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  1. Twenty-four hour ambulatory blood pressure monitoring in adolescents with type 1 diabetes: getting started.

    Science.gov (United States)

    Pellizzari, Margaret; Speiser, Phyllis W; Carey, Dennis E; Fort, Pavel; Kreitzer, Paula M; Frank, Graeme R

    2008-11-01

    Twenty-four hour ambulatory blood pressure monitoring (ABPM) is a valuable tool in the pediatric and adolescent population with type 1 diabetes. It provides useful information not readily available from sporadic clinic blood pressure (BP) measurements and a more reliable estimation of the subject's BP over an extended period of time. Ambulatory blood pressure monitoring is gaining popularity with clinicians and investigators alike. The American Heart Association has recently issued recommendations for the use of ABPM in children and adolescents. We have incorporated ABPM into our adolescent diabetes practice and present useful information for clinicians planning to initiate 24 h ABPM in their clinical practice.

  2. Twenty-four-hour blood pressure among Greenlanders and Danes: relationship to diet and lifestyle

    DEFF Research Database (Denmark)

    Jørgensen, Marit Eika; Pedersen, M.B.; Siggaard, Cecilie

    2002-01-01

    IV: Greenlanders in Greenland consuming mainly traditional Greenlandic food. All subjects underwent a physical examination, laboratory screening of blood and urine samples, and completed a questionnaire on diet, physical activity, smoking status, intake of alcohol, liquorices, vitamins and minerals....../73-127/77), Greenlanders 122/ 69 (119/68-124/70)). Among Greenlanders, blood pressure increased with age and male gender, and systolic blood pressure increased with body mass index (BMI). No association with diet was found. The difference between the two populations persisted after controlling for age, gender, BMI...... to diet and lifestyle - ResearchGate. Available from: http://www.researchgate.net/publication/11001663_Twenty-four-hour_blood_pressure_among_Greenlanders_and_Danes_Relationship_to_diet_and_lifestyle [accessed Oct 7, 2015]....

  3. Twenty-four-hour ambulatory blood pressure monitoring in very elderly patients

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    Cappelleri, Claudia; Janoschka, Alin; Berli, Reto; Kohler, Sibylle; Braun-Dullaeus, Ruediger C.; Heuss, Ludwig T.; Wolfrum, Mathias

    2017-01-01

    Abstract Elevated blood pressure (BP) is frequently diagnosed in very elderly hospitalized patients. Accurate diagnosis of hypertension is challenging in the hospital environment, due to the “white coat effect,” and both overtreatment and undertreatment can adversely affect clinical outcome. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) has the potential to avoid the “white coat effect” and accurately guide the management of hypertension. However, effects of the hospital environment on ABPM are unknown in the very elderly. We set out to enroll 45 patients, age ≥70 years, with elevated conventional BP during hospitalization in this observational study. It was prespecified by protocol to assess initially the difference between 24-hour BP during hospital-admission and home follow-up. Subsequent analysis should investigate the change in anxiety (Hospital Anxiety and Depression Scale-A [HADS-A]) after discharge, the correlation with change in 24-hour BP after discharge, and the prevalence of orthostatic hypertension. Thirty-one patients were included in the final analysis (age 83.5 ± 4.4 years; 71% female). Twenty-four-hour BP decreased significantly after hospital discharge (systolic from 133.5 ± 15.6 to 126.2 ± 14.4 mm Hg [millimeter of mercury], P = .008; diastolic from 71.0 ± 9.0 to 68.3 ± 8.6 mm Hg, P = .046). Anxiety level (HADS-A) decreased significantly after discharge, from 7.5 (interquartile range [IQR]: 4.0–13.8) to 5.0 (IQR: 4.0–8.0, P = .012). The change in anxiety was a predictor of change in systolic BP after discharge (F[1,20] = 5.9, P = .025). Sixty-one percent of the patients had significant orthostatic hypotension during hospital stay. In conclusion, 24-hour BP in very elderly patients is lower in the home environment than during hospitalization. This phenomenon seems to be directly linked to a lower anxiety-level at home. Reassessing hypertension at home may decrease the

  4. Isolated total RNA and protein are preserved after thawing for more than twenty-four hours

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    de Oliveira, Ivone Braga; Ramos, Débora Rothstein; Lopes, Karen Lucasechi; de Souza, Regiane Machado; Heimann, Joel Claudio; Furukawa, Luzia Naôko Shinohara

    2012-01-01

    OBJECTIVE: The preservation of biological samples at a low temperature is important for later biochemical and/or histological analyses. However, the molecular viability of thawed samples has not been studied sufficiently in depth. The present study was undertaken to evaluate the viability of intact tissues, tissue homogenates, and isolated total RNA after defrosting for more than twenty-four hours. METHODS: The molecular viability of the thawed samples (n = 82) was assessed using the A260/A280 ratio, the RNA concentration, the RNA integrity, the level of intact mRNA determined by reverse transcriptase polymerase chain reaction, the protein level determined by Western blotting, and an examination of the histological structure. RESULTS: The integrity of the total RNA was not preserved in the thawed intact tissue, but the RNA integrity and level of mRNA were perfectly preserved in isolated defrosted samples of total RNA. Additionally, the level of β-actin protein was preserved in both thawed intact tissue and homogenates. CONCLUSION: Isolated total RNA does not undergo degradation due to thawing for at least 24 hours, and it is recommended to isolate the total RNA as soon as possible after tissue collection. Moreover, the protein level is preserved in defrosted tissues. PMID:22473407

  5. Twenty-four hour noninvasive ventilation in Duchenne muscular dystrophy: a safe alternative to tracheostomy.

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    McKim, Doug A; Griller, Nadia; LeBlanc, Carole; Woolnough, Andrew; King, Judy

    2013-01-01

    Almost all patients with Duchenne muscular dystrophy (DMD) eventually develop respiratory failure. Once 24 h ventilation is required, either due to incomplete effectiveness of nocturnal noninvasive ventilation (NIV) or bulbar weakness, it is common practice to recommend invasive tracheostomy ventilation; however, noninvasive daytime mouthpiece ventilation (MPV) as an addition to nocturnal mask ventilation is also an alternative. The authors' experience with 12 DMD patients who used 24 h NIV with mask NIV at night and MPV during daytime hours is reported. The mean (± SD) age and vital capacity (VC) at initiation of nocturnal (only) NIV subjects were 17.8±3.5 years and 0.90±0.40 L (21% predicted), respectively; and, at the time of MPV, 19.8±3.4 years and 0.57 L (13.2% predicted), respectively. In clinical practice, carbon dioxide (CO2) levels were measured using different methods: arterial blood gas analysis, transcutaneous partial pressure of CO2 and, predominantly, by end-tidal CO2. While the results suggested improved CO2 levels, these were not frequently confirmed by arterial blood gas measurement. The mean survival on 24 h NIV has been 5.7 years (range 0.17 to 12 years). Of the 12 patients, two deaths occurred after 3.75 and four years, respectively, on MPV; the remaining patients continue on 24 h NIV (range two months to 12 years; mean 5.3 years; median 3.5 years). Twenty-four hour NIV should be considered a safe alternative for patients with DMD because its use may obviate the need for tracheostomy in patients with chronic respiratory failure requiring more than nocturnal ventilation alone.

  6. Twenty-four-hour rhythmicity of circulating metabolites: effect of body mass and type 2 diabetes.

    Science.gov (United States)

    Isherwood, Cheryl M; Van der Veen, Daan R; Johnston, Jonathan D; Skene, Debra J

    2017-12-01

    Metabolic profiling of individuals with type 2 diabetes mellitus (T2DM) has previously been limited to single-time-point samples, ignoring time-of-day variation. Here, we tested our hypothesis that body mass and T2DM affect daily rhythmicity and concentrations of circulating metabolites across a 24-h day in 3 age-matched, male groups-lean, overweight/obese (OW/OB), and OW/OB with T2DM-in controlled laboratory conditions, which were not confounded by large meals. By using targeted liquid chromatography/mass spectrometry metabolomics, we quantified 130 plasma metabolites every 2 h over 24 h, and we show that average metabolite concentrations were significantly altered by increased body mass (90 of 130) and T2DM (56 of 130). Thirty-eight percent of metabolites exhibited daily rhythms in at least 1 study group, and where a metabolite was rhythmic in >1 group, its peak time was comparable. The optimal time of day was assessed to provide discriminating biomarkers. This differed between metabolite classes and study groups-for example, phospholipids showed maximal difference at 5:00 AM (lean vs. OW/OB) and at 5:00 PM (OW/OB vs. T2DM). Metabolites that were identified with both robust 24-h rhythms and significant concentration differences between study groups emphasize the importance of controlling the time of day for diagnosis and biomarker discovery, offering a significant improvement over current single sampling.-Isherwood, C. M., Van der Veen, D. R., Johnston, J. D., Skene, D. J. Twenty-four-hour rhythmicity of circulating metabolites: effect of body mass and type 2 diabetes. © The Author(s).

  7. Twenty-four-hour ambulatory electrocardiography characterization of heart rhythm in Vipera berus-envenomed dogs.

    Science.gov (United States)

    Vestberg, Anna Rave; Tidholm, Anna; Ljungvall, Ingrid

    2017-05-03

    Vipera berus has a worldwide distribution and causes high morbidity in dogs annually. A complication to envenomation may be cardiac arrhythmias. The purpose of this study was to investigate the prevalence, types, and timing of arrhythmias, using 24-h ambulatory electrocardiography (24-AECG), in dogs bitten by V. berus in the first 24-32 h after envenomation. In addition, this study aimed to investigate if there were differences in selected clinical and hematological- and biochemical variables (including cardiac troponin I) at admission between V. berus-envenomed dogs with and without detected pathologic arrhythmias. Seventeen prospectively recruited client-owned dogs acutely envenomed by V. berus, were therefore examined clinically and echocardiographically, sampled for blood, hospitalized, and monitored by 24-AECG. Clinically significant pathologic arrhythmias in this study were of ventricular origin, such as frequent single ventricular premature contractions (VPCs) and couplets of VPCs, episodes of ventricular tachycardia and idioventricular rhythm, and "R-on-T phenomenon". Variations of these arrhythmias were detected by 24-AECG in eight (47%) of included dogs. No arrhythmias were detected by cardiac auscultation. Twenty-four hours following envenomation, four out of eight dogs experienced decreases (all P dogs experienced increases (all P dogs bitten on a limb developed pathologic arrhythmias. Otherwise, no significant differences in clinical, hematological or biochemical variables were seen between dogs with pathologic arrhythmias and those without. Forty-seven percent of dogs bitten by V. berus included in this study experienced pathologic arrhythmias of abnormal ventricular depolarization. During the first 24-32 h from the snakebite, some dogs experienced a decrease in arrhythmic episodes and others an increase in arrhythmic episodes. These findings indicate a potential value of repeated or prolonged electrocardiography monitoring of envenomed dogs for

  8. Brief Report: Validation of a Definition of Flare in Patients With Established Gout.

    Science.gov (United States)

    Gaffo, Angelo L; Dalbeth, Nicola; Saag, Kenneth G; Singh, Jasvinder A; Rahn, Elizabeth J; Mudano, Amy S; Chen, Yi-Hsing; Lin, Ching-Tsai; Bourke, Sandra; Louthrenoo, Worawit; Vazquez-Mellado, Janitzia; Hernández-Llinas, Hansel; Neogi, Tuhina; Vargas-Santos, Ana Beatriz; da Rocha Castelar-Pinheiro, Geraldo; Amorim, Rodrigo B C; Uhlig, Till; Hammer, Hilde B; Eliseev, Maxim; Perez-Ruiz, Fernando; Cavagna, Lorenzo; McCarthy, Geraldine M; Stamp, Lisa K; Gerritsen, Martijn; Fana, Viktoria; Sivera, Francisca; Taylor, William

    2018-03-01

    To perform external validation of a provisional definition of disease flare in patients with gout. Five hundred nine patients with gout were enrolled in a cross-sectional study during a routine clinical care visit at 17 international sites. Data were collected to classify patients as experiencing or not experiencing a gout flare, according to a provisional definition. A local expert rheumatologist performed the final independent adjudication of gout flare status. Sensitivity, specificity, predictive values, and receiver operating characteristic (ROC) curves were used to determine the diagnostic performance of gout flare definitions. The mean ± SD age of the patients was 57.5 ± 13.9 years, and 89% were male. The definition requiring fulfillment of at least 3 of 4 criteria (patient-defined gout flare, pain at rest score of >3 on a 0-10-point numerical rating scale, presence of at least 1 swollen joint, and presence of at least 1 warm joint) was 85% sensitive and 95% specific in confirming the presence of a gout flare, with an accuracy of 92%. The ROC area under the curve was 0.97. The definition based on a classification and regression tree algorithm (entry point, pain at rest score >3, followed by patient-defined flare "yes") was 73% sensitive and 96% specific. The definition of gout flare that requires fulfillment of at least 3 of 4 patient-reported criteria is now validated to be sensitive, specific, and accurate for gout flares, as demonstrated using an independent large international patient sample. The availability of a validated gout flare definition will improve the ascertainment of an important clinical outcome in studies of gout. © 2017, American College of Rheumatology.

  9. Using natural language processing and machine learning to identify gout flares from electronic clinical notes.

    Science.gov (United States)

    Zheng, Chengyi; Rashid, Nazia; Wu, Yi-Lin; Koblick, River; Lin, Antony T; Levy, Gerald D; Cheetham, T Craig

    2014-11-01

    Gout flares are not well documented by diagnosis codes, making it difficult to conduct accurate database studies. We implemented a computer-based method to automatically identify gout flares using natural language processing (NLP) and machine learning (ML) from electronic clinical notes. Of 16,519 patients, 1,264 and 1,192 clinical notes from 2 separate sets of 100 patients were selected as the training and evaluation data sets, respectively, which were reviewed by rheumatologists. We created separate NLP searches to capture different aspects of gout flares. For each note, the NLP search outputs became the ML system inputs, which provided the final classification decisions. The note-level classifications were grouped into patient-level gout flares. Our NLP+ML results were validated using a gold standard data set and compared with the claims-based method used by prior literatures. For 16,519 patients with a diagnosis of gout and a prescription for a urate-lowering therapy, we identified 18,869 clinical notes as gout flare positive (sensitivity 82.1%, specificity 91.5%): 1,402 patients with ≥3 flares (sensitivity 93.5%, specificity 84.6%), 5,954 with 1 or 2 flares, and 9,163 with no flare (sensitivity 98.5%, specificity 96.4%). Our method identified more flare cases (18,869 versus 7,861) and patients with ≥3 flares (1,402 versus 516) when compared to the claims-based method. We developed a computer-based method (NLP and ML) to identify gout flares from the clinical notes. Our method was validated as an accurate tool for identifying gout flares with higher sensitivity and specificity compared to previous studies. Copyright © 2014 by the American College of Rheumatology.

  10. Updates on the treatment of gout, including a review of updated treatment guidelines and use of small molecule therapies for difficult-to-treat gout and gout flares.

    Science.gov (United States)

    Soskind, Rose; Abazia, Daniel T; Bridgeman, Mary Barna

    2017-08-01

    Gout is a rheumatologic condition associated with elevated serum uric acid levels and deposition of monosodium urate crystals in joints and soft tissues. Areas covered: In this article, we describe the role of currently available drug therapies for managing acute gout flares and used in reducing serum urate levels. Further, we explore the role of novel small molecular therapies and biologic agents in the treatment of refractory or severe gout symptoms. A literature search of MEDLINE and MEDLINE In-Process & Other Non-Indexed Citations Databases (1996-June 2017) was conducted utilizing the key words 'gout', 'interleukin-1 inhibitors', 'acute gout', 'gout treatment', 'urate lowering therapies', 'hyperuricemia', 'colchicine', 'pegloticase', 'lesinurad', 'xanthine oxidase', 'xanthine oxidase inhibitors', 'allopurinol', 'febuxostat', 'uricosurics', 'probenecid', and 'benzbromarone'. All published articles regarding therapeutic management of gout and hyperuricemia were evaluated. References of selected articles, data from poster presentations, and abstract publications were additionally reviewed. Expert opinion: Numerous therapies are currently available to managing acute gout flares and for lowering serum urate levels; advances in the understanding of the pathophysiology of this disorder has led to the emergence of targeted therapies and novel biologic preparations currently in development which may improve the clinical management of severe or refractory cases of disease that fail to respond to traditional therapies.

  11. Twenty-four-hour esophageal pH monitoring in children and adolescents with chronic and/or recurrent rhinosinusitis

    Directory of Open Access Journals (Sweden)

    V.R.S.G. Monteiro

    2005-02-01

    Full Text Available Gastroesophageal reflux (GER disorder was studied in children and adolescents with chronic and/or recurrent rhinosinusitis not associated with bronchial asthma. Ten children with a clinical and radiological diagnosis of chronic and/or recurrent rhinosinusitis, consecutively attended at the Pediatric Otolaryngology Outpatient Clinic, Federal University of São Paulo, were evaluated. Prolonged esophageal pH monitoring was used to investigate GER disorder. The mean age of the ten patients evaluated (eight males was 7.4 ± 2.4 years. Two patients presented vomiting as a clinical manifestation and one patient presented retrosternal pain with a burning sensation. Twenty-four-hour esophageal pH monitoring was performed using the Sandhill apparatus. An antimony probe electrode was placed in the lower third of the esophagus, confirmed by fluoroscopy and later by a chest X-ray. The parameters analyzed by esophageal pH monitoring included: total percent time of the presence of acid esophageal pH, i.e., pH below 4 (<4.2%; total number of acid episodes (<50 episodes; number of reflux episodes longer than 5 min (3 or less, and duration of the longest reflux episode (<9.2 min. One patient (1/10, 10% presented a 24-h esophageal pH profile compatible with GER disorder. This data suggest that an association between chronic rhinosinusitis not associated with bronchial asthma and GER disorder may exist in children and adolescents, especially in those with compatible GER disorder symptoms. In these cases, 24-h esophageal pH monitoring should be performed before indicating surgery, since the present data suggest that 10% of chronic rhinosinusitis surgeries can be eliminated.

  12. Variability in the Reporting of Serum Urate and Flares in Gout Clinical Trials: Need for Minimum Reporting Requirements.

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    Stamp, Lisa K; Morillon, Melanie B; Taylor, William J; Dalbeth, Nicola; Singh, Jasvinder A; Lassere, Marissa; Christensen, Robin

    2018-03-01

    To describe the ways in which serum urate (SU) and gout flares are reported in clinical trials, and to propose minimum reporting requirements. This analysis was done as part of a systematic review aiming to validate SU as a biomarker for gout. The ways in which SU and flares were reported were extracted from each study by 2 reviewers. A total of 22 studies (10 randomized controlled trials, 3 open-label extension studies, and 9 observational studies) were identified. There were 3 broad categories of SU reporting: percentage at target SU, mean SU, and change in SU. A median of 2 (range 1-3) categories were reported across all studies. The most common method of reporting SU was percentage at target in 17/22 (77.3%) studies, with all studies reporting a target of SU reporting mean SU at some time after study entry, with 7 (58.3%) of these reporting at more than just the final study visit. Two ways of reporting gout flares were identified: mean flare rate and percentage of participants with flares. There was variability in time periods over which flares rates were reported. There is inconsistent reporting of SU and flares in gout studies. Reporting the percentage of participants who achieve a target SU reflects international treatment guidelines. SU should also be reported as a continuous variable with a relevant central and dispersion estimate. Gout flares should be reported as both percentage of participants and mean flare rates at each timepoint.

  13. Gout

    Science.gov (United States)

    ... more quickly than usual, such as psoriasis, hemolytic anemia, and some cancers. Kelley-Seegmiller syndrome or Lesch- ... transplanted organs. Levodopa, a medicine used to treat Parkinson’s disease. What are the symptoms? Gout causes pain ...

  14. Gout

    Science.gov (United States)

    ... Ticketed Sessions Must See Sessions Knowledge Bowl Thieves Market Patient Posters Call for Proposals Faculty Abstracts Abstract ... providers may prescribe anakinra (Kineret) , an “interleukin 1 beta antagonist,” for very severe attacks of gout. Though ...

  15. [The value of twenty-four hour intraoesophageal pH monitoring and manometry in the management of patients with upper gastrointestinal symptoms].

    Science.gov (United States)

    Lakner, Lilla; Döbrönte, Zoltán

    2009-10-25

    Functional gastroenterological examinations (intraoesophageal pH monitoring, oesophageal manometry, scintigraphy, impedance examination) play important role in the management of patients with upper gastrointestinal complaints. Four different cases are demonstrated where diagnose and therapy was developed by these examinations. Two patients had typical gastro-oesophageal reflux symptoms and two others had dysphagia. Intraoesophageal pH monitoring was performed by Zinetics twenty-four hour one or two channel pH catheters and oesophageal manometry was carried out by Zinetics EMC four channel catheter with water perfusion method. In one of the patients with typical and extraoesophageal reflux symptoms, lower oesophageal sphincter incompetency by manometry and pathological acid reflux was observed by intraoesophageal pH monitoring, respectively. Furthermore, hiatal hernia was established, peristalsis of the oesophagus proved to be preserved. Because of incomplete efficacy of proton pump inhibitor (PPI) therapy, antireflux surgery was indicated. An other patient with reflux symptoms had physiological pH monitoring and manometric values. Hypersensitive oesophagus was diagnosed and PPI therapy in double dose was applied. Both patients are symptom free up to now. Other two patients complained difficult swallowing and weight loss. Absence of lower oesophageal sphincter relaxation and hypomotility of the oesophagus was observed. After oesophageal dilatation, both patients with achalasia could easy swallow and eat. Our cases confirm the importance of the twenty-four hour intraoesophageal pH monitoring and oesophageal manometry in the diagnosis of gastro-oesophageal reflux disease, non-cardiac chest pain, other extraoesophageal manifestations and dysphagia. These examinations support the decision for the adequate therapeutic strategy (conventional treatment, surgery or operation or endoscopic intervention) and are important in the follow-up of patients.

  16. Twenty-four-hour ambulatory blood pressure monitoring for clinical evaluation of hypertensive patients in primary care: which groups would most benefit?

    Science.gov (United States)

    Grezzana, Guilherme B; Stein, Airton T; Pellanda, Lucia C

    2017-04-01

    Arterial hypertension is an important risk factor for cardiovascular outcomes. Blood pressure (BP) control levels remain largely out of target among primary healthcare (PHC) patients. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) may contribute toward the identification of cardiovascular risk groups. To assess concordance between conventional office BP measurements and 24-h ABPM of hypertension control in cardiovascular risk groups of PHC hypertensive patients. A cross-sectional study with 569 hypertensive patients was carried out. The evaluation of BP was performed by a PHC doctor, and the 24-h ABPM was performed by a different and blinded provider. The therapeutic targets for BP followed the guidance of The Eighth Joint National Committee, the Brazilian guideline, and the 2013 European Society of Hypertension. Considering the hypertension control therapeutic targets, the guidelines were not similar and were used to evaluate differences in BP value concordances compared with BP standard measurements. After a multivariate logistic regression analysis, a conventional BP was used in comparison with ABPM in different cardiovascular risk groups of hypertensive patients. According to the ABPM by European Society of Hypertension guideline, the subgroup of inactive patients (P=0.006), with altered glycemia (P=0.015) and over 30 mg/dl albuminuria (P=0.001), presented discordance among methods. When a conventional BP measurement in comparison with the ABPM results according to the Brazilian ABPM guideline was used, the discordance occurred significantly in inactive (P=0.001) and microalbuminuria more than 30 mg/dl (P=0.022) subgroups. However, in this comparison, a concordance between high-density lipoprotein more than 60 mg/dl (P=0.015) and obesity (P=0.035) subgroups occurred. Uncontrolled glucose levels, a sedentary lifestyle, and the presence of microalbuminuria correspond to some cardiovascular risk groups that would particularly benefit from 24-h

  17. Twenty-four-hour esophageal impedance-pH monitoring in healthy preterm neonates: rate and characteristics of acid, weakly acidic, and weakly alkaline gastroesophageal reflux.

    Science.gov (United States)

    López-Alonso, Manuel; Moya, Maria Jose; Cabo, Jose Antonio; Ribas, Juan; del Carmen Macías, Maria; Silny, Jiry; Sifrim, Daniel

    2006-08-01

    Gastroesophageal reflux is a physiologic process and is considered pathologic (gastroesophageal reflux disease) when it causes symptoms or results in complications. It is common in preterm infants and occurs in healthy neonates. Twenty-four-hour pH monitoring commonly is used in children for diagnosis of gastroesophageal reflux disease, and abnormal reflux is considered with detection of increased esophageal acid exposure. However, in neonates, relatively few gastroesophageal reflux episodes cause esophageal acidification to pH feeds, which can induce a weaker acid secretory response than that observed in older infants and adults. As a consequence, gastric pH may be > 4 for prolonged periods, and reflux of gastric contents might be less acidic or even alkaline. Esophageal impedance monitoring can detect weakly acidic and even alkaline gastroesophageal reflux. The role of weakly acidic reflux in the pathophysiology of gastroesophageal reflux disease in preterm infants is not clear. To date, studies that have used impedance-pH in neonates assessed the association between nonacid reflux and cardiorespiratory symptoms, but no impedance data from healthy preterm neonates have been available to determine whether those symptomatic neonates had an increased number of weakly acidic reflux episodes or increased reactivity to a physiologic number of reflux events. Our aim with this study was to provide impedance-pH values for acid, weakly acidic, and weakly alkaline reflux from healthy preterm neonates. Esophageal impedance was recorded for 24 hours in 21 asymptomatic preterm neonates by replacing the conventional feeding tube with a specially designed feeding tube that included 9 impedance electrodes (8 French). All neonates were asymptomatic, with spontaneous breathing. Reflux monitoring was performed after comprehensive explanation and on receipt of written parental consent. Esophageal and gastric pH were monitored using a separate parallel pediatric catheter (6 French

  18. Serum urate as surrogate endpoint for flares in people with gout

    DEFF Research Database (Denmark)

    Stamp, Lisa K; Birger Morillon, Melanie; Taylor, William J

    2018-01-01

    trials. Methods Multiple databases through October 2017 were searched. Randomized controlled trials comparing any ULT in people with gout with any control or placebo, ≥three months duration were included. Open label extension (OLE) trial data were included in secondary analyses. Standardized data...... extension studies - SUFederal Drug Administration; HRQol, Health related quality...

  19. Using serum urate as a validated surrogate end point for flares in patients with gout

    DEFF Research Database (Denmark)

    Birger Morillon, Melanie; Stamp, L.; Taylor, E W

    2016-01-01

    , effectively acting as a surrogate for patient-centred outcomes such as frequency of gout attacks or pain. Yet it is not clearly demonstrated that the strength of the relationship between serum urate and clinically relevant outcomes is sufficiently strong for serum urate to be considered an adequate surrogate....... Our objective is to investigate the strength of the relationship between changes in serum urate in randomised controlled trials and changes in clinically relevant outcomes according to the 'Biomarker-Surrogacy Evaluation Schema version 3' (BSES3), documenting the validity of selected instruments...

  20. Novelties in gout

    Directory of Open Access Journals (Sweden)

    Radak-Perović Marija

    2013-01-01

    Full Text Available Chronic asymptomatic hyperuratemia (HUA, gout paroxysm in patients with chronic hyperuratemia (HU and normouricemic attacks of gouty arthritis are well known, but poorly understood. A review of the current literature with attempt of its explanation is presented. The natural course of gout is associated with joint structure changes that may be evaluated by different imaging techniques; comparative advantages and shortcomings of each technique are presented. For almost over 50 years the market has not offered new drugs for the control of HU and gout, while management of such patients was a rather neglected field. Over the last five years an unpredictable number of prospective clinical studies have been conducted involving the investigation of the efficacy and safety of new drugs to control HU (febuxostat, pegloticase. The return of pharmaceutical industry into the world of gout has considerably changed the picture. New recommendations have been presented on appropriate colchicine dose regime for acute gouty flares. Emerging therapies, including pegloticase, uricosuric agent RDEA596 and the interleukin -1 inhibitors have shown promises in early and late phase clinical trials. Each of them deserves to be considered for implementation and feasibility in clinical practice as well as outcome measures for clinical trials. Another purpose of this review was to summarize new knowledge on approved drugs to treat hyperuricemia, or the clinical manifestations of gout. Results of several clinical trials provide new data on the efficacy and safety of the approved urate lowering drugs (allopurinol and febuxostat. Lifestyle and dietary recommendations for gout patients should take into consideration overall health benefits and risks, since gout is often associated with metabolic syndrome and an increased future risk of cardiovascular disease and mortality. This review also summarizes the recent data about lifestyle factors that influence serum uric acid levels

  1. Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Hypertension

    Science.gov (United States)

    2012-01-01

    Executive Summary Objective The objective of this health technology assessment was to determine the clinical effectiveness and cost-effectiveness of 24-hour ambulatory blood pressure monitoring (ABPM) for hypertension. Clinical Need: Condition and Target Population Hypertension occurs when either systolic blood pressure, the pressure in the artery when the heart contracts, or diastolic blood pressure, the pressure in the artery when the heart relaxes between beats, are consistently high. Blood pressure (BP) that is consistently more than 140/90 mmHg (systolic/diastolic) is considered high. A lower threshold, greater than 130/80 mmHg (systolic/diastolic), is set for individuals with diabetes or chronic kidney disease. In 2006 and 2007, the age-standardized incidence rate of diagnosed hypertension in Canada was 25.8 per 1,000 (450,000 individuals were newly diagnosed). During the same time period, 22.7% of adult Canadians were living with diagnosed hypertension. A smaller proportion of Canadians are unaware they have hypertension; therefore, the estimated number of Canadians affected by this disease may be higher. Diagnosis and management of hypertension are important, since elevated BP levels are related to the risk of cardiovascular disease, including stroke. In Canada in 2003, the costs to the health care system related to the diagnosis, treatment, and management of hypertension were over $2.3 billion (Cdn). Technology The 24-hour ABPM device consists of a standard inflatable cuff attached to a small computer weighing about 500 grams, which is worn over the shoulder or on a belt. The technology is noninvasive and fully automated. The device takes BP measurements every 15 to 30 minutes over a 24-to 28-hour time period, thus providing extended, continuous BP recordings even during a patient’s normal daily activities. Information on the multiple BP measurements can be downloaded to a computer. The main detection methods used by the device are auscultation and oscillometry. The device avoids some of the pitfalls of conventional office or clinic blood pressure monitoring (CBPM) using a cuff and mercury sphygmomanometer such as observer bias (the phenomenon of measurement error when the observer overemphasizes expected results) and white coat hypertension (the phenomenon of elevated BP when measured in the office or clinic but normal BP when measured outside of the medical setting). Research Questions Is there a difference in patient outcome and treatment protocol using 24-hour ABPM versus CBPM for uncomplicated hypertension? Is there a difference between the 2 technologies when white coat hypertension is taken into account? What is the cost-effectiveness and budget impact of 24-hour ABPM versus CBPM for uncomplicated hypertension? Research Methods Literature Search Search Strategy A literature search was performed on August 4, 2011 using OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published from January 1, 1997 to August 4, 2011. Abstracts were reviewed by a single reviewer. For those studies meeting the eligibility criteria, full-text articles were obtained. Reference lists were also examined for any additional relevant studies not identified through the search. Articles with unknown eligibility were reviewed with a second clinical epidemiologist and then a group of epidemiologists until consensus was established. The quality of evidence was assessed as high, moderate, low, or very low according to GRADE methodology. Inclusion Criteria English language articles; published between January 1, 1997 and August 4, 2011; adults aged 18 years of age or older; journal articles reporting on the effectiveness, cost-effectiveness, or safety for the comparison of interest; clearly described study design and methods; health technology assessments, systematic reviews, meta-analyses, or randomized controlled trials. Exclusion Criteria non-English papers; animal or in vitro studies; case reports, case series, or case-case studies; studies comparing different antihypertensive therapies and evaluating their antihypertensive effects using 24-hour ABPM; studies on home or self-monitoring of BP, and studies on automated office BP measurement; studies in high-risk subgroups (e.g. diabetes, pregnancy, kidney disease). Outcomes of Interest Patient Outcomes mortality: all cardiovascular events (e.g., myocardial infarction [MI], stroke); non-fatal: all cardiovascular events (e.g., MI, stroke); combined fatal and non-fatal: all cardiovascular events (e.g., MI, stroke); all non-cardiovascular events; control of BP (e.g. systolic and/or diastolic target level). Drug-Related Outcomes percentage of patients who show a reduction in, or stop, drug treatment; percentage of patients who begin multi-drug treatment; drug therapy use (e.g. number, intensity of drug use); drug-related adverse events. Quality of Evidence The quality of the body of evidence was assessed as high, moderate, low, or very low according to the GRADE Working Group criteria. As stated by the GRADE Working Group, the following definitions of quality were used in grading the quality of the evidence: High Further research is very unlikely to change confidence in the estimate of effect. Moderate Further research is likely to have an important impact on confidence in the estimate of effect and may change the estimate. Low Further research is very likely to have an important impact on confidence in the estimate of effect and is likely to change the estimate. Very Low Any estimate of effect is very uncertain. Summary of Findings Short-Term Follow-Up Studies (Length of Follow-Up of ≤ 1 Year) Based on very low quality of evidence, there is no difference between technologies for non-fatal cardiovascular events. Based on moderate quality of evidence, ABPM resulted in improved BP control among patients with sustained hypertension compared to CBPM. Based on low quality of evidence, ABPM resulted in hypertensive patients being more likely to stop antihypertensive therapy and less likely to proceed to multi-drug therapy compared to CBPM. Based on low quality of evidence, there is a beneficial effect of ABPM on the intensity of antihypertensive drug use compared to CBPM. Based on moderate quality of evidence, there is no difference between technologies in the number of antihypertensive drugs used. Based on low to very low quality of evidence, there is no difference between technologies in the risk for a drug-related adverse event or noncardiovascular event. Long-Term Follow-Up Study (Mean Length of Follow-Up of 5 Years) Based on moderate quality of evidence, there is a beneficial effect of ABPM on total combined cardiovascular events compared to CBPM. Based on low quality of evidence, there is a lack of a beneficial effect of ABPM on nonfatal cardiovascular events compared to CBPM; however, the lack of a beneficial effect is based on a borderline result. Based on low quality of evidence, there is no beneficial effect of ABPM on fatal cardiovascular events compared to CBPM. Based on low quality of evidence, there is no difference between technologies for the number of patients who began multi-drug therapy. Based on low quality of evidence, there is a beneficial effect of CBPM on control of BP compared to ABPM. This result is in the opposite direction than expected. Based on moderate quality of evidence, there is no difference between technologies in the risk for a drug-related adverse event. PMID:23074425

  2. Mortality Pattern within Twenty-Four Hours of Emergency Paediatric ...

    African Journals Online (AJOL)

    The highest mortality within the first 24 hours of admission was recorded among patients with malaria (89.0%) followed by protein energy malnutrition. CONCLUSION: Majority of deaths among emergency paediatric admission occur within the first 24 hours of admission and are associated with clinical conditions such as ...

  3. Pola makan, obesitas, dan frekuensi serangan pada pasien artritis gout

    Directory of Open Access Journals (Sweden)

    Fatimah Az-zahra

    2014-07-01

    Full Text Available Background: Trend of gout arthritis prevalence is increasing every year. Obesity, high purine diet, especially from an animal source, are some risk factors for recurrent gout attacks. Objective: To evaluate the relationship between diet, obesity, and frequency of gout flares in gout arthritis patients. Method: This study was a cross-sectional study with patients from RSUP Dr. Sardjito, RSUD Wirosaban, RSUD Panembahan Senopati that ever diagnosed as gout arthritis within February 2010 - February 2012 which can be seen in the medical record and live in Special District of Yogyakarta with the full address provided, as the respondents of this study. The home visit was done for dietary assessment, waist circumference measurement, and interviewing the respondent about gout flares frequency during the last year. Results: Vitamin C consumption in the 1st and 2nd tertiles increase the odds to have any gout flare (OR=5.5; 95% CI: 1.08-27.77 and OR=1.5; 95% CI: 0.29-7.35, respectively. Obesity tends to increase the odds of having any gout flares up to 1.4 times (95% CI: 0,38-5,25. Conclusion: Low consumption of vitamin C significantly increases the odds of having any gout flares. The odds is also higher in patients with obesity, though this relationship is statistically insignificant.

  4. Advances in pharmacotherapy for the treatment of gout.

    Science.gov (United States)

    Robinson, Philip C; Dalbeth, Nicola

    2015-03-01

    Gout is a common inflammatory arthritis affecting almost 6% of US males and 2% of US females. The central cause of gout is deposition of monosodium urate crystals, and the focus of treatment is aimed at crystal dissolution using urate-lowering therapy. The review describes the current treatments for urate-lowering therapy including allopurinol, febuxostat, probenecid, benzbromarone and pegloticase. Anti-inflammatory treatment of acute flares and prophylaxis of flares with NSAIDs, colchicine, corticosteroids and anti-IL-1 agents is also reviewed. In addition, drugs in Phase III clinical trials for gout indications are reviewed. In the last decade, there has been major progress in the pharmacotherapy of gout. Management guidelines have emphasized the importance of a therapeutic serum urate target for effective gout management. Studies have identified the safe and effective dosing strategies for 'old' drugs such as allopurinol and colchicine. New therapeutic agents have been developed and approved for both urate-lowering therapy and anti-inflammatory treatment of acute flares. However, quality of care remains a major challenge in gout management, and strategies to ensure best practice require further focus to ensure that the progress of the last decade translates into clinical benefit for people with gout.

  5. Hyperuricaemia and gout

    African Journals Online (AJOL)

    Epidemiology. The epidemiology of gout has been well documented in previous research. These studies indicate that a variety of factors may influence the development ... Various treatment options are available for gout, and the treatment for each gout patient .... 2 diabetes.8 Furthermore, it is important to note that the drugs.

  6. Severe gout: Strategies and innovations for effective management.

    Science.gov (United States)

    Pascual, Eliseo; Andrés, Mariano; Vázquez-Mellado, Janitzia; Dalbeth, Nicola

    2017-10-01

    Severe gout is characterised by frequent polyarticular flares, numerous tophi, joint damage, and musculoskeletal disability. This is a preventable condition and in many cases, represents a disease that has been insufficiently managed for years. Standard management recommendations may be insufficient for patients with severe gout; these patients frequently require intensive individualised pharmacological management with combinations of urate-lowering therapy and anti-inflammatory agents. In this article, we aim to integrate recent therapeutic advances to provide a practical framework for optimal management of severe gout. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  7. Dietary supplements for chronic gout.

    Science.gov (United States)

    Andrés, Mariano; Sivera, Francisca; Falzon, Louise; Buchbinder, Rachelle; Carmona, Loreto

    2014-10-07

    Dietary supplements are frequently used for the treatment of several medical conditions, both prescribed by physicians or self administered. However, evidence of benefit and safety of these supplements is usually limited or absent. To assess the efficacy and safety of dietary supplementation for people with chronic gout. We performed a search in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and CINAHL on 6 June 2013. We applied no date or language restrictions. In addition, we performed a handsearch of the abstracts from the 2010 to 2013 American College of Rheumatology (ACR) and European League against Rheumatism (EULAR) conferences, checked the references of all included studies and trial registries. We considered all published randomised controlled trials (RCTs) or quasi-RCTs that compared dietary supplements with no supplements, placebo, another supplement or pharmacological agents for adults with chronic gout for inclusion. Dietary supplements included, but were not limited to, amino acids, antioxidants, essential minerals, polyunsaturated fatty acids, prebiotic agents, probiotic agents and vitamins. The main outcomes were reduction in frequency of gouty attacks and trial participant withdrawal due to adverse events. We also considered pain reduction, health-related quality of life, serum uric acid (sUA) normalisation, function (i.e. activity limitation), tophus regression and the rate of serious adverse events. We used standard methodological procedures expected by The Cochrane Collaboration. We identified two RCTs (160 participants) that fulfilled our inclusion criteria. As these two trials evaluated different diet supplements (enriched skim milk powder (SMP) and vitamin C) with different outcomes (gout flare prevention for enriched SMP and sUA reduction for vitamin C), we reported the results separately.One trial including 120 participants, at moderate risk of bias, compared SMP enriched with glycomacropeptides (GMP) with

  8. The epidemiology and treatment of gout

    Directory of Open Access Journals (Sweden)

    McGill NW

    2011-12-01

    Full Text Available Neil W McGillInstitute of Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Camperdown, Sydney, AustraliaAbstract: The development and expression of gout depends on three key steps: (1 chronic hyperuricemia, (2 the growth of monosodium urate (MSU crystals, and (3 interaction between MSU crystals and the inflammatory system. Epidemiological studies have continued to improve our understanding of the environmental and genetic factors which influence chronic hyperuricemia and gout. The influence of obesity, alcohol, race, sex, age, and specific dietary components will be discussed below. The primary mechanism of hyperuricemia is insufficient renal clearance of uric acid which in turn is dependent on transport of uric acid in the proximal renal tubule. Knowledge of the transport mechanisms has improved understanding of the genetic influences on gout and is relevant to understanding of the effects of drugs which can increase or decrease renal uric acid clearance. The application of established principles of management including diagnosis through crystal identification, the gradual introduction of hypouricemic therapy with the use of prophylaxis to reduce the risk of flares, identification of a suitably low target of plasma urate, a progressive increase in therapy to achieve the target and taking steps to encourage good compliance, has the potential to improve outcomes for patients with this very common affliction. The potential role for new therapies will also be discussed.Keywords: gout, hyperuricemia, allopurinol, febuxostat, lesinurad, pegloticase

  9. Chronic tophaceous gout

    Directory of Open Access Journals (Sweden)

    Thappa D

    1993-01-01

    Full Text Available A rare case of chronic tophaceous gout, in a 27-year-old female on diuretics for chronic congestive cardiac failure with characteristic histopathological and radiological changes is reported.

  10. Reproducibility of twenty-four-hour finger arterial blood pressure, variability and systemic hemodynamics

    NARCIS (Netherlands)

    Voogel, A. J.; van Montfrans, G. A.

    1997-01-01

    At present, non-invasive continuous monitoring of finger arterial blood pressure by the volume-clamp technique is considered the best approach to obtain reliable assessments of beat-to-beat blood pressure. However, data on the reproducibility (accuracy and precision) of prolonged recordings and of

  11. Twenty-four hour blood flow in the forefoot after reconstructive vascular surgery

    DEFF Research Database (Denmark)

    Jelnes, R

    1986-01-01

    during day activities. During sleep, however, SBF increased by 80% (p less than 0.001). The relative changes in SBF from day to night at the postoperative examination did not differ from that of the control group, i.e., the normal 24-hour blood flow pattern had been obtained. These changes in SBF...... that the long-term postreconstructive hyperemia merely is a reflection of the normal 24-hour blood flow pattern....

  12. Twenty-Four Hour Noninvasive Ventilation in Duchenne Muscular Dystrophy: A Safe Alternative to Tracheostomy

    Directory of Open Access Journals (Sweden)

    Douglas A McKim

    2013-01-01

    Full Text Available BACKGROUND: Almost all patients with Duchenne muscular dystrophy (DMD eventually develop respiratory failure. Once 24 h ventilation is required, either due to incomplete effectiveness of nocturnal noninvasive ventilation (NIV or bulbar weakness, it is common practice to recommend invasive tracheostomy ventilation; however, noninvasive daytime mouthpiece ventilation (MPV as an addition to nocturnal mask ventilation is also an alternative.

  13. Role of Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Children on Dialysis

    Science.gov (United States)

    Sutherland, Scott M.; Begin, Brandy; Salsbery, Kari; McCabe, Lonisa; Potter, Donald; Alexander, Steven R.; Wong, Cynthia J.

    2011-01-01

    Summary Background and objectives Pre- or postdialysis BP recordings are imprecise, can be biased, and have poor test–retest reliability in children on dialysis. We aimed to examine the possible differences between pre- and postdialysis BP levels and 24-hour ambulatory BP monitoring (ABPM) in diagnosis of hypertension (HTN). Design, setting, participants, & measurements Twenty-four children on dialysis had 24-hour ABPM in the interdialytic period, and values were compared with average pre- and postdialysis systolic BP (SBP) and diastolic BP (DBP) recordings that week. Each patient had an echocardiogram to determine presence of left ventricular hypertrophy (LVH). Results By ABPM, 8% of patients had white coat HTN and 12% had masked HTN. There was no significant difference in diagnosis of systolic HTN based on ABPM daytime SBP mean or load and postdialysis SBP. However, only 15% of patients had diastolic HTN based on postdialysis measures, whereas 46% of patients had significantly elevated daytime DBP loads and 71% had high nighttime DBP loads on ABPM. Forty-eight percent of patients were SBP nondippers. Children with LVH had higher daytime and nighttime SBP loads, significantly higher daytime and nighttime DBP loads, and lesser degree of nocturnal dipping of SBP compared with those who did not. Conclusion ABPM is more informative than pre- and postdialysis BPs and improves the predictability of BP as a risk factor for target organ damage. Diagnosis and treatment monitoring of HTN among pediatric dialysis patients is enhanced with addition of ABPM. PMID:21273374

  14. Twenty-Four Hour Structure of Vigilance under Prolonged Sleep Deprivation: Relationship with Performance

    Science.gov (United States)

    1986-03-01

    experimental caotditios. In somle subjects its appearance resembled the periodic REM - NONREM cycle in uninterrupted sleep periods . lihe dynamics of IREM... periodic activation of sleep iriducing mechanisms. Sleepiness "gates" occur more frequently duri-Ig th•r first half of the day, with periodicity close to...the sleep FPErI- NREM cycles, than dur ing the second hIalif, when they are less frequent and 1ess pronaounced. fhe two most distinctive sleepi.ness

  15. Twenty-four hour cardiopulmonary stability in a model of assisted newborn Fontan circulation.

    Science.gov (United States)

    Myers, Cynthia D; Mattix, Kelly; Presson, Robert G; Vijay, Palaniswamy; Maynes, Domingo; Litwak, Kenneth N; Brown, John W; Rodefeld, Mark D

    2006-01-01

    Morbidity and mortality after stage-1 palliation of hypoplastic left heart syndrome is high as a result of adverse physiologic conditions imposed by the systemic-to-pulmonary arterial shunt. Conversion to a systemic venous source of pulmonary blood flow (Glenn/Fontan) substantially decreases instability and mortality risk. Cavopulmonary assist has the potential to eliminate critical dependence on the problematic systemic arterial shunt. We studied this support modality during a 24-hour period in a neonatal animal model of univentricular Fontan circulation. Lambs (8.1 +/- 0.9 kg, 8.3 +/- 2.1 days, n = 7) underwent total cavopulmonary diversion. A miniature centrifugal pump was used to assist cavopulmonary flow. Control animals (6.6 +/- 1.0 kg, 7.3 +/- 2.1 days, n = 11) underwent placement of monitoring lines only. Hemodynamic and gas exchange data were measured. Within-group and between-group comparisons were made using two-way repeated measures analysis of variance. After an initial phase of reactivity, pulmonary vascular resistance returned to low levels and was not significantly different from baseline values after hour 13 or significantly different from control values after hour 4. Systemic venous pressure remained low. Oxygenation and ventilation remained normal with no histologic evidence of parenchymal lung injury. Pump-assisted cavopulmonary diversion is well tolerated up to 24 hours in the neonatal period. Despite initial reactivity, pulmonary vascular resistance trended toward normal and approached control values. Cavopulmonary assist holds the potential to serve as a bridge to neonatal Fontan repair of single ventricle. Chronic studies are warranted to determine the duration and rate of weaning of support to transition to an unassisted univentricular Fontan circulation.

  16. Twenty-four hour urinary urea excretion and 9-year risk of hypertension: The PREVEND study

    NARCIS (Netherlands)

    Tielemans, S.M.A.J.; Geleijnse, J.M.; Baak, M.A. van; Engberink, M.F.; Brink, E.J.; Jong, P.E. de; Gansevoort, R.T.; Bakker, S.J.L.

    2013-01-01

    OBJECTIVES: It is not yet clear whether dietary protein could help maintaining a healthy blood pressure (BP). We investigated the association between total protein intake, estimated from 24-h urinary urea excretion, and incident hypertension in Dutch men and women. METHODS: We analyzed data of 3997

  17. Twenty-four-hour shift work, depressive symptoms, and job dissatisfaction among Japanese firefighters.

    Science.gov (United States)

    Saijo, Yasuaki; Ueno, Takeji; Hashimoto, Yoshihiro

    2008-05-01

    The influence of a 24-hr shift-work burden on firefighters' mental health has not been fully investigated. The purpose of this study is to clarify the relationships between specific workload items among firefighters engaged in 24-hr shift work and job stress as estimated by the generic job-stress questionnaire on depressive symptoms and job dissatisfaction from the National Institute for Occupational Safety and Health (NIOSH). The subjects were 1,301 firefighters. The questionnaire covered age, gender, job type, job class, marital status, smoking and drinking habits, number of attendances, turnout time, extra work hours, average nap-time, the Center for Epidemiologic Studies Depression Scale (CES-D), and questions from the NIOSH generic job-stress questionnaire, including those on job satisfaction. In multivariate logistic regression analyses, a model that included all variables except the measures from the NIOSH generic job-stress questionnaire showed that shorter nap-time had significant higher odds ratios (ORs) for depressive symptoms and job dissatisfaction, but the significances disappeared in a fully adjusted model. In fully adjusted logistic regression analyses, low quantitative workload, low variance in workload, high intra- and intergroup conflict, low social support from a supervisor, high role conflict and ambiguity, and low self-esteem had significant higher ORs for depressive symptoms and/or job dissatisfaction. Amount of workload, variance in workload, intra- and intergroup conflict, social support from a supervisor, role conflict and ambiguity, and self-esteem were significantly related to depressive symptoms and/or job dissatisfaction among Japanese firefighters. Moreover, inadequate nap-time may affect their mental health. (c) 2008 Wiley-Liss, Inc.

  18. Twenty-four-Hour Measurement of Intraocular Pressure in Guinea Pigs (Cavia porcellus).

    Science.gov (United States)

    Ansari-Mood, Maneli; Mehdi-Rajaei, Seyed; Sadjadi, Reza; Selk-Ghaffari, Masoud; Williams, David L

    2016-01-01

    The objective of this study was to measure intraocular pressure (IOP) in intact, healthy guinea pigs (15 male, 15 female) every 2 h for a 24-h period. First, IOP was measured by using rebound tonometry (RBT). After a 1-min rest period, 0.5% proparacaine ophthalmic solution, a topical anesthetic, was applied to both eyes; 4 min after anesthetic instillation, IOP was measured by using applanation tonometry (APT). The IOP was lower during the light period (0700 to 1900) than during the dark phase (2000 to 0600). The lowest IOP by both RBT and APT (3.68 and 13.37 mm Hg, respectively) occurred at 0700, whereas maximal IOP occurred at 2300 for RBT (8.12 mm Hg) but at 2100 for APT (20.62 mm Hg). No significant differences in IOP between the left and right eyes or between RBT and APT were noted. In addition, daily variations in the IOP of guinea pigs seem to be independent of sex and body weight. The results of this study may be beneficial in the diagnosis and observation of glaucoma in guinea pigs.

  19. Twenty-Four-Hour Mobility During Acute Hospitalization in Older Medical Patients

    DEFF Research Database (Denmark)

    Pedersen, Mette Merete; Bodilsen, Ann Christine; Petersen, Janne

    2013-01-01

    BACKGROUND: Inactivity during hospitalization in older medical patients may lead to functional decline. This study quantified 24-hour mobility, validated the accelerometers used, and assessed the daily level of basic mobility in acutely admitted older medical patients during their hospitalization....... METHODS: This is a prospective cohort study in older medical patients able to walk independently (ambulatory patients) and those not able to walk independently (nonambulatory patients) on admission. The 24-hour mobility level during hospitalization was assessed by measuring the time in lying, sitting......%-100% with positions performed by older medical patients. CONCLUSIONS: Older acutely hospitalized medical patients with walking ability spent 17h/d of their in-hospital time in bed, and the level of in-hospital mobility seemed to depend on the patients' level of basic mobility. The accelerometers were valid...

  20. Twenty-four-hour ambulatory electrocardiography characterization of heart rhythm in Vipera berus-envenomed dogs

    OpenAIRE

    Vestberg, Anna Rave; Tidholm, Anna; Ljungvall, Ingrid

    2017-01-01

    Background Vipera berus has a worldwide distribution and causes high morbidity in dogs annually. A complication to envenomation may be cardiac arrhythmias. The purpose of this study was to investigate the prevalence, types, and timing of arrhythmias, using 24-h ambulatory electrocardiography (24-AECG), in dogs bitten by V. berus in the first 24?32?h after envenomation. In addition, this study aimed to investigate if there were differences in selected clinical and hematological- and biochemica...

  1. Twenty-four-hour melatonin and cortisol plasma levels in relation to timing of cluster headache.

    Science.gov (United States)

    Leone, M; Lucini, V; D'Amico, D; Moschiano, F; Maltempo, C; Fraschini, F; Bussone, G

    1995-06-01

    The cyclic recurrence of cluster periods and the regular timing of headache occurrence in cluster headache (CH) induced us to study the circadian secretion of melatonin and cortisol in 12 patients with episodic CH, during a cluster period, and compare them with 7 age- and sex-matched healthy controls. Blood was sampled every 2 h for 24 h. All subjects were confined to a dark room from 22.00 to 08.00. Plasma melatonin levels were significantly reduced in CH patients (repeated measures ANOVA p cortisol mesor was significantly increased (p melatonin rhythm, and that 5/11 (45.5%) had no cortisol rhythm. Group analysis of cosinor revealed significantly rhythmicity of melatonin and cortisol secretion in both groups. In controls, the timing of melatonin and cortisol acrophase significantly correlated with each other, indicating that the biorhythm controllers for the secretion of these hormones were synchronized. Such correlation was not found in the CH patients; mesor, amplitude and acrophase of melatonin and cortisol did not correlate with duration of illness, duration of headache in course, or time since last headache attack.

  2. Twenty-four hour melatonin secretory pattern in men with idiopathic hemochromatosis.

    Science.gov (United States)

    Fevre-Montange, M; Estour, B; Abou-Samra, A B; Bajard, L; Tourniaire, J

    1983-01-01

    In idiopathic hemochromatosis, iron deposits in endocrine tissue can be associated with hormonal disorders including hypogonadism. We have studied the functional status of the pineal gland in this disease in relation to gonadotrophin levels and cortisol rhythm. Plasma melatonin, luteinizing hormone (LH) and cortisol concentrations were measured by radioimmunoassay every 20 min over a 24 hr period in nine men with idiopathic hemochromatosis aged 36 to 66 years. In six patients a circadian melatonin rhythm was present. The 24 hr means were in the normal range in three patients, and varied below the control values in two patients and above the control values in one patient. These variations seemed unrelated to gonadotrophin status. In the three other patients no plasma melatonin rhythm was observed; two patients with gonadotrophin insufficiency had low melatonin levels, and one with normal gonadotrophin function had high melatonin concentrations. In all cases, the plasma cortisol rhythm was normal. We concluded that the circadian melatonin rhythmicity can be disturbed in some cases of idiopathic hemochromatosis without relationship to the cortisol rhythm and associated endocrine disorders.

  3. Twenty-four-hour rhythms in relation to the natural photoperiod: a field study in humans.

    Science.gov (United States)

    Laakso, M L; Porkka-Heiskanen, T; Alila, A; Stenberg, D; Johansson, G

    1994-01-01

    The daily rhythms of salivary melatonin, salivary cortisol, and axillary body temperature were measured in nine healthy volunteers in midsummer, around the autumn equinox, and in midwinter, at a latitude of 60 degrees N. The aim was to find out whether these rhythms were dependent on variations of the natural daylength. The samples were collected every 2 hr during 24-hr periods in everyday conditions. The individual rhythms were characterized with the acrophase estimates of the best-fitting cosine curve models and with the half-rise and half-decline times calculated from the raw data. The melatonin and cortisol rhythms were delayed significantly (about 1 hr) in midwinter as compared with summer and autumn. The most advanced rhythms were found in autumn. The shifts of the melatonin and cortisol rhythms could be explained as a result of the changes of natural illumination. The overt temperature rhythms did not differ significantly among the sampling months. The lack of seasonal patterns in temperature rhythms probably primarily reflected the socially determined rest-activity cycles of the subjects.

  4. Twenty-four hour and spot urine metabolic evaluations: correlations versus agreements.

    Science.gov (United States)

    Hong, Yet Hoi; Dublin, Norman; Razack, Azad Hassan; Mohd, Mustafa Ali; Husain, Ruby

    2010-06-01

    To investigate the correlations and agreements between the solute/creatinine ratios from the 24-hour and early morning spot urine samples for metabolic evaluation in stone-formers given the various pitfalls with the 24-hour urinary metabolic evaluation in stone-formers. 30 urinary stone-formers out of an initial 62 recruited provided a complete 24-hour urine and early morning spot urine samples for metabolic evaluation. Pearson correlation and Bland and Altman Test were used to assess the correlations and agreements. Significant correlations were established between the 24-hour urinary solute excretions and the corresponding early morning spot urine solute/creatinine ratios for calcium, magnesium, urate, potassium, oxalate, citrate, and the Differential Gibb's free energy value of calcium oxalate DG(CaOx) values. However, all these solute/creatinine measurements between the 24-hour and early morning spot urine samples were judged to be not within the acceptable limits based on the estimated "limit of agreement" by the Bland and Altman Test of Agreement. Diurnal circadian rhythm and postprandial excretion surge are thought to be responsible for the disagreements. Thus, the early morning spot urine is not suitable to be used interchangeably to replace the 24-hour urine collection in the evaluation of urinary metabolic abnormalities in stone-formers. A good correlation does not translate to an agreement between the 2 measurements. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  5. Twenty-four hour radioactive iodine uptake in 35 patients with amiodarone associated thyrotoxicosis

    Energy Technology Data Exchange (ETDEWEB)

    Martino, E.; Aghini-Lombardi, F.; Lippi, F.; Baschieri, L.; Safran, M.; Braverman, L.E.; Pinchera, A.

    1985-12-01

    Amiodarone associated thyrotoxicosis (AAT) occurs in approximately 10% of patients treated with this iodine rich drug in areas of mild iodine deficiency. The thyroid radioactive iodine uptake (RAIU) is usually undetectable or very low in iodine-induced thyrotoxicosis. In the present study, 35 patients with AAT were evaluated. Twelve patients had no thyroid abnormalities by physical exam and all had 24-hr RAIU less than or equal to 4%. In contrast, nine of 11 patients with AAT and diffuse goiters and eight of 12 patients with AAT and nodular goiters had RAIU values greater than 8%. In patients with AAT and goiter it appears possible that the thyroid fails to adapt normally to the excess iodide load, resulting in an inappropriately high RAIU in the presence of excess plasma iodine.

  6. Recovery of bacteria from broiler carcasses rinsed zero and twenty-four hours after immersion chilling.

    Science.gov (United States)

    Cason, J A; Berrang, M E; Smith, D P

    2006-02-01

    Microbiological sampling of processed broiler carcasses often relies on the technique of whole-carcass rinsing; however, the rinse sampling is sometimes done immediately after immersion chilling and sometimes as long as 24 h after immersion chilling. To test whether carcass rinses done immediately after chilling can be compared with rinses 24 h after chilling, 20 whole broiler carcasses exiting the chiller of a broiler processing plant were sampled on each of 3 d. All carcasses were bagged aseptically and rinsed for 1 min in 400 mL of sterile water. Recovered rinse liquid was poured into a sterile container, and rinsed carcasses were placed in clean plastic bags; all materials were held overnight at 4 degrees C. On the following day, all carcasses were rinsed again in 400 mL of sterile water as before, and all rinse samples were cultured by standard methods to enumerate coliforms, Escherichia coli, and Campylobacter and to determine incidence of Salmonella. Statistical analysis used paired comparisons between the same carcasses rinsed at 0 and 24 h after chilling; numbers of bacteria were expressed as log cfu/mL of rinse. In 2 of 3 replications, significantly higher numbers of coliforms and E. coli were found in the rinse samples taken immediately after chilling vs. rinse samples done at 24 h. There were no differences in numbers of Campylobacter or incidence of Salmonella between rinses taken at 0 and 24 h. More study is required to determine whether whole-carcass rinse samples performed at 0 and 24 h after chilling are microbiologically equivalent.

  7. Twenty-four hour blood flow in the forefoot after reconstructive vascular surgery

    International Nuclear Information System (INIS)

    Jelnes, R.

    1986-01-01

    Local blood flow in the forefoot (SBF) was measured continuously during 24 hours by 133xenon clearance technique in 10 patients prior to and at least 1 year after successful reconstructive vascular surgery for severe arterial insufficiency (mean: 18 months, range: 12-36). A group of 10 patients with normal peripheral circulation served as a control group. In spite of a considerable increase of the ankle/arm systolic blood pressure index--preoperative: 0.30 +/- 0.12, postoperative: 0.78 +/- 0.28 (mean +/- 1 SD)--the SBF decreased by 50% (p less than 0.001) following reconstructive vascular surgery during day activities. During sleep, however, SBF increased by 80% (p less than 0.001). The relative changes in SBF from day to night at the postoperative examination did not differ from that of the control group, i.e., the normal 24-hour blood flow pattern had been obtained. These changes in SBF are explained by the reappearance of peripheral vasoregulatory mechanisms. Postreconstructive hyperemia was evaluated by the same technique. The changes in SBF following surgery in the positions supine, awake and supine, asleep were found to be insignificant (0.80 less than p less than 0.90). It is concluded that the long-term postreconstructive hyperemia merely is a reflection of the normal 24-hour blood flow pattern

  8. A cross-sectional internet-based patient survey of the management strategies for gout.

    Science.gov (United States)

    Singh, Jasvinder A; Shah, Nipam; Edwards, N Lawrence

    2016-03-01

    Almost half of the patients with gout are not prescribed urate-lowering therapy (ULT) by their health care provider and >50 % use complementary and alternative therapies. Diet modification is popular among gout patients due to known associations of certain foods with gout flares. The interplay of the use of dietary supplements, diet modification, and ULT adherence in gout patients is not known. Despite the recent interest in diet and supplements, there are limited data on their use. Our objective was to assess ULT use and adherence and patient preference for non-pharmacological interventions by patients with gout, using a cross-sectional survey. People who self-reported physician-diagnosed gout during their visit to a gout website ( http://gouteducation.org ) were invited to participate in a brief anonymous cross-sectional Internet survey between 08/11/2014 to 04/14/2015 about the management of their gout. The survey queried ULT prescription, ULT adherence, the use of non-pharmacological interventions (cherry extract, diet modification) and the likelihood of making a lifelong diet modification for gout management. A total of 499 respondents with a mean age 56.3 years were included; 74% were males and 74% were White. Of these, 57% (285/499) participants were prescribed a ULT for gout, of whom 88% (251/285) were currently taking ULT. Of those using ULT, 78% (97/251) reported ULT adherence >80%. Gender, race, and age were not significantly associated with the likelihood of receiving a ULT prescription or ULT adherence >80%. Fifty-six percent of patients with gout preferred ULT as a lifelong treatment for gout, 24% preferred cherry extract and 16% preferred diet modification (4% preferred none). Men had significantly lower odds of preferring ULT as the lifelong treatment choice for gout vs. other choices (p = 0.03). We found that 38.3% participants were highly motivated to make a lifelong dietary modification to improve their gout (score of 9-10 on a 0

  9. Any sleep is a dream far away: a nominal group study assessing how gout affects sleep.

    Science.gov (United States)

    Singh, Jasvinder A

    2018-02-23

    There are no qualitative studies of sleep in gout; the aim of this study was to examine the impact of gout on sleep. Nine nominal groups were conducted, oversampling for African-Americans and women with gout. Patients discussed and rank-ordered their concerns. Nine nominal groups with 46 gout patients were conducted with mean age, 61 years (s.d. 10.6) and gout duration, 14.9 years (s.d. 12); 63% were men, 46% African-American, 52% married, 46% retired and 63% were allopurinol users. The most frequently cited highly ranked concerns could be divided into three categories. The first category, character of sleep interruption, included the concerns: severe and complete sleep interruption by gout flare pain (nine groups); and inability to get rapid eye movement sleep (one group). The second category, causes of sleep interruption, included: inability to get into a comfortable position during sleep (six groups); anxiety and depression associated with severe gout pain (seven groups); sleep interruption by moderate chronic joint pain (three groups); frequent trips to the bathroom interfering with sleep (two groups); gout medication side effects (four groups); frequent trips to the emergency room (one group); joint swelling with physical/functional deficit interfering with sleep (two groups); and flare pain interfering with sleep apnoea management (two groups). The final category, consequences of sleep interruption, included: effect on daily functioning (two groups); worsens other health conditions, which then affect sleep (four groups); and cumulative effect on sleep (one group). Gout has significant impact on sleep quantity, quality and architecture. Sleep disruption due to gout has several pathways and significant consequences.

  10. Treatment of acute gout in patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Chan CW

    2013-10-01

    Full Text Available Case ScenarioMr. L, aged 63 years, was recently diagnosed to have with acute gouty arthritis. He had an acute gout flare last month and was given diclofenac injection by a private general practitioner. He comes to you for advice whether he should take the injection if he has another flare. Mr. L has been on treatment for his chronic essential hypertension and dyslipidaemia for the past 10 years. He also had two previous episodes of myocardial infarction in year 2005 and 2010, and he had angioplasty done twice. He stopped smoking and consuming alcohol three months ago.

  11. Interventions for tophi in gout.

    Science.gov (United States)

    Sriranganathan, Melonie K; Vinik, Ophir; Bombardier, Claire; Edwards, Christopher J

    2014-10-20

    due to adverse events in all participants, and monthly infusion appeared to result in less benefit.Biweekly pegloticase treatment resulted in resolution of tophi in 21/52 participants compared with 2/27 who received placebo (risk ratio (RR) 5.45, 95% confidence intervals (CI) 1.38 to 21.54; number needed to treat for an additional beneficial outcome (NNTB) 3 (95% CI 2 to 6).Eleven of 52 participants with monthly pegloticase treatment had complete resolution of one or more tophi compared with 2/27 who received placebo (RR 2.86, 95% CI 0.68 to 11.97).Participant-reported pain relief of 30% or greater, function, quality of life, serum urate normalisation, were reported for all participants but not separately for those with tophi; therefore, we did not include the results.Pegloticase administered biweekly resulted in more withdrawals due to adverse events compared with placebo (15/85 participants with pegloticase versus 1/43 participants with placebo; RR 7.59, 95% CI 1.04 to 55.55; number needed to treat for an additional harmful outcome (NNTH) 7, 95% CI 4 to 17). Pegloticase administered monthly also resulted in more withdrawals due to adverse events than placebo (16/84 participants with pegloticase versus 1/43 participants with placebo; RR 8.19, 95% CI 1.12 to 59.71; NNTH 6, 95% CI 4 to 14). Most withdrawals were due to infusion reactions.Total adverse events were high in all treatment groups: 80/85 participants administered pegloticase biweekly reported an adverse event compared with 41/43 from the placebo group (RR 0.99, 95% CI 0.91 to 1.07); 84/84 participants administered pegloticase monthly reported an adverse event versus 41/43 in the placebo group (RR 1.05, 95% CI 0.98 to 1.14). As 80% of adverse events were due to flares of gout, probably unrelated to the drug treatment per se, this may explain the high rate of adverse events in the placebo group - who were essentially untreated. This study showed pegloticase is probably beneficial in the management of tophi in

  12. The Filipino and gout.

    Science.gov (United States)

    Torralba, T P; Bayani-Sioson, P S

    1975-05-01

    Hyperuricemia and gout has been recognized among the Filipinos in Hawaii, Alaska, and mainland United States for almost two decades. Several studies bearing out this impression have been reviewed. The awareness of these observation prompted an extension to the Filipino in his natural environment. These studies showed a lower mean of serum uric acid values in healthy subjects when using comparative enzymatic spectrophotometric determinations. Aside from genetic factors, Filipino hyperuricemia may become manifest because of environmental stress, including dietary stress, and investigators postulate that some Filipinos possess a renal defect that may lead to hyperuricemia due to renal inability to compensate for an increased purine intake which may occur in the shift from a low-purine Filipino diet to a high-purine Western diet in his new environment, as in the case of the Filipino immigrant. The clinical profile of gout as it exists in the Philippines has been compared and found to be similar generally to that of other series. The control of the hyperuricemia and gout has been satisfactorily accomplished in the Filipino patients with the long-term use of allopurinol, sometimes complemented with colchicine taken daily.

  13. Treatment approaches and adherence to urate-lowering therapy for patients with gout

    Directory of Open Access Journals (Sweden)

    Aung T

    2017-04-01

    Full Text Available Thanda Aung,* Gihyun Myung,* John D FitzGerald Division of Rheumatology/Department of Internal Medicine, University of California, Los Angeles, Los Angeles, CA, USA *These authors contributed equally to this work Abstract: Gout is the most common inflammatory arthritis characterized by painful disabling acute attacks. It is caused by hyperuricemia and deposition of urate crystals in and around the joints. Long-standing untreated hyperuricemia can lead to chronic arthritis with joint damage, tophi formation and urate nephropathy. Gout is associated with significant morbidity and health care associated cost. The goal of long-term therapy is to lower the serum urate level to promote dissolution of urate crystals, reduce recurrent acute gout flares, resolve tophi and prevent joint damage. Despite the presence of established gout treatment guidelines and effective medications to manage gout, patient outcomes are often poor. Etiology for these shortcomings is multifactorial including both physician and patient characteristics. Poor adherence to urate-lowering therapy (ULT is prevalent and is a significant contributor to poor patient outcomes. This article reviews the treatment strategies for the management of hyperuricemia in chronic gout, gaps in quality of care in gout management, factors contributing to poor adherence to ULT and discusses potential interventions to achieve improved gout-related outcomes. These interventions include initiation of prophylactic anti-inflammatory medication when starting ULT, frequent follow-ups, regular serum urate monitoring and improved patient education, which can be achieved through pharmacist- or nurse-assisted programs. Interventions such as these could improve adherence to ULT and, ultimately, result in optimal gout-related outcomes. Keywords: gout, adherence, urate-lowering therapy 

  14. A qualitative and quantitative analysis of the characteristics of gout patient education resources.

    Science.gov (United States)

    Robinson, Philip C; Schumacher, H Ralph

    2013-06-01

    Patient education is an important aspect of gout management, but there is evidence that many patients lack adequate knowledge of their condition. Our aim was to examine the characteristics of gout patient education resources. Ten gout patient information resources were examined for readability (Flesch-Kincaid reading level, the Simple Measure of Gobbledygook measure and the Flesch Reading Ease Score), qualitative characteristics such as figure and jargon use and whether they included information on the major points of gout. The median readability grade level of the examined resources was 8.5. The difference in readability grade level between the highest and the lowest education resource was 6.3 grade levels. The information content of the resources was high with an average of only 3.9 proposed criteria of 19 (19 %) absent from the resources. Jargon use was low and concepts were usually explained. However, important information regarding acute flare prophylaxis during urate-lowering therapy initiation and titration and treating serum uric acid to target was absent from 60 % of the patient education resources. There was poor use of key messages at the start. Gout patient resources have a wide range of readability. Thirty percent of resources were above the average reading level of rheumatology outpatients reported in previous studies. Sixty percent of gout patient resources omit education items that could impact on patient adherence and in turn patient outcomes. Further research is needed into the literacy levels and education requirements of patients with gout.

  15. Multiplicative interaction of functional inflammasome genetic variants in determining the risk of gout

    NARCIS (Netherlands)

    McKinney, Cushla; Stamp, Lisa K.; Dalbeth, Nicola; Topless, Ruth K.; Day, Richard O.; Kannangara, Diluk R. W.; Williams, Kenneth M.; Janssen, Matthijs; Jansen, Timothy L.; Joosten, Leo A.; Radstake, Timothy R.|info:eu-repo/dai/nl/255144784; Riches, Philip L.; Tausche, Anne-Kathrin; Liote, Frederic; So, Alexander; Merriman, Tony R.

    2015-01-01

    Introduction: The acute gout flare results from a localised self-limiting innate immune response to monosodium urate (MSU) crystals deposited in joints in hyperuricaemic individuals. Activation of the caspase recruitment domain-containing protein 8 (CARD8) NOD-like receptor pyrin-containing 3

  16. Management of hyperuricemia in gout: focus on febuxostat

    Directory of Open Access Journals (Sweden)

    Mattheus K Reinders

    2010-01-01

    Full Text Available Mattheus K Reinders1, Tim L Th A Jansen21Clinical Pharmacy, Atrium Medisch Centrum Parkstad, Heerlen, The Netherlands; 2Rheumatology, Medisch Centrum Leeuwarden, Leeuwarden, The NetherlandsAbstract: Gout is the most common inflammatory arthritis in an elderly population, and can be diagnosed with absolute certainty by polarization microscopy. However, diagnosis may be challenging because atypical presentations are more common in the elderly. Management of hyperuricemia in the elderly with gout requires special consideration because of co-medication, contra-indications, and risk of adverse reactions. Urate-lowering agents include allopurinol and uricosuric agents. These also must be used sensibly in the elderly, especially when renal function impairment is present. However, if used at the lowest dose that maintains the serum urate level below 5.0 to 6.0 mg/dL (0.30 to 0.36 mmol/L, the excess urate in the body will eventually be eliminated, acute flares will no longer occur, and tophi will resolve. Febuxostat, a new xanthine oxidase inhibitor, is welcomed, as few alternatives for allopurinol are available. Its pharmacokinetics and pharmacodynamics are not significantly altered in patients with moderate renal function or hepatic impairment. Its antihyperuricemic efficacy at 80 to 120 mg/day is better than “standard dosage” allopurinol (300 mg/day. Long-term safety data and efficacy data on tophus diminishment and reduction of gout flares have recently become available. Febuxostat may provide an important option in patients unable to use allopurinol, or refractory to allopurinol.Keywords: aging, febuxostat, hyperuricemia, gout, pharmacotherapy, xanthine oxidase

  17. Bilateral Olecranon Tophaceous Gout Bursitis

    Directory of Open Access Journals (Sweden)

    Güzelali Özdemir

    2017-01-01

    Full Text Available In this case, we present a patient with the diagnosis of bilateral olecranon tophaceous gout. After the surgical treatment, there was no limitation of range of motion or wound problem at 6th month control.

  18. Allopurinol for chronic gout.

    Science.gov (United States)

    Seth, Rakhi; Kydd, Alison S R; Buchbinder, Rachelle; Bombardier, Claire; Edwards, Christopher J

    2014-10-14

    Allopurinol, a xanthine oxidase inhibitor, is considered one of the most effective urate-lowering drugs and is frequently used in the treatment of chronic gout. To assess the efficacy and safety of allopurinol compared with placebo and other urate-lowering therapies for treating chronic gout. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE on 14 January 2014. We also handsearched the 2011 to 2012 American College of Rheumatology (ACR) and European League against Rheumatism (EULAR) abstracts, trial registers and regulatory agency drug safety databases. All randomised controlled trials (RCTs) or quasi-randomised controlled clinical trials (CCTs) that compared allopurinol with a placebo or an active therapy in adults with chronic gout. We extracted and analysed data using standard methods for Cochrane reviews. The major outcomes of interest were frequency of acute gout attacks, serum urate normalisation, pain, function, tophus regression, study participant withdrawal due to adverse events (AE) and serious adverse events (SAE). We assessed the quality of the body of evidence for these outcomes using the GRADE approach. We included 11 trials (4531 participants) that compared allopurinol (various doses) with placebo (two trials); febuxostat (four trials); benzbromarone (two trials); colchicine (one trial); probenecid (one trial); continuous versus intermittent allopurinol (one trial) and different doses of allopurinol (one trial). Only one trial was at low risk of bias in all domains. We deemed allopurinol versus placebo the main comparison, and allopurinol versus febuxostat and versus benzbromarone as the most clinically relevant active comparisons and restricted reporting to these comparisons here.Moderate-quality evidence from one trial (57 participants) indicated allopurinol 300 mg daily probably does not reduce the rate of gout attacks (2/26 with allopurinol versus 3/25 with placebo; risk ratio (RR) 0.64, 95% confidence

  19. Study for Updated Gout Classification Criteria

    DEFF Research Database (Denmark)

    Taylor, William J; Fransen, Jaap; Jansen, Tim L

    2015-01-01

    OBJECTIVE: To determine which clinical, laboratory, and imaging features most accurately distinguished gout from non-gout. METHODS: We performed a cross-sectional study of consecutive rheumatology clinic patients with ≥1 swollen joint or subcutaneous tophus. Gout was defined by synovial fluid or ...

  20. Genetic parameters and factors influencing survival to twenty-four hours after birth in Danish meat sheep breeds.

    Science.gov (United States)

    Maxa, J; Sharifi, A R; Pedersen, J; Gauly, M; Simianer, H; Norberg, E

    2009-06-01

    In this study, influential factors and (co)variance components for survival to 24 h after birth were determined and estimated for Texel, Shropshire, and Oxford Down, the most common sheep breeds in Denmark. Data from 1992 to 2006 containing 138,813 survival records were extracted from the sheep recording database at the Danish Agricultural Advisory Service. Estimation of (co)variance components was carried out using univariate animal models, applying logistic link functions. The logistic functions were also used for estimation of fixed effects. Both direct and maternal additive genetic effects, as well as common litter effects, were included in the models. The mean survival to 24 h after birth was 92.5, 91.7, and 88.5% for Texel, Shropshire, and Oxford Down, respectively. There was a curvilinear relationship between survival to 24 h after birth and birth weight, with survival less for light and heavy lambs. Male lambs, as well as lambs from ewes in the first parity or with difficult lambing, had the least survival to 24 h after birth. Survival to 24 h after birth was greater in twin-born Texel and Shropshire lambs compared with singletons and vice versa in Oxford Down. Estimates of direct heritability were in the range from 0.05 to 0.07. Maternal heritability estimates were slightly greater (0.06 and 0.07) than direct heritabilities in Texel and Shropshire and less (0.04) in Oxford Down. The estimated genetic correlations between direct and maternal effects for survival to 24 h after birth were negative, which will make breeding for this trait more difficult. However, on the basis of estimated genetic parameters, it can be concluded that it is possible to improve survival to 24 h after birth in meat sheep breeds by accounting for both direct and maternal genetic effects in breeding programs.

  1. A Predictive Model to Classify Undifferentiated Fever Cases Based on Twenty-Four-Hour Continuous Tympanic Temperature Recording

    Directory of Open Access Journals (Sweden)

    Pradeepa H. Dakappa

    2017-01-01

    Full Text Available Diagnosis of undifferentiated fever is a major challenging task to the physician which often remains undiagnosed and delays the treatment. The aim of the study was to record and analyze a 24-hour continuous tympanic temperature and evaluate its utility in the diagnosis of undifferentiated fevers. This was an observational study conducted in the Kasturba Medical College and Hospitals, Mangaluru, India. A total of ninety-six (n=96 patients were presented with undifferentiated fever. Their tympanic temperature was recorded continuously for 24 hours. Temperature data were preprocessed and various signal characteristic features were extracted and trained in classification machine learning algorithms using MATLAB software. The quadratic support vector machine algorithm yielded an overall accuracy of 71.9% in differentiating the fevers into four major categories, namely, tuberculosis, intracellular bacterial infections, dengue fever, and noninfectious diseases. The area under ROC curve for tuberculosis, intracellular bacterial infections, dengue fever, and noninfectious diseases was found to be 0.961, 0.801, 0.815, and 0.818, respectively. Good agreement was observed [kappa = 0.618 (p<0.001, 95% CI (0.498–0.737] between the actual diagnosis of cases and the quadratic support vector machine learning algorithm. The 24-hour continuous tympanic temperature recording with supervised machine learning algorithm appears to be a promising noninvasive and reliable diagnostic tool.

  2. A Predictive Model to Classify Undifferentiated Fever Cases Based on Twenty-Four-Hour Continuous Tympanic Temperature Recording.

    Science.gov (United States)

    Dakappa, Pradeepa H; Prasad, Keerthana; Rao, Sathish B; Bolumbu, Ganaraja; Bhat, Gopalkrishna K; Mahabala, Chakrapani

    2017-01-01

    Diagnosis of undifferentiated fever is a major challenging task to the physician which often remains undiagnosed and delays the treatment. The aim of the study was to record and analyze a 24-hour continuous tympanic temperature and evaluate its utility in the diagnosis of undifferentiated fevers. This was an observational study conducted in the Kasturba Medical College and Hospitals, Mangaluru, India. A total of ninety-six ( n = 96) patients were presented with undifferentiated fever. Their tympanic temperature was recorded continuously for 24 hours. Temperature data were preprocessed and various signal characteristic features were extracted and trained in classification machine learning algorithms using MATLAB software. The quadratic support vector machine algorithm yielded an overall accuracy of 71.9% in differentiating the fevers into four major categories, namely, tuberculosis, intracellular bacterial infections, dengue fever, and noninfectious diseases. The area under ROC curve for tuberculosis, intracellular bacterial infections, dengue fever, and noninfectious diseases was found to be 0.961, 0.801, 0.815, and 0.818, respectively. Good agreement was observed [kappa = 0.618 ( p machine learning algorithm. The 24-hour continuous tympanic temperature recording with supervised machine learning algorithm appears to be a promising noninvasive and reliable diagnostic tool.

  3. Twenty-Four Hour Non-Invasive Ambulatory Blood Pressure and Heart Rate Monitoring in Parkinson’s Disease

    Science.gov (United States)

    Stuebner, Eva; Vichayanrat, Ekawat; Low, David A.; Mathias, Christopher J.; Isenmann, Stefan; Haensch, Carl-Albrecht

    2013-01-01

    Non-motor symptoms are now commonly recognized in Parkinson’s disease (PD) and can include dysautonomia. Impairment of cardiovascular autonomic function can occur at any stage of PD but is typically prevalent in advanced stages or related to (anti-Parkinsonian) drugs and can result in atypical blood pressure (BP) readings and related symptoms such as orthostatic hypotension (OH) and supine hypertension. OH is usually diagnosed with a head-up-tilt test (HUT) or an (active) standing test (also known as Schellong test) in the laboratory, but 24 h ambulatory blood pressure monitoring (ABPM) in a home setting may have several advantages, such as providing an overview of symptoms in daily life alongside pathophysiology as well as assessment of treatment interventions. This, however, is only possible if ABPM is administrated correctly and an autonomic protocol (including a diary) is followed which will be discussed in this review. A 24-h ABPM does not only allow the detection of OH, if it is present, but also the assessment of cardiovascular autonomic dysfunction during and after various daily stimuli, such as postprandial and alcohol dependent hypotension, as well as exercise and drug induced hypotension. Furthermore, information about the circadian rhythm of BP and heart rate (HR) can be obtained and establish whether or not a patient has a fall of BP at night (i.e., “dipper” vs. non-“dipper”). The information about nocturnal BP may also allow the investigation or detection of disorders such as sleep dysfunction, nocturnal movement disorders, and obstructive sleep apnea, which are common in PD. Additionally, a 24-h ABPM should be conducted to examine the effectiveness of OH therapy. This review will outline the methodology of 24 h ABPM in PD, summarize findings of such studies in PD, and briefly consider common daily stimuli that might affect 24 h ABPM. PMID:23720648

  4. Twenty-four hour intraocular pressure monitoring with the SENSIMED Triggerfish contact lens: effect of body posture during sleep.

    Science.gov (United States)

    Beltran-Agulló, Laura; Buys, Yvonne M; Jahan, Farzana; Shapiro, Colin M; Flanagan, John G; Cheng, Jason; Trope, Graham E

    2017-10-01

    To determine the difference in relative intraocular pressure (IOP) measured by the SENSIMED Triggerfish (TF) contact lens in flat compared with 30° head-up sleeping positions in patients with progressive primary open-angle glaucoma or normotensive glaucoma, based on recent or recurrent disc haemorrhage. Prospective, randomised, cross-over, open-label comparative study. IOP was monitored for 24 hours using TF on two separate sessions. Patients were randomly assigned to sleep flat one night and 30° head-up the other. Outputs in arbitrary units were obtained. Sleep and wake periods were defined as 22:00-6:00 and 8:00-22:00, respectively. Mean TF values during sleep and wake periods and wake-sleep and sleep-wake slopes were calculated for each session. TF output signals were compared between positions. Twelve subjects completed the study. Significant mean positive slopes were noted during the sleep period for both positions (pSleep position affects IOP as measured by TF in some patients with progressive glaucoma. The upward drift in TF output detected in >50% of the subjects requires further investigation to establish whether the increased output values over time are an artefact induced by the TF or a real change in IOP. NCT01351779. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Twenty-four-hour duration of effect of intranasal corticosteroids for seasonal allergic rhinitis symptoms: clinical evidence and relevance.

    Science.gov (United States)

    DuBuske, Lawrence M

    2012-01-01

    Seasonal allergic rhinitis (SAR) symptoms are often most severe and/or disruptive during overnight and morning hours, resulting in cognitive/performance impairments and reduced quality of life throughout the following day. Surveys of allergy patients and health care practitioners reveal a common perception that intranasal steroids (INSs), many of which are dosed q.d., fail to adequately relieve symptoms for a full 24 hours. This review assessed whether perceptions of the 24-hour duration of action of INSs correspond with duration of action documented in clinical literature. SAR clinical trial literature of the last 5 years was reviewed to identify studies of INSs incorporating morning instantaneous (A.M. NOW) or instantaneous assessments of 24-hour duration of action. In numerous placebo-controlled trials of INSs in patients with SAR, treatment was associated with significantly greater improvements in A.M. NOW symptoms from baseline versus placebo. For congestion, this is noteworthy, because patients often cite this symptom, especially in the morning, as the most bothersome symptom. Comparison of A.M. NOW and daily scores suggests minimal drop in efficacy at 24 hours postdose. In several studies, INS treatment was found superior to intranasal or oral antihistamines in A.M. NOW symptom improvement. Once-daily INSs have potential for effective 24-hour symptom relief; however, there is an apparent disconnect between these findings and patient/physician perceptions. This discrepancy may be explained, in part, by less-than-ideal treatment adherence among "real-world" patients versus subjects treated in clinical trials. Proactive counseling can encourage proper INS use and help maximize treatment benefits.

  6. Twenty-four hours hypothermia has temporary efficacy in reducing brain infarction and inflammation in aged rats

    DEFF Research Database (Denmark)

    Sandu, Raluca Elena; Buga, Ana Maria; Balseanu, Adrian Tudor

    2016-01-01

    Stroke is a major cause of disability for which no neuroprotective measures are available. Age is the principal nonmodifiable risk factor for this disease. Previously, we reported that exposure to hydrogen sulfide for 48 hours after stroke lowers whole body temperature and confers neuroprotection...... in aged animals. Because the duration of hypothermia in most clinical trials is between 24 and 48 hours, we questioned whether 24 hours exposure to gaseous hypothermia confers the same neuroprotective efficacy as 48 hours exposure. We found that a shorter exposure to hypothermia transiently reduced both......-induced hypothermia, the poststroke aged rats experienced a persistent sleep impairment during their active nocturnal period. Our data suggest that cellular events that are delayed by hypothermia in aged rats may, in the long term, rebound, and diminish the beneficial effects....

  7. Phosphorus loss to runoff water twenty-four hours after application of liquid swine manure or fertilizer.

    Science.gov (United States)

    Tabbara, Hadi

    2003-01-01

    Phosphorus (P) added to soil from fertilizer or manure application could pose a threat to water quality due to its role in eutrophication of fresh water resources. Incorporating such amendments into the soil is an established best management practice (BMP) for reducing soluble P losses in runoff water, but could also lead to higher erosion. The objective of this study was to test whether incorporation of manure or fertilizer 24 h before an intense rain could also reduce sediment-bound and total phosphorus (TP) losses in runoff. A rainfall simulation study was conducted on field plots (sandy loam with 6-7% slope, little surface residue, recently cultivated) that received two application rates of liquid swine manure or liquid ammonium polyphosphate fertilizer, using either surface-broadcast or incorporated methods of application. Incorporation increased the total suspended solids (TSS) concentrations in runoff but mass losses were not affected. Incorporation also reduced flow-weighted concentrations and losses of dissolved reactive phosphorus (DRP) and TP by as much as 30 to 60% depending on source (fertilizer vs. manure) and application rate. Phosphorus is moved below the mixing zone of interaction on incorporation, and thus the effect of the amount and availability of P in this zone is more important than cultivation on subsequent P losses in runoff. Incorporating manure or fertilizer in areas of intense erosive rain, recent extensive tillage, and with little or no surface residue is therefore a best management practice that should be adhered to in order to minimize contamination of surface water. Results also show comparatively lower P losses from manure than fertilizer.

  8. Twenty-four-hour urine constituents in stone formers: A study from the northeast part of Peninsular Malaysia

    Directory of Open Access Journals (Sweden)

    N S Hussein

    2013-01-01

    Full Text Available Urolithiasis is a common disease with increasing incidence and prevalence world-wide, probably more common in industrialized countries. The metabolic evaluation of 24-h urine collection has been considered as part of the management of urinary stone patients. The aim of this study was to evaluate the 24-h urine constituents in stone formers and its relation to demographic data in the northeast part of Peninsular Malaysia. One hundred and six patients were recruited in this study from two hospitals in the same geographical region; 96 patients fulfilled the inclusion criteria and an informed consent was obtained from all subjects. The 24-h urine was collected in sterile bottles with a preservative agent and calcium, oxalate, citrate, uric acid, magnesium and phosphate were tested using commercial kits on a Roche Hitachi 912 chemistry analyzer. The age (mean ± SD of 96 patients was 56.45 ± 13.43 years and 82.3% of the patients were male while 17.7% were female. The 24-h urine abnormalities were hypercalciuria (14.5%, hyperoxaluria (61.4%, hypocitraturia (57.2%, hyperuricouria (19.7%, hypomagnesuria (59.3% and hyperphosphaturia (12.5%. Hyperoxaluria (61.4% was the most common abnormality detected during the analysis of 24-h urine constituents in contradiction to industrial countries, where hypercalciuria was the most common finding. The high frequencies of hypomagnesuria and hypocitraturia reflect the important role of magnesium and citrate in stone formation and their prophylactic role in the treatment of urinary stone disease in the given population.

  9. Twenty-four-hour blood pressure profile, orthostatic hypotension, and cardiac dysautonomia in elderly type 2 diabetic hypertensive patients.

    Science.gov (United States)

    Costa, Alfredo; Bosone, Daniele; Ramusino, Matteo Cotta; Ghiotto, Natascia; Guaschino, Elena; Zoppi, Annalisa; D'Angelo, Angela; Fogari, Roberto

    2016-12-01

    The aim of this study was to evaluate the relationship between orthostatic hypotension (OH), defined as a decrease in systolic blood pressure (SBP) ≥20 mmHg and/or a decrease in diastolic blood pressure (DBP) ≥10 mmHg, and 24-h ambulatory BP profile in elderly hypertensive type 2 diabetic patients. After a 2-week antihypertensive wash-out period, 200 hypertensive well-controlled diabetic outpatients, aged 65-75 years, underwent a clinical examination, including BP measurements, ECG, 24-h ABP monitoring (ABPM), an orthostatic test, and three tests for cardiovascular autonomic function assessment [deep breathing, heart rate (HR) variability, resting HR]. According to their nighttime BP profile, patients were divided into three groups: dippers (n = 86) (BP fall during nighttime ≥10 %), non-dippers (n = 80) (BP fall during nighttime 0-10 %), and reverse dippers (n = 34) (nighttime BP > daytime BP). Orthostatic test produced a significantly greater orthostatic SBP fall in dippers and even more in reverse dippers. In these latter, a significant fall was observed also in DBP. Prevalence of OH was 9.3 % in dippers, 30 % in non-dippers, and 79.4 % in reverse dippers. In elderly hypertensive type 2 diabetics, a blunted nocturnal BP fall is associated with OH and autonomic dysfunction. These data suggest that ABPM should be performed in the assessment of hypertensive diabetic patients in whom the cardiovascular dysautonomia is suspected or the signs of it are present (such as OH).

  10. The Twenty-four Hour Workday: Proceedings of a Symposium on Variations in Work-Sleep Schedules

    Science.gov (United States)

    1980-10-01

    materialistic and idealistic values b. Morning-evening-type assesent c. Biorhythmic functions assessment d. Sleep-quality assessment e. Health state...populations such as teenagers /students); the use of appropriately validated dependent variables (e.g. responses in routine simulations are not

  11. Twenty-four-hour pH measurements in morbid obesity: effects of massive overweight, weight loss and gastric distension

    NARCIS (Netherlands)

    Mathus-Vliegen, L. M.; Tytgat, G. N.

    1996-01-01

    To investigate the influence of untreated (super)morbid obesity and the effects of massive weight loss and chronic gastric distension on gastro-oesophageal reflux. Seventeen young morbidly obese patients (32 years old; body weight 166.5 kg; body mass index 55 kg/m2) underwent 24-h ambulatory

  12. Twenty-four-hour exposure to altered blood flow modifies endothelial Ca2+-activated K+ channels in rat mesenteric arteries

    DEFF Research Database (Denmark)

    Hilgers, Rob H P; Janssen, Ger M J; Fazzi, Gregorio E

    2010-01-01

    remodeling. In rats, mesenteric arteries were exposed to increased [+90%, high flow (HF)] or reduced blood flow [-90%, low flow (LF)] and analyzed 24 h later. There were no detectable changes in arterial structure or in expression level of endothelial nitric-oxide synthase, SK3, or IK1. Arterial relaxing......We tested the hypothesis that changes in arterial blood flow modify the function of endothelial Ca2+-activated K+ channels [calcium-activated K+ channel (K(Ca)), small-conductance calcium-activated K+ channel (SK3), and intermediate calcium-activated K+ channel (IK1)] before arterial structural...... arteries, the balance between the NO/prostanoid versus EDHF response was unaltered. However, the contribution of IK1 to the EDHF response was enhanced, as indicated by a larger effect of TRAM-34 and a larger residual NS309-induced relaxation in the presence of UCL 1684. Reduction of blood flow selectively...

  13. CaseBook challenges: Managing gout, hyperuricemia and comorbidities -- dialogue with the experts.

    Science.gov (United States)

    Bakris, George L; Doghramji, Paul P; Keenan, Robert T; Silber, Steven H

    2014-01-01

    The prevalence of gout and hyperuricemia are on the rise in the United States corresponding with an increase in risk factors for these conditions, such as obesity, metabolic syndrome, and the use of diuretics. A progressive disorder, untreated gout can be debilitating and result in tophi, chronic arthropathy, and recurrent kidney stones. Although joint aspiration is needed for a definitive diagnosis, the majority of patients are diagnosed presumptively based on medical history and presentation with characteristic signs and symptoms. Patients with gout also often have multiple comorbidities, and there is an increasing body of evidence that shows hyperuricemia is associated with incidence hypertension, diabetes, chronic kidney disease, and heart failure. Clinical strategies for the management of gout and hyperuricemia must include considerations for these and other common cardiometabolic and renal conditions. In addition to acute flare therapy and prophylaxis, the treatment of gout involves lowering serum uric acid (SUA) levels with the urate-lowering therapies (ULTs) allopurinol or febuxostat. Once begun, treatment with ULT is lifelong. However, inadequate dosing and patient nonadherence or intolerance to therapy often lead to treatment failure. Recent guidelines from the American College of Rheumatology stress tailoring therapy and target SUA level (traditionally managed in primary care, it is important for clinicians practicing in these settings to be able to diagnose and treat this condition and communicate with patients to improve their understanding of the disease process and adherence to treatment. Copyright © 2014. Published by Elsevier Inc.

  14. Solar flares

    International Nuclear Information System (INIS)

    Zirin, H.

    1974-01-01

    A review of the knowledge about solar flares which has been obtained through observations from the earth and from space by various methods is presented. High-resolution cinematography is best carried out at H-alpha wavelengths to reveal the structure, time history, and location of flares. The classification flares in H alpha according to either physical or morphological criteria is discussed. The study of flare morphology, which shows where, when, and how flares occur, is important for evaluating theories of flares. Consideration is given to studies of flares by optical spectroscopy, radio emissions, and at X-ray and XUV wavelengths. Research has shown where and possibly why flares occur, but the physics of the instability involved, of the particle acceleration, and of the heating are still not understood. (IAA)

  15. Uricosuric medications for chronic gout.

    Science.gov (United States)

    Kydd, Alison S R; Seth, Rakhi; Buchbinder, Rachelle; Edwards, Christopher J; Bombardier, Claire

    2014-11-14

    Uricosuric agents have long been used in the treatment of gout but there is little evidence regarding their benefit and safety in this condition. To assess the benefits and harms of uricosuric medications in the treatment of chronic gout. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 4, 2013), Ovid MEDLINE and Ovid EMBASE for studies to the 13 May 2013. We also searched the World Health Organization Clinical Trials Registry, ClinicalTrials.gov and the 2011 to 2012 American College of Rheumatology and European League against Rheumatism abstracts. WE considered black box warnings and searched drug safety databases to identify and describe rare adverse events. We considered all randomised controlled trials (RCTs) or quasi-randomised controlled trials (controlled clinical trials (CCTs)) that compared uricosuric medications (benzbromarone, probenecid or sulphinpyrazone) alone or in combination with another therapy (placebo or other active uric acid-lowering medication, or non-pharmacological treatment) in adults with chronic gout for inclusion. Two review authors independently selected the studies for inclusion, extracted data and performed a risk of bias assessment. Main outcomes were frequency of acute gout attacks, serum urate normalisation, study participant withdrawal due to adverse events, total adverse events, pain reduction, function and tophus regression. The search identified four RCTs and one CCT that evaluated the benefit and safety of uricosurics for gout. One study (65 participants) compared benzbromarone with allopurinol for a duration of four months; one compared benzbromarone with allopurinol (36 participants) for a duration of nine to 24 months; one study (62 participants) compared benzbromarone with probenecid for two months and one study (74 participants) compared benzbromarone with probenecid. One study (37 participants) compared allopurinol with probenecid. No study was completely free from bias

  16. Gout disease-specific quality of life and the association with gout characteristics

    Directory of Open Access Journals (Sweden)

    Jan D Hirsch

    2010-03-01

    Full Text Available Jan D Hirsch1,4, Robert Terkeltaub4, Dinesh Khanna5, Jasvinder Singh6, Andrew Sarkin2, Micki Shieh2, Arthur Kavanaugh3, Susan J Lee3,41Skaggs School of Pharmacy and Pharmaceutical Sciences, 2Health Services Research, 3Center for Innovative  Therapy, Division of Rheumatology, Allergy, and Immunology, University of California San Diego, La Jolla, CA, USA; 4Veterans Administration San Diego Healthcare System, La Jolla, CA, USA; 5Department of Medicine/Rheumatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; 6Department of Medicine/Rheumatology, Minneapolis VA Healthcare System, Minneapolis MN, USAPurpose: Assess the association of gout characteristics with health-related quality of life (HRQoL using a new gout-specific HRQoL instrument, the Gout Impact Scale (GIS.Patients and methods: Gout patients completed the GIS (five scales [0–100 score each] representing impact of gout overall [three scales] and during an attack [two scales] and other questions describing recent gout attacks, treatment, gout history, comorbidities, and demographics. Physicians confirmed gout diagnosis, presence of tophi, and most recent serum uric acid (sUA level. Relationships between gout characteristics and GIS scores were examined using analysis of variance and correlation analyses.Results: The majority of patients were male (90.2% with a mean age of 62.2 (±11.8 years. Approximately one-half (49.7% reported ≥3 gout attacks in the past year and the majority (57.9% reported experiencing gout-related pain between attacks. Patients had appreciable concern about their gout (“gout concern overall” scale, 63.1 ± 28.0 but believed their treatment was adequate (“unmet gout treatment need” scale (38.2 ± 21.4 below scale mid-point. Significantly worse GIS scores were associated with increasing attack frequency and greater amount of time with pain between attacks (most scales, P < 0.001. Common objective measures such

  17. Assessing Elementary Lesions in Gout by Ultrasound

    DEFF Research Database (Denmark)

    Terslev, Lene; Gutierrez, Marwin; Christensen, Robin

    2015-01-01

    OBJECTIVE: To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients. METHODS: Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first m...

  18. Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes

    Directory of Open Access Journals (Sweden)

    John G. Skedros

    2018-01-01

    Full Text Available We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis.

  19. Critical appraisal of the role of pegloticase in the management of gout

    Directory of Open Access Journals (Sweden)

    Ea HK

    2012-06-01

    Full Text Available Hang-Korng Ea,1,2 Pascal Richette1,21Hôpital Lariboisière, Rheumatology Department, Paris, France; 2University of Paris Diderot, Sorbonne Paris Cité, Paris, FranceAbstract: Gout is a debilitating disease secondary to chronic hyperuricemia, and the subsequent deposition of monosodium urate crystals is responsible for acute flare, gout arthropathies, tophi and renal lithiasis. Uric acid is the end product of purine metabolism in humans because the gene encoding uricase was lost during hominoid evolution. Pegloticase is a recombinant mammalian uricase conjugated to polyethylene glycol that catalyzes the oxidation of uric acid into allantoin, a more soluble end product. The use of this drug as urate-lowering therapy is a new approach in treating severe gout refractory to conventional therapy with xanthine oxidase inhibitors and uricosuric agents. Intravenous pegloticase has potent and long-lasting urate-lowering capacity with rapid efficacy on tophi resolution. However, pegloticase treatment is associated with infusion-related reactions despite prevention therapy with high-dose corticosteroids. Exacerbation of pre-existing cardiovascular diseases is another concern. The mechanisms of these events are unknown. Caution with long-term use of pegloticase is warranted, especially for patients with cardiovascular diseases.Keywords: gout, urate-lowering therapy, pegloticase, uricase, urate oxidase, immunogenicity

  20. Gout and Metabolic Syndrome: a Tangled Web.

    Science.gov (United States)

    Thottam, Gabrielle E; Krasnokutsky, Svetlana; Pillinger, Michael H

    2017-08-26

    The complexity of gout continues to unravel with each new investigation. Gout sits at the intersection of multiple intrinsically complex processes, and its prevalence, impact on healthcare costs, and association with important co-morbidities make it increasingly relevant. The association between gout and type 2 diabetes, hypertension, hyperlipidemia, cardiovascular disease, renal disease, and obesity suggest that either gout, or its necessary precursor hyperuricemia, may play an important role in the manifestations of the metabolic syndrome. In this review, we analyze the complex interconnections between gout and metabolic syndrome, by reviewing gout's physiologic and epidemiologic relationships with its major co-morbidities. Increasing evidence supports gout's association with metabolic syndrome. More specifically, both human studies and animal models suggest that hyperuricemia may play a role in promoting inflammation, hypertension and cardiovascular disease, adipogenesis and lipogenesis, insulin and glucose dysregulation, and liver disease. Fructose ingestion is associated with increased rates of hypertension, weight gain, impaired glucose tolerance, and dyslipidemia and is a key driver of urate biosynthesis. AMP kinase (AMPK) is a central regulator of processes that tend to mitigate against the metabolic syndrome. Within hepatocytes, leukocytes, and other cells, a fructose/urate metabolic loop drives key inhibitors of AMPK, including AMP deaminase and fructokinase, that may tilt the balance toward metabolic syndrome progression. Preliminary evidence suggests that agents that block the intracellular synthesis of urate may restore AMPK activity and help maintain metabolic homeostasis. Gout is both an inflammatory and a metabolic disease. With further investigation of urate's role, the possibility of proper gout management additionally mitigating metabolic syndrome is an evolving and important question.

  1. Solar flares

    International Nuclear Information System (INIS)

    Kaastra, J.S.

    1985-01-01

    In this thesis an electrodynamic model for solar flares is developed. The main theoretical achievements underlying the present study are treated briefly and the observable flare parameters are described within the framework of the flare model of this thesis. The flare model predicts large induced electric fields. Therefore, acceleration processes of charged particles by direct electric fields are treated. The spectrum of the accelerated particles in strong electric fields is calculated, 3 with the electric field and the magnetic field perpendicular and in the vicinity of an X-type magnetic neutral line. An electromagnetic field configuration arises in the case of a solar flare. A rising current filament in a quiescent background bipolar magnetic field causes naturally an X-type magnetic field configuration below the filament with a strong induced electric field perpendicular to the ambient magnetic field. This field configuration drives particles and magnetic energy towards the neutral line, where a current sheet is generated. The global evolution of the fields in the flare is determined by force balance of the Lorentz forces on the filament and the force balance on the current sheet. The X-ray, optical and radio observations of a large solar flare on May 16, 1981 are analyzed. It is found that these data fit the model very well. (Auth.)

  2. Gout

    Science.gov (United States)

    ... medicines such as allopurinol (Zyloprim), febuxostat (Uloric) or probenecid (Benemid) to decrease the uric acid level in ... 23024029 www.ncbi.nlm.nih.gov/pubmed/23024029 . Review Date 4/24/2017 Updated by: Gordon A. ...

  3. Flare Observations

    Directory of Open Access Journals (Sweden)

    Benz Arnold O.

    2008-02-01

    Full Text Available Solar flares are observed at all wavelengths from decameter radio waves to gamma-rays at 100 MeV. This review focuses on recent observations in EUV, soft and hard X-rays, white light, and radio waves. Space missions such as RHESSI, Yohkoh, TRACE, and SOHO have enlarged widely the observational base. They have revealed a number of surprises: Coronal sources appear before the hard X-ray emission in chromospheric footpoints, major flare acceleration sites appear to be independent of coronal mass ejections (CMEs, electrons, and ions may be accelerated at different sites, there are at least 3 different magnetic topologies, and basic characteristics vary from small to large flares. Recent progress also includes improved insights into the flare energy partition, on the location(s of energy release, tests of energy release scenarios and particle acceleration. The interplay of observations with theory is important to deduce the geometry and to disentangle the various processes involved. There is increasing evidence supporting reconnection of magnetic field lines as the basic cause. While this process has become generally accepted as the trigger, it is still controversial how it converts a considerable fraction of the energy into non-thermal particles. Flare-like processes may be responsible for large-scale restructuring of the magnetic field in the corona as well as for its heating. Large flares influence interplanetary space and substantially affect the Earth’s lower ionosphere. While flare scenarios have slowly converged over the past decades, every new observation still reveals major unexpected results, demonstrating that solar flares, after 150 years since their discovery, remain a complex problem of astrophysics including major unsolved questions.

  4. Associated factors with functional disability and health-related quality of life in Chinese patients with gout: a case-control study.

    Science.gov (United States)

    Fu, Ting; Cao, Haixia; Yin, Rulan; Zhang, Lijuan; Zhang, Qiuxiang; Li, Liren; Gu, Zhifeng

    2017-11-03

    Gout is a painful, inflammatory disease that may cause decreased function and health-related quality of life (HRQoL). Limited study did not take the influence of gout characteristics and anxiety on HRQoL into consideration and there are no studies associated with functional disability in individuals with gout from China. This study aims to investigate the related factors of functional disability and HRQoL in gout patients recruited from China. A total of 226 consecutive gout patients and 232 age- and gender-matched healthy individuals were involved in the study. A series of questionnaires (the Short Form 36 health survey, the Patient Health Questionnaire, the Generalized Anxiety Disorder questionnaire, the 10 cm Visual Analog Scale, and the Health Assessment Questionnaire-Disability Index) were applied. Blood samples were taken to examine the level of serum uric acid. Independent samples t-tests, Chi square tests, U test, Spearman rank correlation, logistic regression modeling, and linear regression were used to analyze the data. After adjusted demographic variables, individuals with gout have poorer HRQoL compared to healthy controls. Univariate tests presented that patients with functional disability had longer disease duration, more frequent flares/last year, more severe total pain, more number of tophi, higher degree of depression and anxiety, with a trend toward diabetes, the treatment of colchicine and corticosteroids use, compared to patients without functional disability. Meanwhile, place of residence, hypertension, DM, disease duration, cardiovascular disease, number of flares/last year, total pain, more number of tophi, presence of tender joints, depression, anxiety, currently using colchicine and corticosteroids were correlated significantly with HRQoL. Additionally, multiple regression analysis identified severe pain, depression, and colchicine use as predictors of functional disability. Cardiovascular disease, total pain, number of flares/last year

  5. Non-steroidal anti-inflammatory drugs for acute gout

    NARCIS (Netherlands)

    van Durme, Caroline M. P. G.; Wechalekar, Mihir D.; Buchbinder, Rachelle; Schlesinger, Naomi; van der Heijde, Désirée; Landewé, Robert B. M.

    2014-01-01

    Background Gout is an inflammatory arthritis that is characterised by the deposition of monosodium urate crystals in synovial fluid and other tissues. The natural history of articular gout is generally characterised by three periods: asymptomatic hyperuricaemia, episodes of acute gout and chronic

  6. The evolution of gout (an old lifestyle disease) | Omole | South ...

    African Journals Online (AJOL)

    Results: Gout has been recognized as a clinical entity before 2000BC with Hippocrates describing the five aphorism of gout. Between the 1st and the 6th century AD, the role of genetics and the association of gout with an indulgent lifestyle and tophi were described. Hemodactyl (a source of colchicines) was also first ...

  7. Hyperuricemia and gout in solid-organ transplant: update in pharmacological management.

    Science.gov (United States)

    Sullivan, Peter M; William, Asch; Tichy, Eric M

    2015-09-01

    Hyperuricemia is a common comorbid condition experienced by up to 28% of kidney transplant recipients. These patients are at elevated risk of acute flare-ups of gout because of transplant-specific risk factors such as impaired renal function, chronic contributing pharmacotherapy (eg, calcineurin inhibitors, diuretics), and associated comorbid conditions. After transplant, treatment is often complicated by drug-drug interactions, renal impairment, and toxic effects of drugs with the use of first-line recommended agents. A number of therapeutic options remain available for transplant recipients, including dose modifications of historic agents and newer pharmacotherapeutic options. Notably, the Kidney Disease Improving Global Outcomes guidelines address the management of hyperuricemia and gout, but these guidelines were last published in 2009, and new data and treatment options have emerged since then. The management of hyperuricemia and acute and chronic gout is described, including the use of novel agents including urate oxidases, interleukin 1 inhibitors, and human urate transporter 1 inhibitors and alternative immunosuppressive therapy strategies.

  8. Real-world treatment patterns of gout patients treated with colchicine or other common treatments for gout in acute care settings: a retrospective chart review study.

    Science.gov (United States)

    Shiozawa, Aki; Cloutier, Martin; Heroux, Julie; Guerin, Annie; Wu, Eric Q; Jackson, Robert

    2015-08-01

    To describe real-world treatment patterns of patients receiving colchicine or other treatments during a gout-related emergency room or acute care facility (ER/ACF) visit. An online physician-administered questionnaire was used to collect chart data on 500 patients with a gout-related ER/ACF visit after 16 October 2009; 250 patients receiving colchicine (Colchicine Cohort) and 250 receiving NSAIDs, systemic corticosteroids, narcotics, allopurinol, febuxostat, pegloticase, probenecid, or sulfinpyrazone (Other Cohort). Patient characteristics and treatment received/prescribed during the ER/ACF visit (Period 1 [P1]), at discharge (P2), and at the first follow-up visit (P3) are reported. A total of 45 rheumatologists and 63 primary care physicians participated in the study. Patient mean age was 51 years and 74.8% were male. The most common treatments in the Other Cohort were NSAIDs (59.6%), systemic corticosteroids (45.2%), and narcotics (33.6%). The 500 patients contributed 307 distinct treatment patterns from P1 to P3. Of the 20.6% patients not prescribed a treatment in P2, 60.2% were restarted on a treatment in P3. Of the 78.6% treated patients in P2, 27.0% had a treatment adjustment (dose increase, treatment add-on, or initiation of a different gout-related treatment - not with a urate lowering therapy only) in P3; for 72.6% of these patients, physicians justified the treatment adjustment by inadequacy of the treatment for maintenance therapy, insufficient dosage, or inadequate response. In the Colchicine Cohort, 60.8% of patients were prescribed colchicine consistently from P1 to P3, while 26.8% and 17.7% of patients in the Other Cohort were prescribed consistently NSAIDs and systemic corticosteroids from P1 to P3, respectively. Specific nature of the acute gout-related symptoms or potential attack/flare during the ER/ACF visit was not recorded. Real-world clinical practice reveals a substantial number of distinct treatment patterns and frequent treatment

  9. Patients with Gout Treated with Conventional Urate-lowering Therapy: Association with Disease Control, Health-related Quality of Life, and Work Productivity.

    Science.gov (United States)

    Wood, Robert; Fermer, Steve; Ramachandran, Sulabha; Baumgartner, Scott; Morlock, Robert

    2016-10-01

    Implications of inadequate gout control were assessed through health-related quality of life (HRQOL) and work productivity of patients with gout adequately controlled while taking conventional urate-lowering therapy (ULT) for ≥ 3 months vs those whose gout was inadequately controlled. Retrospective data were drawn from the Adelphi Disease Specific Programme (DSP), a cross-sectional survey of patients with gout in France, Germany, the United Kingdom, and the United States. Patients completed these questionnaires: EQ-5D (3L), Patient Reported Outcomes Measurement Information System (PROMIS) Health Assessment Questionnaire (HAQ), and Work Productivity and Activity Impairment. Inadequate control was defined as the most recent serum uric acid (SUA) level > 6 mg/dl (> 360 µmol/l) or ≥ 2 flares in the last 12 months; adequate control as SUA level ≤ 6 mg/dl (≤ 360 µmol/l) and 0 flares. Appropriate statistical tests were used to assess differences between groups. There were 836 (69%) inadequately and 368 (31%) adequately controlled gout cases. Mean age was 61 and 63 years and duration of current ULT was 32 and 57 months, respectively. Patients experiencing inadequate control reported significantly worse functioning and HRQOL, as measured by the EQ-5D (0.790 vs 0.877; difference: -0.087; p work time missed: 4.5% vs 1.3%; impairment while working: 19.1% vs 5.2%; overall work impairment: 20.4% vs 5.6%; activity impairment: 20.3% vs 5.3%; all p quality of life, and work productivity. Gout treatment strategies to improve disease control may lead to improvements in HRQOL and productivity.

  10. International Consensus for ultrasound lesions in gout

    DEFF Research Database (Denmark)

    Gutierrez, Marwin; Schmidt, Wolfgang A; Thiele, Ralf G

    2015-01-01

    OBJECTIVE: To produce consensus-based definitions of the US elementary lesions in gout and to test their reliability in a web-based exercise. METHODS: The process consisted of two steps. In the first step a written Delphi questionnaire was developed from a systematic literature review and expert ...

  11. Diurnal Variation and Twenty-Four Hour Sleep Deprivation Do Not Alter Supine Heart Rate Variability in Healthy Male Young Adults.

    Directory of Open Access Journals (Sweden)

    Daniel S Quintana

    Full Text Available Heart rate variability (HRV has become an increasingly popular index of cardiac autonomic control in the biobehavioral sciences due to its relationship with mental illness and cognitive traits. However, the intraindividual stability of HRV in response to sleep and diurnal disturbances, which are commonly reported in mental illness, and its relationship with executive function are not well understood. Here, in 40 healthy adult males we calculated high frequency HRV-an index of parasympathetic nervous system (PNS activity-using pulse oximetry during brain imaging, and assessed attentional and executive function performance in a subsequent behavioral test session at three time points: morning, evening, and the following morning. Twenty participants were randomly selected for total sleep deprivation whereas the other 20 participants slept as normal. Sleep deprivation and morning-to-night variation did not influence high frequency HRV at either a group or individual level; however, sleep deprivation abolished the relationship between orienting attention performance and HRV. We conclude that a day of wake and a night of laboratory-induced sleep deprivation do not alter supine high frequency HRV in young healthy male adults.

  12. Twenty-four-hour plasma tryptophan concentrations and ratios are below normal in obese subjects and are not normalized by substantial weight reduction

    DEFF Research Database (Denmark)

    Breum, Leif; Rasmussen, Michael H; Hilsted, Jannik

    2003-01-01

    BACKGROUND: Plasma tryptophan concentrations and the ratio of tryptophan to other large neutral amino acids (plasma tryptophan ratio) are reportedly low in obese subjects. The plasma tryptophan ratio predicts brain tryptophan uptake and serotonin production. If this ratio is low in obese subjects...... subjects. Blood samples were drawn frequently throughout the 24-h period. An insulin tolerance test was also used to determine whether weight loss altered the ability of insulin to modify plasma concentrations of tryptophan and of the other large neutral amino acids. RESULTS: Plasma tryptophan...... concentrations and ratios in obese subjects were low at all times; these effects persisted after weight reduction. Plasma concentrations of all the large neutral amino acids decreased during insulin infusion in all the groups. CONCLUSIONS: The low 24-h plasma tryptophan ratios in obese and formerly obese...

  13. Twenty-four-Hour Ambulatory Blood Pressure Monitor Heart Rate: A Potential Marker for Gestational Hypertension in at-Risk Women

    Science.gov (United States)

    Booker, Corenthian J.; Dodson, William C.; Kunselman, Allen R.; Repke, John T.; Legro, Richard S.

    2013-01-01

    We prospectively correlated the 24-hour ambulatory blood pressure measurements (ABPM) to conventional sphygmomanometer blood pressure measurements (CSM) in women at risk for gestational hypertensive disorders (GHTNDs) and identified predictive factors from ABPM for GHTND. We analyzed 73 women with ≥1 risk factor for developing a GHTND. Using both the CSM and ABPM, the systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), and heart rate (HR) were measured for 24 hours during three periods (14 to 24 weeks; 24 to 32 weeks; and 33 weeks to delivery). Correlation between the CSM and ABPM lessened as pregnancy progressed. Seventeen (25%) of women developed a GHTND. MAP variability increased in the GHTND group versus those without a GHTND. The odds of developing a GHTND increased 1.5 times for every 1 beat per minute increase in the ABPM 24-hour HR at visit 1 and reversed by visit 3. In women at risk for a GHTND, CSM and ABPM correlate less well as pregnancy advances. HR changes in at-risk women may be a marker for the development of a GHTND and may reflect increased sympathetic activity and/or decreased baroreceptor sensitivity. PMID:22147639

  14. Twenty-Four-Hour Blood Pressure Monitoring to Predict and Assess Impact of Renal Denervation: The DENERHTN Study (Renal Denervation for Hypertension).

    Science.gov (United States)

    Gosse, Philippe; Cremer, Antoine; Pereira, Helena; Bobrie, Guillaume; Chatellier, Gilles; Chamontin, Bernard; Courand, Pierre-Yves; Delsart, Pascal; Denolle, Thierry; Dourmap, Caroline; Ferrari, Emile; Girerd, Xavier; Michel Halimi, Jean; Herpin, Daniel; Lantelme, Pierre; Monge, Matthieu; Mounier-Vehier, Claire; Mourad, Jean-Jacques; Ormezzano, Olivier; Ribstein, Jean; Rossignol, Patrick; Sapoval, Marc; Vaïsse, Bernard; Zannad, Faiez; Azizi, Michel

    2017-03-01

    The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure (BP) lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report here the effect of denervation on 24-hour BP and its variability and look for parameters that predicted the BP response. Patients with resistant hypertension were randomly assigned to denervation plus stepped-care treatment or treatment alone (control). Average and standard deviation of 24-hour, daytime, and nighttime BP and the smoothness index were calculated on recordings performed at randomization and 6 months. Responders were defined as a 6-month 24-hour systolic BP reduction ≥20 mm Hg. Analyses were performed on the per-protocol population. The significantly greater BP reduction in the denervation group was associated with a higher smoothness index ( P =0.02). Variability of 24-hour, daytime, and nighttime BP did not change significantly from baseline to 6 months in both groups. The number of responders was greater in the denervation (20/44, 44.5%) than in the control group (11/53, 20.8%; P =0.01). In the discriminant analysis, baseline average nighttime systolic BP and standard deviation were significant predictors of the systolic BP response in the denervation group only, allowing adequate responder classification of 70% of the patients. Our results show that denervation lowers ambulatory BP homogeneously over 24 hours in patients with resistant hypertension and suggest that nighttime systolic BP and variability are predictors of the BP response to denervation. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01570777. © 2017 American Heart Association, Inc.

  15. Twenty-four-hour changes of S-adenosylmethionine, S-adenosylhomocysteine adenosine and their metabolizing enzymes in rat liver; possible physiological significance in phospholipid methylation.

    Science.gov (United States)

    Chagoya de Sánchez, V; Hernández-Muñoz, R; Sánchez, L; Vidrio, S; Yáñez, L; Suárez, J

    1991-01-01

    1. The metabolic control of adenosine concentration in the rat liver through the 24-hr cycle is related to the activity of adenosine-metabolizing enzymes [5'-nucleotidase (5'N), adenosine deaminase (A.D.), adenosine kinase (A.K.) and S-adenosylhomocysteine hydrolase (SAH-H)]. 2. Two peaks of adenosine were observed, one at 12:00 hr caused by high activity of 5'N and SAH-H, and the other at 02:00 hr, caused by a decrease in purine catabolism and purine utilization, low activity of SAH-H and de novo purine formation. 3. The similarity of the adenosine and S-adenosylmethionine (SAM) profiles through the 24-hr cycle suggests a role of adenosine in transmethylation reactions, because, during the night (02:00 hr), the metabolic conditions favor the formation and accumulation of S-adenosylhomocysteine (SAH), with consequent inhibition of transmethylation reactions. 4. In the 24-hr variation of phosphatidylcholine (PC) and phosphatidylethanolamine (PE), the lowest ratio of PC/PE was observed at 24:00-02:00 hr when SAH concentration is high, whereas the highest PC/PE ratio occurs at the same time as one of the SAM/SAH ratio maxima.

  16. Twenty four hour insulin infusion impairs the ability of plasma from healthy subjects and Type 2 diabetic patients to promote cellular cholesterol efflux

    NARCIS (Netherlands)

    Dullaart, RPF; van Tol, A

    Removal of cholesterol from peripheral cells by high density lipoproteins (HDL) is regarded as an important defence mechanism against atherosclerosis development. PLTP is involved in the generation of pre beta -HDL that can act as initial accepters of cellular cholesterol. Exogenous

  17. Trends in C-Reactive Protein Levels Are Associated with Neurological Change Twenty-Four Hours after Thrombolysis for Acute Ischemic Stroke.

    Science.gov (United States)

    Gill, Dipender; Sivakumaran, Prasanthi; Wilding, Peter; Love, Madeleine; Veltkamp, Roland; Kar, Arindam

    2016-08-01

    Elevated inflammatory markers such as C-reactive protein (CRP) are associated with worse outcomes in patients thrombolysed for acute ischemic stroke (AIS). To investigate whether changes in CRP levels are associated with neurological change after thrombolysis for AIS. Retrospective analysis of a single-center database of consecutive thrombolysis cases for AIS from October 18, 2011, to June 15, 2015, inclusive. Multivariate regression analysis was used to investigate the relationship between change in CRP 12-24 hours after thrombolysis and change in NIHSS (National Institutes of Health Stroke Scale) score 24 hours after thrombolysis. The other potentially confounding predictor variables included in the model were CRP on admission and NIHSS score before thrombolysis. Complete data were available for 108 out of possible 435 eligible patients. Increases in CRP levels 12-24 hours after thrombolysis were negatively associated with reduction in NIHSS score 24 hours after thrombolysis (coefficient .08, 95% confidence interval .031-.129, P = .002). Thus, on average, for every 12.5 mg/L additional increase in CRP 12-24 hours after thrombolysis, NIHSS score at 24 hours improved by 1 point less. While it was previously known that elevated CRP levels are associated with worse outcomes in patients thrombolysed for AIS, the current work demonstrates that changes in CRP levels after thrombolysis also relate to neurological change, and thus may have scope for use as prognostic markers. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  18. The period of the day affects the twenty-four hour blood pressure response to an acute combined exercise session in Brazilian jiu jitsu athletes

    Directory of Open Access Journals (Sweden)

    Rafaello Pinheiro Mazzoccante

    2015-09-01

    Full Text Available AbstractThe purpose of this study was to compare the effect of a combined exercise session performed at different periods of the day on the 24h blood pressure (BP response. Anaerobic threshold (AT and 12 repetition maximum (12RM tests were evaluated in nine Brazilian jiu-jitsu athletes (male (22±3.7 y; 176±5.0 cm; 73.4±9.7 kg; 6.8±2.1 % body fat. Four experimental sessions were performed: resistance exercise followed by aerobic exercise [Morning (MornS and Afternoon (AfternS] and Control (C [Morning and Afternoon]. The morning sessions were conducted at 09:00 a.m. and the afternoon sessions were conducted at 3:00 p.m. The resistance exercise consisted of three sets at 90% of a 12RM for six resistance exercises. The aerobic exercise consisted of 15min at 90% of the AT. Blood pressure (BP was measured before, during and 1h (Microlife(r BP3A1C after the performance of exercises in laboratory, and then during daily activities for the succeeding 23h by ambulatory BP monitoring (Dyna-MAPA(r. Analysis of the area under the curve (AUC indicated significant reductions in blood pressure parameters at various time points during the 24h monitoring period. For systolic BP (SBP, significantly lower values were shown following the morning session versus the control (MornS: 1756.2±100.8 vs. C: 1818.2±84.3 mmHg*15h; p < .05 and total-24h (MornS: 2695.8±143.3 vs. C: 2784.1±143.2 mmHg*24h; p < .05. The total-24h mean BP (MAP was also significantly lower following the morning session versus the control (MornS: 2015.7±121.2 vs. C: 2087.3±153.8 mmHg*24h; p < .05. There were significant differences in the sleeping AUC of SBP (AfternS: 883.6±27.0 vs. C: 965.2±67.9 mmHg*9h; p< .05, diastolic BP (DBP (AfternS: 481.4±30.9 vs. MornS: 552.9±34.2 and C: 562.1±52.3 mmHg*9h; p < .01 and MBP (AfternS: 651.9±22.4 vs. MornS: 708.7±43.1 and C: 726.9±64.7 mmHg*9h; p < .01. The combined exercise performed at different periods of the day contributed distinctly to the reduction of BP. The morning session was important in reducing SBP and MBP in the total-24h monitoring, while the afternoon session reduced SBP, DBP and MBP during sleeping in jiu-Jitsu athletes.

  19. Twenty-Four-Hour Real-Time Continuous Monitoring of Cerebral Edema in Rabbits Based on a Noninvasive and Noncontact System of Magnetic Induction

    Science.gov (United States)

    Li, Gen; Ma, Ke; Sun, Jian; Jin, Gui; Qin, Mingxin; Feng, Hua

    2017-01-01

    Cerebral edema is a common disease, secondary to craniocerebral injury, and real-time continuous monitoring of cerebral edema is crucial for treating patients after traumatic brain injury. This work established a noninvasive and noncontact system by monitoring the magnetic induction phase shift (MIPS) which is associated with brain tissue conductivity. Sixteen rabbits (experimental group n = 10, control group, n = 6) were used to perform a 24 h MIPS and intracranial pressure (ICP) simultaneously monitored experimental study. For the experimental group, after the establishment of epidural freeze-induced cerebral edema models, the MIPS presented a downward trend within 24 h, with a change magnitude of −13.1121 ± 2.3953°; the ICP presented an upward trend within 24 h, with a change magnitude of 12–41 mmHg. The ICP was negatively correlated with the MIPS. In the control group, the MIPS change amplitude was −0.87795 ± 1.5146 without obvious changes; the ICP fluctuated only slightly at the initial value of 12 mmHg. MIPS had a more sensitive performance than ICP in the early stage of cerebral edema. These results showed that this system is basically capable of monitoring gradual increases in the cerebral edema solution volume. To some extent, the MIPS has the potential to reflect the ICP changes. PMID:28282851

  20. Temporal Changes in Sequential Quantitative Thallium-201 Imaging Following Myocardial Infarction in Dogs: Comparison of Four and Twenty-Four Hour Infarct Images

    Science.gov (United States)

    Umbach, Richard E.; Lange, Robert C.; Lee, John C.; Zaret, Barry L.

    1978-01-01

    Thallium-201 (201T1) myocardial perfusion imaging allows definition of zones of myocardial infarction and ischemia. The temporal changes in sequential quantitative 201T1 infarct imaging was studied 4 and 24 hours in dogs subjected to closed-chest anterior wall myocardial infarction. A temporal decrease in 201T1 imaged infarct areas was noted in 10 of 13 animals. In no animal did the infarct area increase. The imaged infarct area decreased by an average of 30% from 12.9 ± 6.2 cm2 at 4 hours to 9.1 ± 5.1 cm2 at 24 hours (p < 0.001), and involved 34 ± 16% of the total 201T1 left ventricular distribution at 4 hours and 22 ± 14% at 24 hours (p < 0.001). The magnitude of temporal change in imaged infarct area was not predicted by initial image defect or final histopathologic infarct size. Thus, the results of 201T1 infarct imaging in the early period of infarction are clearly dependent upon the time at which the procedure is performed. ImagesFIG. 1 PMID:752198

  1. Twenty four-hour helpline access to expert management advice for food-allergy-triggered anaphylaxis in infants, children and young people: a pragmatic, randomized controlled trial.

    Science.gov (United States)

    Kelleher, M M; Dunngalvin, A; Sheikh, A; Cullinane, C; Fitzsimons, J; Hourihane, J O'B

    2013-12-01

    Anaphylaxis is a life-threatening emergency. If promptly administered, adrenaline is potentially life-saving. Many food-allergic-children/carers are unsure when to use their adrenaline autoinjectors, contributing to a low quality of life and worse outcomes in the setting of an acute allergic reaction. The aim of this study was to assess the effectiveness of 24-hour telephone access to specialist clinical advice on disease-specific quality of life. A pragmatic two-arm, parallel-group randomized control trial was conducted. Children/carers (<16 years) with food allergy, trained in adrenaline auto-injector use, were recruited from a hospital-based paediatric allergy clinic. Baseline disease-specific quality of life was ascertained using the validated Food-Allergy-Related Quality-of-Life Questionnaire (FAQLQ), either Parent Form, Child Form or Teenager Form depending on child's age. Participants were then centrally randomized for a 6-month period to 24-hour telephone specialist support line or to usual care. The primary outcome measure was a change in FAQL scores, at one and 6 months postrandomization, compared with baseline. The minimum clinically important difference (MCID) in score is 0.5. Fifty two children/carers were recruited. FAQL scores remained static in the control group across the three time points. Scores gradually improved in the intervention group, with a significant difference seen at 6 months (T1-T3 Mean difference = -1.5, (CI 0.87-2.25) P < 0.005] Follow-up questionnaires, 6 months after the intervention was removed, T4, showed sustained significant difference between the groups (control M = 3.0; intervention M = 1.1[t = -4.113, P < 0.05]). The 24-hour helpline improved food-allergy-specific quality of life in children. Six-month intervention support resulted in sustained benefits for at least a further 6 months. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. The acute effects of twenty-four hours of sleep loss on the performance of national-caliber male collegiate weightlifters.

    Science.gov (United States)

    Blumert, Peter A; Crum, Aaron J; Ernsting, Mark; Volek, Jeff S; Hollander, Daniel B; Haff, Erin E; Haff, G Gregory

    2007-11-01

    Currently, the degree to which sleep loss influences weightlifting performance is unknown. This study compared the effects of 24 hours of sleep loss on weightlifting performance and subjective ratings of psychological states pre-exercise and postexercise in national-caliber male collegiate weightlifters. Nine males performed a maximal weightlifting protocol following 24 hours of sleep loss and a night of normal sleep. The subjects participated in a randomized, counterbalanced design with each sleep condition separated by 7 days. Testosterone and cortisol levels were quantified prior to, immediately after, and 1 hour after the resistance training session. Additionally, profile of mood states and subjective sleepiness were evaluated at the same time points. The resistance training protocol consisted of several sets of snatches, clean and jerks, and front squats. Performance was evaluated as individual exercise volume load, training intensity and overall workout volume load, and training intensity. During each training session the maximum weight lifted for the snatch, clean and jerk, and front squat were noted. No significant differences were found for any of the performance variables. A significant decrease following the sleep condition was noted for cortisol concentration immediately after and 1 hour postexercise. Vigor, fatigue, confusion, total mood disturbance, and sleepiness were all significantly altered by sleep loss. These data suggest that 24 hours of sleep loss has no adverse effects on weightlifting performance. If an athlete is in an acute period of sleep loss, as noticed by negative mood disturbances, it may be more beneficial to focus on the psychological (motivation) rather than the physiological aspect of the sport.

  3. Twenty-four hour total and dietary fat oxidation in lean, obese and reduced-obese adults with and without a bout of exercise.

    Directory of Open Access Journals (Sweden)

    Audrey Bergouignan

    Full Text Available It has been hypothesized that obese and reduced-obese individuals have decreased oxidative capacity, which contributes to weight gain and regain. Recent data have challenged this concept.To determine (1 whether total and dietary fat oxidation are decreased in obese and reduced-obese adults compared to lean but increase in response to an acute exercise bout and (2 whether regular physical activity attenuates these metabolic alterations.We measured 24-hr total (whole-room calorimetry and dietary fat (14C-oleate oxidation in Sedentary Lean (BMI = 21.5±1.6; n = 10, Sedentary Obese (BMI = 33.6±2.5; n = 9, Sedentary Reduced-Obese (RED-SED; BMI = 26.9±3.7; n = 7 and in Physically Active Reduced-Obese (RED-EX; BMI = 27.3±2.8; n = 12 men and women with or without an acute exercise bout where energy expended during exercise was not replaced.Although Red-SED and Red-EX had a similar level of fatness, aerobic capacity and metabolic profiles were better in Red-EX only compared to Obese subjects. No significant between-group differences were seen in 24-hr respiratory quotient (RQ, Lean: 0.831±0.044, Obese: 0.852±0.023, Red-SED: 0.864±0.037, Red-EX: 0.842±0.039, total and dietary fat oxidation. A single bout of exercise increased total (+27.8%, p<0.0001 and dietary (+6.6%, p = 0.048 fat oxidation across groups. Although exercise did not impact RQ during the day, it decreased RQ during sleep (p = 0.01 in all groups. Red-EX oxidized more fat overnight than Red-SED subjects under both resting (p = 0.036 and negative energy balance (p = 0.003 conditions, even after adjustment for fat-free mass.Obese and reduced-obese individuals oxidize as much fat as lean both under eucaloric and negative energy balance conditions, which does not support the hypothesis of reduced oxidative capacity in these groups. Reduced-obese individuals who exercise regularly have markers of metabolic health similar to those seen in lean adults. Both the acute and chronic effects of exercise were primarily observed at night suggesting an important role of sleep in the regulation of lipid metabolism.

  4. Twenty-four hour metabolic rate measurements utilized as a reference to evaluate several prediction equations for calculating energy requirements in healthy infants

    Directory of Open Access Journals (Sweden)

    Rising Russell

    2011-02-01

    Full Text Available Abstract Background To date, only short-duration metabolic rate measurements of less than four hours have been used to evaluate prediction equations for calculating energy requirements in healthy infants. Therefore, the objective of this analysis was to utilize direct 24-hour metabolic rate measurements from a prior study to evaluate the accuracy of several currently used prediction equations for calculating energy expenditure (EE in healthy infants. Methods Data from 24-hour EE, resting (RMR and sleeping (SMR metabolic rates obtained from 10 healthy infants, served as a reference to evaluate 11 length-weight (LWT and weight (WT based prediction equations. Six prediction equations have been previously derived from 50 short-term EE measurements in the Enhanced Metabolic Testing Activity Chamber (EMTAC for assessing 24-hour EE, (EMTACEE-LWT and EMTACEE-WT, RMR (EMTACRMR-LWT and EMTACRMR-WT and SMR (EMTACSMR-LWT and EMTACSMR-WT. The last five additional prediction equations for calculating RMR consisted of the World Health Organization (WHO, the Schofield (SCH-LWT and SCH-WT and the Oxford (OXFORD-LWT and OXFORD-WT. Paired t-tests and the Bland & Altman limit analysis were both applied to evaluate the performance of each equation in comparison to the reference data. Results 24-hour EE, RMR and SMR calculated with the EMTACEE-WT, EMTACRMR-WT and both the EMTACSMR-LWT and EMTACSMR-WT prediction equations were similar, p = NS, to that obtained from the reference measurements. However, RMR calculated using the WHO, SCH-LWT, SCH-WT, OXFORD-LWT and OXFORD-WT prediction equations were not comparable to the direct 24-hour metabolic measurements (p Conclusions Weight based prediction equations, derived from short-duration EE measurements in the EMTAC, were accurate for calculating EE, RMR and SMR in healthy infants.

  5. Health-related quality of life and treatment satisfaction in patients with gout: results from a cross-sectional study in a managed care setting

    Directory of Open Access Journals (Sweden)

    Khanna PP

    2015-07-01

    differences were: 30.5, gout overall concern; 14.6, gout medication side effects; 22.7, unmet gout treatment needs; 11.5, gout concern during attack (all P<0.05; and 7.9, well-being during attack (NS. Mean difference in SF-12 was -6.6 for physical component summary (P<0.05 and -2.9 for mental component summary (NS. Correlations between several TSQM and GIS scales were moderate.Conclusion: The TSQM and GIS were complementary in evaluating the impact of gout flare on treatment satisfaction and HRQoL. Correlations between the two instruments supported the relationship between treatment satisfaction and HRQoL.Keywords: febuxostat, gout, gouty arthritis, Treatment Satisfaction Questionnaire for Medicine, Gout Impact Scale, SF-12

  6. Metabolic syndrome: prevalence and risk factors in Korean gout patients.

    Science.gov (United States)

    Jung, Jae Hyun; Song, Gwan Gyu; Ji, Jong Dae; Lee, Young Ho; Kim, Jae-Hoon; Seo, Young Ho; Choi, Sung Jae

    2016-10-12

    We performed this study to investigate associations between metabolic syndrome, chronic kidney disease (CKD), and gout. We reviewed the medical records of 151 patients with gout at the Department of Rheumatology in Korea University Ansan Hospital. The following measures were examined: waist circumference, blood pressure, alcohol consumption, and levels of triglyceride, high density lipoprotein cholesterol, fasting serum glucose, serum uric acid (SUA), creatinine, insulin, and C-peptide. We assessed metabolic syndrome by the homeostasis model assessment of insulin resistance (HOMA-IR) index and renal function by the Modification of Diet in Renal Disease equation; patients were classified according to World Health Organization Asia-Pacific obesity criteria. The prevalence of metabolic syndrome in gout patients (50.8%) was higher than in non-gout patients. The mean SUA level was significantly higher in gout patients with metabolic syndrome (9.13 ± 3.15 mg/dL) than in gout patients without metabolic syndrome (8.14 ± 2.07 mg/dL). The mean SUA level was also significantly higher in patients with gout and CKD (9.55 ± 2.86 mg/dL) than in patients with gout but no CKD (7.74 ± 2.27 mg/dL). In gout patients, HOMA-IR was positively correlated with waist circumference (r = 0.409, p = 0.001). The prevalence of metabolic syndrome in patients with gout was 50.8%, which is higher than the prevalence in the general Korean population. Hyperuricemia in gout patients was correlated with metabolic syndrome and CKD. Insulin resistance may provide clues to better understand the relationship between metabolic syndrome, CKD, and gout.

  7. Tophaceous Gout simulating infected Ankle Implants

    Directory of Open Access Journals (Sweden)

    Ioannis K

    2016-11-01

    Full Text Available Gout is a well known metabolic disorder characterized by the formation of urate crystals in joints resulting in recurrent attacks of acute inflammatory arthritis following which tophi can occur in joints or subcutaneous tissues. We report a rare localization of gouty tophi in a 52 years old male. The tophi had formed over the stainless steel implant used for the fixation of a lateral malleolus fracture 20 years ago.

  8. Critical revision of the medical treatment of gout in Brazil.

    Science.gov (United States)

    Azevedo, Valderilio Feijó; Lopes, Maicon Piana; Catholino, Nathan Marostica; Paiva, Eduardo Dos Santos; Araújo, Vitor Andrei; Pinheiro, Geraldo da Rocha Castelar

    Gout is considered the most common form of inflammatory arthritis in men over 40 years. The authors present a brief review of the current treatment of gout and discuss the existing pharmacological limitations in Brazil for the treatment of this disease. Although allopurinol is still the main drug administered for decreasing serum levels of uric acid in gout patients in this country, the authors also present data that show a great opportunity for the Brazilian drug market for the treatment of hyperuricemia and gout and especially for patients using private and public (SUS) health care systems. Copyright © 2017 Elsevier Editora Ltda. All rights reserved.

  9. Management of gout in a South Auckland general practice

    Directory of Open Access Journals (Sweden)

    Reaves E

    2014-03-01

    Full Text Available BACKGROUND AND CONTEXT: In New Zealand, the highest prevalence of gout is in Maori and Pacific people. Counties Manukau District Health Board (CMDHB has the highest Maori and Pacific population of any New Zealand District Health Board. A CMDHB study found that a high proportion of patients with gout were also at increased risk of cardiovascular disease. ASSESSMENT OF PROBLEMS: The primary objective was to examine whether the control of gout had changed over time at one clinic. The secondary objective was to assess the management of cardiovascular risk factors in patients with gout at that clinic. RESULTS: The mean serum uric acid level of patients with gout in the practice had risen in comparison with a similar audit carried out in March 2009. This indicates that the control of gout for patients at the practice has worsened over time. Many patients had not had an annual serum uric acid test. STRATEGIES FOR IMPROVEMENT: A repeat uric acid level was scheduled for all patients with gout in the practice, with follow-up appointments to be arranged if the result was abnormal. LESSONS: Gout is often suboptimally managed. Serum uric acid levels may only be tested when a patient presents with an acute attack of gout. Consideration should be given to a minimum of annual serum uric acid levels. Appropriate management of modifiable cardiovascular risk factors in this particular cohort is important and should be a particular focus of care.

  10. Renal filtration function in patients with gout

    Directory of Open Access Journals (Sweden)

    N. N. Kushnarenko

    2016-01-01

    Full Text Available Aim. To study circadian blood pressure (BP profile in patients with gout depending on the presence of arterial hypertension (HT and their relationship to the renal filtration function.Material and methods. Patients with gout (n=87 were included into the study. All the patients underwent ambulatory BP monitoring (ABPM with the assessment of circadian BP profile, determination of uric acid serum levels, glomerular filtration rate (GFR was evaluated by CKD-EPI method. Depending on GFR level, all the patients were divided into 2 groups - with renal dysfunction or without one.Results. ABPM revealed circadian BP dysregulation in 55% of gout patients both with HT and without HT. Chronic kidney disease (CKD was revealed in 72.4% of male patients, with the prevalence in patients with HT (76.6 vs 61%; p<0.001. Correlations between uric acid levels and some ABPM indicators and GFR were determined.Conclusion. Obtained data suggest the contribution of hyperuricemia in disorders of systemic and renal hemodynamics, leading to the early development of CKD.

  11. Unusual radiographic changes of a gout patient

    International Nuclear Information System (INIS)

    Markota, J.

    2004-01-01

    Background. Gout is a metabolic disorder that results in hyperuricemia and accumulation of uric acid crystals (urats) in tissues, especially joint cartilage. The gouty arthritis presents as acute attacks of arthritis leading eventually to chronic gouty arthritis. In 80% of cases it first occurs in the matatarsophalangeal (MTP) joint of the great toe and is more frequent in male population. Case report. We present a case of unusual radiographic changes accompanying gouty arthritis. A 63 year old female complained about swelling of the first MTP joint on the right, right knee, about stiffness of feet and hands' digits and about backache. First symptoms started to appear 30 years ago. In the time of examination radiographs displayed degenerative changes of the majority of presented joints, bilateral sacroiliitis and osseous ankylosis of both insteps. Microscopic examination showed urate crystals in the samples of the synovial fluid aspirated from the knee. The histological findings of the synovial tissue after the synovectomy were also in favour of gouty arthritis. Conclusions. Radiographs are the most important imaging modality in the diagnostic process of gout. However, radiographic differential diagnosis can be difficult, since the findings overlap with other conditions which cause arthritis and osteoarthritis especially in longstanding gout, elderly patients and females. The diagnosis must be often confirmed with the help of laboratory and histological findings. (author)

  12. A case of extensive synovial involvement by tophaceous gout | Khan ...

    African Journals Online (AJOL)

    Gout is the most common form of microcrystal arthropathy that results in deposition of uric acid crystals in and around the joints and soft tissues. The most common cause is decreased uric acid clearance by the kidneys. The radiological manifestations of gout are generally well known and have remained unchanged.

  13. Menopause, postmenopausal hormone use and risk of incident gout

    NARCIS (Netherlands)

    A.E. Hak (Liesbeth); G.C. Curhan (Gary); F. Grodstein (Francine); H.K. Choi (Hyon)

    2010-01-01

    textabstractObjective: To prospectively study the relation between menopause, postmenopausal hormone use and risk of gout, since female sex hormones have been postulated to decrease gout risk among women. Methods: In the Nurses' Health Study, the association between menopause, age at menopause,

  14. The evolution of gout (an old lifestyle disease)

    African Journals Online (AJOL)

    wrote: “Persons affected with the gout who are aged, have tophi in their joints, have led a hard life, and whose bowels are constipated are beyond the power of medicine to cure”.2 The low prevalence of gout among eunuchs at that time could be explained by their non-indulgent lifestyle. Modern-day understanding suggests ...

  15. Chronic tophaceous gout with unusual large tophi: case report ...

    African Journals Online (AJOL)

    Chronic tophaceous gout with unusual large tophi: case report. Nassira Aradoini, Sofia Talbi, Khadija Berrada, Fatima Zahra Abourazzak, Taoufik Harzy. Abstract. Gout is a metabolic disease, which is characterized by acute or chronic arthritis, and deposition of monosodium urate crystals in joint, bones, soft tissues, and ...

  16. Anti-gout Potential of Malaysian Medicinal Plants

    Directory of Open Access Journals (Sweden)

    Fazleen I. Abu Bakar

    2018-03-01

    Full Text Available Gout is a type of arthritis that causes painful inflammation in one or more joints. In gout, elevation of uric acid in the blood triggers the formation of crystals, causing joint pain. Malaysia is a mega-biodiversity country that is rich in medicinal plants species. Therefore, its flora might offer promising therapies for gout. This article aims to systematically review the anti-gout potential of Malaysian medicinal plants. Articles on gout published from 2000 to 2017 were identified using PubMed, Scopus, ScienceDirect, and Google Scholar with the following keyword search terms: “gout,” “medicinal plants,” “Malaysia,” “epidemiology,” “in vitro,” and “in vivo.” In this study, 85 plants were identified as possessing anti-gout activity. These plants had higher percentages of xanthine oxidase inhibitory activity (>85%; specifically, the Momordica charantia, Chrysanthemum indicum, Cinnamomum cassia, Kaempferia galanga, Artemisia vulgaris, and Morinda elliptica had the highest values, due to their diverse natural bioactive compounds, which include flavonoids, phenolics, tannin, coumarins, luteolin, and apigenin. This review summarizes the anti-gout potential of Malaysian medicinal plants but the mechanisms, active compounds, pharmacokinetics, bioavailability, and safety of the plants still remain to be elucidated.

  17. Febuxostat Treatment for Gout: What the Clinician Needs to Know

    OpenAIRE

    Chen, Lan X.; Schumacher, H. Ralph

    2009-01-01

    Febuxostat is a new non-purine based inhibitor of xanthine oxidase that will be a useful addition to the drugs available to treat gout. This short review covers general principles of the management of gout and then focuses on practical aspects and use of febuxostat.

  18. Colchicine Significantly Reduces Incident Cancer in Gout Male Patients

    Science.gov (United States)

    Kuo, Ming-Chun; Chang, Shun-Jen; Hsieh, Ming-Chia

    2015-01-01

    Abstract Patients with gout are more likely to develop most cancers than subjects without gout. Colchicine has been used for the treatment and prevention of gouty arthritis and has been reported to have an anticancer effect in vitro. However, to date no study has evaluated the relationship between colchicine use and incident cancers in patients with gout. This study enrolled male patients with gout identified in Taiwan's National Health Insurance Database for the years 1998 to 2011. Each gout patient was matched with 4 male controls by age and by month and year of first diagnosis, and was followed up until 2011. The study excluded those who were diagnosed with diabetes or any type of cancer within the year following enrollment. We calculated hazard ratio (HR), aged-adjusted standardized incidence ratio, and incidence of 1000 person-years analyses to evaluate cancer risk. A total of 24,050 male patients with gout and 76,129 male nongout controls were included. Patients with gout had a higher rate of incident all-cause cancers than controls (6.68% vs 6.43%, P = 0.006). A total of 13,679 patients with gout were defined as having been ever-users of colchicine and 10,371 patients with gout were defined as being never-users of colchicine. Ever-users of colchicine had a significantly lower HR of incident all-cause cancers than never-users of colchicine after adjustment for age (HR = 0.85, 95% CI = 0.77–0.94; P = 0.001). In conclusion, colchicine use was associated with a decreased risk of incident all-cause cancers in male Taiwanese patients with gout. PMID:26683907

  19. COPD flare-ups

    Science.gov (United States)

    ... symptoms and signs of a COPD flare-up. Warning Signs of COPD Flare-up Signs of a ... 25321320 www.ncbi.nlm.nih.gov/pubmed/25321320 . Global Initiative for Chronic Obstructive Lung Disease (GOLD) website. ...

  20. Treatment of tophaceous gout: When medication is not enough.

    Science.gov (United States)

    Kasper, Isaac R; Juriga, Matthew D; Giurini, John M; Shmerling, Robert H

    2016-06-01

    To review the literature concerning surgical intervention of tophaeceous gout and propose clinical circumstances for when it may be considered. Tophi develop in approximately 12-35% of patients with gout. Tophaceous disease is usually preventable given the availability of effective urate lowering therapies (ULT) including allopurinol, febuxostat, probenecid, lesinurad, and pegloticase. Despite medical therapy, there remains a subset of patients who develop significant complications of tophi including infection, ulceration, and entrapment neuropathy. Tophi in close proximity to joints can cause joint instability, severely limited range of motion, and significant functional impairment. For the rare circumstance when a tophus is causing an urgent complication or if a patient has a contraindication to all available ULTs, surgery may be an appropriate option. This review summarizes the published experience with surgical interventions for tophaceous gout and offers recommendations for its consideration. Using Medline and Google Scholar, all available series of surgery for tophaceous gout were reviewed. Overall, 7 published surgical series were identified. In all, 6 of these 7 series were published between 2002 and 2014. The reported outcomes of surgical interventions for tophaceous gout were generally positive without major post-surgical complications. Although medical therapy with ULTs should be the first-line approach to tophaceous gout, surgery should be considered for the rare patient with impending or severe, debilitating complications including infections, entrapment neuropathy or those at risk for permanent joint destruction. In these selected clinical circumstances, surgical intervention for tophaceous gout may be appropriate. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Utility of the Morisky Medication Adherence Scale in gout: a prospective study

    Directory of Open Access Journals (Sweden)

    Tan CSL

    2016-12-01

    Full Text Available CSL Tan,1 GG Teng,1,2 KJ Chong,2 PP Cheung,1,2 AYN Lim,1,2 HL Wee,3,4 A Santosa1,2 1University Medicine Cluster, Division of Rheumatology, National University Health System, 2Department of Medicine, Yong Loo Lin School of Medicine, 3Department of Pharmacy, Faculty of Science, 4Saw Swee Hock School of Public Health, National University of Singapore, Singapore Background: The outcomes of any chronic illness often depend on patients’ adherence with their treatment. A tool is lacking to assess adherence in gout that is standardized, allows real-time feedback, and is easy to understand.Objective: We set out to evaluate the utility of the 8-item Morisky Medication Adherence Scale (MMAS-8 in monitoring medication adherence in a multiethnic Asian gout cohort on urate-lowering therapy (ULT.Methods: This cohort study recruited patients with gout where baseline and 6-monthly clinical data, self-report of adherence, and health status by Gout Impact Scale (GIS and EuroQoL-5 dimension 3 levels were collected. Those who received at least 9 months of ULT were analyzed. Convergent and construct validities of MMAS-8 were evaluated against medication possession ratio (MPR and known groups, clinical outcomes, and patient-reported outcomes. Internal consistency and test–retest reliability were assessed using Cronbach’s alpha and intraclass correlation coefficient (ICC, respectively.Results: Of 91 patients, 92.3% were male, 72.5% Chinese with mean age 53.5 years. MMAS-8 (mean 6.17 and MPR (mean 96.3% were poorly correlated (r=0.069, P=0.521. MMAS-8 did not differ between those who did or did not achieve target serum urate (SU <360 µmol/L (P=0.852; or among those whose SU improved, stagnated, or worsened during follow-up (P=0.777. Adherence was associated with age (β=0.256, P=0.015 and education level (P=0.011 but not comorbidities, polypharmacy, or flare frequency. Concerns for medication side effects and anxiety or depression were associated with lower MMAS

  2. Elongation of Flare Ribbons

    Energy Technology Data Exchange (ETDEWEB)

    Qiu, Jiong; Longcope, Dana W. [Department of Physics, Montana State University, Bozeman MT (United States); Cassak, Paul A. [Department of Physics and Astronomy, West Virginia University, Morgantown WV (United States); Priest, Eric R. [School of Mathematics and Statistics, University of St. Andrews, Fife KY16 9SS, Scotland (United Kingdom)

    2017-03-20

    We present an analysis of the apparent elongation motion of flare ribbons along the polarity inversion line (PIL), as well as the shear of flare loops in several two-ribbon flares. Flare ribbons and loops spread along the PIL at a speed ranging from a few to a hundred km s{sup −1}. The shear measured from conjugate footpoints is consistent with the measurement from flare loops, and both show the decrease of shear toward a potential field as a flare evolves and ribbons and loops spread along the PIL. Flares exhibiting fast bidirectional elongation appear to have a strong shear, which may indicate a large magnetic guide field relative to the reconnection field in the coronal current sheet. We discuss how the analysis of ribbon motion could help infer properties in the corona where reconnection takes place.

  3. AMLODIPINI IN THE MANAGEMENT OF HYPERTENSIVE PATIENTS WITH GOUT

    Directory of Open Access Journals (Sweden)

    N.A. Magdeeva

    2008-03-01

    Full Text Available The aim of the present work was a detailed study of questions connected with the peculiarities ofcircadian blood pressure profile, efficiency of amlodipine in patients with goutand arterial hypertension. We used 24-hour blood pressure monitoring before and after 3-months treatment. Patients with gout showed the disturbances of circadian blood pressure profile (Non-dipper. Prolonged calcium antagonists are the best drugs for the hypertensive patients with gout.

  4. Omeprazole, other antiulcer drugs and newly diagnosed gout

    Science.gov (United States)

    Meier, Christoph R.; Jick, Hershel

    1997-01-01

    Aims Case-reports describing patients who developed a first episode of acute gout while being treated with the proton pump inhibitor omeprazole led us to compare incidence rates of newly diagnosed gout cases among omeprazole, ranitidine and cimetidine users. Methods We conducted a cohort study with a nested case-control analysis using the UK-based General Practitioner Research Database (GPRD). The study encompassed a cohort of more than 53 000 subjects who received some 185 000 prescriptions for the three study drugs. Results Neither current omeprazole vs recent use (age- and sex-adjusted relative risk 1.1, 95% CI 0.5–2.1), nor current omeprazole use in comparison with current use of the two histamine H2-receptor blockers was associated with an increased risk of developing newly diagnosed gout. Higher age (RR 2.4, 95% CI 1.5–3.9), male gender (RR 5.4, 95% CI 2.8–10.3), high body mass index (OR 3.3, 95% CI 1.0–10.9) and hypertension (OR 4.5, 95% CI 1.6–12.9) were all important risk factors for gout. Conclusions While other known risk factors were significantly associated with gout, current omeprazole use was not materially associated with an increased gout incidence. PMID:9278205

  5. Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan.

    Science.gov (United States)

    Yu, Kuang-Hui; Chen, Der-Yuan; Chen, Jiunn-Horng; Chen, Shih-Yang; Chen, Shyh-Ming; Cheng, Tien-Tsai; Hsieh, Song-Chou; Hsieh, Tsu-Yi; Hsu, Pai-Feng; Kuo, Chang-Fu; Kuo, Mei-Chuan; Lam, Hing-Chung; Lee, I-Te; Liang, Toong-Hua; Lin, Hsiao-Yi; Lin, Shih-Chang; Tsai, Wen-Pin; Tsay, Gregory J; Wei, James Cheng-Chung; Yang, Chung-Han; Tsai, Wen-Chan

    2018-01-24

    Gout is an inflammatory disease manifested by the deposition of monosodium urate (MSU) crystals in joints, cartilage, synovial bursa, tendons or soft tissues. Gout is not a new disease, which was first documented nearly 5,000 years ago. The prevalence of gout has increased globally in recent years, imposing great disease burden worldwide. Moreover, gout or hyperuricemia is clearly associated with a variety of comorbidities, including cardiovascular diseases, chronic kidney disease, urolithiasis, metabolic syndrome, diabetes mellitus, thyroid dysfunction, and psoriasis. To prevent acute arthritis attacks and complications, earlier use of pharmacotherapeutic treatment should be considered, and patients with hyperuricemia and previous episodes of acute gouty arthritis should receive long-term urate-lowering treatment. Urate-lowering drugs should be used during the inter-critical and chronic stages to prevent recurrent gout attacks, which may elicit gradual resolution of tophi. The goal of urate-lowering therapy should aim to maintain serum uric acid (sUA) level <6.0 mg/dL. For patients with tophi, the initial goal can be set at lowering sUA to <5.0 mg/dL to promote tophi dissolution. The goal of this consensus paper was to improve gout and hyperuricemia management at a more comprehensive level. The content of this consensus paper was developed based on local epidemiology and current clinical practice, as well as consensuses from two multidisciplinary meetings and recommendations from Taiwan Guideline for the Management of Gout and Hyperuricemia. © 2018 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  6. Improving cardiovascular and renal outcomes in gout: what should we target?

    NARCIS (Netherlands)

    Richette, P.; Perez-Ruiz, F.; Doherty, M.; Jansen, T.L.Th.A.; Nuki, G.; Pascual, E.; Punzi, L.; So, A.K.; Bardin, T.

    2014-01-01

    Epidemiological and experimental studies have shown that hyperuricaemia and gout are intricately linked with hypertension, metabolic syndrome, chronic kidney disease and cardiovascular disease. A number of studies suggest that hyperuricaemia and gout are independent risk factors for the development

  7. CLINICAL CHARACTERISTICS OF GOUT: A HOSPITAL CASE SERIES

    Directory of Open Access Journals (Sweden)

    GUN SC

    2011-01-01

    Full Text Available Introduction: Gout is an increasingly common medical problem. The traditional risk factors of male sex and high red meat or alcohol consumption have been joined with newer risks such as increased life expectancy, and the metabolic syndrome (hypertension, diabetes, dyslipidaemia, truncal obesity. Methods: This was a retrospective study to determine the epidemiology, clinical features, associated conditions as well as renal related conditions in existing gout patients followed-up in Rheumatology outpatient clinic, Hospital Tuanku Ja’afar, Seremban. Results: Over a three month period, we identified 54 gouty patients on our follow-up, the majority being male, Malay ethnicity, withthe age of onset in the third and fourth decades of life. Commonly associated risk factors were hypertension, hyperlipidaemia and obesity. However, underlying history of diabetes mellitus, alcohol consumption, and family history were not commonly associated with gout in our group of patients. Half of our patients had at least two or more joints involvement. About half of the patients with tophaceous gout had renal impairment. Conclusion: Our series of gout patients highlight the high prevalence of cardiovascular risk factors. The high prevalence of tophi and renal impairment is a cause for concern.

  8. Topacheous gout as a rare cause of spinal stenosis in the lumbar region. Case report.

    LENUS (Irish Health Repository)

    Kelly, Joseph

    2012-02-03

    Despite the fact that gout is a common metabolic disorder, because its involvement of the axial skeleton is rare the diagnosis is often delayed, even in patients with long-standing gout who present with neurological deficits. The authors report the case of a woman with a history of extensive gout, emphasizing the clinical, radiological, and pathological features of a lumbar spinal stenosis.

  9. Recent big flare

    International Nuclear Information System (INIS)

    Moriyama, Fumio; Miyazawa, Masahide; Yamaguchi, Yoshisuke

    1978-01-01

    The features of three big solar flares observed at Tokyo Observatory are described in this paper. The active region, McMath 14943, caused a big flare on September 16, 1977. The flare appeared on both sides of a long dark line which runs along the boundary of the magnetic field. Two-ribbon structure was seen. The electron density of the flare observed at Norikura Corona Observatory was 3 x 10 12 /cc. Several arc lines which connect both bright regions of different magnetic polarity were seen in H-α monochrome image. The active region, McMath 15056, caused a big flare on December 10, 1977. At the beginning, several bright spots were observed in the region between two main solar spots. Then, the area and the brightness increased, and the bright spots became two ribbon-shaped bands. A solar flare was observed on April 8, 1978. At first, several bright spots were seen around the solar spot in the active region, McMath 15221. Then, these bright spots developed to a large bright region. On both sides of a dark line along the magnetic neutral line, bright regions were generated. These developed to a two-ribbon flare. The time required for growth was more than one hour. A bright arc which connects two ribbons was seen, and this arc may be a loop prominence system. (Kato, T.)

  10. Anakinra treatment in patients with gout and type 2 diabetes.

    Science.gov (United States)

    Vitale, Antonio; Cantarini, Luca; Rigante, Donato; Bardelli, Marco; Galeazzi, Mauro

    2015-05-01

    We report three Caucasian patients affected by gout and type 2 diabetes, who were treated with the recombinant nonglycosylated human interleukin-1 receptor antagonist anakinra (100 mg/day subcutaneously) after an unsatisfactory or incomplete response to urate-lowering therapy, colchicine, nonsteroidal anti-inflammatory drugs, and prednisone. The remarkable clinical improvement in joint symptoms within 24 h and in glycemic control during a 6-month period gives anakinra a potential therapeutic role in the management of gout and type 2 diabetes. When anakinra was discontinued, a gout attack occurred within 3-25 days in all three patients. The contribution of anakinra in the treatment of such syndromes is encouraging, but requires further studies to establish its long-term efficacy.

  11. Radiculopathy in a patient with chronic tophaceus gout: vertebral imaging

    Directory of Open Access Journals (Sweden)

    Joana Borges

    2017-07-01

    Full Text Available Introduction: Spinal involvement is infrequent in chronic gout. However, some cases of back pain with radiculopathy secondary to this etiology have been reported. Case Report: 56-year old male patient, with history of arterial hypertension, hypertriglyceridemia, obesity, glucose intolerance and alcohol abuse, diagnosed with gout in his fifth decade of life. The patient was started on urate lowering therapy, with poor compliance, and evolved with sustained hyperuricemia, recurrent episodes of arthritis, and growth of gouty tophi on the elbows, wrists, hands and knees. In 2011, the patient presented with radiculopathy. When pain recurred, a Computed Tomography was performed and it showed alterations compatible with spinal tophi formation and nerve root involvement. Discussion/Conclusions: Our clinical case is another example of how gout can produce spinal inflammation and nerve damage and superimpose on previously damaged joints and how patients’ compliance to therapeutics may have an important impact on prognosis.

  12. Weight loss for overweight and obese individuals with gout

    DEFF Research Database (Denmark)

    Nielsen, Sabrina M; Bartels, Else M; Henriksen, Marius

    2017-01-01

    OBJECTIVES: Weight loss is commonly recommended for gout, but the magnitude of the effect has not been evaluated in a systematic review. The aim of this systematic review was to determine benefits and harms associated with weight loss in overweight and obese patients with gout. METHODS: We searched...... six databases for longitudinal studies, reporting the effect of weight loss in overweight/obese gout patients. Risk of bias was assessed using the tool Risk of Bias in Non-Randomised Studies of Interventions. The quality of evidence was assessed using the Grading of Recommendations Assessment......, Development and Evaluation. RESULTS: From 3991 potentially eligible studies, 10 were included (including one randomised trial). Interventions included diet with/without physical activity, bariatric surgery, diuretics, metformin or no intervention. Mean weight losses ranged from 3 kg to 34 kg. Clinical...

  13. Clinical features of gout in a cohort of Italian patients

    Directory of Open Access Journals (Sweden)

    M.A. Cimmino

    2011-06-01

    Full Text Available Objective: To assess the clinical characteristics of gout and its diagnostic approach in a group of Italian patients. Methods: In a retrospective analysis, we evaluated 72 consecutive gouty patients examined in the years 2000-2007.We recorded demographic data, family history, comorbidities and disease characteristics (seasonality of the attacks, joints affected, serum uric acid concentration, and treatment. Result: 63/72 (87.5% patients were men and 9 women, with mean age 61.9±13.7 years. 8/72 (11.1% patients reported a familial history of gout. The first attack occurred mainly in the months of June, July and December. The first metatarsophalangeal joint was affected in 59.7% of patients and the hand in 25%. Treatment changed over the follow- up period, with a decreased use of NSAIDs (p<0.0001 and an increased use of colchicine (p=0.015 and allopurinol (p<0.0001. In 9 (12.5% patients, joint aspiration was performed and monosodium urate crystals were found in synovial fluid or tophi. 42/72 (58.3% patients fulfilled a minimum of 6 clinical criteria of the American College of Rheumatology, necessary for gout diagnosis. 47/72 (65.3% patients, met the EULAR recommendations and had an 82% probability of being affected by gout. Conclusions: The diagnosis of gout is not always easy because of its changing clinical spectrum. Identification of MSU crystals in joint aspirates was obtained only in a minority of patients. In this setting the diagnosis with gout was often based on the observation of an acute intermittent monoarthritis involving mainly the first metatarsophlangeal joint, associated with hyperuricaemia and responsive to colchicine.

  14. Bilateral olecranon bursitis – A rare clinical presentation of gout

    Directory of Open Access Journals (Sweden)

    Betul Sargın

    2018-04-01

    Full Text Available Background: Gout is the most common form of crystal arthropathy. Monoarthritis affecting the first metatarsophalangeal joint is the common initial presentation. Bilateral olecranon bursitis is a rare presentation of gout. Aim of the work: To describe the clinical features of bilateral olecranon bursitis as an initial presentation of gout. Case report: A 62-year old male patient presented to the rheumatology clinic , Adnan Menderes University with sudden bilateral elbow pain and swelling for three months . Swellings gradually increased to the size of a golf ball with minimal restriction in the elbow extension (170°. He didn’t have arthritis in the elbows. The patient had medical history of heart failure and chronic obstructive pulmonary disease and medications received included acetylsalicylic acid and diuretics. Blood tests revealed elevated serum uric acid (12.6 mg/dL, with normal renal function tests, erythrocyte sedimentation rate (ESR 43 mm/h and C-reactive protein (CRP 8.8 mg/L. Rheumatoid factor and hepatitis markers were negative. Diagnostic bursal aspiration excluded septic bursitis and under polarized microscopy monosodium urate (MSU crystals were identified with typical negative birefringence. A diagnosis of gout was established. ESR and CRP were normalized after diclofenac potassium (100 mg and colchicine (1.5 mg. Allopurinol 300 mg was added when his joint pain was relieved. Conclusion: This is the first gout case initially presenting with bilateral olecranon bursitis. Bursal fluid analysis is important in such atypical presentation to look for MSU crystals and establish a diagnosis. Keywords: Olecranon bursitis, Gout, Crystal arthropathy, Monosodium urate

  15. Gout in immigrant groups: a cohort study in Sweden.

    Science.gov (United States)

    Wändell, Per; Carlsson, Axel C; Li, Xinjun; Gasevic, Danijela; Ärnlöv, Johan; Holzmann, Martin J; Sundquist, Jan; Sundquist, Kristina

    2017-05-01

    Our aim was to study the association between country of birth and incidence of gout in different immigrant groups in Sweden. The study population included the whole population of Sweden. Gout was defined as having at least one registered diagnosis in the National Patient Register. The association between incidence of gout and country of birth was assessed by Cox regression, with hazard ratios (HRs) and 95% confidence intervals (95% CI), using Swedish-born individuals as referents. All models were conducted in both men and women, and the full model was adjusted for age, place of residence in Sweden, educational level, marital status, neighbourhood socio-economic status and co-morbidities. The risk of gout varied by country of origin, with highest estimates, compared to Swedish born, in fully adjusted models among men from Iraq (HR 1.82, 95% CI 1.54-2.16), and Russia (HR 1.69, 95% CI 1.26-2.27), and also high among men from Austria, Poland, Africa and Asian countries outside the Middle East; and among women from Africa (HR 2.23, 95% CI 1.50-3.31), Hungary (HR 1.98, 95% CI 1.45-2.71), Iraq (HR 1.76, 95% CI 1.13-2.74) and Austria (HR 1.70, 95% CI 1.07-2.70), and also high among women from Poland. The risk of gout was lower among men from Greece, Spain, Nordic countries (except Finland) and Latin America and among women from Southern Europe, compared to their Swedish counterparts. The increased risk of gout among several immigrant groups is likely explained by a high cardio-metabolic risk factor pattern needing attention.

  16. Proton solar flares

    International Nuclear Information System (INIS)

    Shaposhnikova, E.F.

    1979-01-01

    The observations of proton solar flares have been carried out in 1950-1958 using the extrablackout coronograph of the Crimea astrophysical observatory. The experiments permit to determine two characteristic features of flares: the directed motion of plasma injection flux from the solar depths and the appearance of a shock wave moving from the place of the injection along the solar surface. The appearance of the shock wave is accompanied by some phenomena occuring both in the sunspot zone and out of it. The consistent flash of proton flares in the other groups of spots, the disappearance of fibres and the appearance of eruptive prominences is accomplished in the sunspot zone. Beyond the sunspot zone the flares occur above spots, the fibres disintegrate partially or completely and the eruptive prominences appear in the regions close to the pole

  17. Solar Features - Solar Flares

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — A solar flare is a short-lived sudden increase in the intensity of radiation emitted in the neighborhood of sunspots. For many years it was best monitored in the...

  18. Fibromyalgia Flares: A Qualitative Analysis.

    Science.gov (United States)

    Vincent, Ann; Whipple, Mary O; Rhudy, Lori M

    2016-03-01

    Patients with fibromyalgia report periods of symptom exacerbation, colloquially referred to as "flares" and despite clinical observation of flares, no research has purposefully evaluated the presence and characteristics of flares in fibromyalgia. The purpose of this qualitative study was to describe fibromyalgia flares in a sample of patients with fibromyalgia. Using seven open-ended questions, patients were asked to describe how they perceived fibromyalgia flares and triggers and alleviating factors associated with flares. Patients were also asked to describe how a flare differs from their typical fibromyalgia symptoms and how they cope with fibromyalgia flares. Content analysis was used to analyze the text. A total of 44 participants completed the survey. Responses to the seven open-ended questions revealed three main content areas: causes of flares, flare symptoms, and dealing with a flare. Participants identified stress, overdoing it, poor sleep, and weather changes as primary causes of flares. Symptoms characteristic of flares included flu-like body aches/exhaustion, pain, fatigue, and variety of other symptoms. Participants reported using medical treatments, rest, activity and stress avoidance, and waiting it out to cope with flares. Our results demonstrate that periods of symptom exacerbation (i.e., flares) are commonly experienced by patients with fibromyalgia and symptoms of flares can be differentiated from every day or typical symptoms of fibromyalgia. Our study is the first of its kind to qualitatively explore characteristics, causes, and management strategies of fibromyalgia flares. Future studies are needed to quantitatively characterize fibromyalgia flares and evaluate mechanisms of flares. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Modern Therapy for Gout through the Prism of Efficacy and Safety

    Directory of Open Access Journals (Sweden)

    I.Yu. Golovach

    2015-04-01

    Full Text Available The modern data on the treatment of such common condition as gout were presented in this article. Gout management covers and unites two directions: firstly, adequate treatment of acute gout episodes and, secondly, a steady decline in serum urate level below 360 µmol/l (6 mg/dl or lower in some cases to prevent recurrences and to promote resorption of tophi. The therapeutic possibilities in acute gout episode include nonsteroidal anti-inflammatory drugs, colchicine and glucocorticoids; in the treatment of chronic gout, allopurinol is widely used. The efficacy and safety of innovative drugs in the treatment of gout — febuxostat and interleukin-1 inhibitors were shown. It is underlined that the main problems of gout treatment are related to long-term safety and comorbidities.

  20. Hyperuricaemia and gout | Kopke | South African Family Practice

    African Journals Online (AJOL)

    Another important risk factor for the development of gout is hyperuricaemia. Hyperuricaemia results from an imbalance between the rate of production and excretion of uric acid in the body. An excess of uric acid thus builds up in the body, supersaturating body fluids and leading to the formation of monosodium urate crystals.

  1. Lesinurad for the treatment of hyperuricaemia in people with gout.

    Science.gov (United States)

    Robinson, Philip C; Dalbeth, Nicola

    2017-12-01

    Gout is a common form of inflammatory arthritis caused by deposition of monosodium urate crystals. The central strategy for effective long-term management of gout is serum urate lowering. Current urate-lowering drugs include both xanthine oxidase inhibitors and uricosuric agents. Lesinurad is a URAT1 inhibitor that selectively inhibits urate rebsorption at the proximal renal tubule. Lesinurad 200mg daily in combination with a xanthine oxidase is approved for urate-lowering therapy in patients with gout. Areas covered: The published literature was searched using Pubmed and additional information was obtained from publically available regulatory documents. Pre-clinical data and clinical trials of lesinurad are described. Serum urate-lowering efficacy and effects on other clinical endpoints are discussed. Adverse event data, focusing on renal safety are also presented. Expert opinion: Lesinurad is an effective urate-lowering drug that has a generally acceptable safety profile when used at 200mg daily dosing in combination with a xanthine oxidase inhibitor. The recent approval of fixed dose combination pills of lesinurad with allopurinol is an important step in improving adherence and reducing risk of renal adverse events. It remains to be seen if this therapy will provide additional benefit for gout management above improved use of widely available generic therapies.

  2. Outcome measures in acute gout: a systematic literature review.

    Science.gov (United States)

    Dalbeth, Nicola; Zhong, Cathy S; Grainger, Rebecca; Khanna, Dinesh; Khanna, Puja P; Singh, Jasvinder A; McQueen, Fiona M; Taylor, William J

    2014-03-01

    Five core domains have been endorsed by Outcome Measures in Rheumatology (OMERACT) for acute gout: pain, joint swelling, joint tenderness, patient global assessment, and activity limitation. We evaluated instruments for these domains according to the OMERACT filter: truth, feasibility, and discrimination. A systematic search strategy for instruments used to measure the acute gout core domains was formulated. For each method, articles were assessed by 2 reviewers to summarize information according to the specific components of the OMERACT filter. Seventy-seven articles and abstracts met the inclusion criteria. Pain was most frequently reported (76 studies, 20 instruments). The pain instruments used most often were 100 mm visual analog scale (VAS) and 5-point Likert scale. Both methods have high feasibility, face and content validity, and within- and between-group discrimination. Four-point Likert scales assessing index joint swelling and tenderness have been used in numerous acute gout studies; these instruments are feasible, with high face and content validity, and show within- and between-group discrimination. Five-point Patient Global Assessment of Response to Treatment (PGART) scales are feasible and valid, and show within- and between-group discrimination. Measures of activity limitations were infrequently reported, and insufficient data were available to make definite assessments of the instruments for this domain. Many different instruments have been used to assess the acute gout core domains. Pain VAS and 5-point Likert scales, 4-point Likert scales of index joint swelling and tenderness and 5-point PGART instruments meet the criteria for the OMERACT filter.

  3. Some historical remarks on microcrystalline arthritis (gout and chondrocalcinosis

    Directory of Open Access Journals (Sweden)

    G. Pasero

    2012-01-01

    Full Text Available The history of microcrystalline arthritis only began in 1961 when Daniel McCarty and Joseph Lee Hollander demonstrated the presence of sodium monourate crystals in the synovial fluid of gouty patients. However, gout is a historical disease, thanks to the descriptions of Hippocrates, Caelius Aurelianus, Soranus of Ephesus and Araeteus of Cappadocia. The relationship between hyperuricemia and gout was first documented in the nineteenth century by Alfred Baring Garrod, who demonstrated deposits of uric acid crystals on a linen thread held dipped in acidified blood (the so-called “thread method”. Gout has always been considered a prerogative of the moneyed classes (arthritis divitum, and history is full of famous gouty personalities, including kings, emperors, popes, commanders, politicians, artists, writers, philosophers and scientists. Another form of microcrystalline arthritis, chondrocalcinosis, was identified as being a rheumatic disorder different from gout in the 1960s. As a specific clinical entity, it was first identified in 1958 by Dušan Žitnˇan and Štefan Sit’aj in a few Slovak families.

  4. Tophaceous Gout: a tragic course for a preventable disease

    Directory of Open Access Journals (Sweden)

    Filipa Farinha

    2015-07-01

    Full Text Available A 66-year-old man, with a history of chronic tophaceous gout since the age of 30, presented with multiple tophi and significant deformity of all fingers that caused substantial function loss. Due to osteomyelitis refractory to antimicrobial therapy, he underwent disarticulation of several fingers. Finally, both his hands were amputated.

  5. Identifying flares in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Bykerk, Vivian P; Bingham, Clifton O; Choy, Ernest H

    2016-01-01

    to flare, with escalation planned in 61%. CONCLUSIONS: Flares are common in rheumatoid arthritis (RA) and are often preceded by treatment reductions. Patient/MD/DAS agreement of flare status is highest in patients worsening from R/LDA. OMERACT RA flare questions can discriminate between patients with...... Set. METHODS: Candidate flare questions and legacy measures were administered at consecutive visits to Canadian Early Arthritis Cohort (CATCH) patients between November 2011 and November 2014. The American College of Rheumatology (ACR) core set indicators were recorded. Concordance to identify flares...

  6. A concise history of gout and hyperuricemia and their treatment

    Science.gov (United States)

    2006-01-01

    First identified by the Egyptians in 2640 BC, podagra (acute gout occurring in the first metatarsophalangeal joint) was later recognized by Hippocrates in the fifth century BC, who referred to it as 'the unwalkable disease'. The term is derived from the Latin word gutta (or 'drop'), and referred to the prevailing medieval belief that an excess of one of the four 'humors' – which in equilibrium were thought to maintain health – would, under certain circumstances, 'drop' or flow into a joint, causing pain and inflammation. Throughout history, gout has been associated with rich foods and excessive alcohol consumption. Because it is clearly associated with a lifestyle that, at least in the past, could only be afforded by the affluent, gout has been referred to as the 'disease of kings'. Although there is evidence that colchicine, an alkaloid derived from the autumn crocus (Colchicum autumnale), was used as a powerful purgative in ancient Greece more than 2000 years ago, its first use as a selective and specific treatment for gout is attributed to the Byzantine Christian physician Alexander of Tralles in the sixth century AD. Uricosuric agents were first used at the end of the 19th century. In the modern era, nonsteroidal anti-inflammatory drugs are usually the drugs of choice for treating acute gout. Perhaps the most important historical advance in the treatment of hyperuricemia was the development of xanthine oxidase inhibitors, which are effective in reducing plasma and urinary urate levels and have been shown to reverse the development of tophaceous deposits. PMID:16820040

  7. New and improved strategies for the treatment of gout

    Directory of Open Access Journals (Sweden)

    Natalie Dubchak

    2010-11-01

    Full Text Available Natalie Dubchak, Gerald F FalascaDivision of Rheumatology, Cooper University Hospital, UMDNJ – Robert Wood Johnson Medical School at Camden, Camden, NJ, USAAbstract: The Western world appears to be in the midst of the third great gout epidemic of all time. In this century, gout is increasing in prevalence despite an increased understanding of its risk factors and pathophysiology, and the availability of reasonably effective treatment. The main cultural factors responsible for this appear to be diet, obesity, ethanol use and medications. Excess fructose consumption is a newly recognized modifiable risk factor. The debate has been renewed concerning hyperuricemia as an independent risk factor for renal insufficiency and cardiovascular disease. Prevention is still rooted in lifestyle choices. Existing treatments have proven to be unsatisfactory in many patients with comorbidities. New treatments are available today and on the horizon for tomorrow, which offer a better quality of life for gout sufferers. These include febuxostat, a nonpurine inhibitor of xanthine oxidase with a potentially better combination of efficacy and safety than allopurinol, and investigational inhibitors of URAT-1, an anion exchanger in the proximal tubule that is critical for uric acid homeostasis. New abortive treatments include interleukin-1 antagonists that can cut short the acute attack in 1 to 2 days in persons who cannot take nonsteroidal anti-inflammatory drugs, colchicine or corticosteroids. Lastly, newer formulations of uricase have the ability to dissolve destructive tophi over weeks or months in patients who cannot use currently available hypouricemic agents. Diagnostically, ultrasound and magnetic resonance imaging offer advanced ways to diagnose gout noninvasively, and just as importantly, a way to follow the progress of tophus dissolution. The close association of hyperuricemia with metabolic syndrome, hypertension and renal insufficiency ensures that

  8. Citric acid treatment of chronic nonhealing ulcerated tophaceous gout with bursitis.

    Science.gov (United States)

    Nagoba, Basavaraj S; Punpale, Ajay; Poddar, Ashok; Suryawanshi, Namdev M; Swami, Ganesh A; Selkar, Sohan P

    2013-12-01

    The ulceration associated with gout tophi is very difficult to treat because of impaired and halted local inflammatory response resulting from the gout treatment regimen. We report chronic nonhealing tophaceous gout with bursitis in an 80-year-old male, not responding to conventional treatment modality for months together. This nonhealing ulcer was treated successfully with local application of 3% citric acid ointment for 22 days.

  9. Spine and polytopic hyperostoses in gout and hyperuricemia

    Energy Technology Data Exchange (ETDEWEB)

    Stepan, J.; Svab, V.; Susta, A.; Kolar, J.; Cap, F.

    1983-08-01

    Investigations were made on a total of 92 patients with gout and hyperuricemia. 30% had no clinical signs of spinal involvement. The remaining 70% were examined radiologically and by xeroradiography. Examination revealed signs of erosion of vertebral bodies, spondylodiscitis, osteopenia, manifestations of Forestier's disease and changes on sacroiliac joints. In 52% of subjects there were polytopic hyperostoses including an increased incidence of calcifications around the large joints and periostal appositions at the periphery, particularly on the finger and toe tips. The hypothesis was raised that massive calcifications and manifestations of hyperostosis and ossification of the ligaments and tendons (osteodesmoses) in gout may correlate with a latent glycide metabolism disorder like in Forestier's disease.

  10. Experience with febuxostat in a patient with severe disabling gout

    Directory of Open Access Journals (Sweden)

    M. S. Eliseev

    2017-01-01

    Full Text Available Gout is a chronic disease that frequently leads to disability if urate-lowering therapy is inefficient. The paper presents the positive experience with febuxostat, a novel non-purine xanthine oxidase inhibitor, in a young patient with disabling chronic tophaceous gout. Twelve-month therapy with daily 80-mg dose of febuxostat resulted in almost complete resorption of subcutaneous tophi and in a long-term lack of arthritis attacks with the persistent serum uric acid levels below target ones. This is the first experience in successfully switching from one to another xanthine oxidase inhibitor, which was described after febuxostat registration in the Russian Federation.

  11. Gout Initially Mimicking Rheumatoid Arthritis and Later Cervical Spine Involvement

    Directory of Open Access Journals (Sweden)

    Eduardo Araújo Santana Nunes

    2014-01-01

    Full Text Available Gout is clinically characterized by episodes of monoarthritis, but if not treated properly, it can lead to a chronic polyarthritis, which may eventually mimic rheumatoid arthritis (RA. We present the case of a 59-year-old man, with a history of symmetrical polyarthritis of the large and small joints with later development of subcutaneous nodules, which was initially misdiagnosed as RA, being treated with prednisone and methotrexate for a long period of time. He complained of occipital pain and paresthesia in his left upper limb, and computed tomography (CT and magnetic resonance imaging (MRI revealed the presence of an expansive formation in the cervical spine with compression of the medulla. He was admitted for spinal decompressive surgery and the biopsy specimen demonstrated a gouty tophus. Chronic gout can mimic RA and rarely involves the axial skeleton, and thus its correct diagnosis and the implementation of adequate therapy can halt the development of such damaging complications.

  12. [Venous participation in gonarthrosis, rheumatoid arthritis, and gout].

    Science.gov (United States)

    Dufour, R; Sarteel, A M

    1981-01-01

    The authors describe three major rheumatological classifications together with an account of the phlebological aspects of these phenomena. They deal with gonarthrocace, which is predominantly stasis; rheumatoid arthritis, which may be induced by inflammatory injuries to the vein wall, by endothelitis of the venulo-capillary segments, or racemose lividity; and gout which mainly involves turgescence, and mural phlebitis. This is not forgetting the secondary classifications, associated with polyglobulism, anemia, and foranioplasia.

  13. Probenecid, a gout remedy, inhibits pannexin 1 channels

    OpenAIRE

    Silverman, William; Locovei, Silviu; Dahl, Gerhard

    2008-01-01

    Probenecid is a well-established drug for the treatment of gout and is thought to act on an organic anion transporter, thereby affecting uric acid excretion in the kidney by blocking urate reuptake. Probenecid also has been shown to affect ATP release, leading to the suggestion that ATP release involves an organic anion transporter. Other pharmacological evidence and the observation of dye uptake, however, suggest that the nonvesicular release of ATP is mediated by large membrane channels, wi...

  14. SIGNIFICANCE OF DIET AND DIETARY SUPPLEMENTS IN GOUT

    Directory of Open Access Journals (Sweden)

    A E Il'ina

    2008-01-01

    Full Text Available The paper discusses a role of a diet and therapy with the herbal complex Urisan in patients with gout. It is noted that the agent based on herbal components may be used in addition to drug therapy and diet in seasonal hyperuricuria, hyperuricemia observed after heavy strenuous and athletic activity, meat overeating, and alcohol abuse. Urisan may be recommended in subsiding gouty inflammation as a bridge to the use of allopurinol.

  15. Relation of Temperature and Humidity to the Risk of Recurrent Gout Attacks

    Science.gov (United States)

    Neogi, Tuhina; Chen, Clara; Niu, Jingbo; Chaisson, Christine; Hunter, David J.; Choi, Hyon; Zhang, Yuqing

    2014-01-01

    Gout attack risk may be affected by weather (e.g., because of volume depletion). We therefore examined the association of temperature and humidity with the risk of recurrent gout attacks by conducting an internet-based case-crossover study in the United States (in 2003–2010) among subjects with a diagnosis of gout who had 1 or more attacks during 1 year of follow-up. We examined the association of temperature and humidity over the prior 48 hours with the risk of gout attacks using a time-stratified approach and conditional logistic regression. Among 632 subjects with gout, there was a significant dose-response relationship between mean temperature in the prior 48 hours and the risk of subsequent gout attack (P = 0.01 for linear trend). Higher temperatures were associated with approximately 40% higher risk of gout attack compared with moderate temperatures. There was a reverse J-shaped relationship between mean relative humidity and the risk of gout attacks (P = 0.03 for quadratic trend). The combination of high temperature and low humidity had the greatest association (odds ratio = 2.04, 95% confidence interval: 1.26, 3.30) compared with moderate temperature and relative humidity. Thus, high ambient temperature and possibly extremes of humidity were associated with an increased risk of gout attack, despite the likelihood that individuals are often in climate-controlled indoor environments. PMID:24993733

  16. Serum uric acid and gout: from the past to molecular biology.

    Science.gov (United States)

    Punzi, L; So, A

    2013-04-01

    This review will briefly present the epidemiology and risk factors of gout, with a focus on recent advances. Key papers for inclusion were identified by a PubMed search, and articles were selected according to their relevance for the topic, according to authors' judgment. Gout therapy has remained very much unchanged for the last 50 years, but recently we have seen the approval of another gout treatment: the xanthine oxidase inhibitor febuxostat, and several new drugs are now in the late stages of clinical testing. Together with our enhanced level of understanding of the pathophysiology of the inflammatory process involved, we are entering a new era for the treatment of gout.

  17. Evolution of management of gout: a comparison of recent guidelines.

    Science.gov (United States)

    Khanna, Puja P; FitzGerald, John

    2015-03-01

    There have been several guidelines on the management of gout over the last decade; however, inconsistencies between them create confusion for practitioners. This review highlights areas of agreement between guidelines and discusses data where disagreements exist. For acute gout, the guidelines agree that anti-inflammatory treatment should start as soon as possible, preferably within 24 hours. Older guidelines preferred NSAIDs or colchicine over steroids, but newer ones leave the choice of agent to the physician. For colchicine, all guidelines recommend using low dose. Intra-articular, oral or intramuscular steroids are all described as effective. For management of hyperuricemia, indications for initiating urate-lowering therapy (ULT) have become more inclusive over the years by requiring lower burden of disease severity or including patient comorbidities. Probenecid has fallen out of favour with most guidelines favouring allopurinol over febuxostat. Although there is a disagreement about timing of initiation for ULT, guidelines recommend treating to target of serum urate (sUA) less than 6 mg/dl, and less than 5 mg/dl for patients with more severe disease. Concurrent anti-inflammatory prophylaxis has gained strong support over the years. Most guidelines are in agreement with recommendations for management of gout and most changes have been directional and evolutionary.

  18. Which of Kepler's Stars Flare?

    Science.gov (United States)

    Kohler, Susanna

    2017-12-01

    The habitability of distant exoplanets is dependent upon many factors one of which is the activity of their host stars. To learn about which stars are most likely to flare, a recent study examines tens of thousands of stellar flares observed by Kepler.Need for a Broader SampleArtists rendering of a flaring dwarf star. [NASAs Goddard Space Flight Center/S. Wiessinger]Most of our understanding of what causes a star to flare is based on observations of the only star near enough to examine in detail the Sun. But in learning from a sample size of one, a challenge arises: we must determine which conclusions are unique to the Sun (or Sun-like stars), and which apply to other stellar types as well.Based on observations and modeling, astronomers think that stellar flares result from the reconnection of magnetic field lines in a stars outer atmosphere, the corona. The magnetic activity is thought to be driven by a dynamo caused by motions in the stars convective zone.HR diagram of the Kepler stars, with flaring main-sequence (yellow), giant (red) and A-star (green) stars in the authors sample indicated. [Van Doorsselaere et al. 2017]To test whether these ideas are true generally, we need to understand what types of stars exhibit flares, and what stellar properties correlate with flaring activity. A team of scientists led by Tom Van Doorsselaere (KU Leuven, Belgium) has now used an enormous sample of flares observed by Kepler to explore these statistics.Intriguing TrendsVan Doorsselaere and collaborators used a new automated flare detection and characterization algorithm to search through the raw light curves from Quarter 15 of the Kepler mission, building a sample of 16,850 flares on 6,662 stars. They then used these to study the dependence of the flare occurrence rate, duration, energy, and amplitude on the stellar spectral type and rotation period.This large statistical study led the authors to several interesting conclusions, including:Flare star incidence rate as a a

  19. Dynamics of flare sprays

    International Nuclear Information System (INIS)

    Tandberg-Hanssen, E.; Hansen, R.T.

    1980-01-01

    During solar cycle No. 20 new insight into the flare-spray phenomenon has been attained due to several innovations in solar optical-observing techniques (higher spatial resolution cinema-photography, tunable pass-band filters, multi-slit spectroscopy and extended angular field coronographs). From combined analysis of 13 well-observed sprays which occured between 1969-1974 we conclude that (i) the spray material originates from a preexisting active region filament which undergoes increased absorption some tens of minutes prior to the abrupt chromospheric brightening at the 'flare-start', and (ii) the spray material is confined within a steadily expanding, loop-shaped (presumably magnetically controlled) envelope with part of the material draining back down along one or both legs of the loop. (orig.)

  20. Urate crystal induced inflammation and joint pain are reduced in transient receptor potential ankyrin 1 deficient mice--potential role for transient receptor potential ankyrin 1 in gout.

    Science.gov (United States)

    Moilanen, Lauri J; Hämäläinen, Mari; Lehtimäki, Lauri; Nieminen, Riina M; Moilanen, Eeva

    2015-01-01

    In gout, monosodium urate (MSU) crystals deposit intra-articularly and cause painful arthritis. In the present study we tested the hypothesis that Transient Receptor Poten-tial Ankyrin 1 (TRPA1), an ion channel mediating nociceptive signals and neurogenic in-flammation, is involved in MSU crystal-induced responses in gout by utilizing three experi-mental murine models. The effects of selective pharmacological inhibition (by HC-030031) and genetic depletion of TRPA1 were studied in MSU crystal-induced inflammation and pain by using 1) spontaneous weight-bearing test to assess MSU crystal-induced joint pain, 2) subcutaneous air-pouch model resembling joint inflammation to measure MSU crystal-induced cytokine production and inflammatory cell accumulation, and 3) MSU crystal-induced paw edema to assess acute vascular inflammatory responses and swelling. Intra-articularly injected MSU crystals provoked spontaneous weight shift off from the affected limb in wild type but not in TRPA1 knock-out mice referring alleviated joint pain in TRPA1 deficient animals. MSU crystal-induced inflammatory cell infiltration and accumulation of cytokines MCP-1, IL-6, IL-1beta, MPO, MIP-1alpha and MIP-2 into subcu-taneous air-pouch (resembling joint cavity) was attenuated in TRPA1 deficient mice and in mice treated with the selective TRPA1 inhibitor HC-030031 as compared to control animals. Further, HC-030031 treated and TRPA1 deficient mice developed tempered inflammatory edema when MSU crystals were injected into the paw. TRPA1 mediates MSU crystal-induced inflammation and pain in experimental models supporting the role of TRPA1 as a potential mediator and a drug target in gout flare.

  1. Flares on a Bp Star

    Science.gov (United States)

    Mullan, D. J.

    2009-09-01

    Two large X-ray flares have been reported from the direction of a magnetic B2p star (σ Ori E). Sanz-Forcada et al. have suggested that the flares did not occur on the B2p star but on a companion of late spectral type. A star which is a candidate for a late-type flare star near σ Ori E has recently been identified by Bouy et al. However, based on the properties of the flares, and based on a recent model of rotating magnetospheres, we argue that, rather than attributing the two flares to a late-type dwarf, it is a viable hypothesis that the flares were magnetic phenomena associated with the rotating magnetosphere of the B2p star itself.

  2. FLARES ON A Bp STAR

    International Nuclear Information System (INIS)

    Mullan, D. J.

    2009-01-01

    Two large X-ray flares have been reported from the direction of a magnetic B2p star (σ Ori E). Sanz-Forcada et al. have suggested that the flares did not occur on the B2p star but on a companion of late spectral type. A star which is a candidate for a late-type flare star near σ Ori E has recently been identified by Bouy et al. However, based on the properties of the flares, and based on a recent model of rotating magnetospheres, we argue that, rather than attributing the two flares to a late-type dwarf, it is a viable hypothesis that the flares were magnetic phenomena associated with the rotating magnetosphere of the B2p star itself.

  3. Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds® Consensus Exercises

    DEFF Research Database (Denmark)

    de Lautour, Hugh; Taylor, William J; Adebajo, Ade

    2016-01-01

    OBJECTIVES: The aim of this study was to establish consensus for potential remission criteria for use in clinical trials of gout. METHODS: Experts (n=88) in gout from multiple countries were invited to participate in a web-based questionnaire study. Three rounds of Delphi consensus exercises were...

  4. Diagnostic imaging of gout: comparison of high-resolution US versus conventional X-ray

    International Nuclear Information System (INIS)

    Rettenbacher, Thomas; Ennemoser, Sybille; Weirich, Harald; Ulmer, Hanno; Hartig, Frank; Klotz, Werner; Herold, Manfred

    2008-01-01

    The aim was to compare X-ray and ultrasound (US) in diagnosing gout. In a prospective study, 105 consecutive patients with clinical suspicion of gout underwent conventional X-ray und high-resolution US in order to help in arriving at a definite diagnosis. X-ray findings suggestive of gout included soft-tissue opacifications with densities between soft tissue and bone, articular and periarticular bone erosions, and osteophytes at the margins of opacifications or erosions. US findings suggestive of gout included bright stippled foci and hyperechoic soft-tissue areas. Fifty-five patients had a definite diagnosis of gout (102 involved sites), 31 patients were diagnosed as having another disease (59 involved sites), and 19 patients were excluded from the study because a definite diagnosis could not be established. X-ray suggested gout with a sensitivity of 31% (32/102) and a specificity of 93% (55/59), whereas US suggested gout with a sensitivity of 96% (98/102) and a specificity of 73% (43/59). US was much more sensitive than conventional X-ray but less specific. Our data show that US often provided additional diagnostic information in patients with clinical suspicion of gout when laboratory findings and X-ray results were negative or inconclusive and should therefore be used in these cases. (orig.)

  5. Performance of classification criteria for gout in early and established disease

    DEFF Research Database (Denmark)

    Taylor, William J; Fransen, Jaap; Dalbeth, Nicola

    2016-01-01

    OBJECTIVES: To compare the sensitivity and specificity of different classification criteria for gout in early and established disease. METHODS: This was a cross-sectional study of consecutive rheumatology clinic patients with joint swelling in which gout was defined by presence or absence of mono...

  6. Gout, not induced by diuretics? A case-control study from primary care.

    NARCIS (Netherlands)

    Janssens, H.; Lisdonk, E.H. van de; Janssen, M.; Hoogen, H.J.M. van den; Verbeek, A.L.M.

    2006-01-01

    BACKGROUND: It is taken for granted that diuretics may induce gout, but there is a general lack of evidence on this topic. OBJECTIVES: To determine the incidence of gout in patients who use diuretics, taking into account concurrent hypertension and cardiovascular diseases. METHODS: A case-control

  7. Tophaceous gout of the first costochondral junction in a heart transplant patient

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Patrick C.; Seeger, Leanne L.; Motamedi, Kambiz [David Geffen School of Medicine at UCLA, Department of Radiology, Los Angeles, CA (United States); Chan, Jessica B. [David Geffen School of Medicine at UCLA, Department of Pathology, Los Angeles, CA (United States)

    2006-09-15

    We report the case of a 49-year-old man with a 10-year history of gout, who presented with a painful left first costochondral junction mass. A computed tomography (CT)-guided biopsy of the mass revealed foreign body giant cell reaction and crystalline deposition consistent with tophaceous gout. (orig.)

  8. Tophaceous Gout in an Anorectic Patient Visualized by Dual Energy Computed Tomography (DECT)

    DEFF Research Database (Denmark)

    Christensen, Heidi Dahl; Sheta, Hussam; Birger Morillon, Melanie

    2016-01-01

    BACKGROUND Gout is characterized by deposition of uric acid crystals (monosodium urate) in tissues and fluids. This can cause acute inflammatory arthritis. The 2015 ACR/EULAR criteria for the diagnosis of gout include dual energy computed tomography (DECT)-demonstrated monosodium urate crystals...

  9. A Case of Mitral Valve Tophus in a Patient with Severe Gout Tophaceous Arthritis

    Directory of Open Access Journals (Sweden)

    Atooshe Rohani

    2012-01-01

    Full Text Available A few cases of cardiac valve tophi have been reported in literature. In this case report, the echocardiographic characteristics of the hyperechoic mass in the posterior leaflet mitral valve, intact mitral valve ring, and the occurrence of severe tophaceous gout arthritis suggested the diagnosis of a gout tophus on the mitral valve.

  10. Performance of Ultrasound in the Diagnosis of Gout in a Multi-Center Study

    DEFF Research Database (Denmark)

    Ogdie, Alexis; Taylor, William J; Neogi, Tuhina

    2017-01-01

    OBJECTIVES: To examine the performance of ultrasound for the diagnosis of gout using presence of monosodium urate (MSU) crystals as the gold standard. METHODS: We analyzed data from the Study for Updated Gout Classification Criteria (SUGAR), a large, multi-center observational cross-sectional stu...

  11. Step wise approach of gout in the rheumatology ward of Point-G ...

    African Journals Online (AJOL)

    Step wise approach of gout in the rheumatology ward of Point-G University Teaching Hospital of Bamako, Mali. ... Obesity, high blood pressure, diuretics intake, and kidney failure were observed in 83%, 76%, 64% and 37%, respectively. Clinical manifestations of gout were located in joints (100%), in skin (4 cases of tophus) ...

  12. Energy Release in Solar Flares,

    Science.gov (United States)

    1982-10-01

    Plasma Research, Stanford University P. Kaufmanu CRAA/CNPq -Conseiho lacional de Desenvolvimento Cientifico e Tecnologico, Slo Paulo, SP, Brasil D.F...In this case, the two flare filaments drift slowly apart (receding from the magnetic neutral line) so that, late in a flare, regions of the...that the soft X-ray emission was confined to an area small compared to the I alpha flaring region and that the images did not increase in size during

  13. Monitorização eletrocardiográfica ambulatorial por 24-horas em cães com cardiomiopatia dilatada idiopática Twenty-four-hour ambulatory electrocardiographic monitoring in dogs with idiopathic dilated cardiomyopathy

    Directory of Open Access Journals (Sweden)

    F.L. Yamaki

    2007-12-01

    Full Text Available Caracterizou-se monitorização eletrocardiográfica ambulatorial por 24 horas (ou monitorização Holter em cães com cardiomiopatia dilatada idiopática, visando principalmente à detecção de arritmias ventriculares não detectadas pela eletrocardiografia convencional (de repouso. Para tanto, avaliaram-se 40 pacientes com diagnóstico de cardiomiopatia dilatada idiopática, por meio de exame físico e mensuração indireta da pressão arterial, além de exames eletrocardiográfico, ecocardiográfico, radiográfico de tórax e da monitorização Holter. Extra-sístoles ventriculares foram detectadas, por monitorização Holter, em 97,5% dos animais e taquicardia ventricular, em 45%. Não houve correlação entre o número de extra-sístoles ventriculares e a fração de encurtamento. Considerando as manifestações clínicas, apenas houve associação entre presença de taquicardia ventricular e histórico de síncopes. Conclui-se que a incidência de arritmias ventriculares em cães com cardiomiopatia dilatada idiopática é bastante alta, sendo a taquicardia ventricular relativamente freqüente, ocorrendo mais sob a forma não sustentada.This study aimed to characterize 24-hour ambulatory electrocardiographic monitoring (Holter monitoring in dogs with idiopathic dilated cardiomyopathy. Physical examination and indirect (Doppler blood pressure measurement, and also electrocardiography, thoracic radiography, echocardiography, and 24-hour ambulatory electrocardiographic exams were performed in 40 dogs with idiopathic dilated cardiomyopathy. Ventricular extrasystoles were detected in 97.5% of the animals, and ventricular tachycardia in 45%. No correlation between the number of ventricular extrasystoles and the shortening fraction was observed. Concerning the clinical symptoms, there was only association between the presence of ventricular tachycardia and past report of syncope. It was concluded that the incidence of ventricular arrhythmias is high in dogs with dilated cardiomyopathy, being ventricular tachycardia, mostly non-sustained, relatively frequent.

  14. Efeitos agudos do exercício físico prolongado: avaliação após ultramaratona de 24 horas Acute effects of prolonged physical exercise: evaluation after a twenty-four-hour ultramarathon

    Directory of Open Access Journals (Sweden)

    Daniela Guinther Passaglia

    2012-01-01

    Full Text Available FUNDAMENTO: As consequências e os riscos do exercício físico contínuo por períodos prolongados não estão esclarecidos. OBJETIVO: Avaliar os efeitos do exercício prolongado em participantes de uma ultramaratona de 24 horas. MÉTODOS: Vinte corredores foram selecionados para avaliação, um dia antes e imediatamente após a prova em que os corredores devem percorrer a maior distância em 24 horas. Foram obtidos dados clínicos, laboratoriais e ecocardiográficos. RESULTADOS: A distância média percorrida foi de 140,3 ± 18,7 km. Os corredores apresentaram redução do peso corpóreo (p BACKGROUND: The consequences and risks of prolonged physical exercise are not well established. OBJECTIVE: To evaluate the effects of prolonged physical exercise on the participants of a 24-hour ultramarathon race. METHODS: Twenty male runners were selected for evaluation a day before and immediately after the race, where the athletes had to cover the most distance in 24 hours. Clinical, laboratory and echocardiographic data were obtained at both evaluations. RESULTS: Mean distance covered was 140.3 ± 18.7 km. Runners showed weight loss (p < 0.001 and decrease in systolic (p < 0.001 and diastolic (p = 0.004 blood pressure. Hematological changes were compatible with the physiological stress. Plasma levels of creatine phosphokinase strikingly increased post-race (163.4 ± 56.8 vs. 2978.4 ± 1921.9 U/L; p < 0.001 and was inversely correlated with distance covered: those who covered the longest distances showed the lowest CPK levels (Pearson r = 0.69, p = 0.02. After the race, 2 runners showed a slight increase in Troponin levels. One of them also had simultaneous decrease in left ventricular ejection fraction (coronary artery disease was subsequently ruled out. Basal echocardiography assessment had shown LV hypertrophy in one and increased left atrial volume in five runners. After the race, there was a decrease in E/A ratio (p < 0.01. CONCLUSION: Prolonged physical exercise is associated with metabolic and cardiovascular alterations. Cardiac abnormalities found in our study suggest that cardiac fatigue may occur in this specific race modality. The long-term effect of these alterations, while maintaining the routine practice of prolonged strenuous physical activity, is still unknown.

  15. Efeitos agudos do exercício físico prolongado: avaliação após ultramaratona de 24 horas Acute effects of prolonged physical exercise: evaluation after a twenty-four-hour ultramarathon

    Directory of Open Access Journals (Sweden)

    Daniela Guinther Passaglia

    2013-01-01

    Full Text Available FUNDAMENTO: As consequências e os riscos do exercício físico contínuo por períodos prolongados não estão esclarecidos. OBJETIVO: Avaliar os efeitos do exercício prolongado em participantes de uma ultramaratona de 24 horas. MÉTODOS: Vinte corredores foram selecionados para avaliação, um dia antes e imediatamente após a prova em que os corredores devem percorrer a maior distância em 24 horas. Foram obtidos dados clínicos, laboratoriais e ecocardiográficos. RESULTADOS: A distância média percorrida foi de 140,3 ± 18,7 km. Os corredores apresentaram redução do peso corpóreo (p BACKGROUND: The consequences and risks of prolonged physical exercise are not well established. OBJECTIVE: To evaluate the effects of prolonged physical exercise on the participants of a 24-hour ultramarathon race. METHODS: Twenty male runners were selected for evaluation a day before and immediately after the race, where the athletes had to cover the most distance in 24 hours. Clinical, laboratory and echocardiographic data were obtained at both evaluations. RESULTS: Mean distance covered was 140.3 ± 18.7 km. Runners showed weight loss (p < 0.001 and decrease in systolic (p < 0.001 and diastolic (p = 0.004 blood pressure. Hematological changes were compatible with the physiological stress. Plasma levels of creatine phosphokinase strikingly increased post-race (163.4 ± 56.8 vs. 2978.4 ± 1921.9 U/L; p < 0.001 and was inversely correlated with distance covered: those who covered the longest distances showed the lowest CPK levels (Pearson r = 0.69, p = 0.02. After the race, 2 runners showed a slight increase in Troponin levels. One of them also had simultaneous decrease in left ventricular ejection fraction (coronary artery disease was subsequently ruled out. Basal echocardiography assessment had shown LV hypertrophy in one and increased left atrial volume in five runners. After the race, there was a decrease in E/A ratio (p < 0.01. CONCLUSION: Prolonged physical exercise is associated with metabolic and cardiovascular alterations. Cardiac abnormalities found in our study suggest that cardiac fatigue may occur in this specific race modality. The long-term effect of these alterations, while maintaining the routine practice of prolonged strenuous physical activity, is still unknown.

  16. Identification of low-frequency variants associated with gout and serum uric acid levels

    DEFF Research Database (Denmark)

    Sulem, Patrick; Gudbjartsson, Daniel F; Walters, G Bragi

    2011-01-01

    the association with gout by performing Sanger sequencing on 6,017 Icelanders. The association with gout was stronger in males relative to females. We also found a second variant on chromosome 1 associated with gout (OR = 1.92, P = 0.046, at-risk allele frequency = 0.986) and serum uric acid levels (effect = 0......We tested 16 million SNPs, identified through whole-genome sequencing of 457 Icelanders, for association with gout and serum uric acid levels. Genotypes were imputed into 41,675 chip-genotyped Icelanders and their relatives, for effective sample sizes of 968 individuals with gout and 15.......48 s.d., P = 4.5 × 10(-16)). This variant is close to a common variant previously associated with serum uric acid levels. This work illustrates how whole-genome sequencing data allow the detection of associations between low-frequency variants and complex traits....

  17. Formulation of colchicine ointment for the treatment of acute gout.

    Science.gov (United States)

    Maduri, Sairam; Atla, Venkateshwar Reddy

    2012-11-01

    In spite of being the fastest acting drug available for the control of an acute gout attack, colchicine is generally considered a last alternative in gout therapy. This is mainly due to the severe adverse effects associated with its administration through the enteral and parenteral routes, as well as its high risk/benefit ratio. The preparation of dosage forms of colchicine that can be administered by alternative routes is therefore a beneficial exercise. Among the formulable substitute dosage forms of colchicine, its ointment seems to be the best option available due to its ability to deliver the drug transdermally as well as its ease of preparation and evaluation. In this study, we prepared and tested 0.2% and 0.5% colchicine ointments for their effectiveness in delivering colchicine transdermally. Colchicine ointment was prepared using a self-formulated water-in-oil type of emulsion ointment base, with the colchicine dissolved in the water portion of the ointment base. In vitro drug release studies were carried out using the Franz diffusion test apparatus and an ultraviolet (UV)-visible spectrophotometer was used to quantify the drug in the samples. Rabbits were used as test animals for in vivo studies and the blood samples were analysed using the UV-visible spectrophotometer. Colchicine was found to be well-absorbed transdermally, although absorption was not 100%. No side effects were associated with its 0.2% formulation. Ointments containing colchicine in low concentrations may be a feasible and effective treatment option for the prevention and treatment of acute gout attacks.

  18. Colchicine Significantly Reduces Incident Cancer in Gout Male Patients: A 12-Year Cohort Study.

    Science.gov (United States)

    Kuo, Ming-Chun; Chang, Shun-Jen; Hsieh, Ming-Chia

    2015-12-01

    Patients with gout are more likely to develop most cancers than subjects without gout. Colchicine has been used for the treatment and prevention of gouty arthritis and has been reported to have an anticancer effect in vitro. However, to date no study has evaluated the relationship between colchicine use and incident cancers in patients with gout. This study enrolled male patients with gout identified in Taiwan's National Health Insurance Database for the years 1998 to 2011. Each gout patient was matched with 4 male controls by age and by month and year of first diagnosis, and was followed up until 2011. The study excluded those who were diagnosed with diabetes or any type of cancer within the year following enrollment. We calculated hazard ratio (HR), aged-adjusted standardized incidence ratio, and incidence of 1000 person-years analyses to evaluate cancer risk. A total of 24,050 male patients with gout and 76,129 male nongout controls were included. Patients with gout had a higher rate of incident all-cause cancers than controls (6.68% vs 6.43%, P = 0.006). A total of 13,679 patients with gout were defined as having been ever-users of colchicine and 10,371 patients with gout were defined as being never-users of colchicine. Ever-users of colchicine had a significantly lower HR of incident all-cause cancers than never-users of colchicine after adjustment for age (HR = 0.85, 95% CI = 0.77-0.94; P = 0.001). In conclusion, colchicine use was associated with a decreased risk of incident all-cause cancers in male Taiwanese patients with gout.

  19. Solar Flare Studies

    Science.gov (United States)

    1982-03-20

    were written continuously on magnetic tape, but were saved only if a flare occurred. The data may, of course, be displayed either as spectroheliograms...I1" f443.78 F Y Fe I1 16 SY* 3460.250 S Y Mn II 3 3413.99 F Y P Fe I6 3460.41 S Y 3444.220 S Y 5 II 6 SV Gd 11 731 3444.41 S Y 3460.75’ BIIA F N PGd

  20. [Historical Study of the Etymological Form and Translational Process of Gout (Tongfeng,)].

    Science.gov (United States)

    Cho, Jae-Heung; Jung, Jae Young

    2015-08-01

    This study aims to address questions regarding the translation of 'gout' into 'tongfeng ()' in East Asia. To this end, the formation process of the origins, 'gout' from Western medicine and 'tongfeng' from Oriental medicine, and the translational process were investigated through the relevant records and literature dating from the 16th century on. Symptoms associated with gout were originally mentioned in ancient Egypt and various terminologies were used to refer to gout, such as podagra, cheiragra and gonogra. The word 'gout', which is derived from Latin, was used for the first time in the 13th century. The reason for this linguistic alteration is thought to be the need for a comprehensive term to cover the various terms for gout in symptomatic body parts, since it can occur concurrently in many joints. However, it took hundreds of years before gout was independently established as a medical term. In oriental medicine, terms describing diseases with features similar to gout include bibing (), lijiefeng (), baihufeng () and tongfeng (). Among them, the concept of 'tongfeng' has been established since the Jin and Yuan dynasties. The cause, prevention and various treatments for tongfeng were proposed throughout the Ming and Qing dynasties. The early translation of gout and tongfeng in East Asia, respectively, is estimated to have occurred in the 18th century. The first literature translating gout in China was 'An English and Chinese Vocabulary in the Court Dialect (yinghua yunfu lijie, )'. From the publication of this book until the late 19th century, gout was translated into an unfamiliar Chinese character 'Jiu feng jiao ()', likely because the translation was done mostly by foreign missionaries at the time, and they created a new word on the basis of Western medicine instead of researching and translating similar diseases in oriental medicine. In Japan, the first book translating gout was 'A Pocket Dictionary of the English and Japanese Language (Eiwa taiyaku

  1. How flares can be understood

    International Nuclear Information System (INIS)

    Severny, A.B.

    1977-01-01

    Specific features of the flare phenomenon which are important for understanding of flares are the following: (1) Fine structure of visible emission of flares, especially at the very beginning and in the pre-flare active region. This structure can be seen also in later stages of development as bright points, some of which exist from the flare beginning (Babin's observations at Crimea, 1972-1976). (2) Turbulent motion with velocities up to 250-300 km s -1 as can be estimated from broadening of emission lines. (3) Predominantly red asymmetry of emission lines in the explosive phase and during further development of flares. (4) 'Supersonic' velocities and supergravitational accelerations of separate moving masses of the flare plasma. (5) The appearance of flares in areas with high grad H, exceeding 0.1 G km -1 which is equivalent to regions of electric currents > approximately 10 11 A. (6) Strong variations of net magnetic flux through the active region, as it follows from Meudon, Crimean, and Sacramento Peak (Rust's) observations. (Auth.)

  2. Tibialis Posterior Tenosynovitis: A Unique Musculoskeletal Manifestation of Gout.

    Science.gov (United States)

    Shupper, Peter; Stitik, Todd P

    2018-02-01

    Extra-articular manifestations of gout can present in several ways, including tenosynovitis. We present a rare case of acute tibialis posterior gouty tenosynovitis. An 82-year-old man with a history of well-controlled gout presented with acute onset of left ankle pain, occurring without inciting event. The medial ankle was slightly erythematous with moderate dorsal-medial swelling and mild dorsal-lateral swelling, with severe tenderness to palpation over the medial retro-malleolar region. Range of motion and manual muscle testing were pain limited throughout. Ultrasound examination revealed a left posterior tibialis tendon sheath tenosynovitis with effusion and overlying soft tissue edema. Tendon sheath aspirate revealed sodium urate crystals and a white blood cell count of 6400/μL. Tendon sheath injection with a mixture of 1% lidocaine and dexamethasone 4 mg resulted in symptom resolution. Repeat ultrasound examination demonstrated no evidence of tibialis posterior tendon sheath effusion. This case is unique not only because acute gouty posterior tibialis tenosynovitis is very rare, particularly in a normouricemic individual, but also because the sonographic evidence of gouty infiltration into the posterior tibialis tendon and overlying subcutaneous tissue considerably aided in arriving at the correct diagnosis in a timely manner.

  3. Parameterization of solar flare dose

    International Nuclear Information System (INIS)

    Lamarche, A.H.; Poston, J.W.

    1996-01-01

    A critical aspect of missions to the moon or Mars will be the safety and health of the crew. Radiation in space is a hazard for astronauts, especially high-energy radiation following certain types of solar flares. A solar flare event can be very dangerous if astronauts are not adequately shielded because flares can deliver a very high dose in a short period of time. The goal of this research was to parameterize solar flare dose as a function of time to see if it was possible to predict solar flare occurrence, thus providing a warning time. This would allow astronauts to take corrective action and avoid receiving a dose greater than the recommended limit set by the National Council on Radiation Protection and Measurements (NCRP)

  4. Septic arthritis in gout patients: a population-based cohort study.

    Science.gov (United States)

    Lim, Sian Yik; Lu, Na; Choi, Hyon K

    2015-11-01

    To evaluate the association of incident gout with the risk of incident septic arthritis in a general population context. We investigated the association of incident gout with the risk of incident septic arthritis using the Health Improvement Network, a computerized medical record database from general practices in the UK. We conducted a cohort analysis of the risk of an incident septic arthritis diagnosis among adults with incident gout compared with up to five non-gout individuals matched by age, sex, date of study entry and enrolment year. We performed Cox proportional hazard regression models to adjust for lifestyle variables, physician visits, comorbidities and medication use. We identified 72 073 incident gout patients and 358 342 matched non-gout patients. The incidence rates of a septic arthritis diagnosis were 0.24 cases and 0.09 cases per 1000 person-years in the gout and comparison cohorts, respectively. Matched univariate and multivariate hazard ratios of a septic arthritis diagnosis were 2.82 (95% CI 2.15, 3.71) and 2.60 (95% CI 1.93, 3.51), respectively. The association persisted among subgroups stratified by sex, age group (septic arthritis. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Fructose malabsorption in people with and without gout: A case-control study.

    Science.gov (United States)

    Batt, Caitlin; Fanning, Niamh; Drake, Jill; Frampton, Christopher; Gearry, Richard B; Stamp, Lisa K

    2017-10-01

    Higher fructose intake has been associated with hyperuricaemia and gout. Some individuals malabsorb fructose in the small intestine. The aims of this study were to determine the rate of fructose malabsorption and the effects of gout and fructose malabsorption on serum urate in people with and without gout. A total of 100 people with gout (cases) were age and gender matched with one control without gout. After a low fructose diet, fructose malabsorption was measured using a hydrogen and methane breath test with a 35g fructose load. In a subgroup of 35 cases and 35 controls, serum urate response to the fructose load over 240 minutes was measured. There was no significant difference in the rate of fructose malabsorption between cases and controls (48% vs. 52%; p = 0.67). Cases had a significantly lower mean (SEM) serum urate cumulative incremental concentration from baseline-240 minutes (iAUC 0-240 ) compared to controls 0.97 (0.56) vs. 4.78 (0.55); p fructose malabsorption are similar in people with and without gout. Allopurinol inhibits the increase in serum urate induced by a fructose load suggesting that people with gout receiving allopurinol may not need to restrict dietary intake of fructose. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Relation of temperature and humidity to the risk of recurrent gout attacks.

    Science.gov (United States)

    Neogi, Tuhina; Chen, Clara; Niu, Jingbo; Chaisson, Christine; Hunter, David J; Choi, Hyon; Zhang, Yuqing

    2014-08-15

    Gout attack risk may be affected by weather (e.g., because of volume depletion). We therefore examined the association of temperature and humidity with the risk of recurrent gout attacks by conducting an internet-based case-crossover study in the United States (in 2003-2010) among subjects with a diagnosis of gout who had 1 or more attacks during 1 year of follow-up. We examined the association of temperature and humidity over the prior 48 hours with the risk of gout attacks using a time-stratified approach and conditional logistic regression. Among 632 subjects with gout, there was a significant dose-response relationship between mean temperature in the prior 48 hours and the risk of subsequent gout attack (P = 0.01 for linear trend). Higher temperatures were associated with approximately 40% higher risk of gout attack compared with moderate temperatures. There was a reverse J-shaped relationship between mean relative humidity and the risk of gout attacks (P = 0.03 for quadratic trend). The combination of high temperature and low humidity had the greatest association (odds ratio = 2.04, 95% confidence interval: 1.26, 3.30) compared with moderate temperature and relative humidity. Thus, high ambient temperature and possibly extremes of humidity were associated with an increased risk of gout attack, despite the likelihood that individuals are often in climate-controlled indoor environments. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Association of hormone therapy and incident gout: population-based case-control study.

    Science.gov (United States)

    Bruderer, Saskia G; Bodmer, Michael; Jick, Susan S; Meier, Christoph R

    2015-12-01

    This study aims to assess the odds of developing incident gout in association with the use of postmenopausal estrogen-progestogen therapy, according to type, timing, duration, and route of administration of estrogen-progestogen therapy. We conducted a retrospective population-based case-control analysis using the United Kingdom-based Clinical Practice Research Datalink. We identified women (aged 45 y or older) who had a first-time diagnosis of gout recorded between 1990 and 2010. We matched one female control with each case on age, general practice, calendar time, and years of active history in the database. We used multivariate conditional logistic regression to calculate odds ratios (ORs) with 95% CIs (adjusted for confounders). The adjusted OR for gout with current use of oral formulations of opposed estrogens (estrogen-progestogen) was 0.69 (95% CI, 0.56-0.86) compared with never use. Current use was associated with a decreased OR for gout in women without renal failure (adjusted OR, 0.71; 95% CI, 0.57-0.87) and hypertension (adjusted OR, 0.62; 95% CI, 0.44-0.87) compared with never use. Tibolone was associated with a decreased OR for gout (adjusted OR, 0.77; 95% CI, 0.63-0.95) compared with never use. Estrogens alone did not alter the OR for gout. Current use of oral opposed estrogens, but not unopposed estrogens, is associated with a decreased OR for incident gout in women without renal failure and is more pronounced in women with hypertension. Use of tibolone is associated with a decreased OR for incident gout. The decreased OR for gout may be related to the progestogen component rather than the estrogen component.

  8. Maori experiences and perceptions of gout and its treatment: a kaupapa Maori qualitative study

    Directory of Open Access Journals (Sweden)

    Te Karu L

    2013-09-01

    Full Text Available INTRODUCTION: The prevalence of gout among Maori is one of the highest in the world. This study explores the perceptions, understanding and treatment of gout among Maori. METHODS: A qualitative general inductive approach was used, guided by kaupapa Maori principles. Participants included 12 Maori aged 48-79 years with gout. Semi-structured interviews were undertaken, taped and transcribed. Themes were identified from transcripts. FINDINGS: Participants described overwhelming sufferance due to gout, which was sometimes considered inevitable. All participants believed or had been informed that gout is caused by food and/or drink. This led to feelings of self-blame and blame from partners and employers. Whanau (family were a resource for information and a support when independence was limited. Rongoa (traditional medicine played a role in the lives of rural but not urban participants. Many reported stoicism, putting up with pain and putting others before themselves, as the 'Maori way'. Medicines used for gout management were predominantly non-steroidal anti-inflammatory drugs, colchicine and prednisone, with allopurinol only playing a role late in the disease. Medications were often poorly understood and consequently improperly used. Relationships with health professionals were important, but cultural, financial and time barriers impaired access and understanding. Gout had a huge, negative impact on the lives of participants. CONCLUSION: The quality of lives of many people with gout could be improved by better understanding through educational campaigns for health professionals and the community. Culturally sensitive health care systems and a paradigm shift in gout management and early preventive treatment are needed.

  9. Arterial hypertension and gout: the current state of the problem (literature review

    Directory of Open Access Journals (Sweden)

    Kuzmina A.P.

    2017-12-01

    Full Text Available An important aspect of the family doctor's work is the management of patients with comorbid pathology. Pathogenetic mechanisms of interrelation, as well as the bi-directionality of the association of arterial hypertension and gout are actively studied. By data analysis of literature, in many developed countries of the world there are shortcomings in the management of patients with gout at the primary stage. There is a need to improve the quality of management and prescription of combinations of basic therapy drugs for the treatment of patients with hypertension in combination with gout at the primary stage.

  10. The sun and solar flares

    International Nuclear Information System (INIS)

    McKenna-Lawlor, S.

    1982-01-01

    The subject is discussed under the headings: the sun's core (thermonuclear reactions, energy transfer from core through radiation zone, convection zone, photosphere, chromosphere and corona); the photosphere (convection, granulation, sunspots, magnetic fields, solar cycle, rotation of the sun); solar variability and paleoclimatic records (correlation of low solar activity with increased 14 C production in atmosphere); the chromosphere and corona (turbulence, temperature, coronal streamers, energy transfer); solar flares (cosmic rays, aurorae, spectra, velocity of flares, prominences, mechanisms of flares); the solar wind. (U.K.)

  11. Building Big Flares: Constraining Generating Processes of Solar Flare Distributions

    Science.gov (United States)

    Wyse Jackson, T.; Kashyap, V.; McKillop, S.

    2015-12-01

    We address mechanisms which seek to explain the observed solar flare distribution, dN/dE ~ E1.8. We have compiled a comprehensive database, from GOES, NOAA, XRT, and AIA data, of solar flares and their characteristics, covering the year 2013. These datasets allow us to probe how stored magnetic energy is released over the course of an active region's evolution. We fit power-laws to flare distributions over various attribute groupings. For instance, we compare flares that occur before and after an active region reaches its maximum area, and show that the corresponding flare distributions are indistinguishable; thus, the processes that lead to magnetic reconnection are similar in both cases. A turnover in the distribution is not detectable at the energies accessible to our study, suggesting that a self-organized critical (SOC) process is a valid mechanism. However, we find changes in the distributions that suggest that the simple picture of an SOC where flares draw energy from an inexhaustible reservoir of stored magnetic energy is incomplete. Following the evolution of the flare distribution over the lifetimes of active regions, we find that the distribution flattens with time, and for larger active regions, and that a single power-law model is insufficient. This implies that flares that occur later in the lifetime of the active region tend towards higher energies. We conclude that the SOC process must have an upper bound. Increasing the scope of the study to include data from other years and more instruments will increase the robustness of these results. This work was supported by the NSF-REU Solar Physics Program at SAO, grant number AGS 1263241, NASA Contract NAS8-03060 to the Chandra X-ray Center and by NASA Hinode/XRT contract NNM07AB07C to SAO

  12. Use of simulation in flare countermeasure development

    CSIR Research Space (South Africa)

    Delport, JP

    2008-11-01

    Full Text Available ● Assume enough flare energy ● Questions addressed ● Timing ● Geometry ● Dispense logic ● Obscuration ● Physics based, spectrally correct ● Question addressed ● Flare spectrum ● Environmental influences © CSIR 2008 AOC Conference – 12 November... November 2008 Slide 12 Engagement Scenarios & Simulations ● Aircraft with flares versus missile ● Flight conditions ● Flare dispense logic ● Flare pod placement, angles ● Multitude of simulated launches ● Visualisation...

  13. Probenecid, a gout remedy, inhibits pannexin 1 channels.

    Science.gov (United States)

    Silverman, William; Locovei, Silviu; Dahl, Gerhard

    2008-09-01

    Probenecid is a well-established drug for the treatment of gout and is thought to act on an organic anion transporter, thereby affecting uric acid excretion in the kidney by blocking urate reuptake. Probenecid also has been shown to affect ATP release, leading to the suggestion that ATP release involves an organic anion transporter. Other pharmacological evidence and the observation of dye uptake, however, suggest that the nonvesicular release of ATP is mediated by large membrane channels, with pannexin 1 being a prominent candidate. In the present study we show that probenecid inhibited currents mediated by pannexin 1 channels in the same concentration range as observed for inhibition of transport processes. Probenecid did not affect channels formed by connexins. Thus probenecid allows for discrimination between channels formed by connexins and pannexins.

  14. Diagnostic Arthrocentesis for Suspicion of Gout Is Safe and Well Tolerated

    NARCIS (Netherlands)

    Taylor, W.J.; Fransen, J.; Dalbeth, N.; Neogi, T.; Schumacher, H.R.; Brown, M.; Louthrenoo, W.; Vazquez-Mellado, J.; Eliseev, M.; McCarthy, G.; Stamp, L.K.; Perez-Ruiz, F.; Sivera, F.; Ea, H.K.; Gerritsen, M.; Scire, C.A.; Cavagna, L.; Lin, C.; Chou, Y.Y.; Tausche, A.K.; Rocha Castelar-Pinheiro, G. da; Janssen, M; Chen, J.H.; Slot, O.; Cimmino, M.; Uhlig, T.; Jansen, T.L.

    2016-01-01

    OBJECTIVE: To determine the frequency of adverse events of diagnostic arthrocentesis in patients with possible gout. METHODS: Consecutive patients underwent arthrocentesis and were evaluated at 6 weeks to determine adverse events. The 95% CI were obtained by bootstrapping. Results : Arthrocentesis

  15. Solar flares at submillimeter wavelengths

    Czech Academy of Sciences Publication Activity Database

    Krucker, S.; Gimenez de Castro, C.G.; Hudson, H. S.; Trottet, G.; Bastian, T.S.; Hales, A.S.; Kašparová, Jana; Klein, K. L.; Kretzschmar, M.; Luethi, T.; Mackinnon, A.; Pohjolainen, S.; White, S.M.

    2013-01-01

    Roč. 21, č. 1 (2013), 58/1-58/45 ISSN 0935-4956 Institutional support: RVO:67985815 Keywords : Sun * flares * radio observations Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 13.312, year: 2013

  16. Solar Features - Solar Flares - Patrol

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The H-alpha Flare Patrol identifies time periods each day when the sun is being continuously monitored by select ground-based solar observatories.

  17. Radiation hydrodynamics in solar flares

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, G.H.

    1985-10-18

    Solar flares are rather violent and extremely complicated phenomena, and it should be made clear at the outset that a physically complete picture describing all aspects of flares does not exist. From the wealth of data which is available, it is apparent that many different types of physical processes are involved during flares: energetic particle acceleration, rapid magnetohydrodynamic motion of complex field structures, magnetic reconnection, violent mass motion along magnetic field lines, and the heating of plasma to tens of millions of degrees, to name a few. The goal of this paper is to explore just one aspect of solar flares, namely, the interaction of hydrodynamics and radiation processes in fluid being rapidly heated along closed magnetic field lines. The models discussed are therefore necessarily restrictive, and will address only a few of the observed or observable phenomena. 46 refs., 6 figs.

  18. Tophaceous gout in an amputation stump in a patient with chronic myelogenous leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Christine B.; Mohana-Borges, Aurea; Pathria, Mini [Department of Radiology, UCSD and VAHCS, 3350 La Village Drive, La Jolla, CA 92161 (United States)

    2003-07-01

    Gout is a common rheumatologic disorder that can have an unusual clinical presentation. This case report describes the development of a gouty tophus at a site of remote traumatic forearm amputation in a patient with chronic myelogenous leukemia (CML). It further addresses the imaging characteristics of tophaceous gout as well as the differential diagnostic considerations as regards both the imaging findings and the clinical presentation. (orig.)

  19. Food Sources of Protein and Risk of Incident Gout in the Singapore Chinese Health Study.

    Science.gov (United States)

    Teng, Gim Gee; Pan, An; Yuan, Jian-Min; Koh, Woon-Puay

    2015-07-01

    Prospective studies evaluating diet in relation to the risk of gout in Asian populations are lacking. The purpose of this study was to examine the relationship between the consumption of dietary protein from each of its major sources and the risk of gout in a Chinese population. We used data from the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese adults who were 45-74 years old at recruitment during the years 1993-1998. Habitual diet information was collected via a validated semiquantitative food frequency questionnaire, and physician-diagnosed gout was self-reported during 2 followup interviews up to the year 2010. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs), with adjustment for potential confounders, among 51,114 eligible study participants who were free of gout at baseline and responded to our followup interviews. A total of 2,167 participants reported physician-diagnosed gout during the followup period. The multivariate-adjusted HRs (with 95% CIs) of gout, comparing the first quartile with the fourth quartile, were as follows: 1.27 (1.12-1.44; P for trend food, and 0.83 (0.73-0.95; P for trend = 0.012) for nonsoy legumes. No statistically significant associations were found with protein intake from other sources (red meat, eggs, dairy products, grains, or nuts and seeds). In this Chinese population living in Singapore, higher total dietary protein intake from mainly poultry and fish/shellfish was associated with an increased risk of gout, while dietary intake of soy and nonsoy legumes was associated with a reduced risk of gout. © 2015, American College of Rheumatology.

  20. Value of ultrasonography in the diagnosis of gout in patients presenting with acute arthritis.

    Science.gov (United States)

    Pattamapaspong, Nuttaya; Vuthiwong, Withawat; Kanthawang, Thanat; Louthrenoo, Worawit

    2017-06-01

    To evaluate the value of ultrasonographic features of crystal deposition for diagnosing gout in patients presenting with acute arthritis. Ultrasound scanning of the most inflamed joint was performed on 89 consecutively enrolled patients with acute arthritis. Two radiologists independently reviewed the ultrasound images, and a consensus was achieved with a third radiologist when the interpretations of four key ultrasound features of gout differed. Arthrocentesis and crystal analysis using compensated polarized light microscopy of aspirates are considered the gold standards for gout diagnosis. Fifty-three (60%) patients had gout, whereas the remaining 36 (40%) had non-gout arthritis. The mean serum uric acid level was 7.1 mg/dl in patients with gout and 4.7 mg/dl in patients with non-gout arthritis. Three US features differed significantly (p arthritis: the double contour sign (42 vs. 8%, respectively), intra-articular aggregates (58 vs. 8%), and tophi (40 vs. 0%). No statistically significant differences in detecting intra-tendinous aggregates (32 vs. 17%, p = 0.14) were observed. The sensitivity and specificity of the double contour sign were 42 and 92%, respectively; those of the intra-articular aggregates were 58 and 92%; and those of tophi were 40 and 100%. The positive predictive values for these three features ranged from 88 to 100%, whereas the negative predictive values ranged from 52 to 60%. When the prevalence is high, these three ultrasound features may be a useful adjunct in the diagnosis of acute gout, particularly when specialized microscopic techniques are not available.

  1. Identification of low-frequency variants associated with gout and serum uric acid levels

    DEFF Research Database (Denmark)

    Sulem, Patrick; Gudbjartsson, Daniel F; Walters, G Bragi

    2011-01-01

    We tested 16 million SNPs, identified through whole-genome sequencing of 457 Icelanders, for association with gout and serum uric acid levels. Genotypes were imputed into 41,675 chip-genotyped Icelanders and their relatives, for effective sample sizes of 968 individuals with gout and 15......,506 individuals for whom serum uric acid measurements were available. We identified a low-frequency missense variant (c.1580C>G) in ALDH16A1 associated with gout (OR = 3.12, P = 1.5 × 10(-16), at-risk allele frequency = 0.019) and serum uric acid levels (effect = 0.36 s.d., P = 4.5 × 10(-21)). We confirmed...... the association with gout by performing Sanger sequencing on 6,017 Icelanders. The association with gout was stronger in males relative to females. We also found a second variant on chromosome 1 associated with gout (OR = 1.92, P = 0.046, at-risk allele frequency = 0.986) and serum uric acid levels (effect = 0...

  2. Electroacupuncture Alleviates Pain Responses and Inflammation in a Rat Model of Acute Gout Arthritis

    Directory of Open Access Journals (Sweden)

    Wenxin Chai

    2018-01-01

    Full Text Available Acute gout arthritis is one of the most painful inflammatory conditions. Treatments for gout pain are limited to colchicine, nonsteroidal anti-inflammatory drugs, and corticosteroids, which oftentimes result in severe adverse effects. Electroacupuncture (EA has been proved to be effective in relieving many inflammatory pain conditions with few side effects. Here, we aim to investigate the therapeutic potentials of EA on pain and inflammation of a rat model of acute gout arthritis and underlying mechanisms. We found that 2/100 Hz EA produced the most robust analgesic effect on mechanical hyperalgesia of acute gout arthritis rat model compared with 2 and 100 Hz. EA produced similar analgesic effect compared with indomethacin. 2/100 Hz EA also significantly alleviates the ongoing pain behavior, thermal hyperalgesia, and ankle edema. Locally applied μ and κ-opioid receptor antagonists but not adenosine A1 receptor antagonist significantly abolished the analgesic effect of EA. Locally applied μ and κ-opioid receptor agonists produced significant antiallodynia on acute gout arthritis rats, mimicking EA. Furthermore, 2/100 Hz EA upregulated β-endorphin expression in inflamed ankle skin tissue. Our results demonstrated, for the first time, that EA can be used for relieving acute gout arthritis with effect dependent on peripheral opioid system and comparable with the one obtained with indomethacin.

  3. On the history of gout: paleopathological evidence from the Medici family of Florence.

    Science.gov (United States)

    Giuffra, Valentina; Minozzi, Simona; Vitiello, Angelica; Fornaciari, Antonio

    2017-01-01

    Throughout history, gout has been referred to as the "disease of the kings", and has been clearly associated with the lifestyle of the aristocratic social classes. According to the written sources, several members of the famous Medici family of Florence suffered from an arthritic disease that contemporary physicians called "gout". A paleopathological study carried out on the skeletal remains of some members of the family, exhumed from their tombs in the Church of San Lorenzo in Florence, offered a unique opportunity to directly investigate the evidence of the arthritic diseases affecting this elite group. The skeletal remains of several members of the family were examined macroscopically and submitted to x-ray investigation. The results of the study allowed us to ascertain that the so-called "gout of the Medici" should be considered the clinical manifestation of three different joint conditions: diffuse idiopathic skeletal hyperostosis, rheumatoid arthritis and uratic gout. In particular, uric acid gout was diagnosed in the Grand Duke Ferdinand I (1549-1609). Recently, a new case of this disease was diagnosed in Anton Francesco Maria (1618-1659), a probable illegitimate member of the family. With this new case, uratic gout was observed in 2 out of 9 adult males, leading to suppose that the disease should have been a common health problem within the family. The aetiology of the disease has to be searched in environmental factors, since both historical and paleonutritional studies demonstrated that the diet of this aristocratic court was rich in meat and wine.

  4. Analysis of patents on anti-gout therapies issued in China.

    Science.gov (United States)

    Yuan, Hong-Yu; Zhang, Xue-Hui; Zhang, Xiao-Lan; Wei, Ji-Fu; Meng, Ling

    2014-05-01

    The incidence of gout and hyperuricemia has been increasing. The demand for new anti-gout therapies today presents exciting opportunities to organizations and individuals offering such products. This review analyzes the patents of anti-gout products to help pharmaceutical companies and individuals in the patenting of potential candidate drugs for gout treatment in China. In this review, 786 patents were found, among which, 215 are in the protection period. The latter group of patents includes 183 patents for traditional Chinese medicines (TCM, 85%), 30 for synthetic compounds (14%) and 2 for combinations of synthetic compounds and TCM (CST). Among the TCM patents, 84% contain various dosage formulae for different Chinese medicines, 13% are herbal extracts and only 7 patents are from herbal extract derivatives. Synthetic compound patents mainly target xanthine oxidase, urate transporter 1 and uric acid oxidase. Searching for new targets and drugs acting on multiple targets should provide a new stimulus in the field of synthetic compound patents. CST has the smallest proportion of Chinese anti-gout patents, although it is still in the test stage and has not been widely accepted, but has provided a new direction for the field of anti-gout patents.

  5. Upstream petroleum industry flaring guide : review draft

    International Nuclear Information System (INIS)

    1999-03-01

    The Alberta requirements and expectations for upstream petroleum flaring are presented. Flaring is associated with a wide range of energy activities including oil and gas well drilling and well completion operations. The guide incorporates the recommendations made to the Alberta Energy and Utilities Board (EUB) in June 1998 by the multi-stakeholder Clean Air Strategic Alliance (CASA) on associated or solution gas flaring. Additional requirements which address flaring issues not covered in the CASA report are also included in this guide. The Guide requires a 15 per cent reduction in solution gas flare volume by the end of year 2000 from the 1996 baseline, and a 25 per cent reduction by the end of 2001. The Guide prescribes new flare performance requirements for all flares, within three years for existing solution gas flares, five years for flares at other existing permanent facilities. It sets personal consultation and public notification requirements for new and existing solution gas batteries, and new sulphur recovery requirements for facilities not covered by existing EUB regulations. The Guide also addresses the question of conflict resolution to deal with flaring concerns, the release of flaring and venting data, the proposed reduction of flare limits, progress towards minimizing requirements for electricity generators using otherwise flared gas, annual reporting to the EUB, and management framework review in 2001

  6. IMPULSIVITY PARAMETER FOR SOLAR FLARES

    Energy Technology Data Exchange (ETDEWEB)

    Fajardo-Mendieta, W. G.; Alvarado-Gómez, J. D.; Calvo-Mozo, B. [Observatorio Astronómico Nacional, Universidad Nacional de Colombia, Bogotá (Colombia); Martinez-Oliveros, J. C., E-mail: wgfajardom@unal.edu.co, E-mail: bcalvom@unal.edu.co, E-mail: oliveros@ssl.berkeley.edu, E-mail: jalvarad@eso.org [Space Sciences Laboratory, UC Berkeley, Berkeley, CA 94720 (United States)

    2016-02-10

    Three phases are typically observed during solar flares: the preflare, impulsive, and decay phases. During the impulsive phase, it is believed that the electrons and other particles are accelerated after the stored energy in the magnetic field is released by reconnection. The impulsivity of a solar flare is a quantifiable property that shows how quickly this initial energy release occurs. It is measured via the impulsivity parameter, which we define as the inverse of the overall duration of the impulsive phase. We take the latter as the raw width of the most prominent nonthermal emission of the flare. We computed this observable over a work sample of 48 M-class events that occurred during the current Solar Cycle 24 by using three different methods. The first method takes into account all of the nonthermal flare emission and gives very accurate results, while the other two just cover fixed energy intervals (30–40 keV and 25–50 keV) and are useful for fast calculations. We propose an alternative way to classify solar flares according to their impulsivity parameter values, defining three different types of impulsivity, namely, high, medium, and low. This system of classification is independent of the manner used to calculated the impulsivity parameter. Lastly, we show the relevance of this tool as a discriminator of different HXR generation processes.

  7. Patients with gout differ from healthy subjects in renal response to changes in serum uric acid.

    Science.gov (United States)

    Liu, Sha; Perez-Ruiz, Fernando; Miner, Jeffrey N

    2017-03-01

    Our objectives were to determine whether a change in serum uric acid (sUA) resulted in a corresponding change in the fractional excretion of uric acid (FEUA) and whether the renal response was different in patients with gout versus healthy subjects. FEUA was calculated from previously published studies and four new phase I studies in healthy subjects and/or patients with gout before and after treatment to lower or raise sUA. Treatments included xanthine oxidase inhibitors to lower sUA as well as infusion of uric acid and provision of a high-purine diet to raise sUA. Plots were created of FEUA versus sUA before and after treatment. For the phase I studies, percent change in FEUA per mg/dL change in sUA was calculated separately for healthy subjects and patients with gout, and compared using Student's t test. Analysis of previously published data and the new phase I clinical data indicates that changing sUA by a non-renal mechanism leads to a change in FEUA. The magnitude of change is greater in subjects with higher baseline FEUA versus patients with gout. Healthy subjects excrete more urate than do patients with gout at physiological urate-filtered load; this difference disappears when the urate-filtered load is decreased to ∼5000mg/24hours. These observations are consistent with a less saturated urate reabsorption system in patients with gout versus healthy subjects, resulting in elevated retention of uric acid. Further investigation could lead to the discovery of mechanisms responsible for the etiology of hyperuricemia/gout. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  8. Relevant aspects of imaging in the diagnosis and management of gout.

    Science.gov (United States)

    De Avila Fernandes, Eloy; Bergamaschi, Samuel Brighenti; Rodrigues, Tatiane Cantarelli; Dias, Gustavo Coelho; Malmann, Ralff; Ramos, Germano Martins; Monteiro, Soraya Silveira

    Gout is an inflammatory arthritis characterized by the deposition of monosodium urate crystals in the synovial membrane, articular cartilage and periarticular tissues leading to inflammation. Men are more commonly affected, mainly after the 5th decade of life. Its incidence has been growing with the population aging. In the majority of the cases, the diagnosis is made by clinical criteria and synovial fluid analysis, in search for monosodium urate crystals. Nonetheless, gout may sometimes have atypical presentations, complicating the diagnosis. In these situations, imaging methods have a fundamental role, aiding in the diagnostic confirmation or excluding other possible differential diagnosis. Conventional radiographs are still the most commonly used method in gout patients' evaluation; nevertheless, this is not a sensitive method, since it detect only late alterations. In the last years, there have been several advances in imaging methods for gout patients. Ultrasound has shown a great accuracy in the diagnosis of gout, identifying monosodium urate deposits in the synovial membrane and articular cartilage, in detecting and characterizing tophi and in identifying tophaceous tendinopathy and enthesopathy. Ultrasound has also been able to show crystal deposition in patients with articular pain in the absence of a classical gout crisis. Computed tomography is an excellent method for detecting bone erosions, being useful in spine involvement. Dual-energy CT is a new method able to provide information about the chemical composition of tissues, with high accuracy in the identification of monosodium urate deposits, even in the early stages of the disease and in cases of difficult characterization. Magnetic resonance imaging is useful in the evaluation of deep tissues not accessible by ultrasound. Besides the diagnosis, with the emergence of new drugs that aim to reduce tophaceous burden, imaging methods have become useful tools in monitoring the treatment of patients with

  9. Relevant aspects of imaging in the diagnosis and management of gout

    Directory of Open Access Journals (Sweden)

    Eloy De Avila Fernandes

    Full Text Available ABSTRACT Gout is an inflammatory arthritis characterized by the deposition of monosodium urate crystals in the synovial membrane, articular cartilage and periarticular tissues leading to inflammation. Men are more commonly affected, mainly after the 5th decade of life. Its incidence has been growing with the population aging.In the majority of the cases, the diagnosis is made by clinical criteria and synovial fluid analysis, in search for monosodium urate crystals. Nonetheless, gout may sometimes have atypical presentations, complicating the diagnosis. In these situations, imaging methods have a fundamental role, aiding in the diagnostic confirmation or excluding other possible differential diagnosis. Conventional radiographs are still the most commonly used method in gout patients’ evaluation; nevertheless, this is not a sensitive method, since it detect only late alterations. In the last years, there have been several advances in imaging methods for gout patients. Ultrasound has shown a great accuracy in the diagnosis of gout, identifying monosodium urate deposits in the synovial membrane and articular cartilage, in detecting and characterizing tophi and in identifying tophaceous tendinopathy and enthesopathy. Ultrasound has also been able to show crystal deposition in patients with articular pain in the absence of a classical gout crisis. Computed tomography is an excellent method for detecting bone erosions, being useful in spine involvement. Dual-energy CT is a new method able to provide information about the chemical composition of tissues, with high accuracy in the identification of monosodium urate deposits, even in the early stages of the disease and in cases of difficult characterization. Magnetic resonance imaging is useful in the evaluation of deep tissues not accessible by ultrasound. Besides the diagnosis, with the emergence of new drugs that aim to reduce tophaceous burden, imaging methods have become useful tools in monitoring

  10. Magnetohydrodynamic Simulation of a Solar Flare

    OpenAIRE

    横山, 央明; Takaaki, YOKOYAMA; 国立天文台; National Astronomical Observatory of Japan

    2002-01-01

    A solar flare is an explosive release of the magnetic energy in the solar upper atmosphere, the corona. The magnetic reconnection model of a solar flare and the results of magnetohydrohynamic simulations are shown.

  11. Solar Flares and Precise Satellite Timekeeping

    National Research Council Canada - National Science Library

    Camparo, J. C; Moss, S. C

    2002-01-01

    On 14 July 2000 and 9 November 2000 two large solar flares occurred. As measured by the GOES-8 and GOES-10 satellites, these flares were accompanied by an increase in the flux of energetic particles at geosynchronous altitudes...

  12. Case report 445: Bilateral acromioclavicular gouty arthritis with pseudo-tumor of the outer end of the right clavicle: Saturnine gout

    Energy Technology Data Exchange (ETDEWEB)

    Podgorski, M.R.; Ibels, L.S.; Webb, J.

    1987-10-01

    An example of extensive, bilateral, distal clavicular erosion due to tophaceous saturnine gout is discussed, including the differential diagnosis of such lesions. The importance of unrecognized chronic lead nephropathy apparently causing primary gout is emphasized.

  13. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study.

    Science.gov (United States)

    Rai, Sharan K; Fung, Teresa T; Lu, Na; Keller, Sarah F; Curhan, Gary C; Choi, Hyon K

    2017-05-09

    Objective  To prospectively examine the relation between the Dietary Approaches to Stop Hypertension (DASH) and Western diets and risk of gout (ie, the clinical endpoint of hyperuricemia) in men. Design  Prospective cohort study. Setting  The Health Professionals Follow-up Study. Participants  44 444 men with no history of gout at baseline. Using validated food frequency questionnaires, each participant was assigned a DASH dietary pattern score (based on high intake of fruits, vegetables, nuts and legumes, low fat dairy products, and whole grains, and low intake of sodium, sweetened beverages, and red and processed meats) and a Western dietary pattern score (based on high intake of red and processed meats, French fries, refined grains, sweets, and desserts). Main outcome measure  Risk of incident gout meeting the preliminary American College of Rheumatology survey criteria for gout, adjusting for potential confounders, including age, body mass index, hypertension, diuretic use, and alcohol intake. Results  During 26 years of follow-up, 1731 confirmed cases of incident gout were documented. A higher DASH dietary pattern score was associated with a lower risk for gout (adjusted relative risk for extreme fifths 0.68, 95% confidence interval 0.57 to 0.80, P value for trend dietary pattern score was associated with an increased risk for gout (1.42, 1.16 to 1.74, P=0.005). Conclusion  The DASH diet is associated with a lower risk of gout, suggesting that its effect of lowering uric acid levels in individuals with hyperuricemia translates to a lower risk of gout. Conversely, the Western diet is associated with a higher risk of gout. The DASH diet may provide an attractive preventive dietary approach for men at risk of gout. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Up-titration of allopurinol in patients with gout.

    Science.gov (United States)

    Jennings, Claudine G; Mackenzie, Isla S; Flynn, Rob; Ford, Ian; Nuki, George; De Caterina, Raffaele; Riches, Philip L; Ralston, Stuart H; MacDonald, Thomas M

    2014-08-01

    European League against Rheumatism (EULAR) gout management guidelines recommend achieving a target urate level titration in achieving the EULAR target levels. The Febuxostat versus Allopurinol Streamlined Trial (FAST) is an ongoing multi-centre study comparing the cardiovascular safety of febuxostat and allopurinol (target recruitment: 5706 patients). Recruited patients were already taking allopurinol and the protocol required up-titration of daily allopurinol dose, in 100 mg increments, to achieve the EULAR urate target level prior to randomisation. We reviewed pre-randomisation data from the first 400 recruited and subsequently randomised FAST patients. Of 400 patients, 144 (36%) had urate levels ≥357 µmol/L at screening and required allopurinol up-titration. Higher urate levels were significantly associated with lower allopurinol dose, male sex, increased BMI, increased alcohol intake and diuretic use. Mean fall in urate levels after a single 100-mg dose increase was 71 µmol/L. The number of up-titrations required ranged from one to five (median = 1) with 65% of patients controlled after one 100-mg up-titration. Overall, 97% of up-titrated patients achieved target urate levels with median final allopurinol dose of 300 mg daily. Side effects and complications of up-titration were minimal. Overall, 36% of FAST patients were not at target urate levels and required up-titration. Allopurinol up-titration was effective in achieving urate target levels and was generally well tolerated by patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Instant CloudFlare starter

    CERN Document Server

    Dickey, Jeff

    2013-01-01

    Get to grips with a new technology, understand what it is and what it can do for you, and then get to work with the most important features and tasks. Written as a practical guide, CloudFlare Starter will show you all you need to know in order to effectively improve your online presence in a multitude of different ways. ""Instant CloudFlare Starter"" is a practical yet accessible guide for website owners looking to optimize their site for optimum security and maximum performance.

  16. Difficulties and Mistakes in the Management of the Patient with Gout

    Directory of Open Access Journals (Sweden)

    S.A. Trypilka

    2016-10-01

    Full Text Available The issues of the most frequent mistakes and difficulties in the early gout diagnosis and further patient management are discussed in the article. It is known that the diagnosis of gout is made in the first year of the disease only in 1/4 ca­ses, on the average 7–8 years pass until the disease is revealed. Only in one out of 4–5 cases gout is correctly verified in early stages. The reasons of the late diagnostics are the features of the course of gout with periods of absence of a symptom (intermittent gout, diagnostic errors at the first patient encounter, early conduction of X-ray examination without revealing the typical signs of the disease, the lack of joint puncture and verification of uric acid crystals in the synovial fluid. Ano­ther cause of diagnostic errors is the determination of the level of uric acid in the blood serum during acute attack. Late diagnosis of gout leads to a series of further diagnostic and tactical mistakes. First of all, this includes the prescription of non-steroidal anti-inflammatory drugs and glucocorticoids without the correct diagnosis. Current recommendations for the management of patients with gout emphasize that the use of glucocorticoids to treat gout is possible only for short cour­ses, their long-term use is not allowed due to the high risk of side effects in this group of patients, who often have comorbidities. Another tactical error is the prescription of urate-lowering drugs in the period of acute arthritis without dose titration and without prescription of anti-inflammatory therapy. The paper presents a clinical case of the late diagnosis of gout involving inefficient treatment with the long-term use of glucocorticoids and absence of administration of urate-lowering drugs resulting in serious side effects — development of diabetes mellitus and hypertension. A detailed analysis of the clinical errors is conducted; recommendations on the rational tactics in this case are presented.

  17. Handling an Asthma Flare-Up

    Science.gov (United States)

    ... Educators Search English Español Handling an Asthma Flare-Up KidsHealth / For Kids / Handling an Asthma Flare-Up ... controlar las crisis asmáticas What's an Asthma Flare-Up? If you have asthma , you probably know about ...

  18. X-ray Studies of Flaring Plasma

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... Sun; flares; X-rays; spectroscopic plasma diagnostic. Abstract. We present some methods of X-ray data analysis employed in our laboratory for deducing the physical parameters of flaring plasma. For example, we have used a flare well observed with Polish instrument RESIK aboard Russian CORONAS-F ...

  19. Comorbidity of gout and rheumatoid arthritis in a large population database.

    Science.gov (United States)

    Merdler-Rabinowicz, Rona; Tiosano, Shmuel; Comaneshter, Doron; Cohen, Arnon D; Amital, Howard

    2017-03-01

    Coexistence of rheumatoid arthritis and gout is considered to be unusual. The current study was designed as a population-based cross-sectional study, utilizing the medical database of Clalit Health Services, the largest healthcare provider organization in Israel. Data of adult patients who were previously diagnosed with rheumatoid arthritis was retrieved. For each patient, five age- and sex-matched control patients were randomly selected. Different parameters including BMI, socioeconomic status, and existence of gout as well as smoking and hypertension were examined for both groups. The study included 11,540 patients with rheumatoid arthritis and 56,763 controls. The proportion of gout in the study group was high compared to controls (1.61 vs. 0.92%, P rheumatoid arthritis was associated with gout (OR = 1.72, 95% CI 1.45-2.05, P = 0.00). The proportion of gout in rheumatoid arthritis patients is not lower than in the general population.

  20. Multiple genetic loci influence serum urate levels and their relationship with gout and cardiovascular disease risk factors

    NARCIS (Netherlands)

    Q. Yang (Qiong Fang); A. Köttgen (Anna); A. Dehghan (Abbas); A.V. Smith (Albert Vernon); N.L. Glazer (Nicole); M-H. Chen (Ming-Huei); D.I. Chasman (Daniel); T. Aspelund (Thor); G. Eiriksdottir (Gudny); T.B. Harris (Tamara); L.J. Launer (Lenore); M.A. Nalls (Michael); D.G. Hernandez (Dena); D.E. Arking (Dan); E.A. Boerwinkle (Eric); M.L. Grove (Megan); M. Li (Man); W.H. Linda Kao; M. Chonchol (Michel); T. Haritunians (Talin); T. Lumley (Thomas); B.M. Psaty (Bruce); M.G. Shlipak (Michael); S.J. Hwang; M.G. Larson (Martin); C.J. O'Donnell (Christopher); A. Upadhyay (Ashish); P. Tikka-Kleemola (Päivi); A. Hofman (Albert); F. Rivadeneira Ramirez (Fernando); B.H.Ch. Stricker (Bruno); A.G. Uitterlinden (André); G. Paré (Guillaume); A.N. Parker (Alex); P.M. Ridker (Paul); D.S. Siscovick (David); V. Gudnason (Vilmundur); J.C.M. Witteman (Jacqueline); C.S. Fox (Caroline); J. Coresh (Josef)

    2010-01-01

    textabstractBackground - Elevated serum urate levels can lead to gout and are associated with cardiovascular risk factors. We performed a genome-wide association study to search for genetic susceptibility loci for serum urate and gout and investigated the causal nature of the associations of serum

  1. Magnetic Reconnection in Solar Flares

    Science.gov (United States)

    Forbes, Terry G.

    2016-05-01

    Reconnection has at least three possible roles in solar flares: First, it may contribute to the build-up of magnetic energy in the solar corona prior to flare onset; second, it may directly trigger the onset of the flare; and third, it may allow the release of magnetic energy by relaxing the magnetic field configuration to a lower energy state. Although observational support for the first two roles is somewhat limited, there is now ample support for the third. Within the last few years EUV and X-ray instruments have directly observed the kind of plasma flows and heating indicative of reconnection. Continued improvements in instrumentation will greatly help to determine the detailed physics of the reconnection process in the solar atmosphere. Careful measurement of the reconnection outflows will be especially helpful in this regard. Current observations suggest that in some flares the jet outflows are accelerated within a short diffusion region that is more characteristic of Petschek-type reconnection than Sweet-Parker reconnection. Recent resistive MHD theoretical and numerical analyses predict that the length of the diffusion region should be just within the resolution range of current X-ray and EUV telescopes if the resistivity is uniform. On the other hand, if the resistivity is not uniform, the length of the diffusion region could be too short for the outflow acceleration region to be observable.

  2. Return current instability in flares.

    Science.gov (United States)

    Cromwell, D.; McQuillan, P.; Brown, J. C.

    The authors consider the problem of ion-acoustic wave generation, and resultant anomalous Joule heating, by a return current driven unstable by a small-area thick-target electron beam in solar flares. They find that, contrary to the usual assumption, the hard X-ray bremsstrahlung emission may actually be enhanced in comparison to conventional thick-target models.

  3. Thermal Fronts in Solar Flares

    Czech Academy of Sciences Publication Activity Database

    Karlický, Marian

    2015-01-01

    Roč. 814, č. 2 (2015), 153/1-153/7 ISSN 0004-637X R&D Projects: GA ČR GAP209/12/0103 Institutional support: RVO:67985815 Keywords : plasmas * Sun flares * radio radiation Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 5.909, year: 2015

  4. The Crab Nebula flaring activity

    Directory of Open Access Journals (Sweden)

    G. Montani

    2014-12-01

    Full Text Available The discovery made by AGILE and Fermi of a short time scale flaring activity in the gamma-ray energy emission of the Crab Nebula is a puzzling and unexpected feature, challenging particle acceleration theory. In the present work we propose the shock-induced magnetic reconnection as a viable mechanism to explain the Crab flares. We postulate that the emitting region is located at ∼1015 cm from the central pulsar, well inside the termination shock, which is exactly the emitting region size as estimated by the overall duration of the phenomenon ∼1 day. We find that this location corresponds to the radial distance at which the shock-induced magnetic reconnection process is able to accelerate the electrons up to a Lorentz factor ∼109, as required by the spectral fit of the observed Crab flare spectrum. The main merit of the present analysis is to highlight the relation between the observational constraints to the flare emission and the radius at which the reconnection can trigger the required Lorentz factor. We also discuss different scenarios that can induce the reconnection. We conclude that the existence of a plasma instability affecting the wind itself as the Weibel instability is the privileged scenario in our framework.

  5. Gout in Duke Federico of Montefeltro (1422-1482): a new pearl of the Italian Renaissance.

    Science.gov (United States)

    Fornaciari, Antonio; Giuffra, Valentina; Armocida, Emanuele; Caramella, Davide; Rühli, Frank J; Galassi, Francesco Maria

    2018-01-01

    The article examines the truthfulness of historical accounts claiming that Renaissance Duke Federico of Montefeltro (1422-1482) suffered from gout. By direct paleopathological assessment of the skeletal remains and by the philological investigation of historical and documental sources, primarily a 1461 handwritten letter by the Duke himself to his personal physician, a description of the symptoms and Renaissance therapy is offered and a final diagnosis of gout is formulated. The Duke's handwritten letter offers a rare testimony of ancient clinical self-diagnostics and Renaissance living-experience of gout. Moreover, the article also shows how an alliance between historical, documental and paleopathological methods can greatly increase the precision of retrospective diagnoses, thus helping to shed clearer light onto the antiquity and evolution of diseases.

  6. Tophaceous Gout in the Lumbar Spinal Canal Mimicking Epidural Spinal Tumor.

    Science.gov (United States)

    Kim, Taeshin; Kim, Bum-Joon; Kim, Se-Hoon; Lee, Seung-Hwan

    2017-06-01

    Gout is an inflammatory arthritis characterized by deposition of monosodium urate crystals in joints. Though gout frequently involves the big toe or other extremities, it rarely occurs in the spinal canal. A 35-year-old man presented with left L5 radiculopathy. He had leg pain for 8 months and received several epidural steroid injections. Magnetic resonance imaging revealed a 1.7×1.1-cm ovoid contrast-enhancing mass, causing pressure erosion of the left L5 pedicle. Microscopic laminotomy was performed at the left L5 lamina. White chalky materials, identified at the left lateral recess of the spinal canal, were removed in a piecemeal manner. The histopathologic diagnosis was tophaceous gout. Although the patient's radiating pain did not resolve postoperatively, it was dramatically relieved with uric acid-lowering medications. If a mass effect is suspected, surgical removal of gouty tophi might aid in symptom release and definite diagnosis. Medical treatment after rheumatology consultation is crucial.

  7. Mean colors of stellar flare continuum

    International Nuclear Information System (INIS)

    Mullan, D.J.

    1976-01-01

    Shmeleva and Syrovatskii have shown that under certain circumstances the temperature structure in the hotter regions (T>2 x 10 4 K) of a solar flare is characterized by two universal functions: one for constant density conditions, the second for constant pressure conditions. Here we show that the U--B, B--V colors of optically thin thermal bremsstrahlung emitted by both of these temperature structures are consistent with the mean colors of stellar flares near maximum light and also with the observed evolution of flare light in the two-color diagram during flare cooling. We suggest that the transition which occurs in the character of stellar flare light from mostly continuum emission near flare maximum to mostly line emission later in the flare is related to the transition which must occur from the constant density regime to the constant pressure regime on a time scale of order 1--2 minutes. The two types of flares (spike flares and slow flares) identified by Moffett are ascribed to these two different regimes. The flare light-curve model described here resembles in some respects a model previously proposed by Andrews, but there are differences in detail

  8. Mapping patients' experiences from initial symptoms to gout diagnosis: a qualitative exploration.

    Science.gov (United States)

    Liddle, Jennifer; Roddy, Edward; Mallen, Christian D; Hider, Samantha L; Prinjha, Suman; Ziebland, Sue; Richardson, Jane C

    2015-09-14

    To explore patients' experiences from initial symptoms to receiving a diagnosis of gout. Data from in-depth semistructured interviews were used to construct themes to describe key features of patients' experiences of gout diagnosis. A maximum variation sample of 43 UK patients with gout (29 men; 14 women; age range 32-87 years) were recruited from general practices, rheumatology clinics, gout support groups and through online advertising. Severe joint pain, combined with no obvious signs of physical trauma or knowledge of injury, caused confusion for patients attempting to interpret their symptoms. Reasons for delayed consultation included self-diagnosis and/or self-medication, reluctance to seek medical attention, and financial/work pressures. Factors potentially contributing to delayed diagnosis after consultation included reported misdiagnosis, attacks in joints other than the first metatarsophalangeal joint, and female gender. The limitations in using serum uric acid (SUA) levels for diagnostic purposes were not always communicated effectively to patients, and led to uncertainty and lack of confidence in the accuracy of the diagnosis. Resistance to the diagnosis occurred in response to patients' beliefs about the causes of gout and characteristics of the people likely to be affected. Diagnosis prompted actions, such as changes in diet, and evidence was found of self-monitoring of SUA levels. This study is the first to report data specifically about patients' pathways to initial consultation and subsequent experiences of gout diagnosis. A more targeted approach to information provision at diagnosis would improve patients' experiences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Interaction of the GCKR and A1CF loci with alcohol consumption to influence the risk of gout.

    Science.gov (United States)

    Rasheed, Humaira; Stamp, Lisa K; Dalbeth, Nicola; Merriman, Tony R

    2017-07-05

    Some gout-associated loci interact with dietary exposures to influence outcome. The aim of this study was to systematically investigate interactions between alcohol exposure and urate-associated loci in gout. A total of 2792 New Zealand European and Polynesian (Māori or Pacific) people with or without gout were genotyped for 29 urate-associated genetic variants and tested for a departure from multiplicative interaction with alcohol exposure in the risk of gout. Publicly available data from 6892 European subjects were used to test for a departure from multiplicative interaction between specific loci and alcohol exposure for the risk of hyperuricemia (HU). Multivariate adjusted logistic and linear regression was done, including an interaction term. Interaction of any alcohol exposure with GCKR (rs780094) and A1CF (rs10821905) influenced the risk of gout in Europeans (interaction term 0.28, P = 1.5 × 10 -4 ; interaction term 0.29, P = 1.4 × 10 -4 , respectively). At A1CF, alcohol exposure suppressed the gout risk conferred by the A-positive genotype. At GCKR, alcohol exposure eliminated the genetic effect on gout. In the Polynesian sample set, there was no experiment-wide evidence for interaction with alcohol in the risk of gout (all P > 8.6 × 10 -4 ). However, at GCKR, there was nominal evidence for an interaction in a direction consistent the European observation (interaction term 0.62, P = 0.05). There was no evidence for an interaction of A1CF or GCKR with alcohol exposure in determining HU. These data support the hypothesis that alcohol influences the risk of gout via glucose and apolipoprotein metabolism. In the absence of alcohol exposure, genetic variants in the GCKR and A1CF genes have a stronger role in gout.

  10. Inhibition Effects of Teucrium Polium Extract on Gout

    Directory of Open Access Journals (Sweden)

    Elnaz Saghafi

    Full Text Available Background: Teucrium polium (lamiaceae is a natural source containing numerous antioxidant compounds and T. polium had advised for treatment of wide range of diseases including gout, inflammation and diabetes. In this Study, inhibitory effect of extracts, the most important antioxidant contents of T. polium and correlation between them had determined.Materials and Methods: Flowering branches of T. polium were collected from nine regions in north-eastern provinces of Iran and dried and powdered afterwards. The inhibitory effects of the plant extract on xanthine oxidase were assayed in vitro. Total Phenol and anthocyanin and soluble sugar content of each extract were matured. Then, their correlations with the inhibitory effects on xanthine oxidase were also determined. All these measurements were repeated three times and variance analysis was used for comparing means.Results: All extract in different habitat exhibited a good inhibition effects on xanthine oxidase activity, the concentration of 0.3 mg/ml of samples were inhibited the enzyme from 11.44 to 91.45%. The highest inhibitory effect on xanthine oxidase was found in Ramian by 91.45%. Anthocyanin content in Golestan’s samples (Tilabad was remarkably more than other samples, 4.26 mg/g DW. Razari khorasan’s samples (Garmab had the highest of total phenol and soluble sugar contents, 28.11 and 6.84 mg/g DW respectively.Conclusion: These results suggest that T. polium extract in different regions is a rich source of antioxidant and has inhibitors effect on xanthine oxidase. Golestan samples had the highest inhibitory effect on the xanthine oxidase activity and are recommended for pharmacological studies.

  11. Advances in the management of gout: Critical appraisal of febuxostat in the control of hyperuricemia

    OpenAIRE

    Pillinger, Michael

    2010-01-01

    Lada Beara-Lasic1,3, Michael H Pillinger2,3, David S Goldfarb1,31Divisions of Nephrology and 2Rheumatology, Department of Medicine, NYU Langone Medical Center, New York, NY, USA; 3Department of Medicine, New York Harbor VA Health Care System, New York, NY, USAAbstract: Gout recently passed rheumatoid arthritis to become the most common inflammatory arthritis in the United States (US). However, epidemiologic studies indicate that the quality of gout management is suboptimal owing to b...

  12. Neutrophil: Lymphocyte Ratio and Mean Platelet Volume in Patients with Gout

    Directory of Open Access Journals (Sweden)

    Ayse Balkarli

    2016-09-01

    Full Text Available Aim: Gout is a clinical syndrome with increased uric acid concentration, which is caused by inflammatory response against monosodium urate (MSU crystals. In gout, neutrophils are involved in inflammatory response and neutrophil activation is dependent on local cytokine production. Mean platelet volume (MPV and neutrophillymphocyte ratio (NLR are considered as inflammatory markers in several diseases and it is reported that they may have prognostic significance. Inthe current literature, there is no study evaluating MPV and NLR in gout. In this retrospective study, we investigated the role of MPV and NLR in determining inflammation in gout disease. Material and Method: In this retrospective study, 106 patients with gout (91 men and 15 women meeting the inclusion criteria based on patient records and 148 age- and sex-matched healthy controls (128 men and 20 women were included. Laboratory data during attacks (group I and intercritical period (group II were collected for the patient group. Results: Mean age was 59.46±12.93 years in the patient group and 59.00±11.33 years in the control group. Age at first attack was 52.00±12.77 years and mean time interval between first 2 attacks was 6.00±5.52 months. There was tophus in 9 patients (8.5% and family history of gout in 17 patients (16.0%. Compared to groupII (intercritical period and the control, no significant difference in MPV levels was found in groupI (during attack. MPV was similar among the three groups. C-reactive protein (CRP and erythrocyte sedimentation rate (ESR were found to be significantly higher in group I compared to group II. There was significant difference in NLR among three groups. When classified according to the presence of tophus, it was seen that MPV and NLR were similar in both groups. Discussion: The finding of increased NLR during attacks and intercritical period show that patients with gout are subjected to chronic inflammation. Thus, NLR can be a simple, inexpensive

  13. Quality of care in gout: a clinical audit on treating to the target with urate lowering therapy in real-world gout patients.

    Science.gov (United States)

    Janssen, Carly A; Jansen, Tim L Th A; Oude Voshaar, Martijn A H; Vonkeman, Harald E; van de Laar, Mart A F J

    2017-09-01

    The current paper aimed to describe the quality of care for gout patients by showing the clinical outcomes achieved in two patient cohorts in which differing targeted urate lowering therapy (ULT) treatment approaches were employed, both aiming to reach the European League Against Rheumatism recommended serum urate (sUA) targets. A retrospective medical chart review study was conducted. Data from the medical records of gout patients from two clinical centers in The Netherlands, both applying targeted ULT treatments (albeit using different approaches), were reviewed. Patients in cohort A were given a combination of xanthine oxidase inhibitors with uricosurics if treatment with allopurinol monotherapy failed to reach sUA target levels, whereas patients in cohort B were treated with sequential monotherapy. Data on patient characteristics and clinical outcomes were collected. A total of 177 patient dossiers were included: 99 from cohort A and 78 from cohort B. The great majority (n = 146, 82.5%) of the patients in both cohorts had a current sUA level <360 µmol/L. In addition, more than half (n = 104, 58.8%) of the patients met the stringent sUA target level of <300 µmol/L. The largest reductions in mean sUA levels were observed for patients who were treated with combination therapy. This clinical audit of two cohorts of gout patients provides initial-yet promising-results regarding the proportion of real-world gout patients in whom recommended that sUA target levels can be achieved, and demonstrates the added value that a targeted treatment approach may have in reaching these goals.

  14. The Effects of Flare Definitions on the Statistics of Derived Flare Distrubtions

    Science.gov (United States)

    Ryan, Daniel; Dominique, Marie; Seaton, Daniel B.; Stegen, Koen; White, Arthur

    2016-05-01

    The statistical examination of solar flares is crucial to revealing their global characteristics and behaviour. However, statistical flare studies are often performed using standard but basic flare detection algorithms relying on arbitrary thresholds which may affect the derived flare distributions. We explore the effect of the arbitrary thresholds used in the GOES event list and LYRA Flare Finder algorithms. We find that there is a small but significant relationship between the power law exponent of the GOES flare peak flux frequency distribution and the algorithms’ flare start thresholds. We also find that the power law exponents of these distributions are not stable but appear to steepen with increasing peak flux. This implies that the observed flare size distribution may not be a power law at all. We show that depending on the true value of the exponent of the flare size distribution, this deviation from a power law may be due to flares missed by the flare detection algorithms. However, it is not possible determine the true exponent from GOES/XRS observations. Additionally we find that the PROBA2/LYRA flare size distributions are clearly non-power law. We show that this is consistent with an insufficient degradation correction which causes LYRA absolute irradiance values to be unreliable. This means that they should not be used for flare statistics or energetics unless degradation is adequately accounted for. However they can be used to study time variations over shorter timescales and for space weather monitoring.

  15. Helium (3) Rich Solar Flares

    Science.gov (United States)

    Colgate, S. A.; Audouze, J.; Fowler, W. A.

    1977-05-03

    The extreme enrichment of {sup 3} He {sup 4} He greater than or equal to 1 in some solar flares as due to spallation and the subsequent confinement of the products in a high temperature, kT approx. = 200 keV, high density, n{sub e} approx. = 3 x 10{sup 15} cm {sup -3} plasma associated with the magnetic instability producing the flare is interpreted. The pinch or filament is a current of high energy protons that creates the spallation and maintains the temperature that produces the high energy x-ray spectrum and depletes other isotopes D, Li, Be, and B as observed. Finally the high temperature plasma is a uniquely efficient spallation target that is powered by the interaction of stellar convection and self generated magnetic field.

  16. Advances in the management of gout: Critical appraisal of febuxostat in the control of hyperuricemia

    Directory of Open Access Journals (Sweden)

    Lada Beara-Lasic

    2010-02-01

    Full Text Available Lada Beara-Lasic1,3, Michael H Pillinger2,3, David S Goldfarb1,31Divisions of Nephrology and 2Rheumatology, Department of Medicine, NYU Langone Medical Center, New York, NY, USA; 3Department of Medicine, New York Harbor VA Health Care System, New York, NY, USAAbstract: Gout recently passed rheumatoid arthritis to become the most common inflammatory arthritis in the United States (US. However, epidemiologic studies indicate that the quality of gout management is suboptimal owing to both patient and physician issues. Only three options for urate-lowering therapy are currently available in the US: allopurinol, probenecid, and recently, febuxostat. Probenecid is generally safe except for the occurrence of urolithiasis, but is only effective for the subset of patients with better kidney function. Allopurinol use is limited due to its side effects, potential toxicity of uncertain magnitude in patients with renal disease, and failure to achieve targeted serum urate levels. In part this failure may be due to the necessity for it to be titrated for optimal therapeutic effect. Febuxostat is a new medication that may offer several advantages and can be given as an alternative to allopurinol. We review the basic biology and clinical performance of febuxostat, and consider the potential utility of this agent in comparison to the older, better-established gout therapeutics.Keywords: allopurinol, gout suppressants, nephrolithiasis, uric acid, urolithiasis

  17. Olecranon bursitis as initial presentation of gout in asymptomatic normouricemic patients

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El Shaarawy, Nashwa; Rasker, Johannes J.

    2014-01-01

    Background Acute bursitis is a less frequent presentation of gout, especially in normouricemic subjects compared to the typical pattern of acute gouty arthritis. Aim of the work The aim of the current case reports is to describe the clinical and the magnetic resonance imaging features of acute gouty

  18. Improved Gout Outcomes in Primary Care Using a Novel Disease Management Program: A Pilot Study.

    Science.gov (United States)

    Bulbin, David; Denio, Alfred E; Berger, Andrea; Brown, Jason; Maynard, Carson; Sharma, Tarun; Kirchner, H Lester; Ayoub, William T

    2018-02-13

    To pilot a primary care gout management improvement intervention. Two large primary care sites were selected: one underwent the intervention, the other, a control, underwent no intervention. The intervention consisted of: engagement of intervention site staff, surveys of provider performance improvement preferences, and onsite live and enduring online education. Electronic Health Record reminders were constructed. Both the intervention and control sites had 3 quality measures assessed monthly: percent of gout patients treated with urate lowering therapy, percent of treated patients monitored with serum urate, and percent of treated patients at target serum urate ≤ 6.0 mg/dl. The intervention site providers received monthly reports comparing their measures against their peers. By 6 months, the intervention site significantly improved all 3 gout performance measures. Percentage treated increased from 54.4 to 61.1%, OR 1.19 (95% CI 1.08, 1.31 and p-value management program can significantly improve primary care gout management performance. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Ultrasound as an Outcome Measure in Gout. A Validation Process by the OMERACT Ultrasound Working Group

    DEFF Research Database (Denmark)

    Terslev, Lene; Gutierrez, Marwin; Schmidt, Wolfgang A

    2015-01-01

    OBJECTIVE: To summarize the work performed by the Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group on the validation of US as a potential outcome measure in gout. METHODS: Based on the lack of definitions, highlighted in a recent literature review on US as an outcome tool...

  20. Risk of infections in patients with gout : a population-based cohort study

    NARCIS (Netherlands)

    Spaetgens, B; de Vries, F; Driessen, J H M; Leufkens, H G; Souverein, P C; Boonen, A; van der Meer, J W M; Joosten, L A B

    2017-01-01

    To investigate the risk of various types of infections (pneumonia and urinary tract infection (UTI)), and infection-related mortality in patients with gout compared with population-based controls. A retrospective cohort study was conducted using data from the UK Clinical Practice Research Datalink

  1. MINYAK ATSIRI KUNYIT SEBAGAI ANTI RADANG PADA PENDERIT GOUT ARTRITIS DENGAN DIET TINGGI PURIN

    Directory of Open Access Journals (Sweden)

    Rondius Solfaine

    2010-12-01

    Full Text Available Curcuma Domestica Volatile Oil (Curcuma domestica, Val as Anti Inflamation Agent on Gout Arthritis Patient with High Purin Diet. Increased concentrations of crystal monosodium urea at joint and soft tissue represent induced of inflammation at gout arthritis (GA. Incidence and prevalence GA disseminate wide in developed countries in Asian range from 2-15% and In Indonesia, GA prevalence was 29% and mostly found in Minahasa, Toraja, and Batak ethnics. This research was aimed to analyse application of curcuma domestica volatile oil as anti inflammation agent on gout arthritis patient who has high purin diet and to assess specific cellular mediator Tumor Necrosis Factor-α (TNF-α. The design of the study was randomized pretest-posttest control group design with single blind treatment. The GCMS test was performed to identify active component in volatile oil. The sample was the new gout arthritis patient in Haji Public Hospital Surabaya. For a week, treatment group was assigned with volatile oil with dose 25 mg/kg body weight and the control group was given indometasin 150 mg/kg body weight. Blood samples were taken before and after treatment. Volatile oil of curcuma domestica (Curcuma domestica, val has four fraction of active component. There was decreasing in blood urea level in treatment group (p = 0.001 and control group (p = 0.007. Both in control and treatment group, there was also decreasing in TNF-α, however it was not statistically significant.

  2. Multicolor photometry of a meteor with flares

    International Nuclear Information System (INIS)

    Benyukh, V.V.

    1980-01-01

    In various spectral regions the intensity variations are studied along the track of a base meteor with three flares having the character of spherical explosion. The concentration of radiating atoms in the flare is estimated. In the moment of the first flare there was a sharp intensity increase in the red region of spectrum. In two other flares the radiation in the interval 4400-4700 A is predominated. During all the three flares which continued 0.04 s, the meteoric body lost 40% of its initial mass. The concentration of Mg 2 atoms (4481 A) which gave the main contribution into the intensity of the third, brightest flare in blue spectral region, is found to be 1x10 11 cm -3

  3. 2011 recommendations for the diagnosis and management of gout and hyperuricemia.

    Science.gov (United States)

    Hamburger, Max; Baraf, Herbert S B; Adamson, Thomas C; Basile, Jan; Bass, Lewis; Cole, Brent; Doghramji, Paul P; Guadagnoli, Germano A; Hamburger, Frances; Harford, Regine; Lieberman, Joseph A; Mandel, David R; Mandelbrot, Didier A; McClain, Bonny P; Mizuno, Eric; Morton, Allan H; Mount, David B; Pope, Richard S; Rosenthal, Kenneth G; Setoodeh, Katy; Skosey, John L; Edwards, N Lawrence

    2011-11-01

    Gout is a major health problem in the United States; it affects 8.3 million people, which is approximately 4% of the adult population. Gout is most often diagnosed and managed in primary care practices; thus, primary care physicians have a significant opportunity to improve patient outcomes. Following publication of the 2006 European League Against Rheumatism (EULAR) gout guidelines, significant new evidence has accumulated, and new treatments for patients with gout have become available. It is the objective of these 2011 recommendations to update the 2006 EULAR guidelines, paying special attention to the needs of primary care physicians. The revised 2011 recommendations are based on the Grading of Recommendations Assessment, Development, and Evaluation approach as an evidence-based strategy for rating quality of evidence and grading the strength of recommendation formulated for use in clinical practice. A total of 26 key recommendations, 10 for diagnosis and 16 for management, of patients with gout were evaluated, resulting in important updates for patient care. The presence of monosodium urate crystals and/or tophus and response to colchicine have the highest clinical diagnostic value. The key aspect of effective management of an acute gout attack is initiation of treatment within hours of symptom onset. Low-dose colchicine is better tolerated and is as effective as a high dose. When urate-lowering therapy (ULT) is indicated, the xanthine oxidase inhibitors allopurinol and febuxostat are the options of choice. Febuxostat can be prescribed at unchanged doses for patients with mild-to-moderate renal or hepatic impairment. The target of ULT should be a serum uric acid level that is ≤ 6 mg/dL. For patients with refractory and tophaceous gout, intravenous pegloticase is a new treatment option. This article is a summary of the 2011 clinical guidelines published in Postgraduate Medicine. This article provides a streamlined, accessible overview intended for quick

  4. Dwarf Star Erupts in Giant Flare

    Science.gov (United States)

    2005-01-01

    This movie taken by NASA'S Galaxy Evolution Explorer shows one of the largest flares, or star eruptions, ever recorded at ultraviolet wavelengths. The star, called GJ 3685A, just happened to be in the Galaxy Evolution Explorer's field of view while the telescope was busy observing galaxies. As the movie demonstrates, the seemingly serene star suddenly exploded once, then even more intensely a second time, pouring out in total about one million times more energy than a typical flare from our Sun. The second blast of light constituted an increase in brightness by a factor of at least 10,000. Flares are huge explosions of energy stemming from a single location on a star's surface. They are caused by the brief destruction of a star's magnetic fields. Many types of stars experience them, though old, small, rapidly rotating 'red dwarfs' like GJ 3685A tend to flare more frequently and dramatically. These stars, called flare stars, can experience powerful eruptions as often as every few hours. Younger stars, in general, also erupt more often. One of the reasons astronomers study flare stars is to gain a better picture and history of flare events taking place on the Sun. A preliminary analysis of the GJ 3685A flare shows that the mechanisms underlying stellar eruptions may be more complex than previously believed. Evidence for the two most popular flare theories was found. Though this movie has been sped up (the actual flare lasted about 20 minutes), time-resolved data exist for each one-hundredth of a second. These observations were taken at 2 p.m. Pacific time, April 24, 2004. In the still image, the time sequence starts in the upper left panel, continues in the upper right, then moves to the lower left and ends in the lower right. The circular and linear features that appear below and to the right of GJ 3685A during the flare event are detector artifacts caused by the extreme brightness of the flare.

  5. Use of newly available febuxostat in a case of chronic tophaceous gout contraindicated to allopurinol and probenecid.

    Science.gov (United States)

    Hilmi, B A; Asmahan, M I; Rosman, A

    2012-02-01

    Urate lowering therapy in this country has mainly been achieved by the use of allopurinol and probenecid. A new xanthine oxidase inhibitor called febuxostat has been approved in 2009 for treatment of hyperuricaemia in gout. In this report, we describe the management of a patient with chronic tophaceous gout using febuxostat. The reduction in serum uric acid to target levels was rapid, and the tophi size had also reduced significantly while on therapy. There was no unwanted side effect observed during the therapy. Therefore, febuxostat would be a useful alternative drug in the treatment of hyperuricaemia in gout patients who have contraindications to allopurinol and probenecid.

  6. Urate-lowering therapy for the management of gout: a summary of 2 Cochrane reviews.

    Science.gov (United States)

    Kydd, Alison S; Seth, Rakhi; Buchbinder, Rachelle; Falzon, Louise; Edwards, Christopher J; van der Heijde, Désirée M; Bombardier, Claire

    2014-09-01

    To systematically review the evidence on the efficacy, safety, and cost-effectiveness of urate-lowering therapy for gout: xanthine oxidase inhibitors (allopurinol and febuxostat), uricosuric medications (benzbromarone, probenecid and sulfinpyrazone), and uricases (pegloticase and rasburicase). A systematic review was performed as part of the 3e (Evidence, Expertise, Exchange) Initiative on Gout. The primary efficacy outcomes were frequency of acute gout attacks, study participant withdrawal due to adverse events, and cost-effectiveness. Serum urate-lowering was a secondary outcome and was the most commonly reported outcome in the included trials. The search identified 17 articles for efficacy, 31 for safety, and 3 for cost-effectiveness. The main outcome described in these studies was serum urate-lowering. Allopurinol, febuxostat, and pegloticase are all effective at lowering serum urate compared to placebo and febuxostat (≥ 80 mg) was more effective at lowering serum urate than allopurinol. Compared to probenecid, benzbromarone was more effective at lowering serum urate. Regarding acute gout attacks, pegloticase and febuxostat (≥ 120 mg) resulted in more acute attacks than placebo. Regarding the primary safety outcome, more withdrawals due to adverse events were seen only when pegloticase was compared to placebo. The two trials of cost-effectiveness were inconclusive. There is currently moderate quality data supporting the efficacy and safety of allopurinol, febuxostat, benzbromarone, and probenecid in gout. Pegloticase, while efficacious, is associated with more withdrawals due to adverse events and infusion reactions. There is insufficient evidence currently with respect to the cost-effectiveness or the most optimal sequencing of urate-lowering therapy.

  7. Urate lowering therapies in the treatment of gout: a systematic review and meta-analysis.

    Science.gov (United States)

    Borghi, C; Perez-Ruiz, F

    2016-03-01

    In patients with gout, serum uric acid (sUA) concentrations should be lowered at least below the target of 6 mg/dL (even below 5 mg/dL in patients with severe gout). To achieve this goal, urate lowering medications (ULMs) should be considered. Currently-used ULMs include xanthine-oxidase inhibitors such as allopurinol, febuxostat, as well as available uricosuric agents. However, evidence comparing these agents remains scant. We have conducted a systematic review and meta-analysis to retrieve evidence on the clinical trials on the above-mentioned drugs in the treatment of gout. The following efficacy outcomes were considered in the meta-analysis: (1) % of patients meeting the therapeutic target for sUA level (probenecid. Overall, 70.7% of patients reached the target of sUA with febuxostat therapy; the reduction in sUA was 45.3%. Corresponding figures with allopurinol were 44.4% and 33.8%, respectively. The number of patients on benzbromarone (N=129) was too low to retrieve definitive findings. The advantage for febuxostat over allopurinol was evident also in patients with renal dysfunction. Safety analysis favored febuxostat over allopurinol (OR 0.85; 95% CI: 0.75-0.97). On the basis of the reported data, febuxostat can play a major role in the treatment of hyperuricaemia and gout. Febuxostat is a suitable pharmacological option for first line treatment of gout, given its established efficacy and safety, documented in a high number of clinical studies and in daily practice.

  8. The "gout of the Medici": making the modern diagnosis using paleopathology.

    Science.gov (United States)

    Fornaciari, Gino; Giuffra, Valentina

    2013-10-01

    Documentary sources show that painful joint disease afflicted several members of the Medici family, which dominated Renaissance Florence in Italy. The term frequently reported in contemporary archives to indicate these morbid episodes is "gout." Paleopathology allows us to verify the nosological information obtained from the written documents and to clarify the nature of the rheumatological condition that afflicted the Medici. A paleopathological study carried out on the skeletal remains of several members of the Medici family buried in the basilica of S. Lorenzo in Florence demonstrated that the "gout" of the Medici was truly a uric acid gout only in Ferdinand I (1549-1609), whose left foot showed peculiar lesions. Genetic and environmental factors, with particular regard to diet, may have been involved in the etiology of this disease, which in Ferdinand was associated with diffuse idiopatic skeletal hyperostosis (DISH). DISH was observed also in the column of Cosimo the Elder (1389-1464) and Cosimo I (1519-1574); a link between the incidence of DISH and high social status, especially in terms of lifestyle and nutritional patterns, has been suggested and the present study seems to further confirm this association. Finally, rheumatoid arthritis (RA) was diagnosed in Cosimo the Elder, Piero "the Gouty" (1416-1469) and Cardinal Carlo (1596-1666); as for Carlo, macroscopic and radiological findings were supported by molecular results which revealed that he was bearing the specificity HLA-DR4 predisposing to RA. The coexistence of DISH and RA attested in Cosimo the Elder can be interpreted as coincidental. In conclusion, the term "gout" as used in Renaissance texts has to be regarded as the clinical manifestation of a number of different joint diseases. In the case of the Medici family in Florence, these included DISH, rheumatoid arthritis and uric acid gout. Copyright © 2013. Published by Elsevier B.V.

  9. Statistical studies of low-power solar flares. Distribution of flares by area, brightness, and classes

    Directory of Open Access Journals (Sweden)

    Borovik A.V.

    2017-03-01

    Full Text Available An electronic database has been created for 123801 solar flares that occurred on the Sun over the period from 1972 to 2010. It is based on catalogs of the Solar Geophysical Data (SGD and Quarterly Bulletin on Solar Activity. A software package has been used for statistical data preprocessing. The first results revealed a number of new fea-tures in the distribution of parameters of solar flares, which differ from those obtained previously. We have found that more than 90 % of all solar flares are low-power. The most numerous class comprises SF flares (64 %. Flare activity shows a pronounced cyclicity and high correlation with Wolf numbers. The highest correlation coefficients indicate S and 1 solar flares. There is also a high correlation between individual flare classes: S and 1, 1 and (2–4. The results obtained in [Mitra et al., 1972], which provide evidence of the prevalence of SN solar flares (47 % and the existence of significant peaks for SN and 1N flares, have not been confirmed. The distribution of the number of solar flares with increasing optical importance smoothly decreases without significant deviations. With increasing optical importance, solar flares are gradually redistributed toward an increase in brightness class. The excess of the number of SN and 1N solar flares present in the distributions obtained in [Mitra et al., 1972] are most likely associated with poor statistics.

  10. Impact of anti-inflammatory therapies, xanthine oxidase inhibitors and other urate-lowering therapies on cardiovascular diseases in gout.

    Science.gov (United States)

    Richette, Pascal; Frazier, Aline; Bardin, Thomas

    2015-03-01

    The purpose of this study is to give an overview of recently published articles covering the impact of anti-inflammatory therapies, xanthine oxidase inhibitors and other urate-lowering therapies on cardiovascular diseases in gout. In patients with gout, long-term xanthine oxidase inhibition might reduce some cardiovascular comorbidities because of the dual effect of lowering serum uric acid levels and reducing free-radical production during uric acid formation. Among the anti-inflammatory therapies, colchicine has been shown to reduce some major cardiovascular events. Epidemiological and experimental studies have shown that hyperuricaemia and gout are independent risk factors for cardiovascular diseases. The mechanisms that link high serum uric acid levels and gout with cardiovascular diseases are multifactorial, implicating low-grade systemic inflammation and xanthine oxidase activity as well as the deleterious effect of hyperuricaemia itself.

  11. 1 Pengaruh Mengkonsumsi Rebusan Daun Sirsak Terhadap Penurunan Nyeri Pada Penderita Gout Artritis Di Wilayah Kerja Puskesmas Pineleng

    OpenAIRE

    Gerry, Karundeng Fedels; Mulyadi, Ns; Kallo, Vandri

    2015-01-01

    Gout artritis merupakan penyakit yang ditandai dengan nyeri yang terjadi berulang-ulang yang disebabkan adanya endapan kristal monosodium urat yang tertumpuk di dalam sendi sebagai akibat tingginya kadar asam urat di dalam darah. Mengkonsumsi rebusan daun sirsak (Anonna muricata) adalah salah satu jenis terapi nonfamakologi yang bertujuan untuk menurunkan tingkat nyeri pada penderita gout artritis karena senyawa yang terkandung dalam daun sirsak berfungsi sebagai analgetik yang mempu menguran...

  12. X-ray Emission from Solar Flares

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... Solar flares; X-ray detectors; X-ray line emission and continuum; break energy; microflares. Abstract. Solar X-ray Spectrometer (SOXS), the first space-borne solar astronomy experiment of India was designed to improve our current understanding of X-ray emission from the Sun in general and solar flares in ...

  13. Cyclical Variability of Prominences, CMEs and Flares

    Indian Academy of Sciences (India)

    ... Refresher Courses · Symposia · Live Streaming. Home; Journals; Journal of Astrophysics and Astronomy; Volume 21; Issue 3-4. Cyclical Variability of Prominences, CMEs and Flares. J. L. Ballester. Session V – Vector Magnetic Fields, Prominences, CMEs & Flares Volume 21 Issue 3-4 September-December 2000 pp ...

  14. Excitation of XUV radiation in solar flares

    Science.gov (United States)

    Emslie, A. Gordon

    1992-01-01

    The goal of the proposed research was to understand the means by which XUV radiation in solar flares is excited, and to use this radiation as diagnostics of the energy release and transport processes occurring in the flare. Significant progress in both of these areas, as described, was made.

  15. Equatorial ionospheric electrodynamics during solar flares

    Science.gov (United States)

    Zhang, Ruilong; Liu, Libo; Le, Huijun; Chen, Yiding

    2017-05-01

    Previous investigations on ionospheric responses to solar flares focused mainly on the photoionization caused by the increased X-rays and extreme ultraviolet irradiance. However, little attention was paid to the related electrodynamics. In this letter, we explored the equatorial electric field (EEF) and electrojet (EEJ) in the ionosphere at Jicamarca during flares from 1998 to 2008. It is verified that solar flares increase dayside eastward EEJ but decrease dayside eastward EEF, revealing a negative correlation between EEJ and EEF. The decreased EEF weakens the equatorial fountain effect and depresses the low-latitude electron density. During flares, the enhancement in the Cowling conductivity may modulate ionospheric dynamo and decrease the EEF. Besides, the decreased EEF is closely related to the enhanced ASY-H index that qualitatively reflects Region 2 field-aligned current (R2 FAC). We speculated that solar flares may also decrease EEF through enhancing R2 FAC that leads to an overshielding-like effect.

  16. Energetic Particle Estimates for Stellar Flares

    Science.gov (United States)

    Youngblood, Allison; Chamberlin, Phil; Woods, Tom

    2018-01-01

    In the heliosphere, energetic particles are accelerated away from the Sun during solar flares and/or coronal mass ejections where they frequently impact the Earth and other solar system bodies. Solar (or stellar) energetic particles (SEPs) not only affect technological assets, but also influence mass loss and chemistry in planetary atmospheres (e.g., depletion of ozone). SEPs are increasingly recognized as an important factor in assessing exoplanet habitability, but we do not yet have constraints on SEP emission from any stars other than the Sun. Until indirect measurements are available, we must assume solar-like particle production and apply correlations between solar flares and SEPs detected near Earth to stellar flares. We present improved scaling relations between solar far-UV flare flux and >10 MeV proton flux near Earth. We apply these solar scaling relations to far-UV flares from exoplanet host stars and discuss the implications for modeling chemistry and mass loss in exoplanet atmospheres.

  17. [Investigation on "gout" and comparison of disorder between Chinese and Western medicine in pre-Song-yuan dynasty].

    Science.gov (United States)

    Zhang, Yu-Ping; Xiao, Mei-Hua

    2004-10-01

    Before the Song-Yuan dynasties, it was claimed that "gout" is the result of heat in the blood plus invasion of wind, cold, or dampness, leading to coagulation of turbid dampness in the channel-collaterals, characterized by arthralgia, exacerbated in the nighttime. "Gout" was first seen in the Ming yi bie lu (Other Records of Famous Physicians) of the Liang dynasty. Before that, it was categorized under "bi" syndrome. No detailed description was given to "gout" during the period from the first appearance of the title "gout" to the Yuan dynasty. In fact, it was vaguely mentioned in "bi", "li jie", and "bai hu (white tiger)" disorders. The title of "gout" was named by Zhu Danxi, and appeared alternately with gouty arthritis. "li jie" and "bai hu" are titles of two different diseases which were jointly called "lijiebaihu" in the Song dynasty, both similar to gouty arthritis. The TCM title of gout was based on this condition which is specific and very proximate to gouty arthritis.

  18. Anorexia nervosa and uric acid beyond gout: An idea worth researching.

    Science.gov (United States)

    Simeunovic Ostojic, Mladena; Maas, Joyce

    2018-02-01

    Uric acid is best known for its role in gout-the most prevalent inflammatory arthritis in humans-that is also described as an unusual complication of anorexia nervosa (AN). However, beyond gout, uric acid could also be involved in the pathophysiology and psychopathology of AN, as it has many biological functions serving as a pro- and antioxidant, neuroprotector, neurostimulant, and activator of the immune response. Further, recent research suggests that uric acid could be a biomarker of mood dysfunction, personality traits, and behavioral patterns. This article discusses the hypothesis that uric acid in AN may not be a mere innocent bystander determined solely by AN behavior and its medical complications. In contrast, the relation between uric acid and AN may have evolutionary origin and may be reciprocal, where uric acid regulates some features and pathophysiological processes of AN, including weight and metabolism regulation, oxidative stress, immunity, mood, cognition, and (hyper)activity. © 2018 Wiley Periodicals, Inc.

  19. Can racial disparities in optimal gout treatment be reduced? evidence from a randomized trial

    Directory of Open Access Journals (Sweden)

    Singh Jasvinder A

    2012-02-01

    Full Text Available Abstract There is a disproportionate burden of gout in African-Americans in the U.S. due to a higher disease prevalence and lower likelihood of receiving urate-lowering therapy (ULT, compared to Caucasians. There is an absence of strong data as to whether the response to ULT differs by race/ethnicity. BMC Musculoskeletal Disorders recently published a secondary analyses of the CONFIRMS trial, a large randomized controlled, double-blind trial of 2,269 gout patients. The authors reported that the likelihood of achieving the primary study efficacy end-point of achieving serum urate Please see related article: http://www.biomedcentral.com/1471-2474/13/15

  20. Guideline development for the management of gout: role of combination therapy with a focus on lesinurad

    OpenAIRE

    Jones, Graeme; Panova, Elena; Day, Richard

    2017-01-01

    Graeme Jones,1 Elena Panova,1 Richard Day2 1Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia; 2University of New South Wales, Medicine, St Vincent’s Hospital, Sydney, NSW, Australia Abstract: The aim of this review was to summarize the evidence for combination therapy to achieve serum urate (SUA) target levels in gout. Within this overarching aim, a second aim was to evaluate the evidence for a new uricosuric agent lesinurad, which inhibits ur...

  1. Association Between Colchicine and Risk of Diabetes Among the Veterans Affairs Population With Gout.

    Science.gov (United States)

    Wang, Liya; Sawhney, Monika; Zhao, Yingnan; Carpio, Gandahari Rosa; Fonseca, Vivian; Shi, Lizheng

    2015-06-01

    This study aimed to determine the association between colchicine use and the incidence of diabetes in a cohort of patients with gout. This is a retrospective study of 27,876 adults with gout identified via the Veterans Integrated Services Network 16 data warehouse. Patients had up to 11 years of follow-up (January 1999 through December 2010). The final study sample consisted of 1046 pairs of 1:1 propensity score-matched patients from the colchicine treated and control cohorts. Time to first diabetes development since the first gout diagnosis was modeled. After the propensity score matching, the 12-month baseline variables (eg, age, sex, race, index year, body mass index, serum uric acid, antigout drug use, and health care use) were comparable between the matched cohorts (P > 0.05 for all). Among the 1046 matched pairs, 234 patients who had taken colchicine and 224 patients who had never taken colchicine developed diabetes; the incidence rates were 38.95 and 39.02 per 1000 patient-years, respectively. In Poisson and Cox proportional hazards regression, the risk of incident diabetes was reduced with increased duration of colchicine use, but the difference was not statistically significant (P > 0.05). In a time-varying Cox proportional hazards model, the hazard ratio for incident diabetes among patients who had taken colchicine was 0.877 (95% CI, 0.662-1.163; P = 0.362) compared with those who had not taken colchicine. This study suggests a possible duration- or dose-related association between colchicine use and reduced risk of diabetes in adults with gout even though the risk reduction was not significant. Further studies are needed to confirm findings from this study. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  2. Colchicine Use Is Associated with Decreased Prevalence of Myocardial Infarction in Patients with Gout

    Science.gov (United States)

    Crittenden, Daria B.; Lehmann, R. Aaron; Schneck, Laura; Keenan, Robert T.; Shah, Binita; Greenberg, Jeffrey D.; Cronstein, Bruce N.; Sedlis, Steven P.; Pillinger, Michael H.

    2013-01-01

    Objective The ability of antiinflammatory strategies to alter cardiovascular risk has not been rigorously examined. Colchicine is an antiinflammatory agent that affects macrophages, neutrophils, and endothelial cells, all of which are implicated in the pathogenesis of cardiovascular disease. We examined whether colchicine use was associated with a reduced risk of myocardial infarction (MI) in patients with gout. Methods We conducted a retrospective, cross-sectional study of all patients with an International Classification of Diseases, 9th ed, code for gout in the electronic medical record (EMR) of the New York Harbor Healthcare System Veterans Affairs network and ≥ 1 hospital visit between August 2007 and August 2008. Hospital pharmacy data were used to identify patients who had filled at least 1 colchicine prescription versus those who had not. Demographics and CV comorbidities were collected by EMR review. The primary outcome was diagnosis of MI. Secondary outcomes included all-cause mortality and C-reactive protein (CRP) level. Results In total, 1288 gout patients were identified. Colchicine (n = 576) and no colchicine (n = 712) groups had similar baseline demographics and serum urate levels. Prevalence of MI was 1.2% in the colchicine versus 2.6% in the no-colchicine group (p = 0.03). Colchicine users also had fewer deaths and lower CRP levels, although these did not achieve statistical significance. Colchicine effects persisted when allopurinol users were excluded from the analysis. Conclusion In this hypothesis-generating study, gout patients who took colchicine had a significantly lower prevalence of MI and exhibited trends toward reduced all-cause mortality and lower CRP level versus those who did not take colchicine. PMID:22660810

  3. Management of Gout: A Systematic Review in Support of an American College of Physicians Clinical Practice Guideline.

    Science.gov (United States)

    Shekelle, Paul G; Newberry, Sydne J; FitzGerald, John D; Motala, Aneesa; O'Hanlon, Claire E; Tariq, Abdul; Okunogbe, Adeyemi; Han, Dan; Shanman, Roberta

    2017-01-03

    Gout is a common type of inflammatory arthritis in patients seen by primary care physicians. To review evidence about treatment of acute gout attacks, management of hyperuricemia to prevent attacks, and discontinuation of medications for chronic gout in adults. Multiple electronic databases from January 2010 to March 2016, reference mining, and pharmaceutical manufacturers. Studies of drugs approved by the U.S. Food and Drug Administration and commonly prescribed by primary care physicians, randomized trials for effectiveness, and trials and observational studies for adverse events. Data extraction was performed by one reviewer and checked by a second reviewer. Study quality was assessed by 2 independent reviewers. Strength-of-evidence assessment was done by group discussion. High-strength evidence from 28 trials (only 3 of which were placebo-controlled) shows that colchicine, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids reduce pain in patients with acute gout. Moderate-strength evidence suggests that low-dose colchicine is as effective as high-dose colchicine and causes fewer gastrointestinal adverse events. Moderate-strength evidence suggests that urate-lowering therapy (allopurinol or febuxostat) reduces long-term risk for acute gout attacks after 1 year or more. High-strength evidence shows that prophylaxis with daily colchicine or NSAIDs reduces the risk for acute gout attacks by at least half in patients starting urate-lowering therapy, and moderate-strength evidence indicates that duration of prophylaxis should be longer than 8 weeks. Although lower urate levels reduce risk for recurrent acute attacks, treatment to a specific target level has not been tested. Few studies of acute gout treatments, no placebo-controlled trials of management of hyperuricemia lasting longer than 6 months, and few studies in primary care populations. Colchicine, NSAIDs, and corticosteroids relieve pain in adults with acute gout. Urate-lowering therapy

  4. The radiographic and MRI features of gout referred as suspected soft tissue sarcoma: a review of the literature and findings from 27 cases

    Energy Technology Data Exchange (ETDEWEB)

    Upadhyay, Neil [Imperial College Healthcare NHS Trust, Imaging Department, London (United Kingdom); Saifuddin, Asif [The Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom)

    2014-09-24

    Gout has been termed the ''great mimicker'', for its ability to resemble other pathological conditions. Whilst the typical imaging features of gout are well described, there is a relative paucity of literature describing more challenging cases of gout, where a malignant tumour has been considered in the differential diagnosis. The aim of this article is to provide an overview of the radiographic and MRI features of 27 cases of gout that were initially referred to our centre as suspected soft tissue sarcoma, alongside a review of the literature. (orig.)

  5. The Emerging Role of Biotechnological Drugs in the Treatment of Gout

    Directory of Open Access Journals (Sweden)

    L. Cavagna

    2014-01-01

    Full Text Available One of the most important therapeutic advances obtained in the field of rheumatology is the availability of the so-called bio(technological drugs, which have deeply changed treatment perspectives in diseases such as rheumatoid arthritis and ankylosing spondylitis. According to the steadily increasing attention on gout, due to well-established prognostic and epidemiology implications, in the last 5 years, the same change of perspective has been observed also for this disease. In fact, several bio(technological agents have been investigated both for the management of the articular gout symptoms, targeting mainly interleukin-1β, as well as urate-lowering therapies such as recombinant uricases. Among the IL-1β inhibitors, the majority of studies involve drugs such as anakinra, canakinumab, and rilonacept, but other compounds are under development. Moreover, other potential targets have been suggested, as, for example, the TNF alpha and IL-6, even if data obtained are less robust than those of IL-1β inhibitors. Regarding urate-lowering therapies, the recombinant uricases pegloticase and rasburicase clearly showed their effectiveness in gout patients. Also in this case, new compounds are under development. The aim of this review is to focus on the various aspects of different bio(technological drugs in gouty patients.

  6. Uric acid metabolism in patients with primary gout and the metabolic syndrome.

    Science.gov (United States)

    Fraile, J M; Puig, J G; Torres, Rosa J; de Miguel, Eugenio; Martínez, Pedro; Vázquez, J J

    2010-06-01

    Forty-four patients (40 males) with a mean age of 58 years were included in this pilot study. Mean serum urate concentration in patients with and without the metabolic syndrome (MS) was 8.8 mg/dL and 8.1 mg/dL, respectively. Urinary uric acid excretion was 543 mg/day/1.73 m(2) in the former and 609 mg/day/1.73 m(2) in the latter. Uric acid to creatinine ratio was 0.37 mg/mg in patients with the MS and 0.42 mg/mg in those without the MS. Mean serum urate increased from 8.6 mg/dL in subjects with three or more MS components to 10.3 mg/dL in those with five MS components. Serum urate was markedly lower in patients with mild MS (9 patients, 8.6 mg/dL) as compared to severe MS (10 patients, 9.2 mg/dL). In contrast, urinary uric acid to creatinine ratio was 0.42 mg/mg in patients with gout and mild MS and 0.33 mg/mg in gout patients with severe MS. Uric acid underexcretion appears to be more severe in gout patients with the MS. This disturbance appears to be related to the severity of the MS.

  7. A New Paradigm for Flare Particle Acceleration

    Science.gov (United States)

    Guidoni, Silvina E.; Karpen, Judith T.; DeVore, C. Richard

    2017-08-01

    The mechanism that accelerates particles to the energies required to produce the observed high-energy impulsive emission and its spectra in solar flares is not well understood. Here, we propose a first-principle-based model of particle acceleration that produces energy spectra that closely resemble those derived from hard X-ray observations. Our mechanism uses contracting magnetic islands formed during fast reconnection in solar flares to accelerate electrons, as first proposed by Drake et al. (2006) for kinetic-scale plasmoids. We apply these ideas to MHD-scale islands formed during fast reconnection in a simulated eruptive flare. A simple analytic model based on the particles’ adiabatic invariants is used to calculate the energy gain of particles orbiting field lines in our ultrahigh-resolution, 2.5D, MHD numerical simulation of a solar eruption (flare + coronal mass ejection). Then, we analytically model electrons visiting multiple contracting islands to account for the observed high-energy flare emission. Our acceleration mechanism inherently produces sporadic emission because island formation is intermittent. Moreover, a large number of particles could be accelerated in each macroscopic island, which may explain the inferred rates of energetic-electron production in flares. We conclude that island contraction in the flare current sheet is a promising candidate for electron acceleration in solar eruptions. This work was supported in part by the NASA LWS and H-SR programs..

  8. Solar Flares and their Effects on Planets

    Science.gov (United States)

    Guinan, Edward Francis; Engle, Scott G.

    2015-08-01

    The effects of flares from the Sun on Earth and other solar-system planets are discussed. The strong X-ray - UV radiation and high plasma fluxes from flares can strongly effect solar system planets even as far out as the Jovian planets and their moons. Data from our "Sun in Time" program are used to study the flare properties of the Sun and solar-type stars from youth to old age. These data imply that the young Sun had numerous, very powerful flares that may have played major roles in the development and evolution of the early atmospheres of Earth and other terrestiral planets. These strong X-UV fluxes from flares can greatly effect the photochemistry of planetary atmospheres as well as ionizing and possibly eroding their atmospheres. Some examples are given. Also briefly discussed are effects of large flares from the present Sun on the Earth. Even though strong solar flares are rarer and less powerful than from the youthful Sun, they can cause significant damage to our communication and satellite systems, electrical networks, and threaten the lives of astronauts in space.This research is supported by grants from NASA (HST and Chandra) and NSF. We gratefully acknowledge this support

  9. Identifying core domains to assess flare in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Bartlett, Susan J; Hewlett, Sarah; Bingham, Clifton O

    2012-01-01

    For rheumatoid arthritis (RA), there is no consensus on how to define and assess flare. Variability in flare definitions impairs understanding of findings across studies and limits ability to pool results. The OMERACT RA Flare Group sought to identify domains to define RA flares from patient...

  10. Statistics of Flares Sweeping across Sunspots

    OpenAIRE

    Li, Leping; Zhang, Jun

    2009-01-01

    Flare ribbons are always dynamic, and sometimes sweep across sunspots. Examining 588 (513 M-class and 75 X-class) flare events observed by Transition Region and Coronal Explorer (TRACE) satellite and Hinode Solar Optical Telescope (SOT) from 1998 May to 2009 May, we choose the event displaying that one of the flare ribbons completely sweeps across the umbra of a main sunspot of the corresponding active region, and finally obtain 20 (7 X-class and 13 M-class) events as our sample. In each even...

  11. A urate gene-by-diuretic interaction and gout risk in participants with hypertension: results from the ARIC study

    Science.gov (United States)

    McAdams-DeMarco, Mara A; Maynard, Janet W; Baer, Alan N; Kao, Linda W; Kottgen, Anna; Coresh, Josef

    2015-01-01

    Objective To test for a urate gene-by-diuretic interaction on incident gout. Methods The Atherosclerosis Risk in Communities Study is a prospective population-based cohort of 15 792 participants recruited from four US communities (1987–1989). Participants with hypertension and available single nucleotide polymorphism (SNP) genotype data were included. A genetic urate score (GUS) was created from common urate-associated SNPs for eight genes. Gout incidence was self-reported. Using logistic regression, the authors estimated the adjusted OR of incident gout by diuretic use, stratified by GUS median. Results Of 3524 participants with hypertension, 33% used a diuretic and 3.1% developed gout. The highest 9-year cumulative incidence of gout was in those with GUS above the median and taking a thiazide or loop diuretic (6.3%). Compared with no thiazide or loop diuretic use, their use was associated with an OR of 0.40 (95% CI 0.14 to 1.15) among those with a GUS below the median and 2.13 (95% CI 1.23 to 3.67) for those with GUS above the median; interaction p=0.006. When investigating the genes separately, SLC22A11 and SLC2A9 showed a significant interaction, consistent with the former encoding an organic anion/dicarboxylate exchanger, which mediates diuretic transport in the kidney. Conclusions Participants who were genetically predisposed to hyperuricaemia were susceptible to developing gout when taking thiazide or loop diuretics, an effect not evident among those without a genetic predisposition. These findings argue for a potential benefit of genotyping individuals with hypertension to assess gout risk, relative in part to diuretic use. PMID:22753387

  12. 40 CFR 63.987 - Flare requirements.

    Science.gov (United States)

    2010-07-01

    ... at least one of the following addresses: 100 Barr Harbor Drive, West Conshohocken, PA 19428-2959; or... millimeters of mercury (30 inches of mercury). (iii) The actual exit velocity of a flare shall be determined...

  13. Solar Flare Magnetic Fields and Plasmas

    CERN Document Server

    Fisher, George

    2012-01-01

    This volume is devoted to the dynamics and diagnostics of solar magnetic fields and plasmas in the Sun’s atmosphere. Five broad areas of current research in Solar Physics are presented: (1) New techniques for incorporating radiation transfer effects into three-dimensional magnetohydrodynamic models of the solar interior and atmosphere, (2) The connection between observed radiation processes occurring during flares and the underlying flare energy release and transport mechanisms, (3) The global balance of forces and momenta that occur during flares, (4) The data-analysis and theoretical tools needed to understand and assimilate vector magnetogram observations and (5) Connecting flare and CME phenomena to the topological properties of the magnetic field in the Solar Atmosphere. The role of the Sun’s magnetic field is a major emphasis of this book, which was inspired by a workshop honoring Richard C. (Dick) Canfield.  Dick has been making profound contributions to these areas of research over a long and pro...

  14. Physics of Coupled CME and Flare Systems

    Science.gov (United States)

    2016-12-21

    eruption of combined flare-CME systems, as opposed to flares or CME in isolation. This work uses solar synoptic imaging and irradiance data from both...numbers provides a better picture of solar activity. One can characterize what was seen on the projection board. To understand and develop an...over time, a more accurate picture of solar activity can be obtained from a telescope with multiple images than a single observation once a day. These

  15. The distribution of urate deposition within the extremities in gout: a review of 148 dual-energy CT cases

    Energy Technology Data Exchange (ETDEWEB)

    Mallinson, Paul I. [Vancouver General Hospital, Radiology Department, Vancouver (Canada); Vancouver General Hospital, Clinical Fellow in Musculoskeletal Radiology, Vancouver, BC (Canada); Reagan, Adrian C.; Munk, Peter L.; Ouellette, Hugue; Nicolaou, Savvas [Vancouver General Hospital, Radiology Department, Vancouver (Canada); Coupal, Tyler [McMaster University, De Groote School of Medicine, Hamilton, Ontario (Canada)

    2014-03-15

    Clinical detection of gout can be difficult due to co-existent and mimicking arthropathies and asymptomatic disease. Understanding of the distribution of urate within the body can aid clinical diagnosis and further understanding of the resulting pathology. Our aim was to determine this distribution of urate within the extremities in patients with gout. All patients who underwent a four-limb dual-energy computed tomography (DECT) scan for suspected gout over a 2-year period were identified (n = 148, 121 male, 27 female, age range, 16-92 years, mean = 61.3 years, median = 63 years). The reports of the positive cases were retrospectively analyzed and the locations of all urate deposition recorded and classified by anatomical location. A total of 241 cases met the inclusion criteria, of which 148 cases were positive. Of these, 101 (68.2 %) patients had gout in the foot, 81 (56.1 %) in the knee, 79 (53.4 %) in the ankle, 41 (27.7 %) in the elbow, 25 (16.9 %) in the hand, and 25 (16.9 %) in the wrist. The distribution was further subcategorized for each body part into specific bone and soft tissue structures. In this observational study, we provide for the first time a detailed analysis of extremity urate distribution in gout, which both supports and augments to the current understanding based on clinical and microscopic findings. (orig.)

  16. [Clinical value of toes periungual green-coloured voxels of dual-energy CT gout detecting technology].

    Science.gov (United States)

    Li, Huixia; Qu, Jin; Zhan, Ying; Lei, Xinwei

    2015-10-20

    To evaluate the clinical value of dual-energy CT(DECT) in the detection of green-coloured voxels in toenails in patients with gout using DECT. A total of 53 patients with gout could be included in the study composed of 45 men and 8 women, and 33 individuals without gout were regarded as control group. There were no significant differences in gender and age between two groups. DECT were performed for the both feet, DE (80 kV and 140 kV) datasets were reconstructed via gout-recognition software, the pseudo-color images group as the postprocessed group.Imagings were reviewed independently by two senior radiologists. Chi-square test was used for statistical analysis with the SPSS 17.0 software. In the gout group, DECT scans revealed a total of 266 areas of green-coloured voxels in 53 patients (relevance ratio 50.2% (266/530)); in the control group, 27 areas of green-coloured voxels were detected in 33 patients (relevance ratio 8.2% (27/330)), the differences had statistical significance (Pgreen-coloured voxels were detected only in the nail groove in 8 patients which compared with 2 the control group, the differences had statistical significance (Pgreen-coloured voxels of monosodium urate in the toenails, with a great potential in clinical diagnosis.

  17. Toxicity of Flare and Crude Hydrocarbon Mixtures

    Directory of Open Access Journals (Sweden)

    Sonja V. Cook

    2002-01-01

    Full Text Available The toxicity of whole, saturate, and aromatic hydrocarbon mixtures from flare pit and crude oil sources were evaluated using Lumbricus terrestris. Body burden analysis was used to analyze the intrinsic toxicity of the six hydrocarbon mixtures. The major fractions of the whole mixtures, the saturate, and aromatic fractions had different intrinsic toxicities; the aromatics were more toxic than the saturates. The toxicity of the saturate and aromatic fractions also differed between the mixtures. The flare saturate mixture was more toxic than the crude saturate mixture, while the crude aromatic mixture was more toxic than the flare aromatic mixture. The most dramatic difference in toxicity of the two sources was between the flare whole and crude whole mixtures. The crude whole mixture was very toxic; the toxicity of this mixture reflected the toxicity of the crude aromatic fraction. However, the flare whole mixture was not toxic, due to a lack of partitioning from the whole mixture into the lipid membrane of the exposed worms. This lack of partitioning appears to be related to the relatively high concentrations of asphaltenes and polar compounds in the flare pit whole mixture.

  18. Modelling blazar flaring using a time-dependent fluid jet emission model - an explanation for orphan flares and radio lags

    Science.gov (United States)

    Potter, William J.

    2018-01-01

    Blazar jets are renowned for their rapid violent variability and multiwavelength flares, however, the physical processes responsible for these flares are not well understood. In this paper, we develop a time-dependent inhomogeneous fluid jet emission model for blazars. We model optically thick radio flares for the first time and show that they are delayed with respect to the prompt optically thin emission by ∼months to decades, with a lag that increases with the jet power and observed wavelength. This lag is caused by a combination of the travel time of the flaring plasma to the optically thin radio emitting sections of the jet and the slow rise time of the radio flare. We predict two types of flares: symmetric flares - with the same rise and decay time, which occur for flares whose duration is shorter than both the radiative lifetime and the geometric path-length delay time-scale; extended flares - whose luminosity tracks the power of particle acceleration in the flare, which occur for flares with a duration longer than both the radiative lifetime and geometric delay. Our model naturally produces orphan X-ray and γ-ray flares. These are caused by flares that are only observable above the quiescent jet emission in a narrow band of frequencies. Our model is able to successfully fit to the observed multiwavelength flaring spectra and light curves of PKS1502+106 across all wavelengths, using a transient flaring front located within the broad-line region.

  19. Prevalence and correlates of gout in a large cohort of patients with chronic kidney disease: the German Chronic Kidney Disease (GCKD) study.

    Science.gov (United States)

    Jing, Jiaojiao; Kielstein, Jan T; Schultheiss, Ulla T; Sitter, Thomas; Titze, Stephanie I; Schaeffner, Elke S; McAdams-DeMarco, Mara; Kronenberg, Florian; Eckardt, Kai-Uwe; Köttgen, Anna

    2015-04-01

    Reduced kidney function is a risk factor for hyperuricaemia and gout, but limited information on the burden of gout is available from studies of patients with chronic kidney disease (CKD). We therefore examined the prevalence and correlates of gout in the large prospective observational German Chronic Kidney Disease (GCKD) study. Data from 5085 CKD patients aged 18-74 years with an estimated glomerular filtration rate (eGFR) of 30-patients on urate lowering therapy, 47.2% still showed hyperuricaemia. Factors associated with gout were serum urate, lower eGFR, advanced age, male sex, higher body mass index and waist-to-hip ratio, higher triglyceride and C-reactive protein (CRP) concentrations, alcohol intake and diuretics use. While lower eGFR categories showed significant associations with gout in multivariable-adjusted models (prevalence ratio 1.46 for eGFR patients with CKD and lower GFR is strongly associated with gout. Pharmacological management of gout in patients with CKD is suboptimal. Prospective follow-up will show whether gout and hyperuricaemia increase the risk of CKD progression and cardiovascular events in the GCKD study. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  20. Effect of flow parameters on flare stack generator noise

    International Nuclear Information System (INIS)

    Dinn, T.S.

    1998-01-01

    The SoundPLAN Computer Noise Model was used to determine the general effect of flare noise in a community adjacent to a petrochemical plant. Tests were conducted to determine the effect of process flow conditions and the pulsating flame on the flare stack generator noise from both a refinery flare and process flare. Flaring under normal plant operations, the flaring of fuel gas and the flaring of hydrogen were the three conditions that were tested. It was shown that the steam flow rate was the determining factor in the flare stack generated noise. Variations in the water seal level in the flare line surge tank increased or decreased the gas flowrate, which resulted in a pulsating flame. The period and amplitude of the pulsating noise from the flare stacks was determined by measuring several parameters. Flare stack noise oscillations were found to be greater for the process flare than for the refinery flare stack. It was suggested that minimizing the amount of steam fed to the flare and improving the burner design would minimize noise. 2 tabs., 6 figs

  1. Discrepancies in how the impact of gout is assessed in outcomes research compared to how health professionals view the impact of gout, using the lens of the International Classification of Functioning, Health and Disability (ICF).

    Science.gov (United States)

    Kool, Eveline M; Nijsten, Marieke J; van Ede, Annelies E; Jansen, Tim L; Taylor, William J

    2016-09-01

    The International Classification of Functioning, Disability and Health (ICF) provides a common language to understand what health means. An ICF core set, a list of ICF categories affected by a certain disease, is useful to objectify the content validity of a health status measurement. This study aims to identify the potential items of a gout specific 'ICF core set'. A three-round Delphi exercise was conducted, using web-based questionnaires. Health professionals, specialized in gout, nominated and subsequently rated the relevance of life areas divided into ICF categories. Agreement was determined by using the UCLA/RAND criteria. Simultaneously, a systematic review of gout measure outcomes was conducted. The results of these studies were compared using the second level of the ICF categories. In the Delphi study, consensus was found for 136 relevant ICF categories. The literature study extracted 134 different ICF categories in 149 articles. Three hundred and ten were non-defined outcomes. A large number of ICF categories were deemed to be relevant for people with gout. Only 29.7 % (19/64) of the level 2 categories, deemed to be relevant by health professionals, had been assessed as relevant in at least 5 % of gout outcome studies. Conversely, 70 % (19/27) of level 2 ICF categories assessed in at least 5 % of outcome studies were deemed relevant by health professionals. These ICF codes, which are found relevant in both studies, should be considered as mandatory in further research to a validated and practical core set of ICF categories. Published gout outcomes research fails to evaluate many life areas that are thought relevant by health professionals.

  2. Flare magnetic reconnection fluxes as possible signatures of flare contributions to gradual SEP events

    Science.gov (United States)

    Kahler, S. W.; Kazachenko, M.; Lynch, B. J.; Welsch, B. T.

    2017-09-01

    The primary sources of solar energetic (E > 20 MeV) particle (SEP) events are flares and CME-driven shocks. Some studies claim that even up to GeV energies solar flares are major contributors to SEP events. There are several candidate flare processes for producing SEPs, but acceleration in magnetic reconnection regions is probably the most efficient. Previous studies have relied on flare radiation signatures to determine the times and locations of SEP injections. An alternative approach is to use the amount of magnetic flux that gets reconnected during solar flares. The photospheric magnetic flux swept out by flare ribbons is thought to be directly related to the amount of magnetic reconnection in the corona and is therefore a key diagnostic tool for understanding the physical processes in flares and CMEs. We use the database of flare magnetic reconnection fluxes to compare these parameters with peak intensities of SEP events. We find that while sizes of 15 ∼25-MeV SEP events in the western hemisphere correlate with both CME speeds and reconnection fluxes, there are many cases of large reconnection fluxes with no observed SEP events. The occurrence of large reconnection fluxes accompanied by slow CMEs but no SEP events suggests that the CME shocks are the primary, if not the only, sources of high energy (E > 100 MeV) SEP events.

  3. Feasibility of flare gas reformation to practical energy in Farashband gas refinery: no gas flaring.

    Science.gov (United States)

    Rahimpour, Mohammad Reaza; Jokar, Seyyed Mohammad

    2012-03-30

    A suggested method for controlling the level of hazardous materials in the atmosphere is prevention of combustion in flare. In this work, three methods are proposed to recover flare gas instead of conventional gas-burning in flare at the Farashband gas refinery. These methods aim to minimize environmental and economical disadvantages of burning flare gas. The proposed methods are: (1) gas to liquid (GTL) production, (2) electricity generation with a gas turbine and, (3) compression and injection into the refinery pipelines. To find the most suitable method, the refinery units that send gas to the flare as well as the required equipment for the three aforementioned methods are simulated. These simulations determine the amount of flare gas, the number of GTL barrels, the power generated by the gas turbine and the required compression horsepower. The results of simulation show that 563 barrels/day of valuable GTL products is produced by the first method. The second method provides 25 MW electricity and the third method provides a compressed natural gas with 129 bar pressure for injection to the refinery pipelines. In addition, the economics of flare gas recovery methods are studied and compared. The results show that for the 4.176MMSCFD of gas flared from the Farashband gas refinery, the electricity production gives the highest rate of return (ROR), the lowest payback period, the highest annual profit and mild capital investment. Therefore, the electricity production is the superior method economically. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Application of digital imaging techniques to flare monitoring

    International Nuclear Information System (INIS)

    Rodrigues, Shaun J; Yan, Yong

    2011-01-01

    This paper presents a technique for detecting and monitoring flares in harsh industrial environments with the use of an imaging sensor combined with digital image processing. Flare images are captured via an imaging fibre and analysed to detect the flare's presence and region of interest. The flare characteristics are then determined using various image processing algorithms. A prototype system is designed, constructed and evaluated on a purpose built laboratory scale flare test rig. Results indicate that the imaging based technique has potential for the detection, monitoring and analysis of flares amidst various background conditions in the chemical and oil industries for plant safety, pollution prevention and control.

  5. A solar tornado triggered by flares?

    Science.gov (United States)

    Panesar, N. K.; Innes, D. E.; Tiwari, S. K.; Low, B. C.

    2013-01-01

    Context. Solar tornados are dynamical, conspicuously helical magnetic structures that are mainly observed as a prominence activity. Aims: We investigate and propose a triggering mechanism for the solar tornado observed in a prominence cavity by SDO/AIA on September 25, 2011. Methods: High-cadence EUV images from the SDO/AIA and the Ahead spacecraft of STEREO/EUVI are used to correlate three flares in the neighbouring active-region (NOAA 11303) and their EUV waves with the dynamical developments of the tornado. The timings of the flares and EUV waves observed on-disk in 195 Å are analysed in relation to the tornado activities observed at the limb in 171 Å. Results: Each of the three flares and its related EUV wave occurred within ten hours of the onset of the tornado. They have an observed causal relationship with the commencement of activity in the prominence where the tornado develops. Tornado-like rotations along the side of the prominence start after the second flare. The prominence cavity expands with the accelerating tornado motion after the third flare. Conclusions: Flares in the neighbouring active region may have affected the cavity prominence system and triggered the solar tornado. A plausible mechanism is that the active-region coronal field contracted by the "Hudson effect" through the loss of magnetic energy as flares. Subsequently, the cavity expanded by its magnetic pressure to fill the surrounding low corona. We suggest that the tornado is the dynamical response of the helical prominence field to the cavity expansion. Movies are available in electronic form at http://www.aanda.org

  6. SPECTROPOLARIMETRY OF C-CLASS FLARE FOOTPOINTS

    Energy Technology Data Exchange (ETDEWEB)

    Kleint, L., E-mail: kleintl@ucar.edu [High Altitude Observatory/NCAR, P.O. Box 3000, Boulder, CO 80307 (United States)

    2012-04-01

    We investigate the decay phase of a C-class flare in full-Stokes imaging spectropolarimetry with quasi-simultaneous measurements in the photosphere (6302.5 A line) and in the chromosphere (8542 A line) with the IBIS instrument. We analyze data from two fields of view, each spanning about 40'' Multiplication-Sign 80'' and targeting the two footpoints of the flare. A region of interest is identified from V/I images: a patch of opposite polarity in the smaller sunspot's penumbra. We find unusual flows in this patch at photospheric levels: a Doppler shift of -4 km s{sup -1}, but also a possible radial inflow into the sunspot of 4 km s{sup -1}. Such patches seem to be common during flares, but only high-resolution observations allowed us to see the inflow, which may be related to future flares observed in this region. Chromospheric images show variable overlying emission and flows and unusual Stokes profiles. We also investigate the irregular penumbra, whose formation may be blocked by the opposite polarity patch and flux emergence. The 40 minute temporal evolution depicts the larger of the flare ribbons becoming fainter and changing its shape. Measurable photospheric magnetic fields remain constant and we do not detect flare energy transport down from the chromosphere. We find no clear indications of impact polarization in the 8542 A line. We cannot exclude the possibility of impact polarization, because weaker signals may be buried in the prominent Zeeman signatures or it may have been present earlier during the flare.

  7. Risk of Colchicine-Associated Myopathy in Gout: Influence of Concomitant Use of Statin.

    Science.gov (United States)

    Kwon, Oh Chan; Hong, Seokchan; Ghang, Byeongzu; Kim, Yong-Gil; Lee, Chang-Keun; Yoo, Bin

    2017-05-01

    The purpose of this study was to investigate the risk of myopathy when statins are coadministered with colchicine in patients with gout. In gout patients who received colchicine with or without statin, clinical data collected included medications and history of hypertension, chronic kidney disease, and liver cirrhosis. Myopathy was defined as the presence of muscle symptoms with elevated creatine kinase or myoglobin. Multivariate analysis was performed to identify risk factors for myopathy. Inverse probability of treatment weighting (IPTW)-adjusted analysis was used to evaluate the influence of concomitant colchicine and statin use on myopathy. Of 674 patients, 486 received colchicine alone and 188 also received statin. The incidence of myopathy was not significantly higher in those on both drugs than in those on colchicine alone (2.7% vs 1.4%, P = .330). On multivariate analysis, chronic kidney disease (hazard ratio [HR] 29.056; 95% confidence interval [CI], 4.387-192.450; P colchicine dose (HR 20.960; 95% CI, 1.835-239.481; P = .014), and concomitant CYP3A4 inhibitor (HR 12.027; 95% CI, 2.743-52.725; P = .001) were associated with increased risk of myopathy. Concomitant use of statins, however, was not, even after adjusting for confounders (HR 1.123; 95% CI, 0.262-4.814; P = .875; IPTW-adjusted HR 0.321; 95% CI, 0.077-1.345; P = .120). Concomitant use of statin and colchicine was not associated with increased risk of myopathy. Thus, concomitant use of statin with colchicine seems to be safe from myotoxicity in gout patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. CLINICAL IMPORTANCE OF ENDOTHELIAL DYSFUNCTION AND INSULIN RESISTANCE SYNDROME IN PATIENTS WITH GOUT ASSOCIATED WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    N. N. Kushnarenko

    2015-09-01

    Full Text Available Aim. To study the endothelium status and determine the correlation between endothelial dysfunction and glucose metabolism in men with gout associated with arterial hypertension (HT.Material and methods. Patients (n=175, all are males with gout were enrolled into the study. Ambulatory blood pressure monitoring (ABPM was performed in all patients. Endothelial function was studied in tests with reactive hyperemia (endothelium-dependent reaction and nitroglycerin (endothelium independent reaction in brachial artery by ultrasonic Doppler examination. The level of nitrite-nitrate and endothelin-1 in blood serum was determined by ELISA technique. Fasting blood glucose and oral glucose tolerance tests were performed as well as fasting insulin blood level was determined by immunoenzyme method. Insulin-resistance index (HOMA-IR was calculated. Patients with HOMA- IR>2.77 were considered as insulin-resistant.Results. Patients with gout demonstrated endothelial deterioration associated with activation of nitroxid producing function, elevation in endothelin-1 serum level (1.36 fmol/ml [0.91; 2.32 fmol/ml] vs 0.19 fmol/ml [0.16; 0.27 fmol/ml] in controls, p<0.05 and impairments of endothelium-dependent vasodilation (6.4% [3.3; 7.3%] vs 17.8% [12.7; 23.9%] in controls, p<0.05. The revealed changes were the most marked in patients with gout associated with HT. The correlation between some endothelial dysfunction in- dices and glucose metabolism was observed.Conclusion. ABPM, brachial artery endothelium-dependent vasodilation and glucose metabolism status should be studied in patients with gout. Complex treatment of cardiovascular diseases in patients with gout should include ω-3 polyunsaturated fatty acids, angiotensin receptor antagonists should be used for antihypertensive therapy.

  9. FLARES PRODUCING WELL-ORGANIZED POST-FLARE ARCADES (SLINKIES) HAVE EARLY PRECURSORS

    International Nuclear Information System (INIS)

    Ryutova, M. P.; Frank, Z.; Hagenaar, H.; Berger, T.

    2011-01-01

    Exploding loop systems producing X-ray flares often, but not always, bifurcate into a long-living, well-organized system of multi-threaded loop arcades resembling solenoidal slinkies. The physical conditions that cause or prevent this process are not known. To address this problem, we examined most of the major (X-class) flares that occurred during the last decade and found that the flares that bifurcate into long-living slinky arcades have different signatures than those that do not 'produce' such structures. The most striking difference is that, in all cases of slinky formation, GOES high energy proton flux becomes significantly enhanced 10-24 hr before the flare occurs. No such effect was found prior to the 'non-slinky' flares. This fact may be associated with the difference between energy production by a given active region and the amount of energy required to bring the entire system into the form of well-organized, self-similar loop arcades. As an example illustrating the process of post-flare slinky formation, we present observations taken with the Hinode satellite, in several wavelengths, showing a time sequence of pre-flare and flare activity, followed by the formation of dynamically stable, well-organized structures. One of the important features revealed is that post-flare coronal slinky formation is preceded by scale invariant structure formation in the underlying chromosphere/transition region. We suggest that the observed regularities can be understood within the framework of self-organized critical dynamics characterized by scale invariant structure formation with critical parameters largely determined by energy saturation level. The observed regularities per se may serve as a long-term precursor of strong flares and may help to study predictability of system behavior.

  10. Flares Producing Well-organized Post-flare Arcades (Slinkies) Have Early Precursors

    Science.gov (United States)

    Ryutova, M. P.; Frank, Z.; Hagenaar, H.; Berger, T.

    2011-06-01

    Exploding loop systems producing X-ray flares often, but not always, bifurcate into a long-living, well-organized system of multi-threaded loop arcades resembling solenoidal slinkies. The physical conditions that cause or prevent this process are not known. To address this problem, we examined most of the major (X-class) flares that occurred during the last decade and found that the flares that bifurcate into long-living slinky arcades have different signatures than those that do not "produce" such structures. The most striking difference is that, in all cases of slinky formation, GOES high energy proton flux becomes significantly enhanced 10-24 hr before the flare occurs. No such effect was found prior to the "non-slinky" flares. This fact may be associated with the difference between energy production by a given active region and the amount of energy required to bring the entire system into the form of well-organized, self-similar loop arcades. As an example illustrating the process of post-flare slinky formation, we present observations taken with the Hinode satellite, in several wavelengths, showing a time sequence of pre-flare and flare activity, followed by the formation of dynamically stable, well-organized structures. One of the important features revealed is that post-flare coronal slinky formation is preceded by scale invariant structure formation in the underlying chromosphere/transition region. We suggest that the observed regularities can be understood within the framework of self-organized critical dynamics characterized by scale invariant structure formation with critical parameters largely determined by energy saturation level. The observed regularities per se may serve as a long-term precursor of strong flares and may help to study predictability of system behavior.

  11. The tale of a city saved by gout and a letter from Jesus.

    Science.gov (United States)

    Pinals, Robert S

    2008-08-01

    In the 6th century a Persian invasion of the eastern provinces of the Roman empire resulted in the devastation of several cities. Edessa alone was spared, and it was widely believed that this city had divine protection because of postal communication over 5 centuries earlier between its gouty ruler and Jesus Christ. These events are reviewed in detail herein. Some appear to have a well-documented historic basis but others, including the letter from Jesus, have been considered highly questionable by various authorities. The story provides an interesting connection between gout and historic events in the ancient world.

  12. Guava leaves polyphenolics-rich extract inhibits vital enzymes implicated in gout and hypertension in vitro

    Directory of Open Access Journals (Sweden)

    Emmanuel Anyachukwu Irondi

    2016-06-01

    50 of 38.24 ± 2.32 μg/mL, 21.06 ± 2.04 μg/mL and 27.52 ± 1.72 μg/mL against XO, ACE and Fe2+-induced lipid peroxidation, respectively. The extract also strongly scavenged DPPH* and ABTS*+. Conclusion: Guava leaves extract could serve as functional food for managing gout and hypertension and attenuating the oxidative stress associated with both diseases. [J Complement Med Res 2016; 5(2.000: 122-130

  13. Lumbar Gout Tophus Mimicking Epidural Abscess with Magnetic Resonance Imaging, Bone, and Gallium Scans.

    Science.gov (United States)

    Vicente, Justo Serrano; Gómez, Alejandro Lorente; Moreno, Rafael Lorente; Torre, Jose Rafael Infante; Bernardo, Lucía García; Madrid, Juan Ignacio Rayo

    2018-01-01

    Gout is a common metabolic disorder, typically diagnosed in peripheral joints. Tophaceous deposits in lumbar spine are a very rare condition with very few cases reported in literature. The following is a case report of a 52-year-old patient with low back pain, left leg pain, and numbness. Serum uric acid level was in normal range. magnetic resonance imaging, bone scan, and gallium-67 images suggested an inflammatory-infectious process focus at L4. After a decompressive laminectomy at L4-L5 level, histological examination showed a chalky material with extensive deposition of amorphous gouty material surrounded by macrophages and foreign-body giant cells (tophaceous deposits).

  14. Radio-flaring Ultracool Dwarf Population Synthesis

    Energy Technology Data Exchange (ETDEWEB)

    Route, Matthew, E-mail: mroute@purdue.edu [Department of Astronomy and Astrophysics, the Pennsylvania State University, 525 Davey Laboratory, University Park, PA 16802 (United States)

    2017-08-10

    Over a dozen ultracool dwarfs (UCDs), low-mass objects of spectral types ≥M7, are known to be sources of radio flares. These typically several-minutes-long radio bursts can be up to 100% circularly polarized and have high brightness temperatures, consistent with coherent emission via the electron cyclotron maser operating in approximately kilogauss magnetic fields. Recently, the statistical properties of the bulk physical parameters that describe these UCDs have become described adequately enough to permit synthesis of the population of radio-flaring objects. For the first time, I construct a Monte Carlo simulator to model the population of these radio-flaring UCDs. This simulator is powered by Intel Secure Key (ISK), a new processor technology that uses a local entropy source to improve random number generation that has heretofore been used to improve cryptography. The results from this simulator indicate that only ∼5% of radio-flaring UCDs within the local interstellar neighborhood (<25 pc away) have been discovered. I discuss a number of scenarios that may explain this radio-flaring fraction and suggest that the observed behavior is likely a result of several factors. The performance of ISK as compared to other pseudorandom number generators is also evaluated, and its potential utility for other astrophysical codes is briefly described.

  15. Flare differentially rotates sunspot on Sun's surface

    Science.gov (United States)

    Liu, Chang; Xu, Yan; Cao, Wenda; Deng, Na; Lee, Jeongwoo; Hudson, Hugh S.; Gary, Dale E.; Wang, Jiasheng; Jing, Ju; Wang, Haimin

    2016-01-01

    Sunspots are concentrations of magnetic field visible on the solar surface (photosphere). It was considered implausible that solar flares, as resulted from magnetic reconnection in the tenuous corona, would cause a direct perturbation of the dense photosphere involving bulk motion. Here we report the sudden flare-induced rotation of a sunspot using the unprecedented spatiotemporal resolution of the 1.6 m New Solar Telescope, supplemented by magnetic data from the Solar Dynamics Observatory. It is clearly observed that the rotation is non-uniform over the sunspot: as the flare ribbon sweeps across, its different portions accelerate (up to ∼50° h−1) at different times corresponding to peaks of flare hard X-ray emission. The rotation may be driven by the surface Lorentz-force change due to the back reaction of coronal magnetic restructuring and is accompanied by a downward Poynting flux. These results have direct consequences for our understanding of energy and momentum transportation in the flare-related phenomena. PMID:27721463

  16. Gout as a risk factor for osteoporosis: epidemiologic evidence from a population-based longitudinal study involving 108,060 individuals.

    Science.gov (United States)

    Kok, V C; Horng, J-T; Wang, M N; Chen, Z-Y; Kuo, J-T; Hung, G-D

    2018-04-01

    Is gout a risk factor for future osteoporosis? This large population-based study comprising two matched groups of individuals with and without gout demonstrates that patients with gout have a 20% increase in the risk of developing osteoporosis in future through an 8-year follow-up. To examine if gout is associated with an increased risk of osteoporosis. We conducted a nationwide population-based retrospective matched-cohort study. Two matched cohorts (n = 36,458 with gout and 71,602 without gout) assembled and recruited from the Longitudinal Health Insurance Dataset containing 1 million subjects. Exclusion criteria were missing data, age < 20 years, short follow-up period, and pre-existing osteoporosis. Both cohorts were followed up until incident osteoporosis, death, or the end of the study. Person-year data and incidence rates were evaluated. A multivariable Cox model was used to derive an adjusted hazard ratio (aHR) after controlling for socioeconomic proxy, geographical difference, glucocorticoid and allopurinol exposure, various prespecified medical conditions, and comorbidities. Men comprised 72.8% of the cohorts. With a follow-up of 183,729 and 359,900 person-years for the gout and non-gout cohorts, 517 and 811 incidents of osteoporosis occurred, respectively, after excluding osteoporosis incidents in the first 3 years of follow-up. The cumulative incidence of osteoporosis was statistically higher in the gout cohort than in the non-gout cohort, at 3.3 versus 2.1% (P = 0.0036, log-rank). Our Cox model showed a 1.2-fold increase in the incidence of osteoporosis in the gout cohort, with an aHR of 1.2 (95% confidence interval, 1.06-1.35). This first population-based epidemiologic study supports the hypothesis that compared with individuals without gout; those with gout have a modest increase in the risk of developing osteoporosis in future.

  17. Frequency distribution function of stellar flares in the Orion association

    International Nuclear Information System (INIS)

    Parsamian, E.S.

    1981-01-01

    The temporal distributions of flare stars in the Orion association and the numbers of stars with different flare frequencies are determined by means of Ambartsumian's (1978) method, which uses the chronology of discovery of 'first' flares and the chronology of confirmations, i.e., the temporal distributions of 'repeated' flares. It is shown that flare stars with high flare frequency (not greater than 1000 hours) in the Pleiades are basically stars of low luminosity with M(U) not less than 13m. Two independent methods of determining the number of flare stars in the aggregates confirm that there are about 1.5 times more flare stars in the Orion association than in the Pleiades

  18. A study of flare stars in the taurus region

    International Nuclear Information System (INIS)

    Khodzhaev, A.S.

    1986-01-01

    The results are given of a search for flare stars in the region of the dark clouds in Taurus together with the results of photometric, H /sub alpha/ -spectroscopic, and statistical investigations of them. Photographic observations during 1980-1984 revealed 92 new flare stars, 13 of which were found to be known Orion variables with 16 repeated flares of 13 previously known flare stars. Their apparent distribution is considered. The question of whether the flare stars belong to a dark cloud is discussed. A comparative analysis of the flare stars in the Taurus region and other aggregates is made. The Hertzsprung-Russell (V, B - V) and two-color (U - B, B - V) diagrams for the flare stars are similar to the corresponding diagrams constructed for star clusters and associations (Pleiades, Orion, etc.). The total number of flare stars in the region of the dark clouds in Taurus is estimated at ≥ 500

  19. X-ray Emission Characteristics of Flares Associated with CMEs ...

    Indian Academy of Sciences (India)

    LDEs); but the relationship of CMEs with impulsive flares is still unknown. Gosling (1993) showed that solar flares play no fundamental role in causing geomagnetic disturbances. He cited studies which indicate that CMEs are the primary cause ...

  20. Flaring red dwarf stars: news from Crimea

    International Nuclear Information System (INIS)

    Gershberg, Roald E

    1998-01-01

    Important phenomena are briefly described which have recently been discovered in the Crimean studies of flaring red dwarf stars believed to be the most common type of variable stars in the Galaxy. These phenomena include (i) long-lived radiation from a blueshifted component in the ionized-helium λ 4686 A emission line in the active state of one such star, (ii) a long-lived absorption component in the stellar flare light curves with a lifetime exceeding that of the conventional flare emission, and (iii) solarcycle-like activity periodicity of the star EV Lac, whose mass is only 0.3 solar masses. In theoretical terms, a red dwarf star spot model is constructed which, in contrast to the commonly accepted model, agrees well with the solar spot picture. (physics of our days)

  1. Solar flare loops observations and interpretations

    CERN Document Server

    Huang, Guangli; Ji, Haisheng; Ning, Zongjun

    2018-01-01

    This book provides results of analysis of typical solar events, statistical analysis, the diagnostics of energetic electrons and magnetic field, as well as the global behavior of solar flaring loops such as their contraction and expansion. It pays particular attention to analyzing solar flare loops with microwave, hard X-ray, optical and EUV emissions, as well as the theories of their radiation, and electron acceleration/transport. The results concerning influence of the pitch-angle anisotropy of non-thermal electrons on their microwave and hard X-ray emissions, new spectral behaviors in X-ray and microwave bands, and results related to the contraction of flaring loops, are widely discussed in the literature of solar physics. The book is useful for graduate students and researchers in solar and space physics.

  2. Gout in the spine and sacri-iliac joints: radiological manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Jajic, I.

    1982-06-01

    It is well known that deposits of urates in soft tissues occur commonly in gout, particularly in para-articular areas and in articular cartilages of the limbs. Involvement of the spine and sacro-iliac joints by such deposits, however, has been regarded as being relatively unusual and has attracted little attention in the literature. As we were impressed by the frequency of episodes of acute back pain in our patients with gouty arthritis, established definitely on clinical and biochemical grounds, we undertook a radiological investigation of the spine and sacro-iliac joints in a series of 54 subjects. It was suspected that their episodes of pain were clinical manifestations of gout, and 12 of the group had suffered one or more attacks. Of these 12 subjects, eight were found to have radiological abnormalities. In six subjects, evidence of sacro-iliitis was demonstrated, which is comparable to the report of Resnick and Reinke (8), and in two patients vertebral lesions corresponded to those described by Jaffe (5). Hyperostotic spondylosis was present in no fewer than 29 of the series. Although lacking histological confirmation of the lesions demonstrated radiologically, we believe that our suspicions have been confirmed.

  3. Revisiting the pathogenesis of podagra: why does gout target the foot?

    Directory of Open Access Journals (Sweden)

    Roddy Edward

    2011-05-01

    Full Text Available Abstract This invited paper provides a summary of a keynote lecture delivered at the 2011 Australasian Podiatry Conference. Gout is the most prevalent inflammatory arthropathy. It displays a striking predilection to affect the first metatarsophalangeal joint as well as joints within the mid-foot and ankle. A number of factors are known to reduce urate solubility and enhance nucleation of monosodium urate crystals including decreased temperature, lower pH and physical shock, all of which may be particularly relevant to crystal deposition in the foot. An association has also been proposed between monosodium urate crystal deposition and osteoarthritis, which also targets the first metatarsophalangeal joint. Cadaveric, clinical and radiographic studies indicate that monosodium urate crystals more readily deposit in osteoarthritic cartilage. Transient intra-articular hyperuricaemia and precipitation of monosodium urate crystals is thought to follow overnight resolution of synovial effusion within the osteoarthritic first metatarsophalangeal joint. The proclivity of gout for the first metatarsophalangeal joint is likely to be multi-factorial in origin, arising from the unique combination of the susceptibility of the joint to osteoarthritis and other determinants of urate solubility and crystal nucleation such as temperature and minor physical trauma which are particularly relevant to the foot.

  4. THE FLARE-ONA OF EK DRACONIS

    International Nuclear Information System (INIS)

    Ayres, Thomas R.

    2015-01-01

    EK Draconis (HD 129333: G1.5 V) is a well-known young (50 Myr) solar analog. In 2012, Hubble Space Telescope returned to EK Dra to follow up a far-ultraviolet (FUV) SNAPshot visit by Cosmic Origins Spectrograph (COS) two years earlier. The brief SNAP pointing had found surprisingly redshifted, impulsively variable subcoronal “hot-line” emission of Si iv 1400 Å (T ∼ 8 × 10 4 K). Serendipitously, the 2012 follow-on program witnessed one of the largest FUV flares ever recorded on a sunlike star, which again displayed strong redshifts (downflows) of 30–40 km s −1 , even after compensating for small systematics in the COS velocity scales, uncovered through a cross-calibration by Space Telescope Imaging Spectrograph (STIS). The (now reduced, but still substantial) ∼10 km s −1 hot-line redshifts outside the flaring interval did not vary with rotational phase, so cannot be caused by “Doppler imaging” (bright surface patches near a receding limb). Density diagnostic O iv] 1400 Å multiplet line ratios of EK Dra suggest n e ∼ 10 11 cm −3 , an order of magnitude larger than in low-activity solar twin α Centauri A, but typical of densities inferred in large stellar soft X-ray events. The self-similar FUV hot-line profiles between the flare decay and the subsequent more quiet periods, and the unchanging but high densities, reinforce a long-standing idea that the coronae of hyperactive dwarfs are flaring all the time, in a scale-free way; a flare-ona if you will. In this picture, the subsonic hot-line downflows probably are a byproduct of the post-flare cooling process, something like “coronal rain” on the Sun. All in all, the new STIS/COS program documents a complex, energetic, dynamic outer atmosphere of the young sunlike star

  5. Statistical properties of solar Hα flare activity

    Directory of Open Access Journals (Sweden)

    Deng Linhua

    2017-01-01

    Full Text Available Magnetic field structures on the solar atmosphere are not symmetric distribution in the northern and southern hemispheres, which is an important aspect of quasi-cyclical evolution of magnetic activity indicators that are related to solar dynamo theories. Three standard analysis techniques are applied to analyze the hemispheric coupling (north-south asymmetry and phase asynchrony of monthly averaged values of solar Hα flare activity over the past 49 years (from 1966 January to 2014 December. The prominent results are as follows: (1 from a global point of view, solar Hα flare activity on both hemispheres are strongly correlated with each other, but the northern hemisphere precedes the southern one with a phase shift of 7 months; (2 the long-range persistence indeed exists in solar Hα flare activity, but the dynamical complexities in the two hemispheres are not identical; (3 the prominent periodicities of Hα flare activity are 17 years full-disk activity cycle and 11 years Schwabe solar cycle, but the short- and mid-term periodicities cannot determined by monthly time series; (4 by comparing the non-parametric rescaling behavior on a point-by-point basis, the hemispheric asynchrony of solar Hα flare activity are estimated to be ranging from several months to tens of months with an average value of 8.7 months. The analysis results could promote our knowledge on the long-range persistence, the quasi-periodic variation, and the hemispheric asynchrony of solar Hα flare activity on both hemispheres, and possibly provide valuable information for the hemispheric interrelation of solar magnetic activity.

  6. Two-phase Heating in Flaring Loops

    Science.gov (United States)

    Zhu, Chunming; Qiu, Jiong; Longcope, Dana W.

    2018-03-01

    We analyze and model a C5.7 two-ribbon solar flare observed by the Solar Dynamics Observatory, Hinode, and GOES on 2011 December 26. The flare is made of many loops formed and heated successively over one and half hours, and their footpoints are brightened in the UV 1600 Å before enhanced soft X-ray and EUV missions are observed in flare loops. Assuming that anchored at each brightened UV pixel is a half flaring loop, we identify more than 6700 half flaring loops, and infer the heating rate of each loop from the UV light curve at the footpoint. In each half loop, the heating rate consists of two phases: intense impulsive heating followed by a low-rate heating that is persistent for more than 20 minutes. Using these heating rates, we simulate the evolution of their coronal temperatures and densities with the model of the “enthalpy-based thermal evolution of loops.” In the model, suppression of thermal conduction is also considered. This model successfully reproduces total soft X-ray and EUV light curves observed in 15 passbands by four instruments GOES, AIA, XRT, and EVE. In this flare, a total energy of 4.9 × 1030 erg is required to heat the corona, around 40% of this energy is in the slow-heating phase. About two-fifths of the total energy used to heat the corona is radiated by the coronal plasmas, and the other three fifth transported to the lower atmosphere by thermal conduction.

  7. Solar flare impulsivity and its relationship with white-light flares and with CMEs

    Science.gov (United States)

    Watanabe, K.; Masuda, S.

    2017-12-01

    There are many types of classification in solar flares. One of them is a classification by flare duration in soft X-rays; so-called impulsive flare and long duration event (LDE). Typically, the duration of an impulsive flare is shorter than 1 hour, and that of an LDE is longer than 1 hour. These two types of flare show different characteristics. In soft X-rays, impulsive flares usually have a compact loop structure. On the other hand, LDEs show a large-scale loop, sometimes a large arcade structure. In hard X-rays (HXRs), the difference appears clear, too. The former shows a strong and short-time (10 minutes) emissions and show a large coronal source. These facts suggest that HXR observation becomes one of a good indicator to classify solar flares, especially for the study on the particle acceleration and the related phenomena. However, HXR data do not always exist due to the satellite orbit and the small sensitivity of HXR instruments. So, in this study, based on the concept of the Neupert effect (Neupert, 1968), we use soft X-ray derivative data as the proxy of HXR. From this data, we define impulsivity (IP) for each flare. Then we investigate solar flares using this new index. First we apply IP index to white-light flare (WLF) research. We investigate how WL enhancement depends on IP, then it is found that WLF tend to have large IP values. So the flare impulsivity (IP) is one of the important factors if WL enhancement appears or not in a solar flare. Next we investigate how CME itself and/or its physical parameters depend on IP index. It has been believed that most of CMEs are associated with LDEs, but we found that there is only a weak correlation between the existence of CME and IP index. Finally, we also search for the relationship between WLF and CME as a function of IP and discuss the physical condition of WLF.

  8. Impulsive phase of solar flares: theory

    International Nuclear Information System (INIS)

    Mackinnon, A.L.

    1986-01-01

    The paper reviews the theoretical interpretation of impulsive phase phenomena in solar flares. The impulsive phase is defined to be that period of approx. 10 - 100s duration, during which the flare radiative output undergoes its most rapid, dramatic increase and decrease. The interpretation of the various impulsive phase radiation signatures are examined, including the i) hard x-ray emission, ii) radio emission, iii) UV, Hα and white light emissions and iv) gamma-ray emission. The acceleration mechanisms are discussed with respect to candidate acceleration mechanisms, and the synthesis of the theory and observations. (UK)

  9. Solar flares as harbinger of new physics

    CERN Document Server

    Zioutas, K; Semertzidis, Y.; Papaevangelou, T.; Georgiopoulou, E.; Gardikiotis, A.; Dafni, T.; Tsagri, M.; Semertzidis, Y.; Papaevangelou, T.; Dafni, T.

    2011-01-01

    This work provides additional evidence on the involvement of exotic particles like axions and/or other WISPs, following recent measurements during the quietest Sun and flaring Sun. Thus, SPHINX mission observed a minimum basal soft X-rays emission in the extreme solar minimum in 2009. The same scenario (with ~17 meV axions) fits also the dynamical behaviour of white-light solar flares, like the measured spectral components in the visible and in soft X-rays, and, the timing between them. Solar chameleons remain a viable candidate, since they may preferentially convert to photons in outer space.

  10. Statistical Distributions of Optical Flares from Gamma-Ray Bursts

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Shuang-Xi [College of Physics and Engineering, Qufu Normal University, Qufu 273165 (China); Yu, Hai; Wang, F. Y.; Dai, Zi-Gao, E-mail: fayinwang@nju.edu.cn [School of Astronomy and Space Science, Nanjing University, Nanjing 210093 (China)

    2017-07-20

    We statistically study gamma-ray burst (GRB) optical flares from the Swift /UVOT catalog. We compile 119 optical flares, including 77 flares with redshift measurements. Some tight correlations among the timescales of optical flares are found. For example, the rise time is correlated with the decay time, and the duration time is correlated with the peak time of optical flares. These two tight correlations indicate that longer rise times are associated with longer decay times of optical flares and also suggest that broader optical flares peak at later times, which are consistent with the corresponding correlations of X-ray flares. We also study the frequency distributions of optical flare parameters, including the duration time, rise time, decay time, peak time, and waiting time. Similar power-law distributions for optical and X-ray flares are found. Our statistic results imply that GRB optical flares and X-ray flares may share the similar physical origin, and both of them are possibly related to central engine activities.

  11. Relationship of Non-potentiality and Flaring: Intercomparison for an ...

    Indian Academy of Sciences (India)

    1992-10-26

    We have made an attempt to obtain relationship of magnetic shear and vertical currents in NOAA AR7321. Intercomparison of changes observed at several flaring and non-flaring sites associated with an M4/2B flare observed on October 26, 1992 is reported.

  12. The Effect of Synthetic Vision Enhancements on Landing Flare Performance

    NARCIS (Netherlands)

    Le Ngoc, L.; Borst, C.; Mulder, M.; Van Paassen, M.M.

    2010-01-01

    The usage of heads-down, non-conformal synthetic vision displays for landings below minimums has inherent problems during the flare due to minification effects. Literature showed that pilots can use four visual cues to perform a manual flare maneuver. Amongst their strategies, the Jacobson flare

  13. Statistical Distributions of Optical Flares from Gamma-Ray Bursts

    International Nuclear Information System (INIS)

    Yi, Shuang-Xi; Yu, Hai; Wang, F. Y.; Dai, Zi-Gao

    2017-01-01

    We statistically study gamma-ray burst (GRB) optical flares from the Swift /UVOT catalog. We compile 119 optical flares, including 77 flares with redshift measurements. Some tight correlations among the timescales of optical flares are found. For example, the rise time is correlated with the decay time, and the duration time is correlated with the peak time of optical flares. These two tight correlations indicate that longer rise times are associated with longer decay times of optical flares and also suggest that broader optical flares peak at later times, which are consistent with the corresponding correlations of X-ray flares. We also study the frequency distributions of optical flare parameters, including the duration time, rise time, decay time, peak time, and waiting time. Similar power-law distributions for optical and X-ray flares are found. Our statistic results imply that GRB optical flares and X-ray flares may share the similar physical origin, and both of them are possibly related to central engine activities.

  14. 'The tempting girl, I know so well': Representations of Gout and the Self-Fashioning of Bohemian Humanist Scholars

    Czech Academy of Sciences Publication Activity Database

    Storchová, Lucie

    2016-01-01

    Roč. 21, č. 6 (2016), s. 511-530 ISSN 1383-7427 R&D Projects: GA ČR GB14-37038G Institutional support: RVO:67985955 Keywords : Bohemian Lands * humanism * Neo-latin poetry * gout * representation Subject RIV: AB - History Impact factor: 0.317, year: 2016

  15. Toward development of a Tophus Impact Questionnaire: a qualitative study exploring the experience of people with tophaceous gout.

    Science.gov (United States)

    Aati, Opetaia; Taylor, William J; Horne, Anne; Dalbeth, Nicola

    2014-08-01

    Although tophi are known to affect physical function, the impact of tophi on the lives of people with gout has not been explored in detail. The aim of this qualitative study was to understand the experience of people living with tophaceous gout, as the first step to developing a patient-reported Tophus Impact Questionnaire. Twenty-five people with tophaceous gout (22 men; median age, 66 years; median gout disease duration, 26 years) participated in semistructured interviews that explored their experiences and perceptions of tophi. Interviews were recorded and transcribed. The transcripts were analyzed and coded to identify themes using content analysis. Three major interrelated themes arose from the interviews. The first theme was functional impact affecting body structures and functions (causing pain, restricted joint range of motion and deformity, and complications), and causing activity limitation and participation restriction (affecting day-to-day activities, leisure activities, employment participation, and family participation). The second theme was psychological impact including low self-esteem, embarrassment, resignation, but also optimism. The third theme was the lack of impact in some participants. Gouty tophi can have an important impact on many aspects of the patient's life. In addition to the impact of tophi on physical function, tophi may also influence social and psychological functioning. Capturing these aspects of the patient experience will be important in the development of a patient-reported outcome measure of tophus burden.

  16. Path Analysis Identifies Receptor Activator of Nuclear Factor-κB Ligand, Osteoprotegerin, and Sclerostin as Potential Mediators of the Tophus-bone Erosion Relationship in Gout.

    Science.gov (United States)

    Chhana, Ashika; Aati, Opetaia; Gamble, Gregory D; Callon, Karen E; Doyle, Anthony J; Roger, Mark; McQueen, Fiona M; Horne, Anne; Reid, Ian R; Cornish, Jillian; Dalbeth, Nicola

    2016-02-01

    To determine the relationship between tophus, erosion and bone remodeling factors in gout. Computed tomography bone erosion and circulating bone factors were measured in adults with tophaceous gout. Multiple regression modeling and path analysis were used to determine predictors of erosion. Tophus number, Māori or Pacific ethnicity, creatinine, receptor activator of nuclear factor-κB ligand (RANKL), osteoprotegerin (OPG), and sclerostin were independently associated with erosion. Path analysis showed a direct effect of tophus number on erosion, partially mediated through OPG, RANKL, and sclerostin. Tophus number is strongly associated with bone erosion in gout. Circulating RANKL, OPG, and sclerostin are potential mediators of tophus-related erosion.

  17. Hybrid simulations of chromospheric HXR flare sources

    Czech Academy of Sciences Publication Activity Database

    Moravec, Z.; Varady, Michal; Kašparová, Jana; Kramoliš, D.

    2016-01-01

    Roč. 337, č. 10 (2016), s. 1020-1023 ISSN 0004-6337. [Dynamic Sun - Exploring the Many Facets of Solar Eruptive Events. Potsdam, 26.10.2015-29.10.2015] Institutional support: RVO:67985815 Keywords : Sun * chromosphere * flares Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 0.916, year: 2016

  18. X-ray Emission from Solar Flares

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... Solar X-ray Spectrometer (SOXS), the first space-borne solar astronomy experiment of India was designed to improve our current understanding of X-ray emission from the Sun in general and solar flares in particular. SOXS mission is composed of two solid state detectors, viz., Si and CZT semiconductors ...

  19. Second-stage acceleration in solar flares

    International Nuclear Information System (INIS)

    Mullan, D.J.

    1976-01-01

    A model proposed by Chevalier and Scott to account for cosmic ray acceleration in an expanding supernova remnant is applied to the case of a shock wave injected into the solar corona by a flare. Certain features of solar cosmic rays can be explained by this model. (orig.) [de

  20. SUNSPOT ROTATION, FLARE ENERGETICS, AND FLUX ROPE HELICITY: THE HALLOWEEN FLARE ON 2003 OCTOBER 28

    International Nuclear Information System (INIS)

    Kazachenko, Maria D.; Canfield, Richard C.; Longcope, Dana W.; Qiu Jiong

    2010-01-01

    We study the X17 eruptive flare on 2003 October 28 using Michelson Doppler Imager observations of photospheric magnetic and velocity fields and TRACE 1600 A images of the flare in a three-dimensional model of energy buildup and release in NOAA 10486. The most dramatic feature of this active region is the 123 0 rotation of a large positive sunspot over 46 hr prior to the event. We apply a method for including such rotation in the framework of the minimum current corona model of the buildup of energy and helicity due to the observed motions. We distinguish between helicity and energy stored in the whole active region and that released in the flare itself. We find that while the rotation of a sunspot contributes significantly to the energy and helicity budgets of the whole active region, it makes only a minor contribution to that part of the region that flares. We conclude that in spite of the fast rotation, shearing motions alone store sufficient energy and helicity to account for the flare energetics and interplanetary coronal mass ejection helicity content within their observational uncertainties. Our analysis demonstrates that the relative importance of shearing and rotation in this flare depends critically on their location within the parent active region topology.

  1. Allopurinol, Benzbromarone, or a Combination in Treating Patients with Gout: Analysis of a Series of Outpatients

    Directory of Open Access Journals (Sweden)

    Valderilio Feijó Azevedo

    2014-01-01

    Full Text Available Objective. To profile a sample of gouty patients treated with allopurinol, benzbromarone, or a combination of these two drugs and to describe the impact of this therapy in reducing uric acid levels. Methods. An observational, transversal study was performed. We evaluated 48 patients diagnosed with gout who were seen at the Outpatient Rheumatology Clinic of the Federal University of Paraná between January 2009 and November 2010. Clinical data, creatinine serum levels, and basal and posttreatment levels of serum urates, transaminases, and bilirubins were recorded. Uric acid levels were measured in a 24-hour urine sample. Patients were divided into three groups: patients given only allopurinol (A, only benzbromarone (B, and both in combined therapy (A + B. Results. The average age of these patients was 56.6 ± 11.4 years, varying from 35 to 81 years. The entire patient group experienced a significant drop in serum urate levels, from 8.5 ± 1.8 mg/dL (0.472 ± 0.1 mmol/L to 6.7 ± 2.1 mg/dL (0.372 ± 0.116 mmol/L (P<0.001, regardless of the prescribed medication. The number of patients taking both drugs whose serum uric acid values fell within normal range (men <7 mg/dL (0.38 mmol/L and women <6 mg/dL (0.33 mmol/L was 85.7% (6/7 while this value for the group taking benzbromarone alone was 75% (3/4 and for the group taking allopurinol alone this number was 51.8% (14/27. Conclusions. The therapeutic combination of benzbromarone and allopurinol significantly decreased serum urate levels in patients with gout when compared to individual use of each of these agents. This finding is especially important in treating patients who cannot control hyperuricemia with monotherapy. Benzbromarone alone or in combination with allopurinol has an important clinical role in controlling hyperuricemia in patients with gout.

  2. Ankylosing spondylitis, late osteoarthritis, vascular calcification, chondrocalcinosis and pseudo gout: toward a possible drug therapy.

    Science.gov (United States)

    Mebarek, S; Hamade, E; Thouverey, C; Bandorowicz-Pikula, J; Pikula, S; Magne, D; Buchet, R

    2011-01-01

    In this review we consider diseases associated with pathological mineralization/ossification, namely, ankylosing spondylitis (AS), osteoarthritis (OA), generalized artery calcification of infancy (GACI), vascular calcification as well as chondrocalcinosis (CC) and pseudo gout. Deciphering the key enzymes implicated in the calcification process is an objective of prime importance and the ultimate goal is to synthesize inhibitors of these enzymes in order to provide efficient alternate therapeutic strategies that will slow down the pathologic mineralization and complement the arsenal of anti-inflammatory drugs. One of the difficulties in the definition of diseases associated with pathologic mineralization/ossification lies in the controversial relationship between the type of calcification and the nature of the disease. Here, we propose to clarify this relationship by making a distinction between diseases associated with hydroxyapatite (HA) and calcium pyrophosphate dihydrate (CPPD) deposits. AS, OA, GACI and vascular calcification are usually characterized by mineralization/ossification associated with HA deposits, while CC and pseudo gout are mostly characterized by CPPD deposits. Although both HA and CPPD deposits may occur concomitantly, as in chronic pyrophosphate arthritis or in OA with CPPD, they are formed as a result of two antagonistic processes indicating that treatment of distinct diseases can be only achieved by disease-specific drug therapies. The hydrolysis of PPi, an inhibitor of HA formation, is mostly controlled by tissue non-specific alkaline phosphatase TNAP, while PPi production in the extracellular medium is controlled by ANK, a PPi transporter, and/or NPP1 which generates PPi from nucleotide triphosphates. Low PPi concentration may lead to a preferential deposition of HA while high PPi concentration will favor the formation of CPPD deposits. Thus, HA and CCPD deposition cannot occur concomitantly because they are determined by the Pi/PPi ratio

  3. Study on the flare stars in the Taurus region

    International Nuclear Information System (INIS)

    Khodzhaev, A.S.

    1986-01-01

    The results of the search of flare stars and their photometric, Hsub(α)-spectroscopic and statistical study in the Taurus are presented. By means of photographic observations carried out during 1980-1984, 92 new flare stars were discovered, 13 of which are known Orion Population variables, and 16 repeated flare-ups among 13 known flare stars. Spatial distribution of these stars was considered and the problem of their membership was discussed. Comparative analysis of the data of flare stars in the Taurus with that of other systems has been carried out. The Herzsprung-Russel and two-colour (U-B, B-V) diagrams for the Taurus flare stars are similar to the diagrams of stellar clusters and associations (Pleiades, Orion etc.). The estimated total number of flare stars in this region is larger than 500

  4. Management of routine solution gas flaring in Alberta

    International Nuclear Information System (INIS)

    1998-01-01

    Alberta's Clean Air Strategic Alliance (CASA) shares decision-making responsibilities with the Government of Alberta for strategic aspects of air quality. In 1997, the Alliance established the Flaring Project Team to develop recommendations that address potential and observed impacts associated with flaring, with particular focus on 'upstream solution gas' flaring. The upstream industry explores for, acquires, develops, produces and markets crude oil and natural gas. Essentially, solution gas at upstream sites is 'co-produced' during crude oil production. The project team was established to collect and summarize information on flaring and its impacts and to develop recommendations for short-term actions to minimize the practice of routine flaring of solution gas. Another goal of the team is to develop a research strategy to better understand flaring emissions and their effects on human, animal and environmental health. The team is working on developing long-term strategies for actions to address the gas flaring issue. 5 refs., 1 tab., 7 figs

  5. Ultraviolet and radio flares from UX Arietis and HR 1099

    Science.gov (United States)

    Lang, Kenneth R.; Willson, Robert F.

    1988-01-01

    Simultaneous observations of the RS CVn systems UX Ari and HR 1099 with the IUE satellite and the VLA are presented. Flaring activity is observed at ultraviolet wavelengths with the IUE when none is detected at radio wavelengths with the VLA. Radio flares with no detectable ultraviolet activity have also been observed. Thus, flares in the two spectral regions are either uncorrelated or weakly correlated. The flaring emission probably originates in different regions at the two wavelengths. Radio flares from RS CVn stars may originate in sources that are larger than, or comparable to, a star in size. This is in sharp contrast to compact, coherent radio flares from dwarf M stars. The ultraviolet flares from RS CVn stars probably originate in sources that are smaller than a component star.

  6. Identifying Preliminary Domains to Detect and Measure Rheumatoid Arthritis Flares: Report of the OMERACT 10 RA Flare Workshop

    DEFF Research Database (Denmark)

    Bingham, Clifton O; Alten, Rieke; Bartlett, Susan J

    2011-01-01

    critical insights into the multidimensional nature of flare. The perspectives of patients and healthcare and research professionals are being integrated to ensure that any outcome measurement to detect flares fulfills the first OMERACT criteria of Truth. Through an iterative data-driven Delphi process......, a preliminary list of key domains has been identified to evaluate flare. RESULTS: At OMERACT 10, consensus was achieved identifying features of flare in addition to the existing core set for RA, including fatigue, stiffness, symptom persistence, systemic features, and participation. Patient self-report of flare...

  7. Progress report on recommendations of the Flaring Project Team

    International Nuclear Information System (INIS)

    Macken, C.

    1999-01-01

    Part of the mandate of the Clean Air Strategic Alliance (CASA) is to share decision-making responsibility for air quality management with the government of Alberta, through the ministries of Environmental Protection, Energy, and Health, and the Alberta Energy and Utilities Board (EUB). CASA's vision for air quality in Alberta is that 'the air will be odourless, tasteless, look clear, and have no measurable short- or long-term adverse effects on people, animals, or the environment'. In 1997, CASA approved the establishment of the Flaring Project Team in response to public concern about potential and observed impacts associated with flaring of solution gas. Members of that team established a framework for the management of solution gas flaring. Their long-term goal is to eliminate routine flaring of solution gas. The Project Team assessed existing information on solution gas flaring, including technologies, efficiencies, emissions and impacts. Alternative technologies were also reviewed along with biological and health effects of solution gas flaring. A list of data gaps and research needs was compiled in order to help with the development of the Team's recommendations. The Team's final report was delivered in June 1998. It was recommended that the following policy objective hierarchy be used to guide decisions related to routine solution gas flaring: (1) eliminate routine solution gas flaring, (2) reduce volumes of gas flared, and (3) improve the efficiency of flares. By way of progress the Project Team was able to report that in March, 1999, the EUB issued a draft interim directive to address upstream petroleum industry flaring. The draft Directive incorporates the recommendations from the CASA Flaring Project Team with respect to management of solution gas flaring. In December 1998, changes to the royalty structure to encourage the productive use of flare gas have been announced by the Alberta Department of Energy and Alberta Environmental protection, thus

  8. The regulatory context of gas flaring in Alberta

    International Nuclear Information System (INIS)

    Gilmour, B.S.; Cook, C.

    1999-01-01

    The legislative and regulatory regime regarding gas flaring in Alberta was reviewed. The issue of gas flaring has received much attention from petroleum industry regulators in Alberta. Residents living in the vicinity of flares have identified them as sources of odour, smoke, noise and air quality-related health concerns. Sulfur dioxide and carbon dioxide emissions from the flare stacks may contribute to acid rain and the greenhouse effect. The Strosher Report, released by the Alberta Research Council in 1996, has also identified about 250 different compounds in flare emissions, including volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs) and other products of incomplete combustion. The public opposition to solution gas flaring has caused regulators to consider new options designed to reduce the adverse economic and environmental impacts that may be associated with gas flaring. This paper discusses the roles of the Alberta Energy and Utilities Board (EUB) and Alberta Environmental Protection in administering legislation that impacts on gas flaring. In March 1999, the EUB released a guide containing the following five major points regarding gas flaring: (1) implementation of the Clean Air Strategic Alliance's (CASA's) recommendations to eventually eliminate flaring, by starting immediately to reduce flaring, and improve the efficiency of flares, (2) adoption of the CASA schedule of reduction targets for solution gas flaring, (3) conducting a review of the current approval process for small-scale electrical generation systems to encourage co-generation as a productive use of solution gas that is being flared, (4) creating better public notification requirements for new and existing facilities, and (5) discussing conflict resolution between operators and landowners. 26 refs

  9. Gout Diet

    Science.gov (United States)

    ... dressing Skim or low-fat milk Water Afternoon snack 1 cup fresh cherries Water Dinner Roasted salmon ( ... grains, low-fat dairy and moderate lean meat consumption. Therefore, there is generally no risk associated with ...

  10. Potential anti-gout constituents as xanthine oxidase inhibitor from the fruits of Stauntonia brachyanthera.

    Science.gov (United States)

    Liu, Dan; Wang, Dandan; Yang, Wei; Meng, Dali

    2017-07-01

    With the aim of finding a better xanthine oxidase inhibitor with potential anti-gout properties, the studies on the fruit of Stauntonia brachyanthera were carried out, which led to the isolation of 12 glycosides, including 4 new nor-oleanane triterpenoids. Their structures were determined by comprehensive spectroscopic (NMR and HR MS) analysis. Two compounds (4 and 11) exhibited significant inhibitory activities on xanthine oxidase with IC 50 values of 5.22 and 1.60µM, respectively. Another five compounds (1, 2, 3, 8 and 10) showed qualified activities. The results suggested that the existences of nor-oleanane triterpenoids and flavonoids in the fruits were responsible for the inhibitory activity on xanthine oxidase that could cut off the production of uric acid. Nor-oleanane triterpenoids, a new leading XO inhibitor, is worthy of further studies on molecular biology level for its mechanisms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Identification of low-frequency variants associated with gout and serum uric acid levels

    DEFF Research Database (Denmark)

    Sulem, Patrick; Gudbjartsson, Daniel F; Walters, G Bragi

    2011-01-01

    ,506 individuals for whom serum uric acid measurements were available. We identified a low-frequency missense variant (c.1580C>G) in ALDH16A1 associated with gout (OR = 3.12, P = 1.5 × 10(-16), at-risk allele frequency = 0.019) and serum uric acid levels (effect = 0.36 s.d., P = 4.5 × 10(-21)). We confirmed.......48 s.d., P = 4.5 × 10(-16)). This variant is close to a common variant previously associated with serum uric acid levels. This work illustrates how whole-genome sequencing data allow the detection of associations between low-frequency variants and complex traits....

  12. An analysis of MRI and ultrasound imaging in patients with gout who have normal plain radiographs.

    Science.gov (United States)

    Carter, John D; Kedar, Rajendra P; Anderson, Scott R; Osorio, Angie H; Albritton, Nancy L; Gnanashanmugam, Shanmugapriya; Valeriano, Joanne; Vasey, Frank B; Ricca, Louis R

    2009-11-01

    The aim of this study was to analyse the prevalence of occult destructive arthropathy in subjects with gout and normal plain radiographs by utilizing MRI and ultrasound (US). The study consisted of two visits. At Visit 1, a plain radiograph of the 'index joint' was obtained. The 'index joint' was defined as a joint that has had the most acute attacks of gout historically. The index joint plain radiograph had to be free of erosive damage in order for the subject to qualify for Visit 2. At Visit 2, the subject had an MRI with contrast and an US of the index joint. Each subject also had an MRI and US of an 'asymptomatic joint'. The 'asymptomatic joint' was defined as a joint that had never experienced an acute attack of gout (determined by standard protocol). The primary endpoint was erosive changes on the MRI and/or US of the index joint. Secondary endpoints included erosive changes on the asymptomatic joint as well as bone marrow oedema (BME) (on MRI), synovial pannus (SP), soft tissue tophi (STT) or oedema (STE) on either the index or asymptomatic joint. Twenty-seven subjects (26 males; 1 female) completed both visits. Their average age and disease duration were 55.1 years (range 21-75 years) and 6.8 years (range 0.25-25 years), respectively. The subjects' average serum uric acid level over the past 5 years was 8.09 mg/dl (range 4.1-12.8 mg/dl); their average on the day of Visit 1 was 7.96 mg/dl (range 4.6-13.9 mg/dl). The first MTP was the most common index joint (17) followed by the ankle (5), mid-tarsal (2), knee (2) and wrist (1). The knee was the most common asymptomatic joint (21) followed by the wrist (3), MTP (2) and ankle (1). All subjects had both MRIs; one subject refused the US. Out of 27 subjects, 15 (56%) had erosions on MRI of their index joint (P < 0.0001); only 1 subject (4%) had erosions identified in the index joint by US (P = NS). Regarding the secondary endpoints on the index joint, the MRI detected SP (13), BME (4), STE (3) and STT (0); the US

  13. Beneficial Properties of Phytochemicals on NLRP3 Inflammasome-Mediated Gout and Complication.

    Science.gov (United States)

    Jhang, Jhih-Jia; Lin, Jia-Hong; Yen, Gow-Chin

    2018-01-31

    Gouty arthritis is characterized by the precipitation of monosodium urate (MSU) crystals in the joint. Pro-inflammatory cytokine IL-1β is a critical manifestation in response to MSU crystals attack. IL-1β secretion is dependent on the nucleotide-binding oligomerization domain-like receptor pyrin domain containing 3 (NLRP3) inflammasome. Abnormal activation of the NLRP inflammasome is related to cellular oxidative stress. However, recent studies have illustrated that phytochemicals with potent antioxidant activity exert inhibitory effects on NLRP3 inflammasome-mediated diseases. This review focuses on the current findings of studies on the NLRP3 inflammasome and the proposed mechanisms that MSU crystals trigger inflammation via activation of the NLRP3 inflammasome. We also summarized the potential use of phytochemicals on NLRP3 inflammasome-mediated diseases, suggesting that phytochemicals can further prevent acute gout attack.

  14. Tophaceous gout in a female premenopausal patient with an unexpected diagnosis of glycogen storage disease type Ia: a case report and literature review.

    Science.gov (United States)

    Zhang, Bingqing; Zeng, Xuejun

    2016-11-01

    A young female with recurrent tophaceous gout and infertility presented to our clinic. On clinical evaluation, hypoglycaemia, hypertriglyceridaemia, lactic acidosis, and hepatomegaly were noted. Targeted gene sequencing revealed a novel composite heterozygous c.190G>T/c.508C>T mutation in the G6PC gene of the patient, leading to a diagnosis of glycogen storage disease type Ia. Her father possessed a heterozygous c.190G>T mutation, and her mother possessed a heterozygous c.508C>T mutation. A search of the previous literature revealed 16 reported cases of glycogen storage disease type Ia with gout. Here, we describe a female patient with gout, review previous cases, and discuss the mechanisms of gout and hyperuricaemia in glycogen storage disease type Ia.

  15. Guideline development for the management of gout: role of combination therapy with a focus on lesinurad

    Directory of Open Access Journals (Sweden)

    Jones G

    2017-10-01

    Full Text Available Graeme Jones,1 Elena Panova,1 Richard Day2 1Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia; 2University of New South Wales, Medicine, St Vincent’s Hospital, Sydney, NSW, Australia Abstract: The aim of this review was to summarize the evidence for combination therapy to achieve serum urate (SUA target levels in gout. Within this overarching aim, a second aim was to evaluate the evidence for a new uricosuric agent lesinurad, which inhibits urate transport in the kidney. In summary, this review indicates that there are a number of ways to approach patients who do not achieve a target serum urate with allopurinol (APL monotherapy. These include higher doses of APL up to 600–800 mg/d, switching to febuxostat, or adding in a uricosuric. For the latter option, controlled supporting evidence is available for benzbromarone, probenecid, and lesinurad. All options appear similar in terms of success rates, so the choice of option comes down to physician and patient choice, cost, experience, and strength of the evidence base. Increasing the dose of APL is the cheapest option, while febuxostat is consistently superior to standard doses of APL. The strongest evidence for the uricosuric option is available for lesinurad as trials of other agents are either nonexistent or based on small single-centre trials. It is suggested that guidelines should be expanded to consider all of these evidence-based options in the not-uncommon occurrence of APL inadequate response. Keywords: gout, therapy, combination, urate lowering

  16. International Consensus for ultrasound lesions in gout: results of Delphi process and web-reliability exercise.

    Science.gov (United States)

    Gutierrez, Marwin; Schmidt, Wolfgang A; Thiele, Ralf G; Keen, Helen I; Kaeley, Gurjit S; Naredo, Esperanza; Iagnocco, Annamaria; Bruyn, George A; Balint, Peter V; Filippucci, Emilio; Mandl, Peter; Kane, David; Pineda, Carlos; Delle Sedie, Andrea; Hammer, Hilde Berner; Christensen, Robin; D'Agostino, Maria Antonietta; Terslev, Lene

    2015-10-01

    To produce consensus-based definitions of the US elementary lesions in gout and to test their reliability in a web-based exercise. The process consisted of two steps. In the first step a written Delphi questionnaire was developed from a systematic literature review and expert international consensus. This collated information resulted in four statements defining US elementary lesions: double contour (DC), tophus, aggregates and erosion. The Delphi questionnaire was sent to 35 rheumatology experts in US, asking them to rate their level of agreement or disagreement with each statement. The second step tested the reliability by a web-exercise. US images of both normal and gouty elementary lesions were collected by the participants. A facilitator then constructed an electronic database of 110 images. The database was sent to the participants, who evaluated the presence/absence of US elementary lesions. A group of 20 images was displayed twice to evaluate intra-reader reliability. A total of 32 participants responded to the questionnaires. Good agreement (>80%) was obtained for US definitions on DC, tophus, aggregates and erosion in the Delphi exercise after three rounds. The reliability on images showed inter-reader κ values for DC, tophus, aggregates, erosion findings of 0.98, 0.71, 0.54 and 0.85, respectively. The mean intra-reader κ values were also acceptable: 0.93, 0.78, 0.65 and 0.78, respectively. This, the first consensus-based US definition of elementary lesions in gout, demonstrated good reliability overall. It constitutes an essential step in developing a core outcome measurement that permits a higher degree of homogeneity and comparability between multicentre studies. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Prospective observational cohort study of Health Related Quality of Life (HRQOL, chronic foot problems and their determinants in gout: a research protocol

    Directory of Open Access Journals (Sweden)

    Chandratre Priyanka

    2012-11-01

    Full Text Available Abstract Background Gout is the commonest inflammatory arthritis affecting around 1.4% of adults in Europe. It is predominantly managed in primary care and classically affects the joints of the foot, particularly the first metatarsophalangeal joint. Gout related factors (including disease characteristics and treatment as well as comorbid chronic disease are associated with poor Health Related Quality of Life (HRQOL yet to date there is limited evidence concerning gout in a community setting. Existing epidemiological studies are limited by their cross-sectional design, selection of secondary care patients with atypical disease and the use of generic tools to measure HRQOL. This 3 year primary care-based prospective observational cohort study will describe the spectrum of HRQOL in community dwelling patients with gout, associated factors, predictors of poor outcome, and prevalence and incidence of foot problems in gout patients. Methods Adults aged ≥ 18 years diagnosed with gout or prescribed colchicine or allopurinol in the preceding 2 years will be identified through Read codes and mailed a series of self-completion postal questionnaires over a 3-year period. Consenting participants will have their general practice medical records reviewed. Discussion This is the first prospective cohort study of HRQOL in patients with gout in primary care in the UK. The combination of survey data and medical record review will allow an in-depth understanding of factors that are associated with and lead to poor HRQOL and foot problems in gout. Identification of these factors will improve the management of this prevalent, yet under-treated, condition in primary care.

  18. Evaluation of antigout activity of Phyllanthus emblica fruit extracts on potassium oxonate-induced gout rat model

    Directory of Open Access Journals (Sweden)

    Vaidehi N. Sarvaiya

    2015-10-01

    Full Text Available Aim: The present study has been conducted to evaluate antigout activity of aqueous and alcoholic extracts of Phyllanthus emblica fruits following its 28 days repeated oral administration on potassium oxonate-induced gout rat model. Materials and Methods: The study was conducted on 42 male Sprague-Dawely rats dividing them in seven groups having six rats in each group. Groups I, II, and III served as vehicle control group, gout control group, and standard treatment control group, respectively. Rats of all the groups except vehicle control group were administered potassium oxonate at 250 mg/kg (IP, throughout the study period (28 days for induction of gout. Groups IV and V received aqueous extract of P. emblica at 200 and 400 mg/kg, and Groups VI and VII received alcoholic extract of P. emblica at 200 and 400 mg/kg (daily oral for 28 days. At the end of study, all the rats were subjected to blood collection; blood and serum sample were analyzed for hematological and biochemical parameters, respectively. After collection of blood samples on the 29th day, all the rats were sacrificed and subjected to post mortem examination to determine the presence or absence of gross and histopathological lesions in kidney tissues. Results: At the end of study, rats of gout control group showed increase in platelets counts, serum creatinine, uric acid, blood urea nitrogen (BUN, and xanthine oxidase (XO enzyme level along with alterations in kidney tissues as compared to vehicle control group. Gouty rats treated with aqueous and alcoholic extracts of P. emblica at 200 and 400 mg/kg body weight and standard treatment allopurinol at 5 mg/kg body weight showed reduction in platelets counts, serum creatinine, uric acid, BUN, and XO enzyme level along with significant improvements in histological structure of kidney as compared to rats of gout control group. Conclusion: Oral administration of aqueous and alcoholic extracts of P. emblica fruits for 28 days has shown

  19. Characteristics of the Polarity Inversion Line and Solar Flare Forecasts

    Science.gov (United States)

    Sadykov, Viacheslav M.; Kosovichev, Alexander G.

    2017-08-01

    Studying connection between solar flares and properties of magnetic field in active regions is very important for understanding the flare physics and developing space weather forecasts. In this work, we analyze relationship between the flare X-ray peak flux from the GOES satellite, and characteristics of the line-of-sight (LOS) magnetograms obtained by the SDO/HMI instrument during the period of April, 2010 - June, 2016. We try to answer two questions: 1) What characteristics of the LOS magnetic field are most important for the flare initiation and magnitude? 2) Is it possible to construct a reliable forecast of ≥ M1.0 and ≥ X1.0 class flares based only on the LOS magnetic field characteristics? To answer these questions, we apply a Polarity Inversion Line (PIL) detection algorithm, and derive various properties of the PIL and the corresponding Active Regions (AR). The importance of these properties for flare forecasting is determined by their ability to separate flaring cases from non-flaring, and their Fisher ranking score. It is found that the PIL characteristics are of special importance for the forecasts of both ≥ M1.0 and ≥ X1.0 flares, while the global AR characteristics become comparably discriminative only for ≥ X1.0 flares. We use the Support Vector Machine (SVM) classifier and train it on the six characteristics of the most importance for each case. The obtained True Skill Statistics (TSS) values of 0.70 for ≥ M1.0 flares and 0.64 for ≥ X1.0 flares are better than the currently-known expert-based predictions. Therefore, the results confirm the importance of the LOS magnetic field data and, in particular, the PIL region characteristics for flare forecasts.

  20. SLIPPING MAGNETIC RECONNECTIONS WITH MULTIPLE FLARE RIBBONS DURING AN X-CLASS SOLAR FLARE

    International Nuclear Information System (INIS)

    Zheng, Ruisheng; Chen, Yao; Wang, Bing

    2016-01-01

    With the observations of the Solar Dynamics Observatory , we present the slipping magnetic reconnections with multiple flare ribbons (FRs) during an X1.2 eruptive flare on 2014 January 7. A center negative polarity was surrounded by several positive ones, and three FRs appeared. The three FRs showed apparent slipping motions, and hook structures formed at their ends. Due to the moving footpoints of the erupting structures, one tight semi-circular hook disappeared after the slippage along its inner and outer edges, and coronal dimmings formed within the hook. The east hook also faded as a result of the magnetic reconnection between the arcades of a remote filament and a hot loop that was impulsively heated by the under flare loops. Our results are accordant with the slipping magnetic reconnection regime in three-dimensional standard model for eruptive flares. We suggest that the complex structures of the flare are likely a consequence of the more complex flux distribution in the photosphere, and the eruption involves at least two magnetic reconnections.

  1. Plasma Astrophysics, Part II Reconnection and Flares

    CERN Document Server

    Somov, Boris V

    2013-01-01

    This two-part book is devoted to classic fundamentals and current practices and perspectives of modern plasma astrophysics. This second part discusses the physics of magnetic reconnection and flares of electromagnetic origin in space plasmas in the solar system, single and double stars, relativistic objects, accretion disks and their coronae. More than 25% of the text is updated from the first edition, including the additions of new figures, equations and entire sections on topics such as topological triggers for solar flares and the magnetospheric physics problem. This book is aimed at professional researchers in astrophysics, but it will also be useful to graduate students in space sciences, geophysics, applied physics and mathematics, especially those seeking a unified view of plasma physics and fluid mechanics.

  2. Search for neutrinos from flaring blazars

    Energy Technology Data Exchange (ETDEWEB)

    Kreter, Michael [Lehrstuhl fuer Astronomie, Universitaet Wuerzburg, Emil-Fischer-Strasse 31, 97074 Wuerzburg (Germany); ECAP, Universitaet Erlangen-Nuernberg, Erwin-Rommel-Str. 1, 91058 Erlangen (Germany); Eberl, Thomas; James, Clancy [ECAP, Universitaet Erlangen-Nuernberg, Erwin-Rommel-Str. 1, 91058 Erlangen (Germany); Kadler, Matthias [Lehrstuhl fuer Astronomie, Universitaet Wuerzburg, Emil-Fischer-Strasse 31, 97074 Wuerzburg (Germany); Collaboration: ANTARES-KM3NeT-Erlangen-Collaboration

    2016-07-01

    Jets from Active Galactic Nuclei (AGN) are among the best candidates for the recently detected extraterrestrial neutrino flux. Hadronic AGN jet-emission models predict a tight correlation between the neutrino flux and the time-variable gamma-ray emission. At the same time, the atmospheric-background (noise) signal, which often dominates in neutrino-astronomical observations, can be substantially reduced by rejecting long-lasting periods of low flux. For these reasons, short high-amplitude gamma-ray flares, as often observed in blazars, can be used to substantially increase the sensitivity of neutrino telescopes in point-source searches. We develop a strategy to search for TeV neutrinos from flaring blazar jets from the TANAMI sample using the ANTARES telescope and Fermi gamma-ray light curves. An unbinned maximum-likelihood method is applied to optimize the probability of a neutrino detection from TANAMI sources.

  3. VizieR Online Data Catalog: Catalog of Kepler flare stars (Van Doorsselaere+, 2017)

    Science.gov (United States)

    van Doorsselaere, T.; Shariati, H.; Debosscher, J.

    2017-11-01

    With an automated detection method, we have identified stellar flares in the long cadence observations of Kepler during quarter 15. We list each flare time for the respective Kepler objects. Furthermore, we list the flare amplitude and decay time after fitting the flare light curve with an exponential decay. Flare start times in long cadence data of Kepler during quarter 15. (1 data file).

  4. Theoretical and observational assessments of flare efficiencies

    International Nuclear Information System (INIS)

    Leahey, D.M.; Preston, K.; Strosher, M.

    2000-01-01

    During the processing of hydrocarbon materials, gaseous wastes are flared in an effort to completely burn the waste material and therefore leave behind very little by-products. Complete combustion, however is rarely successful because entrainment of air into the region of combusting gases restricts flame sizes to less than optimum values. The resulting flames are often too small to dissipate the amount of heat associated with complete (100 per cent) combustion efficiency. Flaring, therefore, often results in emissions of gases with more complex molecular structures than just carbon dioxide and water. Polycyclic aromatic hydrocarbons and volatile organic compounds which are indicative of incomplete combustion are often associated with flaring. This theoretical study of flame efficiencies was based on the knowledge of the full range of chemical reactions and associated kinetics. In this study, equations developed by Leahey and Schroeder were used to estimate flame lengths, areas and volumes as functions of flare stack exit velocity, stoichiometric mixing ratio and wind speed. This was followed by an estimate of heats released as part of the combustion process. This was derived from the knowledge of the flame dimensions together with an assumed flame temperature of 1200 K. Combustion efficiencies were then obtained by taking the ratio of estimated actual heat release values to those associated with complete combustion. It was concluded that combustion efficiency decreases significantly with wind speed increases from 1 to 6 m/s. After that initial increase, combustion efficiencies level off at values between 10 to 15 per cent. Propane and ethane were found to burn more efficiently than methane or hydrogen sulfide. 24 refs., 4 tabs., 1 fig., 1 append

  5. Sunspot waves and flare energy release

    Czech Academy of Sciences Publication Activity Database

    Sych, R.A.; Karlický, Marian; Altyntsev, A.; Dudík, Jaroslav; Kashapova, L. K.

    2015-01-01

    Roč. 577, May (2015), A43/1-A43/8 ISSN 0004-6361 R&D Projects: GA ČR GAP209/12/0103; GA ČR GAP209/12/1652 Grant - others:EC(XE) 606862 Program:FP7 Institutional support: RVO:67985815 Keywords : Sun flares * Sun oscillations * Sun X-rays Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 4.378, year: 2014

  6. An Exceptional Radio Flare in Markarian 421

    Directory of Open Access Journals (Sweden)

    Richards Joseph L.

    2013-12-01

    Full Text Available In September 2012, the high-synchrotron-peaked (HSP blazar Markarian 421 underwent a rapid wideband radio flare, reaching nearly twice the brightest level observed in the centimeter band in over three decades of monitoring. In response to this event we carried out a five epoch centimeter- to millimeter-band multifrequency Very Long Baseline Array (VLBA campaign to investigate the aftermath of this emission event. Rapid radio variations are unprecedented in this object and are surprising in an HSP BL Lac object. In this flare, the 15 GHz flux density increased with an exponential doubling time of about 9 days, then faded to its prior level at a similar rate. This is comparable with the fastest large-amplitude centimeter-band radio variability observed in any blazar. Similar flux density increases were detected up to millimeter bands. This radio flare followed about two months after a similarly unprecedented GeV gamma-ray flare (reaching a daily E > 100 MeV flux of (1.2 ± 0.7 × 10−6 ph cm−2 s−1 reported by the Fermi Large Area Telescope (LAT collaboration, with a simultaneous tentative TeV detection by ARGO-YBJ. A cross-correlation analysis of long-term 15 GHz and LAT gamma-ray light curves finds a statistically significant correlation with the radio lagging ~40 days behind, suggesting that the gamma-ray emission originates upstream of the radio emission. Preliminary results from our VLBA observations show brightening in the unresolved core region and no evidence for apparent superluminal motions or substantial flux variations downstream.

  7. Solar and stellar flare observations using WATCH

    DEFF Research Database (Denmark)

    Brandt, Søren; Lund, Niels; Rao, A. R.

    1988-01-01

    The Danish experiment WATCH (Wide Angle Telescope for Cosmic Hard X-rays) is to be flown on board the Soviet satellite GRANAT in middle of 1989. The performance characteristics of the WATCH instrument is described. It is estimated that WATCH can detect about 100 solar hard X-ray bursts per day....... WATCH can also detect about 40 energetic stellar soft X-ray flares, similar to the fast transient X-ray emissions detected by the Ariel V satellite....

  8. Technical and economic analysis use of flare gas into alternative energy as a breakthrough in achieving zero routine flaring

    Science.gov (United States)

    Petri, Y.; Juliza, H.; Humala, N.

    2018-03-01

    The activity of exploring natural oil and gas will produce gas flare 0.584 MMSCFD. A gas flare is the combustion of gas remaining to avoid poisonous gas like H2S and CO which is very dangerous for human and environmental health. The combustion can bring about environmental pollution and losses because it still contains valuable energy. It needs the policy to encourage the use of flare gas with Zero Routine Flaring and green productivity to reduce waste and pollution. The objective of the research was to determine the use of gas flare so that it will have economic value and can achieve Zero Routine Flaring. It was started by analysing based on volume or rate and composition gas flare was used to determine technical feasibility, and the estimation of the gas reserves as the determination of the economy of a gas well. The results showed that the use of flare gas as fuel for power generation feasible to be implemented technically and economically with Internal Rate of Return (IRR) 19.32% and the Payback Period (PP) 5 year. Thus, it can increase gas flare value economically and can achieve a breakthrough in Zero Routine Flaring.

  9. Automated Flare Prediction Using Extreme Learning Machine

    Directory of Open Access Journals (Sweden)

    Yuqing Bian

    2013-01-01

    Full Text Available Extreme learning machine (ELM is a fast learning algorithm of single-hidden layer feedforward neural networks (SLFNs. Compared with the traditional neural networks, the ELM algorithm has the advantages of fast learning speed and good generalization. At the same time, an ordinal logistic regression (LR is a statistical method which is conceptually simple and algorithmically fast. In this paper, in order to improve the real-time performance, a flare forecasting method is introduced which is the combination of the LR model and the ELM algorithm. The predictive variables are three photospheric magnetic parameters, that is, the total unsigned magnetic flux, length of the strong-gradient magnetic polarity inversion line, and total magnetic energy dissipation. The LR model is used to map these three magnetic parameters of each active region into four probabilities. Consequently, the ELM is used to map the four probabilities into a binary label which is the final output. The proposed model is used to predict the occurrence of flares with a certain level over 24 hours following the time when the magnetogram is recorded. The experimental results show that the cascade algorithm not only improves learning speed to realize timely prediction but also has higher accuracy of X-class flare prediction in comparison with other methods.

  10. Modeling Meteor Flares for Spacecraft Safety

    Science.gov (United States)

    Ehlert, Steven

    2017-01-01

    NASA's Meteoroid Environment Office (MEO) is tasked with assisting spacecraft operators and engineers in quantifying the threat the meteoroid environment poses to their individual missions. A more complete understanding of the meteoroid environment for this application requires extensive observations. One manner by which the MEO observes meteors is with dedicated video camera systems that operate nightly. Connecting the observational data from these video cameras to the relevant physical properties of the ablating meteoroids, however, is subject to sizable observational and theoretical uncertainties. Arguably the most troublesome theoretical uncertainty in ablation is a model for the structure of meteoroids, as observations clearly show behaviors wholly inconsistent with meteoroids being homogeneous spheres. Further complicating the interpretation of the observations in the context of spacecraft risk is the ubiquitous process of fragmentation and the flares it can produce, which greatly muddles any attempts to estimating initial meteoroid masses. In this talk a method of estimating the mass distribution of fragments in flaring meteors using high resolution video observations will be dis- cussed. Such measurements provide an important step in better understanding of the structure and fragmentation process of the parent meteoroids producing these flares, which in turn may lead to better constraints on meteoroid masses and reduced uncertainties in spacecraft risk.

  11. Post-Flare Giant Arches - Unanswered Questions

    Science.gov (United States)

    West, M. J.; Seaton, D. B.; Dennis, B. R.; Palmerio, E.; Savage, S. L.

    2017-12-01

    Recent observations from the SWAP EUV imager on-board PROBA2 and SXI X-ray observations from the GOES satellite have shown that post-flare giant arches and regular post-flare loops are one and the same thing. However, it is still not clear how certain loop systems are able to sustain prolonged growth to heights greater than half a solar-radii. In this presentation we further explore the energy deposition rate above post-flare loop systems through high-energy RHESSI observations. We also explore the difference between the growth of different loop systems through an epoch analysis. The epoch analysis is initially performed over the period when the STEREO satellites were in quadrature with PROBA2 allowing us to assess the difference between their on-disk and on-limb signatures. Giant arches are generally characterised by their height of growth when observed close to the solar limb, but due to the optically thin nature of the EUV solar atmosphere, projection effects and the scarcity of events occurring within 5 degrees of the limb it is not understood how common these events are. Using the analysis during the quadrature period we gain a better understanding of how rare these events are, and by determining characteristic on disk signatures we can combine our data set with magnetogram observations to better understand their magnetic evolution.

  12. The urate-lowering efficacy and safety of febuxostat in the treatment of the hyperuricemia of gout: the CONFIRMS trial

    OpenAIRE

    Becker, Michael A; Schumacher, H Ralph; Espinoza, Luis R; Wells, Alvin F; MacDonald, Patricia; Lloyd, Eric; Lademacher, Christopher

    2010-01-01

    Introduction The purpose of this study was to compare urate-lowering (UL) efficacy and safety of daily febuxostat and allopurinol in subjects with gout and serum urate (sUA) ≥ 8.0 mg/dL in a six-month trial. Methods Subjects (n = 2,269) were randomized to febuxostat 40 mg or 80 mg, or allopurinol 300 mg (200 mg in moderate renal impairment). Endpoints included the proportion of all subjects with sUA

  13. Flare activity on UV CETI: visible and IUE observations

    International Nuclear Information System (INIS)

    Phillips, K.J.H.; Bromage, G.E.; Dufton, P.L.; Keenan, F.P.; Kingston, A.E.

    1988-06-01

    Simultaneous far-ultraviolet (IUE) spectroscopy and optical photometry and spectrophotometry of a flare on UV Ceti are reported. The flare reached ΔU = 2sup(m) but showed only modest enhancements in the IUE spectra. The optical spectrophotometry indicated broadened Balmer line profiles during the flare, with Hβ and Hγ clearly showing red wings. The results are compared with other IUE and optical observations of UV Ceti, and their solar analogues. (author)

  14. Experimental Comprehensive Solar Flare Indices for Major and Certain Lesser Flares 1975-1979

    Science.gov (United States)

    1981-07-01

    0354-0418 N18W05 20 (0540) 22 0235 -0301 25 (0114) 26 (2117) 29 0501-0512 July 1 (1341) 7 |1205-1230 imi-iny...34I.Eli.il-.K EVENTS" FOR 197 5- 1979 (cor tlnued) TIME (UT) HcMATH Ha FLARE CO HP . OK FUKt HT PLAGE PROFILE FLARE DATK OR EVENT (1755) POSITION IMP...TOr ognHoSTy 0558-önÖ 0028-0111 0118-0214 15579) 1125 2017-2111 (1449) (0221) 0200-0234 "Ö27T-řUI Ö5Ö7-Öfi6 1010-1053 0232- 0235 0306

  15. Efficacy and tolerability of probenecid as urate-lowering therapy in gout; clinical experience in high-prevalence population.

    Science.gov (United States)

    Pui, Karen; Gow, Peter J; Dalbeth, Nicola

    2013-06-01

    Probenecid is recommended as urate-lowering therapy (ULT) in patients with gout where xanthine oxidase inhibitors are ineffective, not tolerated, or contraindicated. The aim of our study was to determine the efficacy of probenecid to achieve serum urate (SU) targets (probenecid from a database of 521 rheumatology clinic attenders with gout. Demographic characteristics, indications for probenecid, probenecid doses, side effects, and laboratory data including estimated glomerular filtration rate (eGFR) and SU were recorded. There were 30/57 (53%) patients treated with probenecid as monotherapy and 27/57 (47%) patients treated with probenecid in combination with allopurinol. Target SU concentrations (probenecid monotherapy group and 10/27 (37%) of the combination treatment group. Baseline SU concentrations, but not eGFR or probenecid dose, independently predicted achievement of target SU. Target SU was achieved in 5/15 (33%) patients with eGFR probenecid were observed in 8/42 (19%) patients with eGFR ≥ 50 ml/min/1.73 m(2) and in 2/15 (13%) patients with eGFR Probenecid has moderate efficacy as ULT in clinical management of patients with complex gout who have a lack of efficacy or intolerance to allopurinol. Patients with chronic kidney disease may respond to probenecid with similar rates of adverse events.

  16. Imaging Observations of Magnetic Reconnection in a Solar Eruptive Flare

    International Nuclear Information System (INIS)

    Li, Y.; Ding, M. D.; Sun, X.; Qiu, J.; Priest, E. R.

    2017-01-01

    Solar flares are among the most energetic events in the solar atmosphere. It is widely accepted that flares are powered by magnetic reconnection in the corona. An eruptive flare is usually accompanied by a coronal mass ejection, both of which are probably driven by the eruption of a magnetic flux rope (MFR). Here we report an eruptive flare on 2016 March 23 observed by the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory . The extreme-ultraviolet imaging observations exhibit the clear rise and eruption of an MFR. In particular, the observations reveal solid evidence of magnetic reconnection from both the corona and chromosphere during the flare. Moreover, weak reconnection is observed before the start of the flare. We find that the preflare weak reconnection is of tether-cutting type and helps the MFR to rise slowly. Induced by a further rise of the MFR, strong reconnection occurs in the rise phases of the flare, which is temporally related to the MFR eruption. We also find that the magnetic reconnection is more of 3D-type in the early phase, as manifested in a strong-to-weak shear transition in flare loops, and becomes more 2D-like in the later phase, as shown by the apparent rising motion of an arcade of flare loops.

  17. Imaging Observations of Magnetic Reconnection in a Solar Eruptive Flare

    Energy Technology Data Exchange (ETDEWEB)

    Li, Y.; Ding, M. D. [School of Astronomy and Space Science, Nanjing University, Nanjing 210023 (China); Sun, X. [W. W. Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA 94305 (United States); Qiu, J. [Department of Physics, Montana State University, Bozeman, MT 59717 (United States); Priest, E. R., E-mail: yingli@nju.edu.cn [School of Mathematics and Statistics, University of St Andrews, Fife KY16 9SS, Scotland (United Kingdom)

    2017-02-01

    Solar flares are among the most energetic events in the solar atmosphere. It is widely accepted that flares are powered by magnetic reconnection in the corona. An eruptive flare is usually accompanied by a coronal mass ejection, both of which are probably driven by the eruption of a magnetic flux rope (MFR). Here we report an eruptive flare on 2016 March 23 observed by the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory . The extreme-ultraviolet imaging observations exhibit the clear rise and eruption of an MFR. In particular, the observations reveal solid evidence of magnetic reconnection from both the corona and chromosphere during the flare. Moreover, weak reconnection is observed before the start of the flare. We find that the preflare weak reconnection is of tether-cutting type and helps the MFR to rise slowly. Induced by a further rise of the MFR, strong reconnection occurs in the rise phases of the flare, which is temporally related to the MFR eruption. We also find that the magnetic reconnection is more of 3D-type in the early phase, as manifested in a strong-to-weak shear transition in flare loops, and becomes more 2D-like in the later phase, as shown by the apparent rising motion of an arcade of flare loops.

  18. Developing a Construct to Evaluate Flares in Rheumatoid Arthritis: A Conceptual Report of the OMERACT RA Flare Definition Working Group

    DEFF Research Database (Denmark)

    Alten, Rieke; Choy, Ernest H; Christensen, Robin

    2011-01-01

    Rheumatoid arthritis (RA) patients and healthcare professionals (HCP) recognize that episodic worsening disease activity, often described as a "flare," is a common feature of RA that can contribute to impaired function and disability. However, there is no standard definition to enable measurement...... of its intensity and impact. The conceptual framework of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) RA Flare Definition Working Group includes an anchoring statement, developed at OMERACT 9 in 2008: "flare in RA" is defined as worsening of signs and symptoms of sufficient intensity...... of minimally clinically detectable and important differences (MCDD, MCID). The measurement of RA flare is composed of data collection assessing a range of unique domains describing key features of RA worsening at the time of patient self-report of flare, and then periodically for the duration of the flare...

  19. Predictors of reaching a serum uric acid goal in patients with gout and treated with febuxostat

    Directory of Open Access Journals (Sweden)

    Sheer R

    2017-10-01

    Full Text Available Richard Sheer,1 Kyle D Null,2 Keith A Szymanski,2 Lavanya Sudharshan,1 Jennifer Banovic,2 Margaret K Pasquale1 1Comprehensive Health Insights, Inc., Louisville, KY, 2Takeda Pharmaceuticals U.S.A., Inc., Deerfield, IL, USA Purpose: Clinical guidelines recommend febuxostat as first-line pharmacologic urate-lowering therapy for patients with gout to achieve a goal serum uric acid (sUA <6 mg/dL; however, little is known about other contributing factors. This study identified clinical characteristics of patients treated with febuxostat to develop and validate a predictive model for achieving a goal sUA.Patients and methods: Patients with Humana Medicare or commercial insurance, diagnosed with gout and newly initiated on febuxostat (index date February 1, 2009 – December 31, 2013, were identified for a retrospective cohort study. Patients were followed for 365 days and the first valid sUA test result ≥120 days after index was retained. A stepwise logistic regression with backward elimination was estimated to model sUA goal attainment, and a linear model was estimated to model the impact of predictor variables on sUA level.Results: The study sample (n=678 was divided into a development (training dataset (n=453 and a validation (holdout dataset (n=225. In the training sample, patients in the sUA <6 mg/dL group were on febuxostat for a longer time, were more adherent, and had a lower average baseline sUA level (all p<0.0001 vs patients in the sUA ≥6 mg/dL group. In the logistic model, febuxostat adherence (odds ratio [OR]=1.03, p<0.0001 and baseline sUA level (OR=0.84, p<0.0001 increased the odds of attaining sUA <6 mg/dL. In the linear regression model, increase in febuxostat adherence (p<0.0001, baseline sUA level (p<0.0001, advanced age (p=0.0021, and not having congestive heart failure (p<0.05 were associated with a reduction of sUA level. Pre-index allopurinol use was a marginally significant predictor of sUA level reduction (p=0

  20. Early X-Ray Flares in GRBs

    Science.gov (United States)

    Ruffini, R.; Wang, Y.; Aimuratov, Y.; Barres de Almeida, U.; Becerra, L.; Bianco, C. L.; Chen, Y. C.; Karlica, M.; Kovacevic, M.; Li, L.; Melon Fuksman, J. D.; Moradi, R.; Muccino, M.; Penacchioni, A. V.; Pisani, G. B.; Primorac, D.; Rueda, J. A.; Shakeri, S.; Vereshchagin, G. V.; Xue, S.-S.

    2018-01-01

    We analyze the early X-ray flares in the GRB “flare–plateau–afterglow” (FPA) phase observed by Swift-XRT. The FPA occurs only in one of the seven GRB subclasses: the binary-driven hypernovae (BdHNe). This subclass consists of long GRBs with a carbon–oxygen core and a neutron star (NS) binary companion as progenitors. The hypercritical accretion of the supernova (SN) ejecta onto the NS can lead to the gravitational collapse of the NS into a black hole. Consequently, one can observe a GRB emission with isotropic energy {E}{iso}≳ {10}52 erg, as well as the associated GeV emission and the FPA phase. Previous work had shown that gamma-ray spikes in the prompt emission occur at ∼ {10}15{--}{10}17 cm with Lorentz Gamma factors {{Γ }}∼ {10}2{--}{10}3. Using a novel data analysis, we show that the time of occurrence, duration, luminosity, and total energy of the X-ray flares correlate with E iso. A crucial feature is the observation of thermal emission in the X-ray flares that we show occurs at radii ∼1012 cm with {{Γ }}≲ 4. These model-independent observations cannot be explained by the “fireball” model, which postulates synchrotron and inverse-Compton radiation from a single ultrarelativistic jetted emission extending from the prompt to the late afterglow and GeV emission phases. We show that in BdHNe a collision between the GRB and the SN ejecta occurs at ≃1010 cm, reaching transparency at ∼1012 cm with {{Γ }}≲ 4. The agreement between the thermal emission observations and these theoretically derived values validates our model and opens the possibility of testing each BdHN episode with the corresponding Lorentz Gamma factor.

  1. Gas flare characterisation with Sentinel-3

    Science.gov (United States)

    Caseiro, Alexandre; Kaiser, Johannes W.; Ruecker, Gernot; Tiemann, Joachim; Leimbach, David

    2017-04-01

    Gas Flaring (GF) is the process of burning waste gases at the tip of a stack. It is widely used in the upstream oil and gas industry. It is a contributor to the imbalance of the greenhouse gases (GHG) concentration in the earth's atmosphere, which prompts global warming. Besides GHG, GF also emits black carbon (BC), a known carcinogen and climate active species. At higher latitudes, GF has been estimated as the main input of atmospheric BC, alongside vegetation fires. The consideration of GF as a source to global budgets has been hindered by technical difficulties of in-situ measurements and the inexistence of a systematic reporting system. Remote sensing offers the possibility of a continuous, global and systematic monitoring of GF over extended periods. Being a high temperature process, GF can be detected from space using measurements at appropriate wavelengths. Considering 1800K as a typical GF temperature and Wien's displacement law, the peak emission will be in the short-wave infrared region. This spectral region is observed by two channels (S5 and S6) of the SLSTR instrument aboard ESA's newly launched Sentinel-3 satellite. Because of solar contamination, only night-time observations are used. In order to characterise the identified gas flares in terms of temperature and area, two Planck curves are fitted to SLSTR radiance observations in five spectral channels (S5 through S9, with F1 and F2). In this work, we present the methodology in detail as well as results for known flaring regions around the world. A comparison with VIIRS on Suomi-NPP and with HSRS on TET-1 over known GF locations is also considered.

  2. Biochemical effectiveness of allopurinol and allopurinol-probenecid in previously benzbromarone-treated gout patients.

    Science.gov (United States)

    Reinders, Mattheus K; van Roon, Eric N; Houtman, Pieternella M; Brouwers, Jacobus R B J; Jansen, Tim L Th A

    2007-09-01

    In 2003, the uricosuric drug benzbromarone was withdrawn from the market. The first alternative drug of choice was the xanthine oxidase inhibitor allopurinol. The purpose was to (1) investigate the efficacy of allopurinol (standard dosage) compared with previous treatment with benzbromarone; and (2) investigate the combination therapy allopurinol-probenecid as an effective alternative treatment compared with previous benzbromarone treatment. A prospective, open study was carried out in a cohort of 51 gout patients who discontinued benzbromarone therapy because of market withdrawal. Patients were given 200-300 mg allopurinol (stage 1). When allopurinol failed to attain the target serum urate (sUr) levels probenecid 1,000 mg/day was added (stage 2). Treatment with benzbromarone monotherapy (range: 100-200 mg/day; mean 138 mg/day) resulted in 92% of patients reaching target levels sUr probenecid combination therapy, which resulted in 86% of patients attaining target sUr levels (after failure on allopurinol monotherapy), which was comparable to previous treatment with benzbromarone (p = 0.81). Decrease in sUr levels was 53[9]% (CI 95%: 48-58%), which was a non-significant difference compared to previous treatment with benzbromarone (p = 0.23). Benzbromarone is a very effective antihyperuricemic drug with 91% success in attainment of target sUr levels probenecid proves to be an effective treatment strategy for attaining sUr target levels (86% success).

  3. Pharmacokinetic and pharmacodynamic interaction between allopurinol and probenecid in patients with gout.

    Science.gov (United States)

    Stocker, Sophie L; Graham, Garry G; McLachlan, Andrew J; Williams, Kenneth M; Day, Richard O

    2011-05-01

    To investigate the pharmacokinetic and pharmacodynamic interaction between probenecid and oxypurinol (the active metabolite of allopurinol) in patients with gout. This was an open-label observational clinical study. Blood and urine samples were collected to measure oxypurinol and urate concentrations. We examined the effects of adding probenecid to allopurinol therapy upon plasma concentrations and renal clearances of urate and oxypurinol. Twenty patients taking allopurinol 100-400 mg daily completed the study. Maximum coadministered doses of probenecid were 250 mg/day (n = 1), 500 mg/day (n = 19), 1000 mg/day (n = 7), 1500 mg/day (n = 3), and 2000 mg/day (n = 1). All doses except the 250 mg daily dose were divided and dosing was twice daily. Estimated creatinine clearances ranged from 28 to 113 ml/min. Addition of probenecid 500 mg/day to allopurinol therapy decreased plasma urate concentrations by 25%, from mean 0.37 mmol/l (95% CI 0.33-0.41) to mean 0.28 mmol/l (95% CI 0.24-0.32) (p probenecid 500 mg/day appeared to be lower in patients with renal impairment. Coadministration of allopurinol with probenecid had a significantly greater hypouricemic effect than allopurinol alone despite an associated reduction of plasma oxypurinol concentrations. Australian Clinical Trials Registry ACTRN012606000276550.

  4. Guideline development for the management of gout: role of combination therapy with a focus on lesinurad.

    Science.gov (United States)

    Jones, Graeme; Panova, Elena; Day, Richard

    2017-01-01

    The aim of this review was to summarize the evidence for combination therapy to achieve serum urate (SUA) target levels in gout. Within this overarching aim, a second aim was to evaluate the evidence for a new uricosuric agent lesinurad, which inhibits urate transport in the kidney. In summary, this review indicates that there are a number of ways to approach patients who do not achieve a target serum urate with allopurinol (APL) monotherapy. These include higher doses of APL up to 600-800 mg/d, switching to febuxostat, or adding in a uricosuric. For the latter option, controlled supporting evidence is available for benzbromarone, probenecid, and lesinurad. All options appear similar in terms of success rates, so the choice of option comes down to physician and patient choice, cost, experience, and strength of the evidence base. Increasing the dose of APL is the cheapest option, while febuxostat is consistently superior to standard doses of APL. The strongest evidence for the uricosuric option is available for lesinurad as trials of other agents are either nonexistent or based on small single-centre trials. It is suggested that guidelines should be expanded to consider all of these evidence-based options in the not-uncommon occurrence of APL inadequate response.

  5. Isolated intraosseous gout in hallux sesamoid mimicking a bone tumor in a teenaged patient

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Shi-Zuo; Yeh, LeeRen; Chen, Clement Kuen-Huang; Pan, Huay-Ban [Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung first Rd., 813, Kaohsiung, Taiwan (Taiwan); Chou, Yi-Jiun [Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (Taiwan)

    2003-11-01

    We are reporting an unusual case of isolated intraosseous tophus in medial hallux sesamoid presenting as tumor-like lesion in a teenage patient without prior history of gouty attack and underlying systemic disorders. The lesion manifested isointensity to surrounding muscles with internal low signal on spin echo (SE) T1-weighted images, and heterogeneous low signal intensity on fast spin echo (FSE) T2-weighted images. Computed tomography (CT) scan disclosed expansion and diffusely increased attenuation of the medial hallux sesamoid with focal cortical erosion and extraosseous extension of high attenuation content. The subsequent resection and pathology revealed intraosseous tophus deposition, which is particularly rare at this site and at this age. Imaging studies revealed some characteristic imaging features which can retrospectively be attributed to gouty tophus. When an expansile osteolytic lesion manifesting low signal intensity on T2-weighted image and internal calcifications on CT scan is encountered, the possibility of intraosseous tophus should be included in the list of differential diagnoses, even in a teenage patient without prior history of gout. (orig.)

  6. Isolated intraosseous gout in hallux sesamoid mimicking a bone tumor in a teenaged patient

    International Nuclear Information System (INIS)

    Liu, Shi-Zuo; Yeh, LeeRen; Chen, Clement Kuen-Huang; Pan, Huay-Ban; Chou, Yi-Jiun

    2003-01-01

    We are reporting an unusual case of isolated intraosseous tophus in medial hallux sesamoid presenting as tumor-like lesion in a teenage patient without prior history of gouty attack and underlying systemic disorders. The lesion manifested isointensity to surrounding muscles with internal low signal on spin echo (SE) T1-weighted images, and heterogeneous low signal intensity on fast spin echo (FSE) T2-weighted images. Computed tomography (CT) scan disclosed expansion and diffusely increased attenuation of the medial hallux sesamoid with focal cortical erosion and extraosseous extension of high attenuation content. The subsequent resection and pathology revealed intraosseous tophus deposition, which is particularly rare at this site and at this age. Imaging studies revealed some characteristic imaging features which can retrospectively be attributed to gouty tophus. When an expansile osteolytic lesion manifesting low signal intensity on T2-weighted image and internal calcifications on CT scan is encountered, the possibility of intraosseous tophus should be included in the list of differential diagnoses, even in a teenage patient without prior history of gout. (orig.)

  7. An Interactive Multi-instrument Database of Solar Flares

    Energy Technology Data Exchange (ETDEWEB)

    Sadykov, Viacheslav M; Kosovichev, Alexander G; Oria, Vincent; Nita, Gelu M [Center for Computational Heliophysics, New Jersey Institute of Technology, Newark, NJ 07102 (United States)

    2017-07-01

    Solar flares are complicated physical phenomena that are observable in a broad range of the electromagnetic spectrum, from radio waves to γ -rays. For a more comprehensive understanding of flares, it is necessary to perform a combined multi-wavelength analysis using observations from many satellites and ground-based observatories. For an efficient data search, integration of different flare lists, and representation of observational data, we have developed the Interactive Multi-Instrument Database of Solar Flares (IMIDSF, https://solarflare.njit.edu/). The web-accessible database is fully functional and allows the user to search for uniquely identified flare events based on their physical descriptors and the availability of observations by a particular set of instruments. Currently, the data from three primary flare lists ( Geostationary Operational Environmental Satellites , RHESSI , and HEK) and a variety of other event catalogs ( Hinode , Fermi GBM, Konus- W IND, the OVSA flare catalogs, the CACTus CME catalog, the Filament eruption catalog) and observing logs ( IRIS and Nobeyama coverage) are integrated, and an additional set of physical descriptors (temperature and emission measure) is provided along with an observing summary, data links, and multi-wavelength light curves for each flare event since 2002 January. We envision that this new tool will allow researchers to significantly speed up the search of events of interest for statistical and case studies.

  8. NIR Flare of radio source GB60713+5738

    Science.gov (United States)

    Carrasco, L.; Porras, A.; Recillas, E.; Chavushyan, V.

    2018-02-01

    In ATel#11331, we reported the NIR detection of the radio source GB60713+5738 and the suggestion of it being in flaring state. However, we found a previous observation in our archive that fully confirms a recent giant flare of this object.

  9. Gas flaring: Carbon dioxide contribution to global warming ...

    African Journals Online (AJOL)

    Flaring been a source of anthropogenic carbon dioxide, is a concern to skeptics and local oil producing communities as a significant contributor to global warming, environmental degradation, health risk and economic loss. The purpose of the study was to ascertain the impacts of gas flaring on global warming and the local ...

  10. Exergy analysis of waste emissions from gas flaring

    Directory of Open Access Journals (Sweden)

    Olawale Saheed ISMAIL

    2016-07-01

    Full Text Available Gas flaring produces a stream of waste gases at high temperature and pressure which contains carbon monoxide, Hydrogen Sulphide etc. The resultant effect of which is detrimental to our planet and, consequently, to the life of both the living and the non-living things. It’s well known that gas flaring contributes in no small measure to the global warming. Exergy analysis is applied in this work to analyze waste emissions from gas flaring so as to have a model through which impact of gas flaring can be measured. The study considers both the thermo-mechanical exergy and the chemical exergy of these gases. Relevant data on gas flaring activities in the Niger-Delta region of Nigeria between the periods of fifteen (15 years was obtained from the Nigerian National Petroleum Corporation (NNPC. A computer program (Exergy Calculator was developed based on the equations generated in the Model. Exergy associated with gas flaring activities in Nigeria between the periods of 1998 through 2012 was calculated. The results show that 1 mscf (in thousand cubic feet of flared gases generate 0.000041 MWh of energy leading to a value of 440158.607 MWh of energy for the period under review.The analysis provides important conclusions and recommendations for improving oil platforms operationsin in order to safeguard the environment, health of the populace, and maximize recovered exergy from gas flaring.

  11. Effect of Particle Acceleration Process on the Flare Characteristics of ...

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    J. Astrophys. Astr. (2002) 23, 95–99. Effect of Particle Acceleration Process on the Flare Characteristics of. Blazars. S. Bhattacharyya, S. Sahayanathan & C. L. Kaul Nuclear Research Laboratory,. Bhabha Atomic Research Centre, Mumbai 400 085, India. Abstract. Following the kinetic equation approach, we study the flare.

  12. Interactive Multi-Instrument Database of Solar Flares (IMIDSF)

    Science.gov (United States)

    Sadykov, Viacheslav M.; Nita, Gelu M.; Oria, Vincent; Kosovichev, Alexander G.

    2017-08-01

    Solar flares represent a complicated physical phenomenon observed in a broad range of the electromagnetic spectrum, from radiowaves to gamma-rays. For a complete understanding of the flares it is necessary to perform a combined multi-wavelength analysis using observations from many satellites and ground-based observatories. For efficient data search, integration of different flare lists and representation of observational data, we have developed the Interactive Multi-Instrument Database of Solar Flares (https://solarflare.njit.edu/). The web database is fully functional and allows the user to search for uniquely-identified flare events based on their physical descriptors and availability of observations of a particular set of instruments. Currently, data from three primary flare lists (GOES, RHESSI and HEK) and a variety of other event catalogs (Hinode, Fermi GBM, Konus-Wind, OVSA flare catalogs, CACTus CME catalog, Filament eruption catalog) and observing logs (IRIS and Nobeyama coverage), are integrated. An additional set of physical descriptors (temperature and emission measure) along with observing summary, data links and multi-wavelength light curves is provided for each flare event since January 2002. Results of an initial statistical analysis will be presented.

  13. An Interactive Multi-instrument Database of Solar Flares

    Science.gov (United States)

    Sadykov, Viacheslav M.; Kosovichev, Alexander G.; Oria, Vincent; Nita, Gelu M.

    2017-07-01

    Solar flares are complicated physical phenomena that are observable in a broad range of the electromagnetic spectrum, from radio waves to γ-rays. For a more comprehensive understanding of flares, it is necessary to perform a combined multi-wavelength analysis using observations from many satellites and ground-based observatories. For an efficient data search, integration of different flare lists, and representation of observational data, we have developed the Interactive Multi-Instrument Database of Solar Flares (IMIDSF, https://solarflare.njit.edu/). The web-accessible database is fully functional and allows the user to search for uniquely identified flare events based on their physical descriptors and the availability of observations by a particular set of instruments. Currently, the data from three primary flare lists (Geostationary Operational Environmental Satellites, RHESSI, and HEK) and a variety of other event catalogs (Hinode, Fermi GBM, Konus-WIND, the OVSA flare catalogs, the CACTus CME catalog, the Filament eruption catalog) and observing logs (IRIS and Nobeyama coverage) are integrated, and an additional set of physical descriptors (temperature and emission measure) is provided along with an observing summary, data links, and multi-wavelength light curves for each flare event since 2002 January. We envision that this new tool will allow researchers to significantly speed up the search of events of interest for statistical and case studies.

  14. Frequencies of Flare Occurrence: Interaction between Convection and Coronal Loops

    Science.gov (United States)

    Mullan, D. J.; Paudel, R. R.

    2018-02-01

    Observations of solar and stellar flares have revealed the presence of power-law dependences between the flare energy and the time interval between flares. Various models have been proposed to explain these dependences and the numerical value of the power-law indices. Here, we propose a model in which convective flows in granules force the footpoints of coronal magnetic loops, which are frozen-in to photospheric gas, to undergo a random walk. In certain conditions, this can lead to a twist in the loop, which drives the loop unstable if the twist exceeds a critical value. The possibility that a solar flare is caused by such a twist-induced instability in a loop has been in the literature for decades. Here, we quantify the process in an approximate way with a view to replicating the power-law index. We find that, for relatively small flares, the random walk twisting model leads to a rather steep power-law slope that agrees very well with the index derived from a sample of 56,000+ solar X-ray flares reported by the GOES satellites. For relatively large flares, we find that the slope of the power law is shallower. The empirical power-law slopes reported for flare stars also have a range that overlaps with the slopes obtained here. We suggest that in the coolest stars, a significant change in slope should occur when the frozen-flux assumption breaks down due to low electrical conductivity.

  15. Hα Intensity Oscillations in Large Flares Ram Ajor Maurya & Ashok ...

    Indian Academy of Sciences (India)

    reinvestigate the problem of oscillations in the quiet, active and flaring locations in the chromosphere. 2. The observational data. The Hα data of solar flares used for this study were obtained by the 6-inch aperture Spar telescope of Udaipur Solar Observatory in the observational period 04:00–12:00 UT of USO time window.

  16. X-ray Emission Characteristics of Flares Associated with CMEs ...

    Indian Academy of Sciences (India)

    Abstract. We present the study of 20 solar flares observed by “Solar. X-ray Spectrometer (SOXS)” mission during November 2003 to December. 2006 and found associated with coronal mass ejections (CMEs) seen by. LASCO/SOHO mission. In this investigation, X-ray emission characteris- tics of solar flares and their ...

  17. Hα LINE PROFILE ASYMMETRIES AND THE CHROMOSPHERIC FLARE VELOCITY FIELD

    Energy Technology Data Exchange (ETDEWEB)

    Kuridze, D.; Mathioudakis, M.; Kennedy, M.; Keenan, F. P. [Astrophysics Research Centre, School of Mathematics and Physics, Queen’s University Belfast BT7 1NN (United Kingdom); Simões, P. J. A.; Voort, L. Rouppe van der; Fletcher, L. [SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ (United Kingdom); Carlsson, M.; Jafarzadeh, S. [Institute of Theoretical Astrophysics, University of Oslo, P.O. Box 1029 Blindern, NO-0315 Oslo (Norway); Allred, J. C.; Kowalski, A. F. [Department of Astronomy, University of Maryland, College Park, MD 20742 (United States); Graham, D. [INAF-Ossevatorio Astrofisico di Arcetri, I-50125 Firenze (Italy)

    2015-11-10

    The asymmetries observed in the line profiles of solar flares can provide important diagnostics of the properties and dynamics of the flaring atmosphere. In this paper the evolution of the Hα and Ca ii λ8542 lines are studied using high spatial, temporal, and spectral resolution ground-based observations of an M1.1 flare obtained with the Swedish 1 m Solar Telescope. The temporal evolution of the Hα line profiles from the flare kernel shows excess emission in the red wing (red asymmetry) before flare maximum and excess in the blue wing (blue asymmetry) after maximum. However, the Ca ii λ8542 line does not follow the same pattern, showing only a weak red asymmetry during the flare. RADYN simulations are used to synthesize spectral line profiles for the flaring atmosphere, and good agreement is found with the observations. We show that the red asymmetry observed in Hα is not necessarily associated with plasma downflows, and the blue asymmetry may not be related to plasma upflows. Indeed, we conclude that the steep velocity gradients in the flaring chromosphere modify the wavelength of the central reversal in the Hα line profile. The shift in the wavelength of maximum opacity to shorter and longer wavelengths generates the red and blue asymmetries, respectively.

  18. Sgr A* flares: tidal disruption of asteroids and planets?

    NARCIS (Netherlands)

    Zubovas, K.; Nayakshin, S.; Markoff, S.

    2012-01-01

    It is theoretically expected that a supermassive black hole (SMBH) in the centre of a typical nearby galaxy disrupts a solar-type star every ∼105 yr, resulting in a bright flare lasting for months. Sgr A*, the resident SMBH of the Milky Way, produces (by comparison) tiny flares that last only hours

  19. Relationships of a growing magnetic flux region to flares

    NARCIS (Netherlands)

    Schadee, A.; Martin, S.F.; Bentley, R.D.; Antalova, A.; Kucera, A.; Dezs, L.; Gesztelyi, L.; Harvey, K.L.; Jones, H.; Livi, S.H.B.; Wang, J.

    1984-01-01

    Some sites for solar flares are known to develop where new magnetic flux emerges and becomes abutted against opposite polarity pre-existing magnetic flux (review by Galzauskas/1/). We have identified and analyzed the evolution of such flare sites at the boundaries of a major new and growing magnetic

  20. Flare Ribbon Expansion and Energy Release Ayumi Asai , Takaaki ...

    Indian Academy of Sciences (India)

    2001-04-10

    1Nobeyama Solar Radio Observatory, Minamisaku, Nagano, 384-1305, Japan. ... X2.3 solar flare which occurred on April 10, 2001. .... In the right panel of. Fig. 3, we show the temporal variation of the physical parameters, such as Bp, vf , ˙ , and S along a slit line. Here, we defined vf as the speed of the flare-ribbon ...

  1. Effect of fenofibrate on uric acid and gout in type 2 diabetes: a post-hoc analysis of the randomised, controlled FIELD study.

    Science.gov (United States)

    Waldman, Boris; Ansquer, Jean-Claude; Sullivan, David R; Jenkins, Alicia J; McGill, Neil; Buizen, Luke; Davis, Timothy M E; Best, James D; Li, Liping; Feher, Michael D; Foucher, Christelle; Kesaniemi, Y Antero; Flack, Jeffrey; d'Emden, Michael C; Scott, Russell S; Hedley, John; Gebski, Val; Keech, Anthony C

    2018-04-01

    Gout is a painful disorder and is common in type 2 diabetes. Fenofibrate lowers uric acid and reduces gout attacks in small, short-term studies. Whether fenofibrate produces sustained reductions in uric acid and gout attacks is unknown. In the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial, participants aged 50-75 years with type 2 diabetes were randomly assigned to receive either co-micronised fenofibrate 200 mg once per day or matching placebo for a median of 5 years follow-up. We did a post-hoc analysis of recorded on-study gout attacks and plasma uric acid concentrations according to treatment allocation. The outcomes of this analysis were change in uric acid concentrations and risk of on-study gout attacks. The FIELD study is registered with ISRCTN, number ISRCTN64783481. Between Feb 23, 1998, and Nov 3, 2000, 9795 patients were randomly assigned to fenofibrate (n=4895) or placebo (n=4900) in the FIELD study. Uric acid concentrations fell by 20·2% (95% CI 19·9-20·5) during the 6-week active fenofibrate run-in period immediately pre-randomisation (a reduction of 0·06 mmol/L or 1 mg/dL) and remained -20·1% (18·5-21·7, puric acid concentration higher than 0·36 mmol/L and 13·9% in those with baseline uric acid concentration higher than 0·42 mmol/L, compared with 3·4% and 5·7%, respectively, in the fenofibrate group. Risk reductions were similar among men and women and those with dyslipidaemia, on diuretics, and with elevated uric acid concentrations. For participants with elevated baseline uric acid concentrations despite taking allopurinol at study entry, there was no heterogeneity of the treatment effect of fenofibrate on gout risk. Taking account of all gout events, fenofibrate treatment halved the risk (HR 0·48, 95% CI 0·37-0·60; puric acid concentrations by 20%, and almost halved first on-study gout events over 5 years of treatment. Fenofibrate could be a useful adjunct for preventing gout in diabetes. None. Copyright

  2. Lower atmosphere of solar flares; Proceedings of the Solar Maximum Mission Symposium, Sunspot, NM, Aug. 20-24, 1985

    International Nuclear Information System (INIS)

    Neidig, D.F.

    1986-01-01

    The topics discussed by the present conference encompass the chromospheric flare phenomenon, white light flares, UV emission and the flare transition region, the flare corona and high energy emissions, stellar flares, and flare energy release and transport. Attention is given to radiative shocks and condensation in flares, impulsive brightening of H-alpha flare points, the structure and response of the chromosphere to radiation backwarming during solar flares, the interpretation of continuum emissions in white light flares, and the radiation properties of solar plasmas. Also discussed are EUV images of a solar flare and C III intensity, an active region survey in H-alpha and X-rays, dynamic thermal plasma conditions in large flares, the evolution of the flare mechanism in dwarf stars, the evidence concerning electron beams in solar flares, the energetics of the nonlinear tearing mode, macroscopic electric fields during two-ribbon flares, and the low temperature signatures of energetic particles

  3. Clinical significance of delta neutrophil index in the differential diagnosis between septic arthritis and acute gout attack within 24 hours after hospitalization.

    Science.gov (United States)

    Pyo, Jung Yoon; Kim, Dae Sik; Jung, Seung Min; Song, Jason Jungsik; Park, Yong-Beom; Lee, Sang-Won

    2017-07-01

    The most important differential diagnoses of acute monoarticular arthritis are septic arthritis and acute gout attack. Identifying infection is crucial in preventing the devastating outcome of septic arthritis. The delta neutrophil index (DNI) is a value that corresponds to the fraction of circulating immature granulocytes. As DNI reflects the burden of infection, we evaluated this index as a differentiating marker between septic arthritis and acute gout attack.The medical records of 149 patients with septic arthritis and 194 patients with acute gout attack were reviewed. A specific cell analyzer, ADVIA 2120, was used to measure DNI. Clinical and laboratory markers associated with predicting septic arthritis were assessed by using logistic regression.Patients with septic arthritis showed higher levels of DNI than those with acute gout attack (3.3 vs 0.6%, P septic arthritis. In the multivariate analysis, DNI was the most powerful independent value for predicting septic arthritis (odds ratio 14.003).This study showed the possibility of using DNI as a differentiating marker between septic arthritis and acute gout attack at the crucial early phase. DNI showed its relevance regardless of confirmation of MSU crystal deposition or serum level of uric acid.

  4. Effects of febuxostat on insulin resistance and expression of high-sensitivity C-reactive protein in patients with primary gout.

    Science.gov (United States)

    Meng, Juan; Li, Yanchun; Yuan, Xiaoxu; Lu, Yuewu

    2017-02-01

    We aimed to investigate the effects of febuxostat on IR and the expression of high-sensitivity C-reactive protein (hs-CRP) in patients with primary gout. Forty-two cases of primary gout patients without uric acid-lowering therapy were included in this study. After a physical examination, 20 age- and sex-matched patients were included as normal controls. The levels of fasting insulin (INS), fasting blood glucose (FBG), and hs-CRP were determined. IR was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Gout patients had higher levels of UA, INS, HOMA-IR, and hs-CRP than normal controls (P HOMA-IR (r = 0.353, P = 0.018) and INS (r = 0.426, P = 0.034). Our findings confirm that IR exists in gout patients and implicate that febuxostat can effectively control the level of serum UA and increase insulin sensitivity in primary gout patients.

  5. Lesinurad, a novel, oral compound for gout, acts to decrease serum uric acid through inhibition of urate transporters in the kidney.

    Science.gov (United States)

    Miner, Jeffrey; Tan, Philip K; Hyndman, David; Liu, Sha; Iverson, Cory; Nanavati, Payal; Hagerty, David T; Manhard, Kimberly; Shen, Zancong; Girardet, Jean-Luc; Yeh, Li-Tain; Terkeltaub, Robert; Quart, Barry

    2016-10-03

    Excess body burden of uric acid promotes gout. Diminished renal clearance of uric acid causes hyperuricemia in most patients with gout, and the renal urate transporter (URAT)1 is important for regulation of serum uric acid (sUA) levels. The URAT1 inhibitors probenecid and benzbromarone are used as gout therapies; however, their use is limited by drug-drug interactions and off-target toxicity, respectively. Here, we define the mechanism of action of lesinurad (Zurampic®; RDEA594), a novel URAT1 inhibitor, recently approved in the USA and Europe for treatment of chronic gout. sUA levels, fractional excretion of uric acid (FE UA ), lesinurad plasma levels, and urinary excretion of lesinurad were measured in healthy volunteers treated with lesinurad. In addition, lesinurad, probenecid, and benzbromarone were compared in vitro for effects on urate transporters and the organic anion transporters (OAT)1 and OAT3, changes in mitochondrial membrane potential, and human peroxisome proliferator-activated receptor gamma (PPARγ) activity. After 6 hours, a single 200-mg dose of lesinurad elevated FE UA 3.6-fold (p uric acid. Lesinurad also has a favorable selectivity and safety profile, consistent with an important role in sUA-lowering therapy for patients with gout.

  6. Solar Flares and the High Energy Solar Spectroscopic Imager (HESSI)

    Science.gov (United States)

    Holman, Gordon D.; Fisher, Richard R. (Technical Monitor)

    2001-01-01

    Solar flares are the biggest explosions in the solar system. They are important both for understanding explosive events in the Universe and for their impact on human technology and communications. The satellite-based HESSI is designed to study the explosive release of energy and the acceleration of electrons, protons, and other charged particles to high energies in solar flares. HESSI produces "color" movies of the Sun in high-energy X rays and gamma rays radiated by these energetic particles. HESSI's X-ray and gamma-ray images of flares are obtained using techniques similar to those used in radio interferometry. Ground-based radio observations of the Sun provide an important complement to the HESSI observations of solar flares. I will describe the HESSI Project and the high-energy aspects of solar flares, and how these relate to radio astronomy techniques and observations.

  7. Models of the Solar Atmospheric Response to Flare Heating

    Science.gov (United States)

    Allred, Joel

    2011-01-01

    I will present models of the solar atmospheric response to flare heating. The models solve the equations of non-LTE radiation hydrodynamics with an electron beam added as a flare energy source term. Radiative transfer is solved in detail for many important optically thick hydrogen and helium transitions and numerous optically thin EUV lines making the models ideally suited to study the emission that is produced during flares. I will pay special attention to understanding key EUV lines as well the mechanism for white light production. I will also present preliminary results of how the model solar atmosphere responds to Fletcher & Hudson type flare heating. I will compare this with the results from flare simulations using the standard thick target model.

  8. Adiabatic heating in impulsive solar flares

    Science.gov (United States)

    Maetzler, C.; Bai, T.; Crannell, C. J.; Frost, K. J.

    1978-01-01

    A study is made of adiabatic heating in two impulsive solar flares on the basis of dynamic X-ray spectra in the 28-254 keV range, H-alpha, microwave, and meter-wave radio observations. It is found that the X-ray spectra of the events are like those of thermal bremsstrahlung from single-temperature plasmas in the 10-60 keV range if photospheric albedo is taken into account. The temperature-emission correlation indicates adiabatic compression followed by adiabatic expansion and that the electron distribution remains isotropic. H-alpha data suggest compressive energy transfer. The projected areas and volumes of the flares are estimated assuming that X-ray and microwave emissions are produced in a single thermal plasma. Electron densities of about 10 to the 9th/cu cm are found for homogeneous, spherically symmetric sources. It is noted that the strong self-absorption of hot-plasma gyrosynchrotron radiation reveals low magnetic field strengths.

  9. ABRUPT LONGITUDINAL MAGNETIC FIELD CHANGES IN FLARING ACTIVE REGIONS

    International Nuclear Information System (INIS)

    Petrie, G. J. D.; Sudol, J. J.

    2010-01-01

    We characterize the changes in the longitudinal photospheric magnetic field during 38 X-class and 39 M-class flares within 65 0 of disk center using 1 minute GONG magnetograms. In all 77 cases, we identify at least one site in the flaring active region where clear, permanent, stepwise field changes occurred. The median duration of the field changes was about 15 minutes and was approximately equal for X-class and for M-class flares. The absolute values of the field changes ranged from the detection limit of ∼10 G to as high as ∼450 G in two exceptional cases. The median value was 69 G. Field changes were significantly stronger for X-class than for M-class flares and for limb flares than for disk-center flares. Longitudinal field changes less than 100 G tended to decrease longitudinal field strengths, both close to disk center and close to the limb, while field changes greater than 100 G showed no such pattern. Likewise, longitudinal flux strengths tended to decrease during flares. Flux changes, particularly net flux changes near disk center, correlated better than local field changes with GOES peak X-ray flux. The strongest longitudinal field and flux changes occurred in flares observed close to the limb. We estimate the change of Lorentz force associated with each flare and find that this is large enough in some cases to power seismic waves. We find that longitudinal field decreases would likely outnumber increases at all parts of the solar disk within 65 0 of disk center, as in our observations, if photospheric field tilts increase during flares as predicted by Hudson et al.

  10. The antinociceptive and anti-inflammatory effects of the crude extract of Jatropha isabellei in a rat gout model.

    Science.gov (United States)

    Silva, Cássia R; Fröhlich, Janaina K; Oliveira, Sara M; Cabreira, Thaíssa N; Rossato, Mateus F; Trevisan, Gabriela; Froeder, Amanda L; Bochi, Guilherme V; Moresco, Rafael N; Athayde, Margareth L; Ferreira, Juliano

    2013-01-09

    Jatropha isabellei Müll Arg. (Euphorbiaceae) is a medicinal plant that has been used in South American folk medicine for the treatment of arthritic diseases, particularly gout. This study was designed to verify the antinociceptive, anti-inflammatory and hypouricemic potential of Jatropha isabellei. Rats were orally administered with the crude extract (100-300 mg/kg) or a fraction that is rich in alkaloids (0.15 mg/kg) of Jatropha isabellei. An intra-articular (i.a.) injection of 50 μl of monosodium urate (MSU) crystals (1.25mg/site) was used to generate the gout model to assess the effect of the treatment on nociception (thermal and mechanical hyperalgesia) and inflammation (oedema and neutrophil infiltration). The effect of Jatropha isabellei on the serum levels of uric acid was evaluated in a model of hyperuricaemia induced by the intraperitoneal injection of potassium oxonate (250 mg/kg). The side effects were analysed using an open-field test, gastric lesion assessment and by measuring the levels of the ALT and AST enzymes. Our study demonstrated that the crude extract of Jatropha isabellei and a fraction rich in alkaloids were able to prevent the thermal hyperalgesia, mechanical allodynia, oedema and neutrophil infiltration induced by intra-articular MSU injection in rats. On the other hand, treatment with Jatropha isabellei did not alter the uric acid levels increased by potassium oxonate in the hyperuricaemia model. In addition, Jatropha isabellei did not induce gastric lesions or liver damage and did not alter spontaneous locomotor activity. The crude extract of Jatropha isabellei and its fraction rich in alkaloid presents antinociceptive and anti-inflammatory effects in a rat gout model, similar to that observed after treatment with colchicine, supporting the traditional use of this plant in gouty patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. Cardiovascular effects of urate-lowering therapies in patients with chronic gout: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Tony; Pope, Janet E

    2017-07-01

    To determine if urate-lowering treatment (ULT) in gout can reduce cardiovascular (CV) outcomes. Randomized trials were searched for treatment with ULT in gout. Eligible trials had to report CV safety of a ULT. Potential medications included allopurinol, febuxostat, pegloticase, rasburicase, probenecid, benzbromarone, sulphinpyrazone, losartan, fenofibrate and sodium-glucose linked transporter 2 inhibitors. A total of 3084 citations were found, with 642 duplicates. After the primary screen, 35 studies were selected for review. Several trials did not report CV events. Six were not randomized controlled trials (RCTs). Four studies reported no events in either intervention arm while the other four had 40 events in the febuxostat group ( n = 3631) and 5 in allopurinol group ( n = 1154). Overall, the pooled analysis did not show a significant difference between the two [febuxostat vs allopurinol: relative risk (RR) 1.69 (95% CI 0.54, 5.34), P = 0.37]. CV events did not decrease over time. Comparing shorter studies (<52 weeks) to longer ones did not reveal any statistical differences. However, in long-term studies with febuxostat vs allopurinol, results were nearly significant, with more CVE occurring with febuxostat treatment. Comparing any ULT to placebo (eight studies, n = 2221 patients) did not demonstrate a significant difference in non-Anti-Platelet Trialists' Collaboration events [any ULT vs placebo: RR 1.47 (95% CI 0.49, 4.40), P = 0.49] or all-cause mortality [any ULT vs placebo: RR 1.45 (95% CI 0.35, 5.77), P = 0.60]. RCT data do not suggest differences in CV events among ULTs in gout. Trials had few events despite high-risk patients being enrolled and may have been too short to show CV reduction by controlling inflammatory attacks and lowering uric acid.

  12. An MRI assessment of chronic synovial-based inflammation in gout and its correlation with serum urate levels.

    Science.gov (United States)

    Carter, John D; Patelli, Michelle; Anderson, Scott R; Prakash, Neelesh; Rodriquez, Ernesto J; Bateman, Helen; Sterrett, Ashley; Valeriano, Joanne; Ricca, Louis R

    2015-02-01

    It is unclear when the synovial-based inflammatory process of gout begins. The aim of this study was to determine the percentage of patients with inter-critical gout who have chronic synovial-based inflammation as evidenced by synovial pannus on a contrast-enhanced magnetic resonance imaging (MRI) of their most involved joint and determine if the presence and/or severity correlates with their serum urate levels. All patients received a 3 T MRI of their index joint, serum urate level, CRP, and creatinine. The primary endpoint was to determine the prevalence of synovial pannus and the correlation of serum urate levels with the presence and/or severity of the synovial pannus on that same joint. MRI erosions, tophi, swelling, effusion, and osteitis were also documented. Seventy-two of 74 subjects (90% men) completed the protocol. Fifty-three of 72 (74%) index joints were the first metatarsophalangeal joint. Thirty-nine (54.2%) of the patients were on urate-lowering therapy; 15 (20.8%) and 7 (9.7%) were taking colchicine or a NSAID daily, respectively. Of the 72 subjects, 63 (87.5%) had synovial pannus on their MRI with good inter-reader agreement between the two radiologists. The mean serum urate level was 7.93 mg/dL. There was no correlation with the presence (p = 0.33) or severity (p = 0.34) of synovial pannus and serum urate levels. There was also no correlation with the presence or severity of synovial pannus and the secondary endpoints. The majority of patients with inter-critical gout have evidence of chronic synovial-based inflammation. However, the presence and severity of this inflammation do not appear to correlate with serum urate levels.

  13. Risk factors of systemic lupus erythematosus flares during pregnancy.

    Science.gov (United States)

    Jara, Luis J; Medina, Gabriela; Cruz-Dominguez, Pilar; Navarro, Carmen; Vera-Lastra, Olga; Saavedra, Miguel A

    2014-12-01

    This review examines the risk factors for the development of systemic lupus erythematosus (SLE) flares during pregnancy. In preconception, anti-DNA, hypocomplementemia, previous thrombosis, triple antiphospholipid (aPL) antibody positivity, active lupus nephritis and discontinuation of medications such as hydroxychloroquine and azathioprine are factors associated with pregnancy failure. During pregnancy, SLE flares are associated with aPL antibodies, synergic changes of pregnancy on Th1 and TH2 cytokines, other cytokines and chemokines that interact with hormones such as estrogen and prolactin that amplify the inflammatory effect. From the clinical point of view, SLE activity at pregnancy onset, thrombocytopenia, lupus nephritis, arterial hypertension, aPL syndromes, preeclampsia is associated with lupus flares and fetal complications. In puerperium, the risk factors of flares are similar to pregnancy. Hyperactivity of immune system, autoantibodies, hyperprolactinemia, active lupus nephritis, decrease in TH2 cytokines with increase in TH1 cytokines probably participate in SLE flare. The SLE flares during pregnancy make the difference between an uncomplicated pregnancy and pregnancy with maternal and fetal complications. Therefore, the knowledge of risk factors leads the best treatment strategies to reduce flares and fetal complications in SLE patients.

  14. TIME-DEPENDENT MODELS OF FLARES FROM SAGITTARIUS A*

    International Nuclear Information System (INIS)

    Dodds-Eden, Katie; Genzel, Reinhard; Gillessen, Stefan; Eisenhauer, Frank; Sharma, Prateek; Quataert, Eliot; Porquet, Delphine

    2010-01-01

    The emission from Sgr A*, the supermassive black hole in the Galactic Center, shows order of magnitude variability ('flares') a few times a day that is particularly prominent in the near-infrared (NIR) and X-rays. We present a time-dependent model for these flares motivated by the hypothesis that dissipation of magnetic energy powers the flares. We show that episodic magnetic reconnection can occur near the last stable circular orbit in time-dependent magnetohydrodynamic simulations of black hole accretion-the timescales and energetics of these events are broadly consistent with the flares from Sgr A*. Motivated by these results, we present a spatially one-zone time-dependent model for the electron distribution function in flares, including energy loss due to synchrotron cooling and adiabatic expansion. Synchrotron emission from transiently accelerated particles can explain the NIR/X-ray light curves and spectra of a luminous flare observed on 2007 April 4. A significant decrease in the magnetic field strength during the flare (coincident with the electron acceleration) is required to explain the simultaneity and symmetry of the simultaneous light curves. Our models predict that the NIR and X-ray spectral indices are related by Δα ≅ 0.5 (where νF ν ∝ ν α ) and that there is only modest variation in the spectral index during flares. We also explore implications of this model for longer wavelength (radio-submillimeter) emission seemingly associated with X-ray and NIR flares; we argue that a few hour decrease in the submillimeter emission is a more generic consequence of large-scale magnetic reconnection than delayed radio emission from adiabatic expansion.

  15. Solar flare protection for manned lunar missions - Analysis of the October 1989 proton flare event

    Science.gov (United States)

    Simonsen, Lisa C.; Nealy, John E.; Townsend, Lawrence W.; Sauer, Herbert H.

    1991-01-01

    Several large solar proton events occurred in the latter half of 1989. For a moderately shielded spacecraft in free space, the potential exposure would have been greatest for the flare which occurred between October 19 to 27, 1989. The temporal variations of the proton energy spectra at approximately 1 AU were monitored by the GOES-7 satellite. These data, recorded and processed at the NOAA-Boulder Space Environment Laboratory, provide the opportunity to analyze dose rates and cumulative doses which might be incurred by astronaus in transit to, or on, the moon. Of particular importance in such an event is the time development of exposure in the early phases of the flare, for which dose rates may range over many orders of magnitude in the first few hours. The cumulative dose as a function of time for the entire event is also predicted. In addition to basic shield calculations, dose rate contours are constructed for flare shelters in free-space and on the lunar surface.

  16. Solar flare protection for manned lunar missions - Analysis of the October 1989 proton flare event

    International Nuclear Information System (INIS)

    Simonsen, L.C.; Nealy, J.E.; Townsend, L.W.; Sauer, H.H.

    1991-07-01

    Several large solar proton events occurred in the latter half of 1989. For a moderately shielded spacecraft in free space, the potential exposure would have been greatest for the flare which occurred between October 19 to 27, 1989. The temporal variations of the proton energy spectra at approximately 1 AU were monitored by the GOES-7 satellite. These data, recorded and processed at the NOAA-Boulder Space Environment Laboratory, provide the opportunity to analyze dose rates and cumulative doses which might be incurred by astronauts in transit to, or on, the moon. Of particular importance in such an event is the time development of exposure in the early phases of the flare, for which dose rates may range over many orders of magnitude in the first few hours. The cumulative dose as a function of time for the entire event is also predicted. In addition to basic shield calculations, dose rate contours are constructed for flare shelters in free-space and on the lunar surface. 14 refs

  17. Distribution function of frequency of stellar flares in the Orion association

    International Nuclear Information System (INIS)

    Parsamyan, Eh.S.

    1980-01-01

    Using the chronology of discoveries of new flares and the chronology of confirmation i.e. the time distribution of second flares (Ambartsumian's method), the distribution function of frequency of flares on stars in the Orion association is obtained. A number of stars having different frequencies is also found. It is shown that flare stars with high flare frequency (ν -1 13sup(m). The quantities of flare stars in aggregates determined by two independent methods show that the number of flare stars in Orion association is about 1.5 times greater than in the Pleiades cluster [ru

  18. Biotic extinctions by solar flares; and reply

    International Nuclear Information System (INIS)

    Beland, P.; Russell, D.A.; Crutzen, P.J.; Reid, G.C.

    1976-01-01

    Some comments are offered on the paper by Reid and others (nature 259:177 (1976)) in which a mechanism was suggested by which solar protons might catastrophically deplete atmospheric D 3 during a reversal of the Earth's geomagnetic field. Organisms would thereby be exposed to a more intense UV environment, leading to species extinctions. These authors assumed that during a reversal the geomagnetic field effectively disappears for about 1000 years, and also that solar flares sufficiently intense to cause extinctions occur at intervals of 1000 years or more. The validity of these assumptions is here examined using data on geomagnetic reversals identified over the past 75 M years, together with extinction data, and some anomalies are pointed out. A reply by Reid and others is appended. (U.K.)

  19. BLAZAR FLARES FROM COMPTON DRAGGED SHELLS

    Energy Technology Data Exchange (ETDEWEB)

    Golan, Omri; Levinson, Amir, E-mail: Levinson@wise.tau.ac.il [School of Physics and Astronomy, Tel Aviv University, Tel Aviv 69978 (Israel)

    2015-08-10

    We compute the dynamics and emission of dissipative shells that are subject to a strong Compton drag, under simplifying assumptions about the dissipation mechanism. We show that under conditions prevailing in blazars, substantial deceleration is anticipated on sub-parsec and parsec scales in cases of rapid dissipation. Such episodes may be the origin of some of the flaring activity occasionally observed in gamma-ray blazars. The shape of the light curves thereby produced reflects the geometry of the emitting surface if the deceleration is very rapid, or the dynamics of the shell if the deceleration is delayed, or initially more gradual, owing, e.g., to continuous injection of energy and momentum.

  20. Excitation of Resonant Helioseimic Modes by Solar Flares.

    Science.gov (United States)

    Leibacher, John W.; Baudin, Frédéric; Rabello Soares,, Maria Cristina

    2015-08-01

    Flares are known to excite propagating sound waves in the solar atmosphere, and Maurya et al. (2009), using a local analysis (ring diagrams) of the 2003 Halloween flare, showed that they excite resonant p-modes as well. We confirm and extend here these results by:-applying the same analysis to other locations on the Sun at the time of the Halloween flare-analyzing other events also showing a signature of p-mode excitation-looking in detail at the results of the ring diagrams analysis in terms of noise fitting and the center-to-limb variation of ring-diagram power.

  1. Establishing a core domain set to measure rheumatoid arthritis flares

    DEFF Research Database (Denmark)

    Bykerk, Vivian P; Lie, Elisabeth; Bartlett, Susan J

    2014-01-01

    to measure RA flare. METHODS: Patient and healthcare professional (HCP) qualitative studies, focus groups, and literature review, followed by patient and HCP Delphi exercises including combined Delphi consensus at Outcome Measures in Rheumatology 10 (OMERACT 10), identified potential domains to measure flare...... Filter 2.0 methodology. RESULTS: A pre-meeting combined Delphi exercise for defining flare identified 9 domains as important (>70% consensus from patients or HCP). Four new patient-reported domains beyond those included in the RA disease activity core set were proposed for inclusion (fatigue...

  2. Mechanisms for Particle Acceleration in Impulsive Flares

    Science.gov (United States)

    Dahlin, J.; Drake, J. F.; Swisdak, M. M.

    2013-12-01

    Magnetic reconnection is a plasma process in which magnetic energy is rapidly converted to kinetic energy via a change in the magnetic topology. Observations of reconnection in solar flares show it to be an very efficient accelerator of particles, e.g. nonthermal electrons. The traditional picture of acceleration via parallel electric fields near the magnetic X-line does not scale well to large systems such as the solar corona. Recent work has shown that particles may be accelerated by a Fermi mechanism inside contracting magnetic islands. This mechanism was previously explored in terms of particles trapped in contracting islands, gaining energy due to the conservation of the parallel adiabatic invariant. However, this treatment is not strictly applicable in complicated island geometries where particles are poorly trapped. To generalize this theory, we examine this mechanism by means of its local expression: the scalar product of the electric force with the curvature drift. This proves equivalent to conservation of the parallel adiabatic invariant for the case of a trapped particle. We present two-dimensional kinetic simulations which explore the relative importance of this term compared to parallel electric fields. The curvature-drift term dominates in antiparallel reconnection, with a negligible contribution from parallel electric fields. In the guide field simulations, relevant for solar flares, the contribution from parallel electric fields is significant. We explore several simulations with varying system sizes and mass ratios in order to examine how the parallel electric fields and the curvature-drift term would scale to large systems relevant for physical applications. We then compare the 2D results with 3D simulations.

  3. Reconstruction of a Large-scale Pre-flare Coronal Current Sheet Associated with a Homologous X-shaped Flare

    Science.gov (United States)

    Jiang, Chaowei; Yan, Xiaoli; Feng, Xueshang; Duan, Aiying; Hu, Qiang; Zuo, Pingbing; Wang, Yi

    2017-11-01

    As a fundamental magnetic structure in the solar corona, electric current sheets (CSs) can form either prior to or during a solar flare, and they are essential for magnetic energy dissipation in the solar corona because they enable magnetic reconnection. However, the static reconstruction of a CS is rare, possibly due to limitations that are inherent in the available coronal field extrapolation codes. Here we present the reconstruction of a large-scale pre-flare CS in solar active region 11967 using an MHD-relaxation model constrained by the SDO/HMI vector magnetogram. The CS is associated with a set of peculiar homologous flares that exhibit unique X-shaped ribbons and loops occurring in a quadrupolar magnetic configuration.This is evidenced by an ’X’ shape, formed from the field lines traced from the CS to the photosphere. This nearly reproduces the shape of the observed flare ribbons, suggesting that the flare is a product of the dissipation of the CS via reconnection. The CS forms in a hyperbolic flux tube, which is an intersection of two quasi-separatrix layers. The recurrence of the X-shaped flares might be attributed to the repetitive formation and dissipation of the CS, as driven by the photospheric footpoint motions. These results demonstrate the power of a data-constrained MHD model in reproducing a CS in the corona as well as providing insight into the magnetic mechanism of solar flares.

  4. An energy storage process and energy budget of solar flares

    International Nuclear Information System (INIS)

    Tanaka, K.; Dryer, M.

    1980-01-01

    The flare energy is generally considered to be stored in stressed (twisted or sheared) magnetic fields. Chatacteristic magnetic configurations in the great activities (inverted, twisted delta-configuration) suggest an inherent shape of fluxtube for these regions: a twisted magnetic knot. Further, evolutionary characteristics such as rapid growths of spots and growth of twist in parallel with apparent shear motion of spot, together with the fact that the shear motion is associated with upward velocity, suggest a continuous emergence of such a twisted knot from below throughout the activity. In this model the flare energy may be supplied directly into the corona as the twisted portion of the fluxtube emerges out. The authors evaluate the energy supply for a very flare-rich and fast-evolved active region McMath 13043 (1974 July), and compare it with released flare energies (thermal and kinetic). (Auth.)

  5. Intralesional triamcinolone for flares of hidradenitis suppurativa (HS)

    DEFF Research Database (Denmark)

    Riis, Peter Theut; Boer, Jurr; Prens, Errol P

    2016-01-01

    BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle. Standard practice of managing acute flares with corticosteroid injection lacks scientific evidence. OBJECTIVE: We sought to assess the outcomes of routine treatment using intralesional triamcinolone ...

  6. A static model of chromospheric heating in solar flares

    Science.gov (United States)

    Ricchiazzi, P. J.; Canfield, R. C.

    1983-01-01

    The response of the solar chromosphere to flare processes, namely nonthermal electrons, thermal conduction, and coronal pressure, is modeled. Finite difference methods employing linearization and iteration are used in obtaining simultaneous solutions to the equations of steady-state energy balance, hydrostatic equilibrium, radiative transfer, and atomic statistical equilibrium. The atmospheric response is assumed to be confined to one dimension by a strong vertical magnetic field. A solution is obtained to the radiative transfer equation for the most important optically thick transitions of hydrogen, magnesium, and calcium. The theoretical atmospheres discussed here are seen as elucidating the role of various physical processes in establishing the structure of flare chromospheres. At low coronal pressures, conduction is found to be more important than nonthermal electrons in establishing the position of the transition region. Only thermal conduction can adequately account for the chromospheric evaporation in compact flares. Of the mechanisms considered, only nonthermal electrons bring about significant heating below the flare transition region.

  7. Forecasting Flare Activity Using Deep Convolutional Neural Networks

    Science.gov (United States)

    Hernandez, T.

    2017-12-01

    Current operational flare forecasting relies on human morphological analysis of active regions and the persistence of solar flare activity through time (i.e. that the Sun will continue to do what it is doing right now: flaring or remaining calm). In this talk we present the results of applying deep Convolutional Neural Networks (CNNs) to the problem of solar flare forecasting. CNNs operate by training a set of tunable spatial filters that, in combination with neural layer interconnectivity, allow CNNs to automatically identify significant spatial structures predictive for classification and regression problems. We will start by discussing the applicability and success rate of the approach, the advantages it has over non-automated forecasts, and how mining our trained neural network provides a fresh look into the mechanisms behind magnetic energy storage and release.

  8. Relativistic electron transport and bremsstrahlung production in solar flares

    Science.gov (United States)

    Miller, James A.; Ramaty, Reuven

    1989-01-01

    A Monte Carlo simulation of ultrarelativistic electron transport in solar flare magnetic loops has been developed. It includes Coulomb, synchrotron, and bremsstrahlung energy losses; pitch-angle scattering by Alfven and whistler turbulence in the coronal region of the loop; and magnetic mirroring in the converging magnetic flux tubes beneath the transition region. Depth distributions, time profiles, energy spectra, and angular distributions of the resulting bremsstrahlung emission are calculated. It is found that both the preferential detection of solar flares with greater than 10 MeV emission near the limb of the sun and the observation of ultrarelativistic electron bremsstrahlung from flares on the disk are consequences of the loop transport model. The declining portions of the observed time profiles of greater than 10 MeV emission from solar flares can also be accounted for, and it is proposed that these portions are determined by transport and not acceleration.

  9. Gamma-ray flares from the Crab nebula

    International Nuclear Information System (INIS)

    Abdo, A.A.; Ackermann, M.; Ajello, M.; Allafort, A.; Baldini, L.; Ballet, J.; Casandjian, J.M.; Grenier, I.A.; Naumann-Godo, M.; Pierbattista, M.; Tibaldo, L.

    2011-01-01

    A young and energetic pulsar powers the well-known Crab Nebula. Here, we describe two separate gamma-ray (photon energy greater than 100 mega-electron volts) flares from this source detected by the Large Area Telescope on board the Fermi Gamma-ray Space Telescope. The first flare occurred in February 2009 and lasted approximately 16 days. The second flare was detected in September 2010 and lasted approximately 4 days. During these outbursts, the gamma-ray flux from the nebula increased by factors of four and six, respectively. The brevity of the flares implies that the gamma rays were emitted via synchrotron radiation from peta-electron-volt (10 15 electron volts) electrons in a region smaller than 1.4 * 10 -2 parsecs. These are the highest-energy particles that can be associated with a discrete astronomical source, and they pose challenges to particle acceleration theory. (authors)

  10. Gamma-Ray Imager Polarimeter for Solar Flares Project

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose here to develop the Gamma-Ray Imager/Polarimeter for Solar flares (GRIPS), the next-generation instrument for high-energy solar observations. GRIPS will...

  11. Trends in hyperuricemia and gout prevalence: Nutrition and Health Survey in Taiwan from 1993-1996 to 2005-2008.

    Science.gov (United States)

    Chuang, Shao-Yuan; Lee, Shu-Chen; Hsieh, Yao-Te; Pan, Wen-Harn

    2011-01-01

    Hyperuricemia is a recognized risk factor for cardiovascular disease. This study investigated trends in uric acid levels, hyperuricemia and gout among adults in Taiwan from 1993-1996 to 2005-2008, using data collection from, Nutrition and health surveys in Taiwan (NAHSIT) conducted in 1993-1996 and 2005-2008. Information on food frequency, medical history, physical measures and fasting blood parameters were analyzed. Mean uric acid levels decreased between 1993-1996 and 2005-2008 in both genders (6.77 vs 6.59 mg/dL in men and 5.33 vs 4.97 mg/dL in women) and the prevalence of hyperuricemia declined from 25.3% to 22.0% in men (pcoffee were negatively associated with hyperuricemia, whereas consumption of organ meats, bamboo shoots, and soft drinks were positively associated with hyperuricemia. The dietary factor score (DFS) composed of the frequency of above food items decreased from -5.40 to -6.00 between the two surveys (p<0.0001). In conclusion, uric acid levels and prevalence of hyperuricemia both declined, whilst self-reported gout increased between 1993-1996 and 2005-2008. Changes in dietary patterns may in part explain the decrease in uric acid levels between the two national surveys.

  12. Electron and proton kinetics and dynamics in flaring atmospheres

    CERN Document Server

    Zharkova, Valentina

    2012-01-01

    This timely book presents new research results on high-energy particle physics related to solar flares, covering the theory and applications of the reconnection process in a clear and comprehensible way. It investigates particle kinetics and dynamics in flaring atmospheres and their diagnostics from spectral observations, while providing an analysis of the observation data and techniques and comparing various models. Written by an internationally acclaimed expert, this is vital reading for all solar, astro-, and plasma physicists working in the field.

  13. Observation of solar flare by Hinotori SXT/HXM

    International Nuclear Information System (INIS)

    Ohki, Ken-ichiro; Takakura, Tatsuo; Tsuneta, Sukehisa; Nitta, Nariaki; Makishima, Kazuo.

    1982-01-01

    Solar flares were observed by SXT (hard X-ray two-dimensional observation system) and HXM (hard X-ray spectrometer) on Hinotori. The results of two-dimensional analysis of 20 flares are reported in this paper. Various images of hard X-ray were observed. Hard X-ray bursts with relatively long duration may be generated in corona. The hard X-ray flare generated on the solar disc gives information on the relative position to the H flare. The examples of this hard X-ray images are presented. The HXM can observe the hard X-ray spectra up to 350 keV. The flares with duration less than 5 min have the spectra coninciding with the thermal radiation from a single temperature before the peak, and power law type non-thermal radiation spectra after the peak. The hard X-ray flares with duration longer than 10 min have power law type spectra. (Kato, T.)

  14. Health and exposure assessment of flare gas emissions

    International Nuclear Information System (INIS)

    Kindzierski, W.B.; Byrne-Lewis, C.; Probert, S.

    2000-01-01

    The incomplete combustion of flare gases produces pollutants such as volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs) which are cause for concern for public health. Some of the concerns relate to potential long-term cumulative health effects from exposure to hazardous air pollutants including benzene, styrene, naphthalene, and benzopyrene. This study demonstrated that several factors should be taken into account when considering the importance of flaring and human exposure to flare gas emissions. Most flare stacks are located in rural areas, but most time-availability studies have been done on urban populations where the majority of people spend their time indoors. It was recommended that more time-activity studies are needed to emphasize the behaviour of rural populations which are most susceptible to exposure from pollutants from flaring. It was concluded that higher indoor air concentrations exist for many VOCs and PAHs compared to outdoors, but in these instances, indoor sources are the major contributors to indoor air concentrations. It was recommended that health assessments of hazardous air pollutants emitted from gas flaring has to take into account the indoor setting and other background exposures in order to provide useful information for decision makers. 49 refs., 8 tabs., 1 fig

  15. Solar flare nuclear gamma-rays and interplanetary proton events

    International Nuclear Information System (INIS)

    Cliver, E.W.; Forrest, D.J.; Cane, H.V.; Reames, D.V.; Mcguire, R.E.; Von Rosenvinge, T.T.

    1989-01-01

    Gamma-ray line (GRL) and solar energetic proton (SEP) events observed from February 1980 through January 1985 are compared in order to substantiate and better characterize the lack of correlation between GRL fluences and SEP event peak fluxes. The scatter plot of SEP event peak flux vs. GRL fluence is presented, and the ratio of 'solar' to 'interplanetary', about 10 MeV protons, is presented. It is shown that, while even large SEP events can originate in flares lacking detectable GRL emission, the converse case of flares with a significant GRL line fluence by lacking protons in space is rare. The ratio R of the number of about 10 MeV protons that produce GRL emission at the flare site to the number of about 10 MeV protons detected in space can vary from event to event by four orders of magnitude. There is a clear tendency for impulsive flares to have larger values of R than long-duration flares, where the flare time scale is given by the e-folding decay time of the associated soft X-ray emission. 103 refs

  16. Magnetohydrodynamic Simulations for Studying Solar Flare Trigger Mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Muhamad, J.; Kusano, K.; Inoue, S.; Shiota, D. [Institute for Space-Earth Environmental Research, Nagoya University, Furocho, Chikusa-ku, Nagoya, Aichi, 464-8601 (Japan)

    2017-06-20

    In order to understand the flare trigger mechanism, we conduct three-dimensional magnetohydrodynamic simulations using a coronal magnetic field model derived from data observed by the Hinode satellite. Several types of magnetic bipoles are imposed into the photospheric boundary of the Nonlinear Force-free Field model of Active Region (AR) NOAA 10930 on 2006 December 13, to investigate what kind of magnetic disturbance may trigger the flare. As a result, we confirm that certain small bipole fields, which emerge into the highly sheared global magnetic field of an AR, can effectively trigger a flare. These bipole fields can be classified into two groups based on their orientation relative to the polarity inversion line: the so-called opposite polarity, and reversed shear structures, as suggested by Kusano et al. We also investigate the structure of the footpoints of reconnected field lines. By comparing the distribution of reconstructed field lines and observed flare ribbons, the trigger structure of the flare can be inferred. Our simulation suggests that the data-constrained simulation, taking into account both the large-scale magnetic structure and small-scale magnetic disturbance (such as emerging fluxes), is a good way to discover a flare-producing AR, which can be applied to space weather prediction.

  17. Oilfield Flare Gas Electricity Systems (OFFGASES Project)

    Energy Technology Data Exchange (ETDEWEB)

    Rachel Henderson; Robert Fickes

    2007-12-31

    The Oilfield Flare Gas Electricity Systems (OFFGASES) project was developed in response to a cooperative agreement offering by the U.S. Department of Energy (DOE) and the National Energy Technology Laboratory (NETL) under Preferred Upstream Management Projects (PUMP III). Project partners included the Interstate Oil and Gas Compact Commission (IOGCC) as lead agency working with the California Energy Commission (CEC) and the California Oil Producers Electric Cooperative (COPE). The project was designed to demonstrate that the entire range of oilfield 'stranded gases' (gas production that can not be delivered to a commercial market because it is poor quality, or the quantity is too small to be economically sold, or there are no pipeline facilities to transport it to market) can be cost-effectively harnessed to make electricity. The utilization of existing, proven distribution generation (DG) technologies to generate electricity was field-tested successfully at four marginal well sites, selected to cover a variety of potential scenarios: high Btu, medium Btu, ultra-low Btu gas, as well as a 'harsh', or high contaminant, gas. Two of the four sites for the OFFGASES project were idle wells that were shut in because of a lack of viable solutions for the stranded noncommercial gas that they produced. Converting stranded gas to useable electrical energy eliminates a waste stream that has potential negative environmental impacts to the oil production operation. The electricity produced will offset that which normally would be purchased from an electric utility, potentially lowering operating costs and extending the economic life of the oil wells. Of the piloted sites, the most promising technologies to handle the range were microturbines that have very low emissions. One recently developed product, the Flex-Microturbine, has the potential to handle the entire range of oilfield gases. It is deployed at an oilfield near Santa Barbara to run on waste gas

  18. Efficacy and tolerability of urate-lowering drugs in gout : a randomised controlled trial of benzbromarone versus probenecid after failure of allopurinol

    NARCIS (Netherlands)

    Reinders, Mattheus; van Roon, E.N.; Jansen, T.L.; Delsing, J.; Griep, E.N.; Hoekstra, M.; van de Laar, M.F.; Brouwers, J.R.

    Objectives: To investigate the efficacy and tolerability of allopurinol as the first-choice antihyperuricaemic treatment for gout, and compare the efficacy and tolerability of benzbromarone and probenecid as second-choice treatment. Methods: Prospective, multicentre, open-label, two-stage randomised

  19. A prospective study of acute inpatient gout diagnoses and management in a tertiary hospital: the determinants and outcome of a rheumatology consultation.

    Science.gov (United States)

    Teichtahl, A J; Clemens, L; Nikpour, M; Romas, E

    2014-11-01

    Despite acute gout frequently complicating hospital admissions, diagnosis and management are variable. Rheumatology input may improve patient outcomes. To examine acute episodes of inpatient gout in a tertiary hospital to determine (i) factors that may lead to rheumatology input being sought and (ii) the differences in outcomes when rheumatology input occurs. Data collection occurred between February and October 2012 for inpatients in a tertiary Australian hospital. Data were prospectively collected for all rheumatology consultations with a diagnosis of gout. Subjects who had an inpatient admission complicated by acute gout and who did not have rheumatology input were identified through health information coding from discharge summaries. Fifty-eight patients (41% with rheumatology input) were included in the study. Rheumatology input was significantly more likely when the patient was younger (68.9 years vs 78.4 years; P = 0.04) with knee joint involvement (41.7% vs 3.0%; P management and a follow-up plan. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  20. M DWARF FLARE CONTINUUM VARIATIONS ON ONE-SECOND TIMESCALES: CALIBRATING AND MODELING OF ULTRACAM FLARE COLOR INDICES

    Energy Technology Data Exchange (ETDEWEB)

    Kowalski, Adam F. [Department of Astronomy, University of Maryland, College Park, MD 20742 (United States); Mathioudakis, Mihalis [Astrophysics Research Centre, School of Mathematics and Physics, Queen’s University Belfast, Belfast, BT7 1NN (United Kingdom); Hawley, Suzanne L.; Hilton, Eric J. [Department of Astronomy, University of Washington, Box 351580, Seattle, WA 98195 (United States); Wisniewski, John P. [HL Dodge Department of Physics and Astronomy, University of Oklahoma, 440 W Brooks Street, Norman, OK 73019 (United States); Dhillon, Vik S. [Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH (United Kingdom); Marsh, Tom R. [Department of Physics, Gibbet Hill Road, University of Warwick, Coventry CV4 7AL (United Kingdom); Brown, Benjamin P., E-mail: adam.f.kowalski@nasa.gov [Laboratory for Atmospheric and Space Physics and Department of Astrophysical and Planetary Sciences, University of Colorado, Boulder, Colorado 80309 (United States)

    2016-04-01

    We present a large data set of high-cadence dMe flare light curves obtained with custom continuum filters on the triple-beam, high-speed camera system ULTRACAM. The measurements provide constraints for models of the near-ultraviolet (NUV) and optical continuum spectral evolution on timescales of ≈1 s. We provide a robust interpretation of the flare emission in the ULTRACAM filters using simultaneously obtained low-resolution spectra during two moderate-sized flares in the dM4.5e star YZ CMi. By avoiding the spectral complexity within the broadband Johnson filters, the ULTRACAM filters are shown to characterize bona fide continuum emission in the NUV, blue, and red wavelength regimes. The NUV/blue flux ratio in flares is equivalent to a Balmer jump ratio, and the blue/red flux ratio provides an estimate for the color temperature of the optical continuum emission. We present a new “color–color” relationship for these continuum flux ratios at the peaks of the flares. Using the RADYN and RH codes, we interpret the ULTRACAM filter emission using the dominant emission processes from a radiative-hydrodynamic flare model with a high nonthermal electron beam flux, which explains a hot, T ≈ 10{sup 4} K, color temperature at blue-to-red optical wavelengths and a small Balmer jump ratio as observed in moderate-sized and large flares alike. We also discuss the high time resolution, high signal-to-noise continuum color variations observed in YZ CMi during a giant flare, which increased the NUV flux from this star by over a factor of 100.

  1. Prediction and comparison of noise levels from ground and elevated flare systems

    International Nuclear Information System (INIS)

    Obasi, E.

    2009-01-01

    Flaring is a process to dispose of hydrocarbons during clean-up, emergency shut downs or dispose a small volume waste streams of mixed gasses that cannot easily or safely be separated. This presentation discussed flaring as a noise issue. It focused on flaring noise characterization; flare noise modeling; flare sound power levels; and flare sound pressure level comparison at a distance of 1.5 km. The presentation included a photograph of flaring at a gas plant in Nigeria. The presentation listed some of the potential health effects associated with long term exposure to excessive noise, such as hearing loss; headaches; stress; fatigue; sleep disturbance; and high blood pressure. Companies flare gas to dispose waste gases in a safe and reliable manner through combustion and to depressurize gas lines during maintenance and emergencies. This presentation also discussed ground and elevated flares; components of flare noise characterization; and key factors affecting flare noise. A model to predict flaring noise was also presented. It demonstrated that at the same gas mass flow rate, the noise level from elevated flare stacks are significantly higher than ground flares. tabs., figs.

  2. Prediction and comparison of noise levels from ground and elevated flare systems

    Energy Technology Data Exchange (ETDEWEB)

    Obasi, E. [Stantec Consulting Ltd., Surrey, BC (Canada)

    2009-07-01

    Flaring is a process to dispose of hydrocarbons during clean-up, emergency shut downs or dispose a small volume waste streams of mixed gasses that cannot easily or safely be separated. This presentation discussed flaring as a noise issue. It focused on flaring noise characterization; flare noise modeling; flare sound power levels; and flare sound pressure level comparison at a distance of 1.5 km. The presentation included a photograph of flaring at a gas plant in Nigeria. The presentation listed some of the potential health effects associated with long term exposure to excessive noise, such as hearing loss; headaches; stress; fatigue; sleep disturbance; and high blood pressure. Companies flare gas to dispose waste gases in a safe and reliable manner through combustion and to depressurize gas lines during maintenance and emergencies. This presentation also discussed ground and elevated flares; components of flare noise characterization; and key factors affecting flare noise. A model to predict flaring noise was also presented. It demonstrated that at the same gas mass flow rate, the noise level from elevated flare stacks are significantly higher than ground flares. tabs., figs.

  3. Flare Prediction Using Photospheric and Coronal Image Data

    Science.gov (United States)

    Jonas, E.; Shankar, V.; Bobra, M.; Recht, B.

    2016-12-01

    We attempt to forecast M-and X-class solar flares using a machine-learning algorithm and five years of image data from both the Helioseismic and Magnetic Imager (HMI) and Atmospheric Imaging Assembly (AIA) instruments aboard the Solar Dynamics Observatory. HMI is the first instrument to continuously map the full-disk photospheric vector magnetic field from space (Schou et al., 2012). The AIA instrument maps the transition region and corona using various ultraviolet wavelengths (Lemen et al., 2012). HMI and AIA data are taken nearly simultaneously, providing an opportunity to study the entire solar atmosphere at a rapid cadence. Most flare forecasting efforts described in the literature use some parameterization of solar data - typically of the photospheric magnetic field within active regions. These numbers are considered to capture the information in any given image relevant to predicting solar flares. In our approach, we use HMI and AIA images of solar active regions and a deep convolutional kernel network to predict solar flares. This is effectively a series of shallow-but-wide random convolutional neural networks stacked and then trained with a large-scale block-weighted least squares solver. This algorithm automatically determines which patterns in the image data are most correlated with flaring activity and then uses these patterns to predict solar flares. Using the recently-developed KeystoneML machine learning framework, we construct a pipeline to process millions of images in a few hours on commodity cloud computing infrastructure. This is the first time vector magnetic field images have been combined with coronal imagery to forecast solar flares. This is also the first time such a large dataset of solar images, some 8.5 terabytes of images that together capture over 3000 active regions, has been used to forecast solar flares. We evaluate our method using various flare prediction windows defined in the literature (e.g. Ahmed et al., 2013) and a novel per

  4. Modeling the Soft X-Ray During Solar Flares

    Science.gov (United States)

    Leaman, C. J.

    2016-12-01

    Solar Radiation can effect our communication and navigation systems here on Earth. In particular, solar X-ray (SXR) and extreme ultraviolet (EUV) radiation is responsible for ionizing (charging) earth's upper atmosphere, and sudden changes in the ionosphere can disrupt high frequency communication systems (e.g. airplane-to-ground) and degrade the location accuracy for GPS navigation. New soft X-ray flare data are needed to study the sources for the SXR radiation and variability of the solar flares and thus help to answer questions if all flares follow the same trend or have different plasma characteristics? In December 2015, the Miniature X-Ray Solar Spectrometer (MinXSS) launched from Cape Canaveral Florida to answer those questions. The MinXSS CubeSat is a miniature satellite that was designed to measure the soft X-ray spectra and study flares in the 1-15 Å wavelength range. So far, the CubeSat has observed more than ten flares. The MinXSS flare data are plotted in energy vs irradiance to display the soft X-ray spectra, and these spectra are compared with different types of CHIANTI models of the soft X-ray radiation. One comparison is for non-flaring spectra using AIA EUV images to identify solar features called active regions, coronal holes, and quiet sun, and then using the fractional area of each feature to calculate a CHIANTI-based spectrum. This comparison reveals how important the active region radiation is for the SXR spectra. A second comparison is for flare spectra to several isothermal models that were created using CHIANTI. The isothermal model comparisons were done with both the raw count spectra from MinXSS and the derived irradiance spectra. This dual comparison helps to validate the irradiance conversion algorithm for MinXSS. Comparisons of the MinXSS data to the models show that flares tend to follow a temperature pattern. Analysis of the MinXSS data can help us understand our sun better, could lead to better forecasts of solar flares, and thus

  5. Is tea consumption associated with the serum uric acid level, hyperuricemia or the risk of gout? A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Yi; Cui, Yang; Li, Xuan-An; Li, Liang-Jun; Xie, Xi; Huang, Yu-Zhao; Deng, Yu-Hao; Zeng, Chao; Lei, Guang-Hua

    2017-02-28

    The aim of this study was to examine the associations of tea consumption with the serum uric acid (SUA) level, hyperuricemia (HU) and the risk of gout. A comprehensive literature search up to June 2016, using PUBMED and EMBASE databases, was conducted to identify the relevant observational studies that examined the associations of tea consumption with the SUA level, HU and the risk of gout. A total of fifteen observational studies were included in this study, and nine studies were extracted for meta-analysis. For the SUA level, seven studies were included. According to the combined weighted mean difference (WMD), there was no significant difference between the highest and the lowest tea intake category in terms of the SUA level (WMD = 7.41 μmol/L, 95%CI: -2.34 to 17.15; P = 0.136). In subgroup analysis including three studies, green tea consumption was positively associated with the SUA level (WMD = 17.20 μmol/L, 95%CI: 7.00 to 27.40; P = 0.01). For the prevalence of HU, five studies were included. The overall multi-variable adjusted odds ratio (OR) for the highest versus the lowest category of tea consumption was 0.98 (95%CI: 0.77 to 1.24; P = 0.839). For the risk of gout, two prospective cohort studies showed that there was no relationship between tea consumption and the risk of gout in males and females, respectively. The current evidences suggest that tea consumption does not seem to be associated with the SUA level, HU and the risk of gout. However, due to the limited number of studies, green tea consumption might be positively associated with the SUA level. More well-designed prospective cohort studies are needed to elaborate these issues further.

  6. Genetic Association for P2X7R rs3751142 and CARD8 rs2043211 Polymorphisms for Susceptibility of Gout in Korean Men: Multi-Center Study.

    Science.gov (United States)

    Lee, Sung Won; Lee, Shin Seok; Oh, Dong Ho; Park, Dong Jin; Kim, Hyun Sook; Choi, Jung Ran; Chae, Soo Cheon; Yun, Ki Jung; Chung, Won Tae; Choe, Jung Yoon; Kim, Seong Kyu

    2016-10-01

    The aim of this study was to determine the association between P2X7R rs3751142 and CARD8 rs2043211 polymorphisms and gout susceptibility in male Korean subjects. This study enrolled a total of 242 male patients with gout and 280 healthy controls. The polymorphisms of two individual genes including rs3751142(C>A) in the P2X7R gene and rs2043211(A>T) in the CARD8 gene were assessed using Taq-Man analysis. Statistical analyses were performed using the Chi-square test, Kruskal-Wallis test, and logistic regression analyses. A difference in genotypic frequency of the P2X7R rs3751142 and CARD8 rs2043211 genes was not detected between gout and control patients. Clinical parameters including age, onset age, disease duration, body mass index, and serum uric acid levels were not different among the three genotypes for either P2X7R or CARD8 (P > 0.05 for all). A pair-wise comparison of P2X7R rs3751142 and CARD8 rs2043211 genotype combinations revealed that subjects with the CA P2X7R rs3751142 genotype and the TT CARD8 rs2043211 genotype had a trend toward a higher risk of gout compared to the CC/AA combination (P = 0.056, OR = 2.618, 95% CI 0.975 - 7.031). In conclusion, this study revealed that genetic variability of the P2X7R rs3751142 and CARD8 rs2043211 genes might, in part, be associated with susceptibility for gout.

  7. NEW SOLAR EXTREME-ULTRAVIOLET IRRADIANCE OBSERVATIONS DURING FLARES

    International Nuclear Information System (INIS)

    Woods, Thomas N.; Hock, Rachel; Eparvier, Frank; Jones, Andrew R.; Chamberlin, Phillip C.; Klimchuk, James A.; Didkovsky, Leonid; Judge, Darrell; Mariska, John; Warren, Harry; Schrijver, Carolus J.; Webb, David F.; Bailey, Scott; Tobiska, W. Kent

    2011-01-01

    New solar extreme-ultraviolet (EUV) irradiance observations from the NASA Solar Dynamics Observatory (SDO) EUV Variability Experiment provide full coverage in the EUV range from 0.1 to 106 nm and continuously at a cadence of 10 s for spectra at 0.1 nm resolution and even faster, 0.25 s, for six EUV bands. These observations can be decomposed into four distinct characteristics during flares. First, the emissions that dominate during the flare's impulsive phase are the transition region emissions, such as the He II 30.4 nm. Second, the hot coronal emissions above 5 MK dominate during the gradual phase and are highly correlated with the GOES X-ray. A third flare characteristic in the EUV is coronal dimming, seen best in the cool corona, such as the Fe IX 17.1 nm. As the post-flare loops reconnect and cool, many of the EUV coronal emissions peak a few minutes after the GOES X-ray peak. One interesting variation of the post-eruptive loop reconnection is that warm coronal emissions (e.g., Fe XVI 33.5 nm) sometimes exhibit a second large peak separated from the primary flare event by many minutes to hours, with EUV emission originating not from the original flare site and its immediate vicinity, but rather from a volume of higher loops. We refer to this second peak as the EUV late phase. The characterization of many flares during the SDO mission is provided, including quantification of the spectral irradiance from the EUV late phase that cannot be inferred from GOES X-ray diagnostics.

  8. Flare evaluation for 32-nm half pitch using SFET

    Science.gov (United States)

    Aoyama, Hajime; Tanaka, Yuusuke; Kamo, Takashi; Iriki, Nobuyuki; Arisawa, Yukiyasu; Tanaka, Toshihiko

    2008-03-01

    Flare degrades critical-dimension (CD) control in EUVL, a promising technology for the 32-nm half-pitch node. To deal with flare, high-quality projection optics in the exposure tool and flare variation compensation (FVC) technology with proper mask resizing are needed. Selete has installed a small-field exposure tool (SFET) with the goal of assessing resist performance. Due to the high-quality optics, the SFET allowed us to determine the required flare specification to be 6.1% or 6.6%, as calculated from the residual part of the low- or middle-frequency region, respectively. The flare level was confirmed through experimental results and from calculations using the power spectral density (PSD) obtained from the mirror roughness by the disappearing-resist method. The lithographic performance was evaluated using 32-nm-halfpitch patterns in a new resist. The resist characteristics can be explained by modeling blur as a Gaussian function with a σ of 8.8 nm and using a very accurate CD variation (area or not, there was no difference in CD as a function of distance up to a distance of 20 µm. In addition, CD degradation was observed at distances not far (area. In a 60-nm neighborhood of the open area, an 8-nm variation in CD appeared up to the distance at which the CD leveled off. When the influences of resist blur and flare on patterns was taken into account in the calculation, it was found that aerial simulations based on a rigorous 3D model of a mask structure matched the experimental results. These results yield the appropriate mask resizing and the range in which flare has an influence, which is needed for FVC. This research was supported in part by NEDO.

  9. Flare parameters inferred from a 3D loop model database

    Science.gov (United States)

    Cuambe, Valente A.; Costa, J. E. R.; Simões, P. J. A.

    2018-04-01

    We developed a database of pre-calculated flare images and spectra exploring a set of parameters which describe the physical characteristics of coronal loops and accelerated electron distribution. Due to the large number of parameters involved in describing the geometry and the flaring atmosphere in the model used (Costa et al. 2013), we built a large database of models (˜250 000) to facilitate the flare analysis. The geometry and characteristics of non-thermal electrons are defined on a discrete grid with spatial resolution greater than 4 arcsec. The database was constructed based on general properties of known solar flares and convolved with instrumental resolution to replicate the observations from the Nobeyama radio polarimeter (NoRP) spectra and Nobeyama radio-heliograph (NoRH) brightness maps. Observed spectra and brightness distribution maps are easily compared with the modelled spectra and images in the database, indicating a possible range of solutions. The parameter search efficiency in this finite database is discussed. Eight out of ten parameters analysed for one thousand simulated flare searches were recovered with a relative error of less than 20 per cent on average. In addition, from the analysis of the observed correlation between NoRH flare sizes and intensities at 17 GHz, some statistical properties were derived. From these statistics the energy spectral index was found to be δ ˜ 3, with non-thermal electron densities showing a peak distribution ⪅107 cm-3, and Bphotosphere ⪆2000 G. Some bias for larger loops with heights as great as ˜2.6 × 109 cm, and looptop events were noted. An excellent match of the spectrum and the brightness distribution at 17 and 34 GHz of the 2002 May 31 flare, is presented as well.

  10. Improving Flare Irradiance Models with the Low Pass Filter Relation Between EUV Flare Emissions with Differing Formation Temperatures

    Science.gov (United States)

    Thiemann, Edward M. B.; Eparvier, Francis G.

    2016-10-01

    Solar flares are the result of magnetic reconnection in the solar corona which converts magnetic energy into kinetic energy resulting in the rapid heating of solar plasma. As this plasma cools, extreme ultraviolet (EUV) line emission intensities evolve as the plasma temperature passes through line formation temperatures, resulting in emission lines with cooler formation temperatures peaking after those with hotter formation temperatures. At the 2016 American Astronomical Society Solar Physics Division Meeting in Boulder (SPD2016), we showed that Fe XVIII solar flare light curves are highly correlated with Fe XXIII light curves that have been subjected to the single-pole Low Pass Filter Equation (LPFE) with a time constant equal to the time difference between the peak emissions. The single-pole (or equivalently, RC) LPFE appears frequently in analyses of systems which both store and dissipate heat, and the flare LPFE effect is believed to be related to the underlying cooling processes. Because the LPFE is constrained by a single parameter, this effect has implications for both operational EUV flare irradiance models and understanding thermal processes that occur in post-flare loops. At the time of SPD2016, it was ambiguous as to whether the LPFE effect relates hot thermal bremsstrahlung soft x-ray (SXR) or EUV line emissions with cooler EUV line emissions since Fe XXIII flare light curves are highly correlated with SXR flare light curves. In this study, we present new results characterizing the LPFE relation between multiple emission lines with differing formation temperatures ranging from 107.2 to 105.7 K observed by SDO/EVE and SXR thermal bremsstrahlung emissions observed by GOES/XRS. We show that the LPFE equation relates Fe XVIII with cooler EUV line emissions, providing unambiguous evidence that the LPFE effect exists between EUV line emissions rather than thermal bremsstrahlung and line emissions exclusively. The exact nature of this effect remains an open

  11. Statistical Properties of Ribbon Evolution and Reconnection Electric Fields in Eruptive and Confined Flares

    Science.gov (United States)

    Hinterreiter, J.; Veronig, A. M.; Thalmann, J. K.; Tschernitz, J.; Pötzi, W.

    2018-03-01

    A statistical study of the chromospheric ribbon evolution in Hα two-ribbon flares was performed. The data set consists of 50 confined (62%) and eruptive (38%) flares that occurred from June 2000 to June 2015. The flares were selected homogeneously over the Hα and Geostationary Operational Environmental Satellite (GOES) classes, with an emphasis on including powerful confined flares and weak eruptive flares. Hα filtergrams from the Kanzelhöhe Observatory in combination with Michelson Doppler Imager (MDI) and Helioseismic and Magnetic Imager (HMI) magnetograms were used to derive the ribbon separation, the ribbon-separation velocity, the magnetic-field strength, and the reconnection electric field. We find that eruptive flares reveal statistically larger ribbon separation and higher ribbon-separation velocities than confined flares. In addition, the ribbon separation of eruptive flares correlates with the GOES SXR flux, whereas no clear dependence was found for confined flares. The maximum ribbon-separation velocity is not correlated with the GOES flux, but eruptive flares reveal on average a higher ribbon-separation velocity (by ≈ 10 km s-1). The local reconnection electric field of confined (cc=0.50 ±0.02) and eruptive (cc=0.77 ±0.03) flares correlates with the GOES flux, indicating that more powerful flares involve stronger reconnection electric fields. In addition, eruptive flares with higher electric-field strengths tend to be accompanied by faster coronal mass ejections.

  12. Inferring Flare Loop Parameters with Measurements of Standing Sausage Modes

    Science.gov (United States)

    Guo, Ming-Zhe; Chen, Shao-Xia; Li, Bo; Xia, Li-Dong; Yu, Hui

    2016-03-01

    Standing fast sausage modes in flare loops were suggested to account for a considerable number of quasi-periodic pulsations (QPPs) in the light curves of solar flares. This study continues our investigation into the possibility of inverting the measured periods P and damping times τ of sausage modes to deduce the transverse Alfvén time R/v_{Ai}, density contrast ρi/ρe, and the steepness of the density distribution transverse to flare loops. A generic dispersion relation governing linear sausage modes is derived for pressureless cylinders where density inhomogeneity of arbitrary form takes place within the cylinder. We show that in general the inversion problem is under-determined for QPP events where only a single sausage mode exists, whether the measurements are spatially resolved or unresolved. While R/v_{Ai} can be inferred to some extent, the range of possible steepness parameters may be too broad to be useful. However, for spatially resolved measurements where an additional mode is present, it is possible to deduce self-consistently ρi/ρe, the profile steepness, and the internal Alfvén speed v_{Ai}. We show that at least for a recent QPP event that involves a fundamental kink mode in addition to a sausage one, flare loop parameters are well constrained even if the specific form of the transverse density distribution remains unknown. We conclude that spatially resolved, multi-mode QPP measurements need to be pursued to infer flare loop parameters.

  13. Impulsive Heating of Solar Flare Ribbons Above 10 MK

    Science.gov (United States)

    Simões, P. J. A.; Graham, D. R.; Fletcher, L.

    2015-12-01

    The chromospheric response to the input of flare energy is marked by extended extreme ultraviolet (EUV) ribbons and hard X-ray (HXR) footpoints. These are usually explained as the result of heating and bremsstrahlung emission from accelerated electrons colliding in the dense chromospheric plasma. We present evidence of impulsive heating of flare ribbons above 10 MK in a two-ribbon flare. We analyse the impulsive phase of SOL2013-11-09T06:38, a C2.6 class event using data from Atmospheric Imaging Assembly (AIA) on board of the Solar Dynamics Observatory (SDO) and the Reuven Ramaty High Energy Solar Spectroscopic Imager (RHESSI) to derive the temperature, emission measure and differential emission measure of the flaring regions and investigate the evolution of the plasma in the flaring ribbons. The ribbons were visible at all SDO/AIA EUV/UV wavelengths, in particular, at 94 and 131 Å filters, sensitive to temperatures of 8 MK and 12 MK. The time evolution of the emission measure of the plasma above 10 MK at the ribbons has a peak near the HXR peak time. The presence of hot plasma in the lower atmosphere is further confirmed by a RHESSI imaging spectroscopy analysis, which shows resolved sources at 11 - 13 MK that are associated with at least one ribbon. We found that collisional beam-heating can only marginally explain the power necessary to heat the 10 MK plasma at the ribbons.

  14. Interactive Multi-Instrument Database of Solar Flares

    Science.gov (United States)

    Ranjan, Shubha S.; Spaulding, Ryan; Deardorff, Donald G.

    2018-01-01

    The fundamental motivation of the project is that the scientific output of solar research can be greatly enhanced by better exploitation of the existing solar/heliosphere space-data products jointly with ground-based observations. Our primary focus is on developing a specific innovative methodology based on recent advances in "big data" intelligent databases applied to the growing amount of high-spatial and multi-wavelength resolution, high-cadence data from NASA's missions and supporting ground-based observatories. Our flare database is not simply a manually searchable time-based catalog of events or list of web links pointing to data. It is a preprocessed metadata repository enabling fast search and automatic identification of all recorded flares sharing a specifiable set of characteristics, features, and parameters. The result is a new and unique database of solar flares and data search and classification tools for the Heliophysics community, enabling multi-instrument/multi-wavelength investigations of flare physics and supporting further development of flare-prediction methodologies.

  15. ELECTRON ACCELERATION IN CONTRACTING MAGNETIC ISLANDS DURING SOLAR FLARES

    Energy Technology Data Exchange (ETDEWEB)

    Borovikov, D.; Tenishev, V.; Gombosi, T. I. [University of Michigan, Department of Climate and Space Sciences and Engineering, 2455 Hayward Street, Ann Arbor, MI 48104-2143 (United States); Guidoni, S. E. [The Catholic University of America, 620 Michigan Avenue Northeast, Washington, DC 20064 (United States); DeVore, C. R.; Karpen, J. T.; Antiochos, S. K. [Heliophysics Science Division, NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States)

    2017-01-20

    Electron acceleration in solar flares is well known to be efficient at generating energetic particles that produce the observed bremsstrahlung X-ray spectra. One mechanism proposed to explain the observations is electron acceleration within contracting magnetic islands formed by magnetic reconnection in the flare current sheet. In a previous study, a numerical magnetohydrodynamic simulation of an eruptive solar flare was analyzed to estimate the associated electron acceleration due to island contraction. That analysis used a simple analytical model for the island structure and assumed conservation of the adiabatic invariants of particle motion. In this paper, we perform the first-ever rigorous integration of the guiding-center orbits of electrons in a modeled flare. An initially isotropic distribution of particles is seeded in a contracting island from the simulated eruption, and the subsequent evolution of these particles is followed using guiding-center theory. We find that the distribution function becomes increasingly anisotropic over time as the electrons’ energy increases by up to a factor of five, in general agreement with the previous study. In addition, we show that the energized particles are concentrated on the Sunward side of the island, adjacent to the reconnection X-point in the flare current sheet. Furthermore, our analysis demonstrates that the electron energy gain is dominated by betatron acceleration in the compressed, strengthened magnetic field of the contracting island. Fermi acceleration by the shortened field lines of the island also contributes to the energy gain, but it is less effective than the betatron process.

  16. Anti-neutrino imprint in solar neutrino flare

    Science.gov (United States)

    Fargion, D.

    2006-10-01

    A future neutrino detector at megaton mass might enlarge the neutrino telescope thresholds revealing cosmic supernova background and largest solar flares (SFs) neutrinos. Indeed the solar energetic (Ep>100 MeV) flare particles (protons, α), while scattering among themselves on solar corona atmosphere must produce prompt charged pions, whose chain decays are source of a solar (electron muon) neutrino 'flare' (at tens or hundreds MeV energy). These brief (minutes) neutrino 'bursts' at largest flare peak may overcome by three to five orders of magnitude the steady atmospheric neutrino noise on the Earth, possibly leading to their detection above detection thresholds (in a full mixed three flavour state). Moreover the birth of anti-neutrinos at a few tens of MeV very clearly flares above a null thermal 'hep' anti-neutrino solar background and also above a tiny supernova relic and atmospheric noise. The largest prompt solar anti-neutrino 'burst' may be well detected in future Super Kamikande (gadolinium implemented) anti-neutrino \\bar\

  17. Modelling Quasi-Periodic Pulsations in Solar and Stellar Flares

    Science.gov (United States)

    McLaughlin, J. A.; Nakariakov, V. M.; Dominique, M.; Jelínek, P.; Takasao, S.

    2018-02-01

    Solar flare emission is detected in all EM bands and variations in flux density of solar energetic particles. Often the EM radiation generated in solar and stellar flares shows a pronounced oscillatory pattern, with characteristic periods ranging from a fraction of a second to several minutes. These oscillations are referred to as quasi-periodic pulsations (QPPs), to emphasise that they often contain apparent amplitude and period modulation. We review the current understanding of quasi-periodic pulsations in solar and stellar flares. In particular, we focus on the possible physical mechanisms, with an emphasis on the underlying physics that generates the resultant range of periodicities. These physical mechanisms include MHD oscillations, self-oscillatory mechanisms, oscillatory reconnection/reconnection reversal, wave-driven reconnection, two loop coalescence, MHD flow over-stability, the equivalent LCR-contour mechanism, and thermal-dynamical cycles. We also provide a histogram of all QPP events published in the literature at this time. The occurrence of QPPs puts additional constraints on the interpretation and understanding of the fundamental processes operating in flares, e.g. magnetic energy liberation and particle acceleration. Therefore, a full understanding of QPPs is essential in order to work towards an integrated model of solar and stellar flares.

  18. Can Sgr A* flares reveal the molecular gas density PDF?

    Science.gov (United States)

    Churazov, E.; Khabibullin, I.; Sunyaev, R.; Ponti, G.

    2017-11-01

    Illumination of dense gas in the Central Molecular Zone by powerful X-ray flares from Sgr A* leads to prominent structures in the reflected emission that can be observed long after the end of the flare. By studying this emission, we learn about past activity of the supermassive black hole in our Galactic Center and, at the same time, we obtain unique information on the structure of molecular clouds that is essentially impossible to get by other means. Here we discuss how X-ray data can improve our knowledge of both sides of the problem. Existing data already provide (I) an estimate of the flare age, (II) a model-independent lower limit on the luminosity of Sgr A* during the flare and (III) an estimate of the total emitted energy during Sgr A* flare. On the molecular clouds side, the data clearly show a voids-and-walls structure of the clouds and can provide an almost unbiased probe of the mass/density distribution of the molecular gas with the hydrogen column densities lower than few 1023 cm-2. For instance, the probability distribution function of the gas density PDF(ρ) can be measured this way. Future high energy resolution X-ray missions will provide the information on the gas velocities, allowing, for example, a reconstruction of the velocity field structure functions and cross-matching the X-ray and molecular data based on positions and velocities.

  19. The Efficacy and Safety of Treatments for Acute Gout: Results from a Series of Systematic Literature Reviews Including Cochrane Reviews on Intraarticular Glucocorticoids, Colchicine, Nonsteroidal Antiinflammatory Drugs, and Interleukin-1 Inhibitors

    NARCIS (Netherlands)

    Wechalekar, Mihir D.; Vinik, Ophir; Moi, John H. Y.; Sivera, Francisca; van Echteld, Irene A. A. M.; van Durme, Caroline; Falzon, Louise; Bombardier, Claire; Carmona, Loreto; Aletaha, Daniel; Landewé, Robert B.; van der Heijde, Désirée M. F. M.; Buchbinder, Rachelle

    2014-01-01

    Objective. To determine the efficacy and safety of glucocorticoids (GC), colchicine, nonsteroidal antiinflammatory drugs (NSAID), interleukin-1 (IL-1) inhibitors, and paracetamol to treat acute gout. Methods. We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials to

  20. Transmembrane TNF-α is sufficient for articular inflammation and hypernociception in a mouse model of gout.

    Science.gov (United States)

    Amaral, Flávio A; Bastos, Leandro F S; Oliveira, Thiago H C; Dias, Ana C F; Oliveira, Vívian L S; Tavares, Lívia D; Costa, Vivian V; Galvão, Izabela; Soriani, Frederico M; Szymkowski, David E; Ryffel, Bernhard; Souza, Danielle G; Teixeira, Mauro M

    2016-01-01

    Gout manifests as recurrent episodes of acute joint inflammation and pain due to the deposition of monosodium urate (MSU) crystals within the affected tissue in a process dependent on NLRP3 inflammasome activation. The synthesis, activation, and release of IL-1β are crucial for MSU-induced inflammation. The current study evaluated the mechanism by which TNF-α contributed to MSU-induced inflammation. Male C57BL/6J or transgenic mice were used in this study and inflammation was induced by the injection of MSU crystals into the joint. TNF-α was markedly increased in the joint after the injection of MSU. There was inhibition in the infiltration of neutrophils, production of CXCL1 and IL-1β, and decreased hypernociception in mice deficient for TNF-α or its receptors. Pharmacological blockade of TNF-α with Etanercept or pentoxyfylline produced similar results. Mechanistically, TNF-α blockade resulted in lower amounts of IL-1β protein and pro-IL-1β mRNA transcripts in joints. Gene-modified mice that express only transmembrane TNF-α had an inflammatory response similar to that of WT mice and blockade of soluble TNF-α (XPro™1595) did not decrease MSU-induced inflammation. In conclusion, TNF-α drives expression of pro-IL-1β mRNA and IL-1β protein in experimental gout and that its transmembrane form is sufficient to trigger MSU-induced inflammation in mice. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Artrite da gota tofácea crônica mimetizando artrite reumatoide Chronic tophaceous gout mimicking rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Juliana F. Sarmento

    2009-12-01

    Full Text Available A gota é um distúrbio no metabolismo das purinas, usualmente associado à ocorrência de crises recorrentes de artrite nas articulações dos membros inferiores em homens entre 40-50 anos, e com o desenvolvimento de tofos subcutâneos nos pacientes com doença de longa evolução. Casos de pacientes com artrite gotosa crônica que mimetizam quadros de artrite reumatoide e vice-versa são raros. Descrevemos o caso de um paciente de 56 anos, com quadro de artrite poliarticular, simétrica e deformante, comprometendo principalmente as articulações de mãos e punhos, com nódulos subcutâneos difusos pelo corpo, alterações radiográficas atípicas e urolitíase, que, após avaliação clínica e dos exames complementares, recebeu diagnóstico de gota tofácea crônica mutilante mimetizando artrite reumatoide.Gout is a disorder of purine metabolism, usually associated with recurrent bouts of arthritis in the joints of the lower limbs, affecting men 40 to 50 years of age, which leads to the development of subcutaneous tophi in patients with long-lasting disease. Cases of patients with chronic gouty arthritis mimicking rheumatoid arthritis, and vice-versa, are rare. This report describes the case of a 56-year old male with symmetric, deforming, and polyarticular arthritis affecting, specially, the joints of the hands and wrists, with diffuse subcutaneous nodules throughout his body, atypical radiographic findings, and urolithiasis. Following clinical evaluation and additional tests, this patient received a diagnosis of chronic tophaceous gout mimicking mutilating rheumatoid arthritis.

  2. Well-observed dynamics of flaring and peripheral coronal magnetic loops during an M-class limb flare

    International Nuclear Information System (INIS)

    Shen, Jinhua; Zhou, Tuanhui; Ji, Haisheng; Feng, Li; Wiegelmann, Thomas; Inhester, Bernd

    2014-01-01

    In this paper, we present a variety of well-observed dynamic behaviors for the flaring and peripheral magnetic loops of the M6.6 class extreme limb flare that occurred on 2011 February 24 (SOL2011-02-24T07:20) from EUV observations by the Atmospheric Imaging Assembly on the Solar Dynamics Observatory and X-ray observations by RHESSI. The flaring loop motion confirms the earlier contraction-expansion picture. We find that the U-shaped trajectory delineated by the X-ray corona source of the flare roughly follows the direction of a filament eruption associated with the flare. Different temperature structures of the coronal source during the contraction and expansion phases strongly suggest different kinds of magnetic reconnection processes. For some peripheral loops, we discover that their dynamics are closely correlated with the filament eruption. During the slow rising to abrupt, fast rising of the filament, overlying peripheral magnetic loops display different responses. Two magnetic loops on the elbow of the active region had a slow descending motion followed by an abrupt successive fast contraction, while magnetic loops on the top of the filament were pushed outward, slowly being inflated for a while and then erupting as a moving front. We show that the filament activation and eruption play a dominant role in determining the dynamics of the overlying peripheral coronal magnetic loops.

  3. The Jets of Microquasars during Giant Flares and Quiet State

    Directory of Open Access Journals (Sweden)

    Sergei Trushkin

    2017-11-01

    Full Text Available We report on the radio properties of jets of the following microquasars, as determined from daily multi-frequency monitoring observations with the RATAN-600 radio telescope during 2010–2017: V404 Cyg, SS433, Cyg X-1, GRS1915+105 and LSI+61 ∘ 303. We have detected many giant flares from SS433, a powerful flare from V404 Cyg in June 2015, an active state of Cyg X-1 in 2017 and fifty periodic flares from LSI+61 ∘ 303. We describe the properties of massive ejections based on multi-band (radio, X-ray and γ -ray studies. The general properties of the light curves are closely connected with the processes of jet formation in microquasars.

  4. Systemic lupus erythematosus flare triggered by a spider bite.

    Science.gov (United States)

    Martín Nares, Eduardo; López Iñiguez, Alvaro; Ontiveros Mercado, Heriberto

    2016-01-01

    Systemic lupus erythematosus is a chronic autoimmune disease with a relapsing and remitting course characterized by disease flares. Flares are a major cause of hospitalization, morbidity and mortality in patients with systemic lupus erythematosus. Some triggers for these exacerbations have been identified, including infections, vaccines, pregnancy, environmental factors such as weather, stress and drugs. We report a patient who presented with a lupus flare with predominantly mucocutaneous, serosal and cardiac involvement after being bitten by a spider and we present the possible mechanisms by which the venom elicited such a reaction. To the best of our knowledge, this is the first such case reported in the literature. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  5. Soliton and strong Langmuir turbulence in solar flare processes

    Science.gov (United States)

    Song, M. T.; Wu, S. T.; Dryer, M.

    1989-01-01

    The occurrence of modulational instability in the current sheet of a solar flare is investigated. Special attention is given to the plasma microinstability in this sheet and its relation to the flare process. It is found that solitons or strong Langmuir turbulence are likely to occur in the diffusion region under solar flare conditions in which the electric resistivity could be enhanced by several orders of magnitude in the region, resulting in significant heating and stochastic acceleration of particles. A numerical example is used to demonstrate the transition of the magnetic field velocity and plasma density from the outer MHD region into the diffusive region and then back out again with the completion of the energy conversion process. This is all made possible by an increase in resistivity of four to five orders of magnitude over the classical value.

  6. HIGH-ENERGY NEUTRINOS FROM RECENT BLAZAR FLARES

    Energy Technology Data Exchange (ETDEWEB)

    Halzen, Francis; Kheirandish, Ali [Wisconsin IceCube Particle Astrophysics Center and Department of Physics, University of Wisconsin, Madison, WI 53706 (United States)

    2016-11-01

    The energy density of cosmic neutrinos measured by IceCube matches the one observed by Fermi in extragalactic photons that predominantly originate in blazars. This has inspired attempts to match Fermi sources with IceCube neutrinos. A spatial association combined with a coincidence in time with a flaring source may represent a smoking gun for the origin of the IceCube flux. In 2015 June, the Fermi Large Area Telescope observed an intense flare from blazar 3C 279 that exceeded the steady flux of the source by a factor of 40 for the duration of a day. We show that IceCube is likely to observe neutrinos, if indeed hadronic in origin, in data that are still blinded at this time. We also discuss other opportunities for coincident observations that include a recent flare from blazar 1ES 1959+650 that previously produced an intriguing coincidence with AMANDA observations.

  7. High-energy particles associated with solar flares

    International Nuclear Information System (INIS)

    Sakurai, K.; Klimas, A.J.

    1974-05-01

    High energy particles, the so-called solar cosmic rays, are often generated in association with solar flares, and then emitted into interplanetary space. These particles, consisting of electrons, protons, and other heavier nuclei, including the iron-group, are accelerated in the vicinity of the flare. By studying the temporal and spatial variation of these particles near the earth's orbit, their storage and release mechanisms in the solar corona and their propagation mechanism can be understood. The details of the nuclear composition and the rigidity spectrum for each nuclear component of the solar cosmic rays are important for investigating the acceleration mechanism in solar flares. The timing and efficiency of the acceleration process can also be investigated by using this information. These problems are described in some detail by using observational results on solar cosmic rays and associated phenomena. (U.S.)

  8. Are All Flare Ribbons Simply Connected to the Corona?

    Energy Technology Data Exchange (ETDEWEB)

    Judge, Philip G. [High Altitude Observatory, National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO 80307-3000 (United States); Paraschiv, Alin; Lacatus, Daniela; Donea, Alina [Monash Center for Astrophysics, School of Mathematical Science, Monash University, Victoria 3800 (Australia); Lindsey, Charlie, E-mail: judge@ucar.edu, E-mail: alina.donea@monash.edu, E-mail: alin.paraschiv@monash.edu, E-mail: daniela.lacatus@monash.edu, E-mail: indsey@cora.nwra.com [Northwest Research Associates, 3380 Mitchell Lane, Boulder, CO 80301 (United States)

    2017-04-01

    We consider the observational basis for the belief that flare ribbons in the chromosphere result from energy transport from the overlying corona. We study ribbons of small flares using magnetic and intensity data from the Hinode , Solar Dynamics Observatory , and IRIS missions. While most ribbons appear connected to the corona and overlie regions of significant vertical magnetic field, we examine one ribbon with no clear evidence for such connections. Evolving horizontal magnetic fields seen with Hinode suggest that reconnection with preexisting fields below the corona can explain the data. The identification of just one, albeit small, ribbon, with no apparent connection to the corona, leads us to conclude that at least two mechanisms are responsible for the heating that leads to flare ribbon emission.

  9. Photographic colorimetry of stellar flares in the Pleiades and Orion. II

    International Nuclear Information System (INIS)

    Mirzoian, L.V.; Chavushian, O.S.; Melikian, N.D.; Natsvlishvili, R.Sh.; Ambarian, V.V.; Brutian, G.A.

    1984-01-01

    Synchronous three-telescope UBV photographic colorimetry of Pleiades and Orion stellar flares obtained at Biurakan Astrophysical Observatory and Abastumani Astrophysical Observatory during 86 observing hours in 1980 and 1981 is presented. The data are compiled in tables and discussed in terms of color differences appearing at different stages of a flare. A total of 32 flares are observed (25 in the Pleiades and 7 in Orion), and four new flare stars are identified in each region. 12 references

  10. Money Talks: Why Nigeria’s Petroleum Industry Bill will Fail to End Gas Flaring

    Science.gov (United States)

    2012-11-02

    Industry Bill ( PIB ) that if enacted would ban gas flaring. However, as currently written the PIB will not end flaring for the same reasons that...previous legislation failed. Loopholes in the PIB combined with corruption, lack of effective enforcement mechanisms and lack of incentives to develop...Bill ( PIB ) that if enacted would ban gas flaring. However, as currently written, the PIB will not end flaring for the same reasons that previous

  11. Max 1991: Flare Research at the Next Solar Maximum. Workshop 1: Scientific Objectives

    Science.gov (United States)

    Canfield, Richard C.; Dennis, Brian R.

    1988-01-01

    The purpose of the Max 1991 program is to gather coordinated sets of solar flare and active region data and to perform interpretive and theoretical research aimed at understanding flare energy storage and release, particle acceleration, flare energy transport, and the propagation of flare effects to Earth. The workshop was divided into four areas of concern: energy storage, energy release, particle acceleration, and energy transport.

  12. HOOKED FLARE RIBBONS AND FLUX-ROPE-RELATED QSL FOOTPRINTS

    International Nuclear Information System (INIS)

    Zhao, Jie; Li, Hui; Gilchrist, Stuart A.; Aulanier, Guillaume; Schmieder, Brigitte; Pariat, Etienne

    2016-01-01

    We studied the magnetic topology of active region 12158 on 2014 September 10 and compared it with the observations before and early in the flare that begins at 17:21 UT (SOL2014-09-10T17:45:00). Our results show that the sigmoidal structure and flare ribbons of this active region observed by the Solar Dynamics Observatory /Atmospheric Imaging Assembly can be well reproduced from a Grad–Rubin nonlinear force-free field extrapolation method. Various inverse-S- and inverse-J-shaped magnetic field lines, which surround a coronal flux rope, coincide with the sigmoid as observed in different extreme-ultraviolet wavelengths, including its multithreaded curved ends. Also, the observed distribution of surface currents in the magnetic polarity where it was not prescribed is well reproduced. This validates our numerical implementation and setup of the Grad–Rubin method. The modeled double inverse-J-shaped quasi-separatrix layer (QSL) footprints match the observed flare ribbons during the rising phase of the flare, including their hooked parts. The spiral-like shape of the latter may be related to a complex pre-eruptive flux rope with more than one turn of twist, as obtained in the model. These ribbon-associated flux-rope QSL footprints are consistent with the new standard flare model in 3D, with the presence of a hyperbolic flux tube located below an inverse-teardrop-shaped coronal QSL. This is a new step forward forecasting the locations of reconnection and ribbons in solar flares and the geometrical properties of eruptive flux ropes.

  13. Flare Activity of Wide Binary Stars with Kepler

    Science.gov (United States)

    Clarke, Riley W.; Davenport, James R. A.; Covey, Kevin R.; Baranec, Christoph

    2018-01-01

    We present an analysis of flare activity in wide binary stars using a combination of value-added data sets from the NASA Kepler mission. The target list contains a set of previously discovered wide binary star systems identified by proper motions in the Kepler field. We cross-matched these systems with estimates of flare activity for ∼200,000 stars in the Kepler field, allowing us to compare relative flare luminosity between stars in coeval binaries. From a sample of 184 previously known wide binaries in the Kepler field, we find 58 with detectable flare activity in at least 1 component, 33 of which are similar in mass (q > 0.8). Of these 33 equal-mass binaries, the majority display similar (±1 dex) flare luminosity between both stars, as expected for stars of equal mass and age. However, we find two equal-mass pairs where the secondary (lower mass) star is more active than its counterpart, and two equal-mass pairs where the primary star is more active. The stellar rotation periods are also anomalously fast for stars with elevated flare activity. Pairs with discrepant rotation and activity qualitatively seem to have lower mass ratios. These outliers may be due to tidal spin-up, indicating these wide binaries could be hierarchical triple systems. We additionally present high-resolution adaptive optics images for two wide binary systems to test this hypothesis. The demographics of stellar rotation and magnetic activity between stars in wide binaries may be useful indicators for discerning the formation scenarios of these systems.

  14. Thermodynamics of supra-arcade downflows in solar flares

    Science.gov (United States)

    Chen, Xin; Liu, Rui; Deng, Na; Wang, Haimin

    2017-10-01

    Context. Supra-arcade downflows (SADs) have been frequently observed during the gradual phase of solar flares near the limb. In coronal emission lines sensitive to flaring plasmas, they appear as tadpole-like dark voids against the diffuse fan-shaped "haze" above, flowing toward the well-defined flare arcade. Aims: We aim to investigate the evolution of SADs' thermal properties, and to shed light on the formation mechanism and physical processes of SADs. Methods: We carefully studied several selected SADs from two flare events and calculated their differential emission measures (DEMs) as well as DEM-weighted temperatures using data obtained by the Atmospheric Imaging Assembly (AIA) onboard the Solar Dynamic Observatory. Results: Our analysis shows that SADs are associated with a substantial decrease in DEM above 4 MK, which is 1-3 orders of magnitude smaller than the surrounding haze as well as the region before or after the passage of SADs, but comparable to the quiet corona. There is no evidence for the presence of the SAD-associated hot plasma (>20 MK) in the AIA data, and this decrease in DEM does not cause any significant change in the DEM distribution as well as the DEM-weighted temperature, which supports this idea that SADs are density depletion. This depression in DEM rapidly recovers in the wake of the SADs studied, generally within a few minutes, suggesting that they are discrete features. In addition, we found that SADs in one event are spatio-temporally associated with the successive formation of post-flare loops along the flare arcade. Movies associated to Figs. A.1 and A.2 are available at http://www.aanda.org

  15. Homologous Circular-ribbon Flares Driven by Twisted Flux Emergence

    Science.gov (United States)

    Xu, Z.; Yang, K.; Guo, Y.; Zhao, J.; Zhao, Z. J.; Kashapova, L.

    2017-12-01

    In this paper, we report two homologous circular-ribbon flares associated with two filament eruptions. They were well observed by the New Vacuum Solar Telescope and the Solar Dynamics Observatory on 2014 March 5. Prior to the flare, two small-scale filaments enclosed by a circular pre-flare brightening lie along the circular polarity inversion line around the parasitic polarity, which has shown a continuous rotation since its first appearance. Two filaments eventually erupt in sequence associated with two homologous circular-ribbon flares and display an apparent writhing signature. Supplemented by the nonlinear force-free field extrapolation and the magnetic field squashing factor investigation, the following are revealed. (1) This event involves the emergence of magnetic flux ropes into a pre-existing polarity area, which yields the formation of a 3D null-point topology in the corona. (2) Continuous input of the free energy in the form of a flux rope from beneath the photosphere may drive a breakout-type reconnection occurring high in the corona, supported by the pre-flare brightening. (3) This initiation reconnection could release the constraint on the flux rope and trigger the MHD instability to first make filament F1 lose equilibrium. The subsequent more violent magnetic reconnection with the overlying flux is driven during the filament rising. In return, the eruption of filament F2 is further facilitated by the reduction of the magnetic tension force above. These two processes form a positive feedback to each other to cause the energetic mass eruption and flare.

  16. Realistic radiative MHD simulation of a solar flare

    Science.gov (United States)

    Rempel, Matthias D.; Cheung, Mark; Chintzoglou, Georgios; Chen, Feng; Testa, Paola; Martinez-Sykora, Juan; Sainz Dalda, Alberto; DeRosa, Marc L.; Viktorovna Malanushenko, Anna; Hansteen, Viggo H.; De Pontieu, Bart; Carlsson, Mats; Gudiksen, Boris; McIntosh, Scott W.

    2017-08-01

    We present a recently developed version of the MURaM radiative MHD code that includes coronal physics in terms of optically thin radiative loss and field aligned heat conduction. The code employs the "Boris correction" (semi-relativistic MHD with a reduced speed of light) and a hyperbolic treatment of heat conduction, which allow for efficient simulations of the photosphere/corona system by avoiding the severe time-step constraints arising from Alfven wave propagation and heat conduction. We demonstrate that this approach can be used even in dynamic phases such as a flare. We consider a setup in which a flare is triggered by flux emergence into a pre-existing bipolar active region. After the coronal energy release, efficient transport of energy along field lines leads to the formation of flare ribbons within seconds. In the flare ribbons we find downflows for temperatures lower than ~5 MK and upflows at higher temperatures. The resulting soft X-ray emission shows a fast rise and slow decay, reaching a peak corresponding to a mid C-class flare. The post reconnection energy release in the corona leads to average particle energies reaching 50 keV (500 MK under the assumption of a thermal plasma). We show that hard X-ray emission from the corona computed under the assumption of thermal bremsstrahlung can produce a power-law spectrum due to the multi-thermal nature of the plasma. The electron energy flux into the flare ribbons (classic heat conduction with free streaming limit) is highly inhomogeneous and reaches peak values of about 3x1011 erg/cm2/s in a small fraction of the ribbons, indicating regions that could potentially produce hard X-ray footpoint sources. We demonstrate that these findings are robust by comparing simulations computed with different values of the saturation heat flux as well as the "reduced speed of light".

  17. UBV-photometry of flare stars in pleiades

    International Nuclear Information System (INIS)

    Chavushyan, O.S.; Garibdzhanyan, A.T.

    1975-01-01

    The results are presented of UBV-photometry of 283 flare stars at the minimum of brightness in the Pleiad region. A new method has been developed and used of taking into account the background in photographic UBV-photometry with an iris microphotometer. The data obtained indicate that the flare Pleiad stars are located on both sides of the main sequence in the light-luminosity (V,B-V) diagram, while in the (U-B,B-V) diagram they are largely located above the main sequence

  18. Acceleration of runaway electrons and Joule heating in solar flares

    Science.gov (United States)

    Holman, G. D.

    1985-01-01

    The electric field acceleration of electrons out of a thermal plasma and the simultaneous Joule heating of the plasma are studied. Acceleration and heating timescales are derived and compared, and upper limits are obtained on the acceleration volume and the rate at which electrons can be accelerated. These upper limits, determined by the maximum magnetic field strength observed in flaring regions, place stringent restrictions upon the acceleration process. The role of the plasma resistivity in these processes is examined, and possible sources of anomalous resistivity are summarized. The implications of these results for the microwave and hard X-ray emission from solar flares are examined.

  19. H2O maser flare in Orion A

    International Nuclear Information System (INIS)

    Matveenko, L.I.; Moran, J.M.; Genzel, R.

    1982-01-01

    The flare of H 2 O maser emission in Orion A was observed with the Crimea--Effelsberg and Haystack--Green Bank interferometers in November 1979. Its position is α = 5/sup h/32/sup m/46/sup s/.6 +- 0/sup s/.06, delta = -5 0 24'.28''.7 +- 1'' (1950.0); its radial velocity, 8 km/sec. The asymmetric line profile has a 28-kHz halfwidth. The flare source comprises a 0''.0005 core (T/sub b/ = 5 x 10 16 0 K) embedded in a 0''.005 halo (T/sub b/ = 3 x 10 14 0 K)

  20. Flare Prediction Using Photospheric and Coronal Image Data

    Science.gov (United States)

    Jonas, Eric; Bobra, Monica; Shankar, Vaishaal; Todd Hoeksema, J.; Recht, Benjamin

    2018-03-01

    The precise physical process that triggers solar flares is not currently understood. Here we attempt to capture the signature of this mechanism in solar-image data of various wavelengths and use these signatures to predict flaring activity. We do this by developing an algorithm that i) automatically generates features in 5.5 TB of image data taken by the Solar Dynamics Observatory of the solar photosphere, chromosphere, transition region, and corona during the time period between May 2010 and May 2014, ii) combines these features with other features based on flaring history and a physical understanding of putative flaring processes, and iii) classifies these features to predict whether a solar active region will flare within a time period of T hours, where T = 2 and 24. Such an approach may be useful since, at the present time, there are no physical models of flares available for real-time prediction. We find that when optimizing for the True Skill Score (TSS), photospheric vector-magnetic-field data combined with flaring history yields the best performance, and when optimizing for the area under the precision-recall curve, all of the data are helpful. Our model performance yields a TSS of 0.84 ±0.03 and 0.81 ±0.03 in the T = 2- and 24-hour cases, respectively, and a value of 0.13 ±0.07 and 0.43 ±0.08 for the area under the precision-recall curve in the T=2- and 24-hour cases, respectively. These relatively high scores are competitive with previous attempts at solar prediction, but our different methodology and extreme care in task design and experimental setup provide an independent confirmation of these results. Given the similar values of algorithm performance across various types of models reported in the literature, we conclude that we can expect a certain baseline predictive capacity using these data. We believe that this is the first attempt to predict solar flares using photospheric vector-magnetic field data as well as multiple wavelengths of image

  1. The excitation of the iron Kα feature in solar flares

    International Nuclear Information System (INIS)

    Emslie, A.G.; Phillips, K.J.H.; Dennis, B.R.

    1985-09-01

    The paper concerns two solar flare events observed with the Hard X-ray Burst Spectrometer and the Kα channel of the X-ray Polychromator Bent Crystal Sepctrometer on the solar Maximum Mission Satellite. The observed magnitude of the Kα enhancement above the fluorescent background at the time of the large X-ray bursts is compared with the predicted Kα flux. The results support a thick-target non-thermal interpretation of impulsive hard X-ray emission in solar flares. (U.K.)

  2. Beam heating in solar flares - Electrons or protons?

    International Nuclear Information System (INIS)

    Brown, J.C.; Karlicky, M.; Mackinnon, A.L.; Van Den Oord, G.H.J.

    1990-01-01

    The current status of electron and proton beam models as candidates for the impulsive phase heating of solar flares is discussed in relation to observational constants and theoretical difficulties. It is concluded that, while the electron beam model for flare heating still faces theoretical and observational problems, the problems faced by low and high energy proton beam models are no less serious, and there are facets of proton models which have not yet been studied. At the present, the electron beam model remains the most viable and best developed of heating model candidates. 58 refs

  3. M DWARF FLARES FROM TIME-RESOLVED SLOAN DIGITAL SKY SURVEY SPECTRA

    International Nuclear Information System (INIS)

    Hilton, Eric J.; Hawley, Suzanne L.; Kowalski, Adam F.; West, Andrew A.

    2010-01-01

    We have identified 63 flares on M dwarfs from the individual component spectra in the Sloan Digital Sky Survey (SDSS) using a novel measurement of emission-line strength called the Flare Line Index. Each of the ∼38,000 M dwarfs in the SDSS low-mass star spectroscopic sample of West et al. was observed several times (usually 3-5) in exposures that were typically 9-25 minutes in duration. Our criteria allowed us to identify flares that exhibit very strong Hα and Hβ emission-line strength and/or significant variability in those lines throughout the course of the exposures. The flares we identified have characteristics consistent with flares observed by classical spectroscopic monitoring. The flare duty cycle for the objects in our sample is found to increase from 0.02% for early M dwarfs to 3% for late M dwarfs. We find that the flare duty cycle is larger in the population near the Galactic plane and that the flare stars are more spatially restricted than the magnetically active but non-flaring stars. This suggests that flare frequency may be related to stellar age (younger stars are more likely to flare) and that the flare stars are younger than the mean active population.

  4. On the Importance of the Flare's Late Phase for the Solar Extreme Ultraviolet Irradiance

    Science.gov (United States)

    Woods, Thomas N.; Eparvier, Frank; Jones, Andrew R.; Hock, Rachel; Chamberlin, Phillip C.; Klimchuk, James A.; Didkovsky, Leonid; Judge, Darrell; Mariska, John; Bailey, Scott; hide

    2011-01-01

    The new solar extreme ultraviolet (EUV) irradiance observations from NASA Solar Dynamics Observatory (SDO) have revealed a new class of solar flares that are referred to as late phase flares. These flares are characterized by the hot 2-5 MK coronal emissions (e.g., Fe XVI 33.5 nm) showing large secondary peaks that appear many minutes to hours after an eruptive flare event. In contrast, the cool 0.7-1.5 MK coronal emissions (e.g., Fe IX 17.1 nm) usually dim immediately after the flare onset and do not recover until after the delayed second peak of the hot coronal emissions. We refer to this period of 1-5 hours after the fl amrea sin phase as the late phase, and this late phase is uniquely different than long duration flares associated with 2-ribbon flares or large filament eruptions. Our analysis of the late phase flare events indicates that the late phase involves hot coronal loops near the flaring region, not directly related to the original flaring loop system but rather with the higher post-eruption fields. Another finding is that space weather applications concerning Earth s ionosphere and thermosphere need to consider these late phase flares because they can enhance the total EUV irradiance flare variation by a factor of 2 when the late phase contribution is included.

  5. Quasi-periodic Pulsations in the Most Powerful Solar Flare of Cycle 24

    Science.gov (United States)

    Kolotkov, Dmitrii Y.; Pugh, Chloe E.; Broomhall, Anne-Marie; Nakariakov, Valery M.

    2018-05-01

    Quasi-periodic pulsations (QPPs) are common in solar flares and are now regularly observed in stellar flares. We present the detection of two different types of QPP signals in the thermal emission light curves of the X9.3-class solar flare SOL2017-09-06T12:02, which is the most powerful flare of Cycle 24. The period of the shorter-period QPP drifts from about 12 to 25 s during the flare. The observed properties of this QPP are consistent with a sausage oscillation of a plasma loop in the flaring active region. The period of the longer-period QPP is about 4 to 5 minutes. Its properties are compatible with standing slow magnetoacoustic oscillations, which are often detected in coronal loops. For both QPP signals, other mechanisms such as repetitive reconnection cannot be ruled out, however. The studied solar flare has an energy in the realm of observed stellar flares, and the fact that there is evidence of a short-period QPP signal typical of solar flares along with a long-period QPP signal more typical of stellar flares suggests that the different ranges of QPP periods typically observed in solar and stellar flares is likely due to observational constraints, and that similar physical processes may be occurring in solar and stellar flares.

  6. M Dwarf Flare Continuum Variations on One-second Timescales: Calibrating and Modeling of ULTRACAM Flare Color Indices

    Science.gov (United States)

    Kowalski, Adam F.; Mathioudakis, Mihalis; Hawley, Suzanne L.; Wisniewski, John P.; Dhillon, Vik S.; Marsh, Tom R.; Hilton, Eric J.; Brown, Benjamin P.

    2016-04-01

    We present a large data set of high-cadence dMe flare light curves obtained with custom continuum filters on the triple-beam, high-speed camera system ULTRACAM. The measurements provide constraints for models of the near-ultraviolet (NUV) and optical continuum spectral evolution on timescales of ≈1 s. We provide a robust interpretation of the flare emission in the ULTRACAM filters using simultaneously obtained low-resolution spectra during two moderate-sized flares in the dM4.5e star YZ CMi. By avoiding the spectral complexity within the broadband Johnson filters, the ULTRACAM filters are shown to characterize bona fide continuum emission in the NUV, blue, and red wavelength regimes. The NUV/blue flux ratio in flares is equivalent to a Balmer jump ratio, and the blue/red flux ratio provides an estimate for the color temperature of the optical continuum emission. We present a new “color-color” relationship for these continuum flux ratios at the peaks of the flares. Using the RADYN and RH codes, we interpret the ULTRACAM filter emission using the dominant emission processes from a radiative-hydrodynamic flare model with a high nonthermal electron beam flux, which explains a hot, T ≈ 104 K, color temperature at blue-to-red optical wavelengths and a small Balmer jump ratio as observed in moderate-sized and large flares alike. We also discuss the high time resolution, high signal-to-noise continuum color variations observed in YZ CMi during a giant flare, which increased the NUV flux from this star by over a factor of 100. Based on observations obtained with the Apache Point Observatory 3.5 m telescope, which is owned and operated by the Astrophysical Research Consortium, based on observations made with the William Herschel Telescope operated on the island of La Palma by the Isaac Newton Group in the Spanish Observatorio del Roque de los Muchachos of the Instituto de Astrofsica de Canarias, and observations, and based on observations made with the ESO Telescopes

  7. Statistical investigation of flare stars. I. UV Ceti stars in the neighborhood of the sun and flare stars in clusters and associations

    Energy Technology Data Exchange (ETDEWEB)

    Mirzoyan, L.V.; Ambaryan, V.V.

    1988-09-01

    An analysis of modern observational data shows that UV Ceti stars in the neighborhood of the sun and flare stars in clusters and associations have many observational characteristics in common. This conclusion is based on the flare light curves, the spectra in the quiescent state, the luminosities, the flare durations, the mean flare frequencies, the energy spectra, the colors of the flare radiation, the Hertzsprung-Russell diagram, and the flares in the radio and x-ray regions. The differences between these stars (luminosities, energy spectra, Hertzsprung-Russell diagram, connection with diffuse nebulas, etc.) are largely quantitative and can be satisfactorily explained by differences in their ages - UV Ceti stars are on the average older formations.

  8. University of Alberta Flare Research Project : interim report November 1996-Jun 2000

    International Nuclear Information System (INIS)

    Kostiuk, L.; Johnson, M.

    2000-01-01

    The Flare Research Project at the University of Alberta is an ongoing multi year study into the emissions, combustion process and fluid mechanics related to flaring, which is commonly used in the energy and petrochemical industries to dispose of unwanted combustible gases by burning them in an open flame. This report focused on the emissions and efficiency of flares under operating conditions typical of solution gas flares. While most solution gas produced in Alberta is conserved, it is estimated that 6 per cent of these gases are flared with significant changes in the volumes flared from site to site. The median volume of flared or vented gas was approximately 60,300 m 3 /year and 95 per cent of battery sites flare and vent less than 1,000,000 m 3 /year. The goal of this project is to experimentally study the scaled-down generic pipe flares under well-controlled conditions to better understand the performance of flares. Research was conducted in a closed-loop wind tunnel to determine the effects of wind on flaring. Other objectives of the research are to develop methods for measuring the overall combustion efficiency of flares with either gaseous flare streams or those containing liquid droplets. Models for the scaling of plumes that disperse the products of combustion from flares as a function of wind speed, exit velocity and flare stack diameter were also examined. And finally, this research project measured the emissions of selected toxic compounds in both their vapor and soot phases. 38 refs., 10 tabs., 56 figs

  9. The Effects of Colchicine on Risk of Cardiovascular Events and Mortality Among Patients with Gout: A Cohort Study Using Electronic Medical Records Linked with Medicare Claims

    Science.gov (United States)

    Solomon, Daniel H.; Liu, Chih-Chin; Kuo, I-Hsin; Zak, Agnes; Kim, Seoyoung C.

    2016-01-01

    Background Colchicine may have beneficial effects on cardiovascular (CV) disease, but there are sparse data on its CV effect among patients with gout. We examined the potential association between colchicine and CV risk and all-cause mortality in gout. Methods The analyses used data from an electronic medical record (EMR) database linked with Medicare claims (2006–2011). To be eligible for the study cohort, subjects must have had a diagnosis of gout in the EMR and Medicare claims. New users of colchicine were identified and followed-up from the first colchicine dispensing date. Non-users had no evidence of colchicine prescriptions during the study period and were matched to users on the start of follow-up, age, and gender. Both groups were followed for the primary outcome, a composite of myocardial infarction (MI), stroke or transient ischemic attack (TIA). We calculated hazard ratios (HRs) in Cox regression, adjusting for potential confounders. Results We matched 501 users with an equal number of non-users with a median follow-up of 16.5 months. During follow-up, 28 primary CV events were observed among users and 82 among non-users. Incidence rates per 1,000 person-years were 35.6 for users and 81.8 for non-users. After full adjustment, colchicine use was associated with a 49% lower risk (HR 0.51, 95% CI 0.30 – 0.88) in the primary CV outcome as well as a 73% reduction in all-cause mortality (HR 0.27, 95% CI 017 – 0.43). Conclusion Colchicine use was associated with a reduced risk of a CV event among patients with gout. PMID:26582823

  10. Paraplegia aguda por compressão da medula espinhal torácica causada por tofo gotoso Acute paraplegia resulting from spinal cord compression by tophaceous gout

    Directory of Open Access Journals (Sweden)

    Eduardo Massato Hasegawa

    2007-08-01

    Full Text Available O acometimento axial pela gota é um evento raro, e o envolvimento da coluna torácica foi descrito em apenas 17 casos na literatura. Apresentamos um caso de paciente do sexo masculino de 48 anos com história de gota, sob tratamento irregular com alopurinol e colchicina, que desenvolveu paraplegia aguda decorrente de compressão medular por tofo gotoso. Realizou-se o diagnóstico por meio de ressonância magnética e anatomia patológica. Foi tratado com antiinflamatórios e descompressão cirúrgica com melhora importante, porém parcial. Apesar de o acometimento medular pelo tofo ser um evento raro, deve ser considerado nos casos de síndrome de compressão medular em pacientes com antecedente de gotaAxial gout is a rare condition and the involvement of the thoracic spine has been described only 17 times in the literature. This paper presents the case of a 48 year-old male patient with a history of gout, under irregular treatment with allopurinol and colchicines, who developed acute paraplegia resulting from spinal cord compression by tophaceous gout. The diagnosis was made using magnetic resonance imaging and anatomic pathology. The patient was treated with anti-inflammatory drugs and surgical decompression and showed important, albeit partial, improvement. Thus, although tophi rarely affect the spinal cord, they should be considered as a possibility in cases of spinal cord compression syndrome in patients with a history of gout

  11. Hypouricaemic effects of yoghurt containing Lactobacillus gasseri PA-3 in patients with hyperuricaemia and/or gout: A randomised, double-blind, placebo-controlled study.

    Science.gov (United States)

    Yamanaka, Hisashi; Taniguchi, Atsuo; Tsuboi, Hiroshi; Kano, Hiroshi; Asami, Yukio

    2018-03-09

    Lactobacillus gasseri PA-3 (PA-3) has been previously shown to decrease serum uric acid (SUA) levels in subjects with increased SUA. In this study, we investigated whether PA-3 is also capable of decreasing SUA levels in patients with hyperuricaemia and/or gout. Twenty-five patients with hyperuricaemia and/or gout completed this study. Urate-lowering drugs were discontinued for 12 weeks (week -4 to week 8). After flushing of urate-lowering drugs for 4 weeks (week 0), patients were randomised equally to receive diets containing yoghurt beverages with PA-3 or without PA-3 for a duration of 8 weeks (week 8). The intention to treat (ITT) population included all subjects who were randomised, and the per-protocol (PP) population included subjects who completed the experiment with compliance. We evaluated SUA levels at the end of the study as well as changes in SUA levels in comparison to week 0. In both ITT and PP analyses, there were no significant differences in SUA levels or in the changes in SUA levels compared to week 0 between the two groups. However, in a sub-population whose SUA levels at week 0 were within one SD of the mean of the whole PP population, changes in SUA levels in the group consuming PA-3-containing yoghurt were significantly lower than those of the control group (p = .0378). PA-3-containing yoghurt improves SUA levels, even in patients with hyperuricaemia and/or gout.

  12. Expression of Caspase-1 Gene Transcript Variant mRNA in Peripheral Blood Mononuclear Cells of Patients with Primary Gout in Different TCM Syndromes

    Directory of Open Access Journals (Sweden)

    Wan-Tai Dang

    2015-01-01

    Full Text Available A large number of studies have shown that cysteinyl aspartate specific protease-1 (CASP1 played an important role in the inflammatory response of primary gout, but the decreased expression of different CASP1 transcript variant could inhibit the activation of IL-1β. Our study mainly analyzed the expression level and function of CASP1 gene transcript variant mRNA in peripheral blood mononuclear cells of patients with gout in different TCM syndromes. The expression of CASP1 gene transcript variant and IL-1β mRNA in PBMCs were detected in patients with PG [acute phase (AP: 44 cases; nonacute phase (NAP: 52 cases] and healthy controls (HC: 30 cases by reverse transcription-polymerase chain reaction and/or real-time quantitative polymerase chain reaction. The expressions of plasma IL-1β in patients with PG and HC were detected by enzyme-linked immunosorbent assay. Dysregulated expression of the CASP1 gene and its transcript variant, plasma proinflammatory cytokines in all patients with primary gout in different TCM syndromes, correlation analysis showed that there was negative correlation between the expression of CASP1-gamma gene transcript variant mRNA and IL-1β protein in APPG group. The study suggested that CASP1 gene and its transcript variant may play a critical role in the inflammatory response of patients with PG in different phases and TCM syndromes.

  13. Measurements on a shock wave generated by a solar flare

    International Nuclear Information System (INIS)

    Maxwell, A.; Dryer, M.

    1982-01-01

    Having reviewed data obtained on a high-velocity shock generated by a solar flare on 18 August 1979, 1400 UT and commented on some previously deduced velocities for the shock, a model, based on current computer programs to account for the overall characteristics of the shock as it propagated through the corona and the interplanetary plasma, is presented. (U.K.)

  14. North–South Distribution of Solar Flares during Cycle 23

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... In this paper, we investigate the spatial distribution of solar flares in the northern and southern hemispheres of the Sun that occurred during the period 1996 to 2003. This period of investigation includes the ascending phase, the maximum and part of the descending phase of solar cycle 23. It is revealed that ...

  15. Phase Relationship Between Sunspot Number, Flare Index and ...

    Indian Academy of Sciences (India)

    Abstract. To understand better the variation of solar activity indicators originated at different layers of the solar atmosphere with respect to sunspot cycles, we carried out a study of phase relationship between sunspot number, flare index and solar radio flux at 2800 MHz from. January 1966 to May 2008 by using ...

  16. The recent NIR Flare of the Blazar 3C279

    Science.gov (United States)

    Carrasco, L.; Recillas, E.; Porras, A.; Escobedo, G.; Chavushyan, V.

    2018-02-01

    In our monitoring campaign of AGNs we found the Blazar 3C279 flaring in the NIR on January 27th,2018. this source is cross identified with the quasar HB891253-055 and the Gamma-ray source 3FGLJ1256.1-054.

  17. Flare Ribbon Expansion and Energy Release Ayumi Asai , Takaaki ...

    Indian Academy of Sciences (India)

    Flare Ribbon Expansion and Energy Release. Ayumi Asai. 1,∗. , Takaaki Yokoyama. 2. , Masumi Shimojo. 1. ,. Satoshi Masuda. 3. & Kazunari Shibata. 4. 1Nobeyama Solar Radio Observatory, Minamisaku, Nagano, 384-1305, Japan. 2Department of Earth and Planetary Science, University of Tokyo, Hongo, Bunkyo, Tokyo,.

  18. Solar flare effects and storm sudden commencement even in ...

    African Journals Online (AJOL)

    1998-05-08

    Variations in the three components of geomagnetic field were observed at the twenty-two geomagnetic Euro-African Observatories during the solar flare that occurred on the 6 May, 1998 at 0080UT and storm sudden commencement that took place on May 8, 1998 at 15.00 UT. The geomagnetic field on 6 May, 1998 was ...

  19. Observations of gamma-ray emission in solar flares

    International Nuclear Information System (INIS)

    Forrest, D.J.; Chupp, E.L.; Suri, A.N.; Reppin, C.

    1973-01-01

    This paper reviews the observations of gamma-ray emission made from the OSO-7 satellite in connection with two solar flares in early August 1972. The details of the measurements and a preliminary interpretation of some of the observed features are given. (U.S.)

  20. Solar Flare Physics Enlivened by TRACE and RHESSI Markus J ...

    Indian Academy of Sciences (India)

    Key words. Solar flares—particle acceleration—hard X-rays. 1. Introduction. In this review, we touch on some selected highlights in the recent exploration of solar flare physics, mostly obtained from data of the TRACE and RHESSI missions. These two missions are most instrumental in the progress of our physical under-.

  1. Strong convective and shock wave behaviour in solar flares

    International Nuclear Information System (INIS)

    Bloomberg, H.W.; Davis, J.; Boris, J.P.

    1977-01-01

    A model has been developed to study the gasdynamics of a flare region heated by a stream of energetic electrons. It is shown that the energy deposition can introduce strong chromospheric dynamical effects. As a result of fluid motion into rarified regions, there is considerable redistribution of mass causing a profound influence on the emitted line radiation. (author)

  2. Interacting CMEs and their associated flare and SEP activities

    Science.gov (United States)

    Shanmugaraju, A.; Prasanna Subramanian, S.

    2014-08-01

    We have analyzed a set of 25 interacting events which are associated with the DH type II bursts. These events are selected from the Coronal Mass Ejections (CMEs) observed during the period 1997-2010 in SOHO/LASCO and DH type IIs observed in Wind/WAVES. Their pre and primary CMEs from nearby active regions are identified using SOHO/LASCO and EIT images and their height-time diagrams. Their interacting time and height are obtained, and their associated activities, such as, flares and Solar Energetic Particles (>10 pfu) are also investigated. Results from the analysis are: primary CMEs are much faster than the pre-CMEs, their X-ray flares are also stronger (X- and M-class) compared to the flares (C- and M-class) of pre-CMEs. Most of the events (22/25) occurred during the period 2000-2006. From the observed width and speed of pre and primary CMEs, it is found that the pre-CMEs are found to be less energetic than the primary CMEs. While the primary CMEs are tracked up to the end of LASCO field of view (30 Rs), most of the pre-CMEs can be tracked up to <26 Rs. The SEP intensity is found to be related with the integrated flux of X-ray flares associated with the primary CMEs for nine events originating from the western region.

  3. Gas Flaring, Environmental Pollution and Abatement Measures in ...

    African Journals Online (AJOL)

    The environmental impact of gas flaring on the oil bearing enclave of the Niger Delta, Nigeria, was examined with a view to evaluating the abatement measures put in place by the Federal government of Nigeria and the oil producing companies. Primary and secondary information and data were analyzed during the study.

  4. Reconnection in Solar Flares: Outstanding Questions Hiroaki Isobe ...

    Indian Academy of Sciences (India)

    The idea of magnetic reconnection has been applied, not only to solar flares, but to various explosive phenomena in the solar atmosphere (e.g., Shibata et al. 1992;. ∗. Present address: Unit of Synergetic Studies for .... sheet, creating many small plasmoid as shown in the left panel of Fig. 1. This is remarkably similar to the.

  5. Real-time mapping of an industrial flare using lidar

    Science.gov (United States)

    da Costa, Renata F.; Steffens, Juliana; Landulfo, E.; Guardani, Roberto; Nakaema, W. M.; Moreira, Paulo F., Jr.; da Silva Lopes, Fabio J. S.; Ferrini, Patricia

    2011-11-01

    Characterization of atmospheric emissions from industrial flare stacks represents a challenge in measurement techniques because it is extremely difficult to determine the real-time concentrations of combustion products by in situ sampling, due to stack height, sensor calibration difficulties, and the dynamics of oscillations in the emission patterns. A ground based laser remote sensing (LIDAR) system has been developed for continuous and real-time monitoring of atmospheric emissions from an oil refinery located approximately 400 m from the instrument. The system is able to perform 3D scanning and profiling around the emission point. Tests were carried out using a scanning system pointed to the refinery flare. The mapping was obtained from a sequence of measurements at different zenithal and azimuthal angles resulting in a 3D image of the flare shape plus the flame itself. The measurements can be used to estimate the aerosol size distribution based on the ratios of the backscattering signal at three distinct wavelengths: 1064/532 nm, 1064/355 nm, and 532/355 nm. The method can be used in real time monitoring of industrial aerosol emissions and in the control of industrial processes. Preliminary results indicate a calibration procedure to assess the refining process efficiency based on the particle size distribution within and around the flare.

  6. On line profile asymmetries in a solar flare

    Czech Academy of Sciences Publication Activity Database

    Prosecký, Tomáš; Kotrč, Pavel; Berlicki, A.

    2006-01-01

    Roč. 30, č. 1 (2006), s. 31-41 ISSN 1845-8319. [Central European Solar Physics Meeting /2./. Bairisch Kölldorf, 19.05.2005-21.05.2005] R&D Projects: GA AV ČR IAA3003203 Institutional research plan: CEZ:AV0Z10030501 Keywords : sun * solar flares * spectrum Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics

  7. PARTICLE ACCELERATION IN SOLAR FLARES AND ASSOCIATED CME SHOCKS

    Energy Technology Data Exchange (ETDEWEB)

    Petrosian, Vahé [Department of Physics and KIPAC, Stanford University, Stanford, CA 94305 (United States); Department of Applied Physics, Stanford University, Stanford, CA 94305 (United States)

    2016-10-10

    Observations relating the characteristics of electrons seen near Earth (solar energetic particles [SEPs]) and those producing flare radiation show that in certain (prompt) events the origin of both populations appears to be the flare site, which shows strong correlation between the number and spectral index of SEP and hard X-ray radiating electrons, but in others (delayed), which are associated with fast coronal mass ejections (CMEs), this relation is complex and SEPs tend to be harder. Prompt event spectral relation disagrees with that expected in thick or thin target models. We show that using a more accurate treatment of the transport of the accelerated electrons to the footpoints and to Earth can account for this discrepancy. Our results are consistent with those found by Chen and Petrosian for two flares using nonparametric inversion methods, according to which we have weak diffusion conditions, and trapping mediated by magnetic field convergence. The weaker correlations and harder spectra of delayed events can come about by reacceleration of electrons in the CME shock environment. We describe under what conditions such a hardening can be achieved. Using this (acceleration at the flare and reacceleration in the CME) scenario, we show that we can describe the similar dichotomy that exists between the so-called impulsive, highly enriched ({sup 3}He and heavy ions), and softer SEP events and stronger, more gradual SEP events with near-normal ionic abundances and harder spectra. These methods can be used to distinguish the acceleration mechanisms and to constrain their characteristics.

  8. Differential rotation, flares and coronae in A to M stars

    Czech Academy of Sciences Publication Activity Database

    Balona, L. A.; Švanda, Michal; Karlický, Marian

    2016-01-01

    Roč. 463, č. 2 (2016), s. 1740-1750 ISSN 0035-8711 R&D Projects: GA ČR GAP209/12/0103 Grant - others:GA ČR(CZ) GA15-02112S Institutional support: RVO:67985815 Keywords : stars * activity * flare Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 4.961, year: 2016

  9. {omega}-8 Flare fire; {omega}-8 feu torche

    Energy Technology Data Exchange (ETDEWEB)

    Pagej, S.

    2003-06-15

    This document provides propositions and recommendations concerning the physical phenomena of the flare fires. The first part describes the accident analysis and the second part the phenomenon. The third part presents a modelization of the flame, the wind effects and the thermal effects. The last part is devoted to the calculated thresholds for the domino effects on structures. (A.L.B.)

  10. ECR plasma source in a flaring magnetic field

    International Nuclear Information System (INIS)

    Meis, C.; Compant La Fontaine, A.; Louvet, P.

    1992-01-01

    The propagation and absorption of an electromagnetic wave, near the electron cyclotron zone, of a cold plasma (T e ∼ 1-5 eV) confined in a flaring magnetic field is studied. The case of both extraordinary and ordinary modes has been considered. Temperature effects and electron-neutral collisions have been taken account in the dielectric tensor

  11. Magnetoacoustic waves in diagnostics of the flare current sheets

    Czech Academy of Sciences Publication Activity Database

    Jelínek, P.; Karlický, Marian

    2012-01-01

    Roč. 537, January (2012), A46/1-A46/10 ISSN 0004-6361 R&D Projects: GA ČR GAP209/10/1680 Institutional research plan: CEZ:AV0Z10030501 Keywords : Sun * flares * numerical methods Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 5.084, year: 2012

  12. Optical-to-Radio Continua in Solar Flares

    Czech Academy of Sciences Publication Activity Database

    Heinzel, Petr; Avrett, E.H.

    2012-01-01

    Roč. 227, č. 1 (2012), s. 31-44 ISSN 0038-0938 R&D Projects: GA ČR GAP209/10/1680 Institutional research plan: CEZ:AV0Z10030501 Keywords : solar flares * spectral continua * diagnostics Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 3.256, year: 2012

  13. The Photospheric Flow near the Flare Locations of Active Regions

    Indian Academy of Sciences (India)

    tribpo

    in the active regions along with few locations of upflows. The localised upflows are observed in the light bridges and emerging flux regions with different speeds (Beckers & Schroter 1969). The flow patterns of flare locations in the active regions are observed by using the tower vector magnetograph (TVM) of Marshall.

  14. Phase Relationship Between Sunspot Number, Flare Index and ...

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... To understand better the variation of solar activity indicators originated at different layers of the solar atmosphere with respect to sunspot cycles, we carried out a study of phase relationship between sunspot number, flare index and solar radio flux at 2800 MHz from January 1966 to May 2008 by using ...

  15. NLTE modelling of the flaring atmosphere above sunspot

    Czech Academy of Sciences Publication Activity Database

    Berlicki, A.; Heinzel, Petr; Schmieder, B.; Li, H.

    2008-01-01

    Roč. 490, č. 1 (2008), s. 315-324 ISSN 0004-6361 Grant - others:EU(XE) ESA-PECS project No. 98030 Institutional research plan: CEZ:AV0Z10030501 Keywords : Sun * flares * atmosphere Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 4.153, year: 2008

  16. The driver in flares and coronal mass ejections: Magnetic expansion

    Science.gov (United States)

    Moore, Ronald L.

    1988-01-01

    Chromospheric filaments, and hence the sheared magnetic fields that they trace, are observed to erupt in flares and coronal mass ejections. In the eruption, the filament-traced field is seen to expand in volume. For frozen-in magnetic field and isotropic expansion, the magnetic energy in a flux tube decreases as the flux tube expands. The amount of expansion of the magnetic field and the corresponding decrease in magnetic energy in a filament-eruption flare and/or coronal mass ejection can be estimated to order of magnitude from the observed expansion of the erupting filament. This evaluation for filament-eruption events in which the filament expansion is clearly displayed gives decreases in magnetic energy of the order of the total energy of the accompanying flare and/or coronal mass ejection. This simple expanding flux tube model can also fit the observed acceleration of coronal mass ejections, if it is assumed that the increase in mechanical energy of the mass ejection comes from the magnetic energy decrease in the expansion. These results encourage the view that magnetic expansion such as seen in filament eruptions drives both the plasma particle energization in flares and the bulk mass motion in coronal mass ejections.

  17. X-ray line coincidence photopumping in a solar flare

    Science.gov (United States)

    Keenan, F. P.; Poppenhaeger, K.; Mathioudakis, M.; Rose, S. J.; Flowerdew, J.; Hynes, D.; Christian, D. J.; Nilsen, J.; Johnson, W. R.

    2018-03-01

    Line coincidence photopumping is a process where the electrons of an atomic or molecular species are radiatively excited through the absorption of line emission from another species at a coincident wavelength. There are many instances of line coincidence photopumping in astrophysical sources at optical and ultraviolet wavelengths, with the most famous example being Bowen fluorescence (pumping of O III 303.80 Å by He II), but none to our knowledge in X-rays. However, here we report on a scheme where a He-like line of Ne IX at 11.000 Å is photopumped by He-like Na X at 11.003 Å, which predicts significant intensity enhancement in the Ne IX 82.76 Å transition under physical conditions found in solar flare plasmas. A comparison of our theoretical models with published X-ray observations of a solar flare obtained during a rocket flight provides evidence for line enhancement, with the measured degree of enhancement being consistent with that expected from theory, a truly surprising result. Observations of this enhancement during flares on stars other than the Sun would provide a powerful new diagnostic tool for determining the sizes of flare loops in these distant, spatially unresolved, astronomical sources.

  18. Flaring and pollution detection in the Niger Delta using Remote Sensing

    OpenAIRE

    Morakinyo, Barnabas Ojo

    2015-01-01

    Merged with duplicate record 10026.1/6553 on 28.02.2017 by CS (TIS) Abstract Through the Global Gas Flaring Reduction (GGFR) initiative a substantial amount of effort and international attention has been focused on the reduction of gas flaring since 2002 (Elvidge et al., 2009). Nigeria is rated as the second country in the world for gas flaring, after Russia. In an attempt to reduce and eliminate gas flaring the federal government of Nigeria has implemented a number of gas flaring reduc...

  19. Frequent Flaring in the TRAPPIST-1 System—Unsuited for Life?

    Energy Technology Data Exchange (ETDEWEB)

    Vida, K.; Kővári, Zs.; Pál, A.; Oláh, K.; Kriskovics, L., E-mail: vidakris@konkoly.hu [Konkoly Observatory, MTA CSFK, H-1121 Budapest, Konkoly Thege M. út 15-17 (Hungary)

    2017-06-01

    We analyze the K2 light curve of the TRAPPIST-1 system. The Fourier analysis of the data suggests P {sub rot} = 3.295 ± 0.003 days. The light curve shows several flares, of which we analyzed 42 events with integrated flare energies of 1.26 × 10{sup 30}–1.24 × 10{sup 33} erg. Approximately 12% of the flares were complex, multi-peaked eruptions. The flaring and the possible rotational modulation shows no obvious correlation. The flaring activity of TRAPPIST-1 probably continuously alters the atmospheres of the orbiting exoplanets, which makes these less favorable for hosting life.

  20. Feasibility and Domain Validation of Rheumatoid Arthritis (RA) Flare Core Domain Set

    DEFF Research Database (Denmark)

    Bartlett, Susan J; Bykerk, Vivian P; Cooksey, Roxanne

    2015-01-01

    , and stiffness scores averaged ≥ 2 times higher (2 of 11 points) in flaring individuals. Correlations between flare domains and corresponding legacy instruments were obtained: r = 0.46 to 0.93. A combined definition (patient report of flare and 28-joint Disease Activity Score increase) was evaluated in 2 other...... provided input for stiffness, self-management, contextual factors, and measurement considerations. RESULTS: Flare data from 501 patients in an observational study indicated 39% were in flare, with mean (SD) severity of 6.0 (2.6) and 55% lasting > 14 days. Pain, physical function, fatigue, participation...