiology of stone formation is important to direct medical treatment. This review article provides an update on the epidemiology, pathophysiology, and management of uric acid renal (kidney) stones. The incidence of uric acid stones varies between countries and accounts for 5 percent to 40 percent of all urinary calculi. Hyperuricuria (high levels of uric acid in the urine), low urinary output, and acidic urine are well known contributing factors. However, the most important factor for uric acid stone formation is persistently acidic urine. Gout and myeloproliferative disorders are associated with uric acid stones. The pathophysiological basis for persistent urine acidity remains unclear, although various mechanisms have been proposed. Urinary alkalization with potassium citrate or sodium bicarbonate is a highly effective treatment, resulting in dissolution of existing stones and prevention of recurrence. 2 figures. 81 references.

Federally Funded Research on Gout The U.S. Government supports a variety of research studies relating to gout. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to gout. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore gout. The following is typical of the type of information found when searching the CRISP database for gout: •

Project Title: EFFECTS OF K MG CITRATE ON INSULIN SENSITIVITY IN GOUTY DIATHESIS Principal Investigator & Institution: Abate, Nicola; University of Texas Sw Med Ctr/Dallas Dallas, TX 753909105 Timing: Fiscal Year 2001 Summary: There is no text on file for this abstract. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENERAL CLINICAL RESEARCH CENTER Principal Investigator & Institution: Pak, Charles Yc. Professor of Internal Medicine; Internal Medicine; University of Texas Sw Med Ctr/Dallas Dallas, TX 753909105

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Timing: Fiscal Year 2001; Project Start 01-DEC-1978; Project End 30-NOV-2003 Summary: The overall goal of the General Clinical Research Center (GCRC) at Dallas is to provide an optimal environment for patient-oriented investigation which leads to an improved understanding of the disease process, allows better methods of diagnosis and treatment, foster interdisciplinary collaboration, and offers training in clinical investigation. Major activities of the GCRC include; to study efficacy and safety of adding a bisphosphonate to sustained-release sodium fluoride (Neosten) and to evaluate a new formulation of sustained-release sodium fluoride combined with calcium citrate (Caflor) for postmenopausal osteoporosis; to utilize newer techniques for assessment of bone quality in osteoporosis such as nuclear magnetic resonance (NMR) microscopy, critical angle reflection ultrasound and strut analysis; determination of the pathophysiology, particularly relate to insulin resistance in gouty diathesis (renal stone formation associated with gout), its molecular genetic basis and the effects of improving insulin sensitivity in reversing the biochemical defects; elucidation of the genetic basis of low levels of high density lipoprotein (HDL) as related to the polymorphisms in hepatic lipase gene; characterization of phenotype and metabolic abnormalities, and elucidation of genetic defects in patients with congenital generalized and familial partial lipodystrophies; to study efficacy and safety of adding methotrexate therapy to ursodeoxycholic acid for therapy of primary billiary cirrhosis in a randomized, blinded, placebo-controlled trial; comparison of innovative and conventional treatments for management of or develop surrogate biologic markers predicting predisposition to specific skin diseases and response to therapy; to study neural mechanisms of obesityrelated hypertension in African-Americans utilizing microelectrode recordings of postganglionic sympathetic nerve activity; and development of new and reliable techniques to assess renal functions and to perform safety and dose-ranging studies of alpha- melanocyte stimulating hormone (MSH) for subsequent clinical trials of alphaMSH to treat or prevent acute renal failure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENOTYPE AND PHENOTYPE OF FAMILIAL NEPHROPATHY WITH GOUT Principal Investigator & Institution: Hart, Thomas C. Associate Professor; Oral Medicine and Pathology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2002; Project Start 15-JUL-2002; Project End 31-MAY-2006 Summary: (provided by applicant): Familial Nephropathy with Gout (FGN) is a rare kidney disorder characterized by reduced fractional excretion of uric acid, precocious and tophaceous gout, and development of chronic renal failure leading to end-stage renal disease. FGN is transmitted as an autosomal dominant trait, clinical fmdings are variable, response to treatment not predictable and the disease pathophysiology is poorly understood. The goals of this proposal are to identify the gene(s) responsible for FGN and to characterize the clinical manifestations of this condition. We have identified two large families with FGN providing unique opportunities to characterize clinical manifestations and progression of FGN and to identify the gene responsible. Our preliminary studies sublocalize an FGN gene to a 2.0 cM region of chromosome l6p in one family. Linkage data from a second, smaller family is consistent with a broader candidate interval. Additional studies will determine if the same gene is responsible for FGN in both families. The genetic interval we have mapped FGN to is not well characterized. Genetic and physical maps of the region are incomplete and there are no obvious candidate genes for FGN. We propose an integrated clinical and laboratory

Studies 11

approach to identify the gene(s) responsible for FGN. We will longitudinally follow affected family members to better characterize clinical manifestations of FGN (Specific Aim#1). To identify the FGN gene (Specific Aim #2) we propose a hierarchical strategy to 1). Clarify and integrate genetic and physical maps of the candidate interval(s), 2). Continue linkage studies to narrow the candidate interval(s), and 3). Systematically evaluate genes within the interval to identify the gene mutation(s) responsible for FGN in these families. Identification of the specific gene mutation will provide an important discovery that will (a) elucidate important aspects of uric acid tubular transport, (b) provide an understanding of interstitial kidney disease and chronic renal failure, and (c) help to better define relationships between hyperuricemia, uric acid excretion, and the development of renal failure. Completion of these studies will permit pre-symptomatic diagnosis for individuals with FGN and enhance our ability to evaluate current treatment strategies as well as to develop new, more effective intervention strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GOUTY DIATHESIS--PATHOPHYSIOLOGY AND MOLECULAR GENETIC BASIS Principal Investigator & Institution: Sakhaee, Khashayar; University of Texas Sw Med Ctr/Dallas Dallas, TX 753909105 Timing: Fiscal Year 2001 Summary: (Taken directly from the application) A disturbance in urate metabolism has been shown to lead to the development of both uric acid and calcium stones. In addition, primary gout is frequently observed with uric acid lithiasis, where undue urinary pH from defective ammonium production is believed to promote uric acid crystallization. We have used the term gouty diathesis to describe stone formation associate with primary gout, and that it is comprised of acquired and primary (genetic) variants. This hypothesis will be tested by (1) assessing whether defective ammonium production in gouty diathesis is evident by controlling acid intake and imposing phosphate restriction and that, in the acquired form of the disease, insulin resistance is responsible for undue acidity and other biochemical features of this disease, and (2) identifying the molecular defect in the "primary" genetic form of the disease. These studies will help elucidate the pathophysiology of gouty diathesis and may lead to improvements in the diagnosis and treatment of this form of urolithiasis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HMO RESEARCH NETWORK CERT 2 Principal Investigator & Institution: Platt, Richard; Associate Professor; Harvard Pilgrim Health Care, Inc. 93 Worcester St Wellesley, MA 02481 Timing: Fiscal Year 2003; Project Start 01-SEP-2000; Project End 29-SEP-2007 Summary: This renewal application for the HMO Research Network Center for Education and Research in Therapeutics (CERT) continues this CERT's focus on "Studies of therapeutics' use, safety, and effectiveness, using health plans' defined populations, providers, delivery systems, and data." The CERT will grow to ten HMOs with nearly 11 million members. The CERT will use its products, including a new approach to multicenter studies, datasets, analytical tools, and intervention capabilities to support new studies. This CERT will also continue to use leveraged funding, exceeding $18 million, as well as ongoing partnerships with AHRQ's Patient Safety Initiative, FDA, NIH, CDC, the American Association of Health Plans, other CERTs, and industry. Past and current work includes assessing adverse drug events under specific conditions, and in

12 Gout

populations of actual use; describing widespread, potentially unsafe drug use by vulnerable populations (pregnant women, children, and the elderly); studying appropriateness of drug use (antibiotics in children); and the impact of increasing copayment requirements on diabetes control. This Center is conducting randomized trials to improve use of computerized physician order entry (CPOE) and other methods to enhance safe prescribing. With AAHP, the applicant has created a public website of interventions proven to improve drug use in managed care settings. The application proposes eight new initiatives: 1) develop new methods for discovery of adverse drug reactions (with FDA and CDC); 2) monitor unsafe prescribing practices; 3) test two patient-centered interventions, one to improve adherence to beta-blockers after MI (with the Duke CERT), and another to stimulate initiation of urate lowering therapy for gout (with the UAB CERT); 4) assess medication errors in ambulatory cancer care (with the NIH Cancer Research Network); 5) disseminate patient and physician materials to improve antibiotic use (with AAHP and the Council for Affordable Quality Healthcare); 6) plan a national conference on the impact of managed care drug cost containment policies on outcomes (with AcademyHealth and AAHP); 7) evaluate cost and outcomes using patient safety data; and 8) enhance therapeutics research training. The CERT is also seeking separate support for additional activities. Examples include design and testing of patient-directed Internet-based methods to improve chronic anti-coagulation, assessing outcomes of antenatal drug exposures, and testing of pharmacy interventions to prevent unsafe drug exposures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INORGANIC PYROPHOSPHATE METABOLISM IN ARTHRITIS Principal Investigator & Institution: Ryan, Lawrence M. Professor; Medicine; Medical College of Wisconsin Po Box26509 Milwaukee, WI 532264801 Timing: Fiscal Year 2002; Project Start 01-MAY-1987; Project End 31-MAR-2007 Summary: (provided by applicant): Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is a common form of arthritis, particularly in the elderly. Prevalence approaches 50 percent in those over 80. CPPD crystals cause acute attacks of gout-like arthritis, but more importantly are associated with debilitating degenerative arthritis. In vitro and in vivo data strongly suggest that these crystals cause or amplify cartilage degeneration. This proposal focuses on the source of inorganic pyrophosphate (PPi), the anion constituent of CPPD crystals. Disordered PPi metabolism is clearly implicated in CPPD crystal deposition. Specific emphasis will be placed on mechanisms underlying PPi generation in extracellular cartilage matrix where crystals form. The effector arm of extracellular PPi (ePPi) generation involves the ectoenzyme nucleoside triphosphate pyrophosphohydrolase (NTPPPH), which generates ePPi from extracellular nucleoside triphosphates such as ATP. NTPPPH activity is highly expressed in articular cartilage. The availability of extracellular ATP substrate for NTPPPH is rate-limiting for generation of ePPi and the most likely cellular source of that ATP is the chondrocyte. These studies are designed to determine the effects of factors that modulate ePPi formation upon the release of ATP from chondrocytes. Specific emphasis is placed on growth factors (transforming growth factor-beta and insulin-like growth factor-I), on chondrocyte donor age, on transduction pathways (protein kinase C and cAMP-related), and on purine receptors (P1and P2). All of the aforementioned influence ePPi elaboration by chondrocytes. The second goal of this proposal is to determine the mechanisms of ATP egress from chondrocytes. Specific focus will be on ATP binding cassette proteins (analogues of human ABC1 and p-glycoprotein expressed in chondrocytes), a gap junction protein (connexin 43), and ANK protein as possible

Studies 13

transporters. The intent of these studies is to develop insights into the pathogenesis of CPPD deposition disease so that therapeutic options may be generated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INOSINE IN THE OVER-THE-COUNTER TREATMENT OF MS Principal Investigator & Institution: Hooper, Douglas C. Microbiology and Immunology; Thomas Jefferson University Office of Research Administration Philadelphia, PA 191075587 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-MAR-2005 Summary: (provided by applicant): For a number of years, inosine, a purine nucleoside, has been marketed by health and dietary supplement distributors as an energy or performance enhancer although there is little scientific evidence that inosine has these properties. Recently, interest has been raised in the possibility that inosine may have therapeutic effects in neurodegenerative disorders, such as multiple sclerosis (MS), through its metabolic product uric acid (UA), a natural inhibitor of peroxynitrite. The highly reactive oxidant peroxynitrite contributes to the pathogenesis of MS and animal models of central nervous system (CNS) inflammation through damaging tissue as well as inducing functional changes in the blood-brain barrier (BBB) that facilitate inflammatory cell invasion into CNS tissues. UA is an intermediate of purine metabolism in lower mammals but the excreted end product in humans. Consequently, serum levels of UA are normally relatively high in humans, offering natural protection against ONOO- -mediated pathological processes. With respect to this concept, it is notable that MS patients most often have lower serum UA levels than age- and sexmatched healthy controls and gout (hyperuricemia) patients rarely, if ever, develop MS. These observations have led us to examine the possibility that raising serum UA levels in MS patients using inosine may have therapeutic value. An FDA-approved clinical trial concerning the use of inosine to treat MS is now underway. In addition, publication of the results of these ongoing studies has evidently resulted in a number of individuals with MS independently taking inosine purchased over-the-counter. Nevertheless, little effort has been made to determine whether or not oral ingestion of inosine has therapeutic effects that are consistent with those of UA in animal models of CNS inflammation. The objective of this proposal is therefore to test the validity of two plausible hypotheses concerning the therapeutic effects of inosine ingestion on neuroinflammatory diseases believed to involve peroxynitrite: 1/inosine is therapeutic by raising serum UA levels and inactivating peroxynitrite; 2/inosine is therapeutic by suppressing the immune functions responsible for disease pathogenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PRECLINICAL DEVELOPMENT OF URICASE-PEG 20 Principal Investigator & Institution: Bomalaski, John S. Pharmacologics, Inc. Astecc Facility #a-217 Lexington, KY 40506

Professor;

Phoenix

Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 31-DEC-2002 Summary: Hyperuricemia (elevated serum uric acid) results in gouty arthritis and chronic renal disease. Severe hyperuricemia can occur following cancer chemotherapy (tumor lysis syndrome) and organ transplantation (most common in heart and kidney transplant patients) which may result in acute uric acid nephropathy with resultant metabolic disorders and death. Moreover, in addition to pain, hyperuricemia can result in destructive gouty arthritis, with concomitant permanent damage to joints and connective tissue. Elevated uric acid levels (hyperuricemia) do not develop in most

14 Gout

mammals because they have the gene which encodes urate oxidase which metabolizes the less soluble uric acid into a much more soluble metabolite, allantoin. However, in humans, the urate oxidase gene has evolved to contain a nonsense codon which results in a complete loss of enzyme activity. Many different groups of investigators have administered uricase, purified from micro organisms, to patients. Although these treatments lower plasma uric acid levels, all of the enzymes used are highly immunogenic and cause allergic reactions and anaphylaxis. Formulation of other therapeutic proteins with polyethylene glycol (PEG) has been shown to reduce their anti-genicity and prolong their circulating half-life. We have initiated Phase I clinical testing of a PEG modified uricase termed Uricase-PEG20. In this proposal we seek funding to perform the additional studies requested by the FDA in order for this drug to move into Phase 2 human clinical testing. PROPOSED COMMERCIAL APPLICATIONS: This proposal focuses on performing the additional preclinical experiments requested by the FDA in order for this drug to enter Phase 2 human testing. Although non-PEG formulated uricase is used in Europe, it has not been approved in the USA because of the high incidence of allergic reactions associated with its use. uricase-PEG 20 is formulated with polyethylene glycol (PEG), a technology known to reduce the antigenicity of heterologous proteins. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REGULATION OF PURINE NUCLEOTIDE SYNTHESIS IN HUMANS Principal Investigator & Institution: Becker, Michael A. Professor; Medicine; University of Chicago 5801 S Ellis Ave Chicago, IL 60637 Timing: Fiscal Year 2001; Project Start 01-SEP-1980; Project End 30-NOV-2002 Summary: The long-term objective of this research is to understand the biochemical and genetic mechanisms regulating human purine nucleotide synthesis. Studies of inherited enzyme defects underlying excessive purine nucleotide and uric acid production in some families with gout have contributed to concepts of the control of rates of purine synthesis de novo. One such defect is superactivity of phosphoribosylpyrophosphate (PRPP) synthetase (PRS), the enzyme catalyzing synthesis of the regulatory substrate PRPP. The proposed investigations focus on expression of two X chromosome-linked human (h) genes, hPRPS1 and hPRPS2, which encode highly homologous PRS isoforms, hPRS1 and hPRS2, respectively. The specific aims are: 1) to delineate the structural and regulatory determinants of normal hPRPS1 and hPRPS2 gene expression; and 2) to define the precise genetic defects and resulting aberrant molecular mechanisms underlying X-linked catalytic superactivity of hPRS. In order to pursue these specific aims, molecular genetic, protein chemical, and enzyme analytical methods will be employed. The structure of hPRPS1 and hPRPS2 promoter and adjacent 5= flanking sequences will be defined by sequencing of cloned PRPS genomic DNA. hPRPS promoter function and cis-acting regulatory elements in the 5= flanking DNAs will be studied in murine and human cell lines transfected with hPRPS promoter region reporter gene plasmid constructs. Pertinent DNA sequences will be tested for nuclear protein and specific transcription factor binding by gel mobility shift assays and, where appropriate, DNA footprinting and site-directed mutation will be utilized to define and delimit key protein-binding sequences in the DNA. PRPS gene promoter activities will be correlated with PRS transcript levels, PRS isoform contents and activities, and PRPP and purine nucleotide synthesis in differentiated human cell lines representative of tissues showing differential expression of PRPS1 and/or PRPS2 transcript abundance. The influences of growth promoting agents, viral transformation, and cell cycle traversal on hPRPS promoter activities and mouse PRS transcript and isoform levels will be

Studies 15

tested in murine cell lines. These studies are aimed at: defining models for cell-specific and gene-differential regulation of PRPS gene expression; identifying where in genetic information transfer control occurs; and ascertaining the molecular mechanisms involved. Altered pretranslational regulation of hPRPS1 expression in PRS catalytic superactivity may reflect transcriptional dysregulation due to structural and/or functional defects in the control of the PRPS1 promoter. This hypothesis will be tested by comparing the structure of promoter regions of affected patients and normal individuals and by measuring the respective PRPS1 promoter activities in murine cells and in normal and patient fibroblasts. Finally, post-translational control of hPRS isoform expression by specific interaction with a PRS-associated 39kDa protein (PAP39) will be examined in studies assessing the specificity and functional consequences of the PAP39PRS isoform complex and the results of selective disruption of the complex and its reconstitution from recombinant components. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SYNTHESIS/ ACTIVITY OF N-AMINOTETRAHYDROPYRIDINES Principal Investigator & Institution: Redda, Kinfe Ken. Professor of Medicinal Chemistry; Florida Agricultural and Mechanical Univ Tallahassee, FL 32307 Timing: Fiscal Year 2001; Project Start 05-JUN-2000; Project End 30-APR-2005 Summary: The primary objective is the design, synthesis and pharmacological evaluation of novel and medicinally important N-amino-1,2,3,6- tetrahydropyridine derivatives. We reported the synthesis of novel N- iminopyridium ylides using the method employed by Tamura and modified in our laboratory. Sodium borohydride reduction of the ylides afforded the stable N-amino-1, 2,3,6-tetrahydropyridines in good yields. We also recently reported preliminary pharmacological test results of a few tetrahydropyridines that exhibited analgesic and anti-inflammatory activities with no observed toxicity, even at very high dose levels. Our earlier work provides the basis for new and exciting studies so that a series of compounds related to the most active analogs could be prepared, and retested and the octanol-water partition coefficient determined. Once sufficient data are accumulated, the compounds prepared will be subjected to structure activity analysis to study the electronic, steric and lipophilic effects of substituents. The physical and pharmacologic data obtained in this study will then be used to design drugs with more beneficial biological activity. The primary focus of the pharmacological studies will be to develop and easily synthesize effective and safe non- steroidal anti-inflammatory agents for the treatment of rheumatic diseases, including rheumatoid arthritis, osteoarthritis, gout and rheumatic fever. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SYNTHETIC APPLICATIONS OF CARBENE COMPLEXES Principal Investigator & Institution: Wulff, William D. Professor; Chemistry; Michigan State University 301 Administration Bldg East Lansing, MI 48824 Timing: Fiscal Year 2001; Project Start 01-DEC-1983; Project End 30-NOV-2003 Summary: The broad scope of the work proposed involves the development of the chemistry of Fischer carbene complexes to the field of organic synthesis and to the synthesis of organic compounds of importance in human health. The reactions of Fischer carbene complexes with alkynes will be examined for the synthesis of the platelet activating factor antagonist phomactin D and for the synthesis of colchicine and allocolchicinoids that have been investigated for the treatment of gout, familial Mediterranean fever and liver cirrhosis. Asymmetric versions of this reaction will also

16 Gout

be used to prepare aS,7S and aR,7S isomers of 1 2 - methylcolchinyl methyl ether to test an unresolved issue regarding the stereochemical requirements for binding of colchicine and allocolchicinoids to tubulin. A new strategy for the synthesis of the new anticancer agent eluetherobin will be explored which involves an intramolecular exo-selective Diels-Alder reaction as a key step. The aldol reaction of Fischer carbene complexes will be utilized in the first synthesis of the anticancer agent fostriecin and analogs of fostriecin which are more stable and thus more useful in the clinic. The reaction of Fischer carbene complexes with 1,6-enynes will be explored as a method for rapid access to the taxol family of antitumor agents. The the cyclopropanation reactions of chiral carbene complexes will be examined for the synthesis of aminocyclopropanes and for a synthesis of the antitumor agent helenalin which involves a tandem cyclopropanation/Cope rearrangement sequence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: UAB CERT OF MUSCULOSKELETAL DISORDERS Principal Investigator & Institution: Saag, Kenneth G. Associate Professor; Medicine; University of Alabama at Birmingham Uab Station Birmingham, AL 35294 Timing: Fiscal Year 2003; Project Start 01-JUL-2000; Project End 29-SEP-2007 Summary: Musculoskeletal disorders (MSDs) affect over 40 million Americans and are the leading cause of activity limitations. Health care costs for arthritis and osteoporosis alone exceed $75 billion per year. In the past decade, there has been a dramatic rise in the number of new therapies for MSDs. During its short tenure, the Alabama Musculoskeletal Disorders CERTs (AMSDC) at the University of Alabama at Birmingham (UAB) has successfully identified, funded and conducted a large number of projects investigating and disseminating knowledge about safe and effective use of MSD therapeutics. Emphasizing the importance of the AMSDC network for promoting multidisciplinary and public-private programs, the applicant has developed active collaborations with three of the other CERTs, with FDA/CBER and NIAMS, the VAHSR&D, national managed care organizations (Aetna & UHC), CMS' Quality Improvement Organizations (QIOs), the Alabama Department of Public Health and several pharmaceutical manufacturers. These collaborations are indicative of the AMSDC's ability to leverage AHRQ core support to build a productive, diverse, and sustainable center. The application's main objective is to seize the momentum of current successes and continue to expand knowledge regarding MSD therapeutics. The specific aims of the AMSDC renewal are as follow: 1.Improve safety and effectiveness of musculoskeletal therapeutics through: a. A randomized trial of a combined physician/patient intervention to improve the safety of NSAID uses in the ambulatory setting (Module 1); b. A pharmacoepidemiological study followed by a randomized trial of a direct to patient intervention to improve safety in gout treatment (Supplemental Module 2); c. The support of nine demonstration projects focusing on diverse areas within MSD therapeutics, all bound by the common thread of improving safety and effectiveness, with the goal of submitting applications for funding to outside agencies; 2. Expand existing collaborations in both the private and public healthcare sectors; 3. Educate practitioners, insurers, policy makers, and the general public about musculoskeletal therapeutics. Given the rising burden of MSD in an aging society and the rapidly advancing efficacious, yet costly and potential dangerous, therapeutic options the objective and aims of the AMSDC are both well timed and urgently needed to improve public health. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

Studies 17

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “gout” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for gout in the PubMed Central database: •

Fructose-Induced Aberration of Metabolism in Familial Gout Identified by 31P Magnetic Resonance Spectroscopy. by Seegmiller JE, Dixon RM, Kemp GJ, Angus PW, McAlindon TE, Dieppe P, Rajagopalan B, Radda GK. 1990 Nov 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=54948

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Gout. by [No authors listed]; 2001 Jan 23; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=80692

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Randomised double blind trial of etoricoxib and indometacin in treatment of acute gouty arthritis. by Schumacher HR Jr, Boice JA, Daikh DI, Mukhopadhyay S, Malmstrom K, Ng J, Tate GA, Molina J. 2002 Jun 22; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=116444

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with gout, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “gout” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for gout (hyperlinks lead to article summaries):

3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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•

A 77-year-old man with right anterior knee pain. Intraosseous gout of the patella. Author(s): Lin HH, Gilula LA. Source: Orthop Rev. 1993 December; 22(12): 1333-6; 1339. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8127619&dopt=Abstract

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A case of Bartter's syndrome, gout and Becker's muscular dystrophy. Author(s): Fishel B, Zhukovsky G, Legum C, Jossiphov J, Alon M, Peer G, Iaina A, Nevo Y. Source: Clin Exp Rheumatol. 2000 May-June; 18(3): 426-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10895394&dopt=Abstract

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A case-control study of alcohol consumption and drinking behaviour in patients with acute gout. Author(s): Sharpe CR. Source: Can Med Assoc J. 1984 September 15; 131(6): 563-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6478339&dopt=Abstract

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A clinical perspective on rheumatoid arthritis, osteoarthritis, and gout. Author(s): Kaye RL. Source: Am Pharm. 1984 July; Ns24(7): 82-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6464988&dopt=Abstract

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A comparison of gout in men and women. A 10-year experience. Author(s): Meyers OL, Monteagudo FS. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1986 December 6; 70(12): 721-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3787395&dopt=Abstract

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A controlled study of diet in patients with gout. Author(s): Gibson T, Rodgers AV, Simmonds HA, Court-Brown F, Todd E, Meilton V. Source: Annals of the Rheumatic Diseases. 1983 April; 42(2): 123-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6847259&dopt=Abstract

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A controlled study of the effect of long term allopurinol treatment on renal function in gout. Author(s): Gibson T, Simmonds HA, Potter C, Rogers V. Source: Advances in Experimental Medicine and Biology. 1980; 122A: 257-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6999847&dopt=Abstract

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A DNA polymorphism of an apoprotein gene associates with the hypertriglyceridaemia of primary gout. Author(s): Ferns GA, Lanham J, Dieppe P, Galton DJ. Source: Human Genetics. 1988 January; 78(1): 55-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2892776&dopt=Abstract

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A neurochemical mechanism for exceptional achievement in gout. Author(s): Sher N. Source: Jama : the Journal of the American Medical Association. 1980 May 2; 243(17): 1711. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7365928&dopt=Abstract

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A population study of hyperuricaemia and gout in Japan--analysis of sex, age and occupational differences in thirty-four thousand people living in Nagano Prefecture. Author(s): Akizuki S. Source: Ryumachi. 1982 June; 22(3): 201-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7123395&dopt=Abstract

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A practical approach to gout. Current management of an 'old' disease. Author(s): Davis JC Jr. Source: Postgraduate Medicine. 1999 October 1; 106(4): 115-6, 119-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10533512&dopt=Abstract

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A prospective study of gout in New Zealand Maoris. Author(s): Brauer GW, Prior IA. Source: Annals of the Rheumatic Diseases. 1978 October; 37(5): 466-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=718280&dopt=Abstract

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A quantitative study of the phagocytosis of urate crystals in the synovial fluid of asymptomatic joints of patients with gout. Author(s): Pascual E, Jovani V. Source: British Journal of Rheumatology. 1995 August; 34(8): 724-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7551655&dopt=Abstract

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A radiologic reevaluation of gout: a study of 2,000 patients. Author(s): Bloch C, Hermann G, Yu TF. Source: Ajr. American Journal of Roentgenology. 1980 April; 134(4): 781-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6767366&dopt=Abstract

20 Gout

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A rare manifestation of gout at the wrist--a case report. Author(s): Schuind FA, Van Geertruyden J, Stallenberg B, Remmelink M, Pasteels JL. Source: Acta Orthopaedica Scandinavica. 2002 October; 73(5): 594-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12440507&dopt=Abstract

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A relationship between free urate, protein-bound urate, hyperuricemia and gout in Caucasians and Maoris. Author(s): Klinenberg JR, Campion DS, Olsen RW, Caughey D, Bluestone R. Source: Advances in Experimental Medicine and Biology. 1977; 76B: 159-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=855742&dopt=Abstract

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A retrospective study on the cause of death, in Japan, of patients with gout. Author(s): Nishioka K, Mikanagi K. Source: Ryumachi. 1981; 21 Suppl: 29-33. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7344132&dopt=Abstract

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A review of the radiographic manifestations of gout. Author(s): Gagliardi JA, Lengyel RJ. Source: Hawaii Med J. 1994 February; 53(2): 40-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8188486&dopt=Abstract

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A simple method of selecting gout patients for treatment with uricosuric agents, using spot urine and blood samples. Author(s): Yamamoto T, Moriwaki Y, Takahashi S, Tsutsumi Z, Ka T, Fukuchi M, Hada T. Source: The Journal of Rheumatology. 2002 September; 29(9): 1937-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12233889&dopt=Abstract

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A structural approach to pathological crystallizations. Gout: the possible role of albumin in sodium urate crystallization. Author(s): Perl-Treves D, Addadi L. Source: Proceedings of the Royal Society of London. Series B. Biological Sciences. 1988 November 22; 235(1279): 145-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2907144&dopt=Abstract

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A study of platelet aggregation and adhesion in gout. Author(s): Macfarlane DG, Slade R, Hopes PA, Hartog MH. Source: Clin Exp Rheumatol. 1983 January-March; 1(1): 63-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6681128&dopt=Abstract

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A survey of indications, results and complications of surgery for tophaceous gout. Author(s): Kumar S, Gow P. Source: N Z Med J. 2002 July 26; 115(1158): U109. Erratum In: N Z Med J 2002 August 23; 115(1160): 1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12362184&dopt=Abstract

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ABC of rheumatology. Gout, hyperuricaemia, and crystal arthritis. Author(s): Snaith ML. Source: Bmj (Clinical Research Ed.). 1995 February 25; 310(6978): 521-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7888900&dopt=Abstract

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Abnormal AMP deaminase in primary gout. Author(s): van der Berghe G, Hers HG. Source: Lancet. 1980 November 15; 2(8203): 1090. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6107718&dopt=Abstract

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Above-normal concentrations of lipid peroxide in serum of patients with gout. Author(s): Nishida Y, Kamatani N, Miyamoto T. Source: Clinical Chemistry. 1984 April; 30(4): 592-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6705221&dopt=Abstract

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Acquired porphyria cutanea tarda, gout, and cirrhosis. Author(s): O'Morain C, Alton BG, Barnes J. Source: Ir Med J. 1978 April 21; 71(6): 194-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=649329&dopt=Abstract

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Acromioclavicular cyst and 'porcupine shoulder' in gout. Author(s): De Santis D, Palazzi C, D'Amico E, Di Mascio DE, Pace-Palitti V, Petricca A. Source: Rheumatology (Oxford, England). 2001 November; 40(11): 1320-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11709623&dopt=Abstract

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Acute arthralgia (gout?) after tricrynafen. Author(s): King RS, Wichman BA. Source: The New England Journal of Medicine. 1979 November 8; 301(19): 1065. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=492241&dopt=Abstract

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Acute carpal tunnel syndrome caused by tophaceous gout. Author(s): Pai CH, Tseng CH. Source: The Journal of Hand Surgery. 1993 July; 18(4): 667-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8349978&dopt=Abstract

22 Gout

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Acute crystal-induced arthritis. Gout and a whole lot more. Author(s): Finch W. Source: Postgraduate Medicine. 1989 June; 85(8): 273-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2542915&dopt=Abstract

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Acute gout after carpal tunnel release. Author(s): Graff SN, Seiler JG 3rd, Jupiter JB. Source: The Journal of Hand Surgery. 1992 November; 17(6): 1031-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1430931&dopt=Abstract

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Acute gout and systemic lupus erythematosus: report of 2 cases and literature review. Author(s): Wall BA, Agudelo CA, Weinblatt ME, Turner RA. Source: The Journal of Rheumatology. 1982 March-April; 9(2): 305-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7097693&dopt=Abstract

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Acute gout and the accident and emergency department. Author(s): Hardy RH, Nation B. Source: Arch Emerg Med. 1984 June; 1(2): 89-95. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6536274&dopt=Abstract

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Acute gout associated with omeprazole. Author(s): Kraus A, Flores-Suarez LF. Source: Lancet. 1995 February 18; 345(8947): 461-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7853986&dopt=Abstract

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Acute gout can mimic deep vein thrombosis. Author(s): Seeman R, Caradoc-Davies TH. Source: N Z Med J. 1988 March 9; 101(841): 124. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3380453&dopt=Abstract

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Acute gout during hypouricaemic therapy: prophylaxis with colchicine. Author(s): Hollingworth P, Reardon JA, Scott JT. Source: Annals of the Rheumatic Diseases. 1980 October; 39(5): 529. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7436588&dopt=Abstract

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Acute gout in a patient taking pefloxacin--a case report. Author(s): Kundu AK. Source: J Indian Med Assoc. 1996 November; 94(11): 427. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9141871&dopt=Abstract

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Acute gout in the great toe. Author(s): Murtagh J. Source: Aust Fam Physician. 1995 March; 24(3): 437. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7717911&dopt=Abstract

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Acute gout involving the acromioclavicular joint following treatment with gemfibrozil. Author(s): Miller-Blair D, White R, Greenspan A. Source: The Journal of Rheumatology. 1992 January; 19(1): 166-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1556682&dopt=Abstract

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Acute gout of subtalar joint in a 56-year-old white female. Case report. Author(s): Gomes DR. Source: J Am Podiatry Assoc. 1977 August; 67(8): 568-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=893960&dopt=Abstract

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Acute gout of the right sacroiliac joint. Author(s): Abraham Z, Gluck Z. Source: The Journal of Dermatology. 1997 December; 24(12): 781-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9492443&dopt=Abstract

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Acute gout precipitated by total parenteral nutrition. Author(s): Moyer RA, John DS. Source: The Journal of Rheumatology. 2003 April; 30(4): 849-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672211&dopt=Abstract

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Acute gout presenting in the manubriosternal joint. Author(s): Kernodle GW Jr, Allen NB. Source: Arthritis and Rheumatism. 1986 April; 29(4): 570-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3707635&dopt=Abstract

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Acute gout secondary to psoriasis exacerbated by photochemotherapy. Author(s): Burnett JW. Source: Archives of Dermatology. 1982 March; 118(3): 211. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7065674&dopt=Abstract

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Acute polyarticular gout. Author(s): Raddatz DA, Mahowald ML, Bilka PJ. Source: Annals of the Rheumatic Diseases. 1983 April; 42(2): 117-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6847258&dopt=Abstract

24 Gout

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Alcohol and gout. Author(s): Scott JT. Source: Bmj (Clinical Research Ed.). 1989 April 22; 298(6680): 1054. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2497889&dopt=Abstract

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Alcohol and response to treatment of gout. Author(s): Ralston SH, Capell HA, Sturrock RD. Source: British Medical Journal (Clinical Research Ed.). 1988 June 11; 296(6637): 1641-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3135052&dopt=Abstract

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Allopurinol effect on renal function in gout. Author(s): Kirwan JR. Source: Annals of the Rheumatic Diseases. 1982 August; 41(4): 435-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7114928&dopt=Abstract

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Allopurinol hypersensitivity in a patient with coexistent systemic lupus erythematosus and tophaceous gout. Author(s): McDonald J, Fam AG, Paton T, Senn J. Source: The Journal of Rheumatology. 1988; 15(5): 865-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3172103&dopt=Abstract

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Allopurinol hypersensitivity in a patient with severe, chronic, tophaceous gout. Author(s): Webster E, Panush RS. Source: Arthritis and Rheumatism. 1985 June; 28(6): 707-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4004980&dopt=Abstract

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Allopurinol sensitivity in a patient with chronic tophaceous gout: success of intravenous desensitization after failure of oral desensitization. Author(s): Walz-LeBlanc BA, Reynolds WJ, MacFadden DK. Source: Arthritis and Rheumatism. 1991 October; 34(10): 1329-31. Erratum In: Arthritis Rheum 1992 January; 35(1): 125. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1930322&dopt=Abstract

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Allopurinol treatment and its effect on renal function in gout: a controlled study. Author(s): Gibson T, Rodgers V, Potter C, Simmonds HA. Source: Annals of the Rheumatic Diseases. 1982 February; 41(1): 59-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7039523&dopt=Abstract

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Allopurinol-associated hand and foot deformities in chronic tophaceous gout. Author(s): Gottlieb NL, Gray RG. Source: Jama : the Journal of the American Medical Association. 1977 October 10; 238(15): 1663-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=578255&dopt=Abstract

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Altered isoelectric property of a superactive 5-phosphoribosyl-1-pyrophosphate (PRPP) synthetase in a patient with clinical gout. Author(s): Nishida Y, Akaoka I, Horiuchi Y. Source: Biochem Med. 1981 December; 26(3): 387-94. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6277305&dopt=Abstract

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Amyloidosis secondary to gout. Author(s): Lens XM, Rosello R, Montoliu J, Sole M, Darnell A, Rotes J, Revert L. Source: The Journal of Rheumatology. 1985 October; 12(5): 1024-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4087259&dopt=Abstract

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Amyloidosis secondary to gout. Identification with a monoclonal antibody to amyloid protein A. Author(s): Jacobelli S, Vial S, Rosenberg H, Benson MD, Scheinberg MA. Source: Clinical Rheumatology. 1988 December; 7(4): 534-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3073036&dopt=Abstract

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Amyloidosis secondary to polyarticular gout. Author(s): Rubinow A, Sonnenblick M. Source: Arthritis and Rheumatism. 1981 November; 24(11): 1425-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7317121&dopt=Abstract

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An aberration of fructose metabolism in familial gout identified by 31P magnetic resonance spectroscopy of the liver. Author(s): Seegmiller JE, Dixon RM, Kemp GJ, Angus PW, McAlindon TE, Dieppe P, Rajagopalan B, Radda GK. Source: Trans Assoc Am Physicians. 1990; 103: 298-306. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2132540&dopt=Abstract

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An approach to hyperuricemia and gout. Author(s): Palella TD, Kelley WN. Source: Geriatrics. 1984 November; 39(11): 89-92, 95-6, 101-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6489762&dopt=Abstract

26 Gout

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An atypical case of primary renal tubular hypokalaemic metabolic alkalosis with chronic tophaceous gout. Author(s): Moriwaki Y, Yamamoto T, Takahashi S, Tsutsumi Z, Hada T. Source: Clinical Rheumatology. 2001; 20(5): 372-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11642522&dopt=Abstract

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An evidence based appraisal of the management of nontophaceous interval gout. Author(s): Ferraz MB. Source: The Journal of Rheumatology. 1995 September; 22(9): 1618-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8523332&dopt=Abstract

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An oil rig worker presenting with acute gout. Author(s): Hynes D, Wyndham M, Golding D. Source: Practitioner. 1997 May; 241(1574): 239-41, 243-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9218399&dopt=Abstract

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An open assessment of tenoxicam (Tilcotil) in the treatment of acute gout in general practice. Author(s): Waterworth RF, Waterworth SM. Source: N Z Med J. 1987 December 9; 100(837): 744-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3502545&dopt=Abstract

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An open assessment of tenoxicam in the treatment of acute gout in general practice. Author(s): Murdoch JC. Source: N Z Med J. 1988 January 27; 101(838): 21. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3380403&dopt=Abstract

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An unusual systemic presentation of gout. Author(s): Kini S, Mittal G, Balakrishna C, Mangat G, Hegde AV, Joshi VR. Source: J Assoc Physicians India. 2000 March; 48(3): 354-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11229128&dopt=Abstract

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Analysis of abnormalities in purine metabolism leading to gout and to neurological dysfunctions in man. Author(s): Curto R, Voit EO, Cascante M. Source: The Biochemical Journal. 1998 February 1; 329 ( Pt 3): 477-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9445373&dopt=Abstract

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Analysis of the genotypes for aldehyde dehydrogenase 2 in Japanese patients with primary gout. Author(s): Yamanaka H, Kamatani N, Hakoda M, Terai C, Kawaguchi R, Kashiwazaki S. Source: Advances in Experimental Medicine and Biology. 1994; 370: 53-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7660963&dopt=Abstract

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Antihypertensive therapy in a patient with gout and asthma. Author(s): Elliott WJ. Source: Jama : the Journal of the American Medical Association. 1994 February 16; 271(7): 555. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8301774&dopt=Abstract

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Antihyperuricemic properties of amflutizole in gout. Author(s): Wortmann RL, Ridolfo AS, Lightfoot RW Jr, Fox IH. Source: The Journal of Rheumatology. 1985 June; 12(3): 540-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3900392&dopt=Abstract

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Apolipoprotein E phenotypes in patients with gout: relation with hypertriglyceridaemia. Author(s): Moriwaki Y, Yamamoto T, Takahashi S, Tsutsumi Z, Higashino K. Source: Annals of the Rheumatic Diseases. 1995 May; 54(5): 351-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7794039&dopt=Abstract

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Arthritis robustus--an unusual form of rheumatoid arthritis masquerading as gout. Author(s): Chopra, Chib P. Source: J Assoc Physicians India. 1986 March; 34(3): 216-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3733655&dopt=Abstract

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Arthrodesis for recurrent manubriosternal gout. Author(s): Shewring DJ, Carvell JE. Source: The Journal of Bone and Joint Surgery. British Volume. 1991 March; 73(2): 341. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2005171&dopt=Abstract

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Aseptic loosening of a total hip prosthesis secondary to tophaceous gout. A case report. Author(s): Ortman BL, Pack LL. Source: The Journal of Bone and Joint Surgery. American Volume. 1987 September; 69(7): 1096-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3654703&dopt=Abstract

28 Gout

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Aspect of purine metabolic aberration associated with uric acid overproduction and gout. Author(s): Yip LC, Yu TF, Balis ME. Source: Advances in Experimental Medicine and Biology. 1980; 122A: 307-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6158848&dopt=Abstract

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Aspiration of the asymptomatic metatarsophalangeal joint in gout patients and hyperuricemic controls. Author(s): Rouault T, Caldwell DS, Holmes EW. Source: Arthritis and Rheumatism. 1982 February; 25(2): 209-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7066051&dopt=Abstract

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Association of emphysema, gout, and inflammatory markers with long-term incidence of age-related maculopathy. Author(s): Klein R, Klein BE, Tomany SC, Cruickshanks KJ. Source: Archives of Ophthalmology. 2003 May; 121(5): 674-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742845&dopt=Abstract

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Asymmetric tophaceous gout. Author(s): Cosgrave PM, Lewkonia RM. Source: The Journal of Rheumatology. 1979 July-August; 6(4): 472-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=522096&dopt=Abstract

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Atherogenic risk factors in patients with gout. Author(s): Tsutsumi Z, Yamamoto T, Takahashi S, Moriwaki Y, Yamakita J, Nasako Y, Higashino K. Source: Advances in Experimental Medicine and Biology. 1998; 431: 69-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9598033&dopt=Abstract

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Azapropazone or allopurinol in the treatment of chronic gout and/or hyperuricaemia. A preliminary report. Author(s): Templeton JS. Source: Br J Clin Pract. 1982 October; 36(10): 353-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7171423&dopt=Abstract

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Azapropazone--a treatment for hyperuricaemia and gout? Author(s): Gibson T, Simmonds HA, Armstrong RD, Fairbanks LD, Rodgers AV. Source: British Journal of Rheumatology. 1984 February; 23(1): 44-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6697072&dopt=Abstract

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Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Author(s): Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J. Source: Annals of the Rheumatic Diseases. 2000 July; 59(7): 539-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10873964&dopt=Abstract

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Benzbromarone: a review of its pharmacological properties and therapeutic use in gout and hyperuricaemia. Author(s): Heel RC, Brogden RN, Speight TM, Avery GS. Source: Drugs. 1977 November; 14(5): 349-66. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=338280&dopt=Abstract

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Bone ankylosis. a rare manifestation of gout. Author(s): Good AE, Rapp R. Source: The Journal of Rheumatology. 1978 Fall; 5(3): 335-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=748558&dopt=Abstract

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Bone scan findings of combined gout and septic arthritis in the same digit. Author(s): Coombs RJ, Pinsky ST, Padanilam TG. Source: Clinical Nuclear Medicine. 2001 May; 26(5): 442-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11317025&dopt=Abstract

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Bullous tophi in gout. Author(s): Schumacher HR. Source: Annals of the Rheumatic Diseases. 1977 February; 36(1): 91-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=320945&dopt=Abstract

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Calcium pyrophosphate dihydrate gout and other crystal deposition diseases. Author(s): Reginato AJ. Source: Current Opinion in Rheumatology. 1991 August; 3(4): 676-83. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1654974&dopt=Abstract

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Can risk scores for vascular disease in gout patients be improved? Author(s): Darlington LG, Scott JT. Source: Advances in Experimental Medicine and Biology. 1989; 253A: 197-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2624190&dopt=Abstract

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Care of the patient with gout. Author(s): Carew M, Roberts K. Source: Geriatric Nursing (New York, N.Y.). 1999 May-June; 20(3): 156-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10661106&dopt=Abstract

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Carpal tunnel release complicated by acute gout. Author(s): Kalia KK, Moossy JJ. Source: Neurosurgery. 1993 December; 33(6): 1102-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8133998&dopt=Abstract

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Carpal tunnel syndrome and gout: case report. Author(s): Hoyt RE. Source: Va Med. 1986 July; 113(7): 407-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3751253&dopt=Abstract

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Carpal tunnel syndrome caused by tophaceous gout: CT and MR imaging features in 20 patients. Author(s): Chen CK, Chung CB, Yeh L, Pan HB, Yang CF, Lai PH, Liang HL, Resnick D. Source: Ajr. American Journal of Roentgenology. 2000 September; 175(3): 655-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10954446&dopt=Abstract

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Case in point. Gout. Author(s): Wages DS, Atwater S. Source: Hosp Pract (Off Ed). 1997 June 15; 32(6): 19. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9194795&dopt=Abstract

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Case in point. Tophaceous gout. Author(s): Fred HL. Source: Hosp Pract (Off Ed). 1995 November 15; 30(11): 27. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8557798&dopt=Abstract

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Case report 178: Gout affecting the tarsal and metatarsal bones of the left foot and right hand. Author(s): Lacey PG, Harrison RB. Source: Skeletal Radiology. 1981; 7(3): 225-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7330683&dopt=Abstract

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Case report 237: gout associated with diffuse idiopathic skeletal hyperostosis (DISH). Author(s): Constantz R, Bluestone R. Source: Skeletal Radiology. 1983; 10(2): 117-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6612365&dopt=Abstract

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Case report 445. Bilateral acromioclavicular gouty arthritis with pseudo-tumor of the outer end of the right clavicle: saturnine gout. Author(s): Podgorski MR, Ibels LS, Webb J. Source: Skeletal Radiology. 1987; 16(7): 589-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3423829&dopt=Abstract

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Case report 536: Chronic tophaceous gout in a 17-year-old male. Author(s): Garagiola DM, Clark SA, Colyer RA, Braunstein EM. Source: Skeletal Radiology. 1989; 18(5): 377-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2781341&dopt=Abstract

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Case report 539. Tophaceous gout of the patella. Author(s): Walot I, Staple TW. Source: Skeletal Radiology. 1989; 18(3): 233-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2749293&dopt=Abstract

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Case report 599: Secondary oxalosis complicating chronic renal failure (oxalate gout). Author(s): Coral A, van Holsbeeck M, Hegg C. Source: Skeletal Radiology. 1990; 19(2): 147-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2321046&dopt=Abstract

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Case report 732. Gout presenting as a large pseudo tumor (tophus) in the proximal end of the tibia. Author(s): Cope R, Marsan R, Castelli MJ. Source: Skeletal Radiology. 1992; 21(4): 269-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1626297&dopt=Abstract

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Case report 763. Osteonecrosis and gout of femoral head. Author(s): Cooper A, Minutello R, Vigorita VJ, Bryk E. Source: Skeletal Radiology. 1992; 21(8): 555-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1465653&dopt=Abstract

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Case report. Initial manifestation of gout after carpal tunnel release. Author(s): Calderon MS, Chung KC. Source: British Journal of Plastic Surgery. 1999 January; 52(1): 76-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10343597&dopt=Abstract

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Case report: an unusual presentation of gout. Author(s): Fleet MS, Raby N. Source: Clinical Radiology. 1997 February; 52(2): 156-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9043053&dopt=Abstract

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Cervical gout. Author(s): Sabharwal S, Gibson T. Source: British Journal of Rheumatology. 1988 October; 27(5): 413-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3179637&dopt=Abstract

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Changes in the proteins coating monosodium urate crystals during active and subsiding inflammation. Immunogold studies of synovial fluid from patients with gout and of fluid obtained using the rat subcutaneous air pouch model. Author(s): Ortiz-Bravo E, Sieck MS, Schumacher HR Jr. Source: Arthritis and Rheumatism. 1993 September; 36(9): 1274-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8216421&dopt=Abstract

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Characterization of gout in a skeletal population sample: presumptive diagnosis in a Micronesian population. Author(s): Rothschild BM, Heathcote GM. Source: American Journal of Physical Anthropology. 1995 December; 98(4): 519-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8599385&dopt=Abstract

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Cholesterol distribution among lipoprotein fractions in patients with gout and normal controls. Author(s): Jacobelli S, Arteaga A, Bidegain F. Source: The Journal of Rheumatology. 1986 August; 13(4): 774-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3464758&dopt=Abstract

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Chondrocalcinosis and tophaceous erosions: gout or pseudogout? Author(s): Martin W 3rd, Klein A. Source: J Can Assoc Radiol. 1982 December; 33(4): 260-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7161306&dopt=Abstract

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Chronic myeloid leukemia presenting as gout. Author(s): Pavithran K, Thomas M. Source: Clinical Rheumatology. 2001; 20(4): 288-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11529641&dopt=Abstract

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Chronic polyarticular gout in the elderly: a report of six cases. Author(s): Schousboe JT, Davey K, Gilchrist NL, Sainsbury R. Source: Age and Ageing. 1986 January; 15(1): 8-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3953333&dopt=Abstract

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Chronic tophaceous gout in a patient with a history of allopurinol toxicity. Author(s): Naas JE, Sanders LJ. Source: Cutis; Cutaneous Medicine for the Practitioner. 1998 November; 62(5): 239-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9836057&dopt=Abstract

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Chronic tophaceous gout in the elderly. Author(s): van der Klooster JM, Peters R, Burgmans JP, Grootendorst AF. Source: The Netherlands Journal of Medicine. 1998 August; 53(2): 69-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9766155&dopt=Abstract

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Chronic tophaceous gout presenting as hyperpigmented nodules in the limbs of a patient with coexisting psoriasis. Author(s): Cho S, Koh GJ, Choi JH, Sung KJ, Moon KC, Koh JK. Source: The Journal of Dermatology. 2001 August; 28(8): 433-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11560160&dopt=Abstract

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Chronic tophaceous gout with severely deforming arthritis: a case report with emphasis on histopathologic considerations. Author(s): Cohen PR, Schmidt WA, Rapini RP. Source: Cutis; Cutaneous Medicine for the Practitioner. 1991 December; 48(6): 445-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1760935&dopt=Abstract

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Chronic tophaceous gout. A case report. Author(s): Graefen TA, Stern J, Joyce M, Sion A. Source: Journal of the American Podiatric Medical Association. 1991 January; 81(1): 22-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1993974&dopt=Abstract

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Chronic tophaceous gout: scintigraphic findings on bone scan. Author(s): Goshen E, Schwartz A, Zwas ST. Source: Clinical Nuclear Medicine. 2000 February; 25(2): 146-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10656658&dopt=Abstract

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Classic gout in Hageman factor (Factor XII) deficiency. Author(s): Green D, Arsever CL, Grumet KA, Ratnoff OD. Source: Archives of Internal Medicine. 1982 August; 142(8): 1556-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7103639&dopt=Abstract

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Clinical and family studies in Hungarian patients with gout. Author(s): Mituszova M, Judak A, Poor G, Gyodi E, Stenszky V. Source: Rheumatology International. 1992; 12(5): 165-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1290017&dopt=Abstract

34 Gout

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Clinical aspects of monosodium urate monohydrate crystal deposition disease (gout). Author(s): Becker MA. Source: Rheumatic Diseases Clinics of North America. 1988 August; 14(2): 377-94. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3051156&dopt=Abstract

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Clinical experience with isoxicam in patients with acute gout. Author(s): Fletcher MA, Wade AG. Source: Br J Clin Pract. 1985 March; 39(3): 108-13. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3885989&dopt=Abstract

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Clinical features of familial gout and effects of probable genetic association between gout and its related disorders. Author(s): Chen SY, Chen CL, Shen ML, Kamatani N. Source: Metabolism: Clinical and Experimental. 2001 October; 50(10): 1203-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11586494&dopt=Abstract

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Clinical image. Tophaceous gout of the lumbar spine: MR findings. Author(s): Miller LJ, Pruett SW, Losada R, Fruauff A, Sagerman P. Source: Journal of Computer Assisted Tomography. 1996 November-December; 20(6): 1004-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8933810&dopt=Abstract

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Clinical Image: acute gout in a young man with osteochondromatosis. Author(s): Ali MM, Meyer C. Source: Arthritis and Rheumatism. 1999 September; 42(9): 2011. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10513820&dopt=Abstract

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Clinical manifestations of gout and their management. Author(s): van Doornum S, Ryan PF. Source: The Medical Journal of Australia. 2000 May 15; 172(10): 493-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10901773&dopt=Abstract

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Clinical pattern of females with crystal-induced arthritis: gout and pseudogout. Author(s): Deesomchok U, Tumrasvin T. Source: J Med Assoc Thai. 1989 April; 72(4): 212-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2786918&dopt=Abstract

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Clinical presentation and disease associations of gout: a hospital-based study of 100 patients in Singapore. Author(s): Koh WH, Seah A, Chai P. Source: Ann Acad Med Singapore. 1998 January; 27(1): 7-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9588267&dopt=Abstract

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Clinical snapshot: gout. Author(s): Bynum DT. Source: The American Journal of Nursing. 1997 July; 97(7): 36-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9254547&dopt=Abstract

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Clinical survey of 200 patients with gout. Author(s): Spaccarelli A, Giacomello A, Sorgi ML, Zoppini A. Source: Advances in Experimental Medicine and Biology. 1984; 165 Pt A: 115-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6720362&dopt=Abstract

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Coexistence of chronic tophaceous gout and rheumatoid arthritis. Author(s): Atdjian M, Fernandez-Madrid F. Source: The Journal of Rheumatology. 1981 November-December; 8(6): 989-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7328573&dopt=Abstract

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Coexistence of rheumatoid nodulosis and gout. Author(s): Strader KW, Agudelo CA. Source: The Journal of Rheumatology. 1986 August; 13(4): 818-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3772930&dopt=Abstract

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Coexistence of systemic lupus erythematosus and gout. Author(s): Kalmar L, Ablonczy E, Muzes GY, Gergely P, Neumark T. Source: Arthritis and Rheumatism. 1982 December; 25(12): 1505-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7150386&dopt=Abstract

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Coexistent gout and hypertrophic osteoarthropathy in patients with cyanotic heart disease. Author(s): Martinez-Lavin M, Amigo MC, Castillejos G, Padilla L, Vintimilla F. Source: The Journal of Rheumatology. 1984 December; 11(6): 832-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6520838&dopt=Abstract

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Coexistent gout and Mycobacterium avium-intracellulare arthritis in a renal transplant recipient. Author(s): Czachor JS, Gopalakrishnan R. Source: Kidney & Blood Pressure Research. 1997; 20(1): 62-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9192913&dopt=Abstract

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Coexistent gout and rheumatoid arthritis. Author(s): McCarty DJ. Source: The Journal of Rheumatology. 1981 March-April; 8(2): 353-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7230169&dopt=Abstract

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Coexistent gout and rheumatoid arthritis. Author(s): Spector AK, Christman RA. Source: Journal of the American Podiatric Medical Association. 1989 November; 79(11): 552-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2607422&dopt=Abstract

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Coexistent gout and septic arthritis: a report of two cases and literature review. Author(s): O'Connell PG, Milburn BM, Nashel DJ. Source: Clin Exp Rheumatol. 1985 July-September; 3(3): 265-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3902298&dopt=Abstract

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Coexistent gout and systemic lupus erythematosus. Author(s): Rose EP, Alves LE. Source: Arthritis and Rheumatism. 1982 June; 25(6): 713-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7092973&dopt=Abstract

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Coexistent gout and systemic lupus erythematosus. Author(s): Moidel RA, Good AE. Source: Arthritis and Rheumatism. 1981 July; 24(7): 969-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7259808&dopt=Abstract

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Coexistent rheumatoid arthritis and gout. Author(s): Virshup AM. Source: Arthritis and Rheumatism. 1985 February; 28(2): 238. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3970742&dopt=Abstract

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Coexistent rheumatoid arthritis and tophaceous gout: a case report. Author(s): Raman D, Abdalla AM, Newton DR, Haslock I. Source: Annals of the Rheumatic Diseases. 1981 August; 40(4): 427-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7259335&dopt=Abstract

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Coexistent systemic lupus erythematosus and tophaceous gout. Author(s): DeCastro P, Jorizzo JL, Solomon AR, Lisse JR, Daniels JC. Source: Journal of the American Academy of Dermatology. 1985 October; 13(4): 650-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4078053&dopt=Abstract

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Co-existent tophaceous gout and systemic lupus erythematosus. Author(s): Helliwell M, Crisp AJ, Grahame R. Source: Rheumatol Rehabil. 1982 August; 21(3): 161-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7100772&dopt=Abstract

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Coexisting psoriatic arthritis, gout, and chondrocalcinosis. Author(s): De Bari C, Lapadula G, Cantatore FP. Source: Scandinavian Journal of Rheumatology. 1998; 27(4): 306-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9751474&dopt=Abstract

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Colchicine and gout. Author(s): Moreland LW, Ball GV. Source: Arthritis and Rheumatism. 1991 June; 34(6): 782-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2053926&dopt=Abstract

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Colchicine in acute gout. Reassessment of risks and benefits. Author(s): Roberts WN, Liang MH, Stern SH. Source: Jama : the Journal of the American Medical Association. 1987 April 10; 257(14): 1920-2. Erratum In: Jama 1987 November 20; 258(19): 2698. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3820512&dopt=Abstract

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Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen. Author(s): Lin KC, Lin HY, Chou P. Source: The Journal of Rheumatology. 2000 April; 27(4): 1045-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10782835&dopt=Abstract

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Comparative effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia and gout. Author(s): Wurzner G, Gerster JC, Chiolero A, Maillard M, Fallab-Stubi CL, Brunner HR, Burnier M. Source: Journal of Hypertension. 2001 October; 19(10): 1855-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11593107&dopt=Abstract

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Comparative effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricemia and gout. Author(s): Liberopoulos E, Christides D, Elisaf M. Source: Journal of Hypertension. 2002 February; 20(2): 347. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821722&dopt=Abstract

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Comparative trial of azapropazone and indomethacin plus allopurinol in acute gout and hyperuricaemia. Author(s): Fraser RC, Davis RH, Walker FS. Source: J R Coll Gen Pract. 1987 September; 37(302): 409-11. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3330140&dopt=Abstract

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Comparison of parenteral adrenocorticotropic hormone with oral indomethacin in the treatment of acute gout. Author(s): Axelrod D, Preston S. Source: Arthritis and Rheumatism. 1988 June; 31(6): 803-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2454635&dopt=Abstract

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Computed tomography of the knee joint as an indicator of intraarticular tophi in gout. Author(s): Gerster JC, Landry M, Duvoisin B, Rappoport G. Source: Arthritis and Rheumatism. 1996 August; 39(8): 1406-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8702451&dopt=Abstract

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Concomitant gout and rheumatoid arthritis. Author(s): Martinez-Cordero E, Bessudo-Babani A, Trevino Perez SC, GuillermoGrajales E. Source: The Journal of Rheumatology. 1988 August; 15(8): 1307-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3263502&dopt=Abstract

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Concurrent gout and Mycobacterium tuberculosis arthritis. Author(s): Lorenzo JP, Csuka ME, Derfus BA, Gotoff RA, McCarthy GM. Source: The Journal of Rheumatology. 1997 January; 24(1): 184-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9002033&dopt=Abstract

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Conquest of the gout. Author(s): Brick JE. Source: W V Med J. 1991 October; 87(10): 470-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1767523&dopt=Abstract

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Continuous recruitment, co-expression of tumour necrosis factor-alpha and matrix metalloproteinases, and apoptosis of macrophages in gout tophi. Author(s): Schweyer S, Hemmerlein B, Radzun HJ, Fayyazi A. Source: Virchows Archiv : an International Journal of Pathology. 2000 November; 437(5): 534-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11147175&dopt=Abstract

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Corot's 'gout' and a 'gipsy' girl. Author(s): Panush RB, Caldwell JR, Panush RS. Source: Jama : the Journal of the American Medical Association. 1990 September 5; 264(9): 1136-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2200893&dopt=Abstract

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Corticotropin for acute management of gout. Author(s): Taylor CT, Brooks NC, Kelley KW. Source: The Annals of Pharmacotherapy. 2001 March; 35(3): 365-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11261536&dopt=Abstract

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Crystal deposition in the knee and great toe joints of asymptomatic gout patients. Author(s): Kennedy TD, Higgens CS, Woodrow DF, Scott JT. Source: Journal of the Royal Society of Medicine. 1984 September; 77(9): 747-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6481756&dopt=Abstract

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Cubital tunnel syndrome caused by tophaceous gout. Author(s): Nakamichi K, Tachibana S. Source: Journal of Hand Surgery (Edinburgh, Lothian). 1996 August; 21(4): 559-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8856554&dopt=Abstract

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Cyclosporin induced hyperuricemia and gout. Author(s): Deray G, Assogba U, Le Hoang P, Brillet G, Baumelou B, Ben Hmida M, Jacobs C. Source: Clinical Nephrology. 1990 March; 33(3): 154. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2323116&dopt=Abstract

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Cyclosporine-induced hyperuricemia and gout in renal transplants. Author(s): Ben Hmida M, Hachicha J, Bahloul Z, Kaddour N, Kharrat M, Jarraya F, Jarraya A. Source: Transplantation Proceedings. 1995 October; 27(5): 2722-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7482890&dopt=Abstract

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Cyclosporine-induced hyperuricemia and gout. Author(s): Lin HY, Rocher LL, McQuillan MA, Schmaltz S, Palella TD, Fox IH. Source: The New England Journal of Medicine. 1989 August 3; 321(5): 287-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2664517&dopt=Abstract

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Decreased activities of lipoprotein lipase and hepatic triglyceride lipase in patients with gout. Author(s): Tsutsumi Z, Yamamoto T, Moriwaki Y, Takahashi S, Hada T. Source: Metabolism: Clinical and Experimental. 2001 August; 50(8): 952-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11474484&dopt=Abstract

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Decreased renal phosphate threshold in patients with gout. Author(s): Nishida Y, Ito K. Source: Nephron. 1992; 62(2): 142-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1436304&dopt=Abstract

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Decreased serum concentrations of 1,25(OH)2-vitamin D3 in patients with gout. Author(s): Takahashi S, Yamamoto T, Moriwaki Y, Tsutsumi Z, Yamakita J, Higashino K. Source: Advances in Experimental Medicine and Biology. 1998; 431: 57-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9598031&dopt=Abstract

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Decreased serum concentrations of 1,25(OH)2-vitamin D3 in patients with gout. Author(s): Takahashi S, Yamamoto T, Moriwaki Y, Tsutsumi Z, Yamakita J, Higashino K. Source: Metabolism: Clinical and Experimental. 1998 March; 47(3): 336-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9500573&dopt=Abstract

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Definitive diagnosis of gout by identification of urate crystals in asymptomatic metatarsophalangeal joints. Author(s): Agudelo CA, Weinberger A, Schumacher HR, Turner R, Molina J. Source: Arthritis and Rheumatism. 1979 May; 22(5): 559-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=444319&dopt=Abstract

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Demonstration of an abnormality of C apoprotein of very low density lipoprotein in patients with gout. Author(s): Macfarlane DG, Midwinter CA, Dieppe PA, Bolton CH, Hartog M. Source: Annals of the Rheumatic Diseases. 1985 June; 44(6): 390-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4015201&dopt=Abstract

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Demonstration of chemotactic factor in human gout: further characterization of occurrence and structure. Author(s): Phelps P, Andrews R, Rosenbloom J. Source: The Journal of Rheumatology. 1981 November-December; 8(6): 889-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7328564&dopt=Abstract

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Demonstration of urate in formalin fixative as support for the histopathological diagnosis of gout. Author(s): Eulderink F, Postma T. Source: Histopathology. 1997 February; 30(2): 195. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9067746&dopt=Abstract

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Desensitization to allopurinol in patients with gout and cutaneous reactions. Author(s): Fam AG, Lewtas J, Stein J, Paton TW. Source: The American Journal of Medicine. 1992 September; 93(3): 299-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1388001&dopt=Abstract

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Development of a 'Charcot-like joint' in tophaceous gout. Author(s): Laversuch CJ, Bruckner FE. Source: Journal of the Royal Society of Medicine. 1995 December; 88(12): 713P-5P. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8786598&dopt=Abstract

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Development of acute gout secondary to pyrazinamide in a patient without a prior history of gout. Author(s): Amodio MI, Bengualid V, Lowy FD. Source: Dicp. 1990 November; 24(11): 1115-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2275240&dopt=Abstract

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Development of the gout tophus. An hypothesis. Author(s): Palmer DG, Highton J, Hessian PA. Source: American Journal of Clinical Pathology. 1989 February; 91(2): 190-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2916461&dopt=Abstract

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Diabetes in Hawaii: arthritis/rheumatism and gout in Hawaii: some statistical analyses. Author(s): Varney JM, Sato MM. Source: Hawaii Med J. 1979 July; 38(7): 197-201. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=528202&dopt=Abstract

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Diagnosis and management of complicated gout. Author(s): Wise CM, Agudelo CA. Source: Bulletin on the Rheumatic Diseases. 1998 June; 47(4): 2-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9624822&dopt=Abstract

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Diagnosis and management of gout. Author(s): Pittman JR, Bross MH. Source: American Family Physician. 1999 April 1; 59(7): 1799-806, 1810. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10208700&dopt=Abstract

42 Gout

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Diagnosis and management of gout. Author(s): Hart FD. Source: Practitioner. 1983 July; 227(1381): 1089-99. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6889266&dopt=Abstract

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Diagnosis of gout in general practice. Author(s): Currie WJ. Source: Current Medical Research and Opinion. 1978; 5(9): 714-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=738076&dopt=Abstract

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Diagnosis of intercritical gout. Author(s): Johnson JR. Source: Annals of Internal Medicine. 2000 May 16; 132(10): 843. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10819714&dopt=Abstract

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Diagnostic and therapeutic aids in gout and hyperuricemia. Author(s): Bollet AJ. Source: Med Times. 1981 August; 109(8): 23-31. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7278540&dopt=Abstract

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Difficult gout and new approaches for control of hyperuricemia in the allopurinolallergic patient. Author(s): Fam AG. Source: Curr Rheumatol Rep. 2001 February; 3(1): 29-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11177768&dopt=Abstract

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Digital flexion contractures secondary to tophaceous gout. A report of three cases. Author(s): Caudle RJ, Heim JM, Stern PJ. Source: Orthopedics. 1989 May; 12(5): 731-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2657684&dopt=Abstract

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Diminished affinity for purine substrates as a basis for gout with mild deficiency of hypoxanthine-guanine phosphoribosyltransferase. Author(s): Sweetman L, Borden M, Lesh P, Bakay B, Becker MA. Source: Advances in Experimental Medicine and Biology. 1977; 76A: 319-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=558714&dopt=Abstract

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Diminished tubular secretion of urate in gout not dependent on serum urate levels. Author(s): Mateos FA, Puig JG, Jimenez ML, Herrero EH, Arnalich FF, Vazquez JJ. Source: Advances in Experimental Medicine and Biology. 1986; 195 Pt A: 299-307. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3728160&dopt=Abstract

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Disease-specific noncompliance with drug treatment as a cause of persistent hyperuricemia and gout in anorexia nervosa. Author(s): Grobner W, Walter-Sack I, de Vries JX. Source: European Journal of Medical Research. 1998 February 21; 3(1-2): 77-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9512972&dopt=Abstract

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Displaced pathological patella fracture due to gout. Author(s): Aboulafia AJ, Prickett B, Giltman L. Source: Orthopedics. 1999 May; 22(5): 543-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10348117&dopt=Abstract

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Dissected popliteal cyst: an unusual presentation of acute gout. Author(s): Costello PB, Kennedy AC, Green FA. Source: The American Journal of the Medical Sciences. 1981 January-February; 281(1): 57-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7468642&dopt=Abstract

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Dissected popliteal cyst: an unusual presentation of acute gout. Author(s): Costello PB, Kennedy AC, Green FA. Source: The American Journal of the Medical Sciences. 1980 January-February; 279(1): 57-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7369250&dopt=Abstract

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Disseminated cutaneous sporotrichosis: a marker of osteoarticular sporotrichosis masquerading as gout. Author(s): Gordhan A, Ramdial PK, Morar N, Moodley SD, Aboobaker J. Source: International Journal of Dermatology. 2001 November; 40(11): 717-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11737440&dopt=Abstract

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Disseminated fat necrosis mimicking gout. Author(s): Watson BM, Jackson AR. Source: The Medical Journal of Australia. 1984 June 9; 140(12): 726-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6203022&dopt=Abstract

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Distinguishing gout from other types of arthritis. Author(s): Fessel WJ. Source: Postgraduate Medicine. 1978 May; 63(5): 134-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=643760&dopt=Abstract

44 Gout

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Diuretic induced gout: a multifactorial condition. Author(s): Scott JT, Higgens CS. Source: Annals of the Rheumatic Diseases. 1992 February; 51(2): 259-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1550414&dopt=Abstract

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Diuretic-induced gout in elderly women. Author(s): Macfarlane DG, Dieppe PA. Source: British Journal of Rheumatology. 1985 May; 24(2): 155-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3995213&dopt=Abstract

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Diuretic-induced gout: the beginnings of an epidemic? Author(s): Platt PN, Dick WC. Source: Practitioner. 1985 March; 229(1401): 281, 283-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3975212&dopt=Abstract

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Diversity of opinions on the management of gout in France. A survey of 750 rheumatologists. Author(s): Rozenberg S, Lang T, Laatar A, Koeger AC, Orcel P, Bourgerois P. Source: Rev Rhum Engl Ed. 1996 April; 63(4): 255-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8738444&dopt=Abstract

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Does colchicine work? The results of the first controlled study in acute gout. Author(s): Ahern MJ, Reid C, Gordon TP, McCredie M, Brooks PM, Jones M. Source: Aust N Z J Med. 1987 June; 17(3): 301-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3314832&dopt=Abstract

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Does renal impairment protect from gout? Author(s): Youssef P, Brama T, York H, Pickard P, Stewart P, McGill N. Source: The Journal of Rheumatology. 1995 March; 22(3): 494-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7783068&dopt=Abstract

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Double-blind trial of feprazone and phenylbutazone in acute gout. Author(s): Reardon JA, Stockman A, Darlington LG, Scott JT. Source: Current Medical Research and Opinion. 1980; 6(7): 445-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6988172&dopt=Abstract

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Down syndrome with coexistent gout: report of six patients and possible reasons for the scarcity of descriptions of this association. Author(s): Kamatani N, Yamanaka H, Totokawa S, Kashiwazaki S, Higurashi M. Source: Annals of the Rheumatic Diseases. 1996 September; 55(9): 649-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8882140&dopt=Abstract

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Drug control of gout and hyperuricaemia. Author(s): Emmerson BT. Source: Drugs. 1978 August; 16(2): 158-66. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=352666&dopt=Abstract

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Drug therapy reviews: pathogenesis and clinical management of hyperuricemia and gout. Author(s): Mangini RJ. Source: Am J Hosp Pharm. 1979 April; 36(4): 497-504. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=433935&dopt=Abstract

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Drug-induced gout. Author(s): Scott JT. Source: Baillieres Clin Rheumatol. 1991 April; 5(1): 39-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2070427&dopt=Abstract

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Drugs in current use: gout. Author(s): Soh A. Source: Aust Nurses J. 1979 May; 8(10): 27-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=313207&dopt=Abstract

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Dynamic videomicroscopy evaluation of synovial fluid in gout. Author(s): De Angelis R, Grassi W. Source: The Journal of Rheumatology. 2001 August; 28(8): 1926-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11508602&dopt=Abstract

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Dyshormonal disorders in gout: experimental and clinical studies. Author(s): Mukhin IV, Ignatenko GA, Nikolenko VY. Source: Bulletin of Experimental Biology and Medicine. 2002 May; 133(5): 491-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420070&dopt=Abstract

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Effect of gradual accumulation of iron, molybdenum and sulfur, slow depletion of zinc and copper, ethanol or fructose ingestion and phlebotomy in gout. Author(s): Johnson S. Source: Medical Hypotheses. 1999 November; 53(5): 407-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10616042&dopt=Abstract

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Effect of low level lead exposure on hyperuricemia and gout among middle aged and elderly men: the normative aging study. Author(s): Shadick NA, Kim R, Weiss S, Liang MH, Sparrow D, Hu H. Source: The Journal of Rheumatology. 2000 July; 27(7): 1708-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10914856&dopt=Abstract

46 Gout

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Effect of treatment on erythrocyte phosphoribosyl pyrophosphate synthetase and glutathione reductase activity in patients with primary gout. Author(s): Braven J, Hardwell TR, Hickling P, Whittaker M. Source: Annals of the Rheumatic Diseases. 1986 November; 45(11): 941-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3024593&dopt=Abstract

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Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout. Author(s): Perez-Ruiz F, Calabozo M, Pijoan JI, Herrero-Beites AM, Ruibal A. Source: Arthritis and Rheumatism. 2002 Aug15; 47(4): 356-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12209479&dopt=Abstract

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Effective management of gout. Author(s): Weinstein J. Source: The American Journal of Medicine. 1999 October; 107(4): 406. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10527052&dopt=Abstract

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Effective management of gout: an analogy. Author(s): Wortmann RL. Source: The American Journal of Medicine. 1998 December; 105(6): 513-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9870838&dopt=Abstract

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Effectiveness of etodolac ('Lodine') compared with naproxen in patients with acute gout. Author(s): Maccagno A, Di Giorgio E, Romanowicz A. Source: Current Medical Research and Opinion. 1991; 12(7): 423-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1838075&dopt=Abstract

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Effects of hemodialysis on advanced bony tophi in a tophaceous gout patient with chronic renal failure. Author(s): Migita K, Aratake K, Yoneda M, Tsukada T, Ida H, Sakai M, Shimada H, Otsubo T, Eguchi K. Source: Clin Exp Rheumatol. 2001 May-June; 19(3): 359-60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11407103&dopt=Abstract

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Efficacy of allopurinol and benzbromarone for the control of hyperuricaemia. A pathogenic approach to the treatment of primary chronic gout. Author(s): Perez-Ruiz F, Alonso-Ruiz A, Calabozo M, Herrero-Beites A, Garcia-Erauskin G, Ruiz-Lucea E. Source: Annals of the Rheumatic Diseases. 1998 September; 57(9): 545-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9849314&dopt=Abstract

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Enthesopathy and tendinopathy in gout: computed tomographic assessment. Author(s): Gerster JC, Landry M, Rappoport G, Rivier G, Duvoisin B, Schnyder P. Source: Annals of the Rheumatic Diseases. 1996 December; 55(12): 921-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9014587&dopt=Abstract

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Entrapment neuropathy caused by tophaceous gout. Author(s): Akizuki S, Matsui T. Source: Journal of Hand Surgery (Edinburgh, Lothian). 1984 October; 9(3): 331-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6512373&dopt=Abstract

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Enzyme defect in primary gout. Author(s): Hers HG, Van Den Berghe G. Source: Lancet. 1979 March 17; 1(8116): 585-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=85169&dopt=Abstract

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Epidemiology of gout: is the incidence rising? Author(s): Arromdee E, Michet CJ, Crowson CS, O'Fallon WM, Gabriel SE. Source: The Journal of Rheumatology. 2002 November; 29(11): 2403-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415600&dopt=Abstract

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Epidemiology of Rheumatic disorders in the Pacific with particular emphasis on hyperuricaemia and gout. Author(s): Prior L. Source: Seminars in Arthritis and Rheumatism. 1981 August; 11(1): 213-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6974401&dopt=Abstract

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Erosion of the patella secondary to gout. A case report. Author(s): Cohn BT, Ibarra JA, Jackson DW. Source: The American Journal of Sports Medicine. 1988 July-August; 16(4): 421-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3189671&dopt=Abstract

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Erosive osteoarthritis and gout: gout in 36 joints. Author(s): Parhami N, Greenstein N, Juozevicius JL. Source: The Journal of Rheumatology. 1986 April; 13(2): 469-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3723513&dopt=Abstract

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Erythrocyte adenosine-deaminase activity in gout and hyperuricemia. Author(s): Carcassi A, Macri P, Chiaroni G, Boschi S. Source: Advances in Experimental Medicine and Biology. 1980; 122A: 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7424652&dopt=Abstract

48 Gout

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Erythrocyte glutathione reductase in gout and in glucose-6-phosphate dehydrogenase deficiency. Author(s): Wasserzug O, Szeinberg A, Sperling O. Source: Monogr Hum Genet. 1978; 9: 16-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=732835&dopt=Abstract

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Evaluation and management of gout. Author(s): Ali NS. Source: J Pak Med Assoc. 1999 November; 49(11): 282-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10647242&dopt=Abstract

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Evaluation of allopurinol use in patients with gout. Author(s): Zell SC, Carmichael JM. Source: Am J Hosp Pharm. 1989 September; 46(9): 1813-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2801716&dopt=Abstract

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Evaluation of crystals in formalin-fixed, paraffin-embedded tissue sections for the differential diagnosis of pseudogout, gout, and tumoral calcinosis. Author(s): Shidham V, Chivukula M, Basir Z, Shidham G. Source: Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc. 2001 August; 14(8): 806-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11504841&dopt=Abstract

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Excess release of hypoxanthine from exercising muscle in two gout patients with partial HGPRTase deficiency: lack of ammonium release. Author(s): Hisatome I, Kitamura H, Saito M, Kinugawa T, Miyakoda H, Kotake H, Mashiba H, Azumi T, Ohno K, Takeda A, et al. Source: The American Journal of Medicine. 1991 April; 90(4): 533-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2012099&dopt=Abstract

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Extradural spinal involvement by gout. Case report. Author(s): Wald SL, McLennan JE, Carroll RM, Segal H. Source: Journal of Neurosurgery. 1979 February; 50(2): 236-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=430138&dopt=Abstract

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Extradural spinal tophaceous gout: evolution with medical treatment. Author(s): Dhote R, Roux FX, Bachmeyer C, Tudoret L, Daumas-Duport C, Christoforov B. Source: Clin Exp Rheumatol. 1997 July-August; 15(4): 421-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9272305&dopt=Abstract

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Eye tophi deposition in gout. Author(s): Martinez-Cordero E, Barreira-Mercado E, Katona G. Source: The Journal of Rheumatology. 1986 April; 13(2): 471-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3723515&dopt=Abstract

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Factor XII deficiency in a man with gout and angioimmunoblastic lymphadenopathy. Author(s): Londino AV Jr, Luparello FJ. Source: Archives of Internal Medicine. 1984 July; 144(7): 1497-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6732412&dopt=Abstract

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Familial calcium pyrophosphate crystal deposition disease or calcium pyrophosphate gout. Author(s): Reginato AJ, Reginato AM, Fernandez-Dapica MP, Ramachandrula A. Source: Rev Rhum Engl Ed. 1995 May; 62(5): 376-91. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7655871&dopt=Abstract

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Familial gout and renal failure in young women. Author(s): Simmonds HA, Warren DJ, Cameron JS, Potter CF, Farebrother DA. Source: Clinical Nephrology. 1980 October; 14(4): 176-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7428192&dopt=Abstract

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Familial gout and renal failure. Author(s): Warren DJ, Simmonds HA, Gibson T, Naik RB. Source: Archives of Disease in Childhood. 1981 September; 56(9): 699-704. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7294873&dopt=Abstract

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Familial nephropathy and gout: which comes first? Author(s): Puig JG, Miranda Carus ME, Mateos FA, Luz Picazo M, Lopez Jimenez M, Ortiz Vazquez J. Source: Advances in Experimental Medicine and Biology. 1991; 309A: 195-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1789207&dopt=Abstract

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Familial nephropathy with hyperuricemia and gout. Author(s): Leumann EP, Wegmann W. Source: Nephron. 1983; 34(1): 51-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6855996&dopt=Abstract

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Familial occurrence of hyperuricemia, gout, and medullary cystic disease. Author(s): Thompson GR, Weiss JJ, Goldman RT, Rigg GA. Source: Archives of Internal Medicine. 1978 November; 138(11): 1614-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=718310&dopt=Abstract

50 Gout

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Family study of lipid and purine levels in gout patients and analysis of mortality. Author(s): Darlington LG, Slack J, Scott JT. Source: Advances in Experimental Medicine and Biology. 1980; 122A: 21-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7424637&dopt=Abstract

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Family study of lipid and purine levels in gout patients. Author(s): Darlington LG, Slack J, Scott JT. Source: Annals of the Rheumatic Diseases. 1982 June; 41(3): 253-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7092337&dopt=Abstract

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Fatty acid composition of plasma lipid fractions in gout. Author(s): Novak A, Knesl E, Muller MM, Kaiser E. Source: Advances in Experimental Medicine and Biology. 1977; 76A: 563-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=855731&dopt=Abstract

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Fatty acid composition of plasma lipids in gout. Author(s): Vannoni D, Ciccoli L, Leoncini R, Marcolongo R, Marinello E. Source: Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 1986; 40(9): 348-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3828481&dopt=Abstract

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Female gout. Clinical spectrum and uric acid metabolism. Author(s): Puig JG, Michan AD, Jimenez ML, Perez de Ayala C, Mateos FA, Capitan CF, de Miguel E, Gijon JB. Source: Archives of Internal Medicine. 1991 April; 151(4): 726-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2012455&dopt=Abstract

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Female premenopausal tophaceous gout induced by long-term diuretic abuse. Author(s): Hayem G, Delahousse M, Meyer O, Palazzo E, Chazerain P, Kahn MF. Source: The Journal of Rheumatology. 1996 December; 23(12): 2166-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8970059&dopt=Abstract

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Fenofibrate enhances urate reduction in men treated with allopurinol for hyperuricaemia and gout. Author(s): Feher MD, Hepburn AL, Hogarth MB, Ball SG, Kaye SA. Source: Rheumatology (Oxford, England). 2003 February; 42(2): 321-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12595630&dopt=Abstract

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Fenofibrate: a new treatment for hyperuricaemia and gout? Author(s): Hepburn AL, Kaye SA, Feher MD. Source: Annals of the Rheumatic Diseases. 2001 October; 60(10): 984-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11589178&dopt=Abstract

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Fibroblast phosphoribosylpyrophosphate and ribose-5-phosphate concentration and generation in gout with purine overproduction. Author(s): Becker MA. Source: Advances in Experimental Medicine and Biology. 1977; 76A: 270-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=193370&dopt=Abstract

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Fine needle aspiration of tophi for crystal identification in problematic cases of gout. A report of two cases. Author(s): Rege J, Shet T, Naik L. Source: Acta Cytol. 2000 May-June; 44(3): 433-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10834006&dopt=Abstract

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Finger pad deposits. Gout. Author(s): Eng AM, Schmidt K, Bansal V. Source: Archives of Dermatology. 1994 November; 130(11): 1435, 1438. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7979451&dopt=Abstract

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Finger pad tophi in gout. Author(s): Holland NW, Jost D, Beutler A, Schumacher HR, Agudelo CA. Source: The Journal of Rheumatology. 1996 April; 23(4): 690-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8730128&dopt=Abstract

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Flexor tendinitis and median nerve compression caused by gout in a patient with rheumatoid arthritis. Author(s): Weinzweig J, Fletcher JW, Linburg RM. Source: Plastic and Reconstructive Surgery. 2000 December; 106(7): 1570-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11129187&dopt=Abstract

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Flexor tendon rupture caused by gout: a case report. Author(s): Wurapa RK, Zelouf DS. Source: The Journal of Hand Surgery. 2002 July; 27(4): 591-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132081&dopt=Abstract

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Flurbiprofen in the treatment of acute gout. A comparison with indomethacin. Author(s): Lomen PL, Turner LF, Lamborn KR, Winblad MA, Sack RL, Brinn EL. Source: The American Journal of Medicine. 1986 March 24; 80(3A): 134-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3963020&dopt=Abstract

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Food, drink, and gout. Author(s): Scott JT. Source: British Medical Journal (Clinical Research Ed.). 1983 July 9; 287(6385): 78-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6407712&dopt=Abstract

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Free oxypurines in plasma and urine of gout patients before and after a purine-free diet. Author(s): Porcelli B, Vannoni D, Leoncini R, Pizzichini M, Pagani R, Marinello E. Source: Advances in Experimental Medicine and Biology. 1994; 370: 47-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7660951&dopt=Abstract

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Frequency of chondrocalcinosis of the knees and avascular necrosis of the femoral heads in gout, a controlled study. Author(s): Stockman A, Darlington LG, Scott JT. Source: Advances in Experimental Medicine and Biology. 1980; 122A: 55-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7424661&dopt=Abstract

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Frequency of chondrocalcinosis of the knees and avascular necrosis of the femoral heads in gout: a controlled study. Author(s): Stockman A, Darlington LG, Scott JT. Source: Annals of the Rheumatic Diseases. 1980 February; 39(1): 7-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7377863&dopt=Abstract

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Fructose-induced aberration of metabolism in familial gout identified by 31P magnetic resonance spectroscopy. Author(s): Seegmiller JE, Dixon RM, Kemp GJ, Angus PW, McAlindon TE, Dieppe P, Rajagopalan B, Radda GK. Source: Proceedings of the National Academy of Sciences of the United States of America. 1990 November; 87(21): 8326-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2236043&dopt=Abstract

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Fulminating carpal tunnel syndrome due to gout. Author(s): Ogilvie C, Kay NR. Source: Journal of Hand Surgery (Edinburgh, Lothian). 1988 February; 13(1): 42-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3361205&dopt=Abstract

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Fungalbionics: a new concept of the etiology of gout, hyperuricemia and their related diseases. Author(s): Costantini AV. Source: Advances in Experimental Medicine and Biology. 1989; 253A: 261-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2696348&dopt=Abstract

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Gout after intraarticular injection of hylan GF-20 (Synvisc) Author(s): Yacyshyn EA, Matteson EL. Source: The Journal of Rheumatology. 1999 December; 26(12): 2717. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10606396&dopt=Abstract

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Gout and hyperuricaemia. Author(s): Darmawan J, Lutalo SK. Source: Baillieres Clin Rheumatol. 1995 February; 9(1): 83-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7728891&dopt=Abstract

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Gout and hyperuricemia. Author(s): Wortmann RL. Source: Current Opinion in Rheumatology. 2002 May; 14(3): 281-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11981327&dopt=Abstract

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Gout and hyperuricemia. Author(s): Harris MD, Siegel LB, Alloway JA. Source: American Family Physician. 1999 February 15; 59(4): 925-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10068714&dopt=Abstract

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Gout and hyperuricemia. Author(s): Simkin PA. Source: Current Opinion in Rheumatology. 1997 May; 9(3): 268-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9204265&dopt=Abstract

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Gout and hypothyroidism. Author(s): Gregoline PE, Peshoff ML, Trepal MJ. Source: Journal of the American Podiatric Medical Association. 1997 August; 87(8): 3946. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9274097&dopt=Abstract

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Gout and mechanisms of crystal-induced inflammation. Author(s): Terkeltaub RA. Source: Current Opinion in Rheumatology. 1993 July; 5(4): 510-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8357747&dopt=Abstract

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Gout and other crystal arthropathies. Author(s): McGill NW. Source: The Medical Journal of Australia. 1997 January 6; 166(1): 33-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9006612&dopt=Abstract

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Gout and other crystal-associated arthropathies. Author(s): McGill NW. Source: Bailliere's Best Practice & Research. Clinical Rheumatology. 2000 September; 14(3): 445-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10985980&dopt=Abstract

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Gout and pseudogout chronobiology. Author(s): Rovensky J, Mikulecky M, Masarova R. Source: The Journal of Rheumatology. 1999 June; 26(6): 1426-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10381081&dopt=Abstract

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Gout and pseudogout in hospitalized patients. Author(s): Ho G Jr, DeNuccio M. Source: Archives of Internal Medicine. 1993 December 27; 153(24): 2787-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8257255&dopt=Abstract

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Gout and pseudogout. Author(s): Agarwal AK. Source: Primary Care. 1993 December; 20(4): 839-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8310084&dopt=Abstract

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Gout and 'pseudogout'. When are arthritic symptoms caused by crystal deposition? Author(s): Beutler A, Schumacher HR Jr. Source: Postgraduate Medicine. 1994 February 1; 95(2): 103-6, 109, 113-6 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8309855&dopt=Abstract

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Gout and pseudogout: crystal-induced arthropathies. Author(s): Pritchard MH. Source: Clin Endocrinol Metab. 1981 March; 10(1): 141-61. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7014045&dopt=Abstract

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Gout and quackery; or Banks and the mountebanks. Author(s): Porter R. Source: Clio Medica (Amsterdam, Netherlands). 1998; 48: 255-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9646026&dopt=Abstract

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Gout and risk for subsequent coronary heart disease. The Meharry-Hopkins Study. Author(s): Gelber AC, Klag MJ, Mead LA, Thomas J, Thomas DJ, Pearson TA, Hochberg MC. Source: Archives of Internal Medicine. 1997 July 14; 157(13): 1436-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9224221&dopt=Abstract

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Gout and secondary amyloid. Author(s): Guma M, Bayes B, Bonet J, Olive A. Source: Clinical Rheumatology. 1999; 18(1): 54-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10088952&dopt=Abstract

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Gout and stones or stones and gout? Author(s): Stoller ML. Source: The Journal of Urology. 1995 November; 154(5): 1670. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7563317&dopt=Abstract

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Gout and the gullible. Author(s): Pritzker KP. Source: The Journal of Rheumatology. 1994 December; 21(12): 2175-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7699613&dopt=Abstract

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Gout and uric acid excretion. Author(s): Paulsen TP. Source: American Family Physician. 1992 January; 45(1): 48, 50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1728101&dopt=Abstract

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Gout arthropathy: description of an atypical case. Author(s): Busanelli L, Sudanese A, Baldini N. Source: Chir Organi Mov. 1993 October-December; 78(4): 247-50. Review. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8149786&dopt=Abstract

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Gout as a source of sesamoid pain. Author(s): Mair SD, Coogan AC, Speer KP, Hall RL. Source: Foot & Ankle International / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society. 1995 October; 16(10): 613-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8574372&dopt=Abstract

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Gout attacks and lunar cycle. Author(s): Mikulecky M, Rovensky J. Source: Medical Hypotheses. 2000 July; 55(1): 24-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11021320&dopt=Abstract

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Gout attacks in chronic alcoholics occur at lower serum urate levels than in nonalcoholics. Author(s): Vandenberg MK, Moxley G, Breitbach SA, Roberts WN. Source: The Journal of Rheumatology. 1994 April; 21(4): 700-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8035396&dopt=Abstract

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Gout basics. Author(s): Weselman KO, Agudelo CA. Source: Bulletin on the Rheumatic Diseases. 2001; 50(9): 1-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12092090&dopt=Abstract

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Gout due to xanthine derivatives. Author(s): Toda K, Goriki K, Ochiai M, Tokunou H, Uehara S, Takahashi H, Okusaki K. Source: British Journal of Rheumatology. 1997 October; 36(10): 1131-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9374937&dopt=Abstract

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Gout during pregnancy. Author(s): Kelsall JT, O'Hanlon DP. Source: The Journal of Rheumatology. 1994 July; 21(7): 1365-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7966087&dopt=Abstract

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Gout in a patient with Reiter's syndrome. Author(s): Warren KJ, Kazi S, Nassar NN. Source: Cutis; Cutaneous Medicine for the Practitioner. 1998 February; 61(2): 85-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9515213&dopt=Abstract

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Gout in black South Africans: a clinical and genetic study. Author(s): Cassim B, Mody GM, Deenadayalu VK, Hammond MG. Source: Annals of the Rheumatic Diseases. 1994 November; 53(11): 759-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7826138&dopt=Abstract

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Gout in patients attending the rheumatology unit of Lome Hospital. Author(s): Mijiyawa M. Source: British Journal of Rheumatology. 1995 September; 34(9): 843-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7582724&dopt=Abstract

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Gout in patients with systemic lupus erythematosus. Author(s): McMillen MA, Cunningham ME, Schoen R, Fikrig E. Source: British Journal of Rheumatology. 1994 June; 33(6): 595-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8205413&dopt=Abstract

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Gout in the cervical spine: MR pattern mimicking diskovertebral infection. Author(s): Duprez TP, Malghem J, Vande Berg BC, Noel HM, Munting EA, Maldague BE. Source: Ajnr. American Journal of Neuroradiology. 1996 January; 17(1): 151-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8770267&dopt=Abstract

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Gout in the elderly. Clinical presentation and treatment. Author(s): Fam AG. Source: Drugs & Aging. 1998 September; 13(3): 229-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9789727&dopt=Abstract

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Gout in the hip joint. Author(s): Parhami N, Feng H. Source: Arthritis and Rheumatism. 1993 July; 36(7): 1026. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8318031&dopt=Abstract

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Gout in women: a historical perspective. Author(s): Benedek TG. Source: Bulletin of the History of Medicine. 1997 Spring; 71(1): 1-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9086625&dopt=Abstract

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Gout is on the increase in New Zealand. Author(s): Klemp P, Stansfield SA, Castle B, Robertson MC. Source: Annals of the Rheumatic Diseases. 1997 January; 56(1): 22-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9059136&dopt=Abstract

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Gout masquerading as rheumatoid vasculitis. Author(s): Sharma A, Baethge BA, Smith EB, Shepherd ME, Lisse JR. Source: The Journal of Rheumatology. 1994 February; 21(2): 368-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8182655&dopt=Abstract

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Gout nodulosis: widespread subcutaneous deposits without gout. Author(s): Iglesias A, Londono JC, Saaibi DL, Pena M, Lizarazo H, Gonzalez EB. Source: Arthritis Care and Research : the Official Journal of the Arthritis Health Professions Association. 1996 February; 9(1): 74-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8945116&dopt=Abstract

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Gout of the spine. Two case reports and a review of the literature. Author(s): Fenton P, Young S, Prutis K. Source: The Journal of Bone and Joint Surgery. American Volume. 1995 May; 77(5): 76771. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7744902&dopt=Abstract

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Gout of the temporomandibular joint: pitfalls in diagnosis. Author(s): Barthelemy I, Karanas Y, Sannajust JP, Emering C, Mondie JM. Source: Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery. 2001 October; 29(5): 307-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11673927&dopt=Abstract

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Gout or 'pseudogout': how to differentiate crystal-induced arthropathies. Author(s): Joseph J, McGrath H. Source: Geriatrics. 1995 April; 50(4): 33-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7721112&dopt=Abstract

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Gout presenting as infectious arthritis. Two case reports. Author(s): Rogachefsky RA, Carneiro R, Altman RD, Burkhalter WE. Source: The Journal of Bone and Joint Surgery. American Volume. 1994 February; 76(2): 269-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8113264&dopt=Abstract

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Gout presenting as non-union of a patellar fracture. Author(s): Espinosa-Morales R, Escalante A. Source: The Journal of Rheumatology. 1997 July; 24(7): 1421-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9228149&dopt=Abstract

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Gout related upper limb cellulitis: an ultrasound study. Author(s): Wakefield RJ, Emery P, Pease C. Source: The Journal of Rheumatology. 2003 February; 30(2): 417-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12563707&dopt=Abstract

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Gout secondary to pyrazinamide and ethambutol. Author(s): Rao TP, Schmitt JK. Source: Va Med Q. 1996 Fall; 123(4): 271. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8909152&dopt=Abstract

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Gout secondary to ritonavir and didanosine. Author(s): Mehlhaff DL, Stein DS. Source: Aids (London, England). 1996 December; 10(14): 1744. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8970701&dopt=Abstract

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Gout tophus in the bipartite patella. Author(s): Tashiro S, Sugita T, Nakamura S, Kurata Y. Source: Orthopedics. 2002 November; 25(11): 1295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452351&dopt=Abstract

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Gout update: from lab to the clinic and back. Author(s): Pascual E. Source: Current Opinion in Rheumatology. 2000 May; 12(3): 213-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10803751&dopt=Abstract

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Gout with aseptic loosening of cementless total hip arthroplasty--a case report. Author(s): Yeh WL, Shi CH. Source: Changgeng Yi Xue Za Zhi. 1994 December; 17(4): 384-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7850656&dopt=Abstract

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Gout without hyperuricemia. Author(s): McCarty DJ. Source: Jama : the Journal of the American Medical Association. 1994 January 26; 271(4): 302-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8295290&dopt=Abstract

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Gout, bradycardia, and hypercholesterolemia after renal transplantation. Author(s): Kelleher SP, Davis WR, Paraskevopoulos N. Source: Southern Medical Journal. 2001 July; 94(7): 732-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11531183&dopt=Abstract

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Gout, diet, and the insulin resistance syndrome. Author(s): Fam AG. Source: The Journal of Rheumatology. 2002 July; 29(7): 1350-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12136887&dopt=Abstract

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Gout, uric acid and purine metabolism in paediatric nephrology. Author(s): Cameron JS, Moro F, Simmonds HA. Source: Pediatric Nephrology (Berlin, Germany). 1993 February; 7(1): 105-18. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8439471&dopt=Abstract

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Gout, uric acid metabolism, and crystal-induced inflammation. Author(s): Weinberger A. Source: Current Opinion in Rheumatology. 1995 July; 7(4): 359-63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7547116&dopt=Abstract

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Gout, uric acid, albumin, and aging. Author(s): Seaton K. Source: Journal of the National Medical Association. 1996 August; 88(8): 473, 486. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8803426&dopt=Abstract

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Gout. Author(s): Corkill MM. Source: N Z Med J. 1994 August 24; 107(984): 337-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8072733&dopt=Abstract

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Gout. Author(s): Rott KT, Agudelo CA. Source: Jama : the Journal of the American Medical Association. 2003 June 4; 289(21): 2857-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783917&dopt=Abstract

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Gout. Author(s): Howard W. Source: Australian Nursing Journal (July 1993). 1999 October; 7(4): Suppl 1-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11894317&dopt=Abstract

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Gout. Author(s): Perkins P, Jones AC. Source: Annals of the Rheumatic Diseases. 1999 October; 58(10): 611-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10491359&dopt=Abstract

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Gout. Author(s): Wyndham M. Source: Practitioner. 1998 July; 242(1588): 546. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10492933&dopt=Abstract

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Gout. Author(s): Klipper AR. Source: Lippincott's Primary Care Practice. 1998 January-February; 2(1): 93-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9451203&dopt=Abstract

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Gout. Easy to misdiagnose. Author(s): Sturrock RD. Source: Bmj (Clinical Research Ed.). 2000 January 15; 320(7228): 132-3. Erratum In: Bmj 2000 April 1; 320(7239): 913. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10634714&dopt=Abstract

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Gout: 'a disease of plenty'. Author(s): Rasaratnam I, Christophidis N. Source: Aust Fam Physician. 1995 May; 24(5): 849-51, 855-6, 859-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7794148&dopt=Abstract

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Gout: an experience from Zimbabwe. Author(s): Lutalo SK. Source: Cent Afr J Med. 1993 March; 39(3): 60-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8306386&dopt=Abstract

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Gout: beyond the stereotype. Author(s): Jones RE, Ball EV. Source: Hosp Pract (Off Ed). 1999 June 15; 34(6): 95-102; Discussion 102-3; Quiz 133. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10386113&dopt=Abstract

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Gout: can management be improved? Author(s): Schlesinger N, Schumacher HR Jr. Source: Current Opinion in Rheumatology. 2001 May; 13(3): 240-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11333356&dopt=Abstract

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Gout: diagnosis, pathogenesis, and clinical manifestations. Author(s): Agudelo CA, Wise CM. Source: Current Opinion in Rheumatology. 2001 May; 13(3): 234-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11333355&dopt=Abstract

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Gout: diet and uric acid revisited. Author(s): Snaith ML. Source: Lancet. 2001 August 18; 358(9281): 525. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11520519&dopt=Abstract

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Gout: framing and fantasizing disease. Author(s): Porter R. Source: Bulletin of the History of Medicine. 1994 Spring; 68(1): 1-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8173299&dopt=Abstract

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Gout: its causes, symptoms and treatment. Author(s): Hill J. Source: Nurs Times. 1999 November 24-December 1; 95(47): 48-50. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11096905&dopt=Abstract

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Gout: modern management of an ancient malady. Author(s): Boyd RE. Source: J S C Med Assoc. 1993 May; 89(5): 240-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8515662&dopt=Abstract

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Gout: new questions for an ancient disease. Author(s): Puig JG, Mateos FA, Sancho T, Torres RJ, Buno A, de Miguel E, Gil A. Source: Advances in Experimental Medicine and Biology. 1998; 431: 1-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9598021&dopt=Abstract

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Gout: not just for the rich and famous! Everyman's disease. Author(s): Kamienski M. Source: Orthopaedic Nursing / National Association of Orthopaedic Nurses. 2003 January-February; 22(1): 16-20; Quiz 21-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12640948&dopt=Abstract

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Gout: questions that still need to be answered. Author(s): Terkeltaub RA. Source: Annals of the Rheumatic Diseases. 1995 February; 54(2): 79-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7702409&dopt=Abstract

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Gout: radiographic findings mimicking infection. Author(s): Rousseau I, Cardinal E E, Raymond-Tremblay D, Beauregard CG, Braunstein EM, Saint-Pierre A. Source: Skeletal Radiology. 2001 October; 30(10): 565-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11685479&dopt=Abstract

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Gout: rare cause of hallucal sesamoid pain: a case report. Author(s): Reber PU, Patel AG, Noesberger B. Source: Foot & Ankle International / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society. 1997 December; 18(12): 818-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9429885&dopt=Abstract

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Gout: the best understood form of arthritis? Author(s): Hasselbacher P. Source: Arthritis Care and Research : the Official Journal of the Arthritis Health Professions Association. 1996 February; 9(1): 5-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8945106&dopt=Abstract

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Gout: the last 50 years. Author(s): Scott JT. Source: Journal of the Royal Society of Medicine. 1996 November; 89(11): 634-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9135593&dopt=Abstract

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Gout-induced arthropathy after total knee arthroplasty: a report of two cases. Author(s): Archibeck MJ, Rosenberg AG, Sheinkop MB, Berger RA, Jacobs JJ. Source: Clinical Orthopaedics and Related Research. 2001 November; (392): 377-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11716410&dopt=Abstract

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Granulomatous tophaceous gout mimicking tuberculous tenosynovitis: report of two cases. Author(s): Kostman JR, Rush P, Reginato AJ. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1995 July; 21(1): 217-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7578737&dopt=Abstract

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Hereditary nephropathy associated with hyperuricemia and gout. Author(s): Puig JG, Miranda ME, Mateos FA, Picazo ML, Jimenez ML, Calvin TS, Gil AA. Source: Archives of Internal Medicine. 1993 February 8; 153(3): 357-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8427538&dopt=Abstract

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High prevalence of gout and related risk factors in Taiwan's Aborigines. Author(s): Chang SJ, Ko YC, Wang TN, Chang FT, Cinkotai FF, Chen CJ. Source: The Journal of Rheumatology. 1997 July; 24(7): 1364-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9228138&dopt=Abstract

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High prevalence of hyperuricaemia among Kuwaitis possibly without a proportionate increase in gout. Author(s): Malaviya AN, al-Ali N, Sharma P, al-Sughayer A, Umamaheswaran I, alGaurer S, Hussain AA. Source: British Journal of Rheumatology. 1997 March; 36(3): 405-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9133983&dopt=Abstract

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High prevalence of hyperuricaemia and gout in an urbanised Micronesian population. Author(s): Zimmet PZ, Whitehouse S, Jackson L, Thoma K. Source: British Medical Journal. 1978 May 13; 1(6122): 1237-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=647212&dopt=Abstract

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Histologic differentiation of gout and pseudogout using polarized light. Author(s): Pappolla MA. Source: Archives of Pathology & Laboratory Medicine. 1984 May; 108(5): 361. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6546859&dopt=Abstract

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Historical note: the concept of gout in 1880. Author(s): Appelboom T, Ehrlich GE. Source: Arthritis and Rheumatism. 1998 August; 41(8): 1511-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9704653&dopt=Abstract

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Hormonal aspects of human gout--excretion of adrenal hormone derivatives in gouty patients. Author(s): Gregolini L, Ferrari S, Marcolongo R, Aleo MF, Marinello E, Bianchi E. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1983 June 15; 130(3): 269-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6223725&dopt=Abstract

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How is gout managed in primary care? A review of current practice and proposed guidelines. Author(s): Pal B, Foxall M, Dysart T, Carey F, Whittaker M. Source: Clinical Rheumatology. 2000; 19(1): 21-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10752494&dopt=Abstract

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How much do we know about hyperuricemia and gout? The expectations and the results. Author(s): Rumboldt Z, Bagatin J, Simunic M, Sardelic S. Source: Acta Med Croatica. 1993; 47(1): 51-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7693087&dopt=Abstract

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How should we treat tophaceous gout in patients with allopurinol hypersensitivity? Author(s): Grahame R, Simmonds HA, McBride MB, Marsh FP. Source: Advances in Experimental Medicine and Biology. 1998; 431: 19-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9598024&dopt=Abstract

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How well have diagnostic tests and therapies for gout been evaluated? Author(s): Schlesinger N, Baker DG, Schumacher HR Jr. Source: Current Opinion in Rheumatology. 1999 September; 11(5): 441-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10503668&dopt=Abstract

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Human hypoxanthine (guanine) phosphoribosyltransferase: an amino acid substitution in a mutant form of the enzyme isolated from a patient with gout. Author(s): Wilson JM, Tarr GE, Kelley WN. Source: Proceedings of the National Academy of Sciences of the United States of America. 1983 February; 80(3): 870-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6572373&dopt=Abstract

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Human hypoxanthine-guanine phosphoribosyltransferase deficiency. The molecular defect in a patient with gout (HPRTAshville). Author(s): Davidson BL, Pashmforoush M, Kelley WN, Palella TD. Source: The Journal of Biological Chemistry. 1989 January 5; 264(1): 520-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2909537&dopt=Abstract

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Human hypoxanthine-guanine phosphoribosyltransferase. Structural alteration in a dysfunctional enzyme variant (HPRTMunich) isolated from a patient with gout. Author(s): Wilson JM, Kelley WN. Source: The Journal of Biological Chemistry. 1984 January 10; 259(1): 27-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6706936&dopt=Abstract

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Hyperbaric oxygen therapy elicits acute arthritis attack and exacerbation of infection in a patient with infected tophaceous gout and vascular insufficiency. Author(s): Kung YY, Tsai CY, Tsai YY, Huang DF, Tsai ST, Yu CL. Source: Clin Exp Rheumatol. 1998 November-December; 16(6): 764. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9844782&dopt=Abstract

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Hyperlipidaemia in hyperuricaemia and gout. Author(s): Emmerson B. Source: Annals of the Rheumatic Diseases. 1998 September; 57(9): 509-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9849306&dopt=Abstract

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Hyperlipidemia in primary gout. Author(s): Yu TF, Dorph DJ, Smith H. Source: Seminars in Arthritis and Rheumatism. 1978 May; 7(4): 233-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=347582&dopt=Abstract

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Hyperlipoproteinaemia in primary gout: hyperlipoproteinaemic phenotype and influence of alcohol intake and obesity in Japan. Author(s): Jiao S, Kameda K, Matsuzawa Y, Tarui S. Source: Annals of the Rheumatic Diseases. 1986 April; 45(4): 308-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3707219&dopt=Abstract

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Hypertension, renal function and gout. Author(s): Gibson T, Highton J, Simmonds HA, Potter CF. Source: Postgraduate Medical Journal. 1979; 55 Suppl 3: 21-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=504036&dopt=Abstract

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Hyperuricaemia and gout in Western Samoans. Author(s): Jackson L, Taylor R, Faaiuso S, Ainuu SP, Whitehouse S, Zimmet P. Source: J Chronic Dis. 1981; 34(2-3): 65-75. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7462382&dopt=Abstract

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Hyperuricaemia, gout and kidney function in New Zealand Maori men. Author(s): Gibson T, Waterworth R, Hatfield P, Robinson G, Bremner K. Source: British Journal of Rheumatology. 1984 November; 23(4): 276-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6487933&dopt=Abstract

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Hyperuricemia and gout among heart transplant recipients receiving cyclosporine. Author(s): Burack DA, Griffith BP, Thompson ME, Kahl LE. Source: The American Journal of Medicine. 1992 February; 92(2): 141-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1543197&dopt=Abstract

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Hyperuricemia and gout in cyclosporin A-treated renal transplant recipients. Author(s): Lin HY, Rocher LL, McQuillan MA, Palella TD, Fox IH. Source: Advances in Experimental Medicine and Biology. 1989; 253A: 289-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2624205&dopt=Abstract

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Hyperuricemia and gout in renal allograft recipients. Author(s): Delaney V, Sumrani N, Daskalakis P, Hong JH, Sommer BG. Source: Transplantation Proceedings. 1992 October; 24(5): 1773-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1412837&dopt=Abstract

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Hyperuricemia and gout in renal transplant recipients. Author(s): Abdelrahman M, Rafi A, Ghacha R, Youmbissi JT, Qayyum T, Karkar A. Source: Renal Failure. 2002 May; 24(3): 361-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12166703&dopt=Abstract

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Hyperuricemia and gout in secondary polycythemia due to chronic obstructive pulmonary disease. Author(s): Kohkhar N. Source: The Journal of Rheumatology. 1980 January-February; 7(1): 114-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7354464&dopt=Abstract

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Hyperuricemia and gout in Taiwan: results from the Nutritional and Health Survey in Taiwan (1993-96). Author(s): Chang HY, Pan WH, Yeh WT, Tsai KS. Source: The Journal of Rheumatology. 2001 July; 28(7): 1640-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11469473&dopt=Abstract

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Hyperuricemia and gout in thyroid endocrine disorders. Author(s): Giordano N, Santacroce C, Mattii G, Geraci S, Amendola A, Gennari C. Source: Clin Exp Rheumatol. 2001 November-December; 19(6): 661-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11791637&dopt=Abstract

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Hyperuricemia and gout. Author(s): Liote F. Source: Curr Rheumatol Rep. 2003 June; 5(3): 227-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744816&dopt=Abstract

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Hyperuricemia and gout. Author(s): Pascual E. Source: Current Opinion in Rheumatology. 1994 July; 6(4): 454-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8068519&dopt=Abstract

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Hyperuricemia and gout. Author(s): German DC, Holmes EW. Source: The Medical Clinics of North America. 1986 March; 70(2): 419-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3512932&dopt=Abstract

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Hyperuricemia and gout. Author(s): Pennes DR, Martel W. Source: Semin Roentgenol. 1986 October; 21(4): 245-55. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3538425&dopt=Abstract

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Hyperuricemia and gout. Author(s): Lo B. Source: The Western Journal of Medicine. 1985 January; 142(1): 104-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3976216&dopt=Abstract

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Hyperuricemia and gout. Author(s): Sloan RW. Source: The Journal of Family Practice. 1982 May; 14(5): 923-6, 930-1, 934. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7042900&dopt=Abstract

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Hyperuricemia and gout. Author(s): Klinenberg JR. Source: The Medical Clinics of North America. 1977 March; 61(2): 299-312. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=323595&dopt=Abstract

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Hyperuricemia and gout. A modern approach to diagnosis and treatment. Author(s): Gall EP. Source: Postgraduate Medicine. 1979 April; 65(4): 163-7, 170, 172. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=424348&dopt=Abstract

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Hyperuricemia and gout. Classification, complications and management. Author(s): Boss GR, Seegmiller JE. Source: The New England Journal of Medicine. 1979 June 28; 300(26): 1459-68. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=221806&dopt=Abstract

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Hyperuricemia and gout: a reign of complacency. Author(s): Mandell BF. Source: Cleve Clin J Med. 2002 August; 69(8): 589-90, 592-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12184467&dopt=Abstract

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Hyperuricemia and gout: an update. Author(s): Khachadurian AK. Source: American Family Physician. 1981 December; 24(6): 143-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6895439&dopt=Abstract

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Hyperuricemia and gout: eminently treatable disorders. Author(s): Lindsley HB. Source: J Kans Med Soc. 1978 November; 79(11): 614-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=712185&dopt=Abstract

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Hyperuricemia in the diagnosis of gout. Author(s): Wallace SL. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 1989 March-April; 4(2): 178-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2651605&dopt=Abstract

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Hyperuricemia, gout and idiopathic aseptic necrosis of bone. Author(s): Giacomello A, Zoppini A, Sorgi ML, Riccieri V, Salerno C. Source: Advances in Experimental Medicine and Biology. 1989; 253A: 211-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2624192&dopt=Abstract

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Hyperuricemia, gout, and autosomal dominant polycystic kidney disease. Author(s): Mejias E, Navas J, Lluberes R, Martinez-Maldonado M. Source: The American Journal of the Medical Sciences. 1989 March; 297(3): 145-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2923134&dopt=Abstract

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Hyperuricemia, gout, and renal function after liver transplantation. Author(s): Neal DA, Tom BD, Gimson AE, Gibbs P, Alexander GJ. Source: Transplantation. 2001 November 27; 72(10): 1689-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11726834&dopt=Abstract

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Hypervitaminosis A toxicity and gout. Author(s): Mawson AR. Source: Lancet. 1984 May 26; 1(8387): 1181. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6144903&dopt=Abstract

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Hypoxanthine guanine phosphoribosyl transferase deficiency presenting with gout and renal failure in infancy. Author(s): Holland PC, Dillon MJ, Pincott J, Simmonds HA, Barratt TM. Source: Archives of Disease in Childhood. 1983 October; 58(10): 831-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6639135&dopt=Abstract

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Hypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency: identification of point mutations in Japanese patients with Lesch-Nyhan syndrome and hereditary gout and their permanent expression in an HPRT-deficient mouse cell line. Author(s): Tohyama J, Nanba E, Ohno K. Source: Human Genetics. 1994 February; 93(2): 175-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8112742&dopt=Abstract

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Hypoxanthine-guanine phosphoribosyltransferase deficiency in three brothers with gout: characterization of a variant, HPRTEdinburgh, having altered isoelectric point, increased thermal lability and normal levels of messenger RNA. Author(s): Snyder FF, Joyce JE, Carter-Edwards T, Joshi R, Rylance HL, Wallace RC, Nuki G. Source: Journal of Inherited Metabolic Disease. 1989; 12(4): 390-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2516172&dopt=Abstract

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Identification of a new single nucleotide substitution on the hypoxanthine-guanine phosphoribosyltransferase gene (HPRT(Tsou) from a Taiwanese aboriginal family with severe gout. Author(s): Chang SJ, Chang JG, Chen CJ, Wang JC, Ou TT, Chang KL, Ko YC. Source: The Journal of Rheumatology. 1999 August; 26(8): 1802-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10451080&dopt=Abstract

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Illustrations of the effects of rheumatic gout or chronic rheumatic arthritis on all the articulations with descriptive and explanatory statements. 1857. Author(s): Adams R. Source: Clinical Orthopaedics and Related Research. 1999 September; (366): 4-7; Discussion 2-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10627712&dopt=Abstract

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Images in clinical medicine. Tophaceous gout. Author(s): Wuthrich DA, Lebowitz AL. Source: The New England Journal of Medicine. 1995 March 9; 332(10): 646. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7845429&dopt=Abstract

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Imaging of tophaceous gout: computed tomography provides specific images compared with magnetic resonance imaging and ultrasonography. Author(s): Gerster JC, Landry M, Dufresne L, Meuwly JY. Source: Annals of the Rheumatic Diseases. 2002 January; 61(1): 52-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11779759&dopt=Abstract

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Immunochemical and ultrastructural characterization of serum proteins associated with monosodium urate crystals (MSU) in synovial fluid cells from patients with gout. Author(s): Cherian PV, Schumacher HR Jr. Source: Ultrastructural Pathology. 1986; 10(3): 209-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3715998&dopt=Abstract

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Impact of associated medical conditions on clinical features of gout. Author(s): Yu TF, Smith H. Source: Advances in Experimental Medicine and Biology. 1986; 195 Pt A: 291-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3728158&dopt=Abstract

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Impaired lipoprotein metabolism in patients with primary gout--influence of alcohol intake and body weight. Author(s): Takahashi S, Yamamoto T, Moriwaki Y, Tsutsumi Z, Higashino K. Source: British Journal of Rheumatology. 1994 August; 33(8): 731-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8055199&dopt=Abstract

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Impaired renal excretion of hypoxanthine and xanthine in primary gout. Author(s): Puig JG, Mateos FA, Jimenez ML, Ramos T, Capitan MC, Gil AA. Source: Advances in Experimental Medicine and Biology. 1989; 253A: 269-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2624202&dopt=Abstract

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Impaired renal function gout: its association with hypertensive vascular disease and intrinsic renal disease. Author(s): Yu TF, Berger L. Source: The American Journal of Medicine. 1982 January; 72(1): 95-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7058827&dopt=Abstract

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Improvement of renal function in patients with chronic gout after proper control of hyperuricemia and gouty bouts. Author(s): Perez-Ruiz F, Calabozo M, Herrero-Beites AM, Garcia-Erauskin G, Pijoan JI. Source: Nephron. 2000 November; 86(3): 287-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11096285&dopt=Abstract

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In patients with chronic cardiac failure who have diuretic induced gout, are certain diuretics less prone at causing problems? Author(s): Hopkinson N, Doherty M. Source: British Journal of Rheumatology. 1991 June; 30(3): 225. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2049588&dopt=Abstract

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Incidence and risk factors for gout in white men. Author(s): Roubenoff R, Klag MJ, Mead LA, Liang KY, Seidler AJ, Hochberg MC. Source: Jama : the Journal of the American Medical Association. 1991 December 4; 266(21): 3004-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1820473&dopt=Abstract

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Incidence of diabetes and gout in hypertensive patients during 8 years of follow-up. The General Practice Hypertension Study Group. Author(s): Grodzicki T, Palmer A, Bulpitt CJ. Source: Journal of Human Hypertension. 1997 September; 11(9): 583-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9364276&dopt=Abstract

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Incorporation of 15N from glycine into uric acid in gout: a follow-up study. Author(s): Yu TF, Roboz J. Source: Advances in Experimental Medicine and Biology. 1984; 165 Pt A: 119-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6720363&dopt=Abstract

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Increased concentrations of serum Lp(a) lipoprotein in patients with primary gout. Author(s): Takahashi S, Yamamoto T, Moriwaki Y, Tsutsumi Z, Higashino K. Source: Annals of the Rheumatic Diseases. 1995 February; 54(2): 90-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7702412&dopt=Abstract

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Increased serum cytidine deaminase activity in gout and articular chondrocalcinosis. Author(s): Rovensky J, Stancikova M, Bosmansky K, Kovalancik M. Source: Annals of the Rheumatic Diseases. 1991 September; 50(9): 659. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1929596&dopt=Abstract

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Increased visceral fat accumulation further aggravates the risks of insulin resistance in gout. Author(s): Takahashi S, Moriwaki Y, Tsutsumi Z, Yamakita J, Yamamoto T, Hada T. Source: Metabolism: Clinical and Experimental. 2001 April; 50(4): 393-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11288032&dopt=Abstract

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Increased visceral fat accumulation in patients with primary gout. Author(s): Takahashi S, Yamamoto T, Tsutsumi Z, Moriwaki Y, Hada T. Source: Advances in Experimental Medicine and Biology. 2000; 486: 131-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11783469&dopt=Abstract

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Individualizing the treatment of gout. Author(s): George TM, Mandell BF. Source: Cleve Clin J Med. 1996 May-June; 63(3): 150-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8665653&dopt=Abstract

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Influence of antihyperuricemic therapy on the clinical and radiographic progression of gout. Author(s): McCarthy GM, Barthelemy CR, Veum JA, Wortmann RL. Source: Arthritis and Rheumatism. 1991 December; 34(12): 1489-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1747133&dopt=Abstract

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Interactions between leukocytes and endothelial cells in gout: lessons from a selflimiting inflammatory response. Author(s): Haskard DO, Landis RC. Source: Arthritis Research. 2002; 4 Suppl 3: S91-7. Epub 2002 May 09. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12110127&dopt=Abstract

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Intermittent control of hyperuricaemia in the treatment of gout. Author(s): Bull PW, Scott JT. Source: Advances in Experimental Medicine and Biology. 1989; 253A: 251-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2624200&dopt=Abstract

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Intermittent control of hyperuricemia in the treatment of gout. Author(s): Bull PW, Scott JT. Source: The Journal of Rheumatology. 1989 September; 16(9): 1246-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2681764&dopt=Abstract

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Intervertebral disc involvement in gout: brief report. Author(s): Das De S. Source: The Journal of Bone and Joint Surgery. British Volume. 1988 August; 70(4): 671. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3403627&dopt=Abstract

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Intra-articular milk of calcium in saturnine gout. Author(s): Daniel WW, Wees SJ. Source: Radiology. 1983 May; 147(2): 389-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6836119&dopt=Abstract

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Intradermal tophi in gout: a case-control study. Author(s): Vazquez-Mellado J, Cuan A, Magana M, Pineda C, Cazarin J, Pacheco-Tena C, Burgos-Vargas R. Source: The Journal of Rheumatology. 1999 January; 26(1): 136-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9918254&dopt=Abstract

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Intraosseous calcifications in tophaceous gout. Author(s): Resnick D, Broderick TW. Source: Ajr. American Journal of Roentgenology. 1981 December; 137(6): 1157-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6976085&dopt=Abstract

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Intraosseous gout of the foot: an unusual case report. Author(s): Surprenant MS, Levy AI, Hanft JR. Source: The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons. 1996 May-June; 35(3): 237-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8807484&dopt=Abstract

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Intraosseous gout: an “aggressive” solitary lesion. Author(s): Lotman DB. Source: Orthopedics. 1997 November; 20(11): 1085-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9397437&dopt=Abstract

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Intravenous indoprofen for prompt relief of acute gout: a regimen-finding study. Author(s): Marcolongo R, Lucchese M, Caruso I, Fumagalli M, Bruni G, Sacchetti G. Source: J Int Med Res. 1980; 8(5): 326-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6998792&dopt=Abstract

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Investigation and management of gout in the young and the elderly. Author(s): Dieppe PA. Source: Annals of the Rheumatic Diseases. 1991 April; 50(4): 263-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2029210&dopt=Abstract

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Involvement of the thoracic spine in tophaceous gout. A case report. Author(s): Souza AW, Fontenele S, Carrete H Jr, Fernandes AR, Ferrari AJ. Source: Clin Exp Rheumatol. 2002 March-April; 20(2): 228-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12051405&dopt=Abstract

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Iron catalyzed oxidative damage, in spite of normal ferritin and transferrin saturation levels and its possible role in Werner's syndrome, Parkinson's disease, cancer, gout, rheumatoid arthritis, etc. Author(s): Johnson S. Source: Medical Hypotheses. 2000 September; 55(3): 242-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10985917&dopt=Abstract

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Irregular gout. Author(s): Bynum B. Source: Lancet. 2000 September 9; 356(9233): 948. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11036929&dopt=Abstract

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Irregular gout: humoral fantasy or saturnine malady. Author(s): Wedeen RP. Source: Bull N Y Acad Med. 1984 December; 60(10): 969-79. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6394093&dopt=Abstract

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Is asteroid hyalosis ocular gout? Author(s): Safir A, Dunn SN, Martin RG, Tate GW, Mincey GJ. Source: Ann Ophthalmol. 1990 February; 22(2): 70-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2316956&dopt=Abstract

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Is gout related to an alteration of the uric acid protein binding? Author(s): Anna T, Gabriella M, Roberto M. Source: Advances in Experimental Medicine and Biology. 1989; 253A: 225-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2624195&dopt=Abstract

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Is it gout? Tap the joint! Author(s): Weselman KO, Agudelo CA. Source: J Med Assoc Ga. 2002 Winter; 91(1): 18-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11938622&dopt=Abstract

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Isolated or dominant lesions of the patella in gout: a report of seven patients. Author(s): Recht MP, Seragini F, Kramer J, Dalinka MK, Hurtgen K, Resnick D. Source: Skeletal Radiology. 1994 February; 23(2): 113-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8191294&dopt=Abstract

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Juvenile gout with typical radiographic findings. Author(s): Kozlowski K, Barrett I, Roy P. Source: Pediatric Radiology. 1992; 22(5): 391-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1408457&dopt=Abstract

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Juvenile metabolic gout caused by chronic compensated hemolytic syndrome. Author(s): Liberman UA, Samuel R, Halabe A, Joshua H, Lubin E, Zoref-Shani E, Sperling O. Source: Arthritis and Rheumatism. 1982 October; 25(10): 1264-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7138596&dopt=Abstract

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Juvenile metabolic gout. Author(s): Jacobs JC. Source: Am J Dis Child. 1985 September; 139(9): 860-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4036910&dopt=Abstract

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Juvenile nephronophthisis and medullary cystic disease--the same disease (report of a large family with medullary cystic disease associated with gout and epilepsy). Author(s): Burke JR, Inglis JA, Craswell PW, Mitchell KR, Emmerson BT. Source: Clinical Nephrology. 1982 July; 18(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7116701&dopt=Abstract

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Kienbock's disease and gout. Author(s): Shin AY, Weinstein LP, Bishop AT. Source: Journal of Hand Surgery (Edinburgh, Lothian). 1999 June; 24(3): 363-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10433457&dopt=Abstract

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Kienbock's disease in gout. Author(s): Castagnoli M, Giacomello A, Argentina RS, Zoppini A. Source: Arthritis and Rheumatism. 1981 July; 24(7): 974-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7259810&dopt=Abstract

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Laryngeal gout. Author(s): Tsikoudas A, Coatesworth AP, Martin-Hirsch DP. Source: The Journal of Laryngology and Otology. 2002 February; 116(2): 140-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11827592&dopt=Abstract

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Laryngeal manifestation of gout: a case report of a subglottic gout tophus. Author(s): Habermann W, Kiesler K, Eherer A, Beham A, Friedrich G. Source: Auris, Nasus, Larynx. 2001 August; 28(3): 265-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11489374&dopt=Abstract

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Laryngeal manifestations of gout. Author(s): Guttenplan MD, Hendrix RA, Townsend MJ, Balsara G. Source: The Annals of Otology, Rhinology, and Laryngology. 1991 November; 100(11): 899-902. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1746824&dopt=Abstract

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Lead nephropathy and gout. Author(s): Yu TF. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1983 March; 2(5): 555-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6829572&dopt=Abstract

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Lean dry gout patients. Author(s): Darlington LG. Source: Advances in Experimental Medicine and Biology. 1984; 165 Pt A: 129-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6720365&dopt=Abstract

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Leukotriene B4, an inflammatory mediator in gout. Author(s): Rae SA, Davidson EM, Smith MJ. Source: Lancet. 1982 November 20; 2(8308): 1122-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6128450&dopt=Abstract

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Lipid abnormalities in Taiwan aborigines with gout. Author(s): Chou CT, Chao PM. Source: Metabolism: Clinical and Experimental. 1999 January; 48(1): 131-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9920157&dopt=Abstract

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Lipid studies in primary gout. Author(s): Yu TF, Oreskes I. Source: The Mount Sinai Journal of Medicine, New York. 1989 January; 56(1): 11-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2784177&dopt=Abstract

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Lipoprotein metabolism in primary gout--influence of alcohol intake and body weight. Author(s): Takahashi S, Yamamoto T, Moriwaki Y, Suda M, Agbedana OE, Hada T, Higashino K. Source: Advances in Experimental Medicine and Biology. 1991; 309A: 217-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1789211&dopt=Abstract

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Living with gout: preventing the fire. Author(s): Skeff KM. Source: The American Journal of Medicine. 1998 December; 105(6): 549-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9870844&dopt=Abstract

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Localization of a gene for familial juvenile hyperuricemic nephropathy causing underexcretion-type gout to 16p12 by genome-wide linkage analysis of a large family. Author(s): Kamatani N, Moritani M, Yamanaka H, Takeuchi F, Hosoya T, Itakura M. Source: Arthritis and Rheumatism. 2000 April; 43(4): 925-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10765940&dopt=Abstract

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Long-term follow-up of incorporation of 15N from glycine into uric acid in gout. Author(s): Yu TF, Roboz J. Source: The American Journal of Medicine. 1981 April; 70(4): 797-802. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7211916&dopt=Abstract

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Long-term management of gout and hyperuricaemia. Author(s): Scott JT. Source: British Medical Journal. 1980 November 1; 281(6249): 1164-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6775757&dopt=Abstract

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Long-term remission from gout associated with fenofibrate therapy. Author(s): Hepburn AL, Kaye SA, Feher MD. Source: Clinical Rheumatology. 2003 February; 22(1): 73-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12605325&dopt=Abstract

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Low-back pain caused by spinal tophus--a complication of gout in a kidney transplant recipient. Author(s): Peeters P, Sennesael J. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1998 December; 13(12): 3245-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9870505&dopt=Abstract

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Lumbar radiculopathy secondary to gouty tophi in the filum terminale in a patient without systemic gout: case report. Author(s): Paquette S, Lach B, Guiot B. Source: Neurosurgery. 2000 April; 46(4): 986-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10764275&dopt=Abstract

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Magnetic resonance imaging diagnosis of gouty tophi in a man with gout and Bartter's syndrome. Author(s): Webb J. Source: Internal Medicine Journal. 2003 April; 33(4): 210; Author Reply 211. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12680994&dopt=Abstract

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Magnetic resonance imaging diagnosis of gouty tophi in a man with gout and Bartter's syndrome. Author(s): Kumar S, Gow P. Source: Internal Medicine Journal. 2002 November; 32(11): 565-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12412941&dopt=Abstract

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Magnetic resonance imaging of tophaceous gout in the hands and wrists. Author(s): Popp JD, Bidgood WD Jr, Edwards NL. Source: Seminars in Arthritis and Rheumatism. 1996 February; 25(4): 282-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8834016&dopt=Abstract

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Management of gout and hyperuricemia. Author(s): Wisner DE, Simkin PA. Source: Primary Care. 1984 June; 11(2): 283-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6206519&dopt=Abstract

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Management of gout in patients with renal insufficiency and a gastrointestinal bleed-an answer to Dr Dunne's letter. Author(s): Pascual E, Trenor P, Medrano C. Source: British Journal of Rheumatology. 1995 May; 34(5): 481-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7788184&dopt=Abstract

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Management of gout. Author(s): Simkin PA. Source: The New England Journal of Medicine. 1996 June 6; 334(23): 1543; Author Reply 1543-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8618615&dopt=Abstract

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Management of gout. Author(s): Sarkozi J. Source: The New England Journal of Medicine. 1996 June 6; 334(23): 1543; Author Reply 1543-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8618614&dopt=Abstract

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Management of gout. Author(s): Dunne C. Source: British Journal of Rheumatology. 1994 October; 33(10): 998. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7921777&dopt=Abstract

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Management of gout. Author(s): Ralston S. Source: Practitioner. 1993 May; 237(1526): 417-21. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8346163&dopt=Abstract

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Management of gout. Author(s): Lockett S. Source: Practitioner. 1991 March; 235(1500): 263-7. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1906615&dopt=Abstract

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Management of gout. Author(s): Fox IH, Kelley WN. Source: Jama : the Journal of the American Medical Association. 1979 July 27; 242(4): 361-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=448944&dopt=Abstract

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Management of gout. Author(s): Simkin PA. Source: Annals of Internal Medicine. 1979 May; 90(5): 812-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=434690&dopt=Abstract

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Management of gout. Author(s): Klinefelter HF. Source: Jama : the Journal of the American Medical Association. 1979 December 21; 242(25): 2758. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=501873&dopt=Abstract

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Management of gout. Author(s): Gordon GV, Schumacher HR. Source: American Family Physician. 1979 January; 19(1): 91-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=760433&dopt=Abstract

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Managing gout in practice. Author(s): Golding D. Source: Practitioner. 1996 August; 240(1565): 486-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8959921&dopt=Abstract

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Managing problem gout. Author(s): Fam AG. Source: Ann Acad Med Singapore. 1998 January; 27(1): 93-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9588282&dopt=Abstract

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Matrix calculi and gout. Author(s): Jaworski RC. Source: The Australian and New Zealand Journal of Surgery. 1981 August; 51(4): 372-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6944060&dopt=Abstract

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McArdle's disease and gout. Author(s): Puig JG, de Miguel E, Mateos FA, Miranda E, Romera NM, Espinosa A, Gijon J. Source: Muscle & Nerve. 1992 July; 15(7): 822-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1501625&dopt=Abstract

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Mechanism and treatment of hypertriglyceridaemia in gout. Author(s): Gibson T, Kilbourn K, Horner I, Simmonds HA. Source: Annals of the Rheumatic Diseases. 1979 February; 38(1): 31-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=434944&dopt=Abstract

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Mechanism of action of colchicine. V. Neutrophil adherence and phagocytosis in patients with acute gout treated with colchicine. Author(s): Dallaverde E, Fan PT, Chang YH. Source: The Journal of Pharmacology and Experimental Therapeutics. 1982 October; 223(1): 197-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7120118&dopt=Abstract

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Mechanisms of vascular damage in gout and oxalosis: crystal induced, granulocyte mediated, endothelial injury. Author(s): Boogaerts MA, Hammerschmidt DE, Roelant C, Verwilghen RL, Jacob HS. Source: Thrombosis and Haemostasis. 1983 August 30; 50(2): 576-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6636034&dopt=Abstract

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Meclofenamate sodium in the treatment of acute gout. Results of a double-blind study. Author(s): Eberl R, Dunky A. Source: Arzneimittel-Forschung. 1983; 33(4A): 641-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6349648&dopt=Abstract

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Medical grand rounds from the Dempsey Hospital of the University of Connecticut: Gout. Author(s): Seibert K, Holland M, Weinstein A. Source: Conn Med. 1978 June; 42(6): 369-73. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=657801&dopt=Abstract

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Medically reversible quadriparesis in tophaceous gout. Author(s): Jacobs SR, Edeiken J, Rubin B, DeHoratius RJ. Source: Archives of Physical Medicine and Rehabilitation. 1985 March; 66(3): 188-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3977576&dopt=Abstract

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Medullary cystic kidney disease with hyperuricemia and gout in a large Cypriot family: no allelism with nephronophthisis type 1. Author(s): Stavrou C, Pierides A, Zouvani I, Kyriacou K, Antignac C, Neophytou P, Christodoulou K, Deltas CC. Source: American Journal of Medical Genetics. 1998 May 1; 77(2): 149-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9605289&dopt=Abstract

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Metabolic aspects in gout. Author(s): Alvsaker JO. Source: Scand J Rheumatol Suppl. 1984; 53: 54-63. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6330884&dopt=Abstract

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Metastatic carcinoma simulating gout. Author(s): Bevan DA, Ehrlich GE, Gupta VP. Source: Jama : the Journal of the American Medical Association. 1977 June 20; 237(25): 2746-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=577230&dopt=Abstract

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Michelangelo's gout in a fresco by Raphael. Author(s): Espinel CH. Source: Lancet. 1999 December 18-25; 354(9196): 2149-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10609832&dopt=Abstract

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Migration and gout: the Tokelau Island migrant study. Author(s): Prior IA, Welby TJ, Ostbye T, Salmond CE, Stokes YM. Source: British Medical Journal (Clinical Research Ed.). 1987 August 22; 295(6596): 45761. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3117170&dopt=Abstract

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Misdiagnosis of rheumatoid arthritis in an elderly woman with gout. Author(s): Sewell KL, Petrucci R, Keiser HD. Source: Journal of the American Geriatrics Society. 1991 April; 39(4): 403-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2010592&dopt=Abstract

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Missed diagnosis of acute arthritic gout in kidney transplant recipients. Author(s): Daniels ID, Friedman EA. Source: N Y State J Med. 1993 January; 93(1): 55-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8429957&dopt=Abstract

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Missed opportunity following diagnosis of gout. Author(s): O'Reilly S, Doherty M. Source: Annals of the Rheumatic Diseases. 1995 February; 54(2): 86-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7702411&dopt=Abstract

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Modern management of gout. Author(s): Gall EP. Source: Ariz Med. 1978 January; 35(1): 30-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=623522&dopt=Abstract

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Modification of the treatment of gout in renal transplant recipients. Author(s): Braun WE. Source: Transplantation Proceedings. 2000 February; 32(1): 199. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10701023&dopt=Abstract

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Monoarticular acromioclavicular joint gout: a case report. Author(s): Musgrave DS, Ziran BH. Source: Am J Orthop. 2000 July; 29(7): 544-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10926404&dopt=Abstract

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Monoarticular gout following trauma: MR appearance. Author(s): Ruiz ME, Erickson SJ, Carrera GF, Hanel DP, Smith MD. Source: Journal of Computer Assisted Tomography. 1993 January-February; 17(1): 151-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8419428&dopt=Abstract

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Monosodium urate crystals in the knee joints of patients with asymptomatic nontophaceous gout. Author(s): Bomalaski JS, Lluberas G, Schumacher HR Jr. Source: Arthritis and Rheumatism. 1986 December; 29(12): 1480-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3801071&dopt=Abstract

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Moonshine-induced gout. Author(s): Saffran B, Scheiner DE. Source: Journal of the American Podiatric Medical Association. 1986 June; 76(6): 365-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3723381&dopt=Abstract

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MR imaging of tophaceous gout. Author(s): Yu JS, Chung C, Recht M, Dailiana T, Jurdi R. Source: Ajr. American Journal of Roentgenology. 1997 February; 168(2): 523-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9016240&dopt=Abstract

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Multicentre trial of naproxen and phenylbutazone in acute gout. Author(s): Sturge RA, Scott JT, Hamilton EB, Liyanage SP, Dixon AS, Davies J, Engler C. Source: Annals of the Rheumatic Diseases. 1977 February; 36(1): 80-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=843115&dopt=Abstract

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Multi-centre trial of naproxen and phenylbutazone in acute gout. Author(s): Sturge RA, Scott JT, Hamilton EB, Liyanage SP, Dixon ST, Engler C. Source: Advances in Experimental Medicine and Biology. 1977; 76B: 290-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=857623&dopt=Abstract

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Multicentric reticulohistiocytosis: a mimic of gout and rheumatoid arthritis. Author(s): Horvath JR, Hoffman GS. Source: Cleve Clin J Med. 1999 March; 66(3): 166-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10079586&dopt=Abstract

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Myoadenylate deaminase deficiency--muscle biopsy and muscle culture in a patient with gout. Author(s): DiMauro S, Miranda AF, Hays AP, Franck WA, Hoffman GS, Schoenfeldt RS, Singh N. Source: Journal of the Neurological Sciences. 1980 August; 47(2): 191-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7411167&dopt=Abstract

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Nephrolithiasis in patients with gout. Author(s): Yu TF. Source: Postgraduate Medicine. 1978 May; 63(5): 164-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=643763&dopt=Abstract

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New knowledge of the pathogenesis of gout. Author(s): Scott JT. Source: J Clin Pathol Suppl (R Coll Pathol). 1978; 12: 205-13. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=32192&dopt=Abstract

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Nodal osteoarthritis and gout: a report of four new cases. Author(s): Foldes K, Petersilge CA, Weisman MH, Resnick D. Source: Skeletal Radiology. 1996 July; 25(5): 421-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8837272&dopt=Abstract

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Nonarticular gout: hyperuricemia and tophus formation without gouty arthritis. Author(s): Hollingworth P, Scott JT, Burry HC. Source: Arthritis and Rheumatism. 1983 January; 26(1): 98-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6824510&dopt=Abstract

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Non-oliguric acute renal failure in gout. Author(s): Patial RK, Sehgal VK. Source: Indian Journal of Medical Sciences. 1992 July; 46(7): 201-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1398813&dopt=Abstract

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Nontraumatic osteonecrosis of the capitate bone associated with gout. Author(s): De Smet L, Willemen D, Kimpe E, Fabry G. Source: Ann Chir Main Memb Super. 1993; 12(3): 210-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7694619&dopt=Abstract

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Normouricemic acute polyarticular gout. Author(s): Wongsurawat V, Wongsurawat N. Source: J Kans Med Soc. 1978 October; 79(10): 564-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=701944&dopt=Abstract

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NSAID-masked gout. Author(s): Scopelitis E, McGrath H Jr. Source: Southern Medical Journal. 1987 November; 80(11): 1464-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3686156&dopt=Abstract

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Ocular abnormalities in patients with gout. Author(s): Ferry AP, Safir A, Melikian HE. Source: Ann Ophthalmol. 1985 October; 17(10): 632-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4073719&dopt=Abstract

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Omeprazole, other antiulcer drugs and newly diagnosed gout. Author(s): Meier CR, Jick H. Source: British Journal of Clinical Pharmacology. 1997 August; 44(2): 175-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9278205&dopt=Abstract

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Optimal management of gout in older patients. Author(s): Gonzalez EB, Miller SB, Agudelo CA. Source: Drugs & Aging. 1994 February; 4(2): 128-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8186540&dopt=Abstract

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Oral desensitization in patients with chronic tophaceous gout and allopurinol hypersensitivity. Author(s): Gillott TJ, Whallett A, Zaphiropoulos G. Source: Rheumatology (Oxford, England). 1999 January; 38(1): 85-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10334688&dopt=Abstract

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Orderly arrayed deposit of urate crystals in gout suggest epitaxial formation. Author(s): Pascual E, Ordonez S. Source: Annals of the Rheumatic Diseases. 1998 April; 57(4): 255. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9709185&dopt=Abstract

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Ouch! It's gout! Author(s): Carbary LJ, Carbary CN. Source: J Nurs Care. 1980 November; 13(11): 13-5, 30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6904511&dopt=Abstract

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Overproduction disease in man due to enzyme feedback resistance mutation. Purine overproduction in gout due to excessive activity of mutant feedback-resistant phosphoribosylpyrophosphate synthetase. Author(s): Sperling O, Boer P, Brosh S, Zoref E, de Vries A. Source: Enzyme. 1978; 23(1): 1-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=203449&dopt=Abstract

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Paget's disease of bone in patients with gout. Author(s): Lluberas-Acosta G, Hansell JR, Schumacher HR Jr. Source: Archives of Internal Medicine. 1986 December; 146(12): 2389-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3778075&dopt=Abstract

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Painful synovitis secondary to gout in the area of a prosthetic hip joint. A case report. Author(s): Healey JH, Dines D, Hershon S. Source: The Journal of Bone and Joint Surgery. American Volume. 1984 April; 66(4): 6101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6707040&dopt=Abstract

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Partial deficiency of hypoxanthine-guanine phosphoribosyltransferase with reduced affinity for PP-ribose-P in four related males with gout. Author(s): Snyder FF, Chudley AE, MacLeod PM, Carter RJ, Fung E, Lowe JK. Source: Human Genetics. 1984; 67(1): 18-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6204922&dopt=Abstract

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Partial deficiency of hypoxanthine-phosphoribosyltransferase:evidence for a structural mutation in a patient with gout. Author(s): Gutensohn W, Jahn H. Source: European Journal of Clinical Investigation. 1979 February; 9(1): 43-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=110599&dopt=Abstract

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Pasteurella multocida and gout in the first metatarsophalangeal joint. Author(s): Shapero C, Fox IM. Source: Journal of the American Podiatric Medical Association. 1999 June; 89(6): 318-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10384759&dopt=Abstract

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Pasteurella multocida infectious arthritis with acute gout after a cat bite. Author(s): Butt TS, Khan A, Ahmad A, Khan MA, Parke A, Hill DR. Source: The Journal of Rheumatology. 1997 August; 24(8): 1649-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9263167&dopt=Abstract

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Pathogenesis and clinical management of hyperuricemia and gout. Author(s): Mangini RJ. Source: J Maine Med Assoc. 1979 March; 70(3): 118-20, 122-7. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=374661&dopt=Abstract

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Pathologic fractures in an unusual case of gout. Author(s): Burnham J, Fraker K, Steinbach H. Source: Ajr. American Journal of Roentgenology. 1977 December; 129(6): 1116-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=413374&dopt=Abstract

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Pathological fracture of the patella secondary to gout. A case report. Author(s): Greenberg DC. Source: The Journal of Bone and Joint Surgery. American Volume. 1986 October; 68(8): 1286-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3771612&dopt=Abstract

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Patient compliance in rheumatoid arthritis, polymyalgia rheumatica, and gout. Author(s): de Klerk E, van der Heijde D, Landewe R, van der Tempel H, Urquhart J, van der Linden S. Source: The Journal of Rheumatology. 2003 January; 30(1): 44-54. Erratum In: J Rheumatol. 2003 February; 30(2): 423. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12508389&dopt=Abstract

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Peroneus brevis tendon rupture with tophaceous gout infiltration. Author(s): De Yoe BE, Ng A, Miller B, Rockett MS. Source: The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons. 1999 September-October; 38(5): 359-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10553550&dopt=Abstract

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Persistence of monosodium urate crystals and low-grade inflammation in the synovial fluid of patients with untreated gout. Author(s): Pascual E. Source: Arthritis and Rheumatism. 1991 February; 34(2): 141-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1994910&dopt=Abstract

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Pharmacokinetic and clinical studies of carprofen in gout. Author(s): Yu TF, Perel J. Source: Journal of Clinical Pharmacology. 1980 May-June; 20(5-6 Pt 1): 347-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7400372&dopt=Abstract

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Phosphoribosyl pyrophosphate synthetase and glutathione reductase in erythrocytes from hyperuricaemic and gout patients. Author(s): Hardwell TR, Braven J, Shaw S, Whittaker M. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1982 December 23; 126(3): 217-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6295664&dopt=Abstract

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Photo quiz. Intradermal tophaceous gout. Author(s): Kling CW, Helm TN, Narins RB. Source: Cutis; Cutaneous Medicine for the Practitioner. 2001 March; 67(3): 196, 205-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11270291&dopt=Abstract

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Pilot study of blood coagulation in gout patients. Author(s): Lane DA, Darlington LG. Source: Advances in Experimental Medicine and Biology. 1984; 165 Pt A: 159-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6720371&dopt=Abstract

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Piroxicam in the treatment of acute gout: a multicentre open study in general practice. Author(s): Murphy JE. Source: J Int Med Res. 1979; 7(6): 507-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=520653&dopt=Abstract

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Piroxicam in treatment of acute gout high dose versus low dose. Author(s): Tumrasvin T, Deesomchok U. Source: J Med Assoc Thai. 1985 March; 68(3): 111-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3894554&dopt=Abstract

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Plasma follicle-stimulating hormone, luteinizing hormone, and sex hormones in patients with gout. Author(s): Marinello E, Riario-Sforza G, Marcolongo R. Source: Arthritis and Rheumatism. 1985 February; 28(2): 127-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3918542&dopt=Abstract

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Platelet-activating activity in synovial fluids of patients with rheumatoid arthritis, juvenile rheumatoid arthritis, gout, and noninflammatory arthropathies. Author(s): Shapleigh C, Valone FH, Schur PH, Goetzl EJ, Austen KF. Source: Arthritis and Rheumatism. 1980 July; 23(7): 800-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7406931&dopt=Abstract

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Pneumococcal arthritis complicating gout. Case report and literature review. Author(s): Edwards GS Jr, Russell IJ. Source: The Journal of Rheumatology. 1980 November-December; 7(6): 907-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7205831&dopt=Abstract

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Podagra is more than gout. Author(s): Bomalaski JS, Schumacher HR. Source: Bulletin on the Rheumatic Diseases. 1984; 34(6): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6546193&dopt=Abstract

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Polyarticular gout induced by probenecid therapy. Author(s): Patrone NA. Source: N C Med J. 1986 September; 47(9): 401-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3463871&dopt=Abstract

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Polyarticular gout. Author(s): Hull RG. Source: Lancet. 1989 May 20; 1(8647): 1142. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2566085&dopt=Abstract

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Polyarticular symmetric tophaceous joint inflammation as the initial presentation of gout. Author(s): Vukmir RB, Weiss L, Verdile VP. Source: The American Journal of Emergency Medicine. 1990 January; 8(1): 43-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2293834&dopt=Abstract

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Polyarticular versus monoarticular gout: a prospective, comparative analysis of clinical features. Author(s): Lawry GV 2nd, Fan PT, Bluestone R. Source: Medicine; Analytical Reviews of General Medicine, Neurology, Psychiatry, Dermatology, and Pediatrics. 1988 September; 67(5): 335-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3412175&dopt=Abstract

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Polynesian women are also at risk for hyperuricaemia and gout because of a genetic defect in renal urate handling. Author(s): Simmonds HA, McBride MB, Hatfield PJ, Graham R, McCaskey J, Jackson M. Source: British Journal of Rheumatology. 1994 October; 33(10): 932-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7921753&dopt=Abstract

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Popular literature on gout in the 16th & 17th centuries. Author(s): Benedek TG. Source: The Journal of Rheumatology. 1987 February; 14(1): 186. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3553589&dopt=Abstract

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Post-cardiac transplantation gout: incidence of therapeutic complications. Author(s): Wluka AE, Ryan PF, Miller AM, Richardson M, Bergin PJ, Page JL, Esmore DS. Source: The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation. 2000 October; 19(10): 951-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11044689&dopt=Abstract

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Postheparin plasma lipoprotein lipase and hepatic triglyceride lipase activities in gout. Author(s): Nishida Y, Miyamoto T, Kodama T, Okazaki M, Hara I. Source: Advances in Experimental Medicine and Biology. 1984; 165 Pt A: 137-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6720368&dopt=Abstract

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Postheparin plasma lipoprotein lipase and hepatic triglyceride lipase activities in patients with primary asymptomatic gout. Author(s): Kodama T, Murase T, Itakura H, Akanuma Y, Takaku F, Nishida Y. Source: Clinical Chemistry. 1983 December; 29(12): 2124-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6640922&dopt=Abstract

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Postsurgical gout. Author(s): Craig MH, Poole GV, Hauser CJ. Source: The American Surgeon. 1995 January; 61(1): 56-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7832383&dopt=Abstract

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Practical therapeutics treatment of gout. Author(s): Obel AO. Source: East Afr Med J. 1981 March; 58(3): 151-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7249983&dopt=Abstract

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Precocious familial gout with reduced fractional urate clearance and normal purine enzymes. Author(s): Calabrese G, Simmonds HA, Cameron JS, Davies PM. Source: The Quarterly Journal of Medicine. 1990 May; 75(277): 441-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2388995&dopt=Abstract

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Precocious familial gout. Author(s): Cameron JS, Ogg CS, Moro F, Chantler C, Simmonds HA. Source: Lancet. 1990 September 22; 336(8717): 745. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1975911&dopt=Abstract

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Predicting acute gout in diuretic-treated hypertensive patients. Author(s): Waller PC, Ramsay LE. Source: Journal of Human Hypertension. 1989 December; 3(6): 457-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2607519&dopt=Abstract

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Preliminary criteria for the classification of the acute arthritis of primary gout. Author(s): Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yu TF. Source: Arthritis and Rheumatism. 1977 April; 20(3): 895-900. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=856219&dopt=Abstract

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Preliminary studies with azapropazone in gout and hyperuricaemia. Author(s): Thomas AL, Majoos FL, Nuki G. Source: Eur J Rheumatol Inflamm. 1983; 6(2): 149-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6673978&dopt=Abstract

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Prepatellar bursitis: a unique presentation of tophaceous gout in an normouricemic patient. Author(s): Dawn B, Williams JK, Walker SE. Source: The Journal of Rheumatology. 1997 May; 24(5): 976-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9150094&dopt=Abstract

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Prevalence and incidence of the diagnosis of gout in Great Britain. Author(s): Currie WJ. Source: Annals of the Rheumatic Diseases. 1979 April; 38(2): 101-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=312625&dopt=Abstract

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Preventing acute gout when starting allopurinol therapy. Colchicine or NSAIDs? Author(s): Kot TV, Day RO, Brooks PM. Source: The Medical Journal of Australia. 1993 August 2; 159(3): 182-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8336619&dopt=Abstract

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Preventing acute gout when starting allopurinol therapy. Colchicine or NSAIDS? Author(s): Kelmann V. Source: The Medical Journal of Australia. 1993 December 6-20; 159(11-12): 833-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8123131&dopt=Abstract

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Preventing acute gout when starting allopurinol therapy. Colchicine or NSAIDS? Author(s): Lewin G. Source: The Medical Journal of Australia. 1993 December 6-20; 159(11-12): 833. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8264482&dopt=Abstract

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Prevention and management of gout. Author(s): Star VL, Hochberg MC. Source: Drugs. 1993 February; 45(2): 212-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7681372&dopt=Abstract

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Primary gout (a case report). Author(s): Padmanabhan K, Dandapani S. Source: J Assoc Physicians India. 1981 December; 29(12): 1073-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7348264&dopt=Abstract

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Primary gout in aging patients. Author(s): Carcassi A, Boschi S, D'Ubaldo F, Campagna S. Source: Advances in Experimental Medicine and Biology. 1986; 195 Pt A: 329-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3728163&dopt=Abstract

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Primary gout in Shantou: a clinical and epidemiological study. Author(s): Zeng Q, Wang Q, Chen R, Xiao Z, Huang S, Xu J. Source: Chin Med J (Engl). 2003 January; 116(1): 66-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12667391&dopt=Abstract

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Properties of a mutant hypoxanthine-phosphoribosyl transferase in a patient with gout. Author(s): Grobner W, Gutensohn W. Source: Advances in Experimental Medicine and Biology. 1980; 122A: 313-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7424649&dopt=Abstract

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Proximal gout following renal transplantation. Author(s): Cohen MR. Source: Arthritis and Rheumatism. 1994 November; 37(11): 1709. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7980683&dopt=Abstract

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Psoriasis and gout. Author(s): Fordham JN, Storey GO. Source: Postgraduate Medical Journal. 1982 August; 58(682): 477-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7134085&dopt=Abstract

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Psoriasis and gout: report of 4 cases. Author(s): Bosmansky K, Trnavsky K. Source: Clinical Rheumatology. 1983 December; 2(4): 423-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6678203&dopt=Abstract

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Psoriasis and normouricemic gout. Author(s): Lundquist CD, Aronson IK, Henderson TW, Skosey JL, Solomon LM. Source: Dermatologica. 1982 February; 164(2): 104-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7075850&dopt=Abstract

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Psychosomatic aspects of gout. Author(s): Murray JB. Source: The Journal of General Psychology. 1980 July; 103(1St Half): 131-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7411121&dopt=Abstract

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Purine biosynthesis de novo by lymphocytes in gout. Author(s): Kamoun P, Chanard J, Brami M, Funck-Brentano JL. Source: Clin Sci Mol Med. 1978 June; 54(6): 595-601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=657727&dopt=Abstract

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Purine metabolism in female patients with primary gout. Author(s): Puig JG, Mateos FA, Miranda ME, Torres RJ, de Miguel E, Perez de Ayala C, Gil A. Source: Advances in Experimental Medicine and Biology. 1994; 370: 69-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7660998&dopt=Abstract

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Purine metabolism in women with primary gout. Author(s): Puig JG, Mateos FA, Miranda ME, Torres RJ, de Miguel E, Perez de Ayala C, Gil AA. Source: The American Journal of Medicine. 1994 October; 97(4): 332-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7942934&dopt=Abstract

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Purine synthesis de novo in cultured lymphoblast cells derived from patients with gout. Author(s): Gordon RB, Emmerson BT. Source: Rheumatology International. 1987; 7(1): 1-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3589399&dopt=Abstract

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Purine synthesis de novo in lymphocytes from patients with gout. Author(s): Gordon RB, Counsilman AC, Cross SM, Emmerson BT. Source: Clinical Science (London, England : 1979). 1982 November; 63(5): 429-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7116783&dopt=Abstract

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Quadriparesis in tophaceous gout. Author(s): Sequeira W, Bouffard A, Salgia K, Skosey J. Source: Arthritis and Rheumatism. 1981 November; 24(11): 1428-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7317122&dopt=Abstract

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Quality control of the laboratory diagnosis of gout by synovial fluid microscopy. Author(s): Von Essen R, Holtta AM. Source: Scandinavian Journal of Rheumatology. 1990; 19(3): 232-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2360001&dopt=Abstract

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Quiz case. Atypical gout arthritis. Author(s): Vorbeck F. Source: European Journal of Radiology. 2000 December; 36(3): 175-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11203456&dopt=Abstract

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Racial differences in the incidence of gout. The role of hypertension. Author(s): Hochberg MC, Thomas J, Thomas DJ, Mead L, Levine DM, Klag MJ. Source: Arthritis and Rheumatism. 1995 May; 38(5): 628-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7748218&dopt=Abstract

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Radiographic features of gout in the foot. Author(s): Egan R, Sartoris DJ, Resnick D. Source: J Foot Surg. 1987 September-October; 26(5): 434-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3316363&dopt=Abstract

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Radiographic features of gout. Author(s): Cardenosa G, DeLuca SA. Source: American Family Physician. 1990 February; 41(2): 539-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2301206&dopt=Abstract

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Radiologic case study. Sacroiliac joint involvement by gout and hyperparathyroidism. Author(s): Kerr R. Source: Orthopedics. 1988 January; 11(1): 185, 187-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3353323&dopt=Abstract

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Radiologic features of gout. Author(s): Buckley TJ. Source: American Family Physician. 1996 September 15; 54(4): 1232-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8816569&dopt=Abstract

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Radiological manifestations of primary gout. Author(s): Idris M, Ilyas M, Afridi SJ. Source: J Pak Med Assoc. 1996 October; 46(10): 218-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8961705&dopt=Abstract

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Rational treatment of gout. Stopping an attack and preventing recurrence. Author(s): Vawter RL, Antonelli MA. Source: Postgraduate Medicine. 1992 February 1; 91(2): 115-8, 127. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1738733&dopt=Abstract

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Recessive X-linked hyperuricemia with gout and renal damage, normal activity of hypoxanthine phosphoribosyltransferase and resistance to azaguanine. Author(s): Westberg NG, Rosen E, Waldenstrom J. Source: Acta Med Scand. 1979; 205(3): 163-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=425844&dopt=Abstract

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Recurrence of gout after total knee arthroplasty. Author(s): Blyth P, Pai VS. Source: The Journal of Arthroplasty. 1999 April; 14(3): 380-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10220195&dopt=Abstract

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Recurrent cervical subluxations in a patient with gout and endstage renal disease. Author(s): Vaccaro AR, An HS, Cotler JM, Ahmad S, Jordan AG. Source: Orthopedics. 1993 November; 16(11): 1273-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8290403&dopt=Abstract

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Recurrent gouty phlebitis without articular gout. Author(s): Pasero G. Source: Advances in Experimental Medicine and Biology. 1977; 76B: 245-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=857621&dopt=Abstract

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Recurrent hemarthrosis associated with gout. Author(s): Martin DJ, Merenda G, McDonald DJ, Sundaram M. Source: Clinical Orthopaedics and Related Research. 1992 April; (277): 262-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1555350&dopt=Abstract

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Recurrent painful calf swelling associated with gout. Author(s): Kovarsky J, Young MB. Source: Clinical Orthopaedics and Related Research. 1978 July-August; (134): 182-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=729241&dopt=Abstract

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Recurrent rupture of a popliteal cyst in a patient with chronic tophaceous gout. Author(s): Rumfeld WR, O'Sullivan MM, Williams BD. Source: Zeitschrift Fur Rheumatologie. 1988 May-June; 47(3): 182-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3213267&dopt=Abstract

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Recurrent spinal stenosis caused by tophaceous gout: a case report and review of literature. Author(s): Ko PJ, Huang TJ, Liao YS, Hsueh S, Hsu RW. Source: Changgeng Yi Xue Za Zhi. 1996 September; 19(3): 272-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8921648&dopt=Abstract

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Reduce serum uric acid levels before withdrawing antihyperuricemic therapy in patients with tophaceous gout. Author(s): Gast LF. Source: Arthritis and Rheumatism. 1992 October; 35(10): 1252. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1418014&dopt=Abstract

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Reduced secretion of proinflammatory cytokines of monosodium urate crystalstimulated monocytes in chronic renal failure: an explanation for infrequent gout episodes in chronic renal failure patients? Author(s): Schreiner O, Wandel E, Himmelsbach F, Galle PR, Marker-Hermann E. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2000 May; 15(5): 6449. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10809805&dopt=Abstract

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Relation between adverse events associated with allopurinol and renal function in patients with gout. Author(s): Vazquez-Mellado J, Morales EM, Pacheco-Tena C, Burgos-Vargas R. Source: Annals of the Rheumatic Diseases. 2001 October; 60(10): 981-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11557658&dopt=Abstract

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Relationship between hypertriglyceridemia and uric acid production in primary gout. Author(s): Matsubara K, Matsuzawa Y, Jiao S, Takama T, Kubo M, Tarui S. Source: Metabolism: Clinical and Experimental. 1989 July; 38(7): 698-701. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2739579&dopt=Abstract

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Relative frequency of gout and pseudogout. Author(s): Egan MW, Canoso JJ. Source: Arthritis and Rheumatism. 1979 April; 22(4): 428-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=426888&dopt=Abstract

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Renal excretion of hypoxanthine and xanthine in primary gout. Author(s): Puig JG, Mateos FA, Jimenez ML, Ramos TH. Source: The American Journal of Medicine. 1988 October; 85(4): 533-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3177401&dopt=Abstract

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Renal failure in young subjects with familial gout. Author(s): Simmonds HA, Cameron JS, Potter CF, Warren D, Gibson T, Farebrother D. Source: Advances in Experimental Medicine and Biology. 1980; 122A: 15-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7424629&dopt=Abstract

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Renal function in gout patients. Author(s): Tarng DC, Lin HY, Shyong ML, Wang JS, Yang WC, Huang TP. Source: American Journal of Nephrology. 1995; 15(1): 31-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7872362&dopt=Abstract

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Renal function in gout. V. Factors influencing the renal hemodynamics. Author(s): Yu TF, Berger L, Dorph DJ, Smith H. Source: The American Journal of Medicine. 1979 November; 67(5): 766-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=507087&dopt=Abstract

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Renal function predicts colchicine toxicity: guidelines for the prophylactic use of colchicine in gout. Author(s): Wallace SL, Singer JZ, Duncan GJ, Wigley FM, Kuncl RW. Source: The Journal of Rheumatology. 1991 February; 18(2): 264-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2023222&dopt=Abstract

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Renal handling of uric acid in gout by means of the pyrazinamide and probenecid tests. Author(s): Puig JG, Mateos F, Munoz A, Gaspar G, Ramos T, Gijon Banos J. Source: Advances in Experimental Medicine and Biology. 1984; 165 Pt A: 201-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6720381&dopt=Abstract

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Renal handling of uric acid in gout: impaired tubular transport of urate not dependent on serum urate levels. Author(s): Garcia Puig J, Mateos Anton F, Lopez Jimenez M, Conthe Gutierrez P. Source: Metabolism: Clinical and Experimental. 1986 December; 35(12): 1147-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3784914&dopt=Abstract

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Renal impairment and gout. Author(s): Gibson T, Highton J, Potter C, Simmonds HA. Source: Annals of the Rheumatic Diseases. 1980 October; 39(5): 417-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7436572&dopt=Abstract

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Renal outcomes of gout and hyperuricemia. Author(s): Fessel WJ. Source: The American Journal of Medicine. 1979 July; 67(1): 74-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=463920&dopt=Abstract

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Renal transplant-associated hyperuricemia and gout. Author(s): Clive DM. Source: Journal of the American Society of Nephrology : Jasn. 2000 May; 11(5): 974-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10770978&dopt=Abstract

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Repeated synovial fluid analysis may be needed to find crystals in gout. Author(s): Mader R. Source: Clinical Rheumatology. 1998; 17(6): 549-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9890692&dopt=Abstract

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Reverse phase partition HPLC for determination of plasma purines and pyrimidines in subjects with gout and renal failure. Author(s): McBurney A, Gibson T. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1980 March 14; 102(1): 19-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7389105&dopt=Abstract

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Review of UK data on the rheumatic diseases--4. Gout. Author(s): Stewart OJ, Silman AJ. Source: British Journal of Rheumatology. 1990 December; 29(6): 485-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2257463&dopt=Abstract

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Rheumatic disorders in the South African Negro. Part IV. Gout and hyperuricaemia. Author(s): Beighton P, Solomon L, Soskolne CL, Sweet MB. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1977 June 25; 51(26): 969-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=888032&dopt=Abstract

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Rheumatoid arthritis preceding the onset of polyarticular tophaceous gout. Author(s): Zonana-Nacach A, Alarcon GS, Daniel WW. Source: Annals of the Rheumatic Diseases. 1996 July; 55(7): 489-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8774172&dopt=Abstract

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Rheumatoid factor in patients with gout. Author(s): Eisman J, Fan PT. Source: Arthritis and Rheumatism. 1977 June; 20(5): 1147. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=869962&dopt=Abstract

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Risk factors for gout in Togolese patients. Author(s): Mijiyawa M, Oniankitan O. Source: Joint, Bone, Spine : Revue Du Rhumatisme. 2000; 67(5): 441-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11143911&dopt=Abstract

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Risk factors for gout: a hospital-based study in urban black South Africans. Author(s): Tikly M, Bellingan A, Lincoln D, Russell A. Source: Rev Rhum Engl Ed. 1998 April; 65(4): 225-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9599790&dopt=Abstract

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Risks and benefits of drugs used in the management and prevention of gout. Author(s): Conaghan PG, Day RO. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 1994 October; 11(4): 252-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7848545&dopt=Abstract

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Roentgenographic changes in gout. Author(s): Berens DL. Source: Postgraduate Medicine. 1978 May; 63(5): 154-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=643762&dopt=Abstract

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Roentgenographic manifestations of gout. A case report. Author(s): Lieberman R, Califano P. Source: Journal of the American Podiatric Medical Association. 1987 September; 77(9): 506-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3668829&dopt=Abstract

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Role of the kidneys in the pathogenesis of gout. Author(s): Klinenberg JR. Source: Postgraduate Medicine. 1978 May; 63(5): 145-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=643761&dopt=Abstract

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Runner with gout and an aortic valve nodule. Author(s): Moore GE, Anderson AL. Source: Medicine and Science in Sports and Exercise. 1995 May; 27(5): 626-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7674864&dopt=Abstract

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Rupture of the popliteal cyst in gout. Case report. Author(s): Stojanovic I, Tomic S. Source: Scandinavian Journal of Rheumatology. 1983; 12(1): 15-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6836234&dopt=Abstract

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Safety of the mycophenolate mofetil-allopurinol combination in kidney transplant recipients with gout. Author(s): Jacobs F, Mamzer-Bruneel MF, Skhiri H, Thervet E, Legendre C, Kreis H. Source: Transplantation. 1997 October 15; 64(7): 1087-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9381537&dopt=Abstract

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Salivary urate in gout, exercise, and diurnal variation. Author(s): Owen-Smith B, Quiney J, Read J. Source: Lancet. 1998 June 27; 351(9120): 1932. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9654268&dopt=Abstract

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Samuel Johnson's gout. Author(s): Rogers JP. Source: Medical History. 1986 April; 30(2): 133-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3517522&dopt=Abstract

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Sartorial ridge gout. Author(s): Abeles M. Source: Clinical Orthopaedics and Related Research. 1984 April; (184): 178-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6705343&dopt=Abstract

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Saturnine gout among Roman aristocrats. Author(s): Gaebel RE. Source: The New England Journal of Medicine. 1983 August 18; 309(7): 431. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6348540&dopt=Abstract

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Saturnine gout among Roman aristocrats. Did lead poisoning contribute to the fall of the Empire? Author(s): Nriagu JO. Source: The New England Journal of Medicine. 1983 March 17; 308(11): 660-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6338384&dopt=Abstract

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Saturnine gout. Author(s): Poor G, Mituszova M. Source: Baillieres Clin Rheumatol. 1989 April; 3(1): 51-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2661030&dopt=Abstract

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Seasonal variations in the frequency and synovial fluid inflammation in acute gout and pseudogout. Author(s): Punzi L, Salvati GP, Gambari PF. Source: The Journal of Rheumatology. 1999 July; 26(7): 1642-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10405963&dopt=Abstract

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Secondary gout in hemoglobinopathies: report of two cases and review of the literature. Author(s): Ballou SP, Khan MA, Kushner I, Harris JW. Source: American Journal of Hematology. 1977; 2(4): 397-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=602929&dopt=Abstract

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Secondary hypertriglyceridemia and hyperlipoproteinemia in patients with primary asymptomatic gout. Author(s): Naito HK, Mackenzie AH. Source: Clinical Chemistry. 1979 March; 25(3): 371-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=262176&dopt=Abstract

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Selected data on primary gout. Author(s): Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yu TF. Source: Bulletin on the Rheumatic Diseases. 1978-79; 29(7): 992-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=754839&dopt=Abstract

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Self-treatment for gout. Author(s): Symons MC. Source: Medical Hypotheses. 2001 August; 57(2): 241-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11461181&dopt=Abstract

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Septic arthritis and calcium pyrophosphate deposition disease in the setting of chronic gout. Author(s): Jahn TW. Source: Military Medicine. 1998 January; 163(1): 61-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9465576&dopt=Abstract

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Septic polyarthritis in chronic tophaceous gout. Author(s): Salvi A, Rossi M, Balestrieri GP, di Stefano O, Baratto G, Giustina G. Source: Recenti Prog Med. 1991 October; 82(10): 527-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1759037&dopt=Abstract

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Serum concentration of Lp(a) in patients with primary gout. Author(s): Takahashi S, Yamamoto T, Moriwaki Y, Tsutsumi Z, Higashino K. Source: Advances in Experimental Medicine and Biology. 1994; 370: 79-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7661024&dopt=Abstract

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Serum lipids and lipoproteins in patients with primary gout. Author(s): Ulreich A, Kostner GM, Pfeiffer KP, Sedlmayr P, Rainer F. Source: Rheumatology International. 1985; 5(2): 73-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3983533&dopt=Abstract

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Serum uric acid in acute gout. Author(s): Schlesinger N, Schumacher HR Jr, Beutler AM. Source: Annals of the Rheumatic Diseases. 1998 July; 57(7): 443-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9797577&dopt=Abstract

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Serum uric acid in acute gout. Author(s): Logan JA, Morrison E, McGill PE. Source: Annals of the Rheumatic Diseases. 1997 November; 56(11): 696-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9462177&dopt=Abstract

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Serum uric acid levels and gout: what does this herald for the population? Author(s): Rigby AS, Wood PH. Source: Clin Exp Rheumatol. 1994 July-August; 12(4): 395-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7955603&dopt=Abstract

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Severe debilitating polyarticular gout and terminal renal failure in an allopurinol 'non-responder'. Author(s): Reiter S, Engelleiter R, Proske H, Muller A, van der Woude FJ, Duley JA, Simmonds HA. Source: Advances in Experimental Medicine and Biology. 1998; 431: 51-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9598030&dopt=Abstract

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Severe tophaceous gout. Author(s): Chan T, Dunford J. Source: The Journal of Emergency Medicine. 1996 March-April; 14(2): 223. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8740756&dopt=Abstract

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Should dietary restrictions always be prescribed in the treatment of gout? Author(s): Gonzalez AA, Puig JG, Mateos FA, Jimenez ML, Casas E, Capitan MC. Source: Advances in Experimental Medicine and Biology. 1989; 253A: 243-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2624199&dopt=Abstract

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Should patients with interval gout be treated with urate lowering drugs? Author(s): Fam AG. Source: The Journal of Rheumatology. 1995 September; 22(9): 1621-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8523333&dopt=Abstract

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Simultaneous gout and pyarthrosis. Author(s): Hamilton ME, Parris TM, Gibson RS, Davis JS 4th. Source: Archives of Internal Medicine. 1980 July; 140(7): 917-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7387300&dopt=Abstract

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Simultaneous gout, pseudogout, and septic arthritis. Author(s): Jarrett MP, Grayzel AI. Source: Arthritis and Rheumatism. 1980 January; 23(1): 128-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7352936&dopt=Abstract

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Spinal cord compression: an unusual neurological complication of gout. Author(s): St George E, Hillier CE, Hatfield R. Source: Rheumatology (Oxford, England). 2001 June; 40(6): 711-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11426037&dopt=Abstract

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Spinal gout: an unusual clinical and cytological presentation. Author(s): Kaye PV, Dreyer MD. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 1999 December; 10(6): 411-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10607012&dopt=Abstract

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Spinal involvement in gout. Author(s): Staub-Schmidt T, Chaouat A, Rey D, Bloch JG, Christmann D. Source: Arthritis and Rheumatism. 1995 January; 38(1): 139-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7818563&dopt=Abstract

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Spinal tophaceous gout. Author(s): Clerc D, Marfeuille M, Labous E, Desmoulins F, Quillard J, Bisson M. Source: Clin Exp Rheumatol. 1998 September-October; 16(5): 621. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9779316&dopt=Abstract

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Spondylodiscal erosions due to gout: anatomico-radiological study of a case. Author(s): Lagier R, Mac Gee W. Source: Annals of the Rheumatic Diseases. 1983 June; 42(3): 350-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6859968&dopt=Abstract

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Spontaneous rupture of the Achilles tendon in a patient with gout. Author(s): Mahoney PG, James PD, Howell CJ, Swannell AJ. Source: Annals of the Rheumatic Diseases. 1981 August; 40(4): 416-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7259334&dopt=Abstract

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Spot urine uric acid to creatinine ratio used in the estimation of uric acid excretion in primary gout. Author(s): Moriwaki Y, Yamamoto T, Takahashi S, Yamakita J, Tsutsumi Z, Hada T. Source: The Journal of Rheumatology. 2001 June; 28(6): 1306-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11409124&dopt=Abstract

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Stopping progression to tophaceous gout. When and how to use urate-lowering therapy. Author(s): McDonald E, Marino C. Source: Postgraduate Medicine. 1998 December; 104(6): 117-20, 123-4, 127. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9861261&dopt=Abstract

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Strategies and controversies in the treatment of gout and hyperuricaemia. Author(s): Fam AG. Source: Baillieres Clin Rheumatol. 1991 August; 4(2): 177-92. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2032295&dopt=Abstract

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Studies of urate crystallisation in relation to gout. Author(s): Fiddis RW, Vlachos N, Calvert PD. Source: Annals of the Rheumatic Diseases. 1983 August; 42 Suppl 1: 12-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6615025&dopt=Abstract

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Studies on the interaction of rheumatoid factor with monosodium urate crystals and case report of coexistent tophaceous gout and rheumatoid arthritis. Author(s): Gordon TP, Ahern MJ, Reid C, Roberts-Thomson PJ. Source: Annals of the Rheumatic Diseases. 1985 June; 44(6): 384-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4015200&dopt=Abstract

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Study of the effect of hypouricaemic therapy on serum lipid levels in gout patients. Author(s): Darlington LG, Scott JT. Source: Advances in Experimental Medicine and Biology. 1986; 195 Pt A: 341-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3728165&dopt=Abstract

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Study on lipoprotein lipase and hepatic triglyceride lipase activities in patients with gout. Author(s): Tsutsumi Z, Takahashi S, Yamamoto T, Moriwaki Y, Nasako Y, Hiroishi K, Hada T, Higashino K. Source: Advances in Experimental Medicine and Biology. 1994; 370: 83-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7661032&dopt=Abstract

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Subclinical lead exposure: a possible cause of gout. Author(s): Campbell BC, Moore MR, Goldberg A, Hernandez LA, Dick WC. Source: British Medical Journal. 1978 November 18; 2(6149): 1403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=719427&dopt=Abstract

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Subjective sensation of heaviness in gout patients. Author(s): Toda K. Source: Hiroshima J Med Sci. 2000 June; 49(2): 101-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10920575&dopt=Abstract

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Sudden appearance of tophaceous gout in a woman with chronic renal failure. Author(s): Talor Z, Better OS, Chaimovitz C. Source: Archives of Internal Medicine. 1980 April; 140(4): 582-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7362402&dopt=Abstract

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Sudden hypotonic paraparesis caused by tophaceous gout of the lumbar spine. Author(s): Vervaeck M, De Keyser J, Pauwels P, Frecourt N, D'Haens J, Ebinger G. Source: Clinical Neurology and Neurosurgery. 1991; 93(3): 233-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1660379&dopt=Abstract

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Sulindac in the treatment of acute gout arthritis. Author(s): Karachalios GN, Donas G. Source: Int J Tissue React. 1982; 4(4): 297-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7169301&dopt=Abstract

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Superactivity of phosphoribosylpyrophosphate synthetase, due to feedback resistance, causing purine overproduction and gout. Author(s): Sperling O, Boer P, Brosh S, Zoref E, de Vries A. Source: Ciba Found Symp. 1977; (48): 143-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=204460&dopt=Abstract

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Surgery for tophaceous gout. Author(s): Frankel JP, Boysen TJ, Ochwat GF. Source: J Foot Surg. 1984 November-December; 23(6): 440-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6520344&dopt=Abstract

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Surgical management of chronic tophaceous gout. A case report. Author(s): Ford TC. Source: Journal of the American Podiatric Medical Association. 1992 October; 82(10): 514-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1474484&dopt=Abstract

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Surgical management of tophaceous gout in the hand. Author(s): Ertugrul Sener E, Guzel VB, Takka S. Source: Archives of Orthopaedic and Trauma Surgery. 2000; 120(7-8): 482-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10968548&dopt=Abstract

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Surgical management of tophaceous gout: a literature review and case report. Author(s): Martin SM, Gastwirth CM. Source: J Am Podiatry Assoc. 1982 April; 72(4): 195-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7069128&dopt=Abstract

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Syndrome X and gout: benefits of altered diet. Author(s): Terkeltaub R. Source: Curr Rheumatol Rep. 2001 February; 3(1): 9-10. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11177765&dopt=Abstract

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Synovial fluid analysis for diagnosis of intercritical gout. Author(s): Pascual E, Batlle-Gualda E, Martinez A, Rosas J, Vela P. Source: Annals of Internal Medicine. 1999 November 16; 131(10): 756-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10577299&dopt=Abstract

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Synovial membrane histopathology in the differential diagnosis of rheumatoid arthritis, gout, pseudogout, systemic lupus erythematosus, infectious arthritis and degenerative joint disease. Author(s): Goldenberg DL, Cohen AS. Source: Medicine; Analytical Reviews of General Medicine, Neurology, Psychiatry, Dermatology, and Pediatrics. 1978 May; 57(3): 239-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=642792&dopt=Abstract

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Systemic inflammatory response syndrome (SIRS) from acute polyarticular gout. Author(s): Nicholls DW, Rajapakse CN. Source: N Z Med J. 1999 November 12; 112(1099): 434-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10678233&dopt=Abstract

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Systemic lupus erythematosus and gout. Author(s): Greenfield DI, Fong JS, Barth WF. Source: Seminars in Arthritis and Rheumatism. 1985 February; 14(3): 176-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4081786&dopt=Abstract

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Systemic lupus erythematosus, gout and Paget's disease. Author(s): Alarcon GS, Ball GV, Goldfarb PM Jr. Source: Arthritis and Rheumatism. 1983 February; 26(2): 238. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6824522&dopt=Abstract

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Systemic steroid therapy for acute gout: a clinical trial and review of the literature. Author(s): Groff GD, Franck WA, Raddatz DA. Source: Seminars in Arthritis and Rheumatism. 1990 June; 19(6): 329-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2196674&dopt=Abstract

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Tacrolimus for the treatment of gout in renal transplantation: two case reports and review of the literature. Author(s): Pilmore HL, Faire B, Dittmer I. Source: Transplantation. 2001 November 27; 72(10): 1703-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11726837&dopt=Abstract

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Tc-99m HMPAO leukocyte uptake in articular gout. Author(s): Herrmann T, Granjon D, Loboguerrero A, Decousus M. Source: Clinical Nuclear Medicine. 1991 June; 16(6): 457. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1868665&dopt=Abstract

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Ten years' experience with benzbromarone in the management of gout and hyperuricaemia. Author(s): Masbernard A, Giudicelli CP. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1981 May 9; 59(20): 701-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7221794&dopt=Abstract

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The “switch-off” mechanism of spontaneous resolution of acute gout attack. Author(s): Marcolongo R, Calabria AA, Mazzullo G, Lalumera M, Morozzi G, Cavallo G. Source: Advances in Experimental Medicine and Biology. 1986; 195 Pt A: 371-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3014836&dopt=Abstract

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The “switch-off” mechanism of spontaneous resolution of acute gout attack. Author(s): Marcolongo R, Calabria AA, Lalumera M, Gerli R, Alessandrini C, Cavallo G. Source: The Journal of Rheumatology. 1988 January; 15(1): 101-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2832599&dopt=Abstract

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The acute phase response in gout. Author(s): Roseff R, Wohlgethan JR, Sipe JD, Canoso JJ. Source: The Journal of Rheumatology. 1987 October; 14(5): 974-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2448456&dopt=Abstract

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The association between gout and nephrolithiasis: the National Health and Nutrition Examination Survey III, 1988-1994. Author(s): Kramer HM, Curhan G. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 July; 40(1): 37-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12087559&dopt=Abstract

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The case for uricase in gout. Author(s): Pay S, Terkeltaub AR. Source: Curr Rheumatol Rep. 2003 June; 5(3): 213-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744813&dopt=Abstract

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The City of Glasgow's first recorded disease: an acute attack of gout. Author(s): Buchanan WW. Source: Clinical Rheumatology. 1991 March; 10(1): 94-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2065517&dopt=Abstract

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The clinical management of gout. Author(s): Sterling LP. Source: Am Pharm. 1991 May; Ns31(5): 52-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2063772&dopt=Abstract

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The crystal, the gout, and the paradox. Author(s): Mandell BF. Source: Cleve Clin J Med. 2002 September; 69(9): 720. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12222976&dopt=Abstract

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The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. 1956. Author(s): Vague J. Source: Nutrition (Burbank, Los Angeles County, Calif.). 1999 January; 15(1): 89-90; Discussion 91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9918082&dopt=Abstract

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The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. 1956. Author(s): Vague J. Source: Obesity Research. 1996 March; 4(2): 204-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8681057&dopt=Abstract

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The diagnosis of gout and CPPD crystal arthropathy. Author(s): Pascual E. Source: British Journal of Rheumatology. 1996 April; 35(4): 306-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8624633&dopt=Abstract

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The effect of allopurinol therapy on coexistent gout and rheumatoid arthritis. Author(s): Waterworth RF. Source: Arthritis and Rheumatism. 1981 January; 24(1): 103-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7470163&dopt=Abstract

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The effect of benzbromarone on allopurinol/oxypurinol kinetics in patients with gout. Author(s): Muller FO, Schall R, Groenewoud G, Hundt HK, van der Merwe JC, van Dyk M. Source: European Journal of Clinical Pharmacology. 1993; 44(1): 69-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8436158&dopt=Abstract

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The effects of alcoholic beverages on urate metabolism in gout sufferers. Author(s): Eastmond CJ, Garton M, Robins S, Riddoch S. Source: British Journal of Rheumatology. 1995 August; 34(8): 756-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7551661&dopt=Abstract

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The elevated prevalence of apolipoprotein E2 in patients with gout is associated with reduced renal excretion of urates. Author(s): Cardona F, Tinahones FJ, Collantes E, Escudero A, Garcia-Fuentes E, Soriguer FJ. Source: Rheumatology (Oxford, England). 2003 March; 42(3): 468-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626798&dopt=Abstract

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The epidemiology of gout and hyperuricemia in a rural population of Java. Author(s): Darmawan J, Valkenburg HA, Muirden KD, Wigley RD. Source: The Journal of Rheumatology. 1992 October; 19(10): 1595-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1464874&dopt=Abstract

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The epidemiology of hyperuricaemia and gout in Taiwan aborigines. Author(s): Chou CT, Lai JS. Source: British Journal of Rheumatology. 1998 March; 37(3): 258-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9566664&dopt=Abstract

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The epidemiology study of hyperuricemia and gout in a community population of Huangpu District in Shanghai. Author(s): Chen S, Du H, Wang Y, Xu L. Source: Chin Med J (Engl). 1998 March; 111(3): 228-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10374422&dopt=Abstract

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The incidence and management of osteoporosis, gout, and avascular necrosis in recipients of renal allografts functioning more than 20 years (level 5A) treated with prednisone and azathioprine. Author(s): Braun WE, Richmond BJ, Protiva DA, Gifford RW Jr, Straffon RA. Source: Transplantation Proceedings. 1999 February-March; 31(1-2): 1366-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10083606&dopt=Abstract

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The incidence of gout in patients with Dupuytren's disease. Author(s): Adam RF, Loynes RD. Source: Journal of Hand Surgery (Edinburgh, Lothian). 1992 April; 17(2): 219-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1588208&dopt=Abstract

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The incidence of gout in renal transplant recipients. Author(s): West C, Carpenter BJ, Hakala TR. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1987 November; 10(5): 369-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3314490&dopt=Abstract

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The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study. Author(s): Lin KC, Lin HY, Chou P. Source: The Journal of Rheumatology. 2000 June; 27(6): 1501-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10852278&dopt=Abstract

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The management of gout. Author(s): Emmerson BT. Source: The New England Journal of Medicine. 1996 February 15; 334(7): 445-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8552148&dopt=Abstract

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The management of hyperuricemia and gout in patients with heart failure. Author(s): Spieker LE, Ruschitzka FT, Luscher TF, Noll G. Source: European Journal of Heart Failure : Journal of the Working Group on Heart Failure of the European Society of Cardiology. 2002 August; 4(4): 403-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12167377&dopt=Abstract

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The medical/surgical management of gout. Author(s): Landry JR, Schilero J. Source: J Foot Surg. 1986 March-April; 25(2): 160-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3519742&dopt=Abstract

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The misdiagnosis of gout and hyperuricemia. Author(s): Wolfe F, Cathey MA. Source: The Journal of Rheumatology. 1991 August; 18(8): 1232-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1941830&dopt=Abstract

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The pain of acute gout. Author(s): Alexander AG. Source: The American Journal of Medicine. 1986 March 24; 80(3A): 133. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3963019&dopt=Abstract

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The prevalence and prophylaxis of gout in England. Author(s): Harris CM, Lloyd DC, Lewis J. Source: Journal of Clinical Epidemiology. 1995 September; 48(9): 1153-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7636517&dopt=Abstract

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The prevalence of hypothyroidism in gout. Author(s): Erickson AR, Enzenauer RJ, Nordstrom DM, Merenich JA. Source: The American Journal of Medicine. 1994 September; 97(3): 231-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8092171&dopt=Abstract

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The radiographic appearance of gout. Author(s): Dowd SB. Source: Orthopaedic Nursing / National Association of Orthopaedic Nurses. 1993 January-February; 12(1): 53-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8451063&dopt=Abstract

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The role of lead in gout nephropathy reviewed: pathogenic or associated factor? Author(s): Miranda ME, Puig JG, Mateos FA, Ramos TH, Herrero E, Gonzalez A, Gil A, Vazquez JO. Source: Advances in Experimental Medicine and Biology. 1991; 309A: 209-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1789210&dopt=Abstract

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The ruin of the constitution: the early interpretation of gout. Ordinary meeting Monday, 25th April 1994. Author(s): Porter R. Source: Trans Med Soc Lond. 1993-94; 110: 90-103. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8729545&dopt=Abstract

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The treatment of hyperuricaemia and gout. Author(s): O'Connor JP, Emmerson BT. Source: Aust Fam Physician. 1985 March; 14(3): 193-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3994597&dopt=Abstract

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The very rare development of rheumatoid arthritis in a patient with gout. Author(s): Godfrey RG. Source: Clin Exp Rheumatol. 2000 September-October; 18(5): 649. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11072614&dopt=Abstract

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Therapy in gout. Author(s): Wallace SL, Singer JZ. Source: Rheumatic Diseases Clinics of North America. 1988 August; 14(2): 441-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3051159&dopt=Abstract

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Thiazide diuretics and the initiation of anti-gout therapy. Author(s): Gurwitz JH, Kalish SC, Bohn RL, Glynn RJ, Monane M, Mogun H, Avorn J. Source: Journal of Clinical Epidemiology. 1997 August; 50(8): 953-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9291881&dopt=Abstract

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Thoracic cord compression due to gout: a case report and literature review. Author(s): Kao MC, Huang SC, Chiu CT, Yao YT. Source: J Formos Med Assoc. 2000 July; 99(7): 572-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10925570&dopt=Abstract

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Tophaceous deposition in the absence of known antecedent gout. Author(s): Lerman RL, Danna AT, Boykoff TJ. Source: Journal of the American Podiatric Medical Association. 1991 May; 81(5): 273-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2061826&dopt=Abstract

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Tophaceous gout as a fungating mass. Author(s): Low LL, Cervantes AG, Melcher WL. Source: Arthritis and Rheumatism. 1992 November; 35(11): 1399-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1445464&dopt=Abstract

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Tophaceous gout as the emblem of a mid 19th century itinerant salesman in Paris. Author(s): Alarcon-Segovia D. Source: The Journal of Rheumatology. 1985 April; 12(2): 382. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3897538&dopt=Abstract

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Tophaceous gout in a nigerian with rheumatoid arthritis. Author(s): Adelowo OO. Source: Scandinavian Journal of Rheumatology. 1986; 15(3): 272-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3798042&dopt=Abstract

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Tophaceous gout in patients with renal transplants treated with cyclosporine A. Author(s): Baethge BA, Work J, Landreneau MD, McDonald JC. Source: The Journal of Rheumatology. 1993 April; 20(4): 718-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8496871&dopt=Abstract

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Tophaceous gout in young patients with systemic lupus erythematosus. Author(s): Veerapen K, Schumacher HR Jr, van Linthoudt D, Neilson EG, Wang F. Source: The Journal of Rheumatology. 1993 April; 20(4): 721-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8496872&dopt=Abstract

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Tophaceous gout involving the fourth toes bilaterally. Author(s): Addante AR, Paicos PC Jr. Source: Journal of the American Podiatric Medical Association. 1988 November; 78(11): 599-603. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3246661&dopt=Abstract

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Tophaceous gout mimicking tumoral growth. Author(s): Garcia-Porrua C, Gonzalez-Gay MA, Vazquez-Caruncho M. Source: The Journal of Rheumatology. 1999 February; 26(2): 508-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9972997&dopt=Abstract

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Tophaceous gout of patella partita. Author(s): Kanbe K, Nagase M, Kobuna Y, Kimura M. Source: The Journal of Rheumatology. 1993 August; 20(8): 1456-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8230051&dopt=Abstract

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Tophaceous gout of the axial skeleton. Author(s): Arnold MH, Brooks PM, Savvas P, Ruff S. Source: Aust N Z J Med. 1988 December; 18(7): 865-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2977940&dopt=Abstract

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Tophaceous gout of the cervical spine without peripheral tophi. Author(s): van de Laar MA, van Soesbergen RM, Matricali B. Source: Arthritis and Rheumatism. 1987 February; 30(2): 237-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3827965&dopt=Abstract

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Tophaceous gout of the foot: an unusual presentation of severe chronic gout in an undiagnosed patient. Author(s): Kerman BL, Mack G, Moshirfar MM. Source: The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons. 1993 March-April; 32(2): 167-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8318974&dopt=Abstract

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Tophaceous gout of the lumbar spine in a renal transplant patient: a case report and literature review. Author(s): Thornton FJ, Torreggiani WC, Brennan P. Source: European Journal of Radiology. 2000 December; 36(3): 123-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11091009&dopt=Abstract

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Tophaceous gout of the lumbar spine mimicking an epidural abscess: MR features. Author(s): Bonaldi VM, Duong H, Starr MR, Sarazin L, Richardson J. Source: Ajnr. American Journal of Neuroradiology. 1996 November-December; 17(10): 1949-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8933885&dopt=Abstract

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Tophaceous gout of the navicular bone as a cause of medial inflammatory tumor of the foot. Author(s): Thomas E, Olive P, Canovas F, Medioni D, Leroux JL, Baldet P, Bonnel F, Blotman F. Source: Foot & Ankle International / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society. 1998 January; 19(1): 48-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9462914&dopt=Abstract

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Tophaceous gout of the patella with primary hyperparathyroidism. Author(s): Thomas E, Leroux JL, Serre I, Bonnel F, Mary H, Baldet P, Blotman F. Source: Clin Exp Rheumatol. 1995 March-April; 13(2): 263-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7656476&dopt=Abstract

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Tophaceous gout of the rotator cuff: a case report. Author(s): O'leary ST, Goldberg JA, Walsh WR. Source: Journal of Shoulder and Elbow Surgery / American Shoulder and Elbow Surgeons. [et Al.]. 2003 March-April; 12(2): 200-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700578&dopt=Abstract

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Tophaceous gout of the spine causing spinal cord compression. Author(s): Murshid WR, Moss TH, Ettles DF, Cummins BH. Source: British Journal of Neurosurgery. 1994; 8(6): 751-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7718175&dopt=Abstract

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Tophaceous gout of the spine mimicking epidural infection: case report and review of the literature. Author(s): Barrett K, Miller ML, Wilson JT. Source: Neurosurgery. 2001 May; 48(5): 1170-2; Discussion 1172-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11334288&dopt=Abstract

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Tophaceous gout of the spine: MR imaging features. Author(s): Hsu CY, Shih TT, Huang KM, Chen PQ, Sheu JJ, Li YW. Source: Clinical Radiology. 2002 October; 57(10): 919-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413917&dopt=Abstract

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Tophaceous gout presenting with bilateral hand contractures and carpal tunnel syndrome. Author(s): Lianga J, Waslen GD, Penney CJ. Source: The Journal of Rheumatology. 1986 February; 13(1): 230-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3701738&dopt=Abstract

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Tophaceous gout simulating infection about a stainless steel plate. Author(s): Torke MD, Henderson RC. Source: Journal of Orthopaedic Trauma. 1990; 4(4): 463-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2266454&dopt=Abstract

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Tophaceous gout. Author(s): Ohta H, Shimizu M. Source: Ann Nucl Med. 2002 September; 16(6): Front Cover, 422. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416582&dopt=Abstract

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Tophaceous gout. Author(s): Peh WC. Source: Am J Orthop. 2001 August; 30(8): 665. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11520025&dopt=Abstract

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Tophaceous gout. An unusual presentation. Author(s): Gaines DR, Finelli LJ. Source: Journal of the American Podiatric Medical Association. 1993 November; 83(11): 652-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8258780&dopt=Abstract

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Tophaceous gout: a case of bilateral carpal tunnel syndrome. Author(s): Ali T, Hofford R, Mohammed F, Maharaj D, Sookhoo S, van Velzen D. Source: The West Indian Medical Journal. 1999 September; 48(3): 160-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10555467&dopt=Abstract

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Tophaceous gout: uncommon presentation of a common disease. Author(s): Johnson S, Toms A, Lee P. Source: The Journal of Rheumatology. 2003 April; 30(4): 863-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672215&dopt=Abstract

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Tophaceous lumbar gout mimicking an epidural abscess. Author(s): Gines R, Bates DJ. Source: The American Journal of Emergency Medicine. 1998 March; 16(2): 216. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9517709&dopt=Abstract

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Tophi as the initial manifestation of gout. Report of six cases and review of the literature. Author(s): Wernick R, Winkler C, Campbell S. Source: Archives of Internal Medicine. 1992 April; 152(4): 873-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1558451&dopt=Abstract

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Total plasma homocysteine in patients with gout. Author(s): Istok R, Kovalancik M, Rovensky J. Source: The Journal of Rheumatology. 1999 September; 26(9): 2068-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10493700&dopt=Abstract

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Total plasma homocysteine is not increased in Japanese patients with gout. Author(s): Tsutsumi Z, Moriwaki Y, Yamamoto T, Takahashi S, Hada T, Fukuchi M. Source: The Journal of Rheumatology. 2002 August; 29(8): 1805-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12180754&dopt=Abstract

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Towards a coherent terminology of gout. Author(s): Simkin PA. Source: Annals of the Rheumatic Diseases. 1993 September; 52(9): 693-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8239767&dopt=Abstract

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Treating gout in the presence of cardiac failure. Author(s): Jolobe O. Source: Practitioner. 1994 June; 238(1539): 489-90. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8208665&dopt=Abstract

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Treatment of acute attacks of gout with a small dose of intraarticular triamcinolone acetonide. Author(s): Fernandez C, Noguera R, Gonzalez JA, Pascual E. Source: The Journal of Rheumatology. 1999 October; 26(10): 2285-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10529162&dopt=Abstract

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Treatment of chronic gout. Can we determine when urate stores are depleted enough to prevent attacks of gout? Author(s): Li-Yu J, Clayburne G, Sieck M, Beutler A, Rull M, Eisner E, Schumacher HR Jr. Source: The Journal of Rheumatology. 2001 March; 28(3): 577-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11296962&dopt=Abstract

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Treatment of gout after transplantation. Author(s): Perez-Ruiz F, Alonso-Ruiz A, Calabozo M, Duruelo J. Source: British Journal of Rheumatology. 1998 May; 37(5): 580. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9651090&dopt=Abstract

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Treatment of gout and crystal arthropathies and uses and mechanisms of action of nonsteroidal anti-inflammatory drugs. Author(s): Abramson SB. Source: Current Opinion in Rheumatology. 1992 June; 4(3): 295-300. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1599806&dopt=Abstract

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Treatment of gout following cardiac transplantation. Author(s): Byrne PA, Fraser AG, Pritchard MH. Source: British Journal of Rheumatology. 1996 December; 35(12): 1329. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9010071&dopt=Abstract

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Treatment with allopurinol decreases the number of acute gout attacks despite persistently elevated serum uric acid levels. Author(s): Beutler AM, Rull M, Schlesinger N, Baker DG, Hoffman BI, Schumacher HR Jr. Source: Clin Exp Rheumatol. 2001 September-October; 19(5): 595. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11579724&dopt=Abstract

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Tuberculous arthritis presenting as tophaceous gout. Author(s): Hoppmann RA, Patrone NA, Rumley R, Burke W. Source: The Journal of Rheumatology. 1989 May; 16(5): 700-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2502626&dopt=Abstract

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Ulnar deviation of the fingers in gout simulating rheumatoid arthritis. Author(s): Yunus M, Plattner PF, Masi AT, Shah IK, Lindahl LS, Conner DE. Source: The Journal of Rheumatology. 1982 July-August; 9(4): 619-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7131461&dopt=Abstract

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Understanding gout. Author(s): Sadik F, McGrath LC, Beamer RL, Bauguess CT. Source: J Am Pharm Assoc. 1977 January; 17(1): 36-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=830722&dopt=Abstract

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Unusual localisation of tophaceous gout. A report of four cases and review of the literature. Author(s): Reber P, Crevoisier X, Noesberger B. Source: Archives of Orthopaedic and Trauma Surgery. 1996; 115(5): 297-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8836466&dopt=Abstract

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Unusual presentations of gout. Tips for accurate diagnosis. Author(s): Uy JP, Nuwayhid N, Saadeh C. Source: Postgraduate Medicine. 1996 July; 100(1): 253-4, 257-60, 266 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8668620&dopt=Abstract

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Update on gout. Author(s): Schlesinger N, Schumacher HR Jr. Source: Arthritis and Rheumatism. 2002 October 15; 47(5): 563-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12382308&dopt=Abstract

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Urate crystals in gout. Author(s): Faure G, Netter P. Source: The Journal of Rheumatology. 1978 Fall; 5(3): 353-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=748559&dopt=Abstract

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Urate metabolism and gout--a perspective. Author(s): Emmerson BT. Source: Aust N Z J Med. 1988 May; 18(3): 319-26. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3056373&dopt=Abstract

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Urate-oxidase for the treatment of tophaceous gout in heart transplant recipients. A report of three cases. Author(s): Rozenberg S, Roche B, Dorent R, Koeger AC, Borget C, Wrona N, Bourgeois P. Source: Rev Rhum Engl Ed. 1995 May; 62(5): 392-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7655872&dopt=Abstract

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Uric acid excretion in patients with gout. Author(s): Simkin PA. Source: Arthritis and Rheumatism. 1979 January; 22(1): 98-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=758925&dopt=Abstract

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Uric acid metabolism in two patients with coexistent Down's syndrome and gout. Author(s): Ciompi ML, Bazzichi LM, Bertolucci D, Mazzoni MR, Barbieri P, Mencacci S, Macchia D, Mariani G. Source: Clinical Rheumatology. 1984 June; 3(2): 229-33.

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Uric acid turnover in normals, in gout and in chronic renal failure using 14C-uric acid. Author(s): Vitali C, Pasero G, Clerico A, Riente L, Molea N, Pilo A, Mariani G, Bianchi R. Source: Advances in Experimental Medicine and Biology. 1980; 122A: 27-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6999848&dopt=Abstract

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Uric acid, gout and the kidney. Author(s): Cameron JS, Simmonds HA. Source: Journal of Clinical Pathology. 1981 November; 34(11): 1245-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7320221&dopt=Abstract

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Urolithiasis in hyperuricemia and gout. Author(s): Yu TF. Source: The Journal of Urology. 1981 October; 126(4): 424-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7288928&dopt=Abstract

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Use of intravenous colchicine in patients with acute gout. Author(s): Stephan WH. Source: American Family Physician. 2000 April 15; 61(8): 2343-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10794578&dopt=Abstract

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Use of piroxicam in the treatment of acute gout. Author(s): Cobra CJ, Cobra JF, Cobra Neto C. Source: Eur J Rheumatol Inflamm. 1983; 6(1): 126-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6861811&dopt=Abstract

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Vascular mortality in patients with gout and in their families. Author(s): Darlington LG, Slack J, Scott JT. Source: Annals of the Rheumatic Diseases. 1983 June; 42(3): 270-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6859957&dopt=Abstract

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Vertebral erosion, paraplegia, and spinal gout. Author(s): Pfister AK, Schlarb CA, O'Neal JF. Source: Ajr. American Journal of Roentgenology. 1998 November; 171(5): 1430-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9798898&dopt=Abstract

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William Harvey and his gout. Author(s): Hart FD. Source: Annals of the Rheumatic Diseases. 1984 April; 43(2): 125-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6370146&dopt=Abstract

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William Stukeley and the gout. Author(s): Fraser KJ. Source: Medical History. 1992 April; 36(2): 160-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1583973&dopt=Abstract

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Withdrawal of longterm antihyperuricemic therapy in tophaceous gout. Author(s): van Lieshout-Zuidema MF, Breedveld FC. Source: The Journal of Rheumatology. 1993 August; 20(8): 1383-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8230024&dopt=Abstract

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Withdrawal of longterm antihyperuricemic therapy in tophaceous gout. Author(s): Gast LF. Source: Clinical Rheumatology. 1987 March; 6(1): 70-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3581700&dopt=Abstract

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Xanthinuria : study of a large kindred with familial urolithiasis and gout. Author(s): Auscher C, Pasquier C, de Gery A, Weissenbach R, Delbarre F. Source: Biomedicine. 1977 March; 27(2): 57-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=861350&dopt=Abstract

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Xanthinuria, lithiasis and gout in the same family. Author(s): Auscher C, de Gery A, Pasquier C, Delbarre F. Source: Advances in Experimental Medicine and Biology. 1977; 76A: 405-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=855719&dopt=Abstract

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X-linked pattern of inheritance of gout due to mutant feedback-resistant phosphoribosylpyrophosphate synthetase. Author(s): Zoref E, de Vries A, Sperling O. Source: Advances in Experimental Medicine and Biology. 1977; 76A: 287-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=193372&dopt=Abstract

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Younger age of onset of gout in Taiwan. Author(s): Yu KH, Luo SF. Source: Rheumatology (Oxford, England). 2003 January; 42(1): 166-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12509631&dopt=Abstract

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Your CE topic this month (No. 26). Gout: medical management. Author(s): Bergman HD. Source: J Pract Nurs. 1987 September; 37(3): 48-55. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3668875&dopt=Abstract

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CHAPTER 2. NUTRITION AND GOUT Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and gout.

Finding Nutrition Studies on Gout The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “gout” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

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Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “gout” (or a synonym): •

A practical approach to gout. Current management of an 'old' disease. Author(s): Division of Rheumatology, UCSF 94143-0633, USA. [email protected] Source: Davis, J C Postgrad-Med. 1999 October 1; 106(4): 115-6, 119-23 0032-5481

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A structural approach to pathological crystallizations. Gout: the possible role of albumin in sodium urate crystallization. Author(s): Department of Structural Chemistry, Weizmann Institute of Science, Rehovot, Israel. Source: Perl Treves, D Addadi, L Proc-R-Soc-Lond-B-Biol-Sci. 1988 November 22; 235(1279): 145-59 0080-4649

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An aberration of fructose metabolism in familial gout identified by 31P magnetic resonance spectroscopy of the liver. Author(s): Department of Biochemistry, John Radcliffe Hospital, Oxford, United Kingdom. Source: Seegmiller, J E Dixon, R M Kemp, G J Angus, P W McAlindon, T E Dieppe, P Rajagopalan, B Radda, G K Trans-Assoc-Am-Physicians. 1990; 103298-306 0066-9458

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An atypical case of primary renal tubular hypokalaemic metabolic alkalosis with chronic tophaceous gout. Author(s): Third Department of Internal Medicine, Hyogo College of Medicine, Japan. Source: Moriwaki, Y Yamamoto, T Takahashi, S Tsutsumi, Z Hada, T Clin-Rheumatol. 2001; 20(5): 372-5 0770-3198

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An oil rig worker presenting with acute gout. Author(s): Princess Alexandra Hospital Trust, Harlow. Source: Hynes, D Wyndham, M Golding, D Practitioner. 1997 May; 241(1574): 239-41, 243-5 0032-6518

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Antigout medications. Source: Gray, M A Orthop-Nurs. 1993 Jul-August; 12(4): 53-5 0744-6020

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Biochemical distinction between hyperuricosuric calcium urolithiasis and gouty diathesis. Author(s): Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8885, USA. Source: Pak, C Y Poindexter, J R Peterson, R D Koska, J Sakhaee, K Urology. 2002 November; 60(5): 789-94 1527-9995

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Case report 599: Secondary oxalosis complicating chronic renal failure (oxalate gout). Author(s): Department of Radiology, University of Michigan Hospitals, Ann Arbor. Source: Coral, A van Holsbeeck, M Hegg, C Skeletal-Radiol. 1990; 19(2): 147-9 0364-2348

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Comparative trial of azapropazone and indomethacin plus allopurinol in acute gout and hyperuricaemia. Source: Fraser, R C Davis, R H Walker, F S J-R-Coll-Gen-Pract. 1987 September; 37(302): 409-11 0035-8797

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Concurrent gout and suspected hypovitaminosis A in crocodile hatchlings. Author(s): Department of Biomedical and Tropical Veterinary Sciences, James Cook University, Townsville, Queensland. Source: Ariel, E Ladds, P W Buenviaje, G N Aust-Vet-J. 1997 April; 75(4): 247-9 00050423

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Conquest of the gout. Source: Brick, J E W-V-Med-J. 1991 October; 87(10): 470-2 0043-3284

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Diagnosis and management of complicated gout. Author(s): Division of Rheumatology, Allergy, and Immunology, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA. Source: Wise, C M Agudelo, C A Bull-Rheum-Dis. 1998 June; 47(4): 2-5 0007-5248

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Does colchicine work? The results of the first controlled study in acute gout. Author(s): Department of Medicine, Flinders University of South Australia. Source: Ahern, M J Reid, C Gordon, T P McCredie, M Brooks, P M Jones, M Aust-N-Z-JMed. 1987 June; 17(3): 301-4 0004-8291

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Effect of gradual accumulation of iron, molybdenum and sulfur, slow depletion of zinc and copper, ethanol or fructose ingestion and phlebotomy in gout. Source: Johnson, S Med-Hypotheses. 1999 November; 53(5): 407-12 0306-9877

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Gout and hyperuricaemia. Source: Faragher, R I Caelli, D J Aust-Fam-Physician. 1987 June; 16(6): 843-4, 848 03008495

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Gout and secondary amyloid. Author(s): Section of Rheumatology, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain. Source: Guma, M Bayes, B Bonet, J Olive, A Clin-Rheumatol. 1999; 18(1): 54-5 0770-3198

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Gouty arthritis: not just a big toe problem. Author(s): University of Nevada in Las Vegas' College of Health Sciences, USA. Source: Meiner, S E Geriatr-Nurs. 2001 May-June; 22(3): 132-4 0197-4572

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How is gout managed in primary care? A review of current practice and proposed guidelines. Author(s): Department of Rheumatology and Clinical Audit, Withington Hospital, Didsbury, Manchester, UK. [email protected] Source: Pal, B Foxall, M Dysart, T Carey, F Whittaker, M Clin-Rheumatol. 2000; 19(1): 215 0770-3198

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Intractable gouty arthritis. Source: McCarty, D J Hosp-Pract-(Off-Ed). 1987 June 15; 22(6): 191-5, 198, 202-4, 206-9 8750-2836

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Is it gout? Tap the joint! Author(s): Georgia Internal Medicine Associates, PA, Atlanta, GA, USA. Source: Weselman, Kelly O Agudelo, Carlos A J-Med-Assoc-Ga. 2002 Winter; 91(1): 1820 0025-7028

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Light induced changes of milk and some milk products. I. Changes of color, taste and different vitamin contents. La photodegradation du lait et de quelques produits laitiers. I. Alterations de la couleur, du gout et de la teneur en quelques vitamines. Source: Desarzens, C. Bosset, J.O. Blanc, B. Lebensm-Wiss-Technol-Food-Sci-Technol. Zurich, Switzerland : Forster-Verlag. Sept 1983. volume 17, i.e. 16 (5) page 241-247. 00326428

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Missed diagnosis of acute arthritic gout in kidney transplant recipients. Author(s): Department of Medicine, State University of New York, Health Science Center, Brooklyn 11203. Source: Daniels, I D Friedman, E A N-Y-State-J-Med. 1993 January; 93(1): 55-7 0028-7628

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Nutrition and gout. Source: B-N-F-Nutr-Bull-Br-Nutr-Found. London : The Foundation. Sept 1990. volume 15 page 169-179. charts. 0141-9684

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Pseudogout in a young patient. Author(s): Department of Rheumatology, Hamad General Hospital, Doha, Qatar. Source: Hammoudeh, M Siam, A R Clin-Rheumatol. 1998; 17(3): 242-5 0770-3198

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Rational treatment of gout. Stopping an attack and preventing recurrence. Author(s): Section of Rheumatology, West Virginia University School of Medicine, Morgantown. Source: Vawter, R L Antonelli, M A Postgrad-Med. 1992 February 1; 91(2): 115-8, 127 0032-5481

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Risk factors for gout: a hospital-based study in urban black South Africans. Author(s): Department of Medicine, Chris Hani Baragwanath Hospital, Johannesburg, South Africa. Source: Tikly, M Bellingan, A Lincoln, D Russell, A Rev-Rhum-Engl-Ed. 1998 April; 65(4): 225-31 1169-8446

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Stopping progression to tophaceous gout. When and how to use urate-lowering therapy. Author(s): Department of Medicine, North Shore University Hospital, Forest Hills, New York 11375, USA. Source: McDonald, E Marino, C Postgrad-Med. 1998 December; 104(6): 117-20, 123-4, 127 0032-5481

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Study of taste disturbances in non-treated cancerous patients. Etude des perturbations du gout chez les malades concereux non traites. Source: Simon, M. Maire, F. Malissard, L. Gauchois, A. Carolus, J. Proceedings of the Xth International Congress of Dietetics / held under the auspices of the I.C.D.A. (the International Committee of Dietetic Associations); edited by M.F. Moyal. London : Libbey Eurotext, c1988. volume 1 page 209-212.

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Syndrome X and gout: benefits of altered diet. Source: Terkeltaub, R Curr-Rheumatol-Repage 2001 February; 3(1): 9-10 1523-3774

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Treating gout in the presence of cardiac failure. Author(s): Tameside General Hospital, Ashton-under-Lyme, Lancashire. Source: Jolobe, O Practitioner. 1994 June; 238(1539): 489-90 0032-6518

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Withdrawal of longterm antihyperuricemic therapy in tophaceous gout. Source: Gast, L F Clin-Rheumatol. 1987 March; 6(1): 70-3 0770-3198

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to gout; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Folic Acid Source: Healthnotes, Inc. www.healthnotes.com Niacin Source: Integrative Medicine Communications; www.drkoop.com Niacin Source: WholeHealthMD.com, LLC. www.wholehealthmd.com

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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,892,00.html Vitamin A Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10067,00.html Vitamin B12 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B3 Source: Healthnotes, Inc. www.healthnotes.com Vitamin B3 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B3 (Niacin) Source: Integrative Medicine Communications; www.drkoop.com Vitamin C Source: Healthnotes, Inc. www.healthnotes.com Vitamin C Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,904,00.html Vitamin E Source: Prima Communications, Inc.www.personalhealthzone.com •

Minerals Copper Source: Integrative Medicine Communications; www.drkoop.com Folate Source: Prima Communications, Inc.www.personalhealthzone.com Molybdenum Source: Healthnotes, Inc. www.healthnotes.com Quercetin Source: Healthnotes, Inc. www.healthnotes.com Quercetin Source: Integrative Medicine Communications; www.drkoop.com Quercetin Source: WholeHealthMD.com, LLC. www.wholehealthmd.com

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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10053,00.html Selenium Source: Prima Communications, Inc.www.personalhealthzone.com Sodium Bicarbonate Source: Healthnotes, Inc. www.healthnotes.com •

Food and Diet Blackberries Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,142,00.html Cherries Source: Healthnotes, Inc. www.healthnotes.com Cherries Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,49,00.html Fasting Diet Source: Healthnotes, Inc. www.healthnotes.com Jarlsberg Source: Healthnotes, Inc. www.healthnotes.com Low-Purine Diet Source: Healthnotes, Inc. www.healthnotes.com Soy products Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,135,00.html Tendinitis Source: Healthnotes, Inc. www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND GOUT Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to gout. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to gout and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “gout” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to gout: •

A biochemical investigation on chicken gout observed in the Marmara region in Turkey. Author(s): Mert N. Source: Advances in Experimental Medicine and Biology. 1991; 309A: 251-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1789220&dopt=Abstract

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Acute renal failure and gout as presenting features of acute lymphoblastic leukaemia. Author(s): Morley CJ, Houston IB, Morris-Jones P. Source: Archives of Disease in Childhood. 1976 September; 51(9): 723-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1069569&dopt=Abstract

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Chronic lead accumulation as a possible cause of renal failure in gouty patients. Author(s): Colleoni N, D'Amico G.

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Source: Nephron. 1986; 44(1): 32-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3092121&dopt=Abstract •

Chronic lead nephropathy: the diagnostic use of calcium EDTA and the association with gout. Author(s): Emmerson BT. Source: Australas Ann Med. 1963 November; 12: 310-24. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14078907&dopt=Abstract

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Chronic renal failure with gout: a marker of chronic lead poisoning. Author(s): Craswell PW, Price J, Boyle PD, Heazlewood VJ, Baddeley H, Lloyd HM, Thomas BJ, Thomas BW. Source: Kidney International. 1984 September; 26(3): 319-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6439940&dopt=Abstract

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Colchicum autumnale and the gout. Naked ladies and portly gentlemen. Author(s): Lee MR. Source: Proc R Coll Physicians Edinb. 1999 January; 29(1): 65-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11623671&dopt=Abstract

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Cushing's syndrome caused by treatment of gout with traditional Chinese medicine. Author(s): Edwards CJ, Lian TY, Chng HH. Source: Qjm : Monthly Journal of the Association of Physicians. 2002 October; 95(10): 705. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12324644&dopt=Abstract

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Earliest description of gout. Author(s): Rosner F. Source: Arthritis and Rheumatism. 1983 February; 26(2): 236. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6337596&dopt=Abstract

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Effect of balneotherapy in Ciechocinek Spa on the occurrence of gouty attacks and the symptoms of chronic gouty arthropathy (observations of 112 cures). Author(s): Kawenoki-Minc E, Zielinski Z. Source: Pol Med J. 1972; 11(6): 1494-500. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4659072&dopt=Abstract

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Gout in the Bible and the Talmud. Author(s): Rosner F. Source: Annals of Internal Medicine. 1977 June; 86(6): 833. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=326118&dopt=Abstract

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Historical aspects of gout. Author(s): Copeman WS. Source: Clinical Orthopaedics and Related Research. 1970; 71: 14-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4914838&dopt=Abstract

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Inhibition of xanthine oxidase by some Chinese medicinal plants used to treat gout. Author(s): Kong LD, Cai Y, Huang WW, Cheng CH, Tan RX. Source: Journal of Ethnopharmacology. 2000 November; 73(1-2): 199-207. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11025157&dopt=Abstract

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Lack of effect of two pectins in idiopathic or gout-associated hyperdyslipidemia hypercholesterolemia. Author(s): Delbarre F, Rondier J, de Gery A. Source: The American Journal of Clinical Nutrition. 1977 April; 30(4): 463-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=851070&dopt=Abstract

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Lead and the gouty kidney. Author(s): Wedeen R. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1983 March; 2(5): 559-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6402928&dopt=Abstract

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Lead and the kidney: nephropathy, hypertension, and gout. Author(s): Perazella MA. Source: Conn Med. 1996 September; 60(9): 521-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uid s=8908777&dopt=Abstract

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Lead chelation therapy and urate excretion in patients with chronic renal diseases and gout. Author(s): Lin JL, Yu CC, Lin-Tan DT, Ho HH. Source: Kidney International. 2001 July; 60(1): 266-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11422760&dopt=Abstract

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Lead nephropathy, gout, and hypertension. Author(s): Batuman V. Source: The American Journal of the Medical Sciences. 1993 April; 305(4): 241-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8475950&dopt=Abstract

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Lead-related gout. A case report. Author(s): Niamane R, El Hassani S, Bezza A, Lazrak N, Hajjaj-Hassouni N. Source: Joint, Bone, Spine : Revue Du Rhumatisme. 2002 June; 69(4): 409-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12184440&dopt=Abstract

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Moonshine and lead. Relationship to the pathogenesis of hyperuricemia in gout. Author(s): Reynolds PP, Knapp MJ, Baraf HS, Holmes EW. Source: Arthritis and Rheumatism. 1983 September; 26(9): 1057-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6412722&dopt=Abstract

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Occult lead intoxication in patients with gout and kidney disease. Author(s): Wright LF, Saylor RP, Cecere FA. Source: The Journal of Rheumatology. 1984 August; 11(4): 517-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6434739&dopt=Abstract

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Patterns of lead excretion in patients with gout and chronic renal failure--a comparative German and Australian study. Author(s): Craswell PW, Price J, Boyle PD, Behringer D, Stoeppler M, Ritz E. Source: The Science of the Total Environment. 1987 October; 66: 17-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3120309&dopt=Abstract

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Psychiatric observations on attacks of gout in a patient with ulcerative colitis. Report of a case. Author(s): Castelnuovo-Tedesco P. Source: Psychosomatic Medicine. 1966 November-December; 28(6): 781-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5972491&dopt=Abstract

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Purine metabolism in patients with gout: the role of lead. Author(s): Miranda-Carus E, Mateos FA, Sanz AG, Herrero E, Ramos T, Puig JG. Source: Nephron. 1997; 75(3): 327-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9069456&dopt=Abstract

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Saturnine gout: a review of 42 patients. Author(s): Halla JT, Ball GV. Source: Seminars in Arthritis and Rheumatism. 1982 February; 11(3): 307-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6821383&dopt=Abstract

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Sir William Temple and the therapeutic use of moxa for gout in England. Author(s): Rosen G. Source: Bulletin of the History of Medicine. 1970 January-February; 44(1): 31-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4909173&dopt=Abstract

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St. Wolfgang and gout. Author(s): Rodnan GP. Source: British Medical Journal. 1968 March 2; 1(591): 581. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4868555&dopt=Abstract

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The anti-inflammatory and anti-hyperuricemic effects of Chinese herbal formula danggui-nian-tong-tang on acute gouty arthritis: a comparative study with indomethacin and allopurinol. Author(s): Chou CT, Kuo SC. Source: The American Journal of Chinese Medicine. 1995; 23(3-4): 261-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8571922&dopt=Abstract

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The Filipino and gout. Author(s): Torralba TP, Bayani-Sioson PS. Source: Seminars in Arthritis and Rheumatism. 1975 May; 4(4): 307-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1135632&dopt=Abstract

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The past four decades of progress in the knowledge of gout, with an assessment of the present status. Author(s): Gutman AB. Source: Arthritis and Rheumatism. 1973 July-August; 16(4): 431-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4147308&dopt=Abstract

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The role of lead in gout nephropathy. Author(s): Batuman V, Maesaka JK, Haddad B, Tepper E, Landy E, Wedeen RP. Source: The New England Journal of Medicine. 1981 February 26; 304(9): 520-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6779160&dopt=Abstract

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The treatment of gout. Author(s): Wallace SL. Source: Arthritis and Rheumatism. 1972 May-June; 15(3): 317-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5031616&dopt=Abstract

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Xanthine oxidase inhibitory activity of northeastern North American plant remedies used for gout. Author(s): Owen PL, Johns T. Source: Journal of Ethnopharmacology. 1999 February; 64(2): 149-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10197750&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

Open Directory Project: http://dmoz.org/Health/Alternative/

•

HealthGate: http://www.tnp.com/

•

WebMDHealth: http://my.webmd.com/drugs_and_herbs

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to gout; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Bone Marrow Disorders Source: Integrative Medicine Communications; www.drkoop.com Bursitis Source: Integrative Medicine Communications; www.drkoop.com Chronic Myelogenous Leukemia Source: Integrative Medicine Communications; www.drkoop.com Cutaneous Drug Reactions Source: Integrative Medicine Communications; www.drkoop.com Epilepsy Source: Healthnotes, Inc. www.healthnotes.com Gout Source: Healthnotes, Inc. www.healthnotes.com Gout Source: Integrative Medicine Communications; www.drkoop.com Gout Source: Prima Communications, Inc.www.personalhealthzone.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com

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High Cholesterol Source: Healthnotes, Inc. www.healthnotes.com High Cholesterol Source: Integrative Medicine Communications; www.drkoop.com Hypercholesterolemia Source: Integrative Medicine Communications; www.drkoop.com Hypertension Source: Integrative Medicine Communications; www.drkoop.com Myelofibrosis Source: Integrative Medicine Communications; www.drkoop.com Myeloproliferative Disorders Source: Integrative Medicine Communications; www.drkoop.com Osteoarthritis Source: Healthnotes, Inc. www.healthnotes.com Osteoarthritis Source: Integrative Medicine Communications; www.drkoop.com Polycythemia Vera Source: Integrative Medicine Communications; www.drkoop.com Rheumatoid Arthritis Source: Healthnotes, Inc. www.healthnotes.com Thrombocytosis Source: Integrative Medicine Communications; www.drkoop.com •

Alternative Therapy Grape Cure Alternative names: grape diet Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/g.html Tai Chi Source: Integrative Medicine Communications; www.drkoop.com

•

Chinese Medicine Gouteng Alternative names: Gambir Plant; Ramulus Uncariae cum Uncis Source: Chinese Materia Medica

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•

Homeopathy Arnica Source: Healthnotes, Inc. www.healthnotes.com Belladonna Source: Healthnotes, Inc. www.healthnotes.com Berberis vulgaris Source: Healthnotes, Inc. www.healthnotes.com Calcarea fluorica Source: Healthnotes, Inc. www.healthnotes.com Colchicum Source: Healthnotes, Inc. www.healthnotes.com Ledum palustre Source: Healthnotes, Inc. www.healthnotes.com Rhododendron Source: Healthnotes, Inc. www.healthnotes.com Rhus toxicodendron Source: Healthnotes, Inc. www.healthnotes.com Sulphur Source: Healthnotes, Inc. www.healthnotes.com

•

Herbs and Supplements Allopurinol Source: Healthnotes, Inc. www.healthnotes.com Barberry Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Blackberry Alternative names: Rubus fructicosus Source: Healthnotes, Inc. www.healthnotes.com Blackberry Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,837,00.html Bromelain Source: Prima Communications, Inc.www.personalhealthzone.com Bromelain Source: WholeHealthMD.com, LLC. www.wholehealthmd.com

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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,760,00.html Buchu Alternative names: Barosma betulina, Agathosma betulina, Agathosma crenultata Source: Healthnotes, Inc. www.healthnotes.com Celery extract Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10014,00.html Celery seed Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Cherry fruit extract Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10015,00.html Colchicine Source: Healthnotes, Inc. www.healthnotes.com Dandelion Source: Prima Communications, Inc.www.personalhealthzone.com Devil's Claw Source: Prima Communications, Inc.www.personalhealthzone.com Eugenia Clove Alternative names: Cloves; Eugenia sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Flavonoids Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,782,00.html Greater Celandine Alternative names: Chelidonium majus Source: Healthnotes, Inc. www.healthnotes.com Green-Lipped Mussel Source: Healthnotes, Inc. www.healthnotes.com Gymnema Alternative names: Gurmar; Gymnema sylvestre Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Horsetail Source: Prima Communications, Inc.www.personalhealthzone.com

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Indomethacin Source: Healthnotes, Inc. www.healthnotes.com Inosine Source: Healthnotes, Inc. www.healthnotes.com Juniper Alternative names: Juniperus communis Source: Healthnotes, Inc. www.healthnotes.com Non-steroidal Anti-Inflammatory Drugs Source: Healthnotes, Inc. www.healthnotes.com Pregnenolone Source: Healthnotes, Inc. www.healthnotes.com Sulindac Source: Healthnotes, Inc. www.healthnotes.com Trace minerals Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10061,00.html Uricosuric Agents Source: Integrative Medicine Communications; www.drkoop.com Willow Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Willow Bark Alternative names: There are several species of willow includingSalix alba, Salix nigra, Salix fragilis, Salix purpurea, Salix babylonica, White Willow, European Willow, Black Willow, Pussy Willow, Crack Willow, Purple Willow, Weeping Willow, Liu-zhi Source: Integrative Medicine Communications; www.drkoop.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. PATENTS ON GOUT Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “gout” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on gout, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Gout By performing a patent search focusing on gout, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will

8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on gout: •

Composition for treating infectious diseases, gout or arteriosclerosis containing human pepsin and/or human leukocyte pepsin-like enzyme and method for using same Inventor(s): Kosuzume; Hiroshi (Yokohama, JP), Ohnishi; Haruo (Funabashi, JP), Suzuki; Yasuo (Kawaguchi, JP), Mochida; Ei (Toshima, JP) Assignee(s): Mochida Pharmaceutical Co., Ltd. (Tokyo, JP) Patent Number: 4,534,966 Date filed: November 17, 1983 Abstract: There are provided a pharmaceutical composition having an effect to control phagocytic function, which comprises a pharmaceutically effective amount of human pepsin and/or a human leukocyte pepsin-like enzyme and a pharmaceutically acceptable carrier, and a therapeutic method using said composition. The pharmaceutical composition is useful for treatment of infectious diseases, gout and arteriosclerosis. Excerpt(s): This invention relates to pharmaceutical compositions having an effect to control phagocytic function, which comprise human pepsin and/or a human leukocyte pepsin-like enzyme as an active ingredient. One of the functions which the living body performs for maintaining homeostasis is the immune mechanism. It is known that foreign matter which has invaded from the outside or a substance which has become foreign matter in vivo can sometimes adversely affect the living body, and that the immune mechanism exerts an effect upon the attack and development of such diseases as infectious diseases, tumors, autoimmune diseases, etc. For that reason, there have lately been made attempts to treat these diseases by controlling the immune mechanism, and immunomodulators have been employed for treatment of tumors. However, the conventional immunomodulatory agents are drugs which mainly control the functions of lymphocytes which act as effectors for humoral immunity and cellular immunity, and there has been little research done on drugs which directly control phagocytic functions. Phagocytes not only engulf and digest foreign matter which has invaded the living body, e.g. microorganisms such as virus, bacteria, eumycetes, etc., and foreign matter which has been generated in the body, e.g. tumors, etc., but also play an important role in controlling immune response by transferring information on said foreign matter to lymphocytes. Further, it is believed that gout and arteriosclerosis are brought about by uric acid or cholesterol deposits generated in the body, and it is presumed that phagocytes also participate in disposal of these deposits. Therefore, drugs having an effect to control phagocytic functions are expected to be effective as drugs for treating not only such diseases to which lymphocytic function-controlling agents have been conventionally applied but also such diseases as infectious diseases, tumors, arteriosclerosis, etc. Web site: http://www.delphion.com/details?pn=US04534966__

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•

Diagnosing an animal for pyrophosphate gout, osteoporosis, or osteoarthritis by assaying intracellular pyrophosphate content in peripheral blood cells Inventor(s): Seegmiller; J. Edwin (La Jolla, CA) Assignee(s): The Regents of the University of California (Oakland, CA) Patent Number: 6,521,615 Date filed: January 4, 2001 Abstract: This invention provides a method of treating an animal with pyrophosphate gout or osteoarthritis comprising administering an effective amount of a calcium antagonist, thereby reducing calcium pyrophosphate crystal deposition in the animal. Excerpt(s): The invention is directed to the use of an existing class of calcium blocking drugs, or calcium antagonists for the correction of an underlying metabolic abnormality responsible for calcium pyrophosphate crystal formation and the resulting development of one of the most recently recognized forms of crystal-induced arthritis from deposition of these crystals in the cartilage of major joints. The first two decades of the past halfcentury marked the first successful treatment in a preventive mode of the most anciently recognized form of crystal-induced arthritis--gouty arthritis, by simply reducing the supersaturated concentrations of serum urate to the normal range by use of new drugs that became available. (Seegmiller, J E., "Conquest of Gouty Arthritis" in Landmark Advances in Rheumatology, ed. McCarty, D J (Amer. Rheum. Assn., Atlanta, Ga.) pp. 89-101 (1985)). It may well serve as a model for similar success with the above new and as yet unpublished finding. An important difference is that the elevated pyrophosphate was first found inside, instead of outside, the cells (Lust, G., et al. Arthritis Rheum (1976) 19:479-487). Inorganic pyrophosphate (PPi) serves a number of different biological functions. In bone and growth plate cartilage, extracellular inorganic PPi provides a critical source of phosphate (Pi) for the physiologic deposition of calcium phosphate crystals during bone mineralization (Ali, Y., "Calcification of Cartilage" in Cartilage: Structure, Function, Biochemistry, ed. Hall, B K (Academic, New York), pp. 343-378 (1983); Oyajobi, B O, et al., J Bone Miner Res (:1259-1266 (1944); Anderson, H C, Rhem Dis Clin North Am 14:303-319 (1988), and Rosen et al., Arthritis & Rheumatism, 40:7 (July 1997)). Web site: http://www.delphion.com/details?pn=US06521615__

•

Herbal compositions and their use as anti-inflammatory agents for alleviation of arthritis and gout Inventor(s): Tomer; Onkar S. (Watchung, NJ), Glomski; Peter (South Amboy, NJ), Borah; Kripanath (Morris Plains, NJ) Assignee(s): Chromak Research, Inc. (Somerset, NJ) Patent Number: 6,274,176 Date filed: July 1, 1999 Abstract: An edible composition for use as an anti-inflammatory agent for alleviation of arthritis and gout in mammals. The edible composition is a mixture of at least three, preferably at least seven, herbs selected from the group consisting of Tanacetum parthenium, Zingibar officinale, Curcuma longa, Coriandrum sativum, Centella asiatica, Oenothera biennis, Valeriana officinalis, Tabebuia impetiginosa, Thymus vulgaris and Sambucus nigra. A preferred composition will contain at least Tanacetum parthenium,

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Zingibar officinale and Curcuma longa. The composition preferably contains the herbs in approximately equal amounts. Excerpt(s): The present invention is directed to an edible composition for use as an antiinflammatory agent for alleviation of arthritis and gout in mammals. The composition comprises a synergistic mixture of at least three herbs selected from a group of ten herbs identified below. The prior art is replete with references to herbal medicines for treatment of a variety of ailments in mammals. Typically, such herbal medicines are obtained as the active compound(s) by extraction from plant tissues. Although the use of various herbs have been described in related areas, the synergistic combination of the herbs in the edible composition of the invention has never previously been described. Japanese Patent Publication No. 4,005,237 discloses a combination of Cinnamomum sieboldii and Allium sativum for superoxide scavenging in the treatment of inflammatory disorders. German patent Publication No. 3,724,341 discloses a combination of Cinnamomum zeylanicum, Pumica granitum cortex, Cardamon zingiberaceie fruit and Piper longum fruit. Web site: http://www.delphion.com/details?pn=US06274176__ •

Method of treating gout with certain indole compounds Inventor(s): Johnson; Douglas W (Zionsville, IN), Sawyer; Jason S (Indianapolis, IN), Morin, Jr. John M (Brownsburg, IN), Shuman; Robert T (Sedona, AZ) Assignee(s): Eli Lilly and Company (Indianapolis, IN) Patent Number: 6,303,610 Date filed: March 6, 2000 Abstract: This invention relates to a method of treating gout with certain indole compounds and other aromatic compounds. Excerpt(s): This invention relates to the use of tryptophan derivatives as inhibitors of neutrophil mediated oxidant production and their use in treating neutrophil associated diseases and disorders. Neutrophils play a vital role in the resistance of a host to infection. Key characteristics of neutrophils in this role include their ability to adhere initially to the endothelium, to migrate into tissue, and to kill engulfed microbes with oxidants and proteolytic enzymes. Unfortunately, in certain disease states, neutrophils secrete these oxidants and proteolytic enzymes extracellularly resulting in inflammatory diseases and conditions. The compounds of the present invention have been shown to effectively inhibit adhesion-dependent oxidant production. Accordingly, this invention provides methods of treating disease and conditions associated with excess neutrophil mediated oxidant production, including the following inflammatory diseases and other conditions: smoking, chronic bronchitis, emphysema, asthma, cystic fibrosis, cancer, adult respiratory distress syndrome, Wegener's granulomatosis, idiopathic pulmonary fibrosis, collagen vascular disorders, interstitial lung disease, hypersensitivity pneumonitis, sarcoidosis, bronchiolitis obliterans with organizing pneumonia, Crohn's Disease, Secondary Sjorgren's Syndrome, rheumatoid arthritis, progressive systemic sclerosis, dermatopolymyositis, mixed connective tissue disease, familial idiopathic pulmonary fibrosis, systemic lupus erythematosus, progressive systemic sclerosis, autoimmune thyroid disease, inflammatory bowel disease, juvenile periodontitis, myocardial infarction, hemorrhagic shock, septic shock, ischemic shock, cerebral ischemia, stroke, hypertension, unstable angina, diabetes complications, thrombotic stroke, fibrosing alveolitis, bronchiectasis, periodontal disease, glomerulonephritis,

Patents 143

alcoholic hepatitis, Kawasaki Disease, gingivitis, chronic obstructive pulmonary disease, pulmonary infections (staphylococcal or klebsiella pneumonia), ulcerative colitis, psoriasis, artherosclerosis, gout, gastroesophageal reflux disease, carditis, Barrett's Esophagus, Behcet's Disease, iritis, acute glomerulonephritis, periarteritis nodosa, unstable angina, coronary artery disease, coronary angioplasty, immune complex disease, cryoglobulinemic glomerulonephritis, anti-gbm glomerulonephritis, Goodpasture's Syndrome, myositis, and acute pancreatitis. Web site: http://www.delphion.com/details?pn=US06303610__ •

Method of treating gout with novel 9-deazaguanines Inventor(s): Kostlan; Catherine R. (Ann Arbor, MI), Sircar; Jagadish C. (Ann Arbor, MI) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,102,879 Date filed: October 31, 1990 Abstract: The present invention is novel derivatives of pyrrolo[3,2-d]pyrimidines and pharmaceutical compositions and methods of use therefor. The derivatives are inhibitors of purine nucleoside phosphorylase selectively cytotoxic to T-cells but not to B-cells in the presence of 2'-deoxyguanosine and, therefore, are for use in the treatment of autoimmune diseases, gout, psoriasis or rejection of transplantation. Excerpt(s): Various purine derivatives are known including guanine derivatives having activity as inhibitors of purine nucleoside phosphoxylase (PNP-4) Ser. No. 767,202 filed Aug. 22, 1985, which is a continuation of U.S. Ser. No. 660,152 filed Oct. 12, 1984, now abandoned. Selected guanine derivatives previously known are also disclosed in the application. Therefore, U.S. Ser. No. 767,202 is incorporated herein by reference. The present invention also includes methods of manufacturing and a pharmaceutical composition for treating autoimmune diseases; such as arthritis, systemic lupus erythematosus, inflammatory bowel diseases, juvenile diabetes, myasthenia gravis, multiple sclerosis, gout and gouty arthritis, as well as psoriasis, viral infections, and cancer, or rejection of transplantation, comprising an immunomodulator or antirejection effective amount; such as a cytotoxic to T-cell amount, of a compound of the Formula I with a pharmaceutically acceptable carrier. Thus, the invention is also a method of treating an autoimmune disease, psoriasis, or rejection of transplantation as listed above comprising administering to a host, such as a mammal including a human suffering from an autoimmune disease or psoriasis or transplantation rejection advantageously affected by T-cell toxicity of the compounds of the present invention comprising administering an effective amount of a compound of the Formula I in unit dosage form. It is understood, an ordinarily skilled physician would begin treatment with a nontoxic and less than effective amount and increase the dose until the desired effect is obtained exercising care to administer an amount less than the amount toxic to the host of the disease. Under certain circumstances it may be necessary to protect either the N or O of intermediates in the above noted process with suitable protecting groups which are known. Introduction and removal of such suitable oxygen and nitrogen protecting groups are well known in the art of organic chemistry; see for example, (1) "Protective Groups in Organic Chemistry, " J. F. W. McOmie, ed., (New York, 1973), pp 43ff, 95ff; (2) J. F. W. McOmie, Advances in Organic Chemistry, Vol. 3, 191-281 (1963); (3) R. A. Borssonas, Advances in Organic Chemistry, Vol. 3, 159-190 (1963); and (4) J. F. W. McOmie, Chem. & Ind., 603 (1979).

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Web site: http://www.delphion.com/details?pn=US05102879__ •

Methods, compounds and compositions for treating gout Inventor(s): Li; Jia-He (Cockeysville, MD), Zhang; Jie (Ellicott City, MD) Assignee(s): Guilford Pharmaceuticals Inc. (Baltimore, MD) Patent Number: 6,348,475 Date filed: June 1, 2001 Abstract: This invention relates to methods of preventing, treating or lessening the severity of gout by administration of PARP inhibitors. Excerpt(s): The present invention relates to methods of treating gout with inhibitors of the nuclear enzyme poly(adenosine 5'-diphospho-ribose) polymerase ["poly(ADPribose) polymerase" or "PARP", which is also referred to as ADPRT (NAD:protein (ADPribosyl transferase (polymersing)) and PARS (poly(ADP-ribose) synthetase) and provides compounds and compositions containing the disclosed compounds for use in the disclosed method. Reviews of PARP as well as the effects of inhibiting the same may be found, for example, in PCT/US98/18184, PCT/US98/18226, PCT/US98/18187, PCT/US98/18195, PCT/US98/18196, PCT/US98/18188, PCT/US98/18189, PCT/US98/18185, PCT/US98/18186, the entire contents of each of which are hereby incorporated by reference. Deposition of crystals of monosodium urate (MSU crystals) in the joint articular space is the etiological cause of inflammatory pathologies such as gout and pseudogout. Clinically, these inflammatory diseases are associated with oedema and erythema of the joints with consequently severe pain. A strong infiltration of leucocytes in the intraarticular and periarticular space leading to: 1) acute, episodic articular and periarticular inflammation, and 2) chronic articular changes, are also characteristic of this pathology. It has long been clear that neutrophils are the predominant cell type recovered from these inflammatory joints (Dieppe et al., (1979). Synovial fluid crystals. Q. J. Med. XLVIII: 533-553; Terkletaub, (1991). Monocyte-derived neutrophil chemotactic factor/interleukin-8 is a potential mediator of crystal-induced inflammation. Arth. Rheum. 34: 894-903.). A better understanding of the inflammatory processes elicited by MSU crystals, and the fact that there is a clear relationship between these crystals and gouty arthritis, has prompted the characterisation of experimental models of crystal-induced inflammation. Examples of models where crystal challenge has led to call recruitment into specific cavities, are canine joints (Phelps & McCarty, 1966, Ann Int. Med. 9: 115-125), rat pleurisy (Deporter et al., 1979, Br. J. Pharmacol. 65: 163-165; Sedgwick et al., 1985, Agents Actions 17: 209-213), and utilisation of a preformed rat air-pouch (Brookes et al., 1987). The latter experimental system has shown that neutrophil accumulation was related to generation of chemoattractants such as LTB.sub.4, which was subsequently inhibited by colchicine (Brooks et al., 1987, Br. J. Pharmacol. 90: 413-419). Web site: http://www.delphion.com/details?pn=US06348475__

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•

Oxypurinol alkali and alkaline earth salts in amorphorous or crystalline form as agents for treating hyperuricaemia and gout Inventor(s): Scheiffele; Ekkehard (Berlin, DE) Assignee(s): Henning Berlin GmbH Chemie-Und Pharmawerk (Berlin, DE) Patent Number: 5,661,154 Date filed: February 6, 1995 Abstract: Treatment of hyperuricaemia and gout is possible by agents, among usual carriers and adjuvants containing pharmakologically active doses of oxypurinol alkali and/or alkaline earth salts in amorphous or crystalline form. Excerpt(s): Therapy of hyperuricaemia and gout may be carried out using uricostatic or uricosuric agents or a combination of an uricostatic and an uricosuric agent. Generally, the xanthine oxidase inhibitors allopurinol or thiopurinol are being used as uricostatic agents; and as uricosuric agents, sulfinpyrazone and benzbromarone are primarily used. Investigations concerning the mechanism of action of allopurinol revealed that allopurinol has little activity itself, but that itstherapeutic effect is achieved only after metabolizing to give 4,6-dihydroxypyrazolo[3,4-d]pyrimidine (oxypurinol). Allopurinol and oxypurinol are inhibiting the enzyme xanthine oxidase equally strongly. However, the residence time of allopurinol within the organism--being well resorbable from appropriate galenic formulations upon peroral application--is only about 6 hours; thereafter, the major portion has been transformed to oxypurinol, part of it is metabolized to allopurinol 1-riboside, and a further 3 to 10% is excreted via kidneys. In comparison, oxypurinol has a half-life of about 22 hours, and, therefore, is the intrinsically active principle in an allopurinol therapy, while allopurinol has to be regarded as a prodrug. It would be a substantial progress and a great advantage, if one could succeed in using oxypurinol itself for gout therapy. For this reason, many attempts have been made to administer the intrinsically active substance, oxypurinol, instead of the prodrug allopurinol. However, failure was encountered, because no success was achieved in finding a galenic formulation being sufficiently resorbable per os. Thus, Elion et al. (Renal Clearance of Oxypurinol, The Chief Metabolite of Allopurinol, American Journal of Medicine, Vol. 45, July 1968) had already carried out such experiments, though with negative results; also cf. Chalmers et al., Clin. Sci. 35, 353-362 (1968). Even by using oxypurinol in micronized form, no practicable form of drug could be created. Web site: http://www.delphion.com/details?pn=US05661154__

Patent Applications on Gout As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to gout:

9

This has been a common practice outside the United States prior to December 2000.

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•

Method for treating gout and binding uric acid Inventor(s): Burke, Steven K. (Sudbury, MA), Holmes-Farley, Stephen Randall; (Arlington, MA) Correspondence: HAMILTON, BROOK, SMITH & REYNOLDS, P.C. 530 VIRGINIA ROAD; P.O. BOX 9133; CONCORD; MA; 01742-9133; US Patent Application Number: 20030039627 Date filed: April 17, 2002 Abstract: A method for treating gout and/or reducing serum uric acid levels in a patient is disclosed that includes administering to the patient a therapeutically effective amount of an amine polymer, for example, an aliphatic amine polymer. In one embodiment, the polymer binds to uric acid or a precursor thereof. Examples of polymers useful in an embodiment of the invention include sevelamer hydrochloride and colesevelam. The invention includes the use of amine polymers such as a cross-linked polymer characterized by a repeat unit having the formula: 1and salts and copolymers thereof, where n is a positive integer and x is zero or an integer between 1 and about 4. Also described is a use, for the manufacture of a medicament, of a polymer that binds serum uric acid in a patient. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/305,567, filed on Jul. 13, 2001, and U.S. Provisional Application No. 60/284,445, filed on Apr. 18, 2001. The entire teachings of the above application(s) are incorporated herein by reference. The prevalence of gout is approximately 1.3 to 3.7 percent of the general population. Individuals suffering from gout excrete approximately 40 percent less uric acid, the final breakdown product of purine degradation, than nongouty individuals for any given plasma urate concentrations. Hyperuricemia, a condition which precedes gout, can result from increased production or decreased excretion of uric acid, or from a combination of the two processes. In an individual with hyperuricemia, plasma and extracellular fluids are supersaturated with urate (a serum uric acid level greater than 8.5 mg/dL at baseline), and crystal deposition in tissue is likely to occur, resulting in the clinical manifestations of gout. Acute gout typically results following a prolonged period in which excessive amounts of uric acid and urate are present in serum. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Methods, compounds and compositions for treating gout Inventor(s): Li, Jia-He; (Cockeysville, MD), Zhang, Jie; (Ellicott City, MD) Correspondence: NIXON & VANDERHYE P.C. 1100 North Glebe Rd., 8th Floor; Arlington; VA; 22201-4714; US Patent Application Number: 20020019417 Date filed: June 1, 2001 Abstract: This invention relates to methods of preventing, treating or lessening verity of gout by administration of PARP inhibitors. Excerpt(s): The present invention relates to methods of treating gout with inhibitors of the nuclear enzyme poly(adenosine 5'-diphospho-ribose) polymerase ["poly(ADPribose) polymerase" or "PARP", which is also referred to as ADPRT (NAD:protein (ADPribosyl transferase (polymersing)) and PARS (poly(ADP-ribose) synthetase) and provides compounds and compositions containing the disclosed compounds for use in

Patents 147

the disclosed method. Reviews of PARP as well as the effects of inhibiting the same may be found, for example, in PCT/US98/18184, PCT/US98/18226, PCT/US98/18187, PCT/US98/18195, PCT/US98/18196, PCT/US98/18188, PCT/US98/18189, PCT/US98/18185, PCT/US98/18186, the entire contents of each of which are hereby incorporated by reference. Deposition of crystals of monosodium urate (MSU crystals) in the joint articular space is the etiological cause of inflammatory pathologies such as gout and pseudogout. Clinically, these inflammatory diseases are associated with oedema and erythema of the joints with consequently severe pain. A strong infiltration of leucocytes in the intraarticular and periarticular space leading to: 1) acute, episodic articular and periarticular inflammation, and 2) chronic articular changes, are also characteristic of this pathology. It has long been clear that neutrophils are the predominant d cell type recovered from these inflammatory joints (Dieppe et al., (1979). Synovial fluid crystals. Q. J. Med. XLVIII: 533-553; Terkletaub, (1991). Monocyte-derived neutrophil chemotactic factor/interleukin-8 is a potential mediator of crystal-induced inflammation. Arth. Rheum. 34: 894-903.). A better understanding of the inflammatory processes elicited by MSU crystals, and the fact that there is a clear relationship between these crystals and gouty arthritis, has prompted the characterisation of experimental models of crystal-induced inflammation. Examples of models where crystal challenge has led to cell recruitment into specific cavities, are canine joints (Phelps & McCarty, 1966, Ann Int. Med. 9: 115-125), rat pleurisy (Deporter et al., 1979, Br. J. Pharmacol. 65: 163-165; Sedgwick et al., 1985, Agents Actions 17: 209-213), and utilisation of a preformed rat air-pouch (Brookes et al., 1987). The latter experimental system has shown that neutrophil accumulation was related to generation of chemoattractants such as LTB.sub.4, which was subsequently inhibited by colchicine (Brooks et al., 1987, Br. J. Pharmacol. 90: 413-419). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with gout, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “gout” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on gout. You can also use this procedure to view pending patent applications concerning gout. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON GOUT Overview This chapter provides bibliographic book references relating to gout. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on gout include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “gout” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on gout: •

Podiatry Sourcebook Source: Detroit, MI: Omnigraphics, Inc. 2001. 392 p. Contact: Available from Omnigraphics, Inc. 615 Griswold Street, Detroit, MI. (800) 2341340. Fax (800) 875-1340. Website: www.omnigraphics.com. PRICE: $78.00 plus shipping. ISBN 0780802152. Summary: This book provides the general public and the layperson who has been diagnosed with a serious disease or disorder with general information about the practice of podiatry and health information about foot conditions, diseases, and injuries. Part 1 offers general information about foot care, including tips on selecting a podiatrist, facts about problems associated with shoe fit, and an overview of treatments for foot problems. The chapters in part 1 also provide information for special populations, such as pregnant women, the elderly, people who have diabetes, children, and athletes. Part 2 discusses the etiology, diagnosis, and treatment of common foot conditions, including

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athlete's foot, ingrown toenail, onychomycosis, skin disorders, foot odor, clawtoes, hammertoes, bunions, burning feet, peripheral neuropathy, Morton's neuroma, tarsal tunnel syndrome, clubfoot, pigeon toes, genetic foot disorders, and structural deformities. Part 3 presents information about foot-related problems caused by diseases such as diabetes, neuropathic arthropathy, gout, arthritis, Parkinson's disease, and AIDS. Part 4 offers facts about the etiology, diagnosis, and treatment of foot injuries, including heel pain, Sever's disease, overuse injuries, foot and ankle fractures, ankle sprains, great toe and midfoot injuries, tendinitis, bursitis, and sports-related injuries. The final chapter in part 4 presents information for amputees. Part 5 provides a glossary of podiatry terms, lists medical resources for foot care, and offers a directory of resources specific to foot safety. 55 figures, 11 tables, and numerous references. •

PDR for Herbal Medicines. 1st ed Source: Montvale, NJ: Medical Economics Company. 1998. 1244 p. Contact: Available from Medical Economics Publishing Inc. P.O. Box 10689, Des Moines, IA 50336. (800) 922-0937. Fax (515) 284-6714. Website: www.medecbookstore.com. PRICE: $59.99. ISBN: 1563632926. Summary: Most of today's herbal remedies exhibit varying degrees of therapeutic value. Some, such as ginkgo, valerian, and saw palmetto, seem genuinely useful, while others, such as ephedra, tansy, and nightshade, can actually be dangerous. As the use of unfamiliar botanicals spreads, the need to steer patients toward the few truly useful preparations and warn them away from ineffective, dangerous alternatives is becoming an increasingly significant priority. This volume, from the publishers of Physicians Desk Reference, brings together the findings of the German Regulatory Authority's herbal watchdog agency (commonly caused Commission E). This agency conducted an intensive assessment of the peer-reviewed literature on some 300 common botanicals, weighing the quality of the clinical evidence and identifying the uses for which the herb can reasonably be considered effective. This reference book contains profiles of over 600 medicinal herbs. Each entry contains up to 9 standard sections: name(s), description, actions and pharmacology, indications and usage, contraindications, precautions and adverse reactions, overdosage, dosage, and literature. The entries have also been indexed by scientific and common name, indications, therapeutic category, and side effects. To assist in identification, the reference book includes a section of full-color plates of the plants included. The book concludes with a glossary of the specialized botanical nomenclature and other unfamiliar terminology, a list of poison control centers, and a list of drug information centers. Some of the herbs are listed for use for abdominal cramps or distress, acid indigestion, appetite stimulation, rectal bleeding, various bowel disorders, stomach cancer, cholelithiasis (gallstones), colic, colitis, constipation, dehydration, diarrhea, digestive disorders, dysentery, enteritis, anal fissure, flatulence (intestinal gas), gastritis, gastroenteritis, gastrointestinal disorders, gout, helminthiasis, hemorrhage, hemorrhoids, hepatitis, hypercholesterolemia, jaundice, liver and gall bladder complaints, liver disorders, malaria, nausea, abdominal pain, and vomiting.

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Foods That Harm, Foods That Heal: An A-Z Guide to Safe and Healthy Eating Source: Pleasantville, NY: Reader's Digest. 1997. 400 p. Contact: Available from Customer Service, Reader's Digest. Pleasantville, NY 10570. (800) 846-2100. PRICE: $30.00. ISBN: 0895779129.

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Summary: This nutrition reference book features more than 400 photographs and illustrations with more than 400 A to Z entries on a vast range of foods and health concerns, include caffeine, cancer, diabetes, fast food, garlic, heart disease, influenza, osteoporosis, pregnancy, sexually transmitted diseases, and vegetarianism. The book is designed to provide families with information to help understand the close links between foods and wellness. Each food entry provides at-a-glance information on its nutrients (or lack of) and its benefits and drawbacks. Each ailment is accompanied by a list of foods and beverages that are considered safe, and what foods or beverages should be cut down or avoided altogether. Personalized case studies help to illustrate various topics. There are special features on eating during different life stages, from infancy to old age, as well as such issues as genetically altered foods, irradiation, pesticides, and pollution. Other topics include how to cook foods to achieve maximum nutritional benefits; which dietary supplements really work; tips on exercising, storing food, and reading food labels; an instructive analysis of the most popular diet regimens; and controversial foods and additives such as eggs, nitrites, bran, cheese, milk, fat, wine, and alcohol. A glossary defines unfamiliar or technical terms; there is also a listing of organizations that can provide further information and resources. Topics specifically related to digestive diseases include allergic reactions to food, anorexia nervosa, antioxidants, appetite loss, basic food groups, carbohydrates, celiac disease, childhood and adolescent nutrition, cholesterol, constipation, convenience foods, Crohn's disease, diarrhea, dieting and weight control, digestive and malabsorption disorders, diverticulitis, fats, fiber, food poisoning, gastritis, gastroenteritis, gout, hiatal hernia, indigestion and heartburn, intolerance to milk and other foods, irritable bowel syndrome, malnutrition, medicine-food interactions, minerals, obesity, organic and health foods, preparation and storage of food, restaurants and eating out, smoking and diet, sports nutrition, supplements, traveler's health, ulcers, vitamins, and worms and other parasites. •

101 Foot Care Tips for People with Diabetes Source: Alexandria, VA: American Diabetes Association. 2000. 120 p. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $14.95 plus shipping and handling. ISBN: 158040040X. Summary: This book answers 101 of the most commonly asked questions about diabetes and foot care. Questions in chapter one provide general information about foot care, including the importance of foot care; the foot problems people with diabetes experience; the people at greatest risk for developing foot problems; the prevention of diabetic foot problems; the role of weight, blood glucose control, and meal planning in diabetic foot problems; and health care checkups. Chapter two offers tips on washing and soaking the feet; caring for dry skin; and dealing with athlete's foot fungus, foot odor, and foot swelling. The third chapter provides tips for nail care, including trimming toenails and caring for ingrown toenails. Questions in chapter four provide information on shoe and sock selection. Topics include selecting shoes that fit properly, using insoles and orthotic devices, and seeing a pedorthist. This is followed by a chapter that explains how to treat minor foot problems, including blisters, corns, calluses, warts, bunions, minor injuries, and deformities. Chapter six provides tips for exercising. Questions in the next chapter deal with the identification of major problems, including foot ulcers and infections. This is followed by chapters that answer questions about complications such as peripheral neuropathy and poor circulation. Topics include the

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symptoms, diagnosis, and treatment of these complications. The final chapter answers questions about other foot problems, including arthritis, gout, Charcot's joint, osteomyelitis, gangrene, and toe amputation. The book also includes a list of resources and an index.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “gout” at online booksellers’ Web sites, you may discover nonmedical books that use the generic term “gout” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “gout” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Acute Gout: The Devil's Curse by Macey Casebeer (1995); ISBN: 096455464X; http://www.amazon.com/exec/obidos/ASIN/096455464X/icongroupinterna

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Alberto Gout (1907-1966) by Eduardo de la Vega Alfaro; ISBN: 9688054143; http://www.amazon.com/exec/obidos/ASIN/9688054143/icongroupinterna

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Arthritis Sourcebook: Basic Consumer Health Information About Specific Forms of Arthrits and Related Disorders, Including Rheumatoid Arthritis, Osteoarthrits, Gout, polymya (Health Reference Series, Vol 46) by Allan R. Cook (Editor) (1998); ISBN: 0780802012; http://www.amazon.com/exec/obidos/ASIN/0780802012/icongroupinterna

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Doctor Discusses Learning to Cope with Arthritis Rheumatism and Gout by Robert E. Dunbar (1990); ISBN: 0318375044; http://www.amazon.com/exec/obidos/ASIN/0318375044/icongroupinterna

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Eclectic Tastes: Fine and Decorative Arts from the McCord/Questions De Gout: Arts Decoratifs Et Beaux-Arts Au McCord by Conrad Graham, et al (1992); ISBN: 0773509666; http://www.amazon.com/exec/obidos/ASIN/0773509666/icongroupinterna

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Getting Rid of Gout by Bryan Emmerson (2003); ISBN: 0195516672; http://www.amazon.com/exec/obidos/ASIN/0195516672/icongroupinterna

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Gout by Roy Porter, et al; ISBN: 0300082746; http://www.amazon.com/exec/obidos/ASIN/0300082746/icongroupinterna

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Gout - the 'At Your Fingertips Guide' (At Your Fingertips) by Rodney Grahame, et al; ISBN: 1859590675; http://www.amazon.com/exec/obidos/ASIN/1859590675/icongroupinterna

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Gout (Domestic Ambient Noise Series) by Lawrence Upton, Bob Cobbing; ISBN: 0861627431; http://www.amazon.com/exec/obidos/ASIN/0861627431/icongroupinterna

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Gout and hyperuricemia by James B. Wyngaarden; ISBN: 0808909460; http://www.amazon.com/exec/obidos/ASIN/0808909460/icongroupinterna

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Gout and Its Cure by J.Compton Burnett (1998); ISBN: 8170216346; http://www.amazon.com/exec/obidos/ASIN/8170216346/icongroupinterna

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Gout and pseudogout : discussions in patient management by H. Ralph Schumacher; ISBN: 0874888883; http://www.amazon.com/exec/obidos/ASIN/0874888883/icongroupinterna

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Gout and the gouty by William Asbury Smith; ISBN: 0811103331; http://www.amazon.com/exec/obidos/ASIN/0811103331/icongroupinterna

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Gout and uric acid metabolism by John Harold Talbott; ISBN: 0913258385; http://www.amazon.com/exec/obidos/ASIN/0913258385/icongroupinterna

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Gout Hater's Cookbook : Recipes Lower in Purines by Jodi Schneiter; ISBN: 1888141719; http://www.amazon.com/exec/obidos/ASIN/1888141719/icongroupinterna

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Gout Hater's Cookbook II: The Low Purine Diet Cookbook by Jodi Schneiter; ISBN: 1888141808; http://www.amazon.com/exec/obidos/ASIN/1888141808/icongroupinterna

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Gout Haters Cookbook: Recipes Low in Purines by Jodi Schneiter, Renee Miller (Editor) (1997); ISBN: 1888141549; http://www.amazon.com/exec/obidos/ASIN/1888141549/icongroupinterna

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Gout, Hyperuricemia, and Other Crystal-Associated Arthropathies by Charley J. Smyth (Editor), V. Michael Holers (Editor); ISBN: 0824702107; http://www.amazon.com/exec/obidos/ASIN/0824702107/icongroupinterna

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Gout: recent studies; ISBN: 0842271910; http://www.amazon.com/exec/obidos/ASIN/0842271910/icongroupinterna

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Gouty Arthritis and Gout: An Ancient Disease With Modern Interest by Thomas Albert Segaloff Weiss; ISBN: 0398020353; http://www.amazon.com/exec/obidos/ASIN/0398020353/icongroupinterna

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How to Eat Away Arthritis and Gout by Norman D. Ford; ISBN: 0134056477; http://www.amazon.com/exec/obidos/ASIN/0134056477/icongroupinterna

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Hyperuricaemia and Gout in Clinical Practice by Bryan T Emerson (1983); ISBN: 0683100068; http://www.amazon.com/exec/obidos/ASIN/0683100068/icongroupinterna

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Kidney in Gout and Hyperuricemia by Ts'Ai-Fan Yu (Editor), et al; ISBN: 0879931736; http://www.amazon.com/exec/obidos/ASIN/0879931736/icongroupinterna

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Purine and Pyrimidine Metabolism in Man: Part A: Chemotherapy, Atp Depletion, and Gout (Advances in Experimental Medicine and Biology, 309A) by R. Angus Harkness, et al (1992); ISBN: 030644092X; http://www.amazon.com/exec/obidos/ASIN/030644092X/icongroupinterna

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The 2002 Official Patient's Sourcebook on Gout by James N., Md. Parker (Editor), et al (2002); ISBN: 0597832404; http://www.amazon.com/exec/obidos/ASIN/0597832404/icongroupinterna

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The arthritis handbook: a patient's manual on arthritis, rheumatism and gout by Darrell C. Crain; ISBN: 0682472115; http://www.amazon.com/exec/obidos/ASIN/0682472115/icongroupinterna

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The Gout-Lover's Cookbook by Jodi Vickers (1995); ISBN: 1888141514; http://www.amazon.com/exec/obidos/ASIN/1888141514/icongroupinterna

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The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “gout” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 •

A doctor discusses learning to cope with arthritis, rheumatism, and gout, by Robert E. Dunbar in consultation with Harold F. Seegall. Author: Dunbar, Robert E.; Year: 1966; Chicago, Budlong, c1973

•

A letter to Dr. Cadogan with remarks on the most interesting paragraphs in his Treatise on the gout: in which the immediate cause of a fit of the gout is proved, both from observation and experiments: with the reasons assigned, why the gout prevails now, more than it did some ages ago Author: Smith, Daniel,; Year: 1972; London: Printed for Carnan and Newberry, booksellers., [1772]

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About gout; a handbook for patients. Author: Arthritis and Rheumatism Foundation.; Year: 1956; [New York, c1959]

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An apology to the public for commencing the practice of physic: particularly in gouty, rheumatic, and hysterical cases: in which are related some recent and extraordinary cures of the gout, performed on gentlemen of credit and property, by a course of medicines no less safe than efficacious Author: Smith, Daniel,; Year: 1956; [London]: Printed for Carnan and Newberry, in St. Paul's Churchyard., [1775]

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An attempt to restore the primitive natural constitution of mankind, and to increase conjugal procreation: to which are added cursory observations on the gout, together with the correspondence between Mr. Hawes and the author relative to the interment of the dead: the author's principal remarks on that subject having been omitted in the pamphlet lately published by the former gentleman inscribed to Dr. Cadogan Author: Renwick, William,; Year: 1972; London: Printed for the author, and sold by S. Bladon., [1778]

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Cases in the acute rheumatism and the gout: with cursory remarks, and the method of treatment Author: Dawson, Thomas,; Year: 1960; London: Printed for J. Johnson. and P. Elmsly., 1776

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Comparison of renal urate clearances and ratios in gouty, chronic hyperuricemia, and nongouty individuals. Author: Colton, Roger Sherman,; Year: 1973; [Minneapolis] 1964

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Gout and gouty arthritis. Author: Talbott, John H. (John Harold),; Year: 1954; New York, Grune; Stratton, 1953

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Gout and the gouty. Author: Smith, William Asbury,; Year: 1970; San Antonio, Tex., Naylor [c1970]; ISBN: 811103331

10

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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Gout, by William Charles Kuzell and Guy Pierre Gaudin. Author: Kuzell, William Charles,; Year: 1965; [Basle, Geigy, 1956]

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Gout. Author: Talbott, John H. (John Harold),; Year: 1957; New York, Grune; Stratton, 1964

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Gout. With a chapter on intermediary purine metabolism, by J. E. Seegmiller. Author: Talbott, John H. (John Harold),; Year: 1970; New York, Grune; Stratton, 1967

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Gout; diagnosis and treatment; a publication for physicians prepared in conjunction with an exhibit on gout. Author: National Institute of Arthritis and Metabolic Diseases (U.S.); Year: 1968; Bethesda, Md. [1967]

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Help for ten million; a manual for patients with arthritis, rheumatism, and gout. Author: Crain, Darrell C.,; Year: 1973; Philadelphia, Lippincott [c1959]

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Instructions for the proper use and application of the remedies prescribed for the gout Author: Smith, Daniel,; Year: 1954; [London]: Printed for Carnan and Newberry, in St. Paul's Churchyard., 1775?]

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Observations on Doctor Williams's Treatise upon the gout Author: Smith, Daniel,; Year: 1971; Bristol: Printed by S. Farley: sold by T. Cadell, Bristol: Frederick and Taylor, Bath: Carnan and Newberry, and J. Wilkie. and T. Cadell. London, [1775?]

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Some observations on the on the origin, progress, and method of treating the atrabilious temperament and gout Author: Grant, William,; Year: 1776; London: Printed for T. Cadell., 1779-1781

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Surgery of osteoarthritis [by] Leonard Marmor. Diabetes mellitus and gout [by] Keith D. Buchanan. Sjögren's syndrome [by] Martin A. Shearn. Author: Marmor, Leonard,; Year: 1964; [New York] Grune; Stratton, 1972

Chapters on Gout In order to find chapters that specifically relate to gout, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and gout using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “gout” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on gout: •

Chapter 52: Gout and Pseudogout Source: in Berkow, R., ed. The Merck Manual of Medical Information: Home Edition (online version). Rahway, NJ: Merck and Company, Inc. 2000. 4 p. Contact: Available online from Merck and Company, Inc. (800) 819-9456. Website: www.merck.com/pubs/mmanual_home/contents.htm. Also available from your local book store. PRICE: $29.95 plus shipping. Summary: This chapter provides the general public and people who have gout or pseudogout with information on the symptoms, diagnosis, and treatment of these disorders, which are caused by crystal deposits in the joints. Gout is characterized by sudden, recurring attacks of very painful arthritis caused by deposits of monosodium urate crystals. Gout attacks may be triggered by surgery, consumption of large quantities of alcohol or protein rich food, fatigue, emotional stress, or illness. Severe

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pain occurs suddenly in one or more joints, and it becomes progressively worse. The joint becomes swollen, and the skin over it appears red or purplish, tight, and shiny. Other symptoms include fever, chills, a generally sick feeling, and a rapid heartbeat. Gout most often affects the joint at the base of the big toe. Symptoms gradually disappear after a few days, and no symptoms appear until the next attack. If gout progresses, untreated attacks last longer, occur more frequently, and affect several joints. Diagnosis is made on the basis of the distinctive symptoms of gout and an examination of the joint. A high uric acid level in the blood supports the diagnosis. The identification of needle shaped urate crystals in a sample of joint fluid confirms the diagnosis. The first step in treating gout is to relieve pain by controlling the inflammation with colchicine, nonsteroidal antiinflammatory drugs (NSAIDs), and corticosteroids. The next step is to prevent recurrences. Long term drug treatment with low doses of colchicine, NSAIDs, probenecid, sulfinpyrazone, or allupurinol may be needed for people who have repeated, severe attacks. Pseudogout is characterized by intermittent attacks of painful arthritis caused by deposits of calcium pyrophosphate crystals. Symptoms vary from person to person. Diagnosis is based on the identification of calcium pyrophosphate crystals in joint fluid. X rays may support the diagnosis. Treatment with NSAIDs, colchicine, or corticosteroid crystal suspension can stop acute attacks and prevent new attacks but cannot prevent damage to the affected joint.

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CHAPTER 6. MULTIMEDIA ON GOUT Overview In this chapter, we show you how to keep current on multimedia sources of information on gout. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Bibliography: Multimedia on Gout The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in gout (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on gout: •

Crystalline arthritis [slide]: gout Source: by Bruce M. Rothschild; Year: 1982; Format: Slide; [Westport, Conn.]: Medical Education Programs, c1982

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Gout [motion picture] Source: Burroughs Wellcome Co. produced by MEDCOM; Year: 1971; Format: Motion picture; Research Triangle Park: Burroughs Wellcome: [for loan by Burroughs Wellcome Co., Hospital Services Dept.], c1971

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Gout [slide] Source: Herbert S. Diamond; Year: 1979; Format: Slide; [New York]: Medcom, c1979

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Gout [slide]. Year: 1983; Format: Slide; [Tempe, Ariz.]: C.E. Institute, c1983

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Gout and gouty arthritis [slide] Source: Continuing Education Committee of the New York State Podiatry Society, Western Division; Year: 1975; Format: Slide; [Buffalo, N. Y.]: Communications in Learning, 1975

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Gout and hyperuricemia [videorecording] Source: [presented by] Audio-Video Digest Foundation, in collaboration with the University of California, San Francisco, School of Medicine; Year: 1981; Format: Videorecording; [Berkeley, Calif.]: Regents of the University of California, c1981

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Management of hyperuricemia and gout [videorecording] Source: Biomedical Media Production Unit, the University of Michigan Medical Center, Office of Educational

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Resources & Research; Year: 1981; Format: Videorecording; Ann Arbor, Mich.: The University, c1981

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CHAPTER 7. PERIODICALS AND NEWS ON GOUT Overview In this chapter, we suggest a number of news sources and present various periodicals that cover gout.

News Services and Press Releases One of the simplest ways of tracking press releases on gout is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “gout” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to gout. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “gout” (or synonyms). The following was recently listed in this archive for gout: •

Gout drug looked at for prevention of heart attack Source: Reuters Health eLine Date: August 14, 2003 http://www.reutershealth.com/archive/2003/08/14/eline/links/20030814elin003.htm l

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Savient gout treatment clears phase I Source: Reuters Industry Breifing Date: July 07, 2003

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Amino acid, gout drug mend smokers' artery damage Source: Reuters Health eLine Date: January 06, 2003

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Independent link between gout and kidney stones suggests shared etiology Source: Reuters Medical News Date: August 02, 2002

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Gout drug may help heart failure patients Source: Reuters Health eLine Date: June 17, 2002

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Ice packs may help ease pain of gouty arthritis Source: Reuters Health eLine Date: March 01, 2002

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Gout drug shows promise for heart failure: study Source: Reuters Health eLine Date: November 13, 2001

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Gout drug shows promise for heart failure in early study Source: Reuters Industry Breifing Date: November 13, 2001

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Gout drug shows promise as heart failure therapy Source: Reuters Medical News Date: November 13, 2001

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Maintaining low serum urate levels prevents attacks of gout Source: Reuters Industry Breifing Date: April 13, 2001

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Reduced-carbohydrate/calorie diet halves frequency of acute gout episodes Source: Reuters Medical News Date: August 15, 2000

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Gout frequently unrecognized in the Asia-Pacific region Source: Reuters Medical News Date: June 09, 2000

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Japanese gout drugs tied to six deaths Source: Reuters Medical News Date: February 24, 2000

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Arthrocentesis effective for diagnosing gout between acute attacks Source: Reuters Medical News Date: November 22, 1999

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TAP Holdings licenses gout compound Source: Reuters Medical News Date: October 07, 1999

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Gout No Picnic for T. Rex Source: Reuters Health eLine Date: May 21, 1997 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “gout” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or

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you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “gout” (or synonyms). If you know the name of a company that is relevant to gout, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “gout” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “gout” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on gout: •

Gout: A Painful Joint Disorder Source: Mayo Clinic Health Letter. 19(11): 1-3. November 2001. Contact: Available from Mayo Clinic Health Letter. 200 First Street, SW, Rochester, MN 55905. (800) 333-9037 or (303) 604-1465. E-mail: [email protected]. Summary: This newsletter article provides people who have gout with information on this painful joint disorder. Although gout is characterized by acute inflammation commonly affecting the big toe, it can affect the knees, ankles, and wrists. Symptoms occur when high levels of uric acid in the blood, or other triggers, cause urate crystals to form in joint spaces and other tissues. Gout occurs more frequently in men than in women, especially in men between 40 and 50 years old. Risk factors include excess weight, certain medical conditions, excessive alcohol intake or intake of foods high in purines, certain medications, surgery, and severe illness or injury. A gout attack produces intense pain, usually in one joint at a time. Symptoms typically resolve over several days. Untreated gout may result in increased pain and joint damage. Diagnosis is based on analysis of synovial fluid from the affected joint and a blood test to check for elevated uric acid levels. Nonsteroidal antiiflammatory drugs, prednisone, and colchicine may be used to treat gout. Preventive medications, such as allopurinol, probenecid, and sulfinpyrazone, may be prescribed to prevent future attacks. Lifestyle changes may also help prevent repeat gout attacks. 1 figure.

•

Gout: How To Control an Ancient Disease Source: Mayo Clinic Women's HealthSource. 4(6): 6. June 2000. Contact: Available from Mayo Clinic Women's HealthSource, 200 First Street SW, Rochester, MN 55905. (800) 876-8633 or (303) 604-1465. Email: [email protected].

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Summary: This newsletter article provides people who have gout with information on controlling this disease. Gout, or gouty arthritis, has been recognized for more than 2,000 years. It is caused by too much uric acid. People who have gout either produce too much uric acid or excrete too little. Uric acid is typically dissolved in the blood and passed through the kidneys into the urine. When excess uric acid builds up, sharp crystals can form and deposit in a joint and surrounding tissue. This causes pain, inflammation, and swelling. Other factors that contribute to gout include foods high in purines, alcohol consumption, obesity, high cholesterol, diabetes, and medications. Diagnosis involves undergoing a blood uric acid test and having fluid drawn from the affected joint to look for crystals. An acute attack can be treated with nonsteroidal antiinflammatory drugs. Preventive treatment involves a regimen of medications such as allopurinol. Lifestyle changes such as weight loss, dietary changes, and abstinence from alcohol can also help. 1 figure.

Academic Periodicals covering Gout Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to gout. In addition to these sources, you can search for articles covering gout that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for gout. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with gout. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The following

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drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to gout: Allopurinol •

Systemic - U.S. Brands: Aloprim; Zyloprim http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202021.html

Anti-Inflammatory Drugs, Nonsteroidal •

Systemic - U.S. Brands: Actron; Advil; Advil Caplets; Advil, Children's; Aleve; Anaprox; Anaprox DS; Ansaid; Bayer Select Ibuprofen Pain Relief Formula Caplets; Cataflam; Clinoril; Cotylbutazone; Cramp End; Daypro; Dolgesic; Dolobid; EC-Naprosyn; Excedrin IB; Excedrin IB Caple http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202743.html

Caffeine •

Systemic - U.S. Brands: Cafcit; Caffedrine Caplets; Dexitac Stay Alert Stimulant; Enerjets; Keep Alert; Maximum Strength SnapBack Stimulant Powders; NoDoz Maximum Strength Caplets; Pep-Back; Quick Pep; Ultra Pep-Back; Vivarin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202105.html

Citrates •

Systemic - U.S. Brands: Bicitra; Citrolith; Oracit; Polycitra Syrup; Polycitra-K; Polycitra-K Crystals; Polycitra-LC; Urocit-K http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202144.html

Colchicine •

Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202105.html

Corticosteroids •

Dental - U.S. Brands: Kenalog in Orabase; Orabase-HCA; Oracort; Oralone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202010.html

•

Inhalation - U.S. Brands: AeroBid; AeroBid-M; Azmacort; Beclovent; Decadron Respihaler; Pulmicort Respules; Pulmicort Turbuhaler; Vanceril; Vanceril 84 mcg Double Strength http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202011.html

•

Nasal - U.S. Brands: Beconase; Beconase AQ; Dexacort Turbinaire; Flonase; Nasacort; Nasacort AQ; Nasalide; Nasarel; Nasonex; Rhinocort; Vancenase; Vancenase AQ 84 mcg; Vancenase pockethaler http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202012.html

•

Ophthalmic - U.S. Brands: AK-Dex; AK-Pred; AK-Tate; Baldex; Decadron; Dexair; Dexotic; Econopred; Econopred Plus; Eflone; Flarex; Fluor-Op; FML Forte; FML Liquifilm; FML S.O.P. HMS Liquifilm; Inflamase Forte; Inflamase Mild; I-Pred; Lite Pred; Maxidex; Ocu-Dex; Ocu-Pred; Ocu-Pr http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202013.html

•

Otic - U.S. Brands: Decadron http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202014.html

•

Rectal - U.S. Brands: Anucort-HC; Anu-Med HC; Anuprep HC; Anusol-HC; Anutone-HC; Anuzone-HC; Cort-Dome; Cortenema; Cortifoam; Hemorrhoidal HC; Hemril-HC Uniserts; Proctocort; Proctosol-HC; Rectosol-HC

Researching Medications 167

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203366.html Epinephrine •

Ophthalmic - U.S. Brands: Epifrin; Epinal; Eppy/N; Glaucon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202213.html

Ethambutol •

Systemic - U.S. Brands: Myambutol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202229.html

Probenecid •

Systemic - U.S. Brands: Benemid; Probalan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202480.html

Probenecid and Colchicine •

Systemic - U.S. Brands: ColBenemid; Col-Probenecid; Proben-C http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202481.html

Pyrazinamide •

Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202480.html

Sulfinpyrazone •

Systemic - U.S. Brands: Anturane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202538.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html.

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Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to gout by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “gout” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for gout: •

Polyethylene glycol (PEG)-uricase http://www.rarediseases.org/nord/search/nodd_full?code=1086

•

Polyethylene glycol (PEG)-uricase http://www.rarediseases.org/nord/search/nodd_full?code=1121

•

Polyethylene glycol (PEG)-uricase (trade name: NONE Assigned) http://www.rarediseases.org/nord/search/nodd_full?code=1193

•

Potassium citrate (trade name: Urocit-K) http://www.rarediseases.org/nord/search/nodd_full?code=418

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

171

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

11

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “gout” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “gout” (or synonyms) into the “For these words:” box. The following is a sample result: •

Meeting the Challenge and Reaping the Rewards: Coping with Kidney Transplantation Source: in Exceptional Parent. End Stage Renal Disease: A Practical Guide for Physicians, Dietitians, Nurses, Patients, Families, and Caregivers. Englewood Cliffs, NJ: Exceptional Parent. 1999. p. 30-33. Contact: Available from Exceptional Parent. P.O. Box 1807, Englewood Cliffs, NJ 07632. (800) 535-1910. Fax (201) 947-9376. E-mail: [email protected]. Website: www.eparent.com. PRICE: $5.95. Summary: Transplantation is an ongoing journey that begins with the first visit to the transplant center. This article on coping with kidney transplantation is from a monograph written to soften the blow of receiving the diagnosis of kidney failure by providing patients, caregivers, and their families some practical, easy to read information. The articles are written to be practical enough for patients to use, yet informative enough that professionals can refer to them as well. This article reviews the pre transplant process, the transplant surgery itself, common immunosuppressive medications and their side effects, postoperative care, and common post transplant problems, including delayed graft function, acute rejection, hypertension (high blood pressure), diabetes mellitus related problems, gout (elevated uric acid), weight gain, hypercholesterolemia, infections, mood disturbances, and malignancies. One sidebar discusses covering the costs of transplantation; another focuses on rehabilitation perspectives for life after the transplant; a third shares the experience of a kidney donor who donated one of his kidneys to his infant daughter. 1 figure. 1 table.

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, 14

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

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providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “gout” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 8241 627 150 3 0 9021

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “gout” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles 15 The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17

The HSTAT URL is http://hstat.nlm.nih.gov/.

18

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 19 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 20

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each

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every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Gout In the following section, we will discuss databases and references which relate to the Genome Project and gout. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “gout” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for gout: •

Gout Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?138900

•

Gout, Hprt-related Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?300323

vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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Genes and Disease (NCBI - Map) The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

•

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

•

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

•

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

•

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html

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Entrez Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

•

Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “gout” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually

23

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html.

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limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “gout” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

24

Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on gout can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to gout. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to gout. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “gout”:

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•

Guides on gout Gout http://www.nlm.nih.gov/medlineplus/tutorials/goutloader.html Gout and Pseudogout http://www.nlm.nih.gov/medlineplus/goutandpseudogout.html

•

Other guides Arthritis http://www.nlm.nih.gov/medlineplus/arthritis.html Coronary Disease http://www.nlm.nih.gov/medlineplus/coronarydisease.html Foot Injuries and Disorders http://www.nlm.nih.gov/medlineplus/footinjuriesanddisorders.html Hepatitis C http://www.nlm.nih.gov/medlineplus/hepatitisc.html Kidney Stones http://www.nlm.nih.gov/medlineplus/kidneystones.html Kidney Transplantation http://www.nlm.nih.gov/medlineplus/kidneytransplantation.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Pancreas Transplantation http://www.nlm.nih.gov/medlineplus/pancreastransplantation.html Rheumatoid Arthritis http://www.nlm.nih.gov/medlineplus/rheumatoidarthritis.html

Within the health topic page dedicated to gout, the following was listed: •

General/Overviews Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD) (Pseudo Gout) Source: Arthritis Foundation http://www.arthritis.org/conditions/DiseaseCenter/cppd.asp Gout http://www.nlm.nih.gov/medlineplus/tutorials/goutloader.html What is Gout? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com//invoke.cfm?id=DS00090

•

Diagnosis/Symptoms Ankle Problems: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/543.html

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Foot Problems: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/544.html Hand/Wrist/Arm Problems: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/526.html Knee Problems: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/542.html Shoulder Problems: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/518.html •

Treatment 2003 Drug Guide Source: Arthritis Foundation http://www.arthritis.org/conditions/DrugGuide/default.asp Joint Injection/Aspiration Source: American College of Rheumatology http://www.rheumatology.org/patients/factsheet/injection.html

•

Specific Conditions/Aspects Gout and Your Feet Source: American College of Foot and Ankle Surgeons http://www.acfas.org/brgoutft.html

•

Organizations American College of Rheumatology http://www.rheumatology.org/ Arthritis Foundation http://www.arthritis.org/ National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/

•

Prevention/Screening Uric Acid Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/uric_acid/test.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating

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unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on gout. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Questions and Answers About Gout Source: Bethesda, MD: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 2002. 16 p. Contact: Available from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1 AMS Circle, Bethesda, MD 20892-3675. (877) 226-4267 or (301) 495-4484. Fax (301) 718-6366. TTY (301) 565-2966. E-mail: [email protected]. Website: www.niams.nih.gov. PRICE: 1 to 25 copies free. Order Number: AR-99 QA (booklet), or AR-99L QA (large print). Summary: This booklet uses a question and answer format to provide people who have gout with information on the causes, symptoms, diagnosis, and treatment of this painful rheumatic disease. A list of key words to help readers understand the terms used in this fact sheet is also included. Gout results from deposits of needle-like crystals of uric acid in the connective tissue, joint spaces, or both. These deposits lead to inflammatory arthritis. Men are more likely to develop gout than women. The joints in the big toe are affected in many people who have gout, which can also affect the instep, ankles, heels, knees, wrists, fingers, and elbows. The disease can progress through the stages of asymptomatic hyperuricemia, acute gout or acute gouty arthritis, interval or intercritical gout, and chronic tophaceous gout. Risk factors for gout include having a family history of the disease, being overweight, consuming too much alcohol, eating too many foods that are rich in purines, being exposed to lead in the environment, and taking certain medications. Diagnosis is confirmed by testing synovial fluid for monosodium urate crystals or examining joint or tophi deposits. Treatment options include taking high doses of nonsteroidal anti-inflammatory drugs, injecting corticosteroids into the affected joint, and taking colchicine. People who have gout can stay healthy by taking all prescribed medications, making followup visits to their doctor, eating a healthy diet, and exercising on a regular basis. Research on gout is focusing on treatment options. The fact sheet includes a list of additional sources of information.

•

Gout and Your Feet Source: Park Ridge, IL: American College of Foot and Ankle Surgeons. 1998. 6 p. Contact: Available from American College of Foot and Ankle Surgeons. 515 Busse Highway, Park Ridge, IL 60068. (800) 421-2237 or (847) 292-2237. Fax (800) 382-8270 or (847) 292-2022. E-mail: [email protected]. Website: www.acfas.org. PRICE: Package of 50 for members $18.50 plus shipping; for nonmembers $27.50 plus shipping. Summary: This illustrated brochure provides people who have gout with information on the symptoms, diagnosis, treatment, and prevention of this form of arthritis. Gout

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occurs as a result of the buildup of uric acid in the body and the joint fluid. This accumulation of uric acid usually occurs when the body has difficulty processing proteins known as purines. Symptoms include sudden, intense pain in one or more joints accompanied by redness, swelling, and warmth over the joint. Although symptoms commonly occur in the big toe, any joint may be affected. Diagnosis is based on a personal and family history, a physical examination, and laboratory tests. Treatment involves the use of oral antiinflammatory medications. If medical treatment is ineffective, surgery may be needed. Prevention involves avoiding foods high in purines, evaluating current medications, and drinking six to eight glasses of water per day. 3 figures. •

Gout Source: Atlanta, GA: Arthritis Foundation. 1997. 12 p. Contact: Available from Arthritis Foundation. P.O. Box 1616, Alpharetta, GA 300091616. (800) 207-8633. Fax (credit card orders only) (770) 442-9742. http://www.arthritis.org. PRICE: Single copy free from local Arthritis Foundation chapter (call 800-283-7800 for closest local chapter); bulk orders may be purchased from address above. Summary: This brochure for people with gout uses a question and answer format to provide information on the causes, diagnosis, and treatment of this disease. Gout causes sudden, severe episodes of pain, tenderness, redness, warmth, and swelling as uric acid crystals are deposited in the joints. The brochure explains what happens in acute episodes of gout, and it discusses the development of large uric acid crystal deposits known as tophi, as well as other problems. Further, the brochure identifies the causes of gout and the risk factors. It explains how gout is diagnosed, and describes medications used to treat it. The brochure also provides suggestions on taking medications such as allopurinol, probenecid, and sulfinpyrazone; explains the relationship between diet and gout; and comments on treating it with surgery. In addition, it provides information on the Arthritis Foundation and its services.

•

Managing Gout: Limiting Painful Attacks Source: San Bruno, CA: StayWell Company. 1997. 6 p. Contact: Available from StayWell Company. 1100 Grundy Lane, San Bruno, CA 940663030. (800) 333-3032. Website: www.staywell.com. PRICE: Call or write for current pricing on single and bulk orders. Summary: This brochure provides people who have gout with information on managing this joint disease. Gout is caused by too much uric acid in the blood. The excess uric acid causes crystals to form in the joints and soft tissues, resulting in severe joint inflammation. Attacks may occur weeks or months apart. If left untreated, attacks become more frequent or last longer. Gout can be controlled by avoiding triggers and taking the proper medications. Triggers include too much alcohol, obesity, foods high in purines, a sudden illness or infection, surgery, and diuretics. Medications may be used to reduce the amount of uric acid made by the body or to increase the amount of uric acid passed in the urine. The brochure offers tips on taking medications and reducing joint swelling.

•

Pseudogout Source: American College of Rheumatology. 2000. 1 p.

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Contact: American College of Rheumatology. 1800 Century Place, Suite 250, Atlanta, GA 30345. (404) 633-3777. Website: www.rheumatology.org. Email: [email protected]. Summary: This fact sheet provides patients with information on the cause, diagnosis, and treatment of pseudogout. Calcium pyrophosphate crystals collect in joint tissues resulting in swelling and pain. This condition primarily affects people over the age of 60 and has no known cause. There may be a genetic component as it sometimes runs in families. Thyroid disorders are also associated. Diagnosis of pseudogout is confirmed by finding crystals in the fluid removed from the affected joint. X-rays are used to identify the calcium containing deposits in cartilage frequently found in patients with pseudogout. No treatment can dissolve the calcium crystals in the joints but oral antiinflammatory medication and corticosteroid injections may help alleviate pain. •

Gout, and What To Do About It Source: American Family Physician. 59(7): 1810. April 1, 1999. Contact: American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail: [email protected]. Website: www.aafp.org. Summary: This journal article uses a question and answer format to provide people who have gout with information on this type of arthritis, which is caused by too much uric acid in the joints. Risk factors for gout include eating foods that are rich in purines, being overweight, drinking alcohol, having high cholesterol, or using certain medications. A gout attack usually starts at night and often affects the big toe. The joint becomes red, feels hot, and hurts, especially when touched. Medication, bed rest, and application of heat and cold should end the attack in a few days. Without treatment, a gout attack can last for days or weeks. Untreated attacks can lead to the development of tophi, which are soft tissue swellings caused by uric acid crystals. Medications that wash the uric acid from the joints can be used to prevent future attacks. Other preventive measures include losing weight; reducing blood pressure or cholesterol level; following a low salt, low fat diet; avoiding alcohol and foods that are high in purines; and drinking a lot of water.

•

Gouty Arthritis Source: Physician Assistant. 23(11): 45-46. November 1999. Summary: This information sheet uses a question and answer format to provide people who have gouty arthritis with information on this disease, which produces swelling in one or more joints as a result of deposits of uric acid. Gouty arthritis, which is commonly called gout, occurs in 2 to 2.6 per 1,000 people in the United States. In the first phase of gout, known as asymptomatic hyperuricemia, the blood has high levels of uric acid but the person has no symptoms. In the next phase, gout causes pain, stiffness, and swelling in the affected joint. The third phase, known as intercritical gout, is the phase between attacks. In the final phase, accumulations of hard crystals of uric acid, called tophi, are deposited in various areas of the body. Diagnosis is based on a physical examination, blood tests, and x rays. Acute attacks of gout may be treated with nonsteroidal anti-inflammatory drugs, colchicine, corticosteroids, and adrenocorticotropic hormones. Nonpharmacologic methods of treating acute attacks include bedrest, hot or cold compresses, and elevation of the affected joint. Preventing future attacks involves following a diet low in purine; increasing fluid intake to 3 liters per day; losing weight; and taking medications such as colchicine, indomethacin, probenecid, sulfinpyrazone, and allopurinol. 1 figure.

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Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Gout Fact Sheet Summary: This online fact sheet provides basic information for consumers about gout -a painful musculoskeletal condition caused by excessive amounts of uric acid crystals settling in the joints or other Source: Arthritis Foundation http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2216

•

Questions and Answers About Gout Summary: Gout is one of the most painful rheumatic diseases. It results from deposits of needle-like crystals of uric acid in connective tissue, in the joint space between two bones, or in both. Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6721 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to gout. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources

A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

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•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Associations and Gout The following is a list of associations that provide information on and resources relating to gout: •

Arthritis Foundation of Australia Telephone: 02 221 2456 Fax: 02 232 2538 Web Site: http://www.span.com.au/arthritis/ Background: The Arthritis Foundation of Australia is a not-for-profit organization that is committed to providing care, education, and research for people affected by arthritis and other musculoskeletal disorders. The term arthritis, meaning inflammation of the joints, may encompass several conditions or disease states, such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, and others. The Arthritis Foundation of Australia, which was founded in 1949, is dedicated to promoting research into the causes, control, and cure of arthritis; supporting the professional education and training of physicians and allied health professionals; and enhancing community awareness of the needs of those affected by arthritis. The Foundation's additional objectives include representing people with arthritis nationally and internationally, serving as national secretariat of affiliated state and territory foundations, and assisting affiliated foundations in promoting self-management programs for people with arthritis. The Arthritis Foundation of Australia currently consists of eight state and territory affiliates. These affiliated foundations offer a wide range of services to their members and represent their interests to their own state and territory governments. Each affiliated foundation may also provide the addresses of a wide network of branches and self-help groups in each state.

•

Lesch-Nyhan Syndrome Registry Telephone: (212) 263-6458 Fax: (212) 629-9523 Email: [email protected] Web Site: http://lndinfo.org Background: This is a multipurpose site for parents, patients, teachers, doctors, researchers, and students. Parents can get information on genetic testing and medical care. They can learn about adaptive equipment and exchange handyman suggestions. Parents are encouraged to register, and get help with networking. Doctors can find medical information and other areas of interest. Researchers can make contact with research subjects and participate in the research forum and essay. Students can get help with basic information and research projects. There is a glossary, a bibliography, and help finding Internet library sites. Everyone can participate in the Forum. Topics include 'Favorite Medicines', 'Diet for Behavior and Health', 'Research Ideas', 'Politics and LND', and others. A patient 'refrigerator door' is provided where patients can submit artwork, photos and written material. There is also an E-mail 'pen pal' service that helps patients

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meet other patients with Lesch-Nyhan Disease. Comments, suggestion and submissions are encouraged. •

Purine Research Society Telephone: (301) 530-0354 Fax: (301) 564-9597 Email: [email protected] Web Site: http://www2.dgsys.com/~purine/ Background: The Purine Research Society is a national nonprofit charitable organization dedicated to funding research and treatments for purine-related metabolic diseases. Errors in the metabolism of purines (compounds commonly found in food) can lead to a variety of disorders. Established in 1986 by parents of children with purine autism (autistic children who excrete too much uric acid in their urine), the Society serves people with purine metabolic disorders and their families, health care professionals, and the general public. The Society has contributed a significant amount of money to fund M.D./Ph.D. researchers to find out why their children with autism were excreting excess uric acid, the end product of purines, and is now very close to beginning a treatment protocol. The Purine Research Society provides appropriate referrals to affected individuals and offers educational pamphlets and brochures, as well as a purine restricted diet. Relevant area(s) of interest: Gout

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to gout. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with gout. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about gout. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine.

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To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “gout” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “gout”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “gout” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “gout” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.25

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

25

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)26: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

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California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

26

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries 193

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries 195

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

196 Gout

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

197

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on gout: •

Basic Guidelines for Gout Infectious arthritis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000430.htm

•

Signs & Symptoms for Gout Chills Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003091.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Nodules Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003230.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm

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Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Tachycardia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm •

Diagnostics and Tests for Gout ALT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003473.htm ESR Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003638.htm Radiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm Uric acid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003476.htm White blood cell count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003643.htm X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm

•

Background Topics for Gout Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Renal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002289.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

Online Glossaries 199

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

201

GOUT DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Cramps: Abdominal pain due to spasmodic contractions of the bowel. [NIH] Abdominal fat: Fat (adipose tissue) that is centrally distributed between the thorax and pelvis and that induces greater health risk. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Aborigines: Native inhabitants or indigenous individuals of a country. [NIH] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acromioclavicular Joint: The gliding joint formed by the outer extremity of the clavicle and the inner margin of the acromion process of the scapula. [NIH] Acromion: The lateral extension of the spine of the scapula and the highest point of the shoulder. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adhesions: Pathological processes consisting of the union of the opposing surfaces of a wound. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adolescent Nutrition: Nutrition of children aged 13-18 years. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the

202 Gout

complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Aldehyde Dehydrogenase: An enzyme that oxidizes an aldehyde in the presence of NAD+ and water to an acid and NADH. EC 1.2.1.3. Before 1978, it was classified as EC 1.1.1.70. [NIH]

Aldehydes: Organic compounds containing a carbonyl group in the form -CHO. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkalosis: A pathological condition that removes acid or adds base to the body fluids. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allograft: An organ or tissue transplant between two humans. [NIH] Allopurinol: A xanthine oxidase inhibitor that decreases uric acid production. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy,

Dictionary 203

magnet therapy, spiritual healing, and meditation. [NIH] Alveolitis: Inflammation of an alveolus. Called also odontobothritis. [EU] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Substitution: The naturally occurring or experimentally induced replacement of one or more amino acids in a protein with another. If a functionally equivalent amino acid is substituted, the protein may retain wild-type activity. Substitution may also diminish or eliminate protein function. Experimentally induced substitution is often used to study enzyme activities and binding site properties. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of

204 Gout

hemoglobin. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Ankylosis: Fixation and immobility of a joint. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antecedent: Existing or occurring before in time or order often with consequential effects. [EU]

Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte.

Dictionary 205

Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]

Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the

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walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthralgia: Pain in the joint. [NIH] Arthropathy: Any joint disease. [EU] Arthroplasty: Surgical reconstruction of a joint to relieve pain or restore motion. [NIH] Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Aspiration: The act of inhaling. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Azaguanine: One of the early purine analogs showing antineoplastic activity. It functions as an antimetabolite and is easily incorporated into ribonucleic acids. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls,

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multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barbiturates: A class of chemicals derived from barbituric acid or thiobarbituric acid. Many of these are medically important as sedatives and hypnotics (sedatives, barbiturate), as anesthetics, or as anticonvulsants. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Bed Rest: Confinement of an individual to bed for therapeutic or experimental reasons. [NIH] Benzbromarone: Uricosuric that acts by increasing uric acid clearance. It is used in the treatment of gout. [NIH] Beta-pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Beta-Thromboglobulin: A platelet-specific protein which is released when platelets aggregate. Elevated plasma levels have been reported after deep venous thrombosis, preeclampsia, myocardial infarction with mural thrombosis, and myeloproliferative disorders. Measurement of beta-thromboglobulin in biological fluids by radioimmunoassay is used for the diagnosis and assessment of progress of thromboembolic disorders. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH]

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Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Coagulation Factors: Endogenous substances, usually proteins, that are involved in the blood coagulation process. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Burden: The total amount of a chemical, metal or radioactive substance present at any time after absorption in the body of man or animal. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH]

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Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradycardia: Excessive slowness in the action of the heart, usually with a heart rate below 60 beats per minute. [NIH] Brain Diseases: Pathologic conditions affecting the brain, which is composed of the intracranial components of the central nervous system. This includes (but is not limited to) the cerebral cortex; intracranial white matter; basal ganglia; thalamus; hypothalamus; brain stem; and cerebellum. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchiectasis: Persistent abnormal dilatation of the bronchi. [NIH] Bronchioles: The tiny branches of air tubes in the lungs. [NIH] Bronchiolitis: Inflammation of the bronchioles. [NIH] Bronchiolitis Obliterans: Inflammation of the bronchioles with obstruction by fibrous granulation tissue or bronchial exudate. It may follow inhalation of irritating gases or foreign bodies and it complicates pneumonia. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bronchoconstriction: Diminution of the caliber of a bronchus physiologically or as a result of pharmacological intervention. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH]

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Calcaneus: The largest of the tarsal bones and is situated at the lower and back part of the foot forming the heel. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcinosis: Pathologic deposition of calcium salts in tissues. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Oxalate: The calcium salt of oxalic acid, occurring in the urine as crystals and in certain calculi. [NIH] Calcium Pyrophosphate: Diphosphoric acid, calcium salt. An inorganic pyrophosphate which affects calcium metabolism in mammals. Abnormalities in its metabolism occur in some human diseases, notably hypophosphatasia and pseudogout. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in

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obstructions. [NIH] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chelation: Combination with a metal in complexes in which the metal is part of a ring. [EU] Chelation Therapy: Therapy of heavy metal poisoning using agents which sequester the metal from organs or tissues and bind it firmly within the ring structure of a new compound which can be eliminated from the body. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or

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immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholelithiasis: Presence or formation of gallstones. [NIH] Choleretic: A choleretic agent. [EU] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chondrocytes: Polymorphic cells that form cartilage. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chronobiology: The study of biological systems as affected by time. Aging, biological rhythms, and cyclic phenomena are included. Statistical, computer-aided mathematical procedures are used to describe, in mathematical terminology, various biological functions over time. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clavicle: A long bone of the shoulder girdle. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

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Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clubfoot: A deformed foot in which the foot is plantarflexed, inverted and adducted. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Codon: A set of three nucleotides in a protein coding sequence that specifies individual amino acids or a termination signal (codon, terminator). Most codons are universal, but some organisms do not produce the transfer RNAs (RNA, transfer) complementary to all codons. These codons are referred to as unassigned codons (codons, nonsense). [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colchicine: A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (periodic disease). [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Communis: Common tendon of the rectus group of muscles that surrounds the optic foramen and a portion of the superior orbital fissure, to the anterior margin of which it is attached at the spina recti lateralis. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols

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C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU]

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Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Connexin 43: A 43 kD peptide which is a member of the connexin family of gap junction proteins. Connexin 43 is a product of a gene in the alpha class of connexin genes (the alpha-1 gene). It was first isolated from mammalian heart, but is widespread in the body including the brain. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments,

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etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Crystallization: The formation of crystals; conversion to a crystalline form. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]

Cytidine: A pyrimidine nucleoside that is composed of the base cytosine linked to the fivecarbon sugar D-ribose. [NIH] Cytidine Deaminase: An enzyme that catalyzes the deamination of cytidine, forming uridine. EC 3.5.4.5. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH]

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Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytotoxic: Cell-killing. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decubitus: An act of lying down; also the position assumed in lying down. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Deoxyguanosine: A nucleoside consisting of the base guanine and the sugar deoxyribose. [NIH]

Dermatitis: Any inflammation of the skin. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Foot: Ulcers of the foot as a complication of diabetes. Diabetic foot, often with infection, is a common serious complication of diabetes and may require hospitalization and disfiguring surgery. The foot ulcers are probably secondary to neuropathies and vascular problems. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH]

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Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastolic: Of or pertaining to the diastole. [EU] Diathesis: A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the person more than usually susceptible to certain diseases. [EU] Didanosine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. Didanosine is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA by binding to reverse transcriptase; ddI is then metabolized to dideoxyadenosine triphosphate, its putative active metabolite. [NIH] Dideoxyadenosine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is an inhibitor of HIV replication, acting as a chain-terminator of viral DNA by binding to reverse transcriptase. Its principal side effect is nephrotoxicity. In vivo, dideoxyadenosine is rapidly metabolized to didanosine (ddI) by enzymatic deamination; ddI is then converted to dideoxyinosine monophosphate and ultimately to dideoxyadenosine triphosphate, the putative active metabolite. [NIH] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilatation: The act of dilating. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Diurnal: Occurring during the day. [EU]

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Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysentery: Any of various disorders marked by inflammation of the intestines, especially of the colon, and attended by pain in the abdomen, tenesmus, and frequent stools containing blood and mucus. Causes include chemical irritants, bacteria, protozoa, or parasitic worms. [EU]

Dysmenorrhea: Painful menstruation. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as

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an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH]

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Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocyte Indices: Quantification of size and cell hemoglobin content or concentration of the erythrocyte, usually derived from erythrocyte count, blood hemoglobin concentration, and hematocrit. Includes the mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC). Use also for cell diameter and thickness. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Etodolac: A nonsteroidal anti-inflammatory agent with potent analgesic and antiarthritic properties. It has been shown to be effective in the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and in the alleviation of postoperative pain. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excrete: To get rid of waste from the body. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]

Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked

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to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fat Necrosis: A condition in which the death of adipose tissue results in neutral fats being split into fatty acids and glycerol. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Foot Care: Taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses. Good care includes daily examination of the feet, toes, and toenails and choosing shoes and socks or stockings that fit well. People with diabetes have to take special care of their feet because nerve damage and reduced blood flow sometimes mean they will have

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less feeling in their feet than normal. They may not notice cuts and other problems as soon as they should. [NIH] Foot Deformities: Alterations or deviations from normal shape or size which result in a disfigurement of the foot. [NIH] Foot Injuries: General or unspecified injuries involving the foot. [NIH] Foot Ulcer: Lesion on the surface of the skin of the foot, usually accompanied by inflammation. The lesion may become infected or necrotic and is frequently associated with diabetes or leprosy. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Fungemia: The presence of fungi circulating in the blood. Opportunistic fungal sepsis is seen most often in immunosuppressed patients with severe neutropenia or in postoperative patients with intravenous catheters and usually follows prolonged antibiotic therapy. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Gangrene: Death and putrefaction of tissue usually due to a loss of blood supply. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU]

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Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gemfibrozil: A lipid-regulating agent that lowers elevated serum lipids primarily by decreasing serum triglycerides with a variable reduction in total cholesterol. These decreases occur primarily in the VLDL fraction and less frequently in the LDL fraction. Gemfibrozil increases HDL subfractions HDL2 and HDL3 as well as apolipoproteins A-I and A-II. Its mechanism of action has not been definitely established. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH]

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Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Gonadal: Pertaining to a gonad. [EU] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Granulation Tissue: A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid cells, macrophages, and plasma cells. [NIH] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its

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earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Growth Plate: The area between the epiphysis and the diaphysis within which bone growth occurs. [NIH] Guanine: One of the four DNA bases. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Helminthiasis: Infestation with parasitic worms of the helminth class. [NIH] Hemarthrosis: Bleeding into the joints. It may arise from trauma or spontaneously in patients with hemophilia. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level

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may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin M: A group of abnormal hemoglobins in which amino acid substitutions take place in either the alpha or beta chains but near the heme iron. This results in facilitated oxidation of the hemoglobin to yield excess methemoglobin which leads to cyanosis. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemophilia: Refers to a group of hereditary disorders in which affected individuals fail to make enough of certain proteins needed to form blood clots. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Hip Prosthesis: Replacement for a hip joint. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH]

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Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperostosis: Increase in the mass of bone per unit volume. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperuricaemia: Excess of uric acid or urates in the blood; it is a prerequisite for the development or gout and may lead to renal disease. Called also uricacidaemia and, formerly, lithemia. [EU] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hypovitaminosis: A condition due to a deficiency of one or more essential vitamins. [EU]

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Hypoxanthine: A purine and a reaction intermediate in the metabolism of adenosine and in the formation of nucleic acids by the salvage pathway. [NIH] Hypoxanthine Phosphoribosyltransferase: An enzyme that catalyzes the conversion of 5phosphoribosyl-1-pyrophosphate and hypoxanthine, guanine, or 6-mercaptopurine to the corresponding 5'-mononucleotides and pyrophosphate. The enzyme is important in purine biosynthesis as well as central nervous system functions. Complete lack of enzyme activity is associated with the Lesch-Nyhan syndrome, while partial deficiency results in overproduction of uric acid. EC 2.4.2.8. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunomodulator: New type of drugs mainly using biotechnological methods. Treatment of cancer. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Impotence: The inability to perform sexual intercourse. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH]

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Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Information Centers: Facilities for collecting and organizing information. They may be specialized by subject field, type of source material, persons served, location, or type of services. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Insecticides: Pesticides designed to control insects that are harmful to man. The insects may be directly harmful, as those acting as disease vectors, or indirectly harmful, as destroyers of crops, food products, or textile fabrics. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood

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glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Interleukin-8: A cytokine that activates neutrophils and attracts neutrophils and Tlymphocytes. It is released by several cell types including monocytes, macrophages, Tlymphocytes, fibroblasts, endothelial cells, and keratinocytes by an inflammatory stimulus. IL-8 is a member of the beta-thromboglobulin superfamily and structurally related to platelet factor 4. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Iritis: Inflammation of the iris characterized by circumcorneal injection, aqueous flare, keratotic precipitates, and constricted and sluggish pupil along with discoloration of the iris. [NIH]

Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells.

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This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Irritants: Drugs that act locally on cutaneous or mucosal surfaces to produce inflammation; those that cause redness due to hyperemia are rubefacients; those that raise blisters are vesicants and those that penetrate sebaceous glands and cause abscesses are pustulants; tear gases and mustard gases are also irritants. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoelectric: Separation of amphoteric substances, dissolved in water, based on their isoelectric behavior. The amphoteric substances are a mixture of proteins to be separated and of auxiliary "carrier ampholytes". [NIH] Isoelectric Point: The pH in solutions of proteins and related compounds at which the dipolar ions are at a maximum. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to

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another. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Klebsiella: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria whose organisms arrange singly, in pairs, or short chains. This genus is commonly found in the intestinal tract and is an opportunistic pathogen that can give rise to bacteremia, pneumonia, urinary tract and several other types of human infection. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lead Poisoning: Disease caused by the gradual accumulation of a significant body burden of lead. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukaemia: An acute or chronic disease of unknown cause in man and other warm-blooded animals that involves the blood-forming organs, is characterized by an abnormal increase in the number of leucocytes in the tissues of the body with or without a corresponding increase of those in the circulating blood, and is classified according of the type leucocyte most prominently involved. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH]

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Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lipopolysaccharides: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lipoprotein Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. The enzyme hydrolyzes triacylglycerols in chylomicrons, very-low-density lipoproteins, low-density lipoproteins, and diacylglycerols. It occurs on capillary endothelial surfaces, especially in mammary, muscle, and adipose tissue. Genetic deficiency of the enzyme causes familial hyperlipoproteinemia Type I. (Dorland, 27th ed) EC 3.1.1.34. [NIH] Lithiasis: A condition characterized by the formation of calculi and concretions in the hollow organs or ducts of the body. They occur most often in the gallbladder, kidney, and lower urinary tract. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH]

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Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphoblastic: One of the most aggressive types of non-Hodgkin lymphoma. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lymphoproliferative: Disorders characterized by proliferation of lymphoid tissue, general or unspecified. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mannans: Polysaccharides consisting of mannose units. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in

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wound healing, angiogenesis, and tumor cell metastasis. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medicament: A medicinal substance or agent. [EU] Medication Errors: Errors in prescribing, dispensing, or administering medication with the result that the patient fails to receive the correct drug or the indicated proper drug dosage. [NIH]

MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mercaptopurine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metatarsal Bones: The five long bones of the metatarsus articulating with the tarsal bones

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proximally and the toes (phalanges) distally. [NIH] Metatarsophalangeal Joint: The articulation between a metatarsal bone and a phalanx. [NIH] Metatarsus: The part of the foot between the tarsa and the toes. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mixed Connective Tissue Disease: A syndrome with overlapping clinical features of systemic lupus erythematosus, scleroderma, polymyositis, and Raynaud's phenomenon. The disease is differentially characterized by high serum titers of antibodies to ribonucleasesensitive extractable (saline soluble) nuclear antigen and a "speckled" epidermal nuclear staining pattern on direct immunofluorescence. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH]

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Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multidrug resistance: Adaptation of tumor cells to anticancer drugs in ways that make the drugs less effective. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myalgia: Pain in a muscle or muscles. [EU] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mycophenolate mofetil: A drug that is being studied for its effectiveness in preventing graft-versus-host disease and autoimmune disorders. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myeloproliferative Disorders: Disorders in which one or more stimuli cause proliferation of hemopoietically active tissue or of tissue which has embryonic hemopoietic potential. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH]

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Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myositis: Inflammation of a voluntary muscle. [EU] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Naproxen: An anti-inflammatory agent with analgesic and antipyretic properties. Both the acid and its sodium salt are used in the treatment of rheumatoid arthritis and other rheumatic or musculoskeletal disorders, dysmenorrhea, and acute gout. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephrolithiasis: Kidney stones. [NIH] Nephrology: A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroma: A tumor that arises in nerve cells. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]

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Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophil: A type of white blood cell. [NIH] Neutrophil Activation: The process in which the neutrophil is stimulated by diverse substances, resulting in degranulation and/or generation of reactive oxygen products, and culminating in the destruction of invading pathogens. The stimulatory substances, including opsonized particles, immune complexes, and chemotactic factors, bind to specific cellsurface receptors on the neutrophil. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount

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of urine secreted. [NIH] Omeprazole: A highly effective inhibitor of gastric acid secretion used in the therapy of gastric ulcers and Zollinger-Ellison syndrome. The drug inhibits the H(+)-K(+)-ATPase (H(+)-K(+)-exchanging ATPase) in a pH-dependent manner. This ATPase is considered the proton pump in the secretory membrane of the parietal cell. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Onychomycosis: Mycosis of the nails, possibly due to some extent to humidity. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orthotic Devices: Apparatus used to support, align, prevent, or correct deformities or to improve the function of movable parts of the body. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Osteonecrosis: Death of a bone or part of a bone, either atraumatic or posttraumatic. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Overdosage: 1. The administration of an excessive dose. 2. The condition resulting from an excessive dose. [EU] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Oxalate: A chemical that combines with calcium in urine to form the most common type of kidney stone (calcium oxalate stone). [NIH] Oxidants: Oxidizing agents or electron-accepting molecules in chemical reactions in which electrons are transferred from one molecule to another (oxidation-reduction). In vivo, it appears that phagocyte-generated oxidants function as tumor promoters or cocarcinogens rather than as complete carcinogens perhaps because of the high levels of endogenous antioxidant defenses. It is also thought that oxidative damage in joints may trigger the autoimmune response that characterizes the persistence of the rheumatoid disease process. [NIH]

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Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxypurinol: A xanthine oxidase inhibitor. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Paraffin: A mixture of solid hydrocarbons obtained from petroleum. It has a wide range of uses including as a stiffening agent in ointments, as a lubricant, and as a topical antiinflammatory. It is also commonly used as an embedding material in histology. [NIH] Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of spinal cord diseases; peripheral nervous system diseases; muscular diseases; intracranial hypertension; parasagittal brain lesions; and other conditions. [NIH] Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with spinal cord diseases, although brain diseases; peripheral nervous system diseases; neuromuscular diseases; and muscular diseases may also cause bilateral leg weakness. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH]

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Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Patella: The flat, triangular bone situated at the anterior part of the knee. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pectins: High molecular weight polysaccharides present in the cell walls of all plants. Pectins cement cell walls together. They are used as emulsifiers and stabilizers in the food industry. They have been tried for a variety of therpeutic uses including as antidiarreals, where they are now generally considered ineffective, and in the treatment of hypercholesterolemia. [NIH] Pefloxacin: An orally administered broad spectrum quinolone antibacterial agent active against most gram-negative and gram-positive bacteria. It is effective against urinary tract infections as well as against many other systemic infections. The drug is well tolerated in adults, but should not be given to children and pregnant women. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex.

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[NIH]

Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peroral: Performed through or administered through the mouth. [EU] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Pesticides: Chemicals used to destroy pests of any sort. The concept includes fungicides (industrial fungicides), insecticides, rodenticides, etc. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] P-Glycoprotein: A 170 kD transmembrane glycoprotein from the superfamily of ABC transporters. It serves as an ATP-dependent efflux pump for a variety of chemicals, including many antineoplastic agents. Overexpression of this glycoprotein is associated with multidrug resistance. [NIH] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phlebitis: Inflammation of a vein. [NIH] Phlebotomy: The letting of blood from a vein. Although it is one of the techniques used in drawing blood to be used in diagnostic procedures, in modern medicine, it is used commonly in the treatment of erythrocytosis, hemochromocytosis, polycythemia vera, and porphyria cutanea tarda. Its historical counterpart is bloodletting. (From Cecil Textbook of

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Medicine, 19th ed & Wintrobe's Clinical Hematology, 9th ed) Venipuncture is not only for the letting of blood from a vein but also for the injecting of a drug into the vein for diagnostic analysis. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphoribosyl Pyrophosphate: The key substance in the biosynthesis of histidine, tryptophan, and purine and pyrimidine nucleotides. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylase: An enzyme of the transferase class that catalyzes the phosphorylysis of a terminal alpha-1,4-glycosidic bond at the non-reducing end of a glycogen molecule, releasing a glucose 1-phosphate residue. Phosphorylase should be qualified by the natural substance acted upon. EC 2.4.1.1. [NIH] Photochemotherapy: Therapy using oral or topical photosensitizing agents with subsequent exposure to light. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Photosensitivity: An abnormal cutaneous response involving the interaction between photosensitizing substances and sunlight or filtered or artificial light at wavelengths of 280400 mm. There are two main types : photoallergy and photoxicity. [EU] Photosensitizing Agents: Drugs that are pharmacologically inactive but when exposed to ultraviolet radiation or sunlight are converted to their active metabolite to produce a beneficial reaction affecting the diseased tissue. These compounds can be administered topically or systemically and have been used therapeutically to treat psoriasis and various types of neoplasms. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Piroxicam: 4-Hydroxy-2-methyl-N-2-pyridyl-2H-1,2-benzothiazine-3-carboxamide 1,1dioxide. A non-steroidal anti-inflammatory agent that is well established in the treatment of rheumatoid arthritis and osteoarthritis. Its usefulness has also been demonstrated in the treatment of musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily. The drug has also been shown to be effective if administered rectally. Gastrointestinal complaints are the most frequently reported side effects. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH]

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Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Platelet Activating Factor: A phospholipid derivative formed by platelets, basophils, neutrophils, monocytes, and macrophages. It is a potent platelet aggregating agent and inducer of systemic anaphylactic symptoms, including hypotension, thrombocytopenia, neutropenia, and bronchoconstriction. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pleura: The thin serous membrane enveloping the lungs and lining the thoracic cavity. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Pleurisy: Inflammation of the pleura, with exudation into its cavity and upon its surface. It may occur as either an acute or a chronic process. In acute pleurisy the pleura becomes reddened, then covered with an exudate of lymph, fibrin, and cellular elements (the dry stage); the disease may progress to the second stage, in which a copious exudation of serum occurs (stage of liquid effusion). The inflamed surfaces of the pleura tend to become united by adhesions, which are usually permanent. The symptoms are a stitch in the side, a chill, followed by fever and a dry cough. As effusion occurs there is an onset of dyspnea and a diminution of pain. The patient lies on the affected side. [EU] Pneumonia: Inflammation of the lungs. [NIH] Pneumonitis: A disease caused by inhaling a wide variety of substances such as dusts and molds. Also called "farmer's disease". [NIH] Podiatrist: A doctor who treats and takes care of people's feet. [NIH] Podiatry: A specialty concerned with the diagnosis and treatment of foot disorders and injuries and anatomic defects of the foot. [NIH]

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Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [NIH] Poison Control Centers: Facilities which provide information concerning poisons and treatment of poisoning in emergencies. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyarthritis: An inflammation of several joints together. [EU] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]

Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polymyalgia Rheumatica: A syndrome in the elderly characterized by proximal joint and muscle pain, high erythrocyte sedimentation rate, and a self-limiting course. Pain is usually accompanied by evidence of an inflammatory reaction. Women are affected twice as commonly as men and Caucasians more frequently than other groups. The condition is frequently associated with temporal arteritis and some theories pose the possibility that the two diseases arise from a single etiology or even that they are the same entity. [NIH] Popliteal: Compression of the nerve at the neck of the fibula. [NIH] Popliteal Cyst: A synovial cyst in the popliteal space arising from the semimembranous bursa or the knee joint. [NIH] Porphyria: A group of disorders characterized by the excessive production of porphyrins or their precursors that arises from abnormalities in the regulation of the porphyrin-heme pathway. The porphyrias are usually divided into three broad groups, erythropoietic, hepatic, and erythrohepatic, according to the major sites of abnormal porphyrin synthesis. [NIH]

Porphyria Cutanea Tarda: A form of hepatic porphyria (porphyria, hepatic) characterized by photosensitivity resulting in bullae that rupture easily to form shallow ulcers. This condition occurs in two forms: a sporadic, nonfamilial form that begins in middle age and has normal amounts of uroporphyrinogen decarboxylase with diminished activity in the liver; and a familial form in which there is an autosomal dominant inherited deficiency of uroporphyrinogen decarboxylase in the liver and red blood cells. [NIH] Porphyria, Hepatic: Porphyria in which the liver is the site where excess formation of porphyrin or its precursors is found. Acute intermittent porphyria and porphyria cutanea tarda are types of hepatic porphyria. [NIH] Porphyrins: A group of compounds containing the porphin structure, four pyrrole rings

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connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Post-translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium Citrate: A powder that dissolves in water, which is administered orally, and is used as a diuretic, expectorant, systemic alkalizer, and electrolyte replenisher. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Presumptive: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probenecid: The prototypical uricosuric agent. It inhibits the renal excretion of organic anions and reduces tubular reabsorption of urate. Probenecid has also been used to treat patients with renal impairment, and, because it reduces the renal tubular excretion of other drugs, has been used as an adjunct to antibacterial therapy. [NIH] Procreation: The entire process of bringing a new individual into the world. [EU]

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Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that

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promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Protozoan: 1. Any individual of the protozoa; protozoon. 2. Of or pertaining to the protozoa; protozoal. [EU] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary Fibrosis: Chronic inflammation and progressive fibrosis of the pulmonary alveolar walls, with steadily progressive dyspnea, resulting finally in death from oxygen lack or right heart failure. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by

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pus. [EU] Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Pyrazinamide: A pyrazine that is used therapeutically as an antitubercular agent. [NIH] Pyrimidines: A family of 6-membered heterocyclic compounds occurring in nature in a wide variety of forms. They include several nucleic acid constituents (cytosine, thymine, and uracil) and form the basic structure of the barbiturates. [NIH] Quackery: The fraudulent misrepresentation of the diagnosis and treatment of disease. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Reconstitution: 1. A type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. The restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH]

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Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Renal tubular: A defect in the kidneys that hinders their normal excretion of acids. Failure to excrete acids can lead to weak bones, kidney stones, and poor growth in children. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH]

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Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rheumatology: A subspecialty of internal medicine concerned with the study of inflammatory or degenerative processes and metabolic derangement of connective tissue structures which pertain to a variety of musculoskeletal disorders, such as arthritis. [NIH] Ribonuclease: RNA-digesting enzyme. [NIH] Ribonucleic acid: RNA. One of the two nucleic acids found in all cells. The other is deoxyribonucleic acid (DNA). Ribonucleic acid transfers genetic information from DNA to proteins produced by the cell. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Ritonavir: An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rodenticides: Substances used to destroy or inhibit the action of rats, mice, or other rodents. [NIH]

Rotator: A muscle by which a part can be turned circularly. [NIH] Rotator Cuff: The musculotendinous sheath formed by the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. These help stabilize the head of the humerus in the glenoid fossa and allow for rotation of the shoulder joint about its longitudinal axis. [NIH] Rural Population: The inhabitants of rural areas or of small towns classified as rural. [NIH] Sacroiliac Joint: The immovable joint formed by the lateral surfaces of the sacrum and ilium. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Saturnine: Pertaining to or caused by a lead. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Scleroderma: A chronic disorder marked by hardening and thickening of the skin.

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Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Sclerotic: Pertaining to the outer coat of the eye; the sclera; hard, indurated or sclerosed. [NIH]

Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sedimentation: The act of causing the deposit of sediment, especially by the use of a centrifugal machine. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Sequester: A portion of dead bone which has become detached from the healthy bone tissue, as occurs in necrosis. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH]

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Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Shock, Septic: Shock due to circulatory insufficiency caused most commonly by gramnegative bacteremia. It is less often the result of the persistent presence of other microorganisms in the blood (fungemia, viremia); in rare instances, it is caused by gram-positive organisms, but with different symptomatology. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Sodium Fluoride: A source of inorganic fluoride which is used topically to prevent dental caries. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spasmodic: Of the nature of a spasm. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and

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types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Compression: Acute and chronic conditions characterized by external mechanical compression of the spinal cord due to extramedullary neoplasm; epidural abscess; spinal fractures; bony deformities of the vertebral bodies; and other conditions. Clinical manifestations vary with the anatomic site of the lesion and may include localized pain, weakness, sensory loss, incontinence, and impotence. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spinal Fractures: Broken bones in the vertebral column. [NIH] Spinal Stenosis: Narrowing of the spinal canal. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sporotrichosis: The commonest and least serious of the deep mycoses, characterized by nodular lesions of the cutaneous and subcutaneous tissues. It is caused by inhalation of contaminated dust or by infection of a wound. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Sterile: Unable to produce children. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between

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the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Struvite: A type of kidney stone caused by infection. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Subtalar Joint: Formed by the articulation of the talus with the calcaneus. [NIH] Sulfinpyrazone: A uricosuric drug that is used to reduce the serum urate levels in gout therapy. It lacks anti-inflammatory, analgesic, and diuretic properties. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Cyst: A nodular, tumorlike lesion in or about a tendon sheath or joint capsule, especially of the hands, wrists, or feet. It is not a true cyst as it lacks an epithelial wall, and it does not communicate with the underlying synovial space. The lesion represents a focal

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accumulation of mucin in the dermis of the dorsal aspect of the distal phalanges or, less often, other portions of the extremities. [NIH] Synovial Fluid: The clear, viscous fluid secreted by the synovial membrane. It contains mucin, albumin, fat, and mineral salts and serves to lubricate joints. [NIH] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Synovitis: Inflammation of a synovial membrane. It is usually painful, particularly on motion, and is characterized by a fluctuating swelling due to effusion within a synovial sac. Synovitis is qualified as fibrinous, gonorrhoeal, hyperplastic, lipomatous, metritic, puerperal, rheumatic, scarlatinal, syphilitic, tuberculous, urethral, etc. [EU] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Talus: The second largest of the tarsal bones and occupies the middle and upper part of the tarsus. [NIH] Tarsal Bones: The seven bones which form the tarsus - namely, calcaneus, talus, cuboid, navicular, and first, second and third cuneiforms. The tarsus is a skeletal part of the foot. [NIH]

Tarsal Tunnel Syndrome: A syndrome produced by entrapment neuropathy of posterior tibial nerve. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temperament: Predisposition to react to one's environment in a certain way; usually refers to mood changes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Tendinitis: Inflammation of tendons and of tendon-muscle attachments. [EU] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Tenesmus: Straining, especially ineffectual and painful straining at stool or in urination. [EU] Tenosynovitis: Inflammation of a tendon sheath. [EU] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia;

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intracranial hemorrhages; and infectious processes. [NIH] Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tibia: The second longest bone of the skeleton. It is located on the medial side of the lower leg, articulating with the fibula laterally, the talus distally, and the femur proximally. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH]

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Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tophus: A chalky deposit of sodium urate occurring in gout; tophi form most often around joints in cartilage, bone, bursae, and subcutaneous tissue and in the external ear, producing a chronic foreign-body inflammatory response. [EU] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicodendron: A genus (formerly Rhus) of shrubs, vines, or trees that yields a highly allergenic oleoresin which causes a severe contact dermatitis. The most toxic species are Toxicodendron vernix (poison sumac), T. diversilobum (poison oak), and T. radicans (poison ivy). T. vernicifera yields a useful varnish from which certain enzymes (laccases) are obtained. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH]

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Triamcinolone Acetonide: An esterified form of triamcinolone. It is an anti-inflammatory glucocorticoid used topically in the treatment of various skin disorders. Intralesional, intramuscular, and intra-articular injections are also administered under certain conditions. [NIH]

Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] Tumor Lysis Syndrome: A syndrome resulting from cytotoxic therapy, occurring generally in aggressive, rapidly proliferating lymphoproliferative disorders. It is characterized by combinations of hyperuricemia, lactic acidosis, hyperkalemia, hyperphosphatemia and hypocalcemia. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uracil: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urate Oxidase: An enzyme that catalyzes the conversion of urate and unidentified products. It is a copper protein. The initial products decompose to form allantoin. EC 1.7.3.3. [NIH]

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Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Uricosuric: 1. Pertaining to, characterized by, or promoting uricosuria (= the excretion of uric acid in the urine). 2. An agent that promotes uricosuria. [EU] Uricosuric Agents: Gout suppressants that act directly on the renal tubule to increase the excretion of uric acid, thus reducing its concentrations in plasma. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Calculi: Calculi in any part of the urinary tract. According to their composition or pattern of chemical composition distribution, urinary calculi types may include alternating or combination, cystine, decubitus, encysted, fibrin, hemp seed, matrix, mulberry, oxalate, struvite, urostealith, and xanthic calculi. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urolithiasis: Stones in the urinary system. [NIH] Uroporphyrinogen Decarboxylase: One of the enzymes active in heme biosynthesis. It catalyzes the decarboxylation of uroporphyrinogen III to coproporphyrinogen III by the conversion of four acetic acid groups to four methyl groups. EC 4.1.1.37. [NIH] Ursodeoxycholic Acid: An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Valerian: Valeriana officinale, an ancient, sedative herb of the large family Valerianaceae. The roots were formerly used to treat hysterias and other neurotic states and are presently used to treat sleep disorders. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH]

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Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vegetarianism: Dietary practice of consuming only vegetables, grains, and nuts. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. It is a mitotic inhibitor. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viremia: The presence of viruses in the blood. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral fat: One of the three compartments of abdominal fat. Retroperitoneal and subcutaneous are the other two compartments. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others.

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[NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xanthine: An urinary calculus. [NIH] Xanthine Oxidase: An iron-molybdenum flavoprotein containing FAD that oxidizes hypoxanthine, some other purines and pterins, and aldehydes. Deficiency of the enzyme, an autosomal recessive trait, causes xanthinuria. EC 1.1.3.22. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

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INDEX A Abdomen, 201, 208, 209, 219, 231, 234, 242, 243, 244, 256, 259 Abdominal, 150, 201, 213, 217, 224, 242, 244, 261, 263 Abdominal Cramps, 150, 201 Abdominal fat, 201, 263 Abdominal Pain, 150, 201, 224, 261 Aberrant, 14, 201 Aborigines, 63, 76, 109, 201 Abscess, 114, 115, 201, 256 Acidity, 9, 11, 201 Acidosis, 201, 261 Acromioclavicular Joint, 23, 82, 201 Acromion, 201 Acute renal, 10, 84, 129, 201, 227 Adenine, 201, 250 Adenosine, 47, 144, 146, 201, 209, 229, 245, 259 Adhesions, 201, 246 Adipose Tissue, 201, 222, 234 Adolescent Nutrition, 151, 201 Adrenal Cortex, 201, 216, 249 Adverse Effect, 201, 255 Affinity, 42, 86, 201, 234, 255 Age of Onset, 120, 202 Albumin, 20, 59, 122, 202, 246, 258 Aldehyde Dehydrogenase, 27, 202 Aldehydes, 202, 264 Alertness, 202, 209 Algorithms, 202, 208 Alimentary, 202, 242 Alkaline, 145, 201, 202, 203, 210 Alkaloid, 202, 213, 238, 259 Alkalosis, 26, 122, 202 Allergen, 202, 217 Allograft, 4, 8, 66, 202 Allylamine, 202, 203 Alpha Particles, 202, 251 Alpha-1, 202, 215, 245 Alternative medicine, 161, 202 Alveolitis, 142, 203 Amenorrhea, 203, 204 Amine, 146, 203 Amino Acid Substitution, 64, 203, 227 Ammonia, 203 Amputation, 152, 203 Amyloid, 25, 55, 123, 203

Anaerobic, 203, 233 Anal, 150, 203 Anal Fissure, 150, 203 Analgesic, 15, 203, 221, 238, 239, 257 Analytes, 183, 203 Anaphylaxis, 14, 203 Anatomical, 203, 206, 208, 229, 254 Androgens, 201, 203, 216 Anemia, 177, 203, 226, 235 Angina, 142, 204 Angiogenesis, 204, 236 Angioplasty, 143, 204 Animal model, 13, 204 Anions, 202, 204, 231, 248 Ankle, 6, 55, 62, 73, 87, 113, 114, 150, 182, 183, 184, 204 Ankylosis, 29, 204 Anorexia, 43, 151, 204, 224, 261 Anorexia Nervosa, 43, 151, 204 Antagonism, 204, 209, 259 Antecedent, 112, 204 Antibacterial, 204, 243, 248, 256 Antibiotic, 12, 204, 223, 256 Antibodies, 204, 226, 235, 237 Antibody, 25, 202, 204, 213, 226, 227, 229, 230, 232, 236, 238, 251, 255, 264 Anticoagulant, 204, 249 Antigen, 202, 203, 204, 214, 224, 227, 228, 230, 236, 237 Anti-inflammatory, 4, 5, 6, 7, 15, 117, 133, 141, 142, 184, 186, 205, 216, 221, 224, 230, 239, 242, 245, 248, 257, 261 Anti-Inflammatory Agents, 4, 15, 141, 205, 216 Antimetabolite, 205, 206, 237 Antineoplastic, 205, 206, 216, 237, 244 Antineoplastic Agents, 205, 244 Antioxidant, 205, 241 Antipyretic, 205, 239 Anuria, 205, 232 Anus, 203, 205, 213, 222, 251 Aorta, 205, 263 Aortic Valve, 99, 205 Apolipoproteins, 205, 224, 234 Apoptosis, 38, 205 Aqueous, 205, 207, 217, 231, 233 Aromatic, 142, 205, 244 Arterial, 202, 205, 212, 215, 228, 249, 258

266 Gout

Arteries, 205, 208, 216, 234, 237, 238, 250 Arterioles, 205, 206, 208, 210, 237 Arteriolosclerosis, 205, 206 Arteriosclerosis, 140, 205, 228 Arteritis, 206, 247 Artery, 143, 160, 204, 205, 206, 216, 219, 243, 250 Arthralgia, 21, 206 Arthropathy, 55, 63, 108, 130, 150, 206 Arthroplasty, 59, 63, 94, 206 Articular, 4, 12, 72, 73, 95, 106, 144, 147, 206, 241, 261 Articulation, 206, 237, 257 Aseptic, 27, 59, 68, 206 Aspiration, 4, 6, 28, 51, 183, 206 Asymptomatic, 5, 6, 7, 19, 28, 39, 40, 82, 89, 100, 110, 184, 186, 206, 242 Ataxia, 177, 206, 258 Atrial, 206, 215, 261 Atrioventricular, 206, 215 Atrium, 206, 215, 261, 263 Atrophy, 177, 206 Atypical, 26, 55, 93, 122, 206 Autacoids, 206, 230 Autodigestion, 206, 242 Autoimmune disease, 140, 143, 206, 238 Azaguanine, 94, 206 B Back Pain, 77, 206 Bacteremia, 206, 233, 255 Bacteria, 140, 204, 206, 207, 217, 219, 220, 222, 225, 233, 237, 243, 246, 256, 260, 262 Bactericidal, 207, 221 Bacteriophage, 207, 246, 260 Bacterium, 207, 227 Barbiturates, 207, 251 Basal Ganglia, 206, 207, 209 Basal Ganglia Diseases, 206, 207 Base, 156, 201, 202, 207, 216, 217, 232, 247, 258, 261 Basophils, 207, 225, 233, 246 Bed Rest, 186, 207 Benzbromarone, 29, 46, 107, 108, 145, 207 Beta-pleated, 203, 207 Beta-Thromboglobulin, 207, 231 Bilateral, 31, 115, 207, 242 Bile, 207, 208, 212, 223, 224, 228, 232, 234, 256, 262 Bile Acids, 207, 224, 256 Bile duct, 207, 223 Bile Pigments, 207, 232 Biliary, 207, 210, 242

Biliary Tract, 207, 210, 242 Bilirubin, 202, 207, 208, 223, 228 Biochemical, 10, 11, 14, 26, 122, 129, 205, 208, 232, 241, 254 Biological therapy, 208, 226 Biopsy, 83, 208 Biotechnology, 17, 154, 161, 173, 176, 177, 178, 208 Bladder, 150, 208, 214, 223, 229, 238, 249, 252, 262 Bloating, 208, 229 Blood Cell Count, 208, 226 Blood Coagulation, 87, 208, 210, 259 Blood Coagulation Factors, 208 Blood Glucose, 151, 208, 226, 231 Blood pressure, 7, 174, 186, 208, 228, 238, 250, 255 Blood vessel, 204, 208, 209, 210, 215, 220, 222, 227, 232, 235, 245, 255, 257, 258, 259, 262 Blood-Brain Barrier, 13, 208 Body Burden, 208, 233 Body Fluids, 4, 202, 208, 255 Body Mass Index, 208, 241 Body Regions, 208, 213 Bone Marrow, 134, 208, 216, 225, 234, 235, 238 Bone scan, 29, 33, 209 Bowel, 150, 151, 201, 203, 209, 220, 230, 231, 257, 261 Brachial, 209, 236 Brachial Plexus, 209, 236 Brachytherapy, 209, 231, 232, 251, 264 Bradycardia, 59, 209 Brain Diseases, 209, 242 Branch, 195, 209, 235, 243, 250, 255, 257, 259 Breakdown, 146, 209, 218, 223 Bronchi, 209, 221, 259, 260 Bronchial, 209, 259 Bronchiectasis, 142, 209 Bronchioles, 209 Bronchiolitis, 142, 209 Bronchiolitis Obliterans, 142, 209 Bronchitis, 142, 209, 212 Bronchoconstriction, 209, 246 Buccal, 209, 234 Bursitis, 90, 134, 150, 209 C Caffeine, 151, 166, 209, 250 Calcaneus, 210, 257, 258 Calcification, 141, 205, 210

Index 267

Calcinosis, 48, 210 Calcium, 9, 10, 11, 12, 29, 49, 73, 101, 122, 141, 156, 182, 186, 209, 210, 214, 235, 241 Calcium Oxalate, 210, 241 Calcium Pyrophosphate, 49, 101, 141, 156, 182, 210 Calculi, 9, 80, 210, 225, 234, 262 Capillary, 210, 234 Carbohydrate, 29, 160, 210, 216, 225 Carcinogenic, 210, 230, 249, 256 Carcinogens, 210, 241 Carcinoma, 81, 210 Cardiac, 71, 89, 116, 117, 124, 202, 209, 210, 215, 239, 256 Carpal Tunnel Syndrome, 21, 52, 115, 210 Catheterization, 204, 210 Cause of Death, 20, 211 Celiac Disease, 151, 211 Cell Death, 205, 211, 224 Cell Division, 177, 207, 211, 226, 237, 246 Cell proliferation, 206, 211 Cell Survival, 211, 226 Cellulitis, 58, 211 Cellulose, 211, 223, 246 Central Nervous System, 13, 209, 211, 226, 229, 238, 254, 259 Cerebellar, 206, 211, 252 Cerebral, 142, 206, 207, 208, 209, 211, 222, 235 Cerebral Cortex, 206, 209, 211, 222 Cerebrum, 211, 261 Cervical, 32, 57, 94, 113, 209, 211, 236 Cervix, 211, 222 Character, 211, 217, 225 Chelation, 131, 211 Chelation Therapy, 131, 211 Chemotactic Factors, 211, 214, 240 Chemotherapy, 13, 153, 212 Chenodeoxycholic Acid, 212, 262 Chlorophyll, 212, 223 Cholelithiasis, 150, 212 Choleretic, 212, 262 Cholesterol, 32, 135, 140, 151, 163, 186, 207, 212, 216, 223, 224, 228, 234, 256 Cholesterol Esters, 212, 234 Chondrocytes, 12, 212 Chromatin, 205, 212, 220 Chromosomal, 212, 246 Chromosome, 10, 14, 212, 226, 233 Chronic Disease, 212, 233 Chronic Obstructive Pulmonary Disease, 66, 143, 212

Chronic renal, 10, 13, 31, 46, 95, 104, 119, 122, 130, 131, 132, 212, 247, 261 Chronobiology, 54, 212 Chylomicrons, 212, 234 Cirrhosis, 10, 21, 212 CIS, 14, 212 Clavicle, 31, 201, 212 Clear cell carcinoma, 212, 217 Clinical Medicine, 70, 212, 248 Clinical trial, 9, 10, 13, 106, 173, 213, 215, 216, 219, 250, 251 Cloning, 208, 213 Clubfoot, 150, 213 Coagulation, 12, 208, 213, 246, 259 Codon, 14, 213 Cofactor, 213, 249, 259 Colic, 150, 213 Colitis, 150, 213 Collagen, 142, 203, 213, 222, 224, 235, 246, 249 Collapse, 203, 209, 213 Colloidal, 202, 213 Colon, 177, 213, 219, 230, 233, 261 Communis, 138, 213 Complement, 213, 214, 246 Complementary and alternative medicine, 129, 138, 214 Complementary medicine, 129, 214 Complete remission, 214, 252 Compliance, 6, 7, 87, 214 Computational Biology, 173, 176, 214 Computed tomography, 38, 70, 214 Computerized tomography, 214 Concomitant, 13, 38, 214 Concretion, 210, 214 Congestion, 214, 221 Conjunctiva, 214, 215, 230 Connective Tissue, 13, 184, 187, 208, 211, 213, 215, 222, 224, 225, 234, 252, 253, 258 Connective Tissue Cells, 215 Connexin 43, 12, 215 Consciousness, 203, 215, 218 Constipation, 150, 151, 215 Constitutional, 215, 238 Constriction, 215, 232 Consultation, 154, 215 Consumption, 3, 7, 18, 155, 163, 215, 224, 252 Contraindications, ii, 4, 8, 150, 215 Controlled study, 18, 24, 44, 52, 123, 215 Conventional therapy, 215 Conventional treatment, 10, 215

268 Gout

Coordination, 215, 238 Cor, 6, 7, 39, 215 Coronary, 54, 143, 182, 215, 216, 237, 238 Coronary heart disease, 54, 216 Coronary Thrombosis, 216, 237, 238 Cortex, 7, 142, 216, 241, 252 Corticosteroid, 4, 156, 186, 216, 248, 256 Cortisol, 202, 216 Cortisone, 216, 248 Creatinine, 103, 216, 232, 261 Crystallization, 11, 20, 122, 216 Curative, 216, 240, 259 Cutaneous, 33, 41, 43, 56, 87, 134, 216, 232, 234, 245, 256 Cyclic, 209, 212, 216, 248, 259 Cyclosporine, 8, 39, 66, 112, 216 Cyst, 21, 216, 257 Cystine, 216, 262 Cytidine, 72, 216 Cytidine Deaminase, 72, 216 Cytokine, 216, 231 Cytoplasm, 205, 207, 217, 220, 238 Cytosine, 216, 217, 251 Cytotoxic, 143, 217, 251, 261 D De novo, 14, 92, 93, 217 Deamination, 216, 217, 218 Decubitus, 217, 262 Degenerative, 12, 106, 217, 227, 241, 253 Dehydration, 6, 150, 217 Deletion, 205, 217 Density, 10, 40, 208, 217, 234, 241, 247 Dental Caries, 217, 255 Deoxyguanosine, 143, 217 Dermatitis, 217, 260 DES, 124, 217 Desensitization, 24, 41, 85, 217 Deuterium, 217, 228 Diabetes Mellitus, 174, 217, 225, 226 Diabetic Foot, 151, 217 Diagnostic procedure, 139, 161, 217, 244 Dialyzer, 217, 226 Diaphragm, 217, 227, 246 Diarrhea, 150, 151, 218 Diarrhoea, 218, 224 Diastolic, 218, 228 Diathesis, 10, 11, 122, 218 Didanosine, 58, 218 Dideoxyadenosine, 218 Dietary Fats, 218, 233 Digestion, 202, 207, 209, 218, 219, 229, 231, 233, 234, 256

Dihydrotestosterone, 218, 252 Dilatation, 204, 209, 218 Diploid, 218, 246 Direct, iii, 9, 16, 165, 212, 218, 237, 252 Discrete, 218, 258 Disinfectant, 218, 221 Dissociation, 201, 218 Distal, 218, 224, 244, 250, 258 Diuresis, 209, 218, 259 Diurnal, 99, 218 Diverticula, 219 Diverticulitis, 151, 219 Diverticulum, 219 Double-blind, 44, 80, 219 Drug Interactions, 8, 167, 219 Duodenum, 207, 219, 242, 257 Dyes, 203, 207, 219 Dysentery, 150, 219 Dysmenorrhea, 219, 239, 245 Dyspepsia, 219, 229 Dysplasia, 177, 219 Dyspnea, 219, 246, 250 Dystrophy, 18, 177, 219 E Edema, 219, 231, 240, 261 Effector, 12, 213, 219 Efficacy, 10, 46, 219 Effusion, 219, 246, 258 Elasticity, 205, 219 Elastin, 213, 219, 222 Electrocoagulation, 213, 219 Electrolyte, 216, 219, 232, 237, 248, 255, 261 Elementary Particles, 219, 235, 240, 250 Emphysema, 28, 142, 212, 219 Endarterectomy, 204, 219 Endemic, 220, 235, 256 Endogenous, 208, 220, 241, 249 Endothelial cell, 72, 208, 220, 231, 259 Endothelium, 142, 220 Endothelium, Lymphatic, 220 Endothelium, Vascular, 220 Endotoxic, 220, 233 End-stage renal, 10, 212, 220, 247 Enhancer, 13, 220 Enteritis, 150, 220 Enterocolitis, 220 Environmental Exposure, 220, 241 Environmental Health, 172, 174, 220 Enzymatic, 203, 210, 214, 217, 218, 220 Eosinophils, 220, 225, 233 Epidemic, 44, 220, 256

Index 269

Epidemiological, 37, 91, 220 Epidermal, 220, 232, 236, 237, 263 Epidural, 114, 115, 220, 256 Epithelium, 220, 221, 231 Erythema, 144, 147, 221, 262 Erythrocyte Indices, 208, 221 Erythrocytes, 87, 203, 208, 221, 251 Esophagus, 143, 221, 224, 226, 234, 244, 257 Essential Tremor, 177, 221 Ethanol, 45, 123, 221 Ether, 16, 221 Etodolac, 46, 221 Evacuation, 215, 221 Excrete, 146, 163, 189, 205, 221, 232, 252 Exhaustion, 204, 221, 235 Exogenous, 220, 221, 249 Expectorant, 221, 248 Extensor, 221, 250 External-beam radiation, 221, 231, 251, 264 Extracellular, 7, 12, 141, 146, 203, 215, 221, 222, 235, 255 Extracellular Matrix, 215, 221, 222, 235 Extracellular Matrix Proteins, 221, 235 Extraction, 142, 222 Extremity, 7, 201, 209, 222, 236, 242 Exudate, 209, 221, 222, 246 F Family Planning, 173, 222 Fat, 29, 43, 151, 186, 201, 208, 215, 216, 222, 233, 234, 238, 241, 253, 255, 258, 261 Fat Necrosis, 43, 222 Fatigue, 155, 222, 226 Fatty acids, 202, 222, 249 Feces, 215, 222, 257 Femoral, 31, 52, 222 Femur, 222, 259 Ferritin, 74, 222 Fibrin, 208, 222, 246, 259, 262 Fibroblasts, 15, 215, 222, 231 Fibrosis, 142, 177, 202, 222, 250, 253, 254 Fibula, 222, 247, 259 Fissure, 213, 222 Flatulence, 150, 222 Flatus, 222, 223 Flexion, 42, 222 Foot Care, 149, 151, 222 Foot Deformities, 25, 223 Foot Injuries, 150, 182, 223 Foot Ulcer, 151, 217, 223 Foramen, 213, 223, 244

Forearm, 208, 223, 236 Fossa, 223, 253 Fructose, 17, 25, 45, 52, 122, 123, 223 Fundus, 222, 223 Fungemia, 223, 255 Fungi, 223, 237, 264 Fungus, 151, 223 G Gallbladder, 201, 207, 223, 234 Gallstones, 150, 212, 223, 262 Gamma Rays, 223, 251 Gangrene, 152, 223 Gas, 150, 203, 222, 223, 228, 229, 240, 263 Gastric, 206, 223, 224, 226, 241, 243 Gastrin, 223, 227 Gastritis, 150, 151, 223 Gastroenteritis, 150, 151, 224 Gastroesophageal Reflux, 143, 224 Gastrointestinal, 78, 150, 221, 222, 224, 235, 245, 254, 257 Gastrointestinal tract, 221, 222, 224, 254 Gelatin, 224, 225 Gemfibrozil, 23, 224 Gene, 10, 14, 19, 69, 77, 154, 178, 179, 208, 215, 224, 241 Gene Expression, 14, 178, 224 Genetic testing, 188, 224 Genotype, 224, 244 Giant Cells, 224, 253 Gingivitis, 143, 224 Gland, 201, 216, 224, 234, 242, 243, 245, 249, 254, 256, 259 Glomerular, 224, 232, 252 Glomeruli, 224 Glomerulonephritis, 142, 224 Glucocorticoid, 5, 224, 248, 261 Glucose, 48, 177, 208, 211, 217, 225, 226, 230, 245, 253 Glucose Intolerance, 217, 225 Gluten, 211, 225 Glycerol, 222, 225, 245 Glycine, 71, 77, 203, 212, 225, 240 Glycogen, 225, 245 Glycoprotein, 224, 225, 244, 259 Glycosidic, 225, 245 Gonadal, 225, 256 Governing Board, 225, 248 Grade, 87, 225 Graft, 174, 225, 227, 229, 238 Graft-versus-host disease, 225, 238 Gram-negative, 220, 225, 233, 243, 255 Gram-positive, 225, 243, 255

270 Gout

Granulation Tissue, 209, 225 Granulocyte, 80, 225 Gravis, 143, 225 Growth, 12, 14, 113, 141, 177, 203, 204, 205, 211, 225, 226, 231, 235, 239, 241, 246, 252, 259, 261 Growth factors, 12, 226 Growth Plate, 141, 226 Guanine, 42, 64, 65, 69, 86, 143, 217, 226, 229, 250 H Hair follicles, 226, 263 Half-Life, 14, 145, 226, 245 Haploid, 226, 246 Haptens, 202, 226 Headache, 209, 226, 230 Heart attack, 159, 226 Heart failure, 110, 160, 226, 240, 250 Heartbeat, 156, 226 Heartburn, 151, 226, 227, 229 Helminthiasis, 150, 226 Hemarthrosis, 95, 226 Hematocrit, 208, 221, 226 Heme, 208, 226, 227, 247, 248, 262 Hemodialysis, 46, 217, 226, 232 Hemodynamics, 96, 226 Hemoglobin, 204, 208, 221, 226, 227, 233, 248 Hemoglobin M, 227 Hemoglobinopathies, 100, 227 Hemoglobinuria, 177, 227 Hemolytic, 75, 227 Hemophilia, 177, 226, 227 Hemorrhage, 150, 219, 226, 227, 257 Hemorrhoids, 150, 227 Hepatic, 10, 40, 89, 104, 202, 227, 234, 247 Hepatitis, 143, 150, 182, 227 Hepatocytes, 227 Hereditary, 63, 69, 225, 227, 252 Heredity, 224, 227 Heterogeneity, 202, 227 Hiatal Hernia, 151, 227 Hip Prosthesis, 27, 227 Histidine, 227, 245 Histology, 227, 242 Homeostasis, 140, 227 Homologous, 14, 227 Hormonal, 64, 206, 216, 227 Hormone, 10, 38, 64, 88, 216, 217, 223, 227, 230, 249, 253, 258, 259 Host, 142, 143, 207, 227, 229, 263 Humoral, 74, 140, 228

Humour, 228 Hydrogen, 201, 203, 207, 210, 217, 218, 221, 228, 237, 240, 242, 250 Hydrolysis, 228, 250 Hydrophobic, 228, 234 Hydroxylysine, 213, 228 Hydroxyproline, 203, 213, 228 Hyperbilirubinemia, 228, 232 Hypercholesterolemia, 59, 131, 135, 150, 174, 228, 243 Hyperlipidemia, 6, 65, 228 Hyperostosis, 30, 228 Hypersensitivity, 24, 64, 85, 142, 202, 203, 217, 228, 253 Hypertension, 6, 7, 8, 10, 37, 65, 71, 90, 93, 131, 135, 142, 174, 205, 228, 231, 261 Hypertriglyceridemia, 96, 100, 228 Hypertrophy, 215, 228, 261 Hypotension, 228, 246 Hypothyroidism, 53, 111, 228 Hypovitaminosis, 122, 228 Hypoxanthine, 42, 48, 64, 65, 69, 70, 86, 92, 94, 96, 229, 264 Hypoxanthine Phosphoribosyltransferase, 94, 229 I Id, 125, 133, 182, 187, 194, 196, 229 Idiopathic, 30, 68, 131, 142, 229, 253 Immune function, 13, 229 Immune response, 140, 204, 206, 216, 226, 229, 257, 263 Immune system, 208, 229, 235, 238, 244, 262, 263 Immunity, 140, 229 Immunodeficiency, 177, 229 Immunofluorescence, 229, 237 Immunogenic, 14, 229, 233 Immunoglobulin, 204, 229, 238 Immunology, 13, 123, 202, 229 Immunomodulator, 143, 229 Immunosuppressant, 229, 237 Immunosuppressive, 174, 224, 229 Immunotherapy, 208, 217, 229 Impairment, 5, 44, 97, 206, 229, 248 Implant radiation, 229, 231, 232, 251, 264 Impotence, 229, 256 In vitro, 12, 229 In vivo, 12, 140, 218, 229, 241 Incompetence, 224, 229 Incontinence, 229, 256 Indicative, 16, 152, 229, 243, 262 Indigestion, 150, 151, 229

Index 271

Indomethacin, 5, 38, 51, 122, 133, 138, 186, 230 Infancy, 69, 151, 230 Infarction, 230 Infiltration, 87, 144, 147, 224, 230 Inflammatory bowel disease, 142, 143, 230 Influenza, 151, 230 Information Centers, 150, 230 Ingestion, 13, 45, 123, 230, 247 Inhalation, 166, 209, 230, 247, 256 Initiation, 12, 112, 230 Innervation, 209, 230, 236, 259 Inorganic, 12, 141, 210, 230, 238, 255 Insecticides, 230, 244 Insulator, 230, 238 Insulin, 10, 11, 12, 59, 72, 230, 231 Insulin-dependent diabetes mellitus, 230 Insulin-like, 12, 231 Interleukin-8, 144, 147, 231 Intermittent, 72, 156, 231, 247 Internal radiation, 231, 232, 251, 264 Interstitial, 4, 11, 142, 209, 231, 232, 252, 264 Intestinal, 150, 211, 212, 220, 231, 233, 235 Intestinal Mucosa, 211, 220, 231 Intestine, 209, 220, 231, 233 Intoxication, 132, 231 Intracellular, 141, 209, 230, 231, 248 Intracranial Hypertension, 226, 231, 242 Intramuscular, 231, 242, 261 Intravenous, 24, 73, 119, 223, 231, 242 Intrinsic, 71, 202, 231 Invasive, 229, 231, 235 Involuntary, 207, 221, 231, 239 Ions, 201, 207, 218, 219, 228, 231, 232 Iris, 231, 250 Iritis, 143, 231 Irradiation, 151, 231, 264 Irritants, 219, 232 Ischemia, 142, 206, 232 Isoelectric, 25, 69, 232 Isoelectric Point, 69, 232 J Jaundice, 150, 228, 232 K Kb, 172, 232 Keratinocytes, 231, 232 Kidney Disease, 11, 68, 76, 81, 107, 110, 131, 132, 172, 177, 232 Kidney Failure, 5, 174, 220, 232 Kidney Failure, Acute, 232 Kidney Failure, Chronic, 232

Kidney stone, 160, 232, 239, 241, 252, 257, 262 Kidney Transplantation, 174, 182, 232 Kinetics, 108, 233 Klebsiella, 143, 233 L Large Intestine, 231, 233, 251, 255 Latent, 233, 248 Lead Poisoning, 100, 130, 233 Lens, 25, 233, 252 Leprosy, 223, 233 Lethargy, 228, 233 Leucine, 233, 243 Leucocyte, 202, 233 Leukaemia, 129, 233 Leukemia, 32, 134, 177, 233 Leukocytes, 7, 72, 207, 208, 212, 220, 230, 233, 238 Library Services, 194, 233 Ligament, 233, 249 Linkage, 10, 77, 233 Lipase, 10, 40, 89, 104, 233 Lipid, 21, 50, 76, 104, 205, 224, 225, 230, 233, 234, 238, 261 Lipid A, 50, 233 Lipophilic, 15, 234 Lipopolysaccharides, 233, 234 Lipoprotein, 10, 29, 32, 40, 70, 71, 76, 89, 104, 225, 234 Lipoprotein Lipase, 40, 89, 104, 234 Lithiasis, 11, 120, 234 Liver, 15, 25, 69, 122, 150, 201, 202, 207, 212, 222, 223, 225, 227, 234, 247, 248, 253 Liver Cirrhosis, 15, 234 Liver Transplantation, 69, 234 Localized, 217, 230, 234, 240, 241, 246, 254, 256, 261, 262 Locomotion, 234, 246 Low-density lipoprotein, 234 Lower Esophageal Sphincter, 224, 234 Lumbar, 34, 77, 104, 113, 114, 115, 206, 234, 259 Lupus, 234, 258 Lymph, 49, 211, 220, 228, 234, 235, 246, 253 Lymph node, 211, 234, 235, 253 Lymphadenopathy, 49, 234 Lymphatic, 220, 230, 234, 235, 240, 256 Lymphatic system, 234, 235, 256 Lymphoblastic, 129, 235 Lymphocyte, 204, 235, 236 Lymphocytic, 140, 235

272 Gout

Lymphoid, 204, 225, 233, 235 Lymphoma, 177, 235 Lymphoproliferative, 235, 261 M Magnetic Resonance Imaging, 70, 235 Magnetic Resonance Spectroscopy, 17, 25, 52, 122, 235 Malabsorption, 151, 177, 211, 235 Malaria, 150, 235 Malaria, Falciparum, 235 Malaria, Vivax, 235 Malignant, 177, 205, 235, 239, 251 Malnutrition, 151, 202, 206, 235, 238 Mammary, 234, 235 Mannans, 223, 235 Matrix metalloproteinase, 38, 235 Medial, 114, 205, 236, 259 Median Nerve, 51, 210, 236 Mediator, 76, 144, 147, 236, 254 Medical Records, 236, 252 Medicament, 146, 236 Medication Errors, 12, 236 MEDLINE, 173, 176, 178, 236 Medullary, 49, 75, 81, 236 Melanocytes, 236 Melanoma, 177, 236 Membrane, 106, 214, 215, 217, 221, 225, 236, 238, 239, 241, 243, 245, 246, 248, 250, 258, 260 Memory, 204, 236 Meninges, 211, 236, 256 Menopause, 3, 236, 248 Menstruation, 203, 219, 236 Mental, iv, 9, 172, 175, 178, 211, 218, 222, 228, 229, 236, 250, 261, 262 Mental Health, iv, 9, 172, 175, 236, 250 Mercaptopurine, 229, 236 Metabolic disorder, 13, 189, 225, 236 Metabolite, 14, 145, 218, 236, 245, 249 Metastasis, 236 Metatarsal Bones, 30, 236 Metatarsophalangeal Joint, 6, 28, 40, 86, 237 Metatarsus, 236, 237 Methionine, 237, 257 Methotrexate, 10, 237 MI, 12, 15, 41, 143, 149, 198, 237 Microbe, 237, 260 Microbiology, 13, 206, 237 Microcirculation, 234, 237 Microorganism, 213, 237, 243, 263 Micro-organism, 217, 237, 255

Microscopy, 6, 10, 93, 237 Mineralization, 7, 141, 237 Mineralocorticoids, 201, 216, 237 Mitosis, 205, 237 Mixed Connective Tissue Disease, 142, 237 Mobility, 14, 237 Modification, 7, 82, 203, 218, 237 Molecular, 10, 11, 14, 65, 173, 175, 176, 203, 208, 214, 237, 243, 257, 261 Molecule, 204, 207, 214, 218, 219, 225, 228, 237, 241, 242, 245, 246, 247, 251, 260, 263 Monitor, 12, 216, 238, 240 Monoclonal, 25, 232, 238, 251, 264 Monocytes, 95, 231, 233, 238, 246 Mononuclear, 238 Morphine, 238, 239 Morphological, 223, 236, 238 Motility, 230, 238, 254 Motion Sickness, 238, 239 Mucosa, 234, 238 Mucus, 219, 221, 238, 261 Multidrug resistance, 238, 244 Multiple sclerosis, 13, 143, 238 Muscle Fibers, 238 Muscular Atrophy, 177, 238 Muscular Diseases, 238, 242 Muscular Dystrophies, 219, 238 Myalgia, 230, 238 Myasthenia, 143, 238 Mycophenolate mofetil, 99, 238 Myelin, 238, 254 Myeloproliferative Disorders, 9, 135, 207, 238 Myocardial infarction, 142, 207, 216, 237, 238 Myocardium, 237, 238, 239 Myositis, 143, 239 Myotonic Dystrophy, 177, 239 N Naproxen, 46, 83, 239 Narcosis, 239 Narcotic, 5, 238, 239 Nasal Mucosa, 230, 239 Nausea, 150, 224, 229, 239, 261, 262 NCI, 1, 171, 212, 239 Need, 3, 6, 7, 62, 149, 150, 155, 162, 168, 174, 190, 212, 225, 235, 239 Neoplasia, 177, 239 Neoplasm, 239, 256, 261 Neoplastic, 235, 239 Nephrolithiasis, 4, 8, 83, 107, 239

Index 273

Nephrology, 8, 39, 49, 59, 75, 77, 95, 96, 97, 239 Nephropathy, 10, 13, 49, 63, 76, 77, 111, 131, 133, 232, 239 Nerve, 10, 80, 206, 209, 222, 230, 236, 238, 239, 243, 244, 247, 253, 254, 256, 259, 260 Nervous System, 177, 211, 236, 239, 244 Neural, 10, 203, 228, 239 Neuroma, 150, 239 Neuromuscular, 239, 242, 261 Neuropathy, 47, 239, 244, 258 Neurotic, 239, 262 Neurotransmitter, 201, 203, 225, 240, 257 Neutrons, 202, 231, 240, 251 Neutrophil, 6, 80, 142, 144, 147, 240 Neutrophil Activation, 6, 240 Niacin, 125, 126, 240, 261 Nitrogen, 143, 202, 203, 221, 232, 240, 261 Nuclear, 10, 14, 29, 33, 106, 144, 146, 207, 223, 237, 240 Nuclei, 202, 235, 237, 240, 250 Nucleic acid, 217, 218, 229, 240, 250, 251, 253 Nucleus, 205, 207, 212, 216, 217, 219, 220, 223, 238, 240, 250, 257, 258 O Ocular, 74, 84, 240 Odour, 205, 240, 261 Oedema, 144, 147, 240 Ointments, 240, 242 Oliguria, 232, 240 Omeprazole, 22, 84, 241 Oncogene, 177, 241 Onychomycosis, 150, 241 Opacity, 217, 241 Orbital, 213, 241 Organ Transplantation, 13, 241 Organelles, 217, 236, 238, 241 Orthotic Devices, 151, 241 Osmotic, 202, 241 Osteoarthritis, 3, 15, 18, 47, 84, 135, 141, 155, 188, 221, 241, 245 Osteomyelitis, 152, 241 Osteonecrosis, 31, 84, 241 Osteoporosis, 10, 16, 109, 141, 151, 241 Overdosage, 150, 241 Overweight, 125, 184, 186, 241 Oxalate, 31, 122, 241, 262 Oxidants, 142, 241 Oxidation, 205, 216, 227, 241, 242 Oxidation-Reduction, 241, 242 Oxypurinol, 108, 145, 242

P Paediatric, 59, 242 Palliative, 242, 259 Pancreas, 182, 201, 230, 233, 242 Pancreatic, 177, 224, 242 Pancreatic cancer, 177, 242 Pancreatic Juice, 224, 242 Pancreatitis, 143, 242 Paraffin, 48, 242 Paraparesis, 104, 242 Paraplegia, 119, 242 Parasitic, 219, 226, 242 Parenteral, 23, 38, 242 Parenteral Nutrition, 23, 242 Parietal, 241, 243, 246 Parotid, 243, 253 Paroxysmal, 177, 243 Partial remission, 243, 252 Patella, 18, 31, 43, 47, 58, 74, 86, 113, 114, 243 Pathogen, 233, 243 Pathogenesis, 3, 13, 45, 61, 83, 86, 99, 132, 243 Pathologic, 86, 201, 205, 208, 209, 210, 216, 228, 243, 250, 256 Pathologic Processes, 205, 243 Pathologies, 144, 147, 243 Pathophysiology, 9, 10, 11, 243 Patient Education, 184, 192, 194, 198, 243 Pectins, 131, 243 Pefloxacin, 22, 243 Pelvic, 243, 249 Pelvis, 201, 234, 243, 262 Pepsin, 140, 243 Pepsin A, 140, 243 Peptide, 203, 215, 243, 249, 250, 259 Pericardium, 243, 258 Periodontal disease, 142, 243 Periodontitis, 142, 224, 243 Peripheral blood, 141, 244 Peripheral Nervous System, 240, 242, 244, 257 Peripheral Nervous System Diseases, 242, 244 Peripheral Neuropathy, 150, 151, 244 Peritoneal, 240, 244 Peritoneal Cavity, 240, 244 Peroral, 145, 244 Peroxide, 21, 244 Pesticides, 151, 230, 244 Petroleum, 242, 244 P-Glycoprotein, 12, 244

274 Gout

Phagocyte, 241, 244 Phagocytosis, 19, 80, 244 Pharmacologic, 4, 6, 15, 206, 226, 244, 260 Pharynx, 224, 230, 244 Phenotype, 10, 65, 244 Phenylalanine, 243, 244 Phlebitis, 95, 244 Phlebotomy, 45, 123, 244 Phospholipids, 222, 234, 245 Phosphoribosyl Pyrophosphate, 46, 245 Phosphorus, 210, 245 Phosphorylase, 143, 245 Photochemotherapy, 23, 245 Photocoagulation, 213, 245 Photosensitivity, 245, 247 Photosensitizing Agents, 245 Physical Examination, 5, 6, 185, 186, 245 Physiologic, 141, 226, 236, 245 Physiology, 239, 245 Pilot study, 29, 87, 245 Piroxicam, 88, 119, 245 Pituitary Gland, 216, 245 Plants, 131, 150, 202, 225, 243, 246, 253, 260 Plaque, 204, 246 Plasma protein, 202, 220, 246 Plasmid, 14, 246, 263 Platelet Activating Factor, 15, 246 Platelet Aggregation, 20, 246 Platelets, 207, 246, 254, 259 Pleura, 246 Pleural, 240, 246 Pleural cavity, 240, 246 Pleurisy, 144, 147, 246 Pneumonia, 142, 209, 215, 233, 246 Pneumonitis, 142, 246 Podiatrist, 149, 246 Podiatry, 23, 105, 149, 157, 246 Point Mutation, 69, 247 Poison Control Centers, 150, 247 Poisoning, 151, 211, 224, 231, 239, 247 Polyarthritis, 101, 247 Polycystic, 68, 177, 247 Polyethylene, 14, 168, 247 Polymerase, 144, 146, 247 Polymers, 146, 247, 249 Polymorphism, 19, 247 Polymyalgia Rheumatica, 87, 247 Popliteal, 43, 95, 99, 247 Popliteal Cyst, 43, 95, 99, 247 Porphyria, 21, 244, 247 Porphyria Cutanea Tarda, 21, 244, 247

Porphyria, Hepatic, 247 Porphyrins, 247 Posterior, 203, 206, 231, 242, 248, 253, 258 Postmenopausal, 6, 10, 241, 248 Postoperative, 4, 174, 221, 223, 245, 248 Post-translational, 15, 248 Potassium, 9, 168, 237, 248 Potassium Citrate, 9, 248 Practice Guidelines, 175, 248 Preclinical, 14, 248 Precursor, 146, 219, 220, 244, 248, 249, 261, 262 Predisposition, 10, 108, 248, 258 Prednisolone, 248 Prednisone, 8, 109, 162, 248 Premenopausal, 50, 248 Presumptive, 7, 32, 248 Prevalence, 6, 8, 12, 63, 91, 109, 110, 111, 146, 248 Probenecid, 4, 5, 6, 7, 88, 97, 156, 162, 167, 185, 186, 248 Procreation, 154, 248 Prodrug, 145, 249 Progesterone, 249, 256 Progression, 7, 10, 72, 103, 124, 204, 249 Progressive, 142, 205, 212, 225, 232, 238, 239, 241, 249, 250, 252, 261 Proline, 213, 228, 249 Promoter, 14, 249 Prone, 71, 249 Prophylaxis, 5, 22, 110, 249, 252 Proportional, 29, 249 Prospective study, 19, 110, 249 Prostaglandins, 230, 249 Prostaglandins A, 230, 249 Prostate, 177, 249 Protease, 249, 253 Protein Binding, 74, 249 Protein C, 14, 202, 205, 207, 213, 222, 234, 249 Protein S, 154, 178, 208, 249 Proteolytic, 142, 202, 214, 249 Protocol, 189, 250 Proton Pump, 241, 250 Protons, 202, 228, 235, 250, 251 Protozoa, 219, 237, 250 Protozoan, 235, 250 Proximal, 31, 92, 218, 247, 250 Psoriasis, 23, 33, 92, 143, 245, 250, 252 Public Health, 16, 175, 250 Public Policy, 173, 250 Pulmonary, 142, 208, 215, 232, 250, 263

Index 275

Pulmonary Artery, 208, 250, 263 Pulmonary Edema, 232, 250 Pulmonary Fibrosis, 142, 250 Pulmonary hypertension, 215, 250 Pulse, 238, 250 Pupil, 231, 250 Purines, 5, 97, 153, 162, 163, 184, 185, 186, 189, 250, 264 Purulent, 201, 250 Putrefaction, 223, 251 Pyogenic, 241, 251 Pyrazinamide, 41, 58, 97, 167, 251 Pyrimidines, 97, 143, 251 Q Quackery, 54, 251 R Radiation, 3, 219, 220, 221, 223, 231, 245, 251, 264 Radiation therapy, 3, 221, 231, 232, 251, 264 Radioactive, 208, 209, 226, 228, 229, 231, 232, 240, 251, 264 Radiolabeled, 232, 251, 264 Radiological, 94, 103, 251 Radiology, 30, 31, 62, 73, 74, 75, 84, 93, 113, 114, 122, 251 Radiotherapy, 209, 232, 251, 264 Randomized, 10, 12, 16, 219, 251 Recombinant, 15, 251, 263 Reconstitution, 15, 251 Rectal, 150, 166, 251 Rectum, 205, 213, 222, 223, 229, 230, 233, 249, 251 Recurrence, 7, 9, 94, 124, 251 Red blood cells, 221, 227, 247, 251, 253 Red Nucleus, 206, 252 Reductase, 46, 48, 87, 237, 252 Refer, 1, 174, 209, 213, 223, 234, 240, 252 Refraction, 252, 256 Regeneration, 251, 252 Regimen, 73, 163, 219, 252 Regurgitation, 224, 226, 252 Remission, 77, 251, 252 Renal failure, 11, 49, 69, 95, 96, 97, 102, 129, 252 Renal pelvis, 232, 252 Renal tubular, 26, 122, 248, 252 Resolving, 6, 252 Respiration, 238, 252 Respiratory distress syndrome, 142, 252 Restoration, 251, 252, 264 Retinoblastoma, 177, 252

Retinoids, 252, 263 Retrospective, 20, 252 Retrospective study, 20, 252 Rheumatoid, 3, 5, 15, 18, 27, 35, 36, 38, 51, 57, 74, 82, 83, 87, 88, 98, 104, 106, 108, 111, 112, 117, 135, 142, 152, 182, 188, 221, 239, 241, 245, 253 Ribonuclease, 237, 253 Ribonucleic acid, 206, 253 Ribose, 51, 86, 144, 146, 201, 216, 253 Rigidity, 246, 253 Risk factor, 8, 28, 63, 71, 98, 110, 124, 162, 184, 185, 186, 249, 253 Ritonavir, 58, 253 Rod, 207, 233, 253 Rodenticides, 244, 253 Rotator, 114, 253 Rotator Cuff, 114, 253 Rural Population, 109, 253 S Sacroiliac Joint, 7, 23, 253 Salivary, 99, 242, 253 Saponins, 253, 256 Sarcoidosis, 142, 253 Saturnine, 31, 73, 74, 100, 132, 253 Sclera, 215, 253, 254 Scleroderma, 205, 237, 253 Sclerosis, 142, 177, 205, 238, 254 Sclerotic, 7, 254 Screening, 183, 213, 254 Sebaceous, 232, 254, 263 Secretion, 42, 95, 216, 228, 231, 237, 238, 241, 254 Secretory, 241, 254 Sedative, 254, 262 Sedimentation, 247, 254, 261 Seizures, 243, 254 Self-Help Groups, 188, 254 Semen, 249, 254 Senile, 241, 254 Sensory loss, 254, 256, 258 Septic, 29, 36, 101, 102, 206, 254 Sequencing, 14, 254 Sequester, 211, 254 Serotonin, 240, 254, 261 Serous, 220, 246, 254 Sex Determination, 177, 254 Sexually Transmitted Diseases, 151, 255 Shock, 142, 203, 255, 260 Shock, Septic, 142, 255 Side effect, 7, 150, 165, 168, 174, 201, 208, 218, 228, 245, 255, 260

276 Gout

Signs and Symptoms, 5, 252, 255, 261 Skeletal, 30, 31, 32, 62, 74, 84, 122, 203, 238, 255, 258 Skeleton, 113, 222, 232, 255, 259 Small intestine, 212, 219, 220, 227, 231, 255 Smooth muscle, 202, 206, 209, 215, 238, 255, 257 Sodium, 9, 10, 15, 20, 80, 122, 127, 225, 237, 239, 255, 260 Sodium Bicarbonate, 9, 127, 255 Sodium Fluoride, 10, 255 Soft tissue, 4, 6, 7, 185, 186, 208, 255 Solvent, 221, 225, 241, 255 Somatic, 228, 237, 244, 255 Spasmodic, 201, 255 Specialist, 189, 255 Species, 138, 213, 224, 235, 237, 238, 241, 242, 255, 257, 260, 263, 264 Specificity, 15, 202, 255 Spectrum, 50, 243, 256 Sperm, 203, 212, 256, 261 Spinal cord, 102, 114, 209, 211, 212, 220, 236, 239, 242, 244, 256 Spinal Cord Compression, 114, 256 Spinal Cord Diseases, 242, 256 Spinal Fractures, 256 Spinal Stenosis, 95, 256 Spleen, 234, 235, 253, 256 Spondylitis, 188, 221, 256 Sporadic, 247, 252, 256 Sporotrichosis, 43, 256 Steel, 115, 256 Sterile, 206, 256 Steroid, 106, 216, 253, 256 Steroid therapy, 106, 256 Stimulant, 166, 209, 256 Stimulus, 230, 231, 256, 259 Stomach, 150, 201, 206, 221, 223, 224, 227, 234, 239, 243, 244, 255, 256 Stool, 213, 229, 233, 257, 258 Strand, 247, 257 Stress, 155, 197, 216, 224, 239, 248, 253, 257, 262 Stroke, 142, 172, 257 Struvite, 257, 262 Stupor, 233, 239, 257 Subacute, 230, 257 Subclinical, 104, 230, 254, 257 Subcutaneous, 32, 57, 211, 219, 240, 242, 256, 257, 260, 263 Subspecies, 255, 257 Substance P, 208, 236, 251, 254, 257

Substrate, 12, 14, 257 Subtalar Joint, 23, 257 Sulfinpyrazone, 4, 5, 6, 7, 145, 156, 162, 167, 185, 186, 257 Sulfur, 45, 123, 221, 237, 257 Superoxide, 142, 257 Suppression, 216, 257 Symphysis, 249, 257 Symptomatic, 11, 242, 257 Symptomatology, 255, 257 Synergistic, 142, 257 Synovial, 4, 6, 7, 19, 32, 45, 70, 87, 88, 93, 97, 100, 105, 106, 144, 147, 162, 184, 247, 257, 258 Synovial Cyst, 247, 257 Synovial Fluid, 4, 6, 7, 19, 32, 45, 70, 87, 88, 93, 97, 100, 162, 184, 258 Synovial Membrane, 258 Synovitis, 85, 258 Systemic lupus erythematosus, 22, 24, 35, 36, 37, 56, 106, 112, 142, 143, 237, 258 Systolic, 228, 258 T Talus, 257, 258, 259 Tarsal Bones, 210, 236, 258 Tarsal Tunnel Syndrome, 150, 258 Telangiectasia, 177, 258 Temperament, 155, 258 Temporal, 247, 258 Tendinitis, 51, 127, 150, 258 Tendon, 51, 87, 103, 209, 213, 257, 258 Tenesmus, 219, 258 Tenosynovitis, 63, 258 Terminator, 213, 218, 258 Testosterone, 252, 258 Thalamic, 206, 258 Thalamic Diseases, 206, 258 Theophylline, 250, 259 Therapeutics, 11, 16, 80, 90, 168, 259 Thermal, 69, 218, 240, 259 Thigh, 222, 259 Thoracic, 74, 112, 206, 209, 217, 236, 246, 259, 264 Thorax, 201, 234, 259 Threshold, 4, 40, 228, 259 Thrombin, 222, 246, 249, 259 Thrombocytopenia, 246, 259 Thrombomodulin, 249, 259 Thrombosis, 22, 80, 207, 249, 257, 259 Thrombus, 216, 230, 246, 259 Thyroid, 67, 142, 186, 228, 259 Thyrotropin, 228, 259

Index 277

Thyroxine, 202, 244, 259 Tibia, 31, 222, 259 Tibial Nerve, 258, 259 Tin, 210, 244, 259 Tomography, 34, 82, 214, 235, 259 Tone, 241, 260 Tophus, 4, 31, 41, 58, 75, 77, 84, 260 Topical, 221, 242, 245, 255, 260 Toxic, iv, 143, 220, 229, 239, 260 Toxicity, 15, 33, 69, 96, 143, 219, 260 Toxicodendron, 136, 260 Toxicology, 98, 174, 260 Toxins, 204, 230, 260 Trachea, 209, 221, 244, 259, 260 Transcriptase, 218, 260 Transduction, 12, 260 Transfection, 208, 260 Translation, 203, 260 Translational, 260 Transmitter, 236, 260 Trauma, 3, 6, 82, 105, 115, 118, 207, 226, 242, 258, 260 Trees, 260 Triamcinolone Acetonide, 116, 261 Tricuspid Atresia, 215, 261 Triglyceride, 40, 89, 104, 228, 261 Tryptophan, 142, 213, 245, 254, 261 Tuberous Sclerosis, 177, 261 Tubulin, 16, 261 Tumor Lysis Syndrome, 13, 261 Tumour, 38, 261 U Ulcer, 211, 225, 261 Ulcerative colitis, 132, 143, 230, 261 Ultrasonography, 70, 261 Unconscious, 229, 261 Uracil, 251, 261 Uraemia, 242, 261 Urate Oxidase, 14, 261 Uremia, 232, 252, 262 Ureters, 232, 262 Urethra, 249, 262 Uricosuric, 4, 5, 6, 7, 8, 20, 138, 145, 207, 248, 257, 262 Uricosuric Agents, 4, 5, 6, 8, 20, 138, 145, 262 Urinary, 8, 9, 11, 210, 229, 233, 234, 240, 243, 262, 264 Urinary Calculi, 9, 262 Urinary tract, 233, 234, 243, 262 Urinary tract infection, 243, 262 Urolithiasis, 11, 119, 120, 122, 262

Uroporphyrinogen Decarboxylase, 247, 262 Ursodeoxycholic Acid, 10, 262 Urticaria, 203, 262 Uterus, 211, 222, 223, 236, 249, 262 V Vaccine, 250, 262 Vagina, 211, 217, 236, 262 Valerian, 150, 262 Vasculitis, 57, 242, 262 Vector, 260, 263 Vegetarianism, 151, 263 Vein, 22, 231, 240, 243, 244, 263 Venous, 207, 208, 227, 240, 249, 261, 263 Venous blood, 208, 263 Ventricle, 205, 206, 215, 250, 258, 261, 263 Ventricular, 215, 261, 263 Vertebrae, 256, 263 Vertebral, 119, 256, 263 Veterinary Medicine, 173, 263 Villous, 211, 263 Vinblastine, 261, 263 Vincristine, 261, 263 Viral, 14, 143, 218, 224, 230, 260, 263 Viremia, 255, 263 Virulence, 260, 263 Virus, 140, 207, 220, 224, 246, 260, 263 Visceral, 72, 263 Visceral fat, 72, 263 Vitamin A, 5, 126, 263 Vitro, 263 Vivo, 263 Vulgaris, 136, 141, 263 W Warts, 151, 263 Weight Gain, 174, 263 White blood cell, 198, 204, 225, 233, 235, 238, 240, 263 Windpipe, 244, 259, 264 Wound Healing, 236, 264 X Xanthine, 4, 6, 56, 70, 96, 131, 133, 145, 202, 242, 264 Xanthine Oxidase, 4, 6, 131, 145, 202, 242, 264 Xenograft, 204, 264 X-ray, 186, 198, 214, 223, 231, 240, 251, 264 X-ray therapy, 232, 264 Y Yeasts, 223, 244, 264 Z Zymogen, 249, 264

278

Index 279

280 Gout

Gout - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References