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Urtica dioica (stinging nettle) has been traditionally used in Chinese medicine for the treatment of joint pain and rheumatoid arthritis. This study aims to elucidate the active compounds and mechanisms by which it acts against gout arthritis (GA). Gout-related genes were identified from the DisGeNet, GeneCards, and OMIM databases. These genes may play a role in inhibiting corresponding proteins targeted by the active compounds identified from the literature, which have an oral bioavailability of ≥ 30% and a drug-likeness score of ≥ 0.18. A human protein-protein interaction network was constructed, resulting in sixteen clusters containing plant-targeted genes, including ABCG2, SLC22A12, MAP2K7, ADCY10, RELA, and TP53. The key bioactive compounds, apigenin-7-O-glucoside and kaempferol, demonstrated significant binding to SLC22A12 and ABCG2, suggesting their potential to reduce uric acid levels and inflammation. Pathway enrichment analysis further identified key metabolic pathways involved, highlighting a dual mechanism of anti-inflammatory and urate-lowering effects. These findings underscore the potential of U. dioica in targeting multiple pathways involved in GA, combining traditional medicine with modern pharmacology. This integrated approach provides a foundation for future research and the development of multi-target therapeutic strategies for managing gout arthritis. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of hyperuricemia is on the rise in specific populations, and there are difficulties in maintaining medication adherence. This study aims to investigate the factors linked to drug adherence in individuals with hyperuricemia. Methods: This was a cross-sectional study, which was conducted in 2023 by recruiting respondents with hyperuricemia. The demographic data collected included age, gender, occupation, body height and weight, education, marital status and ethnicity. Furthermore, drug adherence was determined based on the response to the Morisky Medication Adherence Scale-8. Acceptance and knowledge were measured using questionnaires given to the participants. Multivariate logistic regression analysis was then used to obtain the determinants of drug adherence. Results: Among 524 respondents who participated in the study, 60.3% and 30.15% had moderate and high adherence to serum uric acid-lowering drugs, respectively. The results showed that older age had a strong association with lower adherence (p <.01), while high disease acceptance significantly predicted higher levels (p <.01). Knowledge about gout symptoms (p =.003; OR: 0.28 [95% CI: 0.12-0.65]), causal factors (p <.001; OR: 2.63 [95% CI: 1.48-4.65]) and uric acid-lowering alternatives (p <.001; OR: 8.17 [95% CI: 4.11-16.25]) also had a positive correlation with higher levels. Conclusion: Knowledge and acceptance had a significant correlation with drug adherence among individuals with hyperuricemia in Aceh Province, Indonesia. [ABSTRACT FROM AUTHOR]

Background: Wuwei Xiaodu Drink (WWXDD), a classical decoction of traditional Chinese medicine, has been clinically used for the treatment of gout in China for many years. This study aimed to demonstrate the efficacy of WWXDD in treating gout flares and elucidate its underlying therapeutic mechanism. Methods: A randomized control trial was conducted to compare the effectiveness of WWXDD with low-dose colchicine in gout arthritis. The primary outcome was the clinical response rate on the 7th day, and joint syndrome score and serological tests were secondary outcome measures and were compared in the two groups on the 1st and 7th day. Then we used a network pharmacology approach to investigate the possible mechanism of WWXDD in treating gout, and the effects of WWXDD on the MSU-induced rat model were observed. Results: In the clinical trial, a total of 78 participants completed the study, and the results demonstrated comparable clinical complete response rates, joint symptom scores, and serological test outcomes between the two groups on the 7th day. Network pharmacology analysis identified 51 core genes that target gout and WWXDD interactions. Notably, strong significant correlations were observed with inflammation cytokine genes and metabolism-related genes. Furthermore, it was found that WWXDD reduced gene expression levels of inflammation cytokines including IL-1β, TNF, and IL-18 in an MSU-induced rat model while increasing IL-10 expression. Additionally, WWXDD decreased insulin gene expression in this model. Moreover, WWXDD exhibited a reduction in both gene and protein expressions associated with the NLRP3-mediated inflammatory pathway in inflamed joints of rats. Conclusion: The results of the present study suggested the anti-inflammatory effects of WWXDD in the treatment of gouty arthritis, partially through inhibiting NLRP3 inflammasome activation. [ABSTRACT FROM AUTHOR]

Background: Spinal gout, a rare and often underdiagnosed condition, significantly impacts patients’ quality of life. Therefore, the aim of the research is to analyze cases of spinal gout, including clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, treatment choices, and outcomes from various cases of spinal gout. Methods: The author conducted a systematic literature search in the PUBMED and Science Direct databases from 2013 to 2023. We included clinical case presentations of spinal cases in adults, published in English. The three researchers independently reviewed the title and abstract of each article, and any differences in opinions were resolved through consensus. The extracted data were subsequently analyzed descriptively. Results: A total of 88 cases of spinal gout were obtained and studied. Out of the total reviewed cases of spinal gout, 89.77% of the subjects were male, with an average age of 51.9 years (age range 16–87 years). Common symptoms include back/neck pain (78.41%) and lower extremity weakness (37.50%). The lumbar spine is the most frequently affected region (62.50%), diagnosed primarily through magnetic resonance imaging (MRI) scans. Surgery, performed in 61.36% of cases, commonly involves decompressive laminectomy. Posttreatment, symptoms resolve in 87.50% of cases. Conclusion: Cases of spinal gout present with a variety of symptoms, including back pain and weakness. Diagnosis typically involves an MRI examination and synovial fluid analysis for confirmation. Treatment varies and includes medication therapy and surgical interventions. A deeper understanding of these cases can assist healthcare practitioners in the management and diagnosis of spinal gout cases.

Background: Spinal gout, a rare and often underdiagnosed condition, significantly impacts patients' quality of life. Therefore, the aim of the research is to analyze cases of spinal gout, including clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, treatment choices, and outcomes from various cases of spinal gout. Methods: The author conducted a systematic literature search in the PUBMED and Science Direct databases from 2013 to 2023. We included clinical case presentations of spinal cases in adults, published in English. The three researchers independently reviewed the title and abstract of each article, and any differences in opinions were resolved through consensus. The extracted data were subsequently analyzed descriptively. Results: A total of 88 cases of spinal gout were obtained and studied. Out of the total reviewed cases of spinal gout, 89.77% of the subjects were male, with an average age of 51.9 years (age range 16-87 years). Common symptoms include back/neck pain (78.41%) and lower extremity weakness (37.50%). The lumbar spine is the most frequently affected region (62.50%), diagnosed primarily through magnetic resonance imaging (MRI) scans. Surgery, performed in 61.36% of cases, commonly involves decompressive laminectomy. Posttreatment, symptoms resolve in 87.50% of cases. Conclusion: Cases of spinal gout present with a variety of symptoms, including back pain and weakness. Diagnosis typically involves an MRI examination and synovial fluid analysis for confirmation. Treatment varies and includes medication therapy and surgical interventions. A deeper understanding of these cases can assist healthcare practitioners in the management and diagnosis of spinal gout cases. [ABSTRACT FROM AUTHOR]

Gout Arthritis is joint inflammation caused by increased uric acid levels in the blood due to purine metabolism distribution (hyperuricemia) in the body, characterized by joint pain that can interfere with the patient's activities. One of the non--pharmacological treatments that can be used for Gout Arthritis is red ginger warm compresses, often used to treat joint inflammation. This scientific paper aims to determine the effect of warm red ginger compress on changes in the pain scale in Gout Arthritis patients in Wongsorejo village. The method was a case study of implementing nursing care and applying Evidence-Based Nursing (EBN). From the assessment, the main diagnosis was acute pain. Red Ginger Warm Compress was given once a day by giving 2 segments of ginger or 9 grams, placing it in the area experiencing joint pain for 10 minutes and then doing a pain assessment again with the Numerical Tw`ig Scale (NRS). The results of the case study in the two respondents after seven days was a decrease in the pain scale from 8 and 6 and after the treatment the pain can be reduced to scale 1 in pain. Red ginger warm compresses are an effective complementary therapy for reducing pain in Gout Arthritis patients. It is recommended that nurses can apply Red Ginger Warm compress to reduce pain in Gout Arthritis clients.

Arthritis gout merupakan penyakit yang berhubungan dengan tingginya kadar asam urat dalam darah. Tingginya kadar asam urat dapat menyebabkan serangan gout bersifat mendadak, berulang dan disertai dengan arthritis yang terasa sangat nyeri pada bagian sendi. Mencegah terjadinya komplikasi diperlukan upaya perawatan untuk mengontrol kadar asam urat, selain pengaturan makanan rendah purin upaya untuk mengurangi akumulasi endapan kristal monosodium urat di dalam darah maka dilakukan terapi aktivitas yaitu senam ergonomik yang direkomendasikan mampu menurunkan kadar asam urat. Studi kasus ini bertujuan dengan penerapan senam ergonomik untuk menurunkan kadar asam urat pada klien Gout Arthritis. Desain penulisan studi kasus ini menggunakan metode deskriptif dengan pendekatan proses asuhan keperawatan mulai dari pengkajian hingga evaluasi pada klien yang memenuhi kriteria. Studi kasus menunjukkan bahwa ketiga klien mengalami penurunan kadar asam urat dengan rata-rata 2,4 mg/dL setelah dilakukan senam ergonomik yang dilakukan selama 3 kali dalam seminggu selama 20 menit. Pemberian senam ergonomik mampu menurunan kadar asam urat pada klien Gout Arthritis di RW 4 Desa Wonoplumbon. Diharapkan penerapan senam ergonomik menjadi salah satu intervensi yang dapat dilakukan pada klien Gout Arthritis.

Acid-sensing ion channels (ASICs) in dorsal root ganglion (DRG) neurons play an important role in inflammatory pain. The objective of this study is to observe the regulatory role of ASICs in monosodium urate (MSU) crystal-induced gout pain and explore the basis for ASICs in DRG neurons as a target for gout pain treatment. The gout arthritis model was induced by injecting MSU crystals into the ankle joint of mice. The circumference of the ankle joint was used to evaluate the degree of swelling; the von Frey filaments were used to determine the withdrawal threshold of the paw. ASIC currents and action potentials (APs) were recorded by patch clamp technique in DRG neurons. The results displayed that injecting MSU crystals caused ankle edema and mechanical hyperalgesia of the paw, which was relieved after amiloride treatment. The ASIC currents in DRG neurons were increased to a peak on the second day after injecting MSU crystals, which were decreased after amiloride treatment. MSU treatment increased the current density of ASICs in different diameter DRG cells. MSU treatment does not change the characteristics of AP. The results suggest that ASICs in DRG neurons participate in MSU crystal-induced gout pain. [ABSTRACT FROM AUTHOR]

Gout arthritis is an inflammatory disease in the joints, which is still very high and is still a public health problem, especially in Indonesia with a high prevalence. This study aims to determine the risk factors that influence the incidence of Gout arthritis. Quantitative research with a case control study approach. A sample of 60 respondents was 30 each for the case and control groups. The instrument used in this study was in the form of a questionnaire or questionnaire. The data were analyzed using the chi-square test. Genetic statistical test results with values p = 0.002 (0.05), OR = 1.556 (95% Cl 0.534-4.532) and p = 0.055 (>0.05), OR = 3,500 (95% Cl 1,112-11,017). The conclusion that genetics have a significant influence, while uric acid levels and foods containing purines have no influence on Gout arthritis

Abstract Background Gut microbiota plays a significant role in the development and treatment of gouty arthritis. Simiao decoction has been shown to alleviate gouty arthritis by inhibiting inflammation, regulating NLRP3 inflammasome, and altering gut microbiota. However, there is no evidence to prove whether gut microbiota directly mediates the therapeutic efficiency of Simiao decoction in treating gout arthritis. Methods In this study, fecal microbiota transplantation (FMT) was used to transfer the gut microbiota of gout arthritis mice treated with Simiao decoction or allopurinol to blank gout arthritis mice, in order to investigate whether FMT had therapeutic effects on gout arthritis. Results Both Simiao decoction and allopurinol effectively reduced the levels of serum uric acid, liver XOD activity, foot thickness, serum IL-1β, and G-CSF in gout arthritis mice. However, Simiao decoction also had additional benefits, including raising the pain threshold, reducing serum TNF-α and IL-6, alleviating gut inflammation, and repairing intestinal pathology, which were not observed with allopurinol treatment. Moreover, Simiao decoction had a greater impact on gut microbiota than allopurinol, as it was able to restore the abundance of phylum Proteobacteria and genus Helicobacter. After transplantation into gout arthritis mice, gut microbiota altered by Simiao decoction exhibited similar therapeutic effects to those of Simiao decoction, but gut microbiota altered by allopurinol showed no therapeutic effect. Conclusions These findings demonstrates that Simiao decoction can alleviate gout arthritis symptoms by regulating gut microbiota.

Arthritis is a frequent autoimmune disease with undefined etiology and pathogenesis. Scientific community constantly fascinating quercetin (QUR), as it is the best-known flavonoid among others for curative and preventive properties against a wide range of diseases. Due to its multifaceted activities, the implementation of QUR against various types of arthritis namely, rheumatoid arthritis (RA), osteoarthritis (OA), gouty arthritis (GA) and psoriotic arthritis (PsA) has greatly increased in recent years. Many research evidenced that QUR regulates a wide range of pathways for instance NF-κB, MAK, Wnt/β-catenine, Notch, etc., that are majorly associated with the inflammatory mechanisms. Besides, the bioavailability of QUR is a major constrain to its therapeutic potential, and drug delivery techniques have experienced significant development to overcome the problem of its limited application. Hence, this review compiled the cutting-edge experiments on versatile effects of QUR on inflammatory diseases like RA, OA, GA and PsA, sources and bioavailability, therapeutic challenges, pharmacokinetics, clinical studies as well as toxicological impacts. The use of QUR in a health context would offer a tearing and potential therapeutic method, supporting the advancement of public health, particularly, of arthritic patients worldwide. [ABSTRACT FROM AUTHOR]

Objectives: In previous reports, proton pump inhibitor (PPI) use increased the risk of gout. However, there is no epidemiological study investigating this association. We aimed to examine the potential impact of PPI treatment on the risk of developing gout. Methods: A population‐based case–control study was performed using a Longitudinal Health Insurance Database 2000 from Taiwan (population 23 million). We identified gout cases and non‐gout controls through propensity score matching at 1:1, which was matched by sex and age. We used a conditional logistic regression model to estimate an odds ratio and 95% confidence intervals (CI) for gout population versus controls. Results: Esomeprazole increased the risk of gout after adjusting confounding variables (adjusted odds ratio [aOR] 1.3; 95% CI 1.0–1.6). The risk of gout was highest within 30 days of PPI treatment (aOR 1.7; 95% CI 1.4–1.9) and attenuated thereafter. The risk of gout was increased among female users of PPI compared with male users (aOR 2.2; 95% CI 1.7–2.8). The aOR of gout in people with PPI use was higher in middle‐aged individuals (41–60 years: aOR 2.1; 95% CI 1.7–2.7) than in the older group (≥60 years: aOR 1.8; 95% CI 1.5–2.2). Conclusions: Our findings provide population‐level evidence for the hypothesis that PPI treatment is positively associated with the risk of developing gout. Further research on the mechanism underlying this association is warranted. [ABSTRACT FROM AUTHOR]

Background/Aims The occurrence of gout attacks at the start of uric acid lowering treatment worsens compliance. We aimed to determine the appropriate dose of febuxostat to reduce the occurrence of gout attacks during the initial treatment period. Methods We retrospectively analyzed the data of patients diagnosed with gout who underwent treatment at Jeju National University Hospital between May 2018 and May 2020. Results Two-hundred and twenty-seven patients were included, with a mean age of 53.2 ± 16.4 years, and 219 (96.5%) were male. The patients were divided into two groups according to the starting dose of febuxostat (20 mg vs. 40 mg). There were no significant differences in mean age, disease duration, colchicine, estimated glomerular filtration rate (eGFR), initial uric acid levels, and presence of subcutaneous tophi between the two groups. Gout attacks occurred more frequently in the 20 mg group than in the 40 mg group during the first 3 months of treatment (32.0% vs. 14.3%, p = 0.002), particularly during the first month (21.3% vs. 7.5%, p = 0.005). Multivariate logistic regression analysis was conducted adjusting for the effects of disease duration, the presence of subcutaneous tophi, eGFR, and initial uric acid levels. A febuxostat starting dose of 40 mg (odds ratio, 0.464; 95% confidence interval [CI], 0.246 to 0.862; p = 0.015) and anti-inflammatory prophylaxis (odds ratio, 0.359; 95% CI, 0.158 to 0.813; p = 0.014) were found to be independent factors associated with a gout attack. Conclusions Starting uric acid lowering treatment with febuxostat 40 mg rather than 20 mg may reduce the incidence of gout attacks in the early period of treatment in Korean patients with gout.

Gout arthritis adalah masalah kesehatan umum pada agregat lansia. Penderita gout arthritis di Seksi Kesejahteraan Sosial Padu Wau Waipare sebanyak 18 dari 65 lansia. Penderita gout yang mengalami inflamasi sendi, jika tidak mendapat terapi dapat mengakibatkan kecacatan fisik. Terapi non-farmakologis yang dapat dilakukan untuk menurunkan asam urat adalah edukasi diet rendah purin, rendah lemak dan mengatur aktivitas fisik tingkat sedang. Tindakan terapeutik pemberian kompres jahe serai hangat adalah salah satu intervensi keperawatan manajemen nyeri. Jahe mengandung gingerol limonene, acid aspartic sedangkan serai mengandung minyak astiri yang bermanfaat untuk penghangat dan anti radang. Kompres hangat dapat menstimulasi vasodilatasi memperlancar sirkulasi darah sehingga dapat mengurangi sensai nyeri. Studi kasus ini bertujuan untuk mengurangi nyeri dan menurunkan kadar asam urat lansia gout arthritis setelah dilakukan tindakan keperawatan terapi non-farmakologis. Penelitian ini menggunakan metode case study, responden 2 lansia dengan kriteria inklusi keluhan nyeri, tingkat aktivitas rendah 7mg/dl dan tidak rutin minum obat. Hasil studi kasus pada kedua subjek menunjukkan penurunan nyeri dan kadar asam urat setelah terapi selama 1 minggu. penurunan kadar asam urat subjek studi 1 sebesar 5,8 mg/dl sedangkan subjek studi 2 sebesar 3,5 mg/dl. Penurunan skala nyeri kedua subjek studi kasus sebesar 2 poin.

Background: Gut microbiota plays a significant role in the development and treatment of gouty arthritis. Simiao decoction has been shown to alleviate gouty arthritis by inhibiting inflammation, regulating NLRP3 inflammasome, and altering gut microbiota. However, there is no evidence to prove whether gut microbiota directly mediates the therapeutic efficiency of Simiao decoction in treating gout arthritis. Methods: In this study, fecal microbiota transplantation (FMT) was used to transfer the gut microbiota of gout arthritis mice treated with Simiao decoction or allopurinol to blank gout arthritis mice, in order to investigate whether FMT had therapeutic effects on gout arthritis. Results: Both Simiao decoction and allopurinol effectively reduced the levels of serum uric acid, liver XOD activity, foot thickness, serum IL-1β, and G-CSF in gout arthritis mice. However, Simiao decoction also had additional benefits, including raising the pain threshold, reducing serum TNF-α and IL-6, alleviating gut inflammation, and repairing intestinal pathology, which were not observed with allopurinol treatment. Moreover, Simiao decoction had a greater impact on gut microbiota than allopurinol, as it was able to restore the abundance of phylum Proteobacteria and genus Helicobacter. After transplantation into gout arthritis mice, gut microbiota altered by Simiao decoction exhibited similar therapeutic effects to those of Simiao decoction, but gut microbiota altered by allopurinol showed no therapeutic effect. Conclusions: These findings demonstrates that Simiao decoction can alleviate gout arthritis symptoms by regulating gut microbiota. [ABSTRACT FROM AUTHOR]

Gout arthritis is an inflammatory condition that occurs suddenly in joints affected by high uric acid levels (hyperuricemia). The uric acid levels in this disease fluctuate throughout its various phases, resulting in frequent or recurrent attacks. This study aims to review some aspects of gout arthritis, such as its pathophysiology, treatment goals, and adverse drug reactions. This study employs review literature using articles published between 2017 and 2022 as the research methodology. Furthermore, articles under 2017 are used as references if they are relevant to the study's subject matter. The findings showed the importance of the pathogenesis of inflammation in the treatment of gout arthritis. It is also recommended to use anti-inflammatories such as colchicine and uric acid-lowering medications starting at a specific time to prevent unintended risks. Hence, pharmacotherapy management's adverse effects include nausea, vomiting, myalgia, neuropathy, and stomach pain.

Hongliang Zhang,1 Jie Gao,1 Wenxiang Fang,1 Yujie Tang,1 Xuan Fang,1 Tengchuan Jin,2 Jinhui Tao1 1Department of Rheumatology and Immunology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, People’s Republic of China; 2Laboratory of Structural Immunology, CAS Key Laboratory of Innate Immunity and Chronic Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, People’s Republic of ChinaCorrespondence: Jinhui Tao; Tengchuan Jin, Email taojinhui@ustc.edu.cn; jint@ustc.edu.cnObjective: To determine the role of nerve injury-induced protein 1 (NINJ1) introduced plasma membrane rupture (PMR) and damage-associated molecular patterns (DAMPs) release in the pathogenesis and progression of gout and to explore the potential of NINJ1 as a therapeutic target in gout.Methods: Both peripheral blood mononuclear cells (PBMCs) and serum sample from gout patients (n = 58) and healthy controls (n = 16) were collected and processed to NINJ1 expression, lactate dehydrogenase (LDH) detection, NINJ1 inhibition, and NINJ1 expression experiments, respectively. NINJ1 knockdown was carried out by lentivirus in a monosodium urate (MSU) induced rat model, and NINJ1 neutralizing antibody was applied in a MSU induced mouse model.Results: Our results found that NINJ1 was upregulated during a gout flare, and the resulting induction of PMR correlated with gout progression. NINJ1 knockdown significantly reduced the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome activation and joint swelling in the rat model, and NINJ1 neutralizing antibody also significantly reduced gout flare in the mouse model and PBMCs. Moreover, NINJ1 expression is under NLRP3 inflammasome produced interleukin (IL)-1β control.Conclusion: These results support the notion of a pathogenic role of NINJ1 introduced PMR in gout and provide a detailed mechanism for gout pathogenesis involving inflammatory cell death and DAMPs release introduced by IL-1β. In addition, targeting NINJ1 might be a potential therapeutic approach for gout.Keywords: gout arthritis, NINJ1, NLRP3 inflammasome, plasma membrane rupture, therapeutic target

Gout arthritis (GA) is a common and curable type of inflammatory arthritis that has been attributed to a combination of genetic, environmental and metabolic factors. Chronic deposition of monosodium urate (MSU) crystals in articular and periarticular spaces as well as subsequent activation of innate immune system in the condition of persistent hyperuricemia are the core mechanisms of GA. As is well known, drugs for GA therapy primarily consists of rapidly acting antiinflammatory agents and life-long uric acid lowering agents, and their therapeutic outcomes are far from satisfactory. Although MSU crystals in articular cartilage detected by arthrosonography or in synovial fluid found by polarization microscopy are conclusive proofs for GA, the exact molecular mechanism of NLRP3 inflammasome activation in the course of GA still remains mysterious, severely restricting the early diagnosis and therapy of GA. On the one hand, the activation of Nod-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome requires nuclear factor kappa B (NF-kB)-dependent transcriptional enhancement of NLRP3, precursor (pro)-caspase-1 and pro-IL-1b, as well as the assembly of NLRP3 inflammasome complex and sustained release of inflammatory mediators and cytokines such as IL-1P, IL-18 and caspase-1. On the other hand, NLRP3 inflammasome activated by MSU crystals is particularly relevant to the initiation and progression of GA, and thus may represent a prospective diagnostic biomarker and therapeutic target. As a result, pharmacological inhibition of the assembly and activation of NLRP3 inflammasome may also be a promising avenue for GA therapy. Herein, we first introduced the functional role of NLRP3 inflammasome activation and relevant biological mechanisms in GA based on currently available evidence. Then, we systematically reviewed therapeutic strategies for targeting NLRP3 by potentially effective agents such as natural products, novel compounds and noncoding RNAs (ncRNAs) in the treatment of MSU-induced GA mouse models. In conclusion, our present review may have significant implications for the pathogenesis, diagnosis and therapy of GA. [ABSTRACT FROM AUTHOR]

Gout is an inflammatory arthritis that causes acute pain due to the accumulation of uric acid crystals. Hyperuricemia primarily causes it, resulting in the deposition of monosodium urate crystals in and around joints. Gout can affect joints such as the metatarsophalangeal joint and the foot's talus bone. Treatment involves addressing hyperuricemia and managing symptoms with medications like febuxostat. Surgical treatment is crucial, especially in cases of chronic tophaceous gout or severe joint damage, including arthroscopic debridement, ankle arthrodesis, or total ankle arthroplasty. A 32-year-old male with a history of hyperuricemia experienced pain in his left ankle for a year. The ankle was swollen and prone to pain when he walked. Magnetic resonance imaging (MRI) tests revealed the thickening and irregular shape of the anterior talofibular ligament (ATFL), suggesting a rupture. The arthroscopic operation revealed a crystal deposit, leading to the diagnosis of gout arthritis and subsequent debridement for the patient. Following the surgery, the patient experienced minimal pain, an improved range of motion, and a significant improvement in swelling within a week. The patient was able to walk with minimal assistance and without aid. Gout arthritis and ATFL injuries share common clinical features, including joint swelling, limited motion, and joint deformity. The presence of monosodium urate (MSU) crystals and inflammation in both conditions complicates diagnosis. Performing arthroscopic debridement surgery in gout arthritis presents challenges due to tophi and inflammation, as well as the risk of articular cartilage damage. Expertise is crucial for successful arthroscopic debridement, with patient selection, preoperative planning, and thorough removal of MSU crystals being key factors. Thorough evaluation, patient selection, preoperative planning, joint identification, removal of MSU crystals, and comprehensive postoperative care are crucial for successful arthroscopic debridement for gout arthritis of the ankle. • Gout arthritis and ATFL injury share clinical features like joint swelling and limited motion, making diagnosis challenging. • Gout typically affects older individuals, but cases in younger age groups are not unheard of, necessitating thorough evaluation. • High BMI may influence the prevalence of gout arthritis, although consensus on its direct impact remains varied. • Arthroscopic debridement in gout arthritis poses challenges due to tophi presence hindering visualization and potential for cartilage damage. [ABSTRACT FROM AUTHOR]

Introduction: Intense and severe pain is the most common symptom of acute gout arthritis (GA) flare. A recent study revealed that opioids are commonly prescribed for acute gout flare. Objective: This review aims to explain current evidence of opioid usage in the management of pain for acute GA flare. Method: The literature search was conducted on PubMed and Google Scholar in June 2022. Relevant articles published in the last 10 years were included. Results: The evidence of opioid use in managing acute gout arthritis flares is scarce. Currently, no guidelines recommend opioids as an initial analgesic choice in managing acute GA flare. Opioids are indicated in the flare with severe kidney dysfunction if only oral corticosteroids and intra-articular corticosteroids are not effective in reducing pain. Conclusion: Opioids should be used as only adjuvant and last choice in selected cases.

BACKGROUND: Most elders with gout arthritis pain choose analgesic to deal with their pain. Massage efflurage using red ginger is a therapy to reduce gout arthritis pain. The objective of research was to find out the effectiveness of message efflurage using red ginger in relieving gout arthritis pain in elders. METHOD: The research design employed in this study was pre-experimental one group pre-posttest design. Independent variable was massage efflurage using red ginger and dependent variable was gout arthritis pain in elders. The population of research was all elders in Kedungbendo Village of Mojokerto Regency, consisted of 36 elders. The sample of research consisted of 33 elders taken using probability simple random sampling technique used. Pretest-posttest data were collected using numerical pain scale observation sheet. RESULT: The result of pretest-posttest obtained from 8 respondents with severe pain showed that their pain change into mild (5 respondents) and moderate pains (3). Out of 21 respondents, 9 respondents showed that their pain changed from moderate into no pain, 10 respondents into mild pain and 2 stable. Out of 4 respondents with mild pain, all of them showed that their pain changed into no pain. CONCLUSION: The result of Wilcoxon test showed 0.000 ≤ α= 0.05, meaning that there is an effective effect of massage efflurage using red ginger on the relief of gout arthritis pain in elders. This result indicated that massage efflurage using red ginger affected the gout arthritis pain scale in elders. Respondents are expected to reduce the consumption of analgesics and to switch to a safe alternative therapy to reduce negative effect related to aging process experienced by elders.

Emerging antibiotic resistance in bacteria threatens immune efficacy and increases susceptibility to bone degradation and arthritic disorders. In our current study, we utilized a three-layer in-silico screening approach, employing quantum chemical methods, molecular docking, and molecular dynamic methods to explore the novel drug candidates similar in structure to floroquinolone (ciprofloxacin). We investigated the interaction of novel similar compounds of ciprofloxacin with both a bacterial protein S. aureus TyrRS (1JIJ) and a protein associated with gout arthritis Neutrophil collagenase (3DPE). UTIs and gout are interconnected through the elevation of uric acid levels. We aimed to identify compounds with dual functionality: antibacterial activity against UTIs and antirheumatic properties. Our screening based on several methods, sorted out six promising ligands. Four of these (L1, L2, L3, and L6) demonstrated favorable hydrogen bonding with both proteins and were selected for further analysis. These ligands showed binding affinities of -8.3 to -9.1 kcal/mol with both proteins, indicating strong interaction potential. Notably, L6 exhibited highest binding energies of -9.10 and -9.01 kcal/mol with S. aureus TyrRS and Neutrophil collagenase respectively. Additionally, the pkCSM online database conducted ADMET analysis on all lead ligand suggested that L6 might exhibit the highest intestinal absorption and justified total clearance rate. Moreover, L6 showed a best predicted inhibition constant with both proteins. The average RMSF values for all complex systems, namely L1, L2, L3 and L6 are 0.43 Å, 0.57 Å, 0.55 Å, and 0.51 Å, respectively where the ligand residues show maximum stability. The smaller energy gap of 3.85 eV between the HOMO and LUMO of the optimized molecule L1 and L6 suggests that these are biologically active compound. All the selected four drugs show considerable stabilization energy ranging from 44.78 to 103.87 kcal/mol, which means all four compounds are chemically and physically stable. Overall, this research opens exciting avenues for the development of new therapeutic agents with dual functionalities for antibacterial and antiarthritic drug designing., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Siphonochilus aethiopicus is a medicinal plant widely used in the treatment of many inflammatory conditions such as arthritis. The objective of this study was therefore to evaluate the antioxidant and anti-inflammatory properties of methanolic extract of S. aethiopicus rhizomes. Methods: The total phenolic compounds, flavonoid, and tannin content, as well as the in vitro antioxidant activity of the extract, were estimated. The in vivo anti-inflammatory activity was then evaluated in male mice aged 3 to 4 months using the arthritic mouse model induced by carrageenan (0.05 ml; 1%) and monosodium urate (MSU) crystals (26.6 mg/mL). Mice were treated with the methanolic extract of S. aethiopicus (75, 150, 300 mg/kg) and the reference drugs: indomethacin (3 mg/kg) and colchicine (1 mg/kg). The serum, splenic, and hepatic lysosomal enzymes were determined, and oxidative stress biomarkers were estimated. Paws were sectioned for histological analysis. Results: Results showed that S. aethiopicus extract had non-negligible concentrations of polyphenols, flavonoids, and tannins, which could confer it an antioxidant effect. Further, the methanolic extract of S. aethiopicus at different doses significantly (P < 0.05) reduced paw swelling, attenuated joint inflammation, limited the release of lysosomal enzymes, and improved antioxidant enzymes. Conclusion: The methanolic extract of S. aethiopicus has anti-inflammatory and antioxidant properties, and can be used to treat acute forms of gouty arthritis.

Objective: Gout is the most common form of inflammatory arthritis and is caused by deposition of monosodium urate crystals resulting from a high burden of uric acid (UA). High UA burden also has been associated with increased morbidity and mortality in the general population and progression to chronic kidney disease. In persons with gout and end‐stage renal disease (ESRD), prior studies suggest that UA levels decrease after initiation of hemodialysis (HD). We evaluated UA level and the use of urate‐lowering therapies (ULTs) in patients with gout and ESRD on HD. Methods: We performed a retrospective review of patients with gout and ESRD seen at a large urban public hospital (The MetroHealth System). We extracted data from the medical record (Epic) for patients diagnosed with gout and ESRD on HD. The main outcomes were the UA level and the use of ULTs before and after HD initiation. Results: We identified 131 patients with gout on HD. Of these, 21 patients had crystal proven gout diagnosis, 10 of whom had data on UA level pre‐HD and post‐HD and were included in the analysis. For the total sample (N = 21), the mean age was 65 years, 7 were female and 20 were African American. Mean pre‐HD and post‐HD UA levels were 8.4 and 3.98 mg/dL respectively. Twenty‐one patients were receiving ULT pre‐HD, 11 discontinued post‐HD. Conclusion: Among patients with gout and ESRD, we observed a decrease in UA level associated with initiation of HD. For this group, discontinuation of ULTs may be appropriate. [ABSTRACT FROM AUTHOR]

Introduction: Gout arthritis is a systemic disease caused by deposition of monosodium urate crystals in the joints, causing pain. Pain management may include complementary therapy such as combination therapy of a warm ginger stew compress and Ki. 3 point acupressure to reduce pain. This research aimed to examine the effect of combination therapy of a warm ginger stew compress and Ki. 3 point acupressure on the pain level of gout arthritis patients. Methods: The research design for this study is a quasi-experiment pre-test and post-test, with a control group design for 30 respondents. The respondents were assigned to an experimental group with combination therapy of a warm ginger stew compress and Ki. 3 point acupressure for about 30 minutes, and a control group with a warm ginger stew compress for about 15 minutes. Each group consisted of 15 people. The data was analysed using a paired t-test, independent t-test, and Mann Whitney test. Results: The Mann Whitney test showed an average decrease of pain level in the experimental group of 1,7333 and the control group of 1,0667 so, there were differences in the decreased of pain level before and after intervention between the two groups with p-value=0.013. Conclusion: Combination therapy of a warm ginger stew compress and Ki. 3 point acupressure were effective in decreasing the pain level of gout arthritis patients in Puskesmas 1 Purwokerto Timur. This therapy can be used for the gout arthritis patient to reduce pain level.

Background: Wuwei Xiaodu Drink (WWXDD), a classical decoction of traditional Chinese medicine, has been clinically used for the treatment of gout in China for many years. This study aimed to demonstrate the efficacy of WWXDD in treating gout flares and elucidate its underlying therapeutic mechanism. Methods: A randomized control trial was conducted to compare the effectiveness of WWXDD with low-dose colchicine in gout arthritis. The primary outcome was the clinical response rate on the 7th day, and joint syndrome score and serological tests were secondary outcome measures and were compared in the two groups on the 1st and 7th day. Then we used a network pharmacology approach to investigate the possible mechanism of WWXDD in treating gout, and the effects of WWXDD on the MSU-induced rat model were observed. Results: In the clinical trial, a total of 78 participants completed the study, and the results demonstrated comparable clinical complete response rates, joint symptom scores, and serological test outcomes between the two groups on the 7th day. Network pharmacology analysis identified 51 core genes that target gout and WWXDD interactions. Notably, strong significant correlations were observed with inflammation cytokine genes and metabolism-related genes. Furthermore, it was found that WWXDD reduced gene expression levels of inflammation cytokines including IL-1β, TNF, and IL-18 in an MSU-induced rat model while increasing IL-10 expression. Additionally, WWXDD decreased insulin gene expression in this model. Moreover, WWXDD exhibited a reduction in both gene and protein expressions associated with the NLRP3-mediated inflammatory pathway in inflamed joints of rats. Conclusion: The results of the present study suggested the anti-inflammatory effects of WWXDD in the treatment of gouty arthritis, partially through inhibiting NLRP3 inflammasome activation. Clinical Trial Registration: ClinicalTrials.gov, identifier ChiCTR2100047807., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lin, Dai, Zhang and Xu.)

Background: We explored the mechanisms of Sanguotang (SGT), a Tibetan medicine, in treating gout arthritis (GA)., Methods: The main active components, action targets, and disease targets of SGT were identified through TCMSP databases. The gene functions were analyzed using protein interaction (PPI) networks, Gene Ontology (GO) enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and molecular docking. A GA model induced by monosodium urate was established in rats. The ankle joint swelling was observed. The levels of uric acid (UA) and albumin (ALB) in rat serum were measured. Hematoxylin and eosin (HE) staining was conducted to examine the pathological changes in rat ankle joints., Results: Twenty-nine active components of SGT with proven efficacy and 66 intersection targets were identified, primarily involved in inflammation and immune regulation pathways. The PPI results revealed that the key targets of SGT against GA included ALB, IL6, TNF, TP53, and PTGS. Molecular docking showed favorable binding energy between the ALB protein and the active components. The results from animal experiments demonstrated that SGT effectively alleviated the inflammatory reaction in ankle joints, and decreased UA and ALB levels. Furthermore, SGT effectively inhibited the proliferation of synovial cells in the ankle joint cavity, prevented infiltration of inflammatory cells, and protected synovial tissue, thereby improving GA., Conclusions: SGT comprehensively contributes to the treatment of GA by regulating UA metabolism, reducing the release of inflammatory factors, and modulating immune and inflammatory pathways., Competing Interests: Conflict of Interest Statement All authors declare no conflicts of interest., (Copyright © 2024 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

OBJECTIVE: To explore the related targets and signal pathways of Simiao Yong ’an decoction intervening gout arthritis by using network pharmacology combined with molecular docking technology, so as to probe into the mechanism of Simiao Yong’an decoction in the treatment of gout arthritis. METHODS: The active ingredients and targets of four herbs in the formula of Simiao Yong’an decoction were screened out by the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP), the related gene targets of gout arthritis were screened out by online mendelian inheritance in man (OMIM), GeneCards, PharmGkb, DrugBank and therapeutic target database (TTD), the common intersection of drug targets and disease targets were obtained after integration, and the network diagram of “active ingredient-core target”was topologized with the help of Cytoscape3. 7. 2 software, the protein-protein interaction (PPI) network diagram was obtained through the STRING online database platform, and the gene ontology (GO) functional enrichment analysis and Kyoto encyclopedia of genes and genomes (KEGG)pathway enrichment analysis were used for the acquired key targets. Finally, the matching and validation of molecular docking on main active ingredients and core targets of the drug were conducted by using Autodock 1. 5. 6 software. RESULTS: Totally 96 active ingredients and 38 targets were screened out in the intervention of Simiao Yong ’an decoction on gouty arthritis, including the main active ingredients of quercetin, kaempferol, naringenin and lignan, including the main targets of PTGS2, NOS2, PPARG, MAPK14 and PTGS1. The PPI network had analyzed 8 core targets including CXCL8, PTGS2, MAPK3, TNF, IL-1β, CCL2, MAPK1 and HMOX1. Results of the molecular docking indicated that the main active ingredients of Simiao Yong’an decoction could bind to the core targets and showed good affinity. CONCLUSIONS: The application of Simiao Yong’an decoction in the treatment of gouty arthritis has the characteristics of multiple pathways, multiple components and multiple targets, the potential mechanism of Simiao Yong’an decoction in the treatment of gouty arthritis may be related to its effects of degrading uric acid, down-regulating the expression of inflammatory factors and regulating immune function. [ABSTRACT FROM AUTHOR]

Current data demonstrated that severe cases of coronavirus-disease-19 (COVID-19) require treatment with antiviral therapy, dexamethasone, supportive care, as well as some anti-rheumatic drugs, among them, cytokine inhibitors and colchicine. Colchicine is an anti-inflammatory drug that is being used in rheumatology for many years to treat mostly gout, calcium pyrophosphate deposition disease, and Familial Mediterranean Fever. Here, we present for the first time, two patients suffering from gout being treated with colchicine, who were affected from severe acute respiratory coronavirus-2 (SARS-CoV-2) syndrome. Both patients presented with mild symptoms of COVID-19 expressed with myalgias, arthralgias, and sore throat, while laboratory investigations showed only high acute phase reactants. Four weeks later, both patients were free of symptoms with negative SARS-CoV-2 tests and without any complications. To our knowledge, there are no other studies of gout arthritis and SARS-CoV-2 infection published so far. Thus, our preliminary conclusion is that chronic use of colchicine may mitigate the clinical picture and disease course of COVID-19 in gout arthritis patients. Further studies with a large number of patients are needed to confirm the above beneficial effect of colchicine. [ABSTRACT FROM AUTHOR]

Summary: Down‐regulated miR‐223‐3p was found in rheumatoid arthritis. This study aimed to further explore the level and role of miR‐223‐3p in gout arthritis (GA). After monosodium urate (MSU)‐induced GA rat and fibroblast‐like synoviocytes (FLSs) models were established, the rat paw volume and gait score were documented and the FLSs were transfected with miR‐223‐3p mimic/inhibitor or NLR family pyrin domain containing 3 (NLRP3) over‐expression plasmids. The MiR‐223‐3p target was found through bioinformatics and the dual‐luciferase reporter. The rat joint pathological damage was observed by hematoxylin and eosin staining. The levels of interleukin (IL)‐1β, tumor necrosis factor (TNF)‐α and articular elastase in rats were detected by enzyme‐linked immunosorbent assay (ELISA). The viability and pyroptosis of FLSs were detected by methyl thiazolyl tetrazolium (MTT) and flow cytometry. The expressions of miR‐223‐3p, NLRP3, cleaved caspase‐1, IL‐1β, apoptosis‐associated speck‐like protein (AS) and cleaved N‐terminal gasdermin D (GSDMD) in FLSs or rat synovial tissues were detected by reverse transcription–quantitative polymerase chain reaction (RT‐qPCR), immunofluorescence, Western blot or immunohistochemistry analysis. MSU increased the paw volume, gait score, inflammation in synovial tissues and increased the levels of IL‐1β, TNF‐α and articular elastase in rats. MSU decreased the viability and increased the pyroptosis of FLSs, up‐regulated the expression of NLRP3, ASC, cleaved caspase‐1, cleaved N‐terminal GSDM, and IL‐1β, and down‐regulated miR‐223‐3p expression in synovial tissues of rat joints and FLSs. MiR‐223‐3p mimic reversed the effect of MSU on lowering cell viability, increasing pyroptosis in FLSs, while miR‐223‐3p inhibitor further enhanced the effect of MSU on FLSs. NLRP3 was a target of miR‐223‐3p. Also, NLRP3 over‐expression reversed the effects of miR‐223‐3p on MSU‐induced FLSs. MiR‐223‐3p inhibited pyroptosis in MSU‐induced rats and FLSs by targeting NLRP3. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to determine the prevalence of Chronic renal disease (CKD) in the patients known with gout arthritis. Method:A total of 162 patients with gout arthritis diagnosed between 2014 and 2017 were included in the study. Our work is a retrospective study. Glomerular filtration rate was calculated by Modification of Renal Disease (MDRD) method. Results: The mean age of the patients was found as 59,64 ± 14,54 (18-93). The majority of patients are male. Mean uric acid levels of the patients were found to be 9.07 mg / dL ± 1.75 (4-14.7). Among these individuals with gout arthritis, % 39,5 (64) had CKD stage 3-5, %46,9 (76) had hypertension, %18,5 (30) had diabetes mellitus, %14,2 (23) had coronary artery disease. 33.3% of the patients had CKD stage 2. Nephrolithiasis was detected in 22 of 85 ultrasound patients. The use of diuretics was detected in 36 of the patients. The consultation rate requested by the dietician was 41,4%. Conclusions: Hyperuricemia and hypertension are high in CKD. Diuretics used in the treatment of hypertension and edema may trigger gout arthritis. Similar to other studies in our study, the prevalence of CKD in gout arthritis was found high.

Gout Arthritis is a crystal deposition disease which arises when supersaturation of body tissues with urate occurs, leading to the formation of monosodium urate crystals (MSU) in and around joints. Many factors can cause a risk factors for the development of gout, including diuretic drugs that can be used to patients with hypertension.the aim of this study is to determine the relationship antihypertensive drugs use (thiazide diuretics & loop diuretics) as a risk factor of incident gout arthritis at patients aged 40 – 75 years in Islamic Hospital of Jakarta Cempaka Putih period 2013 – 2015. This study used a cross-sectional study design. The total sample of 75 with a simple random sampling with lottery technique and data analysis using a Chi-Square test. The study was conducted in the Islamic Hospital of Jakarta Cempaka Putih in Oktober 2015. The prevalence of gout arthritis at patients aged 40 – 75 years in RSIJCP as much as 57 people (76%). And there is a significant relationship between antihypertensive drugs use (thiazide & loop diuretics) with an incident of gout arthritis with p-value 0.013 CI 95%: 1.295 – 13.209 and OR 4.14. as conclusion, Thiazide diuretics and loop diuretics were associated with increased gout arthritis risk at patients aged 40 – 75 years in Islamic Hospital of Jakarta Cempaka Putih (RSIJCP) period 2013 – 2015.

The phenomenon that occurs in the community at this time, many elderly gout arthritis as many as 41 of 61 elderly people in Posyandu Wonokromo Surabaya Indonesia who still complain of joint pain suddenly and stiffness in the joints that causes limited movement. This study aims to describe the behavior (cognitive, affective, and psychomotor) of patients with gout arthritis in the elderly. The design of this study uses descriptive research with cross sectional approach. The population in this study were 41 elderly with gout arthritis. The sample in this study were all elderly patients with gout arthritis, with a large sample of 41 respondents. Sampling with Total Sampling technique. This research instrument used a questionnaire and data analysis using descriptive statistics. The results showed that of 41 elderly people with gout arthritis almost half had low cognitive behavior (48.7%), almost half had moderate affective behavior (46%), and almost half had moderate psychomotor behavior (46%). The conclusion of the research is that the elderly who suffer from gout arthritis have low cognitive behavior, moderate affective behavior, and moderate psychomotor behavior. It is expected that all elderly people with gout arthritis, in order to always improve their ability and continue to shift information about the disease gout arthritis in order to improve health and change behavior (cognitive, affective, and psychomotor) to be high. [ABSTRACT FROM AUTHOR]

Background: Spinal gout, a rare and often underdiagnosed condition, significantly impacts patients' quality of life. Therefore, the aim of the research is to analyze cases of spinal gout, including clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, treatment choices, and outcomes from various cases of spinal gout., Methods: The author conducted a systematic literature search in the PUBMED and Science Direct databases from 2013 to 2023. We included clinical case presentations of spinal cases in adults, published in English. The three researchers independently reviewed the title and abstract of each article, and any differences in opinions were resolved through consensus. The extracted data were subsequently analyzed descriptively., Results: A total of 88 cases of spinal gout were obtained and studied. Out of the total reviewed cases of spinal gout, 89.77% of the subjects were male, with an average age of 51.9 years (age range 16-87 years). Common symptoms include back/neck pain (78.41%) and lower extremity weakness (37.50%). The lumbar spine is the most frequently affected region (62.50%), diagnosed primarily through magnetic resonance imaging (MRI) scans. Surgery, performed in 61.36% of cases, commonly involves decompressive laminectomy. Posttreatment, symptoms resolve in 87.50% of cases., Conclusion: Cases of spinal gout present with a variety of symptoms, including back pain and weakness. Diagnosis typically involves an MRI examination and synovial fluid analysis for confirmation. Treatment varies and includes medication therapy and surgical interventions. A deeper understanding of these cases can assist healthcare practitioners in the management and diagnosis of spinal gout cases., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Craniovertebral Junction and Spine.)

Vanillylacetone (VA) is widely used as a food additive owing to its sweet flavour. In this study, we have reported for the first time that VA has an inhibitory role in inflammasome activation. We examined the effect of VA on inflammasome activation and investigated the underlying physiological mechanisms. We verified that VA suppresses IL-1β and caspase-1 secretion, induced by NLRP3 inflammasome activation, in lipopolysaccharide (LPS)-primed bone marrow-derived macrophages. ASC speck formation and oligomerization were also attenuated by VA treatment. VA potentially inhibits NLRP3 inflammasome activation via NLRP3 alkylation. The in vivo efficacy of VA on NLRP3 inflammasome activation was examined in an MSU-induced murine peritonitis model. IL-1β and neutrophil recruitment in peritoneal lavage fluid was significantly reduced by VA treatment, thus suggesting that VA could potentially be used as a therapeutic agent against NLRP3 inflammasome-associated diseases.

The effects and mechanisms of the citrus flavonoid naringenin were investigated in a mouse model of gout arthritis induced by intra-articular injection of monosodium urate crystals (MSU). Mice were treated with naringenin (16.7–150 mg/kg, per oral) 1 h before MSU (100 µg/kg, i.a.) stimulus. MSU induced joint pain and edema, which were inhibited by naringenin at the dose of 150 mg/kg, without inducing liver and kidney toxicity. Naringenin inhibited MSU-induced histopathological changes, leukocyte recruitment, cytokine production, oxidative stress, NFκB activation, NLRP3 inflammasome components mRNA expression, and IL-1β maturation in cultured macrophages. The present data support the therapeutic applicability of naringenin in the treatment of gout arthritis.

Pain is a condition that is more than just a single sensation caused by a particular stimulus, pain is subjective and very individual. Pain occurs when the tissue is damaged and causes the individual to react to relieve the pain. There are several therapeutic ways to deal with pain, one of which is non-pharmacological therapy. One of the non-pharmacological therapies is compress therapy with grated yellow ginger (zinggiber officinale). This study aims to determine the effect of compresses with grated yellow ginger (zinggiber officinale) on reducing pain intensity in the elderly suffering from gout arthritis at the Tresna Werdha Bhakti Yuswa Natar Home. This type of research uses the quasy experimental method, the sample in this study was 16 patients who experienced gouty arthritis pain and patients who were willing to become respondents. Sampling using consecutive sampling technique. The data analysis used was the Dependent T Test. The results of the bivariate analysis obtained with a value of p = 0.000, this shows that there is an effect between compresses and grated yellow ginger (Zinggiber officinale) on reducing pain. Therapy using yellow grated ginger (zinggiber officinale) can reduce the pain scale in patients with gout arthritis. It is hoped that medical personnel can educate patients on how to reduce gouty arthritis pain with a compress of grated yellow ginger (zinggiber officinale). [ABSTRACT FROM AUTHOR]

Objectives: Characterization of sociodemographic and clinical aspects of patients admitted to the Orthopedic Department (OD) after observation in the Emergency Room (ER) with the diagnosis of septic arthritis (SA). Material and Methods: A retrospective, monocentric study was conducted. Sociodemographic and clinical data on patients admitted to the OD with suspected SA between April 2014 and September 2019 were collected. Results: One-hundred and ten patients were included. In the overall sample, most patients were male (n=61; 55.5%) with a median age of 70 (IQR=20) years old. Thirty-six patients (32.7%) had a previous history of hyperuricemia or gout, or had this diagnosis established at the time of their hospital admission. Monoarthritis was the most common form of presentation (n=106; 96.4%), with the knee being the most frequently involved joint (n=60; 54.5%). S. aureus was the most representative microorganism in synovial fluid (SF) cultures (n=33; 30.6%). SF cultures did not allow the identification of a causative microorganism in 53 cases submitted to arthrotomy (50.5%). Serum Creactive protein (CRP) was a predictive factor for microorganism identification in SF cultures, with values = 17.6 mg/dl showing instead of presenting a sensibi - lity and specificity of 60.8% and 77.4%, respectively [AUC (CI 95%): 0.70 (0.52 - 0.80)]. Patients with a diagnosis of hyperuricemia or gout presented a higher risk for a negative SF culture result (OR = 4.7 [CI 95% =1.9 - 11.5]). Conclusions: Elderly subjects with multiple comorbidities, namely cardiovascular risk factors, seem more prone to SA. Serum CRP appears to be a predictive factor for the identification of a causative microorganism. The higher risk of a negative SF culture in patients with hyperuricemia or gout should alert us for the possibility of misdiagnosis of SA in patients with an acute gout attack. [ABSTRACT FROM AUTHOR]

A 48-year-old man visited the emergency room with right hip pain that started abruptly while walking out of the bathroom. Computed tomography showed an intraosseous mass in the femoral neck. The patient had a 15-year history of gout and had numerous bilateral tophi in his hands, feet, knees, and elbows. After operation, we diagnosed a pathological fracture due to intraosseous tophi. Patients with hip pain who have many subcutaneous tophi and long-standing gout should be diagnosed carefully. Peri-hip joint pain caused by gout is uncommon, however, if a patient complains of pain, a simple X-ray may be required. If intraosseous tophi are present, appropriate treatment (e.g., strict hyperuricemia control with or without prophylactic internal fixation), may be required before fracture occurs. [ABSTRACT FROM AUTHOR]

In this study, manganese-doped albumin-gelatin composite nanogels (MAGN) were prepared and used to load berberine (Ber) for the treatment of gouty arthritis (GA). The nanodrug delivery system (Ber-MAGN) can target inflammatory joints due to the intrinsic high affinity of albumin for SPARC, which is overexpressed at the inflammatory site of GA. Characterization of the pharmaceutical properties in vitro showed that Ber-MAGN had good dispersion, and the particle size was 121 ± 10.7 nm. The sustained release effect significantly improved the bioavailability of berberine. In vitro and in vivo experimental results showed that Ber-MAGN has better therapeutic effects in relieving oxidative stress and suppressing inflammation. Therefore, Ber-MAGN, as a potential pharmaceutical preparation for GA, provides a new reference for the clinical treatment plan of GA. [ABSTRACT FROM AUTHOR]

Elderly and geriatric patients represent a significant proportion of patients with rheumatic diseases. It is a specific population that is beyond the physiological changes accompanying aging also burdened by high concurrent polymorbidity and polypharmacy and higher risk of side effects. In general, none of the current antirheumatic therapies is contraindicated solely because of age, but for each patient it is necessary to individually assess the benefit of the treatment and assess its risks in terms of side effects and drug interactions before initiating treatment. In general, it is recommended that elderly patients should be administered agents with lower toxicity and short or medium half-life, initiating treatment at lower doses than the general population, and increasing them gradually according to tolerance. It is necessary to ensure good cooperation of the patient or his / her family regarding the use and dosage of the drug, further advise the patient on possible side effects and regularly evaluate the safety of the treatment according to the guidelines. [ABSTRACT FROM AUTHOR]