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Risk Factors And Triggers For Gout

It's definitely feeling much better there...

It's very common after surgical procedures, not necessarily on the foot or toe, but any surgical procedure that you can develop an acute gout attack. One of the primary recommendations for initial treatment of high blood pressure is a diuretic—a water pill called hydrochlorothiazide and taking hydrochlorothiazide actually has the untoward effect of elevating your uric acid as well. And would that be considered a trigger in and of itself then?

And then there's the more wide-open diet issue in terms of dietary sources that are rich in purines… Purines are one of the building blocks of our nucleic acids, so when we break those entities down, one of the products is uric acid. The foodstuffs that are typically rich in purines are organ meats such as liver, red meats, shell fish, various vegetables that are high in protein, for example beans. And then there's the alcohol ingestion which is also known to be associated with acute gout attacks, particularly beer because of the high protein content in the beer. There is a known association between obesity and the development of gout. I would say primarily perhaps to limit yourself to diets that are low in purines, low fat and also exercise to keep your body mass at an appropriate level. Low fat dairy products are an appropriate source of protein and there are constituents in dairy products that are thought to actually reduce the level of uric acid in your blood. How important is just maintaining proper hydration?

Those who have elevated uric acid are more prone to kidney stones. So the hydration's important to prevent the gout attacks and also is important in reducing the frequency of kidney stones from uric acid precipitation in the urine.","publisher":"WebMD Video"} ]]>

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Shaun Hill

It's definitely feeling much better there...

It's very common after surgical procedures, not necessarily on the foot or toe, but any surgical procedure that you can develop an acute gout attack. One of the primary recommendations for initial treatment of high blood pressure is a diuretic—a water pill called hydrochlorothiazide and taking hydrochlorothiazide actually has the untoward effect of elevating your uric acid as well. And would that be considered a trigger in and of itself then?

And then there's the more wide-open diet issue in terms of dietary sources that are rich in purines… Purines are one of the building blocks of our nucleic acids, so when we break those entities down, one of the products is uric acid. The foodstuffs that are typically rich in purines are organ meats such as liver, red meats, shell fish, various vegetables that are high in protein, for example beans. And then there's the alcohol ingestion which is also known to be associated with acute gout attacks, particularly beer because of the high protein content in the beer. There is a known association between obesity and the development of gout. I would say primarily perhaps to limit yourself to diets that are low in purines, low fat and also exercise to keep your body mass at an appropriate level. Low fat dairy products are an appropriate source of protein and there are constituents in dairy products that are thought to actually reduce the level of uric acid in your blood. How important is just maintaining proper hydration?

Those who have elevated uric acid are more prone to kidney stones. So the hydration's important to prevent the gout attacks and also is important in reducing the frequency of kidney stones from uric acid precipitation in the urine.

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Suspected Bronchiectasis Linked To Increased Mortality In Smokers

Bronchiectasis, a condition defined by widened lung airways, cough and sputum production, and frequent infections, often presents along with chronic obstructive pulmonary disease (COPD). This overlap is associated with airflow obstruction and higher mortality in adults. As healthcare systems now provide access to lung image data more commonly than before, bronchiectasis can be detected incidentally on radiological scans of patients with mild or no symptoms.

A team led by researchers at Brigham and Women's Hospital, a founding member of the Mass General Brigham healthcare system, studied the association between suspected bronchiectasis and mortality in adults with a history of smoking. The researchers analyzed a dataset with information collected over 11 years from more than 7,500 patients, including those with normal breathing test results and others with significantly-impaired airflow. Using a combination of clinical and imaging data, participants were categorized into suspected bronchiectasis or non-suspected bronchiectasis groups.

The study found that suspected bronchiectasis in participants with normal and obstructed airflow was associated with a higher risk of mortality. This increased risk, the investigators suggest, could be explained by the frequent inflammation and exposure to pathogens caused by smoking. Since obstructed airflow is a characteristic of COPD, the study also furthered understanding of the association between mortality risk and disease severity.

Our study represents one of the largest evaluations of suspected bronchiectasis in understudied groups of adults with a history of smoking. These findings suggest that using lung imaging as a clinical tool to identify bronchiectasis could help improve patient care."

Alejandro Diaz, MD, MPH,  corresponding author, Division of Pulmonary and Critical Care Medicine

Source:

Journal reference:

Diaz, A. A., et al. (2023) Suspected Bronchiectasis and Mortality in Adults With a History of Smoking Who Have Normal and Impaired Lung Function. Annals of Internal Medicine. Doi.Org/10.7326/M23-1125.

Risk Factors For Developing Lupus

Your sex. Women are more likely to develop lupus.

Your age. Symptoms and diagnosis occur most often between the ages of 15 and 44. Symptoms of lupus will occur before age 18 in only 15 percent of the people who are later diagnosed with the disease.

Your race/ethnicity. In the United States, lupus is more common in people of color than in the Caucasian population. This includes African Americans, Hispanics/Latinos, Asian Americans, Native Americans, Native Hawaiians and Pacific Islanders. It also appears that lupus develops at an earlier age and is more severe among members of these ethnic groups.

Your family history. Relatives of people with lupus have a 5-13 percent chance of developing lupus. However, only about 5 percent of children will develop lupus if their mother has it.

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