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Gout is a form of arthritis that typically comes on suddenly, causing intense joint pain, especially in the feet, ankles, wrists, or fingers. It is caused by the accumulation of urate crystals in the joint. Whereas normally, uric acid dissolves in the bloodstream and passes out of the body in the urine, at times, uric acid builds up, forming crystals. A diet rich in the foods that increase levels of uric acid—meat, seafood, fructose—may be a risk factor for gout.
It now appears that nurse-led treatments focusing on lifestyle may provide significant aid for gout patients. Medical treatment for gout has usually involved pain relievers and corticosteroids. In addition, doctors may prescribe uric acid inhibitors for patients who have recurrent gout attacks. A recent British study indicates that nurse-led care, which includes holistic education, lifestyle advice, and some form of urate-lowering therapy, is not only cheaper but also more successful than the usual physician-led treatment. Nurses were thoroughly trained in the causes and management of gout and were encouraged to include patients in decisions involving their own treatment. After two years, outcomes largely favored the nurse-led patients.

Gout is a form of arthritis that typically comes on suddenly, causing intense joint pain, especially in the feet, ankles, wrists, or fingers. It is caused by the accumulation of urate crystals in the joint. Whereas normally, uric acid dissolves in the bloodstream and passes out of the body in the urine, at times, uric acid builds up, forming crystals. A diet rich in the foods that increase levels of uric acid—meat, seafood, fructose—may be a risk factor for gout.
It now appears that nurse-led treatments focusing on lifestyle may provide significant aid for gout patients. Medical treatment for gout has usually involved pain relievers and corticosteroids. In addition, doctors may prescribe uric acid inhibitors for patients who have recurrent gout attacks. A recent British study indicates that nurse-led care, which includes holistic education, lifestyle advice, and some form of urate-lowering therapy, is not only cheaper but also more successful than the usual physician-led treatment. Nurses were thoroughly trained in the causes and management of gout and were encouraged to include patients in decisions involving their own treatment. After two years, outcomes largely favored the nurse-led patients.

In California, three paint manufacturers recently settled a 19-year lawsuit for $305 million. Their crime (to which they did not admit) was marketing lead paint while knowing its toxicity. It was a surprising ending for many who believed that because the companies sold the paint prior to the government ban on its use, they could not be held liable for its harmful effects years afterward. The money will be used by municipalities to mitigate lead hazards in older homes, inspecting, evaluating, and removing paint where warranted. The funds are expected to be quickly depleted; there are thousands of such houses, and each could cost over $1,000 to remediate.
Even small amounts of lead in the body can result in serious health problems, but the symptoms are often difficult to associate with lead. In young children, lead exposure can cause brain damage leading to developmental delays, seizures, fatigue, or irritability. Adults may experience high blood pressure, muscle pain, or memory loss. Pregnant women exposed to lead over time are prone to miscarriages and stillbirths.
Although lead paint has been banned in the United States since 1978, and U.S. manufacturers stopped using lead-soldered cans in 1991, older buildings still have lead pipes, and lead may appear in bullets or batteries as well as in some pottery and toys made overseas. A major lead disaster occurred in 2015 when tests indicated dangerous lead levels in residents’ water in Flint, Michigan. In that case, lead leached from the water pipes when the state failed to treat the water with an anticorrosive agent. It took months for the city to declare a state of emergency, during which time thousands of children and adults had been poisoned.

States offer a variety of home and community-based services aimed at enabling seniors to remain in their homes rather than transitioning to assisted-living or nursing homes. Caregiver and respite services are available in most states. Senior Companion or Friendly Visitor Programs are designed to provide social interaction for seniors. Volunteers, usually older retirees, visit the senior for conversation or simple recreational activities. In addition to preventing the isolation that often poses a mental and physical health risk to seniors, companions may alert families and doctors to new and potentially troubling health conditions.
Local offices for aging typically provide short- or long-term assistance with household chores. They offer transportation services to medical appointments, pharmacies, or grocery stores. For low-income seniors or seniors on fixed incomes, home repair assistance and heating or cooling assistance are available. Seniors who require wheelchairs may request modifications such as ramps and grab bars to make their homes more accessible.
By the year 2030, one in five Americans will be retirement age, and seniors will outnumber children for the first time in history. The state resources provided for our older relatives will become increasingly important as the population ages.

Most nail abnormalities are innocuous, but some may be clues to underlying health problems. Everyone should be alert to changes in the color, shape, or texture of his or her nails. Nails may provide an early warning sign to serious illness. White nails may indicate liver problems, especially when they are accompanied by yellowish skin on the fingers.
Yellow nails, on the other hand, usually just mean you have a treatable fungal infection. Pale nails can be a sign of anemia, whereas blue nails usually mean a lack of oxygen due to a lung or heart problem. If your usually smooth nails become pitted, this could be a sign of rheumatoid or psoriatic arthritis. If they are indented and soft, you may have a serious iron deficiency. If normally healthy nails suddenly crack and split, you may need to get your thyroid checked. Dark lines under the nail may indicate the deadly skin cancer, melanoma.
Any unusual changes in your nails should lead you to make an appointment with your general practitioner or with a dermatologist. Your nails may be trying to tell you something about what’s going on in the rest of your body.