ImportanceDifferences have been observed in the association of serum urate levels with consumption of different types of alcoholic beverages. However, previous studies have not standardized the unit of intake for ethanol content, and only limited types of alcoholic beverages have been evaluated.ObjectiveTo examine differences in the association of serum urate levels with various types of alcoholic beverages when their intakes are standardized for ethanol content.Design, Setting, and ParticipantsThis retrospective cross-sectional study was conducted using data from participants aged 20 years or older who completed a medical checkup at St Luke’s International University in Japan between October 1, 2012, and October 31, 2021. Participant demographics, blood test results, and lifestyle questionnaire data were used as covariates. Analysis was performed in December 2021.ExposuresConsumption of alcoholic beverages, including beer, sake (rice wine), shochu (Japanese spirit), wine, and whiskey.Main Outcomes and MeasuresSerum urate levels were measured during the medical checkup. The beverage unit was standardized to 1 standard drink, which contained 20 g of ethanol. Multivariable linear regression including interaction terms of alcohol consumption and dominant alcoholic beverage was performed.ResultsThis study included 78 153 participants. Their mean (SD) age was 47.6 (12.8) years; 36 463 (46.7%) were men and 41 690 were women (53.3%). A total of 45 755 participants (58.5%) were regular alcohol drinkers. Consistent associations of serum urate levels with alcohol consumption were observed in the beer-dominant group, with β coefficients (for 1 standard drink per day) of 0.14 mg/dL (95% CI, 0.11-0.17 mg/dL; P < .001) for men and 0.23 mg/dL (95% CI, 0.20-0.26 mg/dL; P < .001) for women. A moderate increase in serum urate levels was observed in the wine-dominant group compared with a modest and nonsignificant increase in the sake-dominant group, with β coefficients (for 1 standard drink per day) for the latter group of 0.05 mg/dL (95% CI, −0.01 to 0.10; P = .10) for men and 0.04 mg/dL (95% CI, −0.05 to 0.14 mg/dL; P = .38) for women. Restricted cubic splines showed different patterns in associations of serum urate levels with ethanol intake by dominant alcoholic beverages.Conclusions and RelevanceThe results of this study suggest that the extent of the association of serum urate levels with alcohol intake was different for alcoholic beverages even after ethanol content was standardized. Higher beer consumption among men and women was consistently associated with higher serum urate levels, whereas sake was not associated with changes in serum urate levels. Therefore, alcoholic beverage type, in addition to ethanol content, should be considered as a factor contributing to hyperuricemia.
TAFRO syndrome is a systemic inflammatory disease of unknown etiology. It is characterized by thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly. Herein, we report the case of a 60-year-old male with TAFRO syndrome. A few weeks after the patient developed an intermittent fever, he presented to our hospital with diarrhea, abdominal distension, and whole-body edema (face, extremities, and abdomen). Autoantibody and lip biopsy findings supported the diagnosis of primary Sjögren’s syndrome (pSS). High-dose steroids and tocilizumab were used to treat his refractory thrombocytopenia and ascites. However, systemic inflammation and renal dysfunction did not improve, resulting in temporary hemodialysis. Eventually, dual B-cell depletion therapy with rituximab and belimumab ameliorated the patient’s symptoms. About 16 weeks after discharge, the patient’s overall condition had improved. The TAFRO syndrome may be a severe manifestation of pSS. Considering the immunological context, B cell-targeted therapy provides new insights into improving this life-threatening disease and enables rapid steroid tapering.
TAFRO syndrome is a systemic inflammatory disease of unknown etiology. It is characterized by thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly. Herein, we report the case of a 60-year-old male with TAFRO syndrome. A few weeks after the patient developed an intermittent fever, he presented to our hospital with diarrhea, abdominal distension, and whole-body edema (face, extremities, and abdomen). Autoantibody and lip biopsy findings supported the diagnosis of primary Sjögren’s syndrome (pSS). High-dose steroids and tocilizumab were used to treat his refractory thrombocytopenia and ascites. However, systemic inflammation and renal dysfunction did not improve, resulting in temporary hemodialysis. Eventually, combined B-cell immunomodulation therapy with rituximab and belimumab ameliorated the patient’s symptoms. About 16 weeks after discharge, the patient’s overall condition had improved. The TAFRO syndrome may be a severe manifestation of pSS. Considering the immunological context, combined B-cell immunomodulation therapy provides new insights into improving this life-threatening disease and enables rapid steroid tapering.
and the process of acceptance, and then all that is required in daily life'). The core themes that emerged from the LVC and comments emcompassed: disease knowledge, support network, coping strategies, healthcare system, and self-management (Figure 1). Conclusions Understanding these aspects is necessary to address the educational needs of people with lupus. A healthpromoting curriculum aiming to support lupus patients' selfmanagement should consider the critical role that the knowledge plays to move forward into effective personal and collective actions. Epistemic justice is also a primary principle to conduct health policies that seek the full integration of these patients into the society.
positively coupled to adenylyl cyclase in embryonic bovine tracheal (EBTr) cells: pharmacological characterization using agonists and antagonists. Br J Pharmacol 1999;127:204-10. 48. Tesch AM, MacDonald MH, Kollias-Baker C, Benton HP.Chondrocytes respond to adenosine via A 2 receptors and activity is potentiated by an adenosine deaminase inhibitor and a phosphodiesterase inhibitor. Osteoarthritis Cartilage 2002;10: 34-43. 49. Attur M, Al-Mussawir HE, Patel J, Kitay A, Dave M, Palmer G, et al. Prostaglandin E2 exerts catabolic effects in osteoarthritis cartilage: evidence for signaling via the EP4 receptor. The patient, a 56-year-old woman with a 2-year history of untreated stable pulmonary sarcoidosis, was admitted for evaluation of bilateral leg edema without muscle weakness or myalgia. Laboratory tests showed elevated levels of C-reactive protein (3.18 mg/dl [normal ,0.3]), aldolase (13.2 units/liter [normal 2.7-7.5]), and angiotensin-converting enzyme (47.0 IU/liter [normal 7.7-29.4]). Her creatine phosphokinase level was normal. Fluorodeoxyglucose-positron emission tomography (FDG-PET) revealed diffuse FDG uptake in all muscle groups ( A and B). Magnetic resonance imaging (MRI) of the thighs showed diffuse enhancement of the fascia and muscle (C; T2-weighted image with contrast). Muscle biopsy of the right quadriceps revealed noncaseating granulomas in the endomysium and fascia (D), confirming the diagnosis of sarcoid myofasciitis. Corticosteroid treatment was initiated, and the patient's symptoms disappeared within 1 month. Fasciitis in sarcoidosis is a rarely reported condition and can be missed in diagnosis due to normal muscle enzyme levels. Imaging studies such as FDG-PET or MRI should be considered in cases of unexplainable swelling or myalgia in patients with sarcoidosis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.