Effect of caffeinated and decaffeinated coffee on serum uric acid and uric acid clearance, a randomised within-subject experimental study.

OBJECTIVES: The effect of coffee on serum uric acid (SUA) has shown conflicting results. This study was to determine the effects of caffeinated coffee (CC) and decaffeinated coffee (DC) on SUA, serum xanthine oxidase activity (sXOA) and urine uric acid clearance (UAC). METHODS: This was a prospective randomised within-subject experimental study design of 51 healthy male participants. Each study period consisted of 3 periods, including a control, an intervention, and washout period for 1, 3 and 1 week, respectively. During the intervention period, the participants received 2, 4 or 6 gram/day of coffee, either CC or DC. RESULTS: For DC groups, SUA significantly decreased by 6.5 (±1.1) mg/dL to 6.2 (±1.1) mg/dL during the intervention period (p=0.014). sXOA significantly increased by 0.05 (±0.07) nmol/min/mL to 0.20 (±0.38) nmol/min/mL during the intervention period (p=0.010) of CC. For UAC, there was no significant change with CC or DC. In hyperuricaemic participants, SUA significantly decreased by 7.7 (±0.7) mg/dL to 7.2 (±0.7) mg/dL during the intervention period (p=0.028) of DC. For non-hyperuricaemic, CC significantly increased SUA by 5.9 (±0.7) mg/dL to 6.2 (±0.9) mg/dL during the intervention period (p=0.008) and significantly decreased SUA to 6.0 (±0.8) mg/dL (p=0.049) during the withdrawal period. A significant increase of sXOA according with SUA in CC groups from 0.05 (±0.07) nmol/min/mL to 0.25 (±0.44) nmol/min/mL during the intervention period (p=0.040) was presented in non-hyperuricaemic participants. CONCLUSIONS: DC had a significant decrease of SUA during the intervention period. However, in non-HUS participants, SUA significantly increased in CC.

Quality of gout care in the emergency departments: a multicentre study.

BACKGROUND: To report on prevalence of gout flare in emergency departments and to report the quality of gout care in emergency departments and causes of admission at emergency departments. METHODS: A retrospective chart review of visits that had a primary diagnosis in gout by the International Classification of Diseases, the tenth revision, at emergency departments from 6 universities in Thailand over a 5 year period from 1 January 2012 to 31 December 2016. RESULTS: Six hundred thirty-two visits were included to the study. Prevalence of gout flare in emergency departments was 0.04. Only 29.3% of the visits had arthrocentesis. 628/632 (99.4%) and 519/585 (88.7%) of the visits were prescribed medications in emergency departments and had home medications, respectively. Although all visits that were prescribed colchicine in emergency departments received adequate doses of colchicine, it was also found that more than 2.4 mg/day of colchicine was prescribed (3/394, 0.8%) for home medications. In addition, 183/343 (53.4%) of the visits with normal renal function were prescribed non-steroidal anti-inflammatory drugs (NSAIDs). However, prescribed NSAIDs in abnormal renal function (42/343, 12.2%) was also found. The interruption of dosing, including increase, decrease, addition or discontinuance of urate lowing therapy in a gout flare period was 42/632 (6.6%). The most common cause of admission was acute gouty arthritis (31/47, 66.0%). CONCLUSIONS: Quality of gout care in the emergency departments was not good. Inappropriate management of gout flare in emergency departments was demonstrated in our study, particularly with regard to investigations and pharmacological management. Gaps between clinicians and guidelines, the knowledge of clinicians, and overcrowding in emergency departments were hypothesized in the results.

A Study of Interleukin-2 Production and Nck Adaptor Molecule Gene Expression in Systemic Lupus Erythematosus Patients.

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease. The cause of the disease is related to multiple factors and involves immune responses. To the best of our knowledge, the relationship between the production of interleukin-2 (IL-2) and Nck adaptor molecule gene expression by lymphocytes in patients with SLE has not been studied. Objective: Assess the association between IL-2 levels and Nck mRNA gene expression in CD3/CD28 and PHA/PMA stimulated peripheral blood mononuclear cells (PBMCs) from SLE patients compared with those from healthy donors. Material and Method: The present study included 35 SLE patients and six healthy blood donors. Blood samples from these subjects were isolated to obtain PBMCs. Then Nck mRNA gene expression from these cells were quantitatively assessed using real-time reverse-transcriptase polymerase chain reaction (real-time RT-PCR). After stimulation of the PBMCs either with CD3/CD28 antibodies or PHA/PMA, IL-2 production and CD69 expression were assessed by enzyme-linked immunosorbent assay (ELISA) and flow cytometry, respectively. Results: First, a defect in IL-2 levels was not observed in either CD3/CD28 or PHA/PMA stimulated PBMCs when compared with controls. Second, there was no difference in the Nck1 and Nck2 mRNA expression between the SLE patients and the healthy subjects. Conclusion: We found that in SLE patients lymphocyte production of IL-2 did not decrease when compared with that of normal subjects. The Nck1 and Nck2 mRNA expression was not defective in SLE patients. We did not see any altered relation between IL-2 levels and Nck1 and Nck2 gene expression.