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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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Risk Of Endocarditis More Than 3x Higher After COVID-19 Infection In Patients With Cocaine, Opioid Abuse Disorders
People diagnosed with cocaine- and opioid-use disorders are more susceptible to developing endocarditis, a condition that damages the lining of the heart valves and chambers, according to research from the Case Western Reserve University (CWRU) School of Medicine and National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.
The research team found that patients diagnosed with cocaine (CocaineUD)- or opioid-use disorder (OUD) who were infected with SARS-CoV-2 experienced an incident rate of endocarditis three to eight times higher than those without the disorders, showing that endocarditis is a significant health concern for people using cocaine or opioids.
About three million people in the U.S. Meet the criteria for OUD, according to the National Institutes of Health (NIH), while roughly 75% of the more than 91,000 drug overdose deaths in 2020 involved an opioid, reported the Centers for Disease Control and Prevention (CDC).
The new research findings were published Dec. 12 in the journal Molecular Psychiatry. The research team believes the findings highlight the need for endocarditis screenings in those diagnosed with OUD or CocaineUD and infected with COVID-19.
"Endocarditis is a serious and potentially fatal complication of intravenous drug use, and our study shows that patients with opioid- or cocaine-use disorder are at even higher risk for endocarditis if they contract COVID-19," said Pamela Davis, Distinguished University Professor and The Arline H. And Curtis F. Garvin Research Professor at the School of Medicine. "It is essential to monitor patients with these underlying disorders carefully for endocarditis if they become infected with SARS-CoV2."
Endocarditis can be fatal without treatment and, according to researchers, the condition is increasing, driven partly by the rise in intravenous opioid and stimulant use in the U.S. Intravenous drug use involves injecting a substance into a vein.
Study findingsThe researchers analyzed unidentified electronic health records of more than 109 million patients in the U.S., including more than 736,000 with OUD and more than 379,000 with a diagnosis of CocaineUD.
The data showed the number of people with endocarditis and OUD or CocaineUD significantly increased from 2011-22, with a rapid increase from 2021-22. The data was statistically score-matched to account for demographics, comorbidities, medications, medical procedures and socioeconomic determinants of health.
Association of COVID-19 with endocarditis in patients with OUDAmong patients with opioid or cocaine use disorders, 180-day hospitalization risk following a new diagnosis of endocarditis was 67.5% in patients with COVID-19, compared to 58.7% in patients without COVID-19. The 180-day mortality risk following new diagnosis of endocarditis was 9.2% in patients with COVID-19, compared to 8% in patients without COVID-19.
The rapid acceleration in the incidence rate of endocarditis during the pandemic when compared to prepandemic shows that COVID-19 infection likely further increased the risk of endocarditis among patients with OUD or CocaineUD, said Rong Xu, professor of Biomedical Informatics and director of the Center for AI in Drug Discovery at the School of Medicine.
Xu explained future studies are warranted to further understand how SARS-CoV-2 infection damages the heart and vascular endothelium in people with CocaineUD or OUD. (Methamphetamine use was not incorporated in the study as it is not a medically coded diagnosis.)
Study authors included: Davis, Xu, Nathan Berger, David Kaelber and Lindsey Wang from Case Western Reserve, and Nora Volkow from NIDA.
More information:Lindsey Wang et al, Association of COVID-19 with endocarditis in patients with cocaine or opioid use disorders in the US, Molecular Psychiatry (2022). DOI: 10.1038/s41380-022-01903-1
Provided by Case Western Reserve University
Citation: Risk of endocarditis more than 3x higher after COVID-19 infection in patients with cocaine, opioid abuse disorders (2022, December 13) retrieved 14 January 2024 from https://sciencex.Com/wire-news/432365052/risk-of-endocarditis-more-than-3x-higher-after-covid-19-infectio.Html
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