Osteosarcoma-Health Question and Answer

Speaking of the enemies of the “three highs” that bring great threats to people’s health in modern society-hyperglycemia, hypertension and hyperlipidemia, we will certainly not feel strange. Now, the fourth highest after the “three highs”-high uric acid has also surfaced and is coming strongly.

Know your enemy and yourself, You won’t be defeated in a hundred battles], To defeat the enemy, First of all, we need to know the enemy. About high uric acid and gout, There are many common misconceptions in society, It is necessary to comb and learn with everyone. High uric acid may not necessarily lead to gout, Gout does not necessarily have high uric acid. Gout originates from high uric acid. However, it does not mean that high uric acid will necessarily lead to gout, Gout occurs only when uric acid crystals in the blood deposit in the synovium of the joint and cause synovitis. In fact, Only about 10% of patients with high uric acid develop gout. The same is true for the reverse. As the pathogenic factors of gout are complex, When many patients suffer from gout, Serum uric acid levels may still be within the normal range, At this time, don’t be superstitious about the test results and delay the timely treatment of gout. High uric acid can not only induce gout. Uric acid is the metabolic end product of [purine] in human body. High uric acid has harmful effects on multiple tissues and organs of human body. Excessive uric acid deposition in bones and joints will cause gout. Deposition in the kidney will cause nephropathy and renal failure. High uric acid also greatly increases the risk of a variety of metabolic-related diseases (such as obesity, diabetes, hyperlipidemia, etc.) and cardiovascular diseases. For gout patients, Uric acid [normal] is not enough to meet international standards, The normal range of uric acid is: male < 420 umol/L, female < 360 umol/L. However, For gout patients, It is not enough to keep uric acid in such a [normal] range, The latest guidelines suggest that the blood uric acid level of gout patients should be stabilized within 300 mol/L for a long time. Only in this way can the dissolution of tophus be promoted and gout attacks be effectively prevented. High uric acid, which does not cause gout, also needs treatment. The controversy on this issue has a long history, but at present the academic circles have basically agreed that no matter how healthy a person is, as long as uric acid exceeds 520 umol/L, uric acid reduction treatment should be carried out. If the person also has diabetes, chronic kidney disease or risk factors for cardiovascular diseases, So as long as uric acid exceeds the above normal range, Even if there is no gout attack, It is also necessary to start treatment. Uric acid lowering drugs can also be used during acute attacks of gout. It has long been believed that, If uric acid lowering drugs are used during the acute phase of gout, It may cause the surface of intra-articular tophus to dissolve and form insoluble crystals to deposit in tissues to aggravate inflammatory reaction. Therefore, [Can’t use uric acid lowering drugs in acute gout] has almost become the golden rule in gout treatment. However, In 2012, < < Guidelines for Gout Management in the United States > > first proposed, Under the protection of effective anti-inflammatory drugs, Uric acid reduction therapy is not taboo in acute phase. Then, In 2013, China’s “Expert Consensus on Hyperuricemia and Gout Treatment” also recognized this view, believing that uric acid reduction treatment can be started immediately instead of waiting for two weeks after the acute symptoms of gout are relieved. Clinicians generally tend to adopt a conservative attitude towards this avant-garde concept [contrary to common sense]. After all, the old view has a long history and is deeply rooted in the hearts of the people. The new view also needs more evidence-based evidence. Its greater clinical significance lies in the fact that For patients with acute attack of gout during taking uric acid lowering drugs, As a result, there is no need to stop uric acid lowering therapy. For gout patients, Pure diet control is far from enough for uric acid in human blood. 80% come from their own purine metabolism and only 20% from food intake. Therefore, The effect of simple diet control on reducing blood uric acid level is very limited (most of them can only be reduced by 10% ~ 20% or 70-90 mol/L). Therefore, drugs must be reasonably selected according to the disease condition. Many patients refuse to take drugs for fear of [side effects of drugs]. This is a typical [choking off food]. As long as drugs are used scientifically and regularly, the risk of rare complications of drugs is no higher than the possibility of going out and encountering a car accident. Who will stay at home all day for fear of a car accident? The treatment of hyperuricemia and gout cannot be entirely dependent on drugs. After the application of uric acid-lowering drugs, Some patients think they will rest easy from now on, You can eat it on your diet, [Take another pill in a big deal], This idea is not only wrong but also dangerous. For chronic metabolic diseases such as gout, [Low purine] diet is the premise and basis of treatment. Without reducing [purine] intake at the source, drugs alone cannot control the disease. However, due to excessive diet, uric acid is obviously increased. We have to increase the dosage of drugs, This greatly increases the risk of adverse drug reactions. Patients with high uric acid do not need to stop taking aspirin. Aspirin is a century-old classic drug. The range of applications is very wide. However, Small doses of aspirin will inhibit uric acid excretion by renal tubules, It is believed to be an important cause of hyperuricemia. Previously, For patients with gout who need aspirin, Doctors often recommend stopping drugs. But the new view is that, For patients who have developed gout, The negative effect of aspirin is actually very weak. Even negligible. This has important guiding significance for clinical practice, For example, gout patients who take small doses of aspirin to prevent cardiovascular disease hazards, There is no need to stop taking drugs or change dressings. Surgery cannot cure tophus. Tout is a white crystal precipitated by uric acid exceeding its saturation. It usually occurs on the surface of joint extension, tendon and bone process. By taking uric acid lowering drugs, the uric acid is kept below 300 umol/L, It can reduce tophus. But surgery cannot fundamentally solve the problem. If uric acid levels remain high, Tout stone will relapse after resection, Moreover, the surgical incision is difficult to heal, It is easy to induce infection. So, Unless the gout stone is huge, Or affect joint function, compress nerves, Surgical resection is generally not recommended. High uric acid and gout, The incidence rate is high, Harmful, It is related to health and safety, It must be observed. However, Like many common diseases, online rumors are in vogue and fallacies are rampant. If you don’t have a certain professional knowledge background and don’t spend time to identify authenticity, it is not easy to find reliable knowledge. This article’s viewpoint summarizes recent guidelines and consensus from home and abroad, hoping to help everyone to understand diseases [how fast, how good and how economical]. It is the purpose of writing.