Letter to the Editor
Frequency of Gout According to the Perception of Physicians in México
Frecuencia de la gota según la percepción de los médicos en México
Sergio García-Méndez, Roberto Arreguín-Reyes, Omar López-López, Janitzia Vázquez-Mellado
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Servicio de Reumatología, Hospital General de México, Mexico
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OA (osteoarthritis), RA (rheumatoid arthritis), FM (fibromyalgia), SLE (systemic lupus erythematosus) and AS (ankylosing spondylitis).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Prevalence studies may underestimate the frequency of some chronic diseases such as gout, as they are asymptomatic for long periods of time; several articles have reported that osteoarthritis (OA) and rheumatoid arthritis (RA) are the most prevalent rheumatic diseases.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> In an epidemiological study in our country, in which the COPCORD methodology was used, a prevalence of 10.5% and 1.6% for OA and RA was reported, respectively, whereas the prevalence of gout in this report was 0.3%.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Reports of incidence in other countries suggest that gout is the most common inflammatory joint disease, in contrast to some studies that indicate other methodology.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> In our country, there is no epidemiological data on the incidence of various rheumatic diseases, but we have the perception that some of them are more common than others.</p><p id="par0010" class="elsevierStylePara elsevierViewall">With this in mind, we interviewed 111 doctors, asking them the number of persons among their “known”-first-or second-degree family members, political family and friends, who had the diagnosis of OA, fibromyalgia (FM), RA, lupus erythematosus (SLE), ankylosing spondylitis (AS) or gout. Statistical analysis was performed using descriptive statistics.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The physicians who responded to the survey were 57 men/54 women, 45 (40.5%) medical residents, mainly of internal medicine (17), rheumatology (5) and gastroenterology (4); 37 (33.3%) were medical specialists, of which 29.7% saw musculoskeletal diseases, 70.3% are internists or related subspecialists (9 internists, 2 endocrinologists and 2 geriatricians); finally, 24 (21.6%) were general practitioners and 5 (4.5%) family physicians, with a mean age<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation 30.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.7 years. As perceived by the respondents, 85.5% had at least one family member/friend with one of the diseases mentioned. Each respondent had, on average, 4.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.2 (median 2) family/friends with one of the diagnoses. As expected, OA was the most common rheumatic disease followed by gout, RA, FM, SLE and AS (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The respondents knew 1.3 times more patients with gout among family and friends than someone diagnosed with RA; in addition, we found that there were 1.38, 1.7 and 3.75 times more patients with gout than those observed with FM, SLE and AS, respectively.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The reported differences in the frequency of gout are related to the methodology, the type of study and the approach to diagnosis. It is also possible that these differences are related to the characteristics of the disease, since, unlike the OA and RA, gout has episodic clinical manifestations and may remain asymptomatic for long periods of time. In the various studies, the diagnosis is established variably, either by patient self-report, clinical databases and drug use, evaluation by a family doctor, internist or rheumatologist. Sometimes the diagnosis can be challenging for primary care physicians; the preliminary criteria of the American College of Rheumatology<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> have been evaluated in several studies and have shown great limitations.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">There are at least 5 proposals for the clinical diagnosis of gout, including 2 very recent,<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10,11</span></a> but both have some controversial points<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> and these are taken as the basis for a multicenter, multinational study being done in order to propose clinical criteria for the classification of gout that may be used by different studies and primary care physicians.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Surely, improved detection of this disease will be crucial in the reports of its frequency.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-04-08" "fechaAceptado" => "2013-06-02" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García-Méndez S, Arreguín-Reyes R, López-López O, Vázquez-Mellado J. Frecuencia de la gota según la percepción de los médicos en México. Reumatol Clin. 2014;10:197–198.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 854 "Ancho" => 1641 "Tamanyo" => 60019 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Frequency of rheumatic diseases as perceived by physicians. OA (osteoarthritis), RA (rheumatoid arthritis), FM (fibromyalgia), SLE (systemic lupus erythematosus) and AS (ankylosing spondylitis).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of gout and hyperuricemia: a long-term population study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.P. Hall" 1 => "P.E. Barry" 2 => "T.R. Dawber" 3 => "P.M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 2 | 9 |
| 2024 October | 50 | 26 | 76 |
| 2024 September | 54 | 18 | 72 |
| 2024 August | 49 | 32 | 81 |
| 2024 July | 62 | 39 | 101 |
| 2024 June | 62 | 32 | 94 |
| 2024 May | 60 | 33 | 93 |
| 2024 April | 50 | 26 | 76 |
| 2024 March | 44 | 26 | 70 |
| 2024 February | 35 | 22 | 57 |
| 2024 January | 42 | 32 | 74 |
| 2023 December | 19 | 27 | 46 |
| 2023 November | 49 | 33 | 82 |
| 2023 October | 47 | 28 | 75 |
| 2023 September | 60 | 40 | 100 |
| 2023 August | 41 | 15 | 56 |
| 2023 July | 40 | 25 | 65 |
| 2023 June | 38 | 32 | 70 |
| 2023 May | 55 | 18 | 73 |
| 2023 April | 23 | 9 | 32 |
| 2023 March | 52 | 31 | 83 |
| 2023 February | 43 | 24 | 67 |
| 2023 January | 32 | 17 | 49 |
| 2022 December | 41 | 29 | 70 |
| 2022 November | 36 | 28 | 64 |
| 2022 October | 47 | 21 | 68 |
| 2022 September | 41 | 30 | 71 |
| 2022 August | 33 | 35 | 68 |
| 2022 July | 34 | 35 | 69 |
| 2022 June | 42 | 33 | 75 |
| 2022 May | 30 | 43 | 73 |
| 2022 April | 43 | 42 | 85 |
| 2022 March | 26 | 41 | 67 |
| 2022 February | 34 | 39 | 73 |
| 2022 January | 56 | 41 | 97 |
| 2021 December | 23 | 49 | 72 |
| 2021 November | 36 | 52 | 88 |
| 2021 October | 33 | 48 | 81 |
| 2021 September | 32 | 37 | 69 |
| 2021 August | 31 | 38 | 69 |
| 2021 July | 21 | 32 | 53 |
| 2021 June | 43 | 45 | 88 |
| 2021 May | 36 | 36 | 72 |
| 2021 April | 53 | 57 | 110 |
| 2021 March | 50 | 35 | 85 |
| 2021 February | 23 | 15 | 38 |
| 2021 January | 21 | 10 | 31 |
| 2020 December | 27 | 18 | 45 |
| 2020 November | 25 | 19 | 44 |
| 2020 October | 27 | 10 | 37 |
| 2020 September | 39 | 20 | 59 |
| 2020 August | 36 | 20 | 56 |
| 2020 July | 22 | 16 | 38 |
| 2020 June | 38 | 25 | 63 |
| 2020 May | 47 | 12 | 59 |
| 2020 April | 50 | 21 | 71 |
| 2020 March | 27 | 8 | 35 |
| 2020 February | 1 | 0 | 1 |
| 2018 May | 4 | 1 | 5 |
| 2018 April | 48 | 7 | 55 |
| 2018 March | 42 | 7 | 49 |
| 2018 February | 24 | 13 | 37 |
| 2018 January | 16 | 7 | 23 |
| 2017 December | 34 | 13 | 47 |
| 2017 November | 27 | 7 | 34 |
| 2017 October | 26 | 5 | 31 |
| 2017 September | 28 | 4 | 32 |
| 2017 August | 30 | 13 | 43 |
| 2017 July | 27 | 13 | 40 |
| 2017 June | 46 | 15 | 61 |
| 2017 May | 50 | 14 | 64 |
| 2017 April | 33 | 11 | 44 |
| 2017 March | 22 | 11 | 33 |
| 2017 February | 38 | 13 | 51 |
| 2017 January | 28 | 7 | 35 |
| 2016 December | 62 | 18 | 80 |
| 2016 November | 41 | 16 | 57 |
| 2016 October | 65 | 22 | 87 |
| 2016 September | 81 | 20 | 101 |
| 2016 August | 50 | 16 | 66 |
| 2016 July | 40 | 23 | 63 |
| 2015 December | 2 | 0 | 2 |
| 2015 September | 2 | 0 | 2 |
| 2015 August | 2 | 0 | 2 |
| 2015 July | 12 | 6 | 18 |
| 2015 June | 33 | 22 | 55 |
| 2015 May | 55 | 28 | 83 |
| 2015 April | 72 | 15 | 87 |
| 2015 March | 61 | 12 | 73 |
| 2015 February | 51 | 17 | 68 |
| 2015 January | 53 | 31 | 84 |
| 2014 December | 33 | 21 | 54 |
| 2014 November | 28 | 24 | 52 |
| 2014 October | 32 | 25 | 57 |
| 2014 September | 28 | 15 | 43 |
| 2014 August | 25 | 9 | 34 |
| 2014 July | 25 | 16 | 41 |
| 2014 June | 50 | 30 | 80 |
| 2014 May | 25 | 15 | 40 |
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