الجمعة، 3 أغسطس 2012

What is gout?

Gout is considered one of the oldest diseases known in the medical literature, gout a common disease caused by defective metabolism of uric acid uric acid (uric acid, uric acid), which can lead to deposition of crystals of salts of uric acid tissue body soft, and the incidence of recurrent episodes of arthritis is painful, and in the case of non-treatment can be caused crash of the joints and kidneys, and the final diagnosis of gout depends on the presence of crystals of salts of uric acid in the synovial fluid that is withdrawn from the joint, and the early diagnosis of gout with therapy improves the patients significantly and reduces the number of cases of disability due to chronic gout which are held by disabling chronic tophaceous gout, however, chronic gout, which is the contract would be continued because of an error in diagnosis, or failure to provide proper treatment, or not subject the patient to treatment.Generate goutAlthough the presence of crystals of salts of uric acid in the soft tissue and synovial fluid is a condition for the occurrence of attacks of gout, the crystals of salts of uric acid can also be found in the liquid in the absence of inflammation of the joints, and refers to the fact that the mere existence of crystals with fluid albumin is not sufficient for a bouts of inflammation of the joints. And one of the explanations for this are that the concentrations of the contract small, consisting of crystals of salts of uric acid are covered with protein Chapel serum proteins This cover prevents the adhesion of these crystals receptor cell cell receptors, and therefore the attack of gout may be caused by the starting crystals are not covered (for example When you change the salt concentration in blood, and analyzed or melting of a salt small microtophus) or precipitation of crystals when increasing the concentration (for example, when the crash of cells in the body - as it is during chemotherapy for tumors - which causes the starting salts, uric acid) and whatever the source of salts, the crystals bare (non-covered protein Chapel) interact with cell receptors multilateral or macrophages - the white blood cells - either on the cell surface or inside, and this is a sign of the risk of active immune system, has been reinforced by antibodies of the type G immunoglobulin G - IgG of this interaction through the Union with receptors or stimulated, which results in material interleukin-1 interleukin (IL) -1 and arises also the start of many chemicals immune called cytokines cytokines materials include IL-6 and 8, and the factors driving the white blood cells, neutrophil neutrophil chemotactic factors, and factor necrotizing tumor tumor necrosis factor (TNF)-alpha, and increase the process of ingestion by the phagocytic cells, neutrophils Neutrophil phagocytosis the start of the other chemicals.

The depression bouts acute gout is attributable to several mechanisms, including removal of cells, white blood cells neutral dead damaged neutrophils and re-cover the crystals of urate of sodium recoating of urate crystals, and the production of chemicals, immune anti-inflammatory anti-inflammatory cytokines, and production of factor adapter for the growth of transforming growth factor (TGF) -beta.

The incidence of goutIn the United States: about 1% of the population infected with gout.In the world: widespread throughout the world, and because the difference in the prevalence difference from side to side to environmental factors and genetic and nutritional.

Morbidity and mortality due to gout

    
Acute attacks of gout may lead to the inability to move during the affected patient.

    
Not to treat chronic gout and the decade in which they appear chronic tophaceous gout can lead to severe crash joints.

    
Precipitation of salts of uric acid kidney can lead to inflammation and fibrosis, and that leads to the lack of its functions, or to chronic renal failure.

    
Increase of uric acid in blood and gout, be coupled with a mortality rate higher than in natural persons, and whether it is due to the increase of uric acid in blood, or gout, or to diseases associated with gout (such as insulin resistance insulin resistance, or type II diabetes, and obesity abdomen and increased cholesterol in blood, and high blood pressure), and although there is no evidence that gout is the cause of any of these diseases, but high blood pressure in adolescents is associated with an increased salts of uric acid in blood, also be an increase in uric acid blood and gout of the factors that have significant increase in deaths from heart disease and blood circulation in men in middle age.
Relationship gout Races and racesDisease by more than a simple black when for when the eggs.

Relationship gout sex

    
Prevalence of gout is 13.6 cases per 1000 men, and 6.4 cases per 1000 women.

    
Hormone estrogen (which is secreted from the ovary) has little effect in increasing the body get rid of uric acid in the urine, so the gout is rare among women before menopause.
Age-related disease, gout

    
Be an increase in uric acid level before 20 years of the onset of illness.

    
Men increase the proportion of uric acid in adulthood and up the increase of up in the fourth decade to the sixth decade of age, in women the percentage of uric acid at menopause and up increase up to the sixth decade to the eighth decade of life, and rare occurrence of gout in women before menopause It also is rare in men before the age of 30 years, when those who do not suffer from renal insufficiency or genetic abnormalities in the metabolism of purine purine metabolism, and the prevalence of gout ages developed due to the rise of so-called syndrome of metabolic metabolic syndrome, and the use of diuretics to treat high blood pressure and landing of congestive heart muscle, and the use of a simple dose of aspirin, and have discovered the existence of the contract Tophi almost 10 years after the occurrence of the first bout of gout.

    
Can cause the use of drug cyclosporine (a) Cyclosporin A rapid emergence of the form of gout - even in women before menopause - which can be found after a few years of increased blood uric acid, especially if the patient uses the drugs increase diuresis.

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