Changing paradigms in the management of gout

The incidence and prevalence of gout have increased, as have comorbid obesity, diabetes mellitus, hypertension, chronic kidney and cardiovascular disease. Gout is now the commonest type of inflammatory arthritis despite availability of safe, effective and potentially ‘curative’ urate-lowering drugs. Modern imaging studies show that gout is a chronic inflammatory crystal deposition disorder even at the first acute attack and they illuminate the need to eliminate urate crystals by continuing reduction of the serum urate below its solubility threshold.

Scottish Intercollegiate Guidelines Network: the first 15 years (1993–2008)

The Scottish Intercollegiate Guidelines Network (SIGN) was established in 1993. One of the first national programmes of evidence-based clinical practice guidelines, it has played a lead role internationally in many of the developments in guideline methodology. The challenges faced from the beginning of the organisation up to its integration into the National Health Service and how they were addressed are set out and related to SIGN’s contribution to the Scottish tradition of medical education.

Scottish Intercollegiate Guidelines Network: the first 15 years (1993–2008)

The Scottish Intercollegiate Guidelines Network (SIGN) was established in 1993. One of the first national programmes of evidence-based clinical practice guidelines, it has played a lead role internationally in many of the developments in guideline methodology. The challenges faced from the beginning of the organisation up to its integration into the National Health Service and how they were addressed are set out and related to SIGN’s contribution to the Scottish tradition of medical education.