Decrease In Uric Acid Levels Research Articles

The Effectiveness of Health Education about Gout Arthritis Diet Compliance and Uric Acid Levels in Gout Arthritis Patients

The habit of consuming seafood and also some lifestyle in Minahasa culture contributes to the increase cases of gout arthritis. This is also supported by the lack of knowledge and information about the correct diet for gouty arthritis sufferers. The existence of the right information can help sufferers to implement a healthy diet so that it can reduce uric acid levels. The purpose of this study was to assess the effectiveness of health education on uric acid levels in gouty arthritis sufferers. This study was conducted with a quasi-experimental research design, using one group pretest-posttest approach on 30 gout arthritis patients in Bongkudai Selatan Village, North Sulawesi. The sampling technique used was accidental sampling, and the data were analyzed using univariate and bivariate analysis. The results showed that there was a decrease in uric acid levels in 70% of respondents and there was an effect of health education on uric acid levels with a p value of 0.0325.

Urate-lowering therapy for patients with gout on hemodialysis.

ObjectiveGout 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.MethodsWe 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.ResultsWe 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.ConclusionAmong 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.

Efek Pemberian Ekstrak Etanol Daun Sembukan (Paederia foetida L.) Terhadap Penurunan Kadar Asam Urat Tikus Putih (Rattus norvegicus) Jantan

Sembukan leaf is a medicinal plant that is widely used by the community, one of which is as an anti-inflammatory. This study aims to determine the effect of giving sembukan leaves (Paederia foetida L.) to decrease uric acid levels in male white rats (Rattus norvegicus). The study was carried out by testing 5 groups of white rats, namely positive control (Allopurinol 100 mg), negative control (Na.CMC suspension 0.5%), the dose of ethanol extract of sembukan leaves 10 mg/KgBB, 20 mg/KgBB, and 40 mg/KgBB. Each treatment group measured initial uric acid levels (before induction), after induction of chicken liver juice and after giving treatment or test samples using test strips. The results showed that uric acid levels in all groups decreased with the percentage decrease in uric acid levels at a dose of 10 mg/Kg BB, 20 mg/Kg BB and 40 mg/Kg BB, respectively by 13.2%, 24.5% and 54.3%. The results of the One Way Anova statistical test showed a significant difference with P value = 0.010 (α <0.05). The concentration of the extract that gave the greatest reducing effect was the extract dose of 40mg/kgBB.

Soursop Leaf Water Decoction Against Decreased Uric Acid Levels in Menopause

Menopausal women are 60% more likely to develop gout, this is caused by a decrease in levels of the hormone estrogen which causes uncontrolled uric acid disposal. Gout sufferers who continue to take analgesic drugs will cause side effects that are berbahaya so that nonpharmacological treatment is needed. One of the nonpharmacological treatments is the provision of soursop leaf water decoction. The purpose of this study was to find out the effect of giving soursop leaf water decoction on the decrease in uric acid levels in menopausal mothers in Limba B Village of Gorontalo City. This research method uses pre-experiments with the design of one group pre-test-post-test. With a study population of 35 people and a sample of 15 people taken using purposive sampling techniques. The results of the research analysis used the Paired Sample T-Test which showed that there was an effect of giving soursop leaf water decoction before and after being given soursop leaf water decoction. with a value of p = 0.000 (<0.05) which means H0 is rejected and Ha is accepted. Based on the results of research it can be concluded that the decoction of soursop leaf water has an effect on the decrease in uric acid levels in menopause.

Бессимптомная гиперурикемия как маркер обестрения артериальной гипертензии

Introduction. Elevated serum uric acid (UA) concentration is considered to be as one of the factors contributing to endothelial dysfunction. However, it does not lead to clinical manifestations, so it is called asymptomatic hyperuricemia (ASH). The aim of the investigation was to study the effect of ASH on arterial hypertension (AH) followed by its correction. Materials and Methods. A retrospective analysis of patients with AH undergoing inpatient treatment was performed. The control group of patients received standard hypotensive therapy. Although, the main group received standard therapy combined with urate-reducing therapy. Results. Comparative analysis showed that hypotensive therapy was effective in both investigated groups. By the way, index of the main group experienced better results, i.e., the systolic blood pressure (SBP) decreased by 18 Hg (11.6%) compared to the control group. In terms of diastolic blood pressure (DBP), it is dropped by 11.8 Hg (12,1%). The positive effect of urate-reducing therapy is the reason for rising efficiency of the therapy at all. Moreover, significant decrease of UA level was experienced from both researched groups. It averaged 38,3 mmol/l, which is 39.2% of the original result. Conclusion. Thus, the adverse effect of ASH on BP in patients with AH can be compensated by prescription of additional urate-reducing therapy to hypotensive drugs, which helps to reduce the adverse effect of ASH. The obtained data should be taken into account when physicians implement a disease management program.

Increased QT Dispersion and High Risk of Ventricular Arrhythmias is Associated with Hyperuricemia in Individuals with Normal Renal Function

Abstract Background and aim: Uric acid elevation has been shown to be an important risk factor for cardiovascular and cerebrobascular disease. QT dispersion (QTd) is a parameter that shows the heterogeneity of ventricular repolarization and can be calculated noninvasively from surface electrocardiography. Increased QTd has been associated with severe arrhythmia and risk of sudden death in many patients and disease groups. In this context, we aimed to investigate the effect of uric acid levels on QTd and the effects of decrease in uric acid levels on QTd. Methods: A total of 225 patients with normal renal function were included in the study; 133 of these patients were hyperuricemic (>7 mg/dL), and the remaining 72 patients were normouricemic (Group 1). The hyperuricemic patients were randomly divided into 2 groups, one group (n = 67) was given placebo (Group 2) for 4 months, and the remaining 66 patients were given allopurinol 300 mg/day (Group 3). Results: Hyperuricemic patients had higher hsCRP and QTd and lower eGFR values compared to the normouricemic control group. After 4 months of treatment, 66 patients treated with allopurinol showed a significant decrease in serum uric acid, systolic and diastolic blood pressure, and hsCRP levels, and a significant increase in eGFR. Although the QTd values in the treatment group did not decrease to the same levels as in the normouricemic control group, a statistically significant decrease was found compared to their baseline values. In hyperuricemic control and normouricemic control patients, there were no differences in the levels of uric acid, hsCRP, eGFR, systolic and diastolic blood pressure, and QTd values compared to baseline values. Conclusions: There was a significant association between elevated serum uric acid and QTd, as well as with inflammatory biomarkers. Also, patients who had received hypouricemic therapy during the follow-up period presented a significant decrease in inflammatory markers as well as QTd. This indicates the beneficial effects of decreasing uric acid levels in decreasing the risk for future major adverse events related to ventricular arrhythmias.

EFEK PEMBERIAN SEDUHAN SERBUK HERBA SELEDRI (Apium graviolens L.) TERHADAP KADAR ASAM URAT SERUM DARAH AYAM LEGHORN JANTAN HIPERURIKEMIA

Apium graviolens L. is a medicinal plant that is useful for treating gout. Flavonoids are components of chemical compounds found in celery because they can work as antioxidants and inhibit the action of the xanthine oxidase enzyme to form uric acid. This study aims to determine the effect of giving celery herb powder on the blood serum uric acid levels of hyperuricemia male leghorn chickens. This study used twenty-five male leghorn chickens which were randomly divided into 5 groups. All groups were made hyperuricemia by being given 100% chicken liver juice 5 mL/l kg BW once a day orally during treatment. Group 1 was given 0.5% CMC suspension solution as a negative control group. Group 2 was treated with allopurinol 14 mg/1.5 kg BW in CMC 0.5% as a positive control. Groups 3, 4, 5 received infusion of celery herb powder in the order of doses (0.6 g/1.5 kg BW), (1.2 g/1.5 kg BW), (1.8 g/1.5 kg BW). Examination of uric acid levels was carried out on days 0, 4, 8, 12. The results showed that steeping celery could reduce uric acid levels in proportion to the dose. The greater the dose given, the greater the decrease in uric acid levels. The dose of celery herb group 3 (1.8 g/1.5 kg BW) was the most effective doses because it had the same value as the positive control.

Efektivitas Ekstrak Etanol Buah Makasar (Brucea Javanica) terhadap Penurunan Kadar Asam Urat Mus.Musculus Jantan

This study aims to find out the effectiveness of ethanol extract of makasar fruit (Brucea Javanica) against the decrease in uric acid levels of male Mus Muculus. This research is an experimental study using RAL technique using male mencit test animals, Treatment 4 groups divided into P0 (Aquades), P1 (Allopurinol 10 mg/g BB) P2 (chicken liver extract + 100 mg/kgBB), P3 (chicken liver + extract 200 mg/kgBB). The administration of makasar fruit extract can lower the levels of squeaky uric acid induced by the suspension of chicken liver. The administration of makasar fruit extract based on the average value is better in lowering blood uric acid levels than allopurinol drugs, based on different tests with LSD method of decreasing uric acid levels in the positive control group and the treatment group did not have a meaningful difference (p ≥ 0.05). In conclusion, makasar ethanol extract (Brucea Javanica) effectively significantly lowers the uric acid levels of male Mus Muculus than the drug allopurinol, but has no meaningful difference between the treatment group and the control group.
 Keywords: Fruit makasar, Decreased Uric Acid Levels, Mus. Male Musculus

Prognostic significance of uric acid change in acute ischemic stroke patients with reperfusion therapy.

Uric acid (UA) is an important endogenous free radical scavenger that has been found to have a neuroprotective effect. However, there is uncertainty about the relationship between UA change and outcome in acute ischemic stroke (AIS) patients with reperfusion therapy. We consecutively enrolled AIS patients with reperfusion therapy. UA was measured upon admission and during hospitalization. The change in UA levels (ΔUA) was determined by calculating the difference between admission UA and the lowest UA among all follow-up measurements, with a positive ΔUA suggesting a decrease in UA levels. Functional outcome was assessed by modified Rankin Scale (mRS) at 3months. Poor outcome was defined as mRS >2. A total of 361 patients were included (mean age 68.7±13.9years, 54.3% males). The mean UA on admission was 355±96.1μmol/L. The median ΔUA was 121μmol/L (IQR 50-192μmol/L) and 18 (5%) patients had increased UA levels. UA on admission was positively associated with good outcome (p for trend=0.017). When patients were classified into quartiles by ΔUA, patients with the largest decrease in UA (Q4: 199-434μmol/L) had a higher risk of poor outcome at 3months compared to patients with the least decrease in UA (Q1: 0-57μmol/L) (OR 2.55, 95% CI 1.09-5.98, p=0.031). The risk of poor outcome increased with ΔUA (p for trend=0.048). In patients with reperfusion therapy, high UA on admission was associated with a good 3-month outcome, while a greater decrease in UA was associated with poor outcome.

Ефективність та переносимість ранньої комбінованої ліпідознижувальної терапії симвастатином і фенофібратом порівняно із симвастатином у пацієнтів з гострим коронарним синдромом у поєднанні з цукровим діабетом 2-го типу й гіпертригліцеридемією

Мета роботи – оцінити ефективність та безпечність ранньої комбінованої ліпідознижувальної терапії симвастатином і фенофібратом порівняно із симвастатином у пацієнтів із цукровим діабетом (ЦД) 2-го типу й гіпертригліцеридемією (ГТГ), які переносять гострий коронарний синдром (ГКС).Матеріали і методи. Пацієнти (n=60) із ЦД 2-го типу та ГТГ були рандомізовано розподілені протягом 5–21-ї доби від початку будь-якої форми ГКС для отримання комбінації симвастатину 40 мг і фенофібрату 145 мг щодня, або тільки симвастатину 40 мг щодня протягом 12 міс. Через 3 і 12 міс після рандомізації оцінювали динаміку рівнів загального холестерину (ЗХС), холестерину ліпопротеїнів низької (ХС ЛПНЩ), високої (ХС ЛПВЩ) і невисокої (ХС неЛПВЩ) щільності, тригліцеридів (ТГ), визначали частку пацієнтів, в яких були досягнуті та утримувалися цільові рівні ліпідів відповідно до рекомендацій Європейського товариства кардіологів 2011 р., зміни рівнів аполіпопротеїнів А1 (аpoA1) і В (аpoB), ліпопротеїну (а) – ЛП(а), відношення ароB/аpoA1. Досліджували рівні глікованого гемоглобіну, сечової кислоти і загальні параметри безпечності лікування (АЛТ/АСТ, креатинін, швидкість клубочкової фільтрації).Результати та обговорення. Протягом дослідження не виявлено статистично значущої різниці між групами щодо динаміки рівнів ЗХС та ХС ЛПНЩ. Зафіксовано статистично значуще стійке зниження вмісту ХС неЛПВЩ до 2,88 (2,41–3,38) ммоль/л у разі комбінованої терапії (р=0,042) проти очевидної тенденції його збільшення до 3,46 (2,87–4,44) ммоль/л у групі прийому тільки статину через 12 міс лікування зі значущою різницею між групами (р=0,047). Спостерігали постійний значний ступінь зниження рівня ТГ у групі комбінованого лікування, як через 3 міс (р=0,037), так і через 12 міс (р=0,007) зі значною різницею між групами (р=0,035 і р=0,03 відповідно). У групі комбінованої терапії підвищився рівень аpoA1 до 1,45 (1,29–1,62) г/л (р<0,00001 порівняно з початковим), знизилися рівень аpoB до 0,87 (0,71–0,97) г/л (р>0,05) і відношення аpoB/аpoA1 до 0,57 (0,51–0,74) (р=0,0005 порівняно з початковим). У групі монотерапії статином відзначено початкове помірне підвищення рівня аpoA1, який через 3 міс лікування помітно знизився до 1,32 (1,18–1,43) г/л (р=0,02 порівняно з початковими даними), підвищення рівня аpoB до 0,97 (0,77–1,14) г/л разом із відношенням аpoB/аpoА1, що досягло 0,74 (0,56–0,87) з міжгруповою відмінністю відношення аpoB/аpoА1 (р=0,047) наприкінці дослідження. У разі комбінованої терапії рівень ЛП(а) порівняно з початковим знижувався протягом усього дослідження: через 3 міс (р=0,0004) та 12 міс (р=0,005), на відміну від зростання цього показника в групі монотерапії (р>0,05). Комбіноване лікування з фенофібратом привело до значного зниження рівня сечової кислоти через 3 міс (р<0,0001 порівняно з базовим значенням), і цей рівень утримувався весь період дослідження (р=0,002) без будь-яких змін у контрольній групі. Комбінована терапія була пов’язана з невеликим, але значущим (р=0,0006) зниженням функції нирок під час дослідження, чого не спостерігалося в групі статинотерапії, але без припинення лікування та потреби в нефрозамісній терапії.Висновки. Комбінована терапія симвастатином і фенофібратом у хворих на ЦД 2-го типу із ГТГ, ініційована в ранні терміни після ГКС, протягом одного року є безпечною та ефективною для корекції атерогенної дисліпідемії, нормалізує метаболізм аполіпопротеїнів та знижує рівні ЛП(а) і сечової кислоти на відміну від монотерапії симвастатином.

Increased Uric Acid and Life Style Factors Associated with Metabolic Syndrome in Thais.

The prevalence of metabolic syndrome (MS) has been continually increasing in developing countries especially in Thailand. Although insulin resistance and central obesity are initially considered as significant risk factors, the other causal factors leading to the development of MS continue to challenge the investigators. The aims of this study were to evaluate the prevalence of MS in Pathum Thani province, Thailand and to investigate the relationship between MS and risk factors. This cross-sectional study was performed with 202 Thai volunteers. Anthropometric-biochemical variables and blood pressures in each subject were measured. Almost one-third (32.7%) of the participants were diagnosed with MS based on the harmonized criteria, and one of the most significant risk factors is the elevated blood pressure. Weight, BMI, waist and hip circumferences, waist-hip ratio, blood pressure, glucose, triglycerides and uric acid were significantly higher in subjects with MS subjects. However, HDL-C levels were significantly lower in subjects with MS, compared to subjects without MS (p<0.001). The results of regression model after adjustment for age and gender showed that the increased serum uric acid level (OR=1.31, 95%CI: =1.04-1.66), cigarette smoking (OR=3.72, 95%CI: =1.51-9.15) and physical activity (OR=0.36, 95%CI: =0.19-0.67) were significantly related to MS. These findings suggest that the decrease of uric acid level, the promotion of physical activity and smoking cessation may decrease the risk of developing MS among Thais.

Aktivitas Antihiperurisemia Mikroenkapsulasi Ekstrak Kulit Melinjo (Gnetum gnemon L.) secara In Vivo

Hyperuricemicis as an abnormally elevated uric acid level in the blood.Gnetumgnemon, locally known as Melinjo, is one of the Indonesian indigenous plantswhichcan be an alternative source of allopurinol. The peels of Gnetumgnemon, usually be wasted,contains red anthocyanin pigments possessing antioxidant activity owing toits potential for the inactivation of free radicals and peroxyls. However, the anthocyanin will chemically result incompound instability and is easily degraded during the period ofstorage. Encapsulation remains as one of the eminent formulation techniques usedto protect the active pharmaceutical compound through coating ofmainingredient with polymer forming smallersize of particles within micro tonano.This study was aimed at determining the Gnetumgnemonpeel extract in microencapsulated form in inducing antihyperuricemic activity. The male Wistar-strain rats wereused as subjects,groupedinto fivedifferent feeding treatments, i.e. negative group (carboxymethyl cellulose(CMC) Na 0.5%), positive group (allopurinol 12.6 mg/kg BM), andthree doses groups(i.e. 100 mg/kgBM, 200 mg/kg BM, dose group 300 mg/kg BM). Uric acid levels were initially assessed for each group, then every test-animals werefedwith a dose of 300mg/kg BM of potassium oxonate intraperitoneally,and 2.5 mL of chicken liver juiceorally. An hour interval was given for the uric acid levels measurement for each group. The results showed an increase in uric acid levels after the subjectswere treated accordingly with potassium oxonate 300mg/kg BM and 2.5 mL chicken liver juice. At the hour-2, there was a decrease in uric acid levels but showingno significant difference in everygroup (p&gt; 0.05). The significant decrease among the groups was found at hour-4and indicates that dose of 200mg/ kgBM is an effective dose in reducing uric acidlevels Keyword: Gnetumgnemonpeel extract, microencapsulation, antihyperuricemic

Consensus on patients with hyperuricemia and high cardiovascular risk treatment

Substantial amount of epidemiologic studies showed that hyperuricemia is highly associated with cardiovascular disorders, chronic renal disease, and diabetes mellitus development risk. This fact shows necessity of increased focus on uric acid level in serum not only in relation to rheumatic disorders but also in relation to cardiovascular and renal risk. European Society of Cardiology and Russian Arterial Hypertension Society experts included tests on uric acid level serum concentration in routine tests for hypertensive patients. Important steps in increase of hyperuricemia control in clinical practice are increase of awareness as a risk factor of cardiovascular disorders, development of risk management algorithm for patients with hyperuricemia and high cardiovascular risk, and increase of treatment adherence. Decrease of uric acid level in serum achieved after treatment with urate decreasing therapy mostly with xanthine oxidase inhibitor is associated with improvement of blood pressure control and decrease of cardiovascular adverse events frequency.

Pengaruh Pemberian Seduhan Rosella Terhadap Penurunan Kadar Asam Urat Wanita Menopause

Gout disease is a commonly affects men in aged 30-40 years old, while this disease occurred in women in aged 55-70. The lack of estrogen level is contributing to increase the incidence of gout disease in menopause woman. Menopausal women have two times higher risk of gout disease due to deficit role of estrogen in the removal of uric acid trough urine system. The decrease of estrogen hormone level affect the function of excretion system (Integument and kidney) and also digestive system. While the function of these systems decreased, the residual compound like purin could not be removed trough urine, feces, and sweat. The production of uric acid in human body were linear to the breakdown process of purin. The more purines broken down, the more uric acid is produced. One of the plants that can reduce the uric acid level is Rosella (Hibiscus sabdariffa). The anthocyanins pigment in the calyx of Rosella flower could produce flavonoid compound. The question research of this study is the administration of steeping rosella could reduce the uric acid level in menopause women. Objective: To determine the effect of rosella steeping on decreasing uric acid levels in menopausal women. Method: Pre-experimental with the design of one group pre-post-test have been done, the analysis is using the Wilcoxon test signed rank test. The analysis of results obtained by t-test Sig. (2-tailed) 0.001 which value &lt;0.05 is significantly different. The Rosella steeping administration could affect the decrease of uric acid levels in menopausal women.

Kombinasi Rebusan Daun Salam dan Kemangi dalam Menurunkan Kadar Asam Urat Mus musculus

Indonesia is one of the world�s largest of biodiversity. Especially bay leaves (Syzygium polyanthum) and basil leaves (Ocimum basilicum). These plants can be used to reduce blood uric acid. This study aimed to determine the optimum dose that could reduce uric acid levels by providing a combination of decoction of basil leaves and bay leaves and to knew the phytochemical compounds that could reduce uric acid levels in basil leaves and bay leaves. The antihiperuricemia activity of boiled bay leaves and basil leaves was tested on male sex mice (Mus musculus) Balb / C strain, aged 8-10 weeks to reveal the effectiveness of bay leaves and basil leaves as blood uric acid-lowering. The dosage of decoction used is 1.5 glasses, 1 glass, and 0.5 glass from the shrinking of the cooking water which was originally 2 glasses. Tests were carried out on mice that experienced hyperuricemia induced by potassium oxonate 250 mg / kg BW or 5 mg / 20 g BB in mice intraperitoneally and mixed chicken liver, sprouts and melinjo. Measuring the level of urate is done using the POCT (Point Of Care Tasting) method. The results showed that combination of boiled bay leaves and basil leaves could reduce blood uric acid levels in mice around 0.5 - 1.0 mg / dl. The activity was effective in both doses, 0.5 glass and 1.5 glasses, but to get a significant decrease in uric acid levels this cooking water had to be consumed regularly and for a longer time.

PB2282 REASSESSING THE EFFICACY OF LOW DOSE RASBURICASE FOR MANAGEMENT OF TUMOR LYSIS SYNDROME IN HIGH RISK HEMATOLOGIC MALIGNANCIES

Background:Tumor lysis syndrome (TLS) is a potentially life‐threatening metabolic derangement seen in aggressive hematologic malignancies which is characterized by the massive release of toxic metabolic byproducts and consequent kidney damage. Whereas rasburicase is an established standard of care for management of TLS, the high cost of administering standard dosing of rasburicase has led to exploring lower doses of rasburicase.Aims:Assess our center's experience with lower dosing of rasburicase for management of TLS in aggressive hematologic malignancies.Methods:We studied all adult patients with hematologic malignancies who were treated with rasburicase in our institution between the years 2011‐2018. Charts were reviewed and demographic, clinical, and laboratory data were collected. Subjects were defined to be at high risk for TLS if they had any of the following features: acute leukemia, elevated uric acid levels at baseline (&gt;7.5 mg/dL) or aggressive lymphoma.Results:Fifty‐five patients were evaluated. The median age of patients was 67 years (range 22‐92) consisting of 20 patients with acute leukemia, 21 with aggressive lymphoma, 11 with multiple myeloma, and 3 with other hematologic cancers. Nearly all analyzed patients (98%) were considered to be at high risk for TLS and 44 patients did meet criteria for clinical TLS. Twenty‐six patients (47%) received allopurinol prophylaxis. The median dose of rasburicase administered was 3 mg (range 1.5‐9) with 10 patients being given a second dose of rasburicase. The median baseline levels of uric acid and creatinine were 13.9 mg/dL (range 6.5‐42.8) and 2.18 mg/dL (range 0.63‐8.15), respectively. At 24 hours post administration of rasburicase the median uric acid levels were 7.9 mg/dL (range 0.8‐17.5) while at 48 hours they were 4.9 mg/dL (range 0.8‐13.5). Notably, 54 patients (98%) experienced a decrease in uric acid levels of at least 10% within the first 24 hours following rasburicase administration and 40% of patients had normal uric levels by that time. Within the initial 24 hours, creatinine levels were significantly improved in only a minority of patients with only 10 patients (18%) experiencing a decrease of more than 10% compared to baseline levels. Of note, 15 patients required dialysis during their admission and 26 patients died during the index hospitalization.Summary/Conclusion:The majority of subjects in our analysis of a high‐risk patient population responded favorably to low dose rasburicase in terms of rapid uric acid reduction although rates of dialysis and early mortality were substantial. Our data illustrate and confirm the feasibility of lower dosing of rasburicase to patients with aggressive hematologic malignancies.

Uji Praklinik Kombinasi Obat Herbal Kopi Pinogu (Coffea canephora var Robusta) Dan Bunga Cengkeh (Syzygium aromaticum) Terhadap Penurunan Kadar Asam Urat Pada Mencit

Decreasing uric acid levels can be given with coffee plants Pinogu (Coffea canephora var robusta) which is combined with clove flowers (Syzygium aromaticum) as a hyperuricemia drug. This study aims to measure the effect of the combination of Pinogu coffee herbal medicine and clove flower seen from the decrease in uric acid levels of male white mice made hyperuricemia by chicken liver juice. This study uses a pure experimental design with pre and post test design. Where animals are grouped into seven groups, each group consisting of 5 male white mice. Each group was induced 1 mL / 20 g BB chicken liver juice and left for 24 hours then blood was taken after 2 hours, 3 hours and 4 hours of treatment. Group I as a negative control was given Na-CMC, group II was given allopurinol suspension 0.0538 g / kg BB, group III was given a combination of Pinogu coffee and clove flowers 0.209 g / kg BB, group IV was given a combination of Pinogu coffee and clove flower 0.39936 g / kg BB, group V was given a combination of Pinogu coffee and clove flower 0.404 g / kg BB, group VI was given a single Pinogu coffee extract 0.195 g / kg BB, and group VII was given clove flower extract 0.0140 g / kg BW. The results showed that the combination of Pinogu coffee herbal medicine (Coffea canephora var robusta) and clove flower (Syzygium romaticum) can reduce uric acid levels in male white mice (Mus musculus). The combination of Pinogu coffee and clove flower 0.209 g / kg BW gives the optimal effect of reducing blood uric acid levels in mice by 64.93%. Keywords— Gout, Pinogu Coffee, Clove Flowers

Hypouricemic effectiveness of synbiotic in the complex treatment in gout patients

Objective — to evaluate the hypouricemic effects of the combination of synbiotic and allopurinol versus monotherapy with allopurinol in gout patients.Materials and methods. The examinations involved 130 patients (mean age (55.5 ± 9.4) years old) with gout (mean duration (7.7 ± 7.1) years). The gout diagnosis was based on the ACR criteria (2016). The control group consisted of 25 practically healthy men of the corresponding age. Patients with gout who have not reached the target uricemia level after 6 weeks of treatment with allopurinol were included in the treatment groups. The main group (n = 68) included patients who continued to take allopurinol in a dose of 300 mg per day with up-titration of 100 mg per month, and additionally took the synbiotic 1 capsule three times a day. The comparison group (n = 62) consisted of patients receiving allopurinol monotherapy. The treatment duration was 3 months. Qualitative and quantitative parameters of intestinal microbiote were analysed based on the data of bacteriological inoculation of faeces. The effectiveness of therapy was assessed by the levels of uricemia, C-RP, and the degree of dysbiotic changes in the intestinal microbiocenosis. Results and discussion. After treatment of patients in the main group with synbiotic using, the normalization of the indicators was observed due to the reduction of the concentration of opportunistic microorganisms of the Firmicutes group, obligate anaerobes, Bacteroides spp., Candida and the restoration of protective microflora — lacto- and bifidobacteria. In patients with gout after 3 months of complex treatment with the addition of a synbiotic, the transformation of the structure of the intestinal microbiota in the direction of normalization of qualitative (prevalence of mild degree of violations of microbiota in 50 % of subjects) and quantitative composition, revealed a more pronounced hypouricemic effect relative to the comparison group — the target level of uricemia is achieved twice as often — in 40.3 and 21 % of cases respectively. The additional inclusion of the synbiotic demonstrated an increase in the hypouricemic effect of allopurinol (a decrease in uric acid levels by 18.7 versus 13.3 %, p &lt; 0.01), which was associated with more pronounced anti-inflammatory effect (a decrease in C-RP by 75 versus 26.3 %, p &lt; 0.01).Conclusions. For patients with gout there is a pronounced violation of intestinal microbiota characterized by a combination of deficiency of protective microflora and an increase in obligate anaerobes, gram-positive cocci and fungi of the genus Candida. In patients with gout after 3 months of complex treatment with the addition of a synbiotic, against the background of the normalization of the qualitative and quantitative composition of intestinal microbiota, there is a more pronounced hypouricemic effect — the target level of uricemia is achieved twice as often, which is combined with more pronounced anti-inflammatory effect.

Nucleic Acid Metabolism in Patients with Severe Burn Injury and the Possibility of Its Correction

Purpose. To assess changes in nucleic acid (NA) metabolism in severe burn injury and to develop recommendations for correction of the alimentary status taking into account changes in the NA metabolism. Materials and methods. All patients (37 patients with II–III degree thermal burns and a burn area of more than 40%) were divided into 2 groups: Group I included survivors (23 patients), group II consisted of the deceased. The intensity of the NA metabolism was assessed based on the dynamics of the of uric acid (UA) and oligonucleotides serum concentrations. Results. In the acute period of burn injury, marked decrease in UA levels (less than 100 μmol/l), with gradual stabilization in survivors is typical. In addition, a 2–3-fold increase in the concentration of serum oligonucleotides compared to the normal limit is typical for survivors in the acute period, and these changes were significantly different from the group of deceased patients starting from day 5. Taking into account the data obtained, the level of serum UA can be recommended in clinical practice for the assessment of alimentary status in burn disease, as well as a criterion for f the prescription of glutamine administration in critically ill patients. In patients with burn disease a decrease in the UA level to less than 100 μmol/l was regarded as an absolute indication for the use of L-glutamine products. The use of glutamine in patients with significant decrease in UA levels was accompanied by a significant increase in the intensity of NA metabolism, which was demonstrated by both an increase in uric acid levels (by 85% by day 10 after the start of glutamine administration, P&lt;0.01) and restoration of repair processes. Conclusion. Therefore, there was a marked alteration of NA metabolism in both groups of patients with severe burn injury. At the same time, surviving patients are characterized by rapid recovery of NA metabolism. Glutamine was employed as a pharmacological agent that effectively abrogates the depression of NA metabolism.

Metabolic syndrome and the decreased levels of uric acid by leflunomide favor redox imbalance in patients with rheumatoid arthritis

Oxidative stress plays a role in the pathophysiology of rheumatoid arthritis (RA). The aim of the present study was to verify the influence of metabolic syndrome (MetS) and disease-modifying antirheumatic drugs on nitrosative and oxidative biomarkers in patients with RA. A total of 177 patients with RA and 150 healthy volunteers participated in this study, which measured lipid hydroperoxides, advanced oxidation protein products (AOPP), nitric oxide metabolites (NOx), carbonyl protein, total radical-trapping antioxidant parameter (TRAP), uric acid (UA), and C-reactive protein (CRP). NOx and the NOx/TRAP ratio were significantly increased in RA, while no significant differences in lipid hydroperoxides, AOPP, UA, and TRAP levels were found between both groups. Treatment with leflunomide was associated with increased levels of carbonyl protein, and lowered levels in TRAP and UA, while the NOx/TRAP ratio further increased. NOx and the NOx/TRAP ratio were significantly higher in women than in men, while TRAP and UA were significantly lower in women. MetS was accompanied by increased AOPP and UA levels. RA was best predicted by increased NOx/TRAP ratio, CRP, and BMI. In conclusion, our data demonstrated that NOx and NOx/TRAP are strongly associated with RA physiopathology. Our findings suggest that inhibition of iNOS may become an interesting therapeutic approach for the treatment of RA. In addition, the presence of MetS and a decrease in levels of UA by leflunomide favor redox imbalance in RA patients. More studies are needed to evaluate the impact of antioxidant capacity reduction on RA progression.