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Background:\ud Febuxostat and allopurinol are urate-lowering therapies used to treat patients with gout. Following concerns about the cardiovascular safety of febuxostat, the European Medicines Agency recommended a post-licensing study assessing the cardiovascular safety of febuxostat compared with allopurinol.\ud \ud Methods:\ud We did a prospective, randomised, open-label, blinded-endpoint, non-inferiority trial of febuxostat versus allopurinol in patients with gout in the UK, Denmark, and Sweden. Eligible patients were 60 years or older, already receiving allopurinol, and had at least one additional cardiovascular risk factor. Those who had myocardial infarction or stroke in the previous 6 months or who had severe congestive heart failure or severe renal impairment were excluded. After a lead-in phase in which allopurinol dose was optimised towards achieving a serum urate concentration of less than 0·357 mmol/L (

Clinical metrologists have been employed in Leeds for the past seven years. They have come to assume increasing responsibility, particularly in the conduct and recording of clinical trials in the rheumatic diseases. Their work can be extended to the planning of trials, practical procedures, and other research activities. Analysis of 20 applications for a post that recently fell vacant at Leeds suggests that many married women, highly qualified professionally, who have completed their families, would welcome the opportunity to return to part- time nursing duties in "social hours". Increased responsibility and job satisfaction provided by the post compensate for a reduction in salary. Clinical metrology may be a new career grade in the National Health Service that allows for more careful monitoring of patients with a constancy that cannot be achieved with rotating junior medical staff. Physicians can be released from the routine of follow-up, so that they have more time for diagnosis, management of complex problems, and research.