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ABOUT GOUT
Gout is one of the most painful rheumatic diseases. It results from deposits of needle-like crystals of uric acid in the connective tissue, joint spaces, or both. These deposits lead to inflammatory arthritis, which causes swelling, redness, heat, pain, and stiffness in the joints. Gout accounts for about 5 percent of all cases of arthritis. Pseudogout, also a crystal-induced arthritis, is a condition with similar symptoms that results from deposits of calcium pyrophosphate dihydrate crystals in the joints. It is sometimes cal ed calcium pyrophosphate deposition disease, crystal deposition disease, or chondrocalcinosis. Uric acid is a substance that results from the breakdown of purines or waste products in the body. Deposits of uric acid, called tophi, can appear as lumps under the skin around the joints and at the rim of the ear. In addition, uric acid crystals can also collect in the kidneys and cause kidney stones. For many people, gout initial y affects the joints in the big toe, a condition called podagra. Sometime during the course of the disease, gout will affect the big toe in about 75 percent of patients. Gout can also affect the instep, ankles, heels, knees, wrists, fingers, and elbows. The disease can progress through four stages: Asymptomatic (without symptoms) hyperuricemia - In this stage, a person has elevated levels of uric acid in the blood but no other symptoms. The tendency to develop gout, however, is present. Acute gout, or acute gouty arthritis - In this stage, hyperuricemia has caused the deposit of uric acid crystals in joint spaces. This leads to a sudden onset of intense pain and swelling in the joints, which may also be warm and very tender. An acute attack commonly occurs at night and can be triggered by stressful events, alcohol or drugs, or another acute illness. Early attacks usual y subside within 3 to 10 days, even without treatment, and the next attack may not occur for months or even years. Over time, however, attacks can last longer and occur more frequently. Interval or intercritical gout is the period between acute attacks – there are no symptoms and joints function normally. Chronic tophaceous gout is the most disabling stage of gout and usually develops over a long period, such as 10 years. In this stage, the disease has caused permanent damage to the affected joints and sometimes to the kidneys. With proper treatment, most people with gout do not progress to this advanced stage. Symptoms of gout include inflammation, swelling, redness and warmth over the joint, most commonly the big toe. The joint will be extremely tender - touching or moving it will be extremely painful. The individual also may experience fever, chills, and fatigue. Many gout sufferers say they first noticed pain in the middle of the night or upon arising in the morning. Drugs Often Prescribed for Gout Allopurinol (Zyloprim, Lopurin) inhibits the production of uric acid but has been linked to skin eruptions, inflammation of the blood vessels, liver toxicity, nausea, vomiting, diarrhea, numbness and a host of other side effects. Colchicine (no brand name) is used to alleviate attacks but can cause serious side effects and toxicity as well as the other minor side effects of nausea, vomiting, diarrhea, numbness and sometimes bleeding or bruising. And the overdose rating on this one is HIGH! Indomethacin (Indocin, Indocin I. V., Indocin S. R.) This is a non-steroidal anti-inflammatory drug or NSAIDs. It treats the gout attacks but has side effects including stomach pain, indigestion, headaches, dizziness, nausea, and vomiting. Used long term, NSAIDs may also have significant toxicity.
Toll Free U.S. and Canada - 877-505-4372 International - 01-408-719-9026 Fax – 408-351-4955 1722 Yosemite Drive
WHAT CAN YOU DO TO PREVENT GOUT ATTACKS?
When experiencing gout-like symptoms, avoid eating liver, shellfish, yeast, mushrooms, sardines, peas, beans, spinach, asparagus, alcohol, and mussels. You should moderate the amount of poultry and red meat as well. Foods you should eat are vegetables, fruit (especially strawberries and cherries), grains, seeds and nuts, cheese, and white rice. Increasing your water intake can also be of significant benefit to relieving gout, especially if you are taking Gout-Helper products. Gout-Helper™ herbs wil help remove the build up of crystals and the extra water will help remove them from your body. Gout-Helper™ products are herbal formulas that will help people who have gout. They can be purchased on line at www.gout- helper.com or by calling toll free at 877-505-4372. BENEFITS OF USING GOUT-HELPER™
Gout-Helper™ Herbal Supplements are designed to stop pain and inflammation, improve overall well-being, improve blood circulation and reduce the side effects of drugs by improving kidney and liver function. Gout-Helper™ has been shown to relieve the pain and dissolve the crystals that can cause gout. Gout-Helper™ is highly effective in preventing gout attacks and complications. If taken on a continuous basis, Gout- Helper will help the body pass the excess uric acid that it produces. Gout-Helper also will help your body to dissolve any crystals already present and wil help your body to maintain itself. Gout-Helper™ is clinically proven to have no side effects and is guaranteed 100% effective to alleviate the pain and difficulty associated with gout. There is no chance of unwanted side effects or overdose. GOUT-HELPER™ Dosages and Interactions
The suggested adult dosage for Gout Helper is 3-4 capsules twice daily on an empty stomach, 30 minutes before meals or as directed by a health care practitioner. Gout-Helper™ supplements will not interact negatively with any other medicines or therapies. The proprietary blend of herbs in Gout Helper is comprised of Morinda, Eclipta, Alisma and Prunella. For more information: See the Gout Helper websit or call us toll free at 877-505-4372.
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UNIVERSITÀ DEGLI STUDI DI ROMA“LA SAPIENZA” IL RUOLO DEL TRIAGE NELLA CEFALEA IN UN DEA DI II LIVELLO: Relatrice: Prof. Rosanna Cerbo Candidato: Bruna Viviano INDICE INTRODUZIONE ………………………………………………….Pag. n° 3 CLASSIFICAZIONE…………………………………………………Pag. n° 3 PRINCIPALI CEFALEE PRIMARIE ………