Treating gout - can hypouricemia produced by moderate doses of combined oral treatment give early treatment success? Preliminary observations.

Six male patients with gout were treated with combined oral medication (febuxostat, 120 mg/d, and benzbromarone, 50 or 100 mg/d), aiming at a more rapid success of uric acid lowering treatment (ULT) compared to guideline suggestions. By combined oral medication in moderate dosage, the sUA was reduced to <2 mg/dl in all cases. We conclude that, by the treatment schedule outlined, the majority of patients with gout can be cured within 1 - 2 years, with uricase treatment being necessary very rarely only.

Reflective practitioners: The importance of critical thought for change agents.

Investment of resources in international development continues to grow, but evidence suggests that progress is patchy and that parameters such as losses resulting from disasters of all scales continue to grow. It is suggested that critical thought and reflection, as an adjunct to action, is vital for both individuals and organisations concerned for social development. It is further argued that disruption is often required in order to dynamically pursue transformation of structures and institutions in order to secure progress towards sustainable livelihoods.