Gout PDF Ebooks
Gout PDF files are research reports in Portable Document Format (also called Adobe files or ebooks).
The gout information they contain can be viewed on screen or printed using a variety of reading software programs, many of which are free (see below).
Please note that most of these gout ebooks contain scientific terminology, however, I have added simple English summaries where possible.
Many of these gout reports cover several aspects of gout. Where possible, I have categorized these to match the subsections of the Understanding Gout section
- Understanding Uric Acid
- Hyperuricemia
- High Uric Acid
- Urate Deposits
- Immune Response
- Gout Pain
- Other Issues
These gouty PDFs are listed in alphabetical order on the Gout Information Page.
PDF File Viewers
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Understanding Uric Acid
- A retrospective study of the relationship between serum urate level and recurrent attacks of gouty arthritis: evidence for reduction of recurrent gouty arthritis with antihyperuricemic therapy. Jun 2004. Shoji A et al. Gout study showing the relationship between persistent reduction of blood uric acid below the saturation point, and the reduction in frequency of acute gouty attacks.
- Title
- Loss of urate oxidase activity in hominoids and its evolutionary implications.
- Author(s)
- Oda M, Satta Y, Takenaka O, Takahata N.
- Published
- Mol Biol Evol. 2002 May;19(5):640-53.
- Serum uric acid in acute gout. Nov 1997. Logan JA et al. Gout study showing how uric acid often falls during an acute gout flare risking mis-diagnosis and poor patient management.
- Significance of circadian variations of uric acid elimination. Sep 1983. B. D. Owen-Smith. Short article explaining that uric acid excretion is higher at night because uric acid production rises during sleep.
- Title
- Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis.
- Published
- Nov 1981
- Author(s)
- Ames BN, Cathcart R, Schwiers E, Hochstein P.
- On diurnal and nocturnal variations in the excretion of uric acid. Dec 1906. J. B. Leathes. Early study showing that uric acid excretion increases at night.
Hyperuricemia
- July 2008, Mandell. Although hyperuricemia is significant at 6.8mg/dL (0.40 mmol/L), some labs include higher values in the normal range. Hyperuricemia does not prove gout, but patients need to be reviewed individually to assess other factors, as untreated gout is serious.
- Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Feb 2007, Krisnan et al. Establishes hyperuricemia at 7mg/dL, or above, and describes an 80% higher risk of high blood pressure at that level, rising by a further 9% for each mg unit increase.
High Uric Acid
- Treatment failure gout. Nov 2009 Ali S, Lally EV. Describes some potential treatment options in refractory (unresponsive) gout. Reasons for treatment failure are:
- Physician failure to diagnose and treat gout
- Inadequate dosing of urate-lowering therapy
- Allergy or intolerance to urate-lowering therapy
- Allergy or intolerance to urate-lowering therapy
- Lack of compliance with prescribed therapy
- US Prescribing information for rasburicase (brand name Elitek) supplied as a powder for intravenous use. This is only licensed for child and adult cancer patients with high uric acid from chemotherapy. Oct 2009
- Meta-Analysis of 28,141 Individuals Identifies Common Variants within Five New Loci That Influence Uric Acid Concentrations. June 2009, Melanie Kolz et al. This analysis of 14 studies reveals strong genetic influences on excess uric acid. 9 potential genetic weaknesses could be studied further for potential new treatments.
- Patient information on allopurinol from the Australian Rheumatology Association. May 2009 (reviewed annually)
- Briefing Document for Febuxostat. Nov 2008. Takeda Pharmaceuticals North America, Inc. Comprehensive review of studies carried out to support the application for febuxostat, released under the brand name Uloric (Adenuric outside USA).
- Product information for Fasturtec a brandname for rasburicase sold as Elitek in the USA. Contains interesting tables of outstanding uric acid reduction.
- The Dual Actions of Morin (3,5,7,2',4'-Pentahydroxyflavone) as a Hypouricemic Agent: Uricosuric Effect and Xanthine Oxidase Inhibitory Activity. Jan 2006, Zhifeng Yu et al. Morin, found in figs and other fruit, reduces uric acid in rats.
- The Effects of Vitamin C Supplementation on Serum Concentrations of Uric Acid. June 2005, Han-Yao Huang et al. Results of a Randomized Controlled Trial (RCT), showing that 500mg/day vitamin C for 2 months reduces blood uric acid, with better reductions for higher uric acid.
- A retrospective study of the relationship between serum urate level and recurrent attacks of gouty arthritis: evidence for reduction of recurrent gouty arthritis with antihyperuricemic therapy. Jun 2004. Shoji A et al. Gout study showing the relationship between persistent reduction of blood uric acid below the saturation point, and the reduction in frequency of acute gouty attacks.
- Milk- and soy-protein ingestion: acute effect on serum uric acid concentration. Mar 1991, Garrel DR et al. The uricosuric effect of milk proteins reduce blood uric acid concentration, but with soy protein this effect is offset by the high purine levels.
- Purine and pyrimidine metabolism. Sep 1985 Zöllner. In-depth analysis of different sources of purines and uric acid, differentiating between endogenous purines, from body tissue, and exogenous purines, from diet. Reveals that allopurinol eliminates half of internally generated uric acid, and almost all dietary uric acid.
- Effects of some anti-inflammatory drugs on 12 blood constituents: protocol for the study of in vivo effects of drugs. July 1985, Jeli?-Ivanovi? et al. New procedure to eliminate the effects of drugs on blood test results, and application of the procedures on uric acid by some anti-inflammatory drugs. [Abstract summary]
Urate Deposits
- Time required for disappearance of urate crystals from synovial fluid after successful hypouricaemic treatment relates to the duration of gout. Aug 2007. Pascual E, Sivera F. Gout study to find the time taken for urate crystals to disappear from gouty joints under uric acid lowering therapy.
- Effect of Urate-Lowering Therapy on the Velocity of Size Reduction of Tophi in Chronic Gout. Aug 2002 Perez-Ruiz et al. This study of 63 gouty patients explodes the myth that a standard 300mg dose of allopurinol is adequate: “There is much more to the therapy of hyperuricemia than simply prescribing 300 mg/day of allopurinol. How much? As much as necessary to obtain low serum urate levels.” It shows that urate deposits will dissolve when uric acid is reduced below 7 mg/dL (0.42 mmol/L), but they dissolve about 4 times faster with urc acid levels below 4 mg/dL (0.24 mmol/L).
If you are taking allopurinol for gout, this shows how important it is to regularly discuss the right dosage with your doctor.
- Growth of monosodium urate monohydrate crystals: effect of cartilage and synovial fluid components on in vitro growth rates. Oct 1986. Burt HM, Dutt YC. This study shows that Chondroitin sulphate and phosphatidylcholine increased the growth rate of uric acid crystals whilst albumin significantly inhibited crystallization. The authors admit that further work is needed to isolate other factors.
- Studies of urate crystallisation in relation to gout. Aug 1983. Fiddis RW et al. Laboratory studies of uric acid crystals confirm that temperature increase improves uric acid solubility. They claim that crystals form very slowly, though dissolve quickly when concentrations fall. However, they conclude that much more real life investigation is required to understand how the crystallization process can be halted in the body as compared to the test tube.
Immune Response
- Reduction of urate crystal-induced inflammation by root extracts from traditional oriental medicinal plants: elevation of prostaglandin D2 levels. July 2007, Sung Mun Jung et al. Traditional Chinese herbal root extracts of Siberian Ginseng, Dong Quai (Chinese Angelica), and Baikal Skullcap, reduced the inflammatory immune response to urate crystals in mice.
- Novel Targets for Antiinflammatory and Antiarthritic Agents. July 2006. Kulkarni RG et al. Explains how new understanding of inflammatory processes within the human immune system offers new opportunities for pain relief medications. Also reviews currently available anti-inflammatory drugs.
Gout Pain
- Questions and Answers on the Review of Etoricoxib-Containing Medicines. June 2008, European Medicines Agency (EMEA). Etoricoxib should continue to be licensed for short term acute gout and other conditions. Doctors must be aware of heart and blood pressure risks before and during treatment.
- Drug Class Review on Cyclo-oxygenase (COX)-2 Inhibitors and Non-steroidal Anti-inflammatory Drugs (NSAIDs). Nov 2006, Roger Chou, MD. A summary of 26 pain relieving drugs, many of which are prescribed for gout. It includes an assessment of risks for stomach and heart problems, which are associated with longterm use of COX inhibitors.
Other Gouty Issues
These reports cover multiple sections or gout-related issues.
- Serum Cystatin C is a Potential Endogenous Marker for the Estimation of Renal Function in Male Gout Patients with Renal Impairment. Jan 2010, Choe JY et al. Shows Cystatin C is a better measure of kidney function than more traditional tests. Important for allopurinol users, and they recommend allopurinol for kidney patients.
- Elevated Uric Acid Increases the Risk for Kidney Disease. Dec 2008. Obermayr RP et al. Though not offering any medical explanations, the study reveals a strong independent statistical link between high uric acid and increased likelihood of kidney disease. There is a suggestion that asymptomatic hyperuricemia (raised uric acid levels without gout flares) be taken more seriously, especially where high blood pressure is involved.
- British Society for Rheumatology and British Health Professionals in Rheumatology Guideline for the Management of Gout. Feb 2007, Kelsey M. Jordan et al. Comprehensive guidelines for gout management including wise-ranging references to supporting studies.
- Serum uric acid and cognitive function in community-dwelling older adults. Neuropsychology. Jan 2007. Schretlen DJ et al. A uric acid measurement study on 96 men and women over 60 to assess the correlation between uric acid levels and cognitive function.
"Despite its antioxidant properties, these findings suggest that even mild elevations of UA might increase the risk of cognitive decline among older adults."
- Pathology and proposed pathophysiology of diclofenac poisoning in free-living and experimentally exposed oriental white-backed vultures (Gyps bengalensis). Oct 2005. Meteyer CU et al. Report into diclofenac poisoning in vultures. Though the deaths are termed visceral gout, there is no apparent risk to gouty humans who take diclofenac for gout pain relief.
- Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men. March 2004, Hyon K. Choi et al. Statistical study showing a link between increased meat and fish intake and increased risk of gout. Increased dairy is associated with lower risk of gout, and high purine vegetables have no association with gout.
- Seasonal variation in the onset of acute microcrystalline arthritis. Oct 1999. Gallerani M et al. Statistical evaluation of the incidence of gout and pseudogout in an Italian hospital. Gout was most prevalent in April and least prevalent in October. They found no significant seasonal variation in pseudogout.
- Title
- Bartter's syndrome with gouty arthritis.
- Published
- Sep 1992
- Author(s)
- Ogawa T, Fujise Y, Shibata S, Abiru M, Takigami Y, Miura T, Kikuchi K, Fukazawa Y, Iimura O.
- Effect of Short-Term Use of Different Non-Steroidal Anti-Inflammatory Drugs on Renal Function During Fasting in Ramadan. Jan-Mar 1985 Al-Arfaj HF et al. This investigation confirms a short term uric acid increase from fasting. They conclude that using NSAIDs at this time has no adverse effects, but note that there is an emphasis on short term use.
Next Gout PDF Steps
This list of gout reports barely scratches the surface of the huge number of gout studies that have been published.
If you know of any other gout reports that are available in PDF format, please let me know. Use the Gout Forum to share gout information ebooks, or any other good gout resources.