"may occur due to factors including trauma, surgery, chemotherapy, diuretics, and stopping or starting allopurinol. Calcium channel blockers and losartan are associated with a lower risk of gout compared to other medications for hypertension. Gout may be diagnosed and treated without further investigations in someone with hyperuricemia and the classic acute arthritis of the base of the great toe (known as podagra). Synovial fluid analysis should be done if the diagnosis is in doubt. X-rays, while useful for identifying chronic gout, have little utility in acute attacks. A definitive diagnosis of gout is based upon the identification of monosodium urate"
"suffering from, or at risk of gout. Cadmium catalyzes the transformation of vitamin C into oxalic acid. This can be a problem for people exposed to high levels of cadmium in their diets, in the workplace, or through smoking. In studies with rats, calcium supplements given along with foods high in oxalic acid can cause calcium oxalate to precipitate in the gut and reduce the levels of oxalate absorbed by the body (by 97% in some cases.) Oxalic acid can also be produced by the metabolism of ethylene glycol (""antifreeze""), glyoxylic acid, or ascorbic acid (vitamin C). Powdered oxalate is"
"complicated by gout. Gout frequently occurs in combination with other medical problems. Metabolic syndrome, a combination of abdominal obesity, hypertension, insulin resistance, and abnormal lipid levels, occurs in nearly 75% of cases. Other conditions commonly complicated by gout include lead poisoning, kidney failure, hemolytic anemia, psoriasis, solid organ transplants and myeloproliferative disorders such as polycythemia. A body mass index greater than or equal to 35 increases male risk of gout threefold. Chronic lead exposure and lead-contaminated alcohol are risk factors for gout due to the harmful effect of lead on kidney function. Diuretics have been associated with attacks of gout,"
"Glutaric aciduria type 1 Glutaric acidemia type 1 (or ""glutaric aciduria"", ""GA1"", or ""GAT1"") is an inherited disorder in which the body is unable to completely break down the amino acids lysine, hydroxylysine and tryptophan. Excessive levels of their intermediate breakdown products (glutaric acid, glutaryl-CoA, 3-hydroxyglutaric acid, glutaconic acid) can accumulate and cause damage to the brain (and also other organs), but particularly the basal ganglia, which are regions that help regulate movement. GA1 causes secondary carnitine deficiency, as glutaric acid, like other organic acids, is detoxified by carnitine. Mental retardation may also occur. The severity of glutaric acidemia type"
"of genetic disorders affecting peroxisome function as a result. Peroxisomes contain oxidative enzymes, such as D-amino acid oxidase and uric acid oxidase. However the last enzyme is absent in humans, explaining the disease known as gout, caused by the accumulation of uric acid. Certain enzymes within the peroxisome, by using molecular oxygen, remove hydrogen atoms from specific organic substrates (labeled as R), in an oxidative reaction, producing hydrogen peroxide (HO, itself toxic): Catalase, another peroxisomal enzyme, uses this HO to oxidize other substrates, including phenols, formic acid, formaldehyde, and alcohol, by means of the peroxidation reaction: This reaction is important"
"contributing factor. In countries that use iodized salt, Hashimoto's thyroiditis is the most common cause. Goitre can also result from cyanide poisoning; this is particularly common in tropical countries where people eat the cyanide-rich cassava root as the staple food. Goitre is treated according to the cause. If the thyroid gland is producing an excess of thyroid hormones (T3 and T4), radioactive iodine is given to the patient to shrink the gland. If goitre is caused by iodine deficiency, small doses of iodide in the form of Lugol's iodine or KI solution are given. If the goitre is associated with"
"levels are low and calcium and oxalate levels are high. Magnesium oxalate is a million times more soluble than mercury oxalate. Oxalate solubility for metals decreases in the order Mg > Ca > Cd > Zn > {Mn, Ni, Fe, Cu} > {As, Sb, Pb} > Hg. The highly insoluble iron(II) oxalate appears to play a major role in gout, in the nucleation and growth of the otherwise extremely soluble sodium urate. This explains why gout usually appears after age 40 , when ferritin levels in blood exceed 1 μg/L . Foods high in oxalate should be avoided by people"
"Visceral gout Visceral gout is a disease of birds in which kidney failure causes a build-up of urates in the internal organs, leaving a chalky white coating on them. Symptoms include anorexia and emaciation. It is a problem common to caged birds. Vultures are particularly sensitive to poisoning by diclofenac, which leads to renal failure, visceral gout and death to them. The collapse of the vulture population in India and Pakistan, to about a twentieth of their original numbers, has been caused by diclofenac, which is a non-steroidal anti-inflammatory drug (NSAID). Diclofenac is given to working and ill farm cattle"
"is hypothesized to inhibit mI entering the cells and mitigating the function of SMIT. Reductions of cellular levels of myo-inositol results in the inhibition of the phosphoinositide cycle Lithium was first used in the 19th century as a treatment for gout after scientists discovered that, at least in the laboratory, lithium could dissolve uric acid crystals isolated from the kidneys. The levels of lithium needed to dissolve urate in the body, however, were toxic. Because of prevalent theories linking excess uric acid to a range of disorders, including depressive and manic disorders, Carl Lange in Denmark and William Alexander Hammond"
"a resultant large effusion due to inflammation. Gout is usually present with recurrent attacks of acute inflammatory arthritis (red, tender, hot, swollen joint). It is caused by elevated levels of uric acid in the blood that crystallizes and deposits in joints, tendons, and surrounding tissues. Gout affects 1% of individuals in Western populations at some point in their lives. Trauma from ligamentous, osseous or meniscal injuries can result in an effusion. These are often hemarthrosis or bloody effusions. Rest Joint effusion A joint effusion is the presence of increased intra-articular fluid. It may affect any joint. Commonly it involves the"
"males suffer delayed growth and puberty, and most develop shrunken testicles or testicular atrophy. Female carriers are at an increased risk for gouty arthritis but are usually otherwise unaffected. One of the first symptoms of the disease is the presence of sand-like crystals of uric acid in the diapers of the affected infant. Overproduction of uric acid may lead to the development of uric acid crystals or stones in the kidneys, ureters, or bladder. Such crystals deposited in joints later in the disease may produce gout-like arthritis, with swelling and tenderness. The overproduction of uric acid is present at birth,"
"uric acid. Non-medication treatments for hyperuricemia include a low purine diet (see Gout) and a variety of dietary supplements. Treatment with lithium salts has been used as lithium improves uric acid solubility. Serum pH is neither safely nor easily altered. Therapies that alter pH principally alter the pH of urine, to discourage a possible complication of uricosuric therapy: formation of uric acid kidney stones due to increased uric acid in the urine (see Nephrolithiasis). Medications that have a similar effect include acetazolamide. Low temperature is a commonly reported trigger of acute gout: an example would be a day spent standing"
"in cold water, followed by an attack of gout the next morning. This is believed to be due to temperature-dependent precipitation of uric acid crystals in tissues at below normal temperature. Thus, one aim of prevention is to keep the hands and feet warm, and soaking in hot water may be therapeutic. Increased levels predispose for gout and, if very high, kidney failure. The metabolic syndrome often presents with hyperuricemia. Prognosis is good with regular consumption of allopurinol. People with gout, and by inference hyperuricemia, are significantly less likely to develop Parkinson's disease, unless they also require diuretics. In Dalmatian"
"Tophus A tophus (Latin: ""stone"", plural tophi) is a deposit of uric acid crystals, in the form of monosodium urate crystals, in people with longstanding hyperuricemia (high levels of uric acid in the blood). Tophi are pathognomonic for the disease gout. Most people with tophi have had previous attacks of acute arthritis, eventually leading to the formation of tophi. Chronic tophaceous gout is known as Harrison Syndrome. Tophi form in the joints, cartilage, bones, and other places throughout the body. Sometimes, tophi break through the skin and appear as white or yellowish-white, chalky nodules. Without treatment, tophi may develop on"
"to form crystals of the corresponding oxalates which are then excreted in urine as minute crystals. These oxalates can form larger kidney stones that can obstruct the kidney tubules. An estimated 80% of kidney stones are formed from calcium oxalate. Those with kidney disorders, gout, rheumatoid arthritis, or certain forms of chronic vulvar pain (vulvodynia) are typically advised to avoid foods high in oxalic acid . Methods to reduce the oxalate content in food are of current interest. Magnesium (Mg) oxalate is 567 times more soluble than calcium oxalate, so the latter is more likely to precipitate out when magnesium"
"the course of the disease in people who are older. Although less common, tophi can also form in the kidneys and nasal cartilage. Tophus A tophus (Latin: ""stone"", plural tophi) is a deposit of uric acid crystals, in the form of monosodium urate crystals, in people with longstanding hyperuricemia (high levels of uric acid in the blood). Tophi are pathognomonic for the disease gout. Most people with tophi have had previous attacks of acute arthritis, eventually leading to the formation of tophi. Chronic tophaceous gout is known as Harrison Syndrome. Tophi form in the joints, cartilage, bones, and other places"
"Gastric acid Gastric acid, gastric juice or stomach acid, is a digestive fluid formed in the stomach and is composed of hydrochloric acid (HCl), potassium chloride (KCl) and sodium chloride (NaCl). The acid plays a key role in digestion of proteins, by activating digestive enzymes, and making ingested proteins unravel so that digestive enzymes break down the long chains of amino acids. Gastric acid is produced by cells in the lining of the stomach, which are coupled in feedback systems to increase acid production when needed. Other cells in the stomach produce bicarbonate, a base, to buffer the fluid, ensuring"
"form in the kidneys, ureters and urethra. Many studies have concluded magnesium in the diet is a primary cause of struvite urolithiasis in cats. However, researchers have found that urine pH is a more important contributing factor. Urine that is acidic helps to dissolve struvite uroliths and also provides a less favourable environment for its formation. Commercial feline diets now limit the amount of magnesium and add acidifiers in the food to increase urine acidity, thereby reducing the likelihood of struvite formation. The decrease of struvite uroliths coincides with an increase in oxalate uroliths, low magnesium levels and urine pH"
"gastric acid, verifying that acid played a crucial role in digestion. Gastric acid Gastric acid, gastric juice or stomach acid, is a digestive fluid formed in the stomach and is composed of hydrochloric acid (HCl), potassium chloride (KCl) and sodium chloride (NaCl). The acid plays a key role in digestion of proteins, by activating digestive enzymes, and making ingested proteins unravel so that digestive enzymes break down the long chains of amino acids. Gastric acid is produced by cells in the lining of the stomach, which are coupled in feedback systems to increase acid production when needed. Other cells in"
"of the intestinal wall by osmosis, increasing the volume of intestinal content 3 to 5 times; this exerts pressure on the intestinal wall and triggers its peristalsis or movement. Magnesium also additionally stimulates the intestinal hormones that boost peristalsis. The stomach makes 2 to 3 litres of acidic fluids each day. These consist mostly of hydrochloric acid and pepsin (an enzyme that speeds up the metabolism of proteins). Donat Mg contains approximately 7,800 mg of hydrogen carbonate. This high hydrogen carbonate content has a great capacity for bonding to acids and buffering free acids. It bonds to stomach acid in"
"calcium oxalate urinary stones in cats, and potentially in other species. A more pronounced alkaline tide results from vomiting, which stimulates hyperactivity of gastric parietal cells to replace lost stomach acid. Thus, protracted vomiting can result in metabolic alkalosis. Alkaline tide Alkaline tide refers to a condition, normally encountered after eating a meal, where during the production of hydrochloric acid by parietal cells in the stomach, the parietal cells secrete bicarbonate ions across their basolateral membranes and into the blood, causing a temporary increase in pH. During hydrochloric acid secretion in the stomach, the gastric parietal cells extract chloride anions,"
"Goitre A goitre, or goiter, is a swelling in the neck resulting from an enlarged thyroid gland. A goitre is associated with a thyroid that is not functioning properly. Worldwide, over 90% of goitre cases are caused by iodine deficiency. The term is from the Latin ""gutturia"", meaning throat. Most goitres are of a benign nature. A goitre, associated with hypothyroidism or hyperthyroidism, may be present with symptoms of the underlying disorder. For hyperthyroidism, the most common symptoms are associated with adrenergic stimulation: tachycardia (increased heart rate), palpitations, nervousness, tremor, increased blood pressure and heat intolerance. Clinical manifestations are often"
"cholesterol, and sweets are more acid-producing, while fruits, vegetables, legumes, and whole grains are more base-producing. IgA nephropathy is the most common glomerulonephritis throughout the world Primary IgA nephropathy is characterized by deposition of the IgA antibody in the glomerulus. The classic presentation (in 40-50% of the cases) is episodic frank hematuria which usually starts within a day or two of a non-specific upper respiratory tract infection (hence ""synpharyngitic"") as opposed to post-streptococcal glomerulonephritis which occurs some time (weeks) after initial infection. Less commonly gastrointestinal or urinary infection can be the inciting agent. All of these infections have in common"
"sialadenitis, although obstructive sialadenitis is often a consequence of sialolithiasis. Gout may also cause salivary stones, although in this case they are composed of uric acid crystals rather than the normal composition of salivary stones. Diagnosis is usually made by characteristic history and physical examination. Diagnosis can be confirmed by x-ray (80% of salivary gland calculi are visible on x-ray), by sialogram, or by ultrasound. Some current treatment options are: The prevalence of salivary stones in the general population is about 1.2% according to post mortem studies, but the prevalence of salivary stones which cause symptoms is about 0.45% in"
"high in low-fat dairy products may be preventive. Gout affects about 1 to 2% of the Western population at some point in their lives. It has become more common in recent decades. This is believed to be due to increasing risk factors in the population, such as metabolic syndrome, longer life expectancy, and changes in diet. Older males are most commonly affected. Gout was historically known as ""the disease of kings"" or ""rich man's disease"". It has been recognized at least since the time of the ancient Egyptians. Gout can present in multiple ways, although the most usual is a"
"The ""proximal renal tubular dysfunction"" creates low phosphate levels in the blood (""hypophosphatemia""), causing muscle weakness and sometimes coma. The dysfunction also causes gout, a form of arthritis due to the accumulation of uric acid crystals in the joints because of high acidity of the blood (""hyperuricemia""). Another side effect is increased levels of chloride in the blood (""hyperchloremia""). The kidneys can also shrink up to 30%. Cadmium exposure is also associated with the development of kidney stones. Similar to zinc, long term exposure to cadmium fumes can cause life long anosmia. Inside cells, cadmium ions act as a catalytic"
"crystals, such as uric acid or calcium pyrophosphate dihydrate ram crystals found in gout or pseudogout. An X-ray is useful to verify that there is no break or dislocation when there is a history of trauma. May show signs of osteoarthritis. Magnetic Resonance Imaging detects abnormalities of the bone or knee joint, such as a tear in the ligaments, tendons or cartilage. If the knee is swollen and red and warm to the touch when compared to the other knee, a doctor may be concerned about inflammation due to rheumatoid arthritis or a crystalline arthritis, such as gout or pseudogout,"
"rather low. All these salts exhibit greater solubility in hot water than cold, allowing for easy recrystallization. This low solubility is significant for the etiology of gout. The solubility of the acid and its salts in ethanol is very low or negligible. In ethanol/water mixtures, the solubilities are somewhere between the end values for pure ethanol and pure water. The figures given indicate what mass of water is required to dissolve a unit mass of compound indicated. The lower the number the more soluble the substance in the said solvent. Xanthine oxidase is an enzyme which catalyzes the formation of"
"recent studies have found dietary factors once believed to be associated with gout are in fact not, including the intake of purine-rich vegetables and total protein. The Mayo Clinic, meanwhile, advises gout sufferers to avoid some foods that are high in purines. The product is dried and mixed with egg albumen, which acts as a binder. It is then textured, giving it some of the grained character of meat, and pressed either into a mince resembling ground beef; forms resembling chicken breasts, meatballs, and turkey roasts; or chunks resembling diced chicken breast. In these forms, Quorn has a varying colour"
"iodate as dough conditioner in bread and baked goods was gradually replaced by the use of other conditioning agents such as bromide. Iodine deficiency resulting in goiter occurs in 187 million people globally (2.7% of the population). It resulted in 2700 deaths in 2013 up from 2100 deaths in 1990. A low amount of thyroxine (one of the two thyroid hormones) in the blood, due to lack of dietary iodine to make it, gives rise to high levels of thyroid stimulating hormone (TSH), which stimulates the thyroid gland to increase many biochemical processes; the cellular growth and proliferation can result"
"diagnosis, demonstrating the potential role for glyoxylate to be an early predictive marker. Glyoxylate is involved in the development of hyperoxaluria, a key cause of nephrolithiasis (commonly known as kidney stones). Glyoxylate is both a substrate and inductor of sulfate anion transporter-1 (sat-1), a gene responsible for oxalate transportation, allowing it to increase sat-1 mRNA expression and as a result oxalate efflux from the cell. The increased oxalate release allows the buildup of calcium oxalate in the urine, and thus the eventual formation of kidney stones. The disruption of glyoxylate metabolism provides an additional mechanism of hyperoxaluria development. Loss of"
"drugs that induce CYP2C9 and increased by substances that inhibit this enzyme (such as fluconazole), as well as in people who have genetically determined low CYP2C9 activity. The same may be true of microsomal epoxide hydrolase inhibitors (such as valproic acid). High dose aspirin and related drugs reduce the effectiveness of other anti-gout medications. It is not known conclusively whether this also applies to lesinurad, but low dose aspirin does not negatively affect its activity. Lesinurad inhibits URAT1, a protein that is responsible for reabsorption of uric acid in the kidneys. This leads to increased uric acid excretion with the"
"mushrooms, seaweed, and beer yeast. Chicken and potatoes also appear related. Other triggers include physical trauma and surgery. Studies in the early 2000s found that other dietary factors are not relevant. Specifically, moderate consumption of purine-rich vegetables (e.g., beans, peas, lentils, and spinach) are not associated with gout. Neither is total consumption of protein. Alcohol consumption is strongly associated with increased risk, with wine presenting somewhat less of a risk than beer or spirits. The eating or drinking of coffee, vitamin C, and dairy products, as well as physical fitness, appear to decrease the risk. Peanuts, brown bread, and fruit"