Gout disease is recognized as one of the most prevalent forms of arthritis worldwide, with an estimated prevalence of around 2.5%. Its pathophysiology is primarily linked to elevated levels of uric acid in the bloodstream, which may result from either increased production or reduced renal excretion. Clinically, it often presents as a swollen, erythematous, and painful joint. The definitive method for diagnosis remains synovial aspiration from the affected joint. While acute attacks typically require management in the emergency department, long-term care is generally provided in primary care settings.This literature review aims to explore gout disease in terms of its clinical features, diagnostic approaches, and treatment strategies, particularly focusing on the role of primary care. A comprehensive search was conducted on the PubMed database using the MeSH term “gout disease” to identify pertinent studies. Gout disease continues to be among the most widespread rheumatologic conditions globally, and unhealthy lifestyle choices, including alcohol intake and high consumption of red and white meats, may exacerbate its incidence. Diagnosis may involve blood tests, radiographic imaging, and joint aspiration. Maintenance therapy, often administered in primary care, includes the use of Allopurinol or other urate-lowering agents.
This study assesses the risk of severe hyperlactatemia (defined as lactate levels > 4 mmol/L) in patients undergoing chronic low-dose aspirin (ASP) therapy and estimates the strength of this association. A case-crossover design was employed, in which individuals who experienced the outcome also served as their own controls, with exposure evaluated during a pre-event period. Additionally, a person-day–based analytical approach was used to compare exposure between case and control periods. Among the case group (ASP exposed/unexposed), the distribution was 127/578, while in the control group it was 547/3,968, yielding an odds ratio (OR) of 1.6 (95% CI: 1.29–1.97; z = 4.31; P < 0.0001). The findings suggest a modest association between low-dose aspirin use (100 mg/day) and elevated lactate levels, particularly in its primary indication for secondary prevention of vascular ischemic events. Although the observed risk is relatively low (OR = 1.6), clinical monitoring is advisable, especially when aspirin is co-administered with agents sharing similar toxicological profiles. Incorporating lactate level assessment into therapeutic management plans may enhance patient safety and therapeutic outcomes.
Producing enantiomerically pure drugs from racemic mixtures has become a critical objective in modern pharmaceutical science. Racemic compounds typically consist of two or more enantiomers, of which only one may be therapeutically active, while the others may be biologically inactive or even toxic, including teratogenic effects. Hence, the ability to effectively isolate the desired enantiomer is essential for ensuring both the safety and effectiveness of pharmaceutical treatments. This mini-review provides an overview of recent innovations in chiral stationary phases (CSPs) employed for the resolution of racemic drugs and mixtures. It covers various classes of CSPs, including those based on Pirkle-type selectors, polysaccharides, polypeptides, inclusion complexes, ligand-exchange mechanisms, macrocyclic antibiotics, and other novel materials. The performance of these phases in a range of separation techniques—such as high-performance liquid chromatography (HPLC), gas chromatography (GC), capillary electrophoresis (CE), supercritical fluid chromatography (SFC), and simulated moving bed (SMB) chromatography—is examined. Emphasis is also placed on the types of molecular interactions between CSPs and target analytes that drive effective enantioseparation.
Snakebite envenoming remains a significant global health challenge, with high mortality and morbidity rates persisting despite decades of medical attention. Each year, millions are affected by venomous snakebites, often resulting in death or severe disability. Snake venoms exhibit diverse bioactivities, including hemorrhagic, inflammatory, cytotoxic, cardiotoxic, and neurotoxic effects, mainly due to complex mixtures of toxin-rich proteins. Although considerable research has been undertaken, the majority of venom components remain uncharacterized. Recent advancements in proteomics and bioinformatics have enabled more detailed exploration of venom profiles, facilitating the identification and functional prediction of novel toxins. Computational approaches now enable modeling of toxin-target interactions, aiding understanding of venom mechanisms. This review also explores the emerging role of medicinal plants in snakebite treatment, alongside conventional antivenoms. Emphasis is placed on the urgent need to improve access to safe, affordable, and effective antivenoms in low-income tropical regions and to promote their appropriate clinical use.
Eurasian Academy of Medicine and Dentistry