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In situations where the normality assumption does not hold, it becomes imperative to explore alternative distributions, such as those characterized by heavy tails (e.g., t distributions) or skewness (e.g., gamma distributions), in order to more accurately capture the characteristics of observed data

Therefore, gout in premenopausal women should trigger a search for renal disease, in particular analgesic-abuse nephropathy or other interstitial nephropathies