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(See Figure 4 for overall approach to treatment and prevention of gout.) Treatments used for prevention, such as allopurinol (see below) can actually make things worse if given during a flare, and so need to be held back until the flare has resolved for several weeks

The wall technique described earlier, angling the needle so water trickles down the glass before contacting powder, eliminates this impact damage

The process is fast, and any soreness fades quickly

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The secret lies in a specific enzyme called NNMT (Nicotinamide N-methyltransferase)