Gout is a chronic metabolic disease, characterized by joint inflammation caused by monosodium urate monohydrate crystals. The main objective of this study was to identify the prevalence of gout in a rheumatology department in Romania and secondary to describe the characteristics of patients diagnosed with this condition, with emphasis on the comorbidities. This is a longitudinal, retrospective study on 280 patients from the Department of Internal Medicine and Rheumatology, Dr I Cantacuzino Hospital, from January 2017 to May 2019, diagnosed with chronic or acute gout. The prevalence of gout in our hospital in 2 years period was 0.97%. Gouty attack was diagnosed in 38.2% of cases, while 61.8% were evaluated for chronic gout. Male frequency was 69.6%, alcohol consummation was observed in more than half of the cohort (53.2%) and 72.1% were retired persons. The most frequent comorbidity was hypertension (HBP) (82.1%) followed by dyslipidemia (65.3%), atherosclerotic disease(ATS) (55.0%) and chronic kidney disease (53.9%). There was a significant association between HBP, ATS and dyslipidemia with chronic gout (p=0.038, p=0.022 and p=0.009, respectively). The rate of gouty attack significantly increased with the serum level of uric acid (p<0.001). The therapeutic approach complies with international recommendations.

The intestinal microflora consists of micro-organisms (bacteria required for normal functioning of the digestive tract), which are interacting with the human body (commensalism), the digestive tract is the habitat required for the development of these bacteria, and these, in turn, produce the constituents necessary for the organism. Disruption of this balance makes some ordinary saprophytic species to become pathogenic.
Clostridium difficile(CD), gram positive bacillus, anaerobic, sporulated, enters into the structure of normal enteric resident flora in a proportion of 60-70% in newborns, 10 to 30% in hospitalized patients, and only 3% in healthy adults (1). If this flora is iatrogenic depressed by antibiotic therapy, chemotherapy, inhibitors of gastric acidity, CD wins "vital space"
by multiplying causes damage to the intestinal mucosa and subsequently, on the background of comorbidities, gives the lead of severity to the clinical evolution.