Adrenal Insufficiency - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

ADRENAL

INSUFFICIENCY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Adrenal Insufficiency: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00030-X 1. Adrenal Insufficiency-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on adrenal insufficiency. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON ADRENAL INSUFFICIENCY ........................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Adrenal Insufficiency.................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 14 The National Library of Medicine: PubMed ................................................................................ 15 CHAPTER 2. NUTRITION AND ADRENAL INSUFFICIENCY .............................................................. 59 Overview...................................................................................................................................... 59 Finding Nutrition Studies on Adrenal Insufficiency................................................................... 59 Federal Resources on Nutrition ................................................................................................... 60 Additional Web Resources ........................................................................................................... 60 CHAPTER 3. ALTERNATIVE MEDICINE AND ADRENAL INSUFFICIENCY ........................................ 63 Overview...................................................................................................................................... 63 National Center for Complementary and Alternative Medicine.................................................. 63 Additional Web Resources ........................................................................................................... 68 General References ....................................................................................................................... 69 CHAPTER 4. BOOKS ON ADRENAL INSUFFICIENCY ........................................................................ 71 Overview...................................................................................................................................... 71 Book Summaries: Federal Agencies.............................................................................................. 71 Chapters on Adrenal Insufficiency............................................................................................... 74 CHAPTER 5. PERIODICALS AND NEWS ON ADRENAL INSUFFICIENCY ........................................... 75 Overview...................................................................................................................................... 75 News Services and Press Releases................................................................................................ 75 Academic Periodicals covering Adrenal Insufficiency ................................................................. 77 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 81 Overview...................................................................................................................................... 81 NIH Guidelines............................................................................................................................ 81 NIH Databases............................................................................................................................. 83 Other Commercial Databases....................................................................................................... 85 APPENDIX B. PATIENT RESOURCES ................................................................................................. 87 Overview...................................................................................................................................... 87 Patient Guideline Sources............................................................................................................ 87 Finding Associations.................................................................................................................... 89 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 91 Overview...................................................................................................................................... 91 Preparation................................................................................................................................... 91 Finding a Local Medical Library.................................................................................................. 91 Medical Libraries in the U.S. and Canada ................................................................................... 91 ONLINE GLOSSARIES.................................................................................................................. 97 Online Dictionary Directories ..................................................................................................... 97 ADRENAL INSUFFICIENCY DICTIONARY............................................................................ 99 INDEX .............................................................................................................................................. 145

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with adrenal insufficiency is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about adrenal insufficiency, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to adrenal insufficiency, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on adrenal insufficiency. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to adrenal insufficiency, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on adrenal insufficiency. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON ADRENAL INSUFFICIENCY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on adrenal insufficiency.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and adrenal insufficiency, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “adrenal insufficiency” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Supplemental Corticosteroids for Dental Patients with Adrenal Insufficiency: Reconsideration of the Problem Source: JADA. Journal of the American Dental Association. 132: 1580-1587. November 2001. Contact: Available from American Dental Association. ADA Publishing Co, Inc., 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2867. Website: www.ada.org. Summary: Dental patients with primary or secondary adrenal insufficiency (AI) may be at risk of experiencing adrenal crisis during or after invasive dental procedures. Since the mid 1950s, supplemental steroids in rather large doses have been recommended for patients with AI to prevent adrenal crisis. This continuing education article reports on a

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study undertaken to evaluate the need for supplemental steroids in these patients. In this study, the authors searched the literature from 1966 to 2000 using MEDLINE and textbooks for information that addressed AI and adrenal crisis in dentistry. Reference lists of relevant publications and review articles also were examined for information about the topic. The review identified only four reports of purported adrenal crisis in dentistry. Factors associated with the risk of adrenal crisis included the magnitude of surgery, the use of general anesthetics, the health status and stability of the patient, and the degree of pain control. The limited number of reported cases strongly suggests that adrenal crisis is a rare event in dentistry, especially for patients with secondary AI, and most routine dental procedures can be performed without glucocorticoid supplementation. 2 figures. 1 table. 62 references.

Federally Funded Research on Adrenal Insufficiency The U.S. Government supports a variety of research studies relating to adrenal insufficiency. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to adrenal insufficiency. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore adrenal insufficiency. The following is typical of the type of information found when searching the CRISP database for adrenal insufficiency: •

Project Title: A PANHYPOPITUTITARY MOUSE MUTATION Principal Investigator & Institution: Camper, Sally A.; Professor; Human Genetics; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-APR-1993; Project End 30-JUN-2007 Summary: (provided by applicant): Ames (df) dwarf mice provide an entree for understanding the molecular events that regulate pituitary gland organogenesis. Mutants exhibit panhypopituitarism, or multiple pituitary hormone deficiency, failing to produce adequate amounts of prolactin, growth hormone, thyroid stimulating hormone, or gonadotropins. A missense mutation in the homeodomain of the transcription factor Propi is responsible for the defect. This partial loss of function mutation affects development of the pituitary gland early in organogenesis, causing cytodifferentiation failure of several cell types that ultimately results in a hypocellular anterior pituitary lobe. PROP1 mutations cause multiple pituitary hormone deficiency in humans as well, although the phenotype is variable, occasionally involving loss of adrenocorticotropin production. Using genetic engineering in mice we generated both

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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null and gain of function alleles of Prop. Homozygotes for the null allele exhibit lethality with 50% penetrance, which may result from adrenal insufficiency, as observed in some human pedigrees with PROP1 mutations. Propi expression is normally restricted to a short window of pituitary development, and prolonged expression causes transient hypogonadism and delayed puberty due to delayed differentiation of pituitary gonadotropin producing cells. In addition, mice with this gain of function allele develop adult onset hypothyroidism and have increased risk of pituitary adenomas. Pituitary adenomas are the most common type of intracranial tumor in humans, although little is known about the genetic changes that lead to adenoma formation. We have delineated many of the sequential steps in the commitment process of organogenesis, placing Prop 1 in the genetic hierarchy relative to several other critical homeobox genes. During the next grant cycle we propose to characterize the Propi null allele to discover the basis for the failure of cytodifferentiation. We will dissect the interactions of Propi with pituitary transcription factors and secreted signaling molecules that are important in early development using genetics, explant and cell culture, DNA sequence analysis, and differential expression analysis. These studies will expand our understanding of pituitary organogenesis and tumorigenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ADRENAL INSUFFICIENCY AFTER MODERATE&SEVERE HEAD INJURY Principal Investigator & Institution: Cohan, Pejman E.; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 905022052 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Pituitary function is rarely considered in the care of patients with traumatic brain injury (TBI). Yet, TBI poses significant risk to pituitary function given the gland's encasement within the sella, its delicate infundibularhypothalamic structures and vulnerable vascular supply. Autopsy studies of fatal head injury victims confirm that up to one-third of patients sustain acute pituitary necrosis. The investigators and other investigators have documented chronic pituitary failure in long-term follow up studies of TBI subjects. The purpose of this study is to define acute post-traumatic changes in the hypothalamic-pituitary adrenocortical axis given that this hormonal axis is essential for survival, particularly in times of critical illness such as head injury. The major hypotheses to be tested in this study are: 1) a significant proportion of TBI victims suffer from unrecognized ASAI; 2) that ASAI results primarily from hypothalamic-pituitary hypoperfusion; 3) that the consequences of ASAI are systemic hypotension, increased vasopressor requirements and increased levels of serum and cerebrospinal fluid (CSF) proinflammatory cytokines; and 4) that treatment of individuals with ASAI with acute stress doses of glucocorticoids will improve blood pressure control, decrease CSF cytokine levels, shorten intensive care unit stay and improve neurological outcome. To test these hypotheses, they will first compare serial serum cortisol and ACTH levels over the first 10 days after injury in TBI versus matched non-TBI multiple trauma subjects to define ASAI. Next, TBI patients found to have inappropriately low cortisol levels that met criteria of ASAI, will be randomized to 48 hours of placebo or hydrocortisone therapy and changes in hemodynamics, cytokine levels, and neurological outcome will be measured. Pituitary/hypothalamic magnetic resonance imagings (MRIs) will be performed to assess for acute structural lesions and chronic pituitary volumetric changes. By diagnosing and treating acute traumatic neuroendocrine deficiency, this study may lead to dramatically improved management and neurological outcome of many future TBI patients. This proposal will help the

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candidate develop the theoretical and practical research skills necessary for an independent career in clinical investigation. The project will be done at two scientifically rich institutions supported by two GCRCs under the guidance of two experienced mentors from two different subspecialties appropriate for the study and the candidate's career development. Formal research instruction via the K30 Graduate Program at UCLA and courses at Harbor UCLA will complement the candidate's firm background in clinical medicine and endocrinology and enable him to successfully pursue a career as a clinical investigator in the field of neuroendocrinology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AMYLOIDOSIS

ADRENAL

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Principal Investigator & Institution: Berk, John; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BENZODIAZEPINE RECEPTOR AND ADRENAL DEVELOPMENT Principal Investigator & Institution: Widmaier, Eric P.; Professor; Biology; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2002; Project Start 01-MAY-1999; Project End 30-APR-2004 Summary: The objectives of this application are to elucidate the role of the peripheraltype benzodiazepine receptor (PBR) in maturation of the adrenal glands, and to determine mechanisms of regulation of this receptor. PBR is expressed in all steroidogenic cells, including gonads, adrenals, placenta, and brain (glia), where it is believed to mediate transport of cholesterol to the inner mitochondrial membrane, the site of enzymes needed to convert cholesterol to pregnenolone. Inability to transfer cholesterol to the inner membrane is associated with decreased steroidogenesis. Since this is the rate-limiting step in steroidogenesis, it is critical that this process be fully understood if new and better therapeutic approaches to disorders of adrenal pathology (e.g., adrenal insufficiency or hypertrophy) are to be developed. Studies on regulation of this important receptor in have been hindered by the lack of a normal cell or animal model in which the receptor is expressed at low levels. The neonatal rat is a model of ACTH-insensitivity, since during this period adrenocortical cells respond weakly to ACTH (10 percent of adult levels). Insensitivity to ACTH is also observed in fetuses of larger mammals, and prevents neurotoxic effects of high levels of glucocorticoids on developing brain cells. Because adrenal insufficiency is the primary cause of morbidity and mortality in premature infants (glucocorticoids are required for induction of surfactant expression in fetal lungs), the process by which the developing adrenal gland matures is of great significance. Recent findings demonstrate that neonatal rat adrenals express PBR at 10 percent the level in adult adrenals. Thus, it is proposed to characterize the complete developmental profile of PBR and other factors suggested to be important in cholesterol transport, and correlate this with changes in adrenocortical sensitivity to ACTH in vivo and in vitro. PBR expression will be determined by immunoblot, Northern blot, in situ hybridization, and ligand binding assays from fetal life through weaning. The effects of chronic treatment with ACTH or cAMP on cholesterol transport, PBR expression, and steroidogenesis in vivo and in cultured neonatal adrenal cells will be examined. The ability of transfected PBR to restore ACTH sensitivity in cultured

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neonatal cells will also be examined. The ontogenic appearance of PBR ligands will be determined by radioimmunoassay. These studies, therefore, will simultaneously address two important questions: What are the factors that limit steroidogenesis in immature adrenal glands, and which factors regulate expression of PBR? Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CAH: CALCIUM CHANNELS AS THERAPEUTIC TARGETS Principal Investigator & Institution: Loechner, Karen J.; Pediatrics; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2004; Project Start 01-FEB-2004; Project End 31-JAN-2009 Summary: (provided by applicant): This K08 application under the co-mentorship of Drs. Bob Rosenberg and Gerry Oxford has two goals: 1) to understand the cellular mechanisms that underlie coupling of voltage-activated calcium channels to regulated peptide secretion in the anterior pituitary, and 2) to assess the clinical impact of targeted calcium channel blockade in Congenital Adrenal Hyperplasia (CAH), a disorder resulting from pituitary hypersecretion. In studies of a pituitary corticotroph cell line (AtT-20) I identified three distinct high voltage-activated calcium channels that are expressed in similar abundance. Despite this, only the L-type [dihydropyridine (DHP)sensitive] channel is capable of triggering calcium-dependent secretion of ACTH. The primary focus of this proposal, therefore, is to examine the mechanisms that underlie the coupling of DHP-sensitive channels to ACTH release. I hypothesize that differential localization of the L-type channels accounts for the distinct function of the neurosecretory apparatus in ACTH-secreting cells. I propose to: a) examine the cellular sites of calcium channels and synaptic components using immunocytochemistry/ confocal microscopy, and b) disrupt coupling using a dominant-negative approach. In CAH, the most common adrenal disorder in children, a molecular defect in cortisol production removes normal negative feedback to the anterior pituitary and results in elevated ACTH secretion. Elevated ACTH further increases cortisol precursors, and shunts these steroid intermediates to androgen synthetic pathways. The clinical stigmata (e.g., ambiguous genitalia, virilization and short stature in adults) are due to the excess in androgens. Treatment requires life-long glucocorticoid replacement to restore the normal feedback mechanism. Determining the "optimal level" ofglucocorticoid replacement, however, is difficult: under-treatment leads to adrenal insufficiency and androgen excess; over-treatment leads to glucocorticoid excess (e.g., obesity, glucose intolerance and osteopenia). My work with the pituitary cells in culture suggests that selective pharmacologic blockade of L-type (DHP-sensitive) channels, and, in turn, attenuation of ACTH release, will provide a novel adjunct therapy by allowing lower glucocorticoid dosing. This would result in enhanced linear growth and improved bone mineral density. These basic research and clinical studies complement one another, and together, they should enhance our understanding of the cellular mechanisms underlying peptide secretion. Furthermore, they may allow for improved treatment in hypersecretory conditions, such as CAH. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CELLULAR DIFFERENTIATION IN THE PREOPTIC AREA Principal Investigator & Institution: Tobet, Stuart A.; Associate Professor; Vet Biomedical Sciences; Colorado State University-Fort Collins Fort Collins, Co 80523 Timing: Fiscal Year 2003; Project Start 05-SEP-2003; Project End 31-MAY-2005

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Summary: (provided by applicant) The long-term goal of the collaborative research between the PI and the foreign collaborator is to determine the role of gonadal steroids on the sexual differentiation of brain and body during development and in adulthood. Sex differences in brain structure and function have been characterized in a number of places in several vertebrate species. However, it has been difficult to determine how genetic and epigenetic factors interact to result in sexual differentiation of the brain. Recent studies have suggested the potential importance of non-hormonal genetic mechanisms. The current aims extend the specific aims of the parent grant to determine the interaction of hormonal and genetic mechanisms for the generation of sex differences in adults. In SF-1 knockout mice the gonads regress early in embryonic development and so these mice are never exposed to endogenous gonadal steroids. Sex differences in their brains should arise only as a consequence of the different genetic background between males and females. We will use genetically disrupted mice that have been rescued from adrenal insufficiency to determine gonadal steroid dependent sexual dimorphism in the forebrain and establish the cause of sex differences in obesity in adult SF-1 knockout mice. Specifically we will examine brains from SF-1 knockout male and female mice and their littermate controls to determine what sex differences remain to account for the sex differences in activity and body weight. Brains from adult animals will be examined by histological, immunocytochemical and in situ hybridization procedures to characterize sex differences in brain structure and gene expression. Animals will be treated with either estrogen or androgen to assess the steroid responsiveness of brain circuits developed in the absence of gonadal steroids. These results will be critical from the perspective that the most widely held belief is that gonadal steroids are mostly, if not solely, responsible for sexual differentiation of the brain. The unique SF-1 knockout model system that the proposed experiments extend into adulthood will allow us to critically test the importance of gonadal steroids for brain sexual differentiation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CORTISOL, CENTRAL OBESITY, AND INSULIN RESISTANCE Principal Investigator & Institution: Purnell, Jonathan Q.; Associate Professor; Medicine; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 15-AUG-2000; Project End 31-JUL-2004 Summary: (adapted from the application) Central (visceral) obesity contributes to an excess risk of diabetes, dyslipidemia, hypertension, and premature death from coronary heart disease. A feed-back loop model of weight regulation has emerged from recent studies of animals and humans: afferent hormones signal amount of fat mass to the central nervous system; weight regulation centers in the hypothalamus interpret these signals and control efferent systems including appetite, energy expenditure, and enzymes in the fat cell, such as lipoprotein lipase, that facilitate partitioning of energy into lipid storage. It is proposed in this grant that the hypothalamic-pituitary-adrenal axis is an effector system of hypothalamic weight regulatory centers and that increased cortisol production rates in the obese state directly regulate enzyme transcription in the fat cell to promote lipid uptake and central fat distribution. Cross sectional data from lean and obese humans using stable isotope enrichment determined by mass spectroscopy demonstrate that increases in cortisol production rates across the physiological range are associated with increased adipocyte lipoprotein lipase activity, accumulation of fat mass independent of non-fat mass, increased visceral fat, and increased insulin resistance. These findings, however, do not establish whether increased cortisol production causes, or is simply associated with these variables. To

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directly test whether cortisol enhances lipid uptake, fat mass accumulation, increased visceral fat mass, and insulin resistance, it is proposed to study the effect of administration of increasing doses of hydrocortisone (including doses within the physiological replacement range) in subjects with complete adrenal failure on these parameters. Finally, leading cellular candidates for the regulation of adipocyte lipoprotein lipase gene expression and fat cell differentiation, including PPAR-gamma and C/EBP, will be measured in adipose samples from the subjects in these studies to provide a mechanistic link between peripheral signaling systems such as cortisol and the adipocyte enzymes involved with fat partitioning. These studies will not only provide insight into the mechanisms of central obesity and its metabolic consequences, they also have great importance to clinicians who care for subjects with adrenal insufficiency as to the consequences of recommended replacement doses of cortisol on risk factors for heart disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HYPOPITUITARISM AFTER MODERATE AND SEVERE HEAD INJURY Principal Investigator & Institution: Kelly, Daniel F.; Associate Professor; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 905022052 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (Verbatim from applicant's abstract) Pituitary function is rarely considered in the care of patients with traumatic brain injury (TBI). Yet, TBI poses significant risk to pituitary function given the gland's encasement within the sella, its delicate infundibular-hypothalamic structures and vulnerable vascular supply. Autopsy studies of fatal head injury victims confirm that up to one third sustain pituitary necrosis and hundreds of case reports document chronic post-traumatic pituitary failure. The longterm neurobehavioral problems that plague a majority of TBI victims are quite similar to those of patients with hypopituitarism. It is the primary hypothesis of this study that many TBI victims suffer from unrecognized pituitary dysfunction that acutely and chronically compounds the initial brain injury and limits maximal recovery. The major hypotheses being tested in this study are that i) post-traumatic pituitary failure, both acute and chronic, results primarily from a vascular insult to the pituitary gland and/or its hypothalamic-infundibular connections; ii) in the acute phase of TBI such injury can result in acute secondary adrenal insufficiency, iii) in the chronic phase of TBI such injury can result in long-term hypopituitarism, and iv) treatment of pituitary hormone deficiencies will improve neurobehavioral functioning and quality of life in the chronic post-traumatic state. These hypotheses will be tested in a three-phase study. In the first phase, acutely post-injury, subjects will undergo serial determinations of adrenocortical function to diagnose and treat acute adrenal insufficiency. Patients found to have inappropriately low cortisol levels, will be randomized to placebo or hydrocortisone therapy for 48 hours, and changes in blood pressure and vasopressor requirements will be monitored. Pituitary/hypothalamic MRIs will also be performed at 10 days and 6 months post-injury to assess for acute structural lesions and chronic pituitary volumetric changes. In the second phase, at 2 and 6 months post-injury, pituitary function tests will be performed. Hormone deficient patients will be placed on hormone replacement except for growth hormone (GH) after the 2-month time point. In the third phase, from 6 to 12 months post-injury, TBI patients with GH deficiency or GH insufficiency, who have memory impairment, concentration deficits, depression, anxiety or fatigue will be entered into a double-blind placebo-controlled GH replacement therapy trial to assess changes in these neurobehavioral and quality of life complaints. By diagnosing and

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treating both acute and chronic traumatic neuroendocrine deficiencies, this study may dramatically improve the lone-term prognosis of many TBI patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISMS OF ADRENAL DIFFERENTIATION Principal Investigator & Institution: Hammer, Gary D.; Assistant Professor; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2004; Project Start 01-FEB-2004; Project End 31-JAN-2009 Summary: (provided by applicant): The long-range objective of our laboratory is to understand the biochemical mechanisms by which cell-type specific transcription factors direct the differentiation of adrenocortical cells within the adrenal gland. Our strategy for this proposal is to focus on transcriptional regulation mediated by the orphan nuclear receptor, steroidogenic factor-1 (SF-1), a transcription factor that is required for the differentiation of the adrenal cortex. Targeted disruption of the gene encoding SF-1 (Ftzf1, Nr5a1) leads to mouse embryos that lack adrenal glands while point mutations that affect the ability of SF-1 to associate with nuclear receptor coregulators, bind DNA and ultimately activate target genes, result in adrenal insufficiency in humans. Based on our preliminary data, we hypothesize that SF-1 mediated transcriptional activation is specifically regulated by adrenocorticotropin hormone (ACTH) and involves intramolecular modifications and intermolecular protein interactions that serve to modulate transcriptional activation to ultimately control adrenal cell differentiation. Our specific aims are therefore directed towards a systematic analysis of the modification of the SF-1 transcriptional complex by ACTH. We propose to determine the major nuclear phosphoprotein targets of ACTH together with a characterization of the signaling cascades responsible for phosphorylation of components of the complex (specific aim 1), how these modifications regulate the organization of the SF-1 transcription complex (specific aim 2) and the contribution of specific phosphoprotein components of the complex to ACTH-dependent target gene activation in the adrenocortical cell (specific aim 3). We believe that the studies proposed here will provide the framework for understanding the molecular events that dictate adrenocortical cell differentiation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEUROENDOCRINE CORTICOTROPIN R

AND

BEHAVIORAL

ACTIONS

OF

Principal Investigator & Institution: Majzoub, Joseph A.; Professor; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2002; Project Start 23-JUN-1995; Project End 31-MAR-2004 Summary: The overall goal of this project is to better understand how corticotropinreleasing hormone (CRH) and other CRH-like molecules allow mammals to respond successfully to stress. Mouse models will be studied to take advantage of gene knockout and replacement methods that we and others have created. 3 broad areas will be addressed: 1. The activation during stress of endocrine responses; 2. The activation during stress of behavioral responses; and 3. The suppression during stress of appetite and reproduction. Specifically: 1. Are glucocorticoids necessary for life? Adrenal insufficiency causes death, whereas CRH-deficient mice have a normal lifespan despite extremely low (but detectable) levels of glucocorticoid. We will determine it CRH deficiency prevents death in the face of complete glucocorticoid deficiency. If so, this will show that glucocorticoids are not essential for mammalian survival. What is the

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function of the circadian rhythm in ACTH? We will test the hypothesis that the daily rise in blood ACTH in normal mice functions to maintain basal adrenal integrity by preventing adrenocortical apoptosis. What are the relative roles of CRH and vasopressin (VP) in the stress-induced and circadian activation of the pituitary adrenal axis? We will study mice with deletions in the CRH, VP or both CRH and VP genes, which will be analyzed for their hypothalamic, pituitary and adrenal responses to acute and chronic stressors, as well as to circadian cues. 2. What is the identity of the CRH receptor 1 ligand that mediates fear responses in CRH knockout mice? Is it urocortin, or a new, mammalian CRH-like peptide? 3. What is the role of CRH and related molecules in the suppression of appetite and reproduction during the stress response? Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NUCLEAR DEVELOPMENT

RECEPTOR

FUNCTION

IN

HYPOTHALAMIC

Principal Investigator & Institution: Tran, Phu V.; Physiology; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 01-SEP-2002 Summary: (provided by applicant): The ventromedial nucleus of hypothalamus (VMH) has been implicated in regulating various behaviors, including metabolic homeostasis and reproduction. Despite its important roles in normal physiology, mechanisms of VMH development remain largely unknown. However, one nuclear receptor, Steroidogenic factor 1 (SF-1) has been previously shown to be required for VMH formation. In this application, I plan to determine how SF-1 orchestrates the formation of the VMH. To do this, I will first characterize molecular markers that are known to express in the hypothalamus to define the genetic pathway of SF-1. Next, I will identify a necessary promoter sequence to recapitulate SF-1 expression in vivo. This promoter region will then be used to express GFP or lacZ reporters that would allow us to mark and trace SF-1 expressing neurons during VMH development. This information is essential to identify neurons that are specified by SF-1 function. In addition, I will attempt to specifically ablate hypothalamic neurons that are dependent on SF-1 expression. This approach should elucidate physiological functions controlled by the VMH and will eliminate the confounding effects of early lethality exhibited in SF-1 null mice due to adrenal insufficiency. In summary, these studies will help to define pathways controlling VMH development and should provide insights into innate behaviors controlled by the neuroendocrine system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROPHYLAXIS OF ADRENAL INSUFFICIENCY TO PREVENT CLD Principal Investigator & Institution: Watterberg, Kristi L.; Pediatrics; University of New Mexico Albuquerque Controller's Office Albuquerque, Nm 87131 Timing: Fiscal Year 2002; Project Start 20-SEP-2001; Project End 30-JUN-2006 Summary: (provided by applicant): Chronic lung disease (CLD) is a frequent complication of prematurity, resulting in increased health care costs, prolonged hospital stay, frequent rehospitalizations, and compromised growth and development. Early treatment with dexamethasone may decrease CLD; however, this therapy has serious immediate and long-term adverse effects. Lung inflammation is a prominent early finding in the development of CLD. At the same time, many small premature infants show biochemical evidence and clinical signs consistent with adrenal insufficiency in the first week of life. Based on the hypothesis that early adrenal insufficiency results in

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Adrenal Insufficiency

amplified responses to inflammatory stimuli, and other physiologic disruptions, leading to ongoing lung injury and CLD, a randomized, blinded, placebo-controlled pilot study of 40 extremely low birth weight infants (ELBW, 500-999 g birth weight) was conducted. This study showed that hydrocortisone prophylaxis against adrenal insufficiency during the first two weeks of life resulted in a significant increase in survival without chronic lung disease. No increases in adverse outcomes were noted; however, the pilot study was not powerful enough to rule out a Type II error. Based on that hypothesis and pilot study, this application proposes a multicenter, randomized trial of 712 ELBW births, to further define the benefits and assess the risks of hydrocortisone prophylaxis against adrenal insufficiency in these infants. Primary outcome measures will be (1) benefit: increased survival without CLD at 36 weeks postmenstrual age; (2) risk: no increase in cerebral palsy at 18 22 months adjusted age. Other measures of neurodevelopmental outcome will also be assessed. The sample size will detect a change of 10 percentage points in successful outcome, and in the incidence of specific adverse effects, with a power of 80%. The hydrocortisone dose will be 1mg/kg/day for 12 days (equivalent to <10% of the typical starting dexamethasone dose), then 0.5mg/kg/day for 3 days. Baseline data on mother and infant, daily clinical data for the first 28 days of life, outcome data at 36 weeks postmenstrual age, and outcome data at 18 - 22 months adjusted age will be collected. Cortisol and cytokines (IL-1B, 1L6, and ILS) will be assayed at baseline and at 6 days of life. After therapy, cortisol response to ACTH will be assayed. If this study confirms the benefits seen in the pilot study, it will result in a significant improvement in health care for premature infants, both by introducing a beneficial new therapy, and by avoiding higher dose dexamethasone. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROPHYLAXIS OF EARLY ADRENAL INSUFFICIENCY TO PREVENT CHRONIC LUNG DISEASE Principal Investigator & Institution: Cole, Cynthia H.; Associate Professor of Pediatrics; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SMITH-LEMLI-OPITZ SYNDROME STEROIDOGENESIS Principal Investigator & Institution: Shackleton, Cedric H.; Children's Hospital & Res Ctr at Oakland Research Center at Oakland Oakland, Ca 946091809 Timing: Fiscal Year 2002; Project Start 01-MAR-2001; Project End 28-FEB-2003 Summary: (Adapted from the applicant's Description) Smith-Lemli-Opitz syndrome (SLOS) is a devastating birth defect associated with mental retardation and multiple physical malformations. Since it is an enzymatic disorder of cholesterol synthesis (7dehydrocholesterol-7-reductase deficiency) it is likely that steroid hormone synthesis by the adrenal glands and gonads is impacted because all such compounds utilize cholesterol as precursor. SLOS patients may have quantitatively compromised steroid synthesis because of cholesterol deficiency, and in addition novel steroids with unknown pharmacological properties may be produced which retain ring B unsaturation. This application addresses such issues through a study of serum and urinary steroids. About 30 patients are routinely studied for short periods at the NIH and these will be the subjects of the study. The investigators have evidence that 7dehydrocholesterol overproduced in the disorder can act as precursor for novel C21,

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C19, and C18 steroids that are produced in adrenals and gonads. Once confirmed structures of urinary metabolites of such compounds have been obtained, it will be possible to state which (if not all) steroid biosynthetic enzymes accept 7- and 8dehydrocholesterol as precursor. Information on specific steroids produced in SLOS will permit easy diagnosis, maybe leading to future pre- and postnatal screening. Furthermore, is the quantitative production of steroid hormone metabolites reduced in SLOS? If so, does this suggest adrenal insufficiency? The investigators will measure 40 steroid metabolites in urine and relate their excretions to those of age matched controls and to serum hormone measurements obtained in a separate study. In addition, cholesterol is routinely given to SLOS patients for beneficial effect on behavior and growth. Does the cholesterol partially work through the adrenal steroid mechanism by contributing to hormonal synthesis? The investigators will measure steroid hormone metabolites before and after cholesterol administration and determine if there has been a measurable increase in hormonal metabolites concomitant with decreased dehydrometabolite excretion. Finally, if ring B dehydrosteroids are produced, is the ratio of the individual dehydrometabolites to corresponding conventional metabolites related to the dehydrocholesterol to cholesterol ratio and clinical severity? Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE ACD MOUSE: A MODEL FOR CONGENITAL ADRENAL HYPOPLASIA Principal Investigator & Institution: Keegan, Catherine E.; Pediatrics & Communicable Dis; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): A functional adrenal cortex is essential for life as evidenced by the early death of patients with congenital adrenal hypoplasia. The autosomal recessive mouse mutant adrenocortical dysplasia (acd) is a good model for the study of adrenal organogenesis and shares some striking similarities with miniature adult congenital adrenal hypoplasia in humans. Similar to human patients, mutant acd/acd animals lack an "adrenocortical X zone and possess a dysfunctional definitive zone, and the majority die shortly after birth. Serum corticosterone levels are low and ACTH levels are significantly elevated, consistent with a primary adrenal defect. The identification and characterization of the acd mutation via the following specific aims is the focus of this proposal: Aim 1. Perform a detailed characterization of acd mutant animals; Aim 2. Refinement of the genetic and physical map of the acd locus on mouse chromosome 8, and Aim 3. Clone and characterize the acd gene. The identification of the acd gene will be an important step in the understanding of both normal and abnormal adrenal growth. These studies will provide the groundwork for future investigations of abnormal adrenal development in humans and may lead to important therapeutic applications for humans with congenital adrenal insufficiency. The career development program outlined in this proposal will build on my prior research experience and will also provide for the development of new techniques, interaction with a new mentor, and additional didactic training in Developmental Biology and Bioinformatics. The educational climate at the University of Michigan is outstanding and will allow me to foster these new skills. Ultimately, through this additional training I will be poised to continue my long-term career goal of becoming an Independent Investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Adrenal Insufficiency

Project Title: VACCINE THERAPY OF CONGENITAL ADRENAL HYPERPLASIA Principal Investigator & Institution: Rivkees, Scott A.; Associate Professor; L2 Diagnostics, Llc Box 8175 New Haven, Ct 94904 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2004 Summary: (provided by applicant): Congenital virilizing adrenal hyperplasia (CAH) is caused by impaired adrenal steroidogenesis that results in reduced production of cortisol and aldosterone, and excessive production of androgens. Whereas there are consequences of reduced cortisol and aldosterone production, increased androgen is responsible for most of the adverse effects of this condition. In normal conditions and in CAH, excessive androgen production is regulated by pituitary ACTH, which acts via the melanocortin-2 receptor (MC2R) in the adrenal gland to stimulate steroid production. If activation of the MC2R can be inhibited, adrenal activity in CAH will be markedly reduced and management optimized. In this application we propose the development of a novel immunological approach for inducing adrenal insufficiency in patients with CAH by making a vaccine that inhibits ACTH-mediated activation of the MC2R. This application is based on preliminary studies showing that antibodies to the MC2R inhibit the ability of ACTH to activate MC2R function in adrenal cells. We also find that immunizing mice with synthetic peptides that correspond to small regions of the MC2R induces an immune response against the MC2R. Based on these observations, we hypothesize that it is possible to develop a "vaccine" against the MC2R that blocks ACTH action. We also hypothesize that a vaccine against the MC2R will lead to improved treatment of CAH, To test these hypotheses we propose to (1) induce immunity against the MC2R by immunizing mice with modified peptides. (2) Determine if vaccinating mice with modified MC2R peptides leads to adrenal insufficiency. We anticipate that these studies will lead to the development of a novel approach for treating patients with CAH. If these phase I studies are effective, phase II studies will focus on preclinical trials in non-human primates. We also anticipate being able to extend this novel approach to the treatment of other receptor-mediated endocrine disorders, such as hyperthyroidism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “adrenal insufficiency” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for adrenal insufficiency in the PubMed Central database:

3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Circadian rise in maternal glucocorticoid prevents pulmonary dysplasia in fetal mice with adrenal insufficiency. by Venihaki M, Carrigan A, Dikkes P, Majzoub JA.; 2000 Jun 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=16546

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Importance of Sodium Intake and Mineralocorticoid Hormone in the Impaired Water Excretion in Adrenal Insufficiency. by Ufferman RC, Schrier RW.; 1972 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=292311

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On the Role of Antidiuretic Hormone in the Inhibition of Acute Water Diuresis in Adrenal Insufficiency and the Effects of Gluco- and Mineralocorticoids in Reversing the Inhibition. by Green HH, Harrington AR, Valtin H.; 1970 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=322656

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THE HYPERCALCEMIA OF ADRENAL INSUFFICIENCY. by Walser M, Robinson BH, Duckett JW Jr.; 1963 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=289305

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with adrenal insufficiency, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “adrenal insufficiency” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for adrenal insufficiency (hyperlinks lead to article summaries): •

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A case of hypothalamic adrenal insufficiency manifested normal ACTH response to insulin-induced hypoglycemia. Author(s): Hasegawa G, Ashihara E. Source: Endocrine Journal. 2000 February; 47(1): 51-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10811293

PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A case of primary bilateral adrenal lymphoma with partial adrenal insufficiency. Author(s): Lee KS, Chung YS, Park KH, Kim HS, Kim HM. Source: Yonsei Medical Journal. 1999 June; 40(3): 297-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10412344

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A microdeletion in the ligand binding domain of human steroidogenic factor 1 causes XY sex reversal without adrenal insufficiency. Author(s): Correa RV, Domenice S, Bingham NC, Billerbeck AE, Rainey WE, Parker KL, Mendonca BB. Source: The Journal of Clinical Endocrinology and Metabolism. 2004 April; 89(4): 176772. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15070943

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A novel mutation in DAX1 causes delayed-onset adrenal insufficiency and incomplete hypogonadotropic hypogonadism. Author(s): Tabarin A, Achermann JC, Recan D, Bex V, Bertagna X, Christin-Maitre S, Ito M, Jameson JL, Bouchard P. Source: The Journal of Clinical Investigation. 2000 February; 105(3): 321-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10675358

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Abnormal response to adrenocorticotropic hormone tests in critically ill human immunodeficiency virus-infected patients: are we really dealing with adrenal insufficiency? Author(s): Beishuizen A, Spijkstra JJ, Polderman KH, J Girbes AR. Source: Critical Care Medicine. 2003 March; 31(3): 995; Author Reply 995-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12627031

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Acute adrenal insufficiency after cardiac surgery. Author(s): Serrano N, Jimenez JJ, Brouard MT, Malaga J, Mora ML. Source: Critical Care Medicine. 2000 February; 28(2): 569-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10708203

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Acute adrenal insufficiency during pregnancy and puerperium: case report and literature review. Author(s): Perlitz Y, Varkel J, Markovitz J, Ben Ami M, Matilsky M, Oettinger M. Source: Obstetrical & Gynecological Survey. 1999 November; 54(11): 717-22. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10546275

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Acute adrenal insufficiency following unilateral radical nephrectomy: a case report. Author(s): Safir MH, Smith N, Hansen L, Kozlowski JM. Source: Geriatric Nephrology and Urology. 1998; 8(2): 101-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9893218

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Acute adrenal insufficiency in a patient with asthma after changing from fluticasone propionate to budesonide. Author(s): Todd GR, Wright D, Ryan M. Source: The Journal of Allergy and Clinical Immunology. 1999 May; 103(5 Pt 1): 956-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10329837

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Acute adrenal insufficiency precipitated by isolated involvement of the adrenal gland by tuberculosis. Author(s): Llewelyn M, Adler M, Steer K, Pasvol G. Source: The Journal of Infection. 1999 November; 39(3): 244-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10714806

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Acute adrenal insufficiency presenting as high output ileostomy. Author(s): Rai S, Hemingway D. Source: Annals of the Royal College of Surgeons of England. 2003 March; 85(2): 105-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12648340

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Addison disease (adrenal insufficiency). Author(s): Bsoul SA, Terezhalmy GT, Moore WS. Source: Quintessence Int. 2003 November-December; 34(10): 784-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14620271

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Admission cortisol and adrenocorticotrophic hormone levels in children with meningococcal disease: evidence of adrenal insufficiency? Author(s): Riordan FA, Thomson AP, Ratcliffe JM, Sills JA, Diver MJ, Hart CA. Source: Critical Care Medicine. 1999 October; 27(10): 2257-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10548217

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Adrenal antibiotics detect asymptomatic auto-immune adrenal insufficiency in young women with premature ovarian failure. Author(s): Merz S. Source: Human Reproduction (Oxford, England). 2003 May; 18(5): 1132-3; Author Reply 1133. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12721199

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Adrenal insufficiency after incomplete resection of pituitary macrocorticotropinoma of Cushing's disease: role of high molecular weight ACTH. Author(s): Yamakita N, Murai T, Oki Y, Matsuhisa T, Hirata T, Ikeda T, Kuwayama A, Yasuda K. Source: Endocrine Journal. 2001 February; 48(1): 43-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11403102

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Adrenal insufficiency after recurrent post-partum thyroiditis (post-partum Schmidt syndrome): a case report. Author(s): Mehta H, Badenhoop K, Walfish PG. Source: Thyroid : Official Journal of the American Thyroid Association. 1998 March; 8(3): 269-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9545115

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Adrenal insufficiency and abnormal genitalia in a 46XX female with Smith-LemliOpitz syndrome. Author(s): Chemaitilly W, Goldenberg A, Baujat G, Thibaud E, Cormier-Daire V, Abadie V. Source: Hormone Research. 2003; 59(5): 254-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12714790

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Adrenal insufficiency and diabetes mellitus secondary to the use of topical corticosteroids for cosmetic purpose. Author(s): Sobngwi E, Lubin V, Ury P, Timsit FJ, Gautier JF, Vexiau P. Source: Annales D'endocrinologie. 2003 June; 64(3): 202-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12910062

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Adrenal insufficiency as the first clinical manifestation of the primary antiphospholipid antibody syndrome. Author(s): Satta MA, Corsello SM, Della Casa S, Rota CA, Pirozzi B, Colasanti S, Cina G, Grossman AB, Barbarino A. Source: Clinical Endocrinology. 2000 January; 52(1): 123-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10651763

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Adrenal insufficiency caused by primary aggressive non-Hodgkin's lymphoma of bilateral adrenal glands: report of a case and literature review. Author(s): Hsu CW, Ho CL, Sheu WH, Harn HJ, Chao TY. Source: Annals of Hematology. 1999 March; 78(3): 151-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10211758

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Adrenal insufficiency complicating radical nephroureterectomy. Author(s): McNeill SA, Moussa SA, Bollina PR. Source: Bju International. 1999 February; 83(3): 344-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10233510

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Adrenal insufficiency due to isolated adrenocorticotropin deficiency complicated by autosomal recessive polycystic kidney disease. Author(s): Yonemura K, Yasuda H, Fujigaki Y, Oki Y, Hishida A. Source: Renal Failure. 2003 May; 25(3): 485-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12803513

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Adrenal insufficiency due to metastatic hepatocellular carcinoma. Author(s): Takamura T, Nagai Y, Yamashita H, Nohara E, Ando H, Kagaya M, Urabe T, Kaneko S, Kobayashi K. Source: Endocrine Journal. 1999 August; 46(4): 591-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10580753

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Adrenal insufficiency during septic shock. Author(s): Marik PE, Zaloga GP. Source: Critical Care Medicine. 2003 January; 31(1): 141-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12545007

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Adrenal insufficiency from inhaled corticosteroids. Author(s): White A, Woodmansee DP. Source: Annals of Internal Medicine. 2004 March 16; 140(6): W27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15023738

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Adrenal insufficiency in an adult on inhaled corticosteroids; recovery of adrenal function with inhaled nedocromil sodium. Author(s): Albert SG, Slavin RG. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 1998 December; 81(6): 582-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9892030

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Adrenal insufficiency in critically ill emergency department patients: a Taiwan preliminary study. Author(s): Chang SS, Liaw SJ, Bullard MJ, Chiu TF, Chen JC, Liao HC. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 2001 July; 8(7): 761-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11435198

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Adrenal insufficiency in critically ill patients. Author(s): Shenker Y, Skatrud JB. Source: American Journal of Respiratory and Critical Care Medicine. 2001 June; 163(7): 1520-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11401866

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Adrenal insufficiency in high-risk surgical ICU patients. Author(s): Rivers EP, Gaspari M, Saad GA, Mlynarek M, Fath J, Horst HM, Wortsman J. Source: Chest. 2001 March; 119(3): 889-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11243973

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Adrenal insufficiency in HIV infection: a review and recommendations. Author(s): Eledrisi MS, Verghese AC. Source: The American Journal of the Medical Sciences. 2001 February; 321(2): 137-44. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11217816

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Adrenal insufficiency in patients with AIDS: when to suspect it and how to diagnose it. Author(s): Casado JL, Piedrola G. Source: Aids Patient Care and Stds. 1997 October; 11(5): 339-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11361815

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Adrenal insufficiency in septic shock. Author(s): Hatherill M, Tibby SM, Hilliard T, Turner C, Murdoch IA. Source: Archives of Disease in Childhood. 1999 January; 80(1): 51-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10325759

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Adrenal insufficiency in severe acute pancreatitis. Author(s): De Waele JJ, Hoste E, Decruyenaere J, Colardyn F. Source: Pancreas. 2003 October; 27(3): 244-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14508130

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Adrenal insufficiency in Smith-Lemli-Opitz syndrome. Author(s): Andersson HC, Frentz J, Martinez JE, Tuck-Muller CM, Bellizaire J. Source: American Journal of Medical Genetics. 1999 February 19; 82(5): 382-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10069708

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Adrenal insufficiency in the term and preterm neonate. Author(s): Witt CL. Source: Neonatal Netw. 1999 August; 18(5): 21-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10693475

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Adrenal insufficiency masquerading as an acute abdomen. Author(s): Laws SA, Cook PR, Rees M. Source: Hosp Med. 2001 February; 62(2): 118-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11236616

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Adrenal insufficiency masquerading as sepsis in a patient with tetraparesis: a case report. Author(s): Lee LW, Glenn MB. Source: Archives of Physical Medicine and Rehabilitation. 2000 June; 81(6): 830-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10857533

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Adrenal insufficiency. Author(s): Poteliakhoff A. Source: Lancet. 2003 August 16; 362(9383): 580. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12932404

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Adrenal insufficiency. Author(s): Kenward D, White KG; Addison's Disease Self-Help Group. Source: Lancet. 2003 August 16; 362(9383): 579-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12932402

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Adrenal insufficiency. Author(s): Arlt W, Allolio B. Source: Lancet. 2003 May 31; 361(9372): 1881-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12788587

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Adrenal insufficiency: an uncommon cause of fatigue. Author(s): King MS. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1999 September-October; 12(5): 386-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10534087

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Adult reversible cardiomyopathy with pituitary adrenal insufficiency caused by empty sella--a case report. Author(s): Eto K, Koga T, Sakamoto A, Kawazoe N, Sadoshima S, Onoyama K. Source: Angiology. 2000 April; 51(4): 319-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10779002

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Angiotropic large cell lymphoma which infiltrated to the adrenal glands presenting as reversible adrenal insufficiency. Author(s): Kuwahara K, Fukata J, Kamio M, Mochizuki T, Tsuchiya A, Tanaka S. Source: Intern Med. 1998 January; 37(1): 73-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9510405

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ARDS and adrenal insufficiency associated with the antiphospholipid antibody syndrome. Author(s): Argento A, DiBenedetto RJ. Source: Chest. 1998 April; 113(4): 1136-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9554663

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Assessment of corticosteroid replacement therapy in adults with adrenal insufficiency. Author(s): Jeffcoate W. Source: Annals of Clinical Biochemistry. 1999 March; 36 ( Pt 2): 151-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10370729

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Autoimmunity as the most frequent cause of idiopathic secondary adrenal insufficiency: report of 111 cases. Author(s): Kasperlik-Zaluska AA, Czarnocka B, Czech W. Source: Autoimmunity. 2003 May; 36(3): 155-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12911282

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Bilateral adrenal hemorrhage and adrenal insufficiency in a patient with lymphomatous adrenal infiltration following administration of a fusion toxin (DAB486 interleukin-2). Author(s): Cohen R, Jaffe ES, Stetler-Stevenson MA, Sausville EA, DeNigris EC, Woodworth T, Foss FM. Source: J Immunother Emphasis Tumor Immunol. 1994 October; 16(3): 229-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7834123

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Bilateral adrenal hemorrhage resulting in acute adrenal insufficiency as an unusual complication of hepatic arterial chemoembolization. Author(s): Redd DC, Soulen MC, Crooks GW. Source: Journal of Vascular and Interventional Radiology : Jvir. 1998 March-April; 9(2): 271-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9540911

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Bilateral adrenal non-Hodgkin's lymphoma with adrenal insufficiency. Author(s): Ellis RD, Read D. Source: Postgraduate Medical Journal. 2000 August; 76(898): 508-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10908383

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Bilateral primary non-Hodgkin's lymphoma of the adrenal glands with adrenal insufficiency: a case report. Author(s): Utsunomiya M, Takatera H, Itoh H, Tsujimura T, Itatani H. Source: Hinyokika Kiyo. 1992 March; 38(3): 311-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1523986

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Biological parameters of bone remodelling in chronic adrenal insufficiency. Author(s): Willems D, Gillet C, Cogan E, Fuss M, Bergmann P. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 1991 October; 23(10): 511-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1761286

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Can adrenal insufficiency be diagnosed on clinical and laboratory data basis in patients with AIDS? Author(s): Casanova-Cardiel L, Palacios-Jimenez N, Miralrio-Gomez G, GaytanMartinez J, Reyes-Garcia G, Mateos-Garcia E, Fuentes-Allen JL. Source: Proc West Pharmacol Soc. 2003; 46: 103-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14699900

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Cardiac tamponade preceding adrenal insufficiency--an unusual presentation of Addison's disease. Author(s): Jolobe OM. Source: Journal of Internal Medicine. 1998 May; 243(5): 399-400. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9651565

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Cardiac tamponade preceding adrenal insufficiency--an unusual presentation of Addison's disease: a report of two cases. Author(s): Torfoss D, von de Lippe E, Jacobsen D. Source: Journal of Internal Medicine. 1997 June; 241(6): 525-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10497630

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Cardiovascular failure in experimental adrenal insufficiency: a historical revival. Author(s): Cleghorn RA. Source: Perspectives in Biology and Medicine. 1983 Autumn; 27(1): 135-55. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6359051

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Care of the critically ill child: acute adrenal insufficiency. Author(s): Bongiovanni AM. Source: Pediatrics. 1969 July; 44(1): 109-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5795388

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Catecholamine dependency in a polytrauma patient: relative adrenal insufficiency? Author(s): Nieboer P, van der Werf TS, Beentjes JA, Tulleken JE, Zijlstra JG, Ligtenberg JJ. Source: Intensive Care Medicine. 2000 January; 26(1): 125-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10663293

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Central pontine myelinolysis in a patient with adrenal insufficiency. Author(s): Brunner JE. Source: Henry Ford Hosp Med J. 1985; 33(1): 45-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4019226

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Childhood adrenal insufficiency, chorea, and antiphospholipid antibodies. Author(s): Rose CD, Goldsmith DP. Source: Annals of the Rheumatic Diseases. 1990 June; 49(6): 421-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2383070

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Chronic fatigue syndrome, decreased exercise capacity, and adrenal insufficiency. Author(s): Baschetti R. Source: Archives of Internal Medicine. 2001 June 25; 161(12): 1558-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11427109

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Clinical adrenal insufficiency in patients receiving megestrol therapy. Author(s): Subramanian S, Goker H, Kanji A, Sweeney H. Source: Archives of Internal Medicine. 1997 May 12; 157(9): 1008-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9140272

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Clinical features of adrenal insufficiency in patients with acquired immunodeficiency syndrome. Author(s): Piedrola G, Casado JL, Lopez E, Moreno A, Perez-Elias MJ, Garcia-Robles R. Source: Clinical Endocrinology. 1996 July; 45(1): 97-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8796145

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Clinical review 62: Laboratory assessment of adrenal insufficiency. Author(s): Grinspoon SK, Biller BM. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 October; 79(4): 92331. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7962298

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Clinical studies with corticotropin releasing factor: implications for the diagnosis and pathophysiology of depression, Cushing's disease, and adrenal insufficiency. Author(s): Gold PW, Chrousos GP. Source: Psychoneuroendocrinology. 1985; 10(4): 401-19. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3878972

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Close association of severe hyponatremia with exaggerated release of arginine vasopressin in elderly subjects with secondary adrenal insufficiency. Author(s): Yatagai T, Kusaka I, Nakamura T, Nagasaka S, Honda K, Ishibashi S, Ishikawa SE. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2003 February; 148(2): 221-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12590641

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Combined hypothalamic hypothyroidism and secondary adrenal insufficiency. Misdiagnosed as primary hypothyroidism. Author(s): Farese RV, Rodriguez ME, O'Malley BC, Jamieson E, Pollet RJ. Source: Archives of Internal Medicine. 1979 January; 139(1): 99-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=104680

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Compound heterozygous mutations in the cholesterol side-chain cleavage enzyme gene (CYP11A) cause congenital adrenal insufficiency in humans. Author(s): Katsumata N, Ohtake M, Hojo T, Ogawa E, Hara T, Sato N, Tanaka T. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 August; 87(8): 3808-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12161514

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Corticosteroid supplementation for adrenal insufficiency. Author(s): Coursin DB, Wood KE. Source: Jama : the Journal of the American Medical Association. 2002 January 9; 287(2): 236-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11779267

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Corticotropin releasing hormone: relevance to normal physiology and to the pathophysiology and differential diagnosis of hypercortisolism and adrenal insufficiency. Author(s): Gold PW, Kling MA, Khan I, Calabrese JR, Kalogeras K, Post RM, Avgerinos PC, Loriaux DL, Chrousos GP. Source: Adv Biochem Psychopharmacol. 1987; 43: 183-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3035886

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Cortisol-dihydrotachysterol antagonism in a patient with hypoparathyroidism and adrenal insufficiency: apparent inhibition of bone resorption. Author(s): Farrell PM, Rikkers H, Moel D. Source: The Journal of Clinical Endocrinology and Metabolism. 1976 May; 42(5): 953-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1270584

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CT of bilateral adrenal hemorrhage with acute adrenal insufficiency in the adult. Author(s): Wolverson MK, Kannegiesser H. Source: Ajr. American Journal of Roentgenology. 1984 February; 142(2): 311-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6607597

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Cushing's disease: transient secondary adrenal insufficiency after selective removal of pituitary microadenomas; evidence for a pituitary origin. Author(s): Fitzgerald PA, Aron DC, Findling JW, Brooks RM, Wilson CB, Forsham PH, Tyrrell JB. Source: The Journal of Clinical Endocrinology and Metabolism. 1982 February; 54(2): 413-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6274904

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Cutaneous T-cell lymphoma with adrenal insufficiency. Author(s): Blaikley JF, Atkinson P, Almond MK. Source: Journal of the Royal Society of Medicine. 2003 October; 96(10): 503-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14519731

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Cytomegaloviral adrenalitis and adrenal insufficiency in AIDS. Author(s): Pulakhandam U, Dincsoy HP. Source: American Journal of Clinical Pathology. 1990 May; 93(5): 651-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2158225

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Cytomegalovirus-induced adrenal insufficiency and associated renal cell carcinoma in AIDS. Author(s): Bleiweiss IJ, Pervez NK, Hammer GS, Dikman SH. Source: The Mount Sinai Journal of Medicine, New York. 1986 December; 53(8): 676-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3027548

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Decreased glucocorticoid receptor binding in adrenal insufficiency. Author(s): Schlechte JA, Sherman BM. Source: The Journal of Clinical Endocrinology and Metabolism. 1982 January; 54(1): 1459. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7054210

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Defining adrenal insufficiency in septic shock. Author(s): Kenyon N. Source: Critical Care Medicine. 2003 January; 31(1): 321-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12545044

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Definitive adrenal insufficiency due to bilateral adrenal hemorrhage and primary antiphospholipid syndrome. Author(s): Caron P, Chabannier MH, Cambus JP, Fortenfant F, Otal P, Suc JM. Source: The Journal of Clinical Endocrinology and Metabolism. 1998 May; 83(5): 1437-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9589635

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Dehydroepiandrosterone for adrenal insufficiency. Author(s): Oelkers W. Source: The New England Journal of Medicine. 1999 September 30; 341(14): 1073-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10502598

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Dehydroepiandrosterone replacement for patients with adrenal insufficiency. Author(s): Achermann JC, Silverman BL. Source: Lancet. 2001 May 5; 357(9266): 1381-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11356430

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Dehydroepiandrosterone replacement in women with adrenal insufficiency. Author(s): Arlt W, Callies F, van Vlijmen JC, Koehler I, Reincke M, Bidlingmaier M, Huebler D, Oettel M, Ernst M, Schulte HM, Allolio B. Source: The New England Journal of Medicine. 1999 September 30; 341(14): 1013-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10502590

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Dehydroepiandrosterone replacement in women with adrenal insufficiency: effects on body composition, serum leptin, bone turnover, and exercise capacity. Author(s): Callies F, Fassnacht M, van Vlijmen JC, Koehler I, Huebler D, Seibel MJ, Arlt W, Allolio B. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 May; 86(5): 1968-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11344193

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Delayed pubarche in adolescents with adrenal insufficiency. Author(s): Hochberg Z. Source: Clinical Pediatrics. 1980 December; 19(12): 827-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7438663

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DHEA replacement in adrenal insufficiency. Author(s): Arlt W, Allolio B. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 August; 88(8): 4001; Author Reply 4001-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12915701

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DHEA replacement in women with adrenal insufficiency--pharmacokinetics, bioconversion and clinical effects on well-being, sexuality and cognition. Author(s): Arlt W, Callies F, Allolio B. Source: Endocrine Research. 2000 November; 26(4): 505-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11196420

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Diagnosis and therapy of acute adrenal insufficiency. Author(s): Michael KA, Mohler JL. Source: Pharmacotherapy. 1989; 9(4): 269. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2771810

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Diagnosis of adrenal insufficiency. Author(s): Dorin RI, Qualls CR, Crapo LM. Source: Annals of Internal Medicine. 2003 August 5; 139(3): 194-204. Review. Erratum In: Ann Intern Med. 2004 February 17; 140(4): 315. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12899587

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Diagnosis of adrenal insufficiency. Author(s): Clayton RN. Source: Bmj (Clinical Research Ed.). 1989 February 4; 298(6669): 271-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2493892

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Diagnosis of adrenal insufficiency. Author(s): Barron J. Source: Annals of Clinical Biochemistry. 1996 July; 33 ( Pt 4): 357. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8836398

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Diagnosis of adrenal insufficiency: Evaluation of the corticotropin-releasing hormone test and Basal serum cortisol in comparison to the insulin tolerance test in patients with hypothalamic-pituitary-adrenal disease. Author(s): Schmidt IL, Lahner H, Mann K, Petersenn S. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 September; 88(9): 4193-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12970286

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Diagnosis of relative adrenal insufficiency in critically ill patients. Author(s): Ligtenberg JJ, van der Werf TS, Tulleken JE, Beentjes JA, Zijlstra JG. Source: Lancet. 1999 August 28; 354(9180): 774-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10475217

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Diffuse cerebral sclerosis, melanoderma and adrenal insufficiency (adrenoleukodystrophy). Author(s): Hormia M. Source: Acta Neurologica Scandinavica. 1978 August; 58(2): 128-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=707040

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Diffuse sclerosis with adrenal insufficiency. Author(s): Vick NA, Moore RY. Source: Neurology. 1968 November; 18(11): 1066-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5751912

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Disseminated cryptococcosis in an apparently normal host presenting as primary adrenal insufficiency: diagnosis by fine needle aspiration. Author(s): Walker BF, Gunthel CJ, Bryan JA, Watts NB, Clark RV. Source: The American Journal of Medicine. 1989 June; 86(6 Pt 1): 715-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2658577

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Disseminated cryptococcosis presenting with adrenal insufficiency and meningitis: resistant to prolonged antifungal therapy but responding to bilateral adrenalectomy. Author(s): Takeshita A, Nakazawa H, Akiyama H, Takeuchi K, Kawai R, Oohashi K, Shishiba Y. Source: Intern Med. 1992 December; 31(12): 1401-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1300177

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Disseminated North American blastomycosis. Occurrence with clinical manifestations of adrenal insufficiency. Author(s): Eberle DE, Evans RB, Johnson RH. Source: Jama : the Journal of the American Medical Association. 1977 December 12; 238(24): 2629-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=579201

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Dissociation of cortisol and adrenal androgen secretion in patients with secondary adrenal insufficiency. Author(s): Cutler GB Jr, Davis SE, Johnsonbaugh RE, Loriaux DL. Source: The Journal of Clinical Endocrinology and Metabolism. 1979 October; 49(4): 6049. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=225347

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Duchenne muscular dystrophy with adrenal insufficiency and glycerol kinase deficiency: high resolution cytogenetic analysis with molecular, biochemical, and clinical studies. Author(s): Clarke A, Roberts SH, Thomas NS, Whitfield A, Williams J, Harper PS. Source: Journal of Medical Genetics. 1986 December; 23(6): 501-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3027343

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Duchenne muscular dystrophy, glycerol kinase deficiency, and adrenal insufficiency associated with Xp21 interstitial deletion. Author(s): Bartley JA, Patil S, Davenport S, Goldstein D, Pickens J. Source: The Journal of Pediatrics. 1986 February; 108(2): 189-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3003318

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Early adrenal hypofunction in patients with organ-specific autoantibodies and no clinical adrenal insufficiency. Author(s): Boscaro M, Betterle C, Sonino N, Volpato M, Paoletta A, Fallo F. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 August; 79(2): 4525. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8045962

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Effect of meclastine, an H1-antihistamine, on plasma ACTH in adrenal insufficiency. Author(s): Allolio B, Winkelmann W, Hipp FX. Source: Acta Endocrinol (Copenh). 1981 May; 97(1): 98-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6261510

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Effects of short-term glucocorticoid deprivation on growth hormone (GH) response to GH-releasing peptide-6: studies in normal men and in patients with adrenal insufficiency. Author(s): Pinto AC, Silva MR, Martins MR, Brunner E, Lengyel AM. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 April; 85(4): 1540-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10770194

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Effects of variations in physiological cortisol levels on thyrotropin secretion in subjects with adrenal insufficiency: a clinical research center study. Author(s): Samuels MH. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 April; 85(4): 138893. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10770171

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Eosinophilia as a marker of adrenal insufficiency in the surgical intensive care unit. Author(s): Angelis M, Yu M, Takanishi D, Hasaniya NW, Brown MR. Source: Journal of the American College of Surgeons. 1996 December; 183(6): 589-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8957461

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Etiological diagnosis of primary adrenal insufficiency using an original flowchart of immune and biochemical markers. Author(s): Laureti S, Aubourg P, Calcinaro F, Rocchiccioli F, Casucci G, Angeletti G, Brunetti P, Lernmark A, Santeusanio F, Falorni A. Source: The Journal of Clinical Endocrinology and Metabolism. 1998 September; 83(9): 3163-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9745420

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Evaluation of secondary adrenal insufficiency: findings by corticotropin-releasing hormone test and magnetic resonance imaging in parallel. Author(s): Lin SY, Won JG, Lee TI, Tang KT, Lin HD. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2002 April; 65(4): 156-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12135194

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Evidence of early adrenal insufficiency in babies who develop bronchopulmonary dysplasia. Author(s): Watterberg KL, Scott SM. Source: Pediatrics. 1995 January; 95(1): 120-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7770288

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Extra and central pontine myelinolysis in a child with adrenal insufficiency. Author(s): Udani VP, Dharnidharka VR, Gajendragadkar AR, D'Souza B. Source: Pediatric Neurology. 1997 September; 17(2): 158-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9367298

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Familial adrenal insufficiency, achalasia, alacrima, peripheral neuropathy, microcephaly, normal plasma very long chain fatty acids, and normal muscle mitochondrial respiratory chain enzymes. Author(s): Tsao CY, Romshe CA, Lo WD, Wright FS, Sommer A. Source: Journal of Child Neurology. 1994 April; 9(2): 135-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8006362

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Fatigue: the role of adrenal insufficiency. Author(s): Siegel RD, Melby J. Source: Hosp Pract (Off Ed). 1994 July 15; 29(7): 59-63, 67, 71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8027206

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Flexion contracture in adrenal insufficiency. Author(s): Susac JO, Henry JM, Deller JJ. Source: Archives of Physical Medicine and Rehabilitation. 1968 July; 49(7): 13-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5658881

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Fluconazole-associated acute adrenal insufficiency. Author(s): Gradon JD, Sepkowitz DV. Source: Postgraduate Medical Journal. 1991 December; 67(794): 1084-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1800972

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Frequency of hypoglycemia in children with adrenal insufficiency. Author(s): Artavia-Loria E, Chaussain JL, Bougneres PF, Job JC. Source: Acta Endocrinol Suppl (Copenh). 1986; 279: 275-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3465167

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Glucocorticoid replacement is permissive for rapid eye movement sleep and sleep consolidation in patients with adrenal insufficiency. Author(s): Garcia-Borreguero D, Wehr TA, Larrosa O, Granizo JJ, Hardwick D, Chrousos GP, Friedman TC. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 November; 85(11): 4201-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11095454

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Glucocorticoid-induced adrenal insufficiency. Author(s): Krasner AS. Source: Jama : the Journal of the American Medical Association. 1999 August 18; 282(7): 671-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10517721

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Growth hormone (GH) secretion in primary adrenal insufficiency: effects of cortisol withdrawal and patterned replacement on GH pulsatility and circadian rhythmicity. Author(s): Barkan AL, DeMott-Friberg R, Samuels MH. Source: Pituitary. 2000 November; 3(3): 175-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11383482

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Hemodynamic changes in acute adrenal insufficiency. Author(s): Bouachour G, Tirot P, Varache N, Gouello JP, Harry P, Alquier P. Source: Intensive Care Medicine. 1994; 20(2): 138-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8201094

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Hemodynamic instability secondary to adrenal insufficiency in a major burn patient. Author(s): Nacul FE, Jardim A, MacCord F, Penido C, Gomes MV. Source: Burns : Journal of the International Society for Burn Injuries. 2002 May; 28(3): 270-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11996861

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Heparin-associated acute adrenal insufficiency. Author(s): Arthur CK, Grant SJ, Murray WK, Isbister JP, Stiel JN, Lauer CS. Source: Aust N Z J Med. 1985 August; 15(4): 454-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3866544

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Heterozygous mutation in the cholesterol side chain cleavage enzyme (p450scc) gene in a patient with 46,XY sex reversal and adrenal insufficiency. Author(s): Tajima T, Fujieda K, Kouda N, Nakae J, Miller WL. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 August; 86(8): 3820-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11502818

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High output circulatory failure in acute adrenal insufficiency. Author(s): Dorin RI, Kearns PJ. Source: Critical Care Medicine. 1988 March; 16(3): 296-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2830078

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High risk of adrenal insufficiency in adults previously treated for idiopathic childhood onset growth hormone deficiency. Author(s): Lange M, Feldt-Rasmussen U, Svendsen OL, Kastrup KW, Juul A, Muller J. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 December; 88(12): 5784-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14671169

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High-dose and low-dose cosyntropin stimulation tests for diagnosis of adrenal insufficiency. Author(s): Dickstein G. Source: Annals of Internal Medicine. 2004 February 17; 140(4): 312-3; Author Reply 3134. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14970166

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How to keep adrenal insufficiency in check. Author(s): Peterson A, Drass J. Source: The American Journal of Nursing. 1993 October; 93(10): 36-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8213943

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How to recognize and manage acute adrenal insufficiency. Author(s): Noel GL. Source: Med Times. 1975 August; 103(8): 54-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1143060

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Human adrenocortical cell xenotransplantation: model of cotransplantation of human adrenocortical cells and 3T3 cells in scid mice to form vascularized functional tissue and prevent adrenal insufficiency. Author(s): Thomas M, Wang X, Hornsby PJ. Source: Xenotransplantation. 2002 January; 9(1): 58-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12005105

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Hypercalcaemia in acute adrenal insufficiency. A case report. Author(s): Pieters T, Devogelaer JP, Meunier H, Nagant de Deuxchaisnes C. Source: Acta Clin Belg. 1990; 45(1): 42-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2161607

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Hypercalcemia and adrenal insufficiency in a patient with myelofibrosis. Author(s): Hertzberg MS, Wong M. Source: American Journal of Hematology. 2000 February; 63(2): 105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10629582

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Hypercalcemia in a patient with tuberculous adrenal insufficiency. Author(s): Glemarec J, Varin S, Rodet D, Guillot P, Prost A, Maugars Y, Berthelot JM. Source: Joint, Bone, Spine : Revue Du Rhumatisme. 2002 January; 69(1): 88-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11858366

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Hyperkalemia caused by adrenal insufficiency. Author(s): Kumar P, Chugh K. Source: Indian Pediatrics. 1990 March; 27(3): 311-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2351460

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Hypoglycemic stroke precipitated by adrenal insufficiency. Author(s): Huttner WA. Source: Rocky Mt Med J. 1967 October; 64(10): 89-92. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6073756

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Hyponatremia and osmoregulation of thirst and vasopressin secretion in patients with adrenal insufficiency. Author(s): Kamoi K, Tamura T, Tanaka K, Ishibashi M, Yamaji T. Source: The Journal of Clinical Endocrinology and Metabolism. 1993 December; 77(6): 1584-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8263145

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Hyponatremia as a consequence of acute adrenal insufficiency and hypothyroidism. Author(s): Nayback AM. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2000 April; 26(2): 130-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10748385

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Hyponatremia in adrenal insufficiency: review of pathogenetic mechanisms. Author(s): Spital A. Source: Southern Medical Journal. 1982 May; 75(5): 581-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7079815

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Hypotension and adrenal insufficiency. Author(s): Bennett N, Gabrielli A, Chernow B. Source: Journal of Clinical Anesthesia. 1999 August; 11(5): 425-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10526816

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Hypothalamic-pituitary dysfunction with adrenal insufficiency and hyperprolactinaemia in sarcoidosis. A case report. Author(s): Verhage TL, Godfried MH, Alberts C. Source: Sarcoidosis. 1990 September; 7(2): 139-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2255793

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Iatrogenic adrenal insufficiency as a side-effect of combined treatment of itraconazole and budesonide. Author(s): Skov M, Main KM, Sillesen IB, Muller J, Koch C, Lanng S. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 2002 July; 20(1): 127-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12166560

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Identification of a large-scale mitochondrial deoxyribonucleic acid deletion in endocrinopathies and deafness: report of two unrelated cases with diabetes mellitus and adrenal insufficiency, respectively. Author(s): Nicolino M, Ferlin T, Forest M, Godinot C, Carrier H, David M, Chatelain P, Mousson B. Source: The Journal of Clinical Endocrinology and Metabolism. 1997 September; 82(9): 3063-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9284744

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Identification of the main gonadal autoantigens in patients with adrenal insufficiency and associated ovarian failure. Author(s): Winqvist O, Gebre-Medhin G, Gustafsson J, Ritzen EM, Lundkvist O, Karlsson FA, Kampe O. Source: The Journal of Clinical Endocrinology and Metabolism. 1995 May; 80(5): 1717-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7745025

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Idiopathic hypoparathyroidism associated with adrenal insufficiency--report of a case with a study of calcium metabolism. Author(s): Coen G, Mazzuoli GF. Source: Folia Endocrinol. 1965 April; 18(2): 136-48. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5897544

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IgA antiphospholipid and adrenal insufficiency: is there a link? Author(s): al-Momen AK, Sulimani R, Harakati M, Gader AG, Mekki M. Source: Thrombosis Research. 1991 December 1; 64(5): 571-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1808762

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Impairment of AVP regulation in 17alpha-hydroxylase deficiency, a unique form of adrenal insufficiency. Author(s): Leal AM, Elias PC, Moreira AC. Source: J Endocrinol Invest. 2002 July-August; 25(7): 635-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12150340

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Increased insulin binding of erythrocytes and insulin sensitivity in adrenal insufficiency. Author(s): Takeda N, Yasuda K, Kitabchi AE, Horiya T, Jallepalli P, Miura K. Source: Metabolism: Clinical and Experimental. 1987 November; 36(11): 1063-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3312935

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Increased sensitivity to 5-fluorouracil in patients with adrenal insufficiency. Author(s): Awe WC, Donaldson SS, Fletcher WS. Source: Northwest Med. 1966 January; 65(1): 36-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5904397

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Index of suspicion. Case 3. Diagnosis: Acute primary adrenal insufficiency. Author(s): Brenner K, Frohna JG. Source: Pediatrics in Review / American Academy of Pediatrics. 2001 July; 22(7): 245-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11464818

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Infanto-juvenile encephaloneuropathy and pigmentary retinopathy in a girl associated with congenital adrenal insufficiency and altered plasma medium-chain fatty acid levels. Author(s): Federico A, Baracchini G, Dotti MT, Ibba L, Malandrini A, Ciacci G, Meloni M, Palmeri S, Pompella A, Guazzi GC. Source: Journal of Inherited Metabolic Disease. 1988; 11 Suppl 2: 178-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2846958

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Infectious causes of adrenal insufficiency. Author(s): Alevritis EM, Sarubbi FA, Jordan RM, Peiris AN. Source: Southern Medical Journal. 2003 September; 96(9): 888-90. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14513986

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Inhaled corticosteroids and adrenal insufficiency. Author(s): Russell G. Source: Archives of Disease in Childhood. 2002 December; 87(6): 455-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12456537

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Is the ovine CRF test an aid in the evaluation of patients with secondary adrenal insufficiency? Author(s): de Lange WE, Sluiter WJ, Pratt JJ, Wolf RF, Doorenbos H. Source: The Netherlands Journal of Medicine. 1988 February; 32(1-2): 72-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3258061

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Islet cell antibodies and complement fixing islet cell antibodies in blood serum of patients with chronic adrenal insufficiency (Addison's disease). Author(s): Gryczynska M, Majkowska L, Czekalski S. Source: Endokrynol Pol. 1989; 40(4): 155-61. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2701096

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Italian addison network study: update of diagnostic criteria for the etiological classification of primary adrenal insufficiency. Author(s): Falorni A, Laureti S, De Bellis A, Zanchetta R, Tiberti C, Arnaldi G, Bini V, Beck-Peccoz P, Bizzarro A, Dotta F, Mantero F, Bellastella A, Betterle C, Santeusanio F; SIE Addison Study Group. Source: The Journal of Clinical Endocrinology and Metabolism. 2004 April; 89(4): 1598604. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15070918

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Laboratory predictors of relative adrenal insufficiency in septic shock. Author(s): Fessler MB, O'Brien JM, Douglas IS. Source: Critical Care Medicine. 2003 August; 31(8): 2251-2; Author Reply 2252-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12973195

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Letter: Anticoagulant therapy and acute adrenal insufficiency. Author(s): Portnay GI, Vagenakis AG, Braverman LE, Cervi-Skinner SI. Source: Annals of Internal Medicine. 1974 July; 81(1): 115. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4366292

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Letter: Primary aldosteronism: remission and development of adrenal insufficiency after adrenal venography. Author(s): Taylor HC, Sachs CR, Bravo EL. Source: Annals of Internal Medicine. 1976 August; 85(2): 207-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=942145

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Letter: Simultaneous diagnosis and treatment of acute adrenal insufficiency. Author(s): Mattingly D, Sheridan P. Source: Lancet. 1976 February 21; 1(7956): 432-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=55706

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Levels of leptin during hydrocortisone infusions that mimic normal and reversed diurnal cortisol levels in subjects with adrenal insufficiency. Author(s): Purnell JQ, Samuels MH. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 September; 84(9): 3125-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10487674

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Lupus erythematosus in a patient with amyloidosis, adrenal insufficiency, and subsequent immunoblastic sarcoma: demonstration of the LE phenomenon in the lung. Author(s): Schleissner LA, Sheehan WW, Orselli RC. Source: Arthritis and Rheumatism. 1976 March-April; 19(2): 249-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=56940

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Lymphoma presenting with adrenal insufficiency. Adrenal enlargement on computed tomographic scanning as a clue to diagnosis. Author(s): Huminer D, Garty M, Lapidot M, Leiba S, Borohov H, Rosenfeld JB. Source: The American Journal of Medicine. 1988 January; 84(1): 169-72. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3276182

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Measurement of the adrenal cortex reserve using depot beta 1-24-corticotrophin. I--In adrenal insufficiency. Author(s): Galvao-Teles A. Source: Acta Med Port. 1979 March-April; 1(2): 185-93. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=233189

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Mechanism of transient adrenal insufficiency with megestrol acetate treatment of cachexia in children with cancer. Author(s): Meacham LR, Mazewski C, Krawiecki N. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2003 May; 25(5): 414-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12759631

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Medroxyprogesterone acetate-induced secondary adrenal insufficiency. Author(s): Dux S, Bishara J, Marom D, Blum I, Pitlik S. Source: The Annals of Pharmacotherapy. 1998 January; 32(1): 134. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9475840

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Megestrol acetate in the spectrum of adrenal insufficiency. Author(s): Chan AA. Source: Annals of Internal Medicine. 1998 June 15; 128(12 Pt 1): 1047. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9625672

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Megestrol-induced clinical adrenal insufficiency. Author(s): Goodman A, Cagliero E. Source: Eur J Gynaecol Oncol. 2000; 21(2): 117-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10843465

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Metastases as cause of adrenal insufficiency. Author(s): Meyer JS. Source: Geriatrics. 1970 May; 25(5): 182-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5441495

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Metyrapone test with adrenocorticotrophic levels. Separating primary from secondary adrenal insufficiency. Author(s): Dolman LI, Nolan G, Jubiz W. Source: Jama : the Journal of the American Medical Association. 1979 March 23; 241(12): 1251-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=216821

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Mood disorder and secondary adrenal insufficiency after pituitary tumor operation and radiotherapy. Author(s): Lee IT, Lin SY, Sheul WH. Source: J Chin Med Assoc. 2003 June; 66(6): 375-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12889508

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Multifocal disseminated lipoatrophy secondary to intravenous corticosteroid administration in a patient with adrenal insufficiency. Author(s): Bauerschmitz J, Bork K. Source: Journal of the American Academy of Dermatology. 2002 May; 46(5 Suppl): S1302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12004291

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Mycobacterium avium-intracellulare and adrenal insufficiency in AIDS. Author(s): Glasgow BJ, Layfield LJ, Anders KH. Source: Human Pathology. 1988 February; 19(2): 245-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3343037

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Naloxone-induced activation of the hypothalamic-pituitary-adrenal axis in suspected central adrenal insufficiency. Author(s): Blevins LS Jr, Dobs AS, Wand GS. Source: The American Journal of the Medical Sciences. 1994 September; 308(3): 167-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8074133

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Neonatal adrenal insufficiency associated with maternal Cushing's syndrome. Author(s): Kreines K, DeVaux WD. Source: Pediatrics. 1971 March; 47(3): 516-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4323279

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Neonatal subclinical adrenal insufficiency. Result of maternal steroid therapy. Author(s): Grajwer LA, Lilien LD, Pildes RS. Source: Jama : the Journal of the American Medical Association. 1977 September 19; 238(12): 1279-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=578181

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Neurological and adrenal dysfunction in the adrenal insufficiency/alacrima/achalasia (3A) syndrome. Author(s): Grant DB, Barnes ND, Dumic M, Ginalska-Malinowska M, Milla PJ, von Petrykowski W, Rowlatt RJ, Steendijk R, Wales JH, Werder E. Source: Archives of Disease in Childhood. 1993 June; 68(6): 779-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8333772

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No inhibition of corticotrophin (ACTH)-hypersecretion in adrenal insufficiency by somatostatin. Author(s): Jara-Albarran A, Bayort J, Caballero A, Eusebio R, Garcia-Peris P, Toledano E, Perez-Modrego S. Source: Acta Endocrinol (Copenh). 1980 September; 95(1): 71-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6109417

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Non-Hodgkin's lymphoma limited to the adrenal gland with adrenal insufficiency. Author(s): Shea TC, Spark R, Kane B, Lange RF. Source: The American Journal of Medicine. 1985 April; 78(4): 711-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3985045

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Non-Hodgkin's lymphoma presenting with adrenal insufficiency and hypothyroidism: an autopsy case report. Author(s): Nasu M, Aruga M, Itami J, Fujimoto H, Matsubara O. Source: Pathology International. 1998 February; 48(2): 138-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9589478

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Non-Hodgkin's lymphoma presenting with primary adrenal insufficiency. A disease with an underestimated frequency? Author(s): Gamelin E, Beldent V, Rousselet MC, Rieux D, Rohmer V, Ifrah N, Boasson M, Bigorgne JC. Source: Cancer. 1992 May 1; 69(9): 2333-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1562980

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Normokalemic nonazotemic adrenal insufficiency. Author(s): Szwed JJ, White C. Source: Southern Medical Journal. 1983 July; 76(7): 919-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6867804

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Not just another fall in the elderly. Bilateral adrenal lymphoma presenting with adrenal insufficiency causing weakness. Author(s): Gillett M, Haak S. Source: Aust Fam Physician. 2003 April; 32(4): 248-50. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12735264

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Occult adrenal insufficiency in surgical patients. Author(s): Hubay CA, Weckesser EC, Levy RP. Source: Annals of Surgery. 1975 March; 181(3): 325-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=165792

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Occult adrenal insufficiency secondary to amyloidosis in the context of chronic renal failure. Author(s): Harvey CJ, Gower PE, Hawkins PN, Pepys MB, Phillips ME. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1995; 10(7): 1237-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7478132

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Oral hyperpigmentation and adrenocortical hypofunction in a patient with acquired immunodeficiency syndrome. Author(s): Porter SR, Glover S, Scully C. Source: Oral Surg Oral Med Oral Pathol. 1990 July; 70(1): 59-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2371052

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Organ-specific antibodies in idiopathic panhypopituitarism, primary thyroid and adrenal insufficiency. Author(s): Nerup J, Lindholm J, Soborg M, Halberg P. Source: Acta Med Scand. 1969 April; 185(4): 293-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4896707

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Osmoregulation of plasma vasopressin in three cases with adrenal insufficiency of diverse etiologies. Author(s): Iwasaki Y, Kondo K, Hasegawa H, Oiso Y. Source: Hormone Research. 1997; 47(1): 38-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9010716

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Ossification of the auricles: a forgotten sign in adrenal insufficiency. Author(s): Wang CY, Chang TC, Chen FW. Source: The Journal of Otolaryngology. 2002 February; 31(1): 52-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11881775

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Ossification of the auricular cartilages in patients with adrenal insufficiency. Author(s): Talmi YP, Cohen AM, Finkelstein Y, Fluro S, Zohar Y. Source: Archives of Otolaryngology--Head & Neck Surgery. 1989 October; 115(10): 12545. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2506914

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Oxidative phosphorylation defect associated with primary adrenal insufficiency. Author(s): North K, Korson MS, Krawiecki N, Shoffner JM, Holm IA. Source: The Journal of Pediatrics. 1996 May; 128(5 Pt 1): 688-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8627443

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Pearson syndrome: altered tricarboxylic acid and urea-cycle metabolites, adrenal insufficiency and corneal opacities. Author(s): Ribes A, Riudor E, Valcarel R, Salva A, Castello F, Murillo S, Dominguez C, Rotig A, Jakobs C. Source: Journal of Inherited Metabolic Disease. 1993; 16(3): 537-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7609446

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Perioperative steroids for secondary adrenal insufficiency. Author(s): Blavin LR, French L. Source: The Journal of Family Practice. 1997 June; 44(6): 532-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9191621

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Persistent adrenal insufficiency secondary to low-dose ketoconazole therapy. Author(s): Best TR, Jenkins JK, Murphy FY, Nicks SA, Bussell KL, Vesely DL. Source: The American Journal of Medicine. 1987 March 23; 82(3 Spec No): 676-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3826130

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Persistent hypoglycemia due to hyperinsulinemia, hypoglucagonemia and mild adrenal insufficiency. Author(s): Debreceni L, Meszaros I. Source: Exp Clin Endocrinol. 1987 September; 90(2): 221-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2828082

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Plasma renin and aldosterone in pregnancy complicated by adrenal insufficiency. Author(s): Symonds EM, Craven DJ. Source: British Journal of Obstetrics and Gynaecology. 1977 March; 84(3): 191-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=843494

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Polymorphic ventricular tachycardia in a patient with adrenal insufficiency and hypothyroidism. Author(s): Izumi C, Inoko M, Kitaguchi S, Himura Y, Iga K, Gen H, Konishi T. Source: Japanese Circulation Journal. 1998 July; 62(7): 543-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9707014

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Possible association between high-dose fluconazole and adrenal insufficiency in critically ill patients. Author(s): Albert SG, DeLeon MJ, Silverberg AB. Source: Critical Care Medicine. 2001 March; 29(3): 668-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11373442

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Post-thymectomy collapse: an unusual case of acute adrenal insufficiency. Author(s): Richardson J. Source: Postgraduate Medical Journal. 1995 April; 71(834): 242-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7784288

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Prednisolone in the treatment of adrenal insufficiency: a re-evaluation of relative potency. Author(s): Punthakee Z, Legault L, Polychronakos C. Source: The Journal of Pediatrics. 2003 September; 143(3): 402-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14517528

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Pregnancy complicated by preeclampsia and adrenal insufficiency. Author(s): Yarnell RW, D'Alton ME, Steinbok VS. Source: Anesthesia and Analgesia. 1994 January; 78(1): 176-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8267159

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Prenatal treatment of adrenal insufficiency. Author(s): O'Doherty N. Source: Lancet. 1969 November 29; 2(7631): 1194-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4187226

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Preoperative assessment of adrenal insufficiency in glucocorticoid therapy. Author(s): Thygeson NM. Source: Archives of Internal Medicine. 1984 November; 144(11): 2288. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6093729

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Preventing adrenal insufficiency during surgery. Author(s): Byyny RL. Source: Postgraduate Medicine. 1980 May; 67(5): 219-25, 228. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7375407

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Primary adrenal insufficiency caused by disseminated histoplasmosis: report of two cases. Author(s): Roubsanthisuk W, Sriussadaporn S, Vawesorn N, Parichatikanond P, Phoojaroenchanachai M, Homsanit M, Peerapatdit T, Nitiyanant W, Vannasaeng S, Vichayanrat A. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2002 May-June; 8(3): 237-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12113639

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Primary adrenal insufficiency following traumatic brain injury: a case report and review of the literature. Author(s): Webster JB, Bell KR. Source: Archives of Physical Medicine and Rehabilitation. 1997 March; 78(3): 314-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9084356

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Primary adrenal insufficiency in a child with a mitochondrial DNA deletion. Author(s): Bruno C, Minetti C, Tang Y, Magalhaes PJ, Santorelli FM, Shanske S, Bado M, Cordone G, Gatti R, DiMauro S. Source: Journal of Inherited Metabolic Disease. 1998 April; 21(2): 155-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9584267

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Primary adrenal insufficiency in patients with the acquired immunodeficiency syndrome: a report of five cases. Author(s): Freda PU, Wardlaw SL, Brudney K, Goland RS. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 December; 79(6): 1540-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7989453

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Primary adrenal insufficiency in two patients with the acquired immunodeficiency syndrome associated with disseminated cytomegaloviral infection. Author(s): Geusau A, Stingl G. Source: Wiener Klinische Wochenschrift. 1997 November 14; 109(21): 845-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9408982

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Primary adrenal insufficiency manifesting as malignant lymphoma. Author(s): Osei K, Falko JM, Pacht E, Wall R, Goldberg RF. Source: Archives of Internal Medicine. 1983 September; 143(9): 1791-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6615102

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Primary adrenal insufficiency with hypertension. A case report on partial primary adrenal insufficiency and partial 11-beta-hydroxylase deficiency. Author(s): van Deijk WA, Blom PS, VD Vijver JC. Source: The Netherlands Journal of Medicine. 1979; 22(6): 191-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=316501

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Primary adrenal insufficiency, circulating lupus anticoagulant and anticardiolipin antibodies in a patient with multiple abortions and recurrent thrombotic episodes. Author(s): Grottolo A, Ferrari V, Mariano M, Zambruni A, Tincani A, Del Bono R. Source: Haematologica. 1988 November-December; 73(6): 517-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3148516

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Primary adrenal insufficiency: a new cause of reversible gastric stasis. Author(s): Valenzuela G, Davis T Jr, McGroarty D, Pizzani E, Zfass A. Source: The American Journal of Gastroenterology. 1990 December; 85(12): 1626-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2252030

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Primary adrenal lymphoma associated with adrenal insufficiency: a distinct clinical entity. Author(s): Pimentel M, Johnston JB, Allan DR, Greenberg H, Bernstein CN. Source: Leukemia & Lymphoma. 1997 January; 24(3-4): 363-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9156667

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Primary adrenal lymphoma presenting as adrenal insufficiency. A case report and review of literature. Author(s): Zar T, Khan F, Petit W Jr, Bernene JR. Source: Conn Med. 2004 January; 68(1): 7-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14752912

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Primary antiphospholipid syndrome: an unusual cause of adrenal insufficiency. Author(s): Bober E, Kovanlikaya A, Buyukgebiz A. Source: Hormone Research. 2001; 56(3-4): 140-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11847478

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Primary hypothyroidism misdiagnosed as combined hypothalamic hypothyroidism and secondary adrenal insufficiency. Author(s): Phillips PJ, Pain RW. Source: Archives of Internal Medicine. 1980 April; 140(4): 583-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7362403

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Primary T-cell lymphoma of the adrenal glands with adrenal insufficiency. Author(s): Schnitzer B, Smid D, Lloyd RV. Source: Human Pathology. 1986 June; 17(6): 634-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2940163

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Proceedings: Secondary adrenal insufficiency due to cyproterone acetate. Author(s): Girard J, Baumann JB. Source: The Journal of Endocrinology. 1976 June; 69(3): 13P-14P. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=181508

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Progressive onset of adrenal insufficiency and hypogonadism of pituitary origin caused by a complex genetic rearrangement within DAX-1. Author(s): Salvi R, Gomez F, Fiaux M, Schorderet D, Jameson JL, Achermann JC, Gaillard RC, Pralong FP. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 September; 87(9): 4094-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12213854

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Progressive spastic paraparesis and adrenal insufficiency. Author(s): Gumbinas M, Liu HM, Dawson G, Larsen M, Green O. Source: Archives of Neurology. 1976 October; 33(10): 678-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=973804

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Prophylaxis against early adrenal insufficiency to prevent chronic lung disease in premature infants. Author(s): Watterberg KL, Gerdes JS, Gifford KL, Lin HM. Source: Pediatrics. 1999 December; 104(6): 1258-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10585975

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Prospective evaluation of adrenal insufficiency in patients with adrenal metastasis. Author(s): Redman BG, Pazdur R, Zingas AP, Loredo R. Source: Cancer. 1987 July 1; 60(1): 103-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3581024

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Pulsatile administration of human corticotropin-releasing hormone in patients with secondary adrenal insufficiency: restoration of the normal cortisol secretory pattern. Author(s): Avgerinos PC, Schurmeyer TH, Gold PW, Tomai TP, Loriaux DL, Sherins RJ, Cutler GB Jr, Chrousos GP. Source: The Journal of Clinical Endocrinology and Metabolism. 1986 May; 62(5): 816-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3007554

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Rapidly reversible ECG abnormalities in chronic secondary adrenal insufficiency. Author(s): Maffei P, Cajola S, Abrahamsohn C, Martini C. Source: International Journal of Cardiology. 2002 December; 86(2-3): 333-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12419576

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Reciprocal relationship between the level of circulating cortisol and growth hormone secretion in response to growth hormone-releasing hormone in man: studies in patients with adrenal insufficiency. Author(s): Giustina A, Bresciani E, Bossoni S, Chiesa L, Misitano V, Wehrenberg WB, Veldhuis JD. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 November; 79(5): 1266-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7962318

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Recognising adrenal insufficiency. Author(s): Raisbeck E. Source: Emergency Nurse : the Journal of the Rcn Accident and Emergency Nursing Association. 2002 July-August; 10(4): 24-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12138591

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Recognition of adrenal insufficiency in the postoperative patient. Author(s): Steer M, Fromm D. Source: American Journal of Surgery. 1980 March; 139(3): 443-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6244751

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Rectal hydrocortisone during stress in patients with adrenal insufficiency. Author(s): De Vroede M, Beukering R, Spit M, Jansen M. Source: Archives of Disease in Childhood. 1998 June; 78(6): 544-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9713011

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Regarding “adult reversible cardiomyopathy with pituitary adrenal insufficiency caused by empty sella”. Author(s): Rhee B. Source: Angiology. 2001 June; 52(6): 435-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11437037

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Relative adrenal insufficiency in post-transplant lymphoproliferative disorder. Author(s): Cinclair RD, Rice JC, Agraharkar M. Source: Journal of Postgraduate Medicine. 2003 January-March; 49(1): 69-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12865574

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Relative adrenal insufficiency. Author(s): Mark RE. Source: Am J Proctol. 1971 February; 22(1): 56-64. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5101523

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Relative eosinophilia and functional adrenal insufficiency in critically ill patients. Author(s): Beishuizen A, Vermes I, Hylkema BS, Haanen C. Source: Lancet. 1999 May 15; 353(9165): 1675-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10335792

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Reliability of the ACTH low dose test in the evaluation of adrenal insufficiency. Author(s): Laureti S, Falorni A. Source: Journal of Postgraduate Medicine. 2002 October-December; 48(4): 251-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12571377

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Renin and renin substrate in primary adrenal insufficiency: contrasting effects of glucocorticoid and mineralocorticoid deficiency. Author(s): Stockigt JR, Hewett MJ, Topliss DJ, Higgs EJ, Taft P. Source: The American Journal of Medicine. 1979 June; 66(6): 915-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=222144

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Repetitive graded ACTH stimulation test for adrenal insufficiency. Author(s): Huang TS, Jiang YD. Source: J Endocrinol Invest. 2000 March; 23(3): 163-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10803473

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Resolution of Cushing's disease followed by secondary adrenal insufficiency after anticoagulant-associated pituitary hemorrhage: report of a case and review of the literature. Author(s): Taylor HC, McLean S, Monheim K. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2003 March-April; 9(2): 14751. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12917078

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Reversible adrenal insufficiency after adrenal hemorrhage. Author(s): Vengrove MA, Amoroso A. Source: Annals of Internal Medicine. 1993 September 1; 119(5): 439. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8338307

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Reversible adrenal insufficiency induced by ketoconazole. Author(s): Tucker WS Jr, Snell BB, Island DP, Gregg CR. Source: Jama : the Journal of the American Medical Association. 1985 April 26; 253(16): 2413-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3981770

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Reversible hyperthyrotropinemia, hyperthyroxinemia, and hyperprolactinemia due to adrenal insufficiency. Author(s): Stryker TD, Molitch ME. Source: The American Journal of Medicine. 1985 August; 79(2): 271-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4025380

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Reversible hypertriiodothyroninaemia due to adrenal insufficiency. Author(s): Comtois R, Hebert J, Soucy JP. Source: Journal of Internal Medicine. 1991 July; 230(1): 79-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2066714

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Reversible hypothyroidism in adrenal insufficiency. Author(s): Jeffcoate WJ, Davis JR. Source: British Medical Journal (Clinical Research Ed.). 1982 August 28; 285(6342): 651-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6819052

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Reversible hypothyroidism in idiopathic adrenal insufficiency and in isolated ACTH deficiency. Author(s): Proto G, Bertolissi F. Source: J Endocrinol Invest. 1988 March; 11(3): 227. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2836495

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Rhabdomyolysis as a consequence of adrenal insufficiency. Author(s): de Witte SA, Bonnet F, Morlat P, Beylot J. Source: The American Journal of Medicine. 2003 February 1; 114(2): 160. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12586241

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Rifampicin-induced adrenal insufficiency in the acquired immunodeficiency syndrome: difficulties in diagnosis and treatment. Author(s): Ediger SK, Isley WL. Source: Postgraduate Medical Journal. 1988 May; 64(751): 405-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3200786

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Risk of adrenal insufficiency with steroid maintenance therapy in renal transplantation. Author(s): Boots JM, van den Ham EC, Christiaans MH, van Hooff JP. Source: Transplantation Proceedings. 2002 August; 34(5): 1696-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12176541

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Role of hypovolemia in the impaired water diuresis of adrenal insufficiency. Author(s): Ackerman GL, Miller CL. Source: The Journal of Clinical Endocrinology and Metabolism. 1970 February; 30(2): 252-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5413651

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Screening patients with insulin-dependent diabetes mellitus for adrenal insufficiency. Author(s): Brewer KW, Parziale VS, Eisenbarth GS. Source: The New England Journal of Medicine. 1997 July 17; 337(3): 202. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9221352

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Secondary adrenal insufficiency after intrathecal steroid administration. Author(s): Chernow B, Vigersky R, O'Brian JT, Georges LP. Source: Journal of Neurosurgery. 1982 April; 56(4): 567-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6278107

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Secondary adrenal insufficiency associated with autoimmune disorders: a report of twenty-five cases. Author(s): Kasperlik-Zaluska AA, Czarnocka B, Czech W, Walecki J, Makowska AM, Brzezinski J, Aniszewski J. Source: Clinical Endocrinology. 1998 December; 49(6): 779-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10209566

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Secondary adrenal insufficiency manifested as an acute febrile illness. Author(s): Soto-Hernandez JL, Verghese A, Hall BD, Cole CP, Cupp HB Jr. Source: Southern Medical Journal. 1989 March; 82(3): 384-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2922630

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Self-management of adrenal insufficiency by rectal hydrocortisone. Author(s): Newrick PG, Braatvedt G, Hancock J, Corrall RJ. Source: Lancet. 1990 January 27; 335(8683): 212-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1967677

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Sella turcica enlargement and primary adrenal insufficiency. Author(s): Dluhy RG, Moore TJ, Williams GH. Source: Annals of Internal Medicine. 1978 October; 89(4): 513-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=697232

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Series on endocrine metabolic emergencies: II. Acute adrenal insufficiency. Author(s): Hamburger S, Rush D. Source: J Am Med Womens Assoc. 1981 June; 36(6): 199-200, 202-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6265530

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Serum cortisol appearance-disappearance in adrenal insufficiency after oral cortisone acetate. Author(s): Barbato AL, Landau RL. Source: Acta Endocrinol (Copenh). 1977 March; 84(3): 600-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=576533

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Serum dehydroepiandrosterone sulfate concentrations in secondary adrenal insufficiency. Author(s): Yamaji T, Ishibashi M, Takaku F, Itabashi A, Katayama S, Ishii J. Source: The Journal of Clinical Endocrinology and Metabolism. 1987 September; 65(3): 448-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2957384

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Severe early-onset obesity, adrenal insufficiency and red hair pigmentation caused by POMC mutations in humans. Author(s): Krude H, Biebermann H, Luck W, Horn R, Brabant G, Gruters A. Source: Nature Genetics. 1998 June; 19(2): 155-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9620771

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Severe hyponatraemia due to hypothalamic--pituitary adrenal insufficiency. Author(s): Jacobi J, Titze J, Niewerth P, Lang R, Schulze B, Rupprecht HD. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2001 August; 16(8): 1708-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11477181

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Severe hyponatremia caused by hypothalamic adrenal insufficiency. Author(s): Shibata T, Oeda T, Saito Y. Source: Intern Med. 1999 May; 38(5): 426-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10397081

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Severe hyponatremia due to hypopituitarism with adrenal insufficiency: report on 28 cases. Author(s): Diederich S, Franzen NF, Bahr V, Oelkers W. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2003 June; 148(6): 609-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12773132

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Significance of low-dose and standard-dose ACTH tests compared to overnight metyrapone test in the diagnosis of adrenal insufficiency in childhood. Author(s): Gonc EN, Kandemir N, Kinik ST. Source: Hormone Research. 2003; 60(4): 191-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14530608

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Significance of thyrotropin excess in untreated primary adrenal insufficiency. Author(s): Topliss DJ, White EL, Stockigt JR. Source: The Journal of Clinical Endocrinology and Metabolism. 1980 January; 50(1): 52-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6765953

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Simple biochemical screening for aldosterone activity in adrenal insufficiency. Author(s): Truttmann AC, Mullis PE, Bianchetti MG. Source: European Journal of Pediatrics. 1998 June; 157(6): 520. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9667415

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Simultaneous investigation and treatment of suspected acute adrenal insufficiency. Author(s): Sheridan P, Mattingly D. Source: Lancet. 1975 October 11; 2(7937): 676-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=52051

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Somatostatin: a potent inhibitor of ACTH-hypersecretion in adrenal insufficiency. Author(s): Fehm HL, Voigt KH, Lang R, Beinert KE, Raptis S, Pfeiffer EF. Source: Klin Wochenschr. 1976 February 15; 54(4): 173-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1256005

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Steroid-dependent states and adrenal insufficiency. Fluid and electrolyte disturbances. Author(s): Schira MG. Source: Nurs Clin North Am. 1987 December; 22(4): 837-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3684707

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Studies on cortisol substitution therapy in patients with adrenal insufficiency. Author(s): Nickelsen T, Schulz F, Demisch K. Source: Exp Clin Endocrinol. 1983 July; 82(1): 35-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6311594

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Successful treatment of CMV-induced adrenal insufficiency by ganciclovir in a patient with the acquired immunodeficiency syndrome. Author(s): Sanhes L, Michez E, Essig M, Rondeau E, Sraer JD. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1995; 10(5): 704-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7566589

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Successful treatment of primary adrenal insufficiency due to malignant nonHodgkin's lymphoma. Author(s): Dobnig H, Silly H, Ohlinger W, Neubauer M, Leb G, Krejs GJ. Source: Clin Investig. 1992 October; 70(10): 938-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1450618

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Successful treatment of primary adrenal non-Hodgkin's lymphoma associated with adrenal insufficiency. Author(s): Kuyama A, Takeuchi M, Munemasa M, Tsutsui K, Aga N, Goda Y, Kanetada K. Source: Leukemia & Lymphoma. 2000 June; 38(1-2): 203-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10811465

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Successful treatment with ganciclovir of a HIV endstage patient with adrenal insufficiency. Author(s): Muhlhofer A, Jung C, Gross M. Source: European Journal of Medical Research. 1997 November 28; 2(11): 469-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9385116

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Sudden infant death and adrenal insufficiency. Author(s): Franciosi RA. Source: Archives of Pathology & Laboratory Medicine. 1977 October; 101(10): 555. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=578690

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Supplemental corticosteroids for dental patients with adrenal insufficiency: reconsideration of the problem. Author(s): Miller CS, Little JW, Falace DA. Source: The Journal of the American Dental Association. 2001 November; 132(11): 15709; Quiz 1596-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11806072

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Surgical management of isolated bilateral adrenal metastases from colon carcinoma causing adrenal insufficiency. Author(s): Crisci A, Cartei G, De Antoni P, Giannarini G, Moro U, Selli C. Source: Urologia Internationalis. 2001; 67(1): 113-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11464135

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Symptomatic adrenal insufficiency during inhaled corticosteroid treatment. Author(s): Patel L, Wales JK, Kibirige MS, Massarano AA, Couriel JM, Clayton PE. Source: Archives of Disease in Childhood. 2001 October; 85(4): 330-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11567945

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Symptomatic adrenal insufficiency presenting with hypoglycaemia in children with asthma receiving high dose inhaled fluticasone propionate. Author(s): Drake AJ, Howells RJ, Shield JP, Prendiville A, Ward PS, Crowne EC. Source: Bmj (Clinical Research Ed.). 2002 May 4; 324(7345): 1081-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11991916

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Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and adrenal insufficiency induced by rathke's cleft cyst: a case report. Author(s): Iwai H, Ohno Y, Hoshiro M, Fujimoto M, Nishimura A, Kishitani Y, Aoki N. Source: Endocrine Journal. 2000 August; 47(4): 393-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11075719

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Systemic lupus erythematosus associated with adrenal insufficiency. Author(s): Thiagarajan D, Wongsurawat N. Source: J Kans Med Soc. 1978 October; 79(10): 565-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=701945

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Systemic lupus erythematosus with adrenal insufficiency. Author(s): Eichner HL, Schambelan M, Biglieri EG. Source: The American Journal of Medicine. 1973 November; 55(5): 700-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4356101

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Tachyarrhythmia and hyperkalemia in adrenal insufficiency. Author(s): Nora JJ, McGrath RL, Wolfe RR. Source: Chest. 1977 May; 71(5): 686-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=852357

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Teaching a patient to live with adrenal insufficiency. Author(s): Shea KM, O'Connor CP, Karafelis EG, Thorn GW, Kozak GP. Source: The American Journal of Nursing. 1965 December; 65(12): 80-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5174229

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Tests of adrenal insufficiency. Author(s): Agwu JC, Spoudeas H, Hindmarsh PC, Pringle PJ, Brook CG. Source: Archives of Disease in Childhood. 1999 April; 80(4): 330-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10086937

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The “taste” test in adrenal insufficiency. Author(s): Kosowicz J, Pruszewicz A. Source: The Journal of Clinical Endocrinology and Metabolism. 1967 February; 27(2): 214-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6018575

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The changing clinical spectrum of adrenal insufficiency. Author(s): Carey RM. Source: Annals of Internal Medicine. 1997 December 15; 127(12): 1103-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9412314

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The clinical importance of adrenal insufficiency in acute hepatic dysfunction. Author(s): Harry R, Auzinger G, Wendon J. Source: Hepatology (Baltimore, Md.). 2002 August; 36(2): 395-402. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12143048

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The corticotropin-releasing hormone stimulation test: a possible aid in the evaluation of patients with adrenal insufficiency. Author(s): Schulte HM, Chrousos GP, Avgerinos P, Oldfield EH, Gold PW, Cutler GB Jr, Loriaux DL. Source: The Journal of Clinical Endocrinology and Metabolism. 1984 June; 58(6): 1064-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6327750

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The diagnosis of secondary adrenal insufficiency: low dose vs high dose ACTH stimulation test. Author(s): Colao A, Pivonello R. Source: J Endocrinol Invest. 2003 January; 26(1): 1-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12602526

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The effect of pulsatile human corticotropin-releasing hormone administration on the adrenal insufficiency that follows cure of Cushing's disease. Author(s): Avgerinos PC, Nieman LK, Oldfield EH, Loughlin T, Barnes KM, Loriaux DL, Cutler GB Jr. Source: The Journal of Clinical Endocrinology and Metabolism. 1989 May; 68(5): 912-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2541160

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The impact of different glucocorticoid replacement schedules on bone turnover and insulin sensitivity in patients with adrenal insufficiency. Author(s): Suliman AM, Freaney R, Smith TP, McBrinn Y, Murray B, McKenna TJ. Source: Clinical Endocrinology. 2003 September; 59(3): 380-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12919163

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The incidence of adrenal and other antibodies in the sera of patients with idiopathic adrenal insufficiency (Addison's disease). Author(s): Blizzard RM, Chee D, Davis W. Source: Clinical and Experimental Immunology. 1967 January; 2(1): 19-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6030795

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The low dose (1-microg) adrenocorticotropin stimulation test in the evaluation of patients with suspected central adrenal insufficiency. Author(s): Thaler LM, Blevins LS Jr. Source: The Journal of Clinical Endocrinology and Metabolism. 1998 August; 83(8): 2726-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9709938

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The low-dose ACTH test does not provide a useful assessment of the hypothalamicpituitary-adrenal axis in secondary adrenal insufficiency. Author(s): Suliman AM, Smith TP, Labib M, Fiad TM, McKenna TJ. Source: Clinical Endocrinology. 2002 April; 56(4): 533-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11966747

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The relationship between morning serum cortisol and the short ACTH test in the evaluation of adrenal insufficiency. Author(s): Lee MT, Won JG, Lee TI, Yang HJ, Lin HD, Tang KT. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2002 December; 65(12): 580-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12636203

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The role of antidiuretic hormone in hyponatremia in adrenal insufficiency--is the guideline for the diagnosis of syndrome of inappropriate secretion of the antidiuretic hormone appropriate? Author(s): Demura R. Source: Intern Med. 1999 May; 38(5): 382-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10397072

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The role of high- and low-dose corticotropin tests in the diagnosis of secondary adrenal insufficiency. Author(s): Oelkers W. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 1998 December; 139(6): 567-70. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9916857

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The role of plasma renin activity in evaluating the adequacy of mineralocorticoid replacement in primary adrenal insufficiency. Author(s): Flad TM, Conway JD, Cunningham SK, McKenna TJ. Source: Clinical Endocrinology. 1996 November; 45(5): 529-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8977748

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Therapeutic strategies in adrenal insufficiency. Author(s): Oelkers W, Diederich S, Bahr V. Source: Annales D'endocrinologie. 2001 April; 62(2): 212-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11353897

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Thyroid storm presenting with no fever and an absolute adrenal insufficiency. Author(s): De Keulenaer BL, Lahaye FJ, Schepens DR, Daelemans R, Wilmer A. Source: Intensive Care Medicine. 2002 August; 28(8): 1192. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12400520

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Treatment of adrenal insufficiency states including Addison's disease. Author(s): Frawley TF. Source: Mod Treat. 1966 November; 3(6): 1328-47. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5924156

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Type 1 diabetes mellitus masked by primary adrenal insufficiency in a child with autoimmune polyglandular syndrome type 2. Author(s): Aijaz NJ, Blanco E, Lane AH, Wilson TA. Source: Clinical Pediatrics. 2003 January-February; 42(1): 75-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12635986

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Ultrasound diagnosis of testicular masses secondary to hyperplastic adrenal rests in a patient with adrenal insufficiency. Author(s): Arenson AM, Hamilton P, Silverberg J, Withers C, Livingstone D. Source: Journal of Clinical Ultrasound : Jcu. 1991 September; 19(7): 430-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1658070

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Unusual presentations of lung cancer: Case 2. Adrenal insufficiency as the initial manifestation of non-small-cell lung cancer. Author(s): Sirachainan E, Kalemkerian GP. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2002 December 1; 20(23): 4598-600. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12454119

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Unusual presentations of thoracic tumors: Case 1. Acute adrenal insufficiency due to metastatic lung cancer. Author(s): Potti A, Schell DA. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 September 1; 19(17): 3780-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11533102

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Urinary excretion of tetrahydroaldosterone in normal subjects and in patients with adrenal insufficiency and Conn's syndrome. Author(s): Nielsen MD, Lund JO, Munck O. Source: Acta Endocrinol (Copenh). 1972 November; 71(3): 498-511. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4678197

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Ventricular arrhythmia and adrenal insufficiency after fluorouracil: new side effects of an old drug. Author(s): Harris LN, Ragaz J. Source: Journal of the National Cancer Institute. 1993 February 17; 85(4): 326-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8426375

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CHAPTER 2. NUTRITION AND ADRENAL INSUFFICIENCY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and adrenal insufficiency.

Finding Nutrition Studies on Adrenal Insufficiency The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “adrenal insufficiency” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

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Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “adrenal insufficiency” (or a synonym): •

Adrenal insufficiency and cardiac dysfunction in the preterm infant. Author(s): Department of Pediatrics, University of New Mexico, ACC-3 West, Albuquerque, NM 87131, USA. Source: Watterberg, K L Pediatr-Res. 2002 April; 51(4): 422-4 0031-3998

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

Nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to adrenal insufficiency; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Food and Diet Hypoglycemia Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND ADRENAL INSUFFICIENCY Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to adrenal insufficiency. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to adrenal insufficiency and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “adrenal insufficiency” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to adrenal insufficiency: •

A cross-sectional study of growth, puberty and endocrine function in patients with thalassaemia major in Hong Kong. Author(s): Kwan EY, Lee AC, Li AM, Tam SC, Chan CF, Lau YL, Low LC. Source: Journal of Paediatrics and Child Health. 1995 April; 31(2): 83-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7794630

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A new dietary therapy for adrenoleukodystrophy: biochemical and preliminary clinical results in 36 patients. Author(s): Moser AB, Borel J, Odone A, Naidu S, Cornblath D, Sanders DB, Moser HW. Source: Annals of Neurology. 1987 March; 21(3): 240-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2440378

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A two-year trial of oleic and erucic acids (“Lorenzo's oil”) as treatment for adrenomyeloneuropathy. Author(s): Aubourg P, Adamsbaum C, Lavallard-Rousseau MC, Rocchiccioli F, Cartier N, Jambaque I, Jakobezak C, Lemaitre A, Boureau F, Wolf C, et al. Source: The New England Journal of Medicine. 1993 September 9; 329(11): 745-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8350883

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Accidental shock during epidural anesthesia in a patient with NSAID-induced hyporeninemic hypoaldosteronism. Author(s): Tan PH, Chou AK, Perng JS. Source: Journal of Clinical Anesthesia. 1997 August; 9(5): 424-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9257212

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Adaptation to Addison's disease in a child: a case study. Author(s): Gance-Cleveland B. Source: Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners. 2003 November-December; 17(6): 301-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14610444

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Adrenal function in thalassemia major following long-term treatment with multiple transfusions and chelation therapy. Evidence for dissociation of cortisol and adrenal androgen secretion. Author(s): Sklar CA, Lew LQ, Yoon DJ, David R. Source: Am J Dis Child. 1987 March; 141(3): 327-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3028128

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Adrenal insufficiency in critically ill emergency department patients: a Taiwan preliminary study. Author(s): Chang SS, Liaw SJ, Bullard MJ, Chiu TF, Chen JC, Liao HC. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 2001 July; 8(7): 761-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11435198

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Adrenal insufficiency. Author(s): Kenward D, White KG; Addison's Disease Self-Help Group. Source: Lancet. 2003 August 16; 362(9383): 579-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12932402

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Adrenoleukodystrophy. Author(s): Moser HW. Source: Current Opinion in Neurology. 1995 June; 8(3): 221-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7551122

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Adrenoleukodystrophy. The chain shortening of erucic acid (22:1(n-9)) and adrenic acid (22:4(n-6)) is deficient in neonatal adrenoleukodystrophy and normal in X-linked adrenoleukodistrophy skin fibroblasts. Author(s): Christensen E, Gronn M, Hagve TA, Kase BF, Christophersen BO. Source: Biochimica Et Biophysica Acta. 1989 March 14; 1002(1): 79-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2538146

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Adrenoleukodystrophy: a link between adrenal insufficiency and school performance. Author(s): Bakos JT, Goen P, Ogden A, Brown FR 3rd, Karaviti LP. Source: The Journal of Clinical Endocrinology and Metabolism. 1995 October; 80(10): 2869-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7559867

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Adrenoleukodystrophy: dietary oleic acid lowers hexacosanoate levels. Author(s): Rizzo WB, Phillips MW, Dammann AL, Leshner RT, Jennings SS, Avigan J, Proud VK. Source: Annals of Neurology. 1987 March; 21(3): 232-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3037987

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Adrenoleukodystrophy: magnetic resonance follow-up after Lorenzo's oil therapy. Author(s): Duchesne N, Dufour M, Bouchard G, Grondin P, Lemieux B. Source: Canadian Association of Radiologists Journal = Journal L'association Canadienne Des Radiologistes. 1995 October; 46(5): 386-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7552831

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Age-associated changes in the endocrine system. Author(s): Winger JM, Hornick T. Source: Nurs Clin North Am. 1996 December; 31(4): 827-44. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8969342

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Anecdote beats out science-popular but unfortunate. Author(s): Simonsen RJ. Source: Quintessence Int. 1993 April; 24(4): 223. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8362031

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Angiotropic large cell lymphoma which infiltrated to the adrenal glands presenting as reversible adrenal insufficiency. Author(s): Kuwahara K, Fukata J, Kamio M, Mochizuki T, Tsuchiya A, Tanaka S. Source: Intern Med. 1998 January; 37(1): 73-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9510405

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Bilateral adrenal lymphoma with neoplastic angioendotheliosis. Author(s): Kubo M, Koga M, Fujii T, Kaneko T, Yamashita K, Kokubu T. Source: Intern Med. 1997 January; 36(1): 47-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9058101

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Bilateral primary non-Hodgkin's lymphoma of the adrenal glands with adrenal insufficiency: a case report. Author(s): Utsunomiya M, Takatera H, Itoh H, Tsujimura T, Itatani H. Source: Hinyokika Kiyo. 1992 March; 38(3): 311-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1523986

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Bleeding in a patient taking Lorenzo's oil: evidence for a vascular defect. Author(s): Chai BC, Etches WS, Stewart MW, Siminoski K. Source: Postgraduate Medical Journal. 1996 February; 72(844): 113-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8871463

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Blood polyunsaturated fatty acids in patients with peroxisomal disorders. A multicenter study. Author(s): Martinez M, Mougan I, Roig M, Ballabriga A. Source: Lipids. 1994 April; 29(4): 273-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8177020

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Brain, liver, and adipose tissue erucic and very long chain fatty acid levels in adrenoleukodystrophy patients treated with glyceryl trierucate and trioleate oils (Lorenzo's oil). Author(s): Rasmussen M, Moser AB, Borel J, Khangoora S, Moser HW. Source: Neurochemical Research. 1994 August; 19(8): 1073-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7800117

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Clinical and therapeutic aspects of adrenoleukodystrophy and adrenomyeloneuropathy. Author(s): Moser HW. Source: Journal of Neuropathology and Experimental Neurology. 1995 September; 54(5): 740-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7666063

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Conversion reaction. Differential diagnoses in the light of biofeedback research. Author(s): Barr R, Abernethy V. Source: The Journal of Nervous and Mental Disease. 1977 April; 164(4): 287-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=845599

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Critical review of contemporary cellulartherapy (celltherapy). Author(s): Jussek EG, Roscher AA.

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Source: J Gerontol. 1970 April; 25(2): 119-25. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4393437 •

Dietary management of X-linked adrenoleukodystrophy. Author(s): Moser HW, Borel J. Source: Annual Review of Nutrition. 1995; 15: 379-97. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8527226

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Dietary treatment of adrenoleukodystrophy. Author(s): Suzuki S, Kobayashi T, Goto I, Kuroiwa Y. Source: Neurology. 1986 January; 36(1): 104-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3941763

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Effect of dehydroepiandrosterone supplementation on fatty acid and hormone levels in patients with X-linked adrenoleucodystrophy. Author(s): Assies J, Haverkort EB, Lieverse R, Vreken P. Source: Clinical Endocrinology. 2003 October; 59(4): 459-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14510908

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Effect of electroacupuncture (EA) on the functional activity of the rat adrenal. Author(s): Zhao XJ, Fang HR, Shi TR, Lu ZS. Source: Zhen Ci Yan Jiu. 1986; 11(4): 308-11. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2436830

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Effect of erucic acid on platelets in patients with adrenoleukodystrophy. Author(s): Kickler TS, Zinkham WH, Moser A, Shankroff J, Borel J, Moser H. Source: Biochemical and Molecular Medicine. 1996 April; 57(2): 125-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8733890

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Effect of glycyrrhizine on hyperkalemia due to hyporeninemic hypoaldosteronism in diabetes mellitus. Author(s): Murakami T, Uchikawa T. Source: Life Sciences. 1993; 53(5): Pl63-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8336514

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Not just another fall in the elderly. Bilateral adrenal lymphoma presenting with adrenal insufficiency causing weakness. Author(s): Gillett M, Haak S. Source: Aust Fam Physician. 2003 April; 32(4): 248-50. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12735264

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Primary adrenal lymphoma associated with adrenal insufficiency: a distinct clinical entity. Author(s): Pimentel M, Johnston JB, Allan DR, Greenberg H, Bernstein CN. Source: Leukemia & Lymphoma. 1997 January; 24(3-4): 363-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9156667

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Primary adrenal lymphoma presenting as adrenal insufficiency. A case report and review of literature. Author(s): Zar T, Khan F, Petit W Jr, Bernene JR. Source: Conn Med. 2004 January; 68(1): 7-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14752912

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to adrenal insufficiency; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Adrenal Insufficiency Source: Integrative Medicine Communications; www.drkoop.com

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Herbs and Supplements Adrenal Extract Source: Healthnotes, Inc.; www.healthnotes.com Dehydroepiandrosterone (DHEA) Source: Healthnotes, Inc.; www.healthnotes.com DHEA (Dehydroepiandrosterone) Source: Prima Communications, Inc.www.personalhealthzone.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. BOOKS ON ADRENAL INSUFFICIENCY Overview This chapter provides bibliographic book references relating to adrenal insufficiency. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on adrenal insufficiency include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “adrenal insufficiency” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on adrenal insufficiency: •

Dental Management of the Medically Compromised Patient. 5th ed Source: St. Louis, MO: Mosby, Inc. 1997. 668 p. Contact: Available from Harcourt Health Sciences. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 325-4177. Fax (800) 874-6418. Website: www.harcourthealth.com. PRICE: $48.00 plus shipping and handling. ISBN: 0815156340. Summary: A working knowledge of the multitude of compromised health states is essential for dental professionals, as the majority of medically compromised patients need or want oral health care. This knowledge will support high standards for dental and oral health care delivery, which include recognizing and understanding conditions that reflect compromised states, preventing adverse side effects of procedures and drugs used in dentistry, and formulating treatment plans that are consistent with a patient's medical status. This text offers 28 chapters that provide the dental practitioner with an

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up to date reference work describing the dental management of patients with selected medical problems. After an introductory chapter on the interrelationships between medicine and dentistry, the text covers infective endocarditis, rheumatic fever and rheumatic heart disease, congenital heart disease, surgically corrected cardiac and vascular disease, hypertension, ischemic heart disease, cardiac arrhythmias, congestive heart failure, pulmonary disease, chronic renal failure and dialysis, liver disease, gastrointestinal disease, sexually transmitted diseases, AIDS and related conditions, arthritis, neurologic disorders, diabetes, adrenal insufficiency, thyroid disease, pregnancy and breastfeeding, allergy, bleeding disorders, blood dyscrasias, oral cancer, behavioral and psychiatric disorders, organ transplantation, and prosthetic implants. Two appendices offer an overview of infection control and a review of the therapeutic management of common oral lesions. Each chapter includes black and white photographs and concludes with references. A subject index concludes the volume. •

Challenging Cases in Endocrinology Source: Totowa, NJ: The Humana Press, Inc. 2002. 421 p. Contact: Humana Press, Inc. 999 Riverview Dr., Suite 208 Totowa, NJ 07512. (973) 2561699. Fax (973) 256-8341. E-mail: [email protected] PRICE: $145.00, plus shipping and handling. ISBN:0896039145. Summary: In medicine, the difficult cases can yield valuable insights because they force physicians to think a little harder when making a diagnosis and to be creative when treating the patient. In this textbook, distinguished clinician-scientists describe in concise studies their most difficult cases and reveal what they did, how they did it, and why. The cases cover a wide range of medical problems, including pituitary and thyroid tumors, hypopituitarism, hyper and hypo thyroidism, metabolic bone disease, Cushing's syndrome, adrenal insufficiency, cancer, diabetes, and hypoglycemia (low blood glucose). Other cases involve disorders of female reproduction, of water balance and lipoprotein metabolism, of puberty, and of growth and development. Each case study reviews how the patient was managed, details the reasons why various tests and treatments (many only recently available) were carried out, and provides references to ensure that these novel methodologies can be easily translated into the endocrine specialist's daily practice. Two chapters are particularly relevant for diabetes: Type 1 Diabetes Mellitus (Chapter 16) and Type 2 Diabetes Mellitus (Chapter 17). The volume concludes with a detailed subject index.

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Medical Emergencies in the Dental Office. 5th ed Source: St. Louis, MO: Mosby, Inc. 2000. 540 p. Contact: Available from Mosby, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 426-4545. E-mail: [email protected]. Website: www.mosby.com. PRICE: $52.95 plus shipping and handling. ISBN: 1556644205. Summary: Maintaining a high level of skill in the prevention, recognition, and management of medical emergencies is important in the field of dentistry. This textbook covers the management of medical emergencies in the dental office. Thirty chapters are offered in eight sections: prevention, unconsciousness, respiratory distress, altered consciousness, seizures, drug related emergencies, chest pain, and cardiac arrest. Specific topics include medicolegal considerations, vasodepressor syncope (fainting), postural hypotension (low blood pressure and feeling faint upon getting up from a prone or semi prone position), acute adrenal insufficiency, differential diagnosis, airway obstruction, hyperventilation, asthma, heart failure, acute pulmonary edema

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(fluid in the lungs), diabetes mellitus, thyroid gland dysfunction, cerebrovascular accident (stroke), drug overdose reactions, allergy, angina pectoris, acute myocardial infarction, and cardiac arrest and cardiopulmonary resuscitation. The text concludes with a quick reference section to life threatening situations (offered in algorithm format) and a subject index. Each chapter includes black and white photographs and extensive references. •

Dental Management of the Medically Compromised Patient. 4th ed Source: St. Louis, MO: Mosby-Year Book, Inc. 1993. 605 p. Contact: Available from Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-9934. (800) 426-4545 or (314) 872-8370; Fax (800) 535-9935 or (314) 4321380; E-mail: [email protected]; http://www.mosby.com. PRICE: $39.95 plus shipping and handling. ISBN: 0801668379. Summary: This book was written to provide the dental practitioner with an up-to-date, concise reference work describing the dental management of patients with selected medical problems. Twenty-seven chapters cover the interrelationships of medicine and dentistry; infective endocarditis; rheumatic fever, rheumatic heart disease, and murmurs; congenital heart disease; surgically-corrected cardiac and vascular disease; hypertension; ischemic heart disease; cardiac arrhythmias; congestive heart failure; pulmonary disease; chronic renal failure and dialysis; liver disease; sexually transmitted diseases; AIDS and related conditions; arthritis; neurologic disorders; diabetes; adrenal insufficiency; thyroid disease; pregnancy and breast-feeding; allergy; bleeding disorders; blood dyscrasias; oral cancer; behavioral and psychiatric disorders; organ transplantation; and prosthetic implants. Where appropriate, medical problems are organized to provide a brief overview of the basic disease process, pathophysiology, signs and symptoms, laboratory findings, and currently accepted medical therapy for each disorder. This is followed by a detailed explanation and recommendations for specific dental management. Two appendices cover infection control and the therapeutic management of common oral lesions. A detailed subject index concludes the text.

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Dental Management of the Medically Compromised Patient. 6th ed Source: St. Louis, MO: Elsevier Science. 2002. 735 p. Contact: Available from Elsevier Science. Customer Service Department, 11830 Westline Industrial Drive, St. Louis, MO 63146 (800) 545-2522. Fax (800) 535-9935. Email: [email protected]. Website: www.elsevierhealth.com. PRICE: $56.95. ISBN: 323011713. Summary: This resource guide helps dental professionals work with medically compromised patients. The book is not a comprehensive medical reference but rather a book containing enough core information about each of the medical conditions covered to enable the reader to recognize the basis for various dental management recommendations. After an introduction summary table of dental management and a discussion of common medical emergencies in the dental office, the text offers 26 chapters: physical evaluation and risk assessment, infective endocarditis, cardiac conditions associated with endocarditis, hypertension, ischemic heart disease, cardiac arrhythmias, congestive heart failure, pulmonary (lung) disease, chronic renal (kidney) failure and dialysis, liver disease, gastrointestinal disease, sexually transmitted diseases, AIDS and related conditions, diabetes, adrenal insufficiency, thyroid disease, pregnancy and breast-feeding, allergy, bleeding disorders, disorders of red and white blood cells, cancer, neurological disorders, behavioral and psychiatric disorders,

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arthritic diseases, organ transplantation, and the dental management of older adults. Each chapter provides a brief overview of the basic disease process, epidemiology, pathophysiology, signs and symptoms, laboratory findings, currently accepted medical therapy, and recommendations for specific dental management. The text concludes with 3 appendices: infection control, therapeutic management of common oral lesions, and drug interactions of significance to dentistry. A detailed subject index is also included.

Chapters on Adrenal Insufficiency In order to find chapters that specifically relate to adrenal insufficiency, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and adrenal insufficiency using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “adrenal insufficiency” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on adrenal insufficiency: •

Adrenal Insufficiency Source: in Little, J.W., et al. Dental Management of the Medically Compromised Patient. 6th ed. St. Louis, MO: Elsevier Science. 2002. p. 271-282. Contact: Available from Elsevier Science. Customer Service Department, 11830 Westline Industrial Drive, St. Louis, MO 63146 (800) 545-2522. Fax (800) 535-9935. Email: [email protected]. Website: www.elsevierhealth.com. PRICE: $56.95. ISBN: 323011713. Summary: The adrenal glands are small endocrine glands located bilaterally at the superior pole of each kidney. Each gland contains an outer cortex and inner medulla. The adrenal medulla functions as a sympathetic ganglion and secretes primarily epinephrine, whereas the adrenal cortex secretes a variety of hormones with multiple actions. This chapter on adrenal insufficiency is from a resource text that helps dental professionals work with medically compromised patients. The chapter provides a brief overview of the basic disease process, epidemiology, pathophysiology, signs and symptoms, laboratory findings, currently-accepted medical therapy, prevention of medical complications, and recommendations for specific dental treatment planning. Patients with hyperadrenalism have increased likelihood of hypertension, osteoporosis, and risk of peptic ulcer disease. Evidence indicates that the vast majority of patients with adrenal insufficiency can receive routine dental treatment without the need for supplemental glucocorticoids. 18 figures. 1 table. 50 references.

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CHAPTER 5. PERIODICALS AND NEWS ON ADRENAL INSUFFICIENCY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover adrenal insufficiency.

News Services and Press Releases One of the simplest ways of tracking press releases on adrenal insufficiency is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “adrenal insufficiency” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to adrenal insufficiency. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “adrenal insufficiency” (or synonyms). The following was recently listed in this archive for adrenal insufficiency: •

Dehydroepiandrosterone replacement improves well-being in women with adrenal insufficiency Source: Reuters Medical News Date: September 30, 1999

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Adrenal insufficiency linked to inhaled corticosteroid use in asthma Source: Reuters Medical News Date: January 19, 1999

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New-Onset Eosinophilia May Indicate Adrenal Insufficiency Source: Reuters Medical News Date: December 20, 1996

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Megestrol Acetate Linked To Adrenal Insufficiency In AIDS Patients Source: Reuters Medical News Date: August 25, 1995 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “adrenal insufficiency” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “adrenal insufficiency” (or synonyms). If you know the name of a company that is relevant to adrenal insufficiency, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “adrenal insufficiency” (or synonyms).

Academic Periodicals covering Adrenal Insufficiency Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to adrenal insufficiency. In addition to these sources, you can search for articles covering adrenal insufficiency that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute8: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

8

These publications are typically written by one or more of the various NIH Institutes.

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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:10 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

9

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 10 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway11 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “adrenal insufficiency” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 7364 27 949 26 71 8437

HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.15 Simply search by “adrenal insufficiency” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

11

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

12

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists16 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.17 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.18 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

16 Adapted 17

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 18 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on adrenal insufficiency can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to adrenal insufficiency. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to adrenal insufficiency. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “adrenal insufficiency”:

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Addison's Disease http://www.nlm.nih.gov/medlineplus/addisonsdisease.html Adrenal Gland Disorders http://www.nlm.nih.gov/medlineplus/adrenalglanddisorders.html Endocrine Diseases http://www.nlm.nih.gov/medlineplus/endocrinediseases.html Hormones http://www.nlm.nih.gov/medlineplus/hormones.html Kidney Failure http://www.nlm.nih.gov/medlineplus/kidneyfailure.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Pituitary Disorders http://www.nlm.nih.gov/medlineplus/pituitarydisorders.html Thyroid Diseases http://www.nlm.nih.gov/medlineplus/thyroiddiseases.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on adrenal insufficiency. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Addison's Disease Source: Danbury, CT: National Organization for Rare Disorders (NORD). 1997. 6 p. Contact: Available from National Organization for Rare Disorders (NORD). P.O. Box 1968, Danbury, CT 06813-1968. (800) 999-6673 or (203) 744-0100. Fax (203) 798-2291. TDD (203) 797-9590. E-mail: [email protected]. Website: www.rarediseases.org. PRICE: $7.50. Summary: This fact sheet presents the National Organization for Rare Disorders (NORD) database entry on Addison's disease, a rare disorder characterized by chronic, usually progressive, insufficient functioning of the outer layer of the adrenal glands. Major symptoms include fatigue, gastrointestinal discomfort, and changes in skin color (pigmentation). The fact sheet covers symptoms (early and later), causes, the affected

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population, related disorders, standard therapies, and investigational therapies. The fact sheet concludes with the contact information for the National Adrenal Diseases Foundation and the National Digestive Diseases Information Clearinghouse (800-8915389). The exact cause of Addison's disease and the associated loss of function of the adrenal cortex is not known. Approximately 75 percent of Addison's disease cases are thought to be autoimmune related. Autoimmune disorders occur when the body's natural immune defenses (antibodies, lymphocytes) against invading organisms mistakenly attack perfectly healthy tissue. The chronic adrenal insufficiency that characterizes Addison's disease is treated with replacement therapy that consists of cortisone and fludrocortisone. The dosage of these drugs should be increased during infection, trauma, surgery, and other stress to prevent an acute adrenal crisis. In addition, researchers at the National Institutes of Health (NIH) are now studying the use of interleukin 6 for the treatment of Addison's disease. 6 references. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to adrenal insufficiency. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to adrenal insufficiency. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with adrenal insufficiency.

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The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about adrenal insufficiency. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “adrenal insufficiency” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “adrenal insufficiency”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “adrenal insufficiency” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “adrenal insufficiency” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.19

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

19

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)20: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

20

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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ADRENAL INSUFFICIENCY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal fat: Fat (adipose tissue) that is centrally distributed between the thorax and pelvis and that induces greater health risk. [NIH] Ablate: In surgery, is to remove. [NIH] Ablation: The removal of an organ by surgery. [NIH] Acidemia: Increased acidity of blood. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenoma: A benign epithelial tumor with a glandular organization. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal insufficiency: The reduced secretion of adrenal glands. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenoleukodystrophy: A chromosome X-linked disease. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the

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tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Obstruction: Any hindrance to the passage of air into and out of the lungs. [NIH] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of

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pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibodies, Anticardiolipin: Antiphospholipid antibodies found in association with

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systemic lupus erythematosus (lupus erythematosus, systemic), antiphospholipid syndrome, and in a variety of other diseases as well as in healthy individuals. The antibodies are detected by solid-phase immunoassay employing the purified phospholipid antigen cardiolipin. [NIH] Antibodies, Antiphospholipid: Autoantibodies directed against phospholipids. These antibodies are characteristically found in patients with systemic lupus erythematosus, antiphospholipid syndrome, related autoimmune diseases, some non-autoimmune diseases, and also in healthy individuals. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antidiuretic: Suppressing the rate of urine formation. [EU] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihistamine: A drug that counteracts the action of histamine. The antihistamines are of two types. The conventional ones, as those used in allergies, block the H1 histamine receptors, whereas the others block the H2 receptors. Called also antihistaminic. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antiphospholipid Syndrome: The presence of antibodies directed against phospholipids (antibodies, antiphospholipid). The condition is associated with a variety of diseases, notably systemic lupus erythematosus and other connective tissue diseases, thrombopenia, and arterial or venous thromboses. In pregnancy it can cause abortion. Of the phospholipids, the cardiolipins show markedly elevated levels of anticardiolipin antibodies (antibodies, anticardiolipin). Present also are high levels of lupus anticoagulant (lupus coagulation inhibitor). [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH]

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Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspergillosis: Infections with fungi of the genus Aspergillus. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Auricular: Pertaining to an auricle or to the ear, and, formerly, to an atrium of the heart. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autopsy: Postmortem examination of the body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease;

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neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [NIH] Blast phase: The phase of chronic myelogenous leukemia in which the number of immature, abnormal white blood cells in the bone marrow and blood is extremely high. Also called blast crisis. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blastomycosis: A fungal infection that may appear in two forms: 1) a primary lesion characterized by the formation of a small cutaneous nodule and small nodules along the lymphatics that may heal within several months; and 2) chronic granulomatous lesions characterized by thick crusts, warty growths, and unusual vascularity and infection in the middle or upper lobes of the lung. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH]

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Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchopulmonary: Pertaining to the lungs and their air passages; both bronchial and pulmonary. [EU] Bronchopulmonary Dysplasia: A chronic lung disease appearing in certain newborn infants treated for respiratory distress syndrome with mechanical ventilation and elevated concentration of inspired oxygen. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Budesonide: A glucocorticoid used in the management of asthma, the treatment of various skin disorders, and allergic rhinitis. [NIH] Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic disease. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Channels: Voltage-dependent cell membrane glycoproteins selectively permeable to calcium ions. They are categorized as L-, T-, N-, P-, Q-, and R-types based on the activation and inactivation kinetics, ion specificity, and sensitivity to drugs and toxins. The L- and T-types are present throughout the cardiovascular and central nervous systems and the N-, P-, Q-, & R-types are located in neuronal tissue. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU]

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Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiac arrest: A sudden stop of heart function. [NIH] Cardiolipins: Acidic phospholipids composed of two molecules of phosphatidic acid covalently linked to a molecule of glycerol. They occur primarily in mitochondrial inner membranes and in bacterial plasma membranes. They are the main antigenic components of the Wassermann-type antigen that is used in nontreponemal syphilis serodiagnosis. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catecholamines: A general class of ortho-dihydroxyphenylalkylamines derived from tyrosine. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are

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made up of one or more cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Central fat distribution: The waist circumference is an index of body fat distribution. Increasing waist circumference is accompanied by increasing frequencies of overt type 2 diabetes, dyslipidemia, hypertension, coronary heart disease, stroke, and early mortality. In the body fat patterns called android type (apple shaped) fat is deposited around the waist and upper abdominal area and appears most often in men. Abdominal body fat is thought to be associated with a rapid mobilization of fatty acids rather than resulting from other fat depots, although it remains a point of contention. If abdominal fat is indeed more active than other fat depots, it would then provide a mechanism by which we could explain (in part) the increase in blood lipid and glucose levels. The latter have been clearly associated with an increased risk for cardiovascular disease, hypertension, and type 2 diabetes. The gynoid type (pear-shaped) of body fat is usually seen in women. The fat is deposited around the hips, thighs, and buttocks, and presumably is used as energy reserve during pregnancy and lactation. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chelation: Combination with a metal in complexes in which the metal is part of a ring. [EU] Chemoembolization: A procedure in which the blood supply to the tumor is blocked surgically or mechanically, and anticancer drugs are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH]

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Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chondrodysplasia Punctata: A heterogeneous group of bone dysplasias, the common character of which is stippling of the epiphyses in infancy. The group includes a severe autosomal recessive form (Chondrodysplasia punctata, rhizomelic), an autosomal dominant form (Conradi-Hunermann syndrome), and a milder X-linked form. Metabolic defects associated with impaired peroxisomes are present only in the rhizomelic form. [NIH] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Choreatic Disorders: Acquired and hereditary conditions which feature chorea as a primary manifestation of the disease process. [NIH] Chromaffin System: The cells of the body which stain with chromium salts. They occur along the sympathetic nerves, in the adrenal gland, and in various other organs. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or chronic granulocytic leukemia. [NIH] Chronic phase: Refers to the early stages of chronic myelogenous leukemia or chronic lymphocytic leukemia. The number of mature and immature abnormal white blood cells in the bone marrow and blood is higher than normal, but lower than in the accelerated or blast phase. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by

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recurring daylight and darkness. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix

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'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Diseases: A heterogeneous group of disorders, some hereditary, others acquired, characterized by abnormal structure or function of one or more of the elements of connective tissue, i.e., collagen, elastin, or the mucopolysaccharides. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Consolidation: The healing process of a bone fracture. [NIH] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU]

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Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]

Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Corticotropin-Releasing Hormone: A neuropeptide released by the hypothalamus that stimulates the release of corticotropin by the anterior pituitary gland. [NIH]

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Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cosyntropin: Alpha(1-24)-Corticotropin. A synthetic polypeptide with adrenocorticotropic activity. [NIH] Critical Illness: A disease or state in which death is possible or imminent. [NIH] Cryptococcosis: Infection with a fungus of the species Cryptococcus neoformans. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyproterone: An anti-androgen that, in the form of its acetate, also has progestational properties. It is used in the treatment of hypersexuality in males, as a palliative in prostatic carcinoma, and, in combination with estrogen, for the therapy of severe acne and hirsutism in females. [NIH] Cyproterone Acetate: An agent with anti-androgen and progestational properties. It shows competitive binding with dihydrotestosterone at androgen receptor sites. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cytogenetic Analysis: Examination of chromosomes to diagnose, classify, screen for, or manage genetic diseases and abnormalities. Following preparation of the sample, karyotyping is performed and/or the specific chromosomes are analyzed. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytomegalovirus Infections: Infection with Cytomegalovirus, characterized by enlarged cells bearing intranuclear inclusions. Infection may be in almost any organ, but the salivary glands are the most common site in children, as are the lungs in adults. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydroepiandrosterone: DHEA. A substance that is being studied as a cancer prevention drug. It belongs to the family of drugs called steroids. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH]

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Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Deoxyribonucleic: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Deoxyribonucleic acid: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Deoxyribonucleotides: A purine or pyrimidine base bonded to a deoxyribose containing a bond to a phosphate group. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydrotachysterol: Vitamin D. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dissociative Disorders: Sudden temporary alterations in the normally integrative functions of consciousness. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used

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to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Diurnal: Occurring during the day. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]

Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH] Electroacupuncture: A form of acupuncture using low frequency electrically stimulated needles to produce analgesia and anesthesia and to treat disease. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the

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latter being a high-energy biproduct of nuclear decay. [NIH] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most

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species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Erucic Acids: Cis-13-Docosenoic Acids. 22-Carbon monounsaturated, monocarboxylic acids. [NIH]

Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal candidiasis and cryptococcal meningitis in AIDS. [NIH] Fludrocortisone: A synthetic mineralocorticoid with anti-inflammatory activity. [NIH]

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Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganciclovir: Acyclovir analog that is a potent inhibitor of the Herpesvirus family including cytomegalovirus. Ganciclovir is used to treat complications from AIDS-associated cytomegalovirus infections. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of

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fertilization of the ovum until birth. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycerol Kinase: An enzyme that catalyzes the formation of glycerol 3-phosphate from ATP and glycerol. Dihydroxyacetone and L-glyceraldehyde can also act as acceptors; UTP and, in the case of the yeast enzyme, ITP and GTP can act as donors. It provides a way for glycerol derived from fats or glycerides to enter the glycolytic pathway. EC 2.7.1.30. [NIH] Glycoproteins: Conjugated protein-carbohydrate compounds including mucins, mucoid, and amyloid glycoproteins. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or

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as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart Arrest: Sudden and usually momentary cessation of the heart beat. This sudden cessation may, but not usually, lead to death, sudden, cardiac. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]

Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of

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bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Homeobox: Distinctive sequence of DNA bases. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperlipoproteinemia: Metabolic disease characterized by elevated plasma cholesterol and/or triglyceride levels. The inherited form is attributed to a single gene mechanism. [NIH] Hyperpigmentation: Excessive pigmentation of the skin, usually as a result of increased melanization of the epidermis rather than as a result of an increased number of melanocytes. Etiology is varied and the condition may arise from exposure to light, chemicals or other substances, or from a primary metabolic imbalance. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersecretion: Excessive secretion. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hyperthyroxinemia: Excess of thyroxine in the blood. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache,

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accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypophysis: A remnant of the entodermal pouch of Rathke beneath the mucous membrane of the pharynx, which shows pituitary tissue. [NIH] Hypopituitarism: Diminution or cessation of secretion of one or more hormones from the anterior pituitary gland (including LH; FSH; somatotropin; and corticotropin). This may result from surgical or radiation ablation, non-secretory pituitary neoplasms, metastatic tumors, infarction, pituitary apoplexy, infiltrative or granulomatous processes, and other conditions. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Hypovolemia: An abnormally low volume of blood circulating through the body. It may result in hypovolemic shock. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within

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intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infection Control: Programs of disease surveillance, generally within health care facilities, designed to investigate, prevent, and control the spread of infections and their causative microorganisms. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]

Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH]

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Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ion Transport: The movement of ions across energy-transducing cell membranes. Transport can be active or passive. Passive ion transport (facilitated diffusion) derives its energy from the concentration gradient of the ion itself and allows the transport of a single solute in one direction (uniport). Active ion transport is usually coupled to an energy-yielding chemical or photochemical reaction such as ATP hydrolysis. This form of primary active transport is called an ion pump. Secondary active transport utilizes the voltage and ion gradients produced by the primary transport to drive the cotransport of other ions or molecules. These may be transported in the same (symport) or opposite (antiport) direction. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Itraconazole: An antifungal agent that has been used in the treatment of histoplasmosis, blastomycosis, cryptococcal meningitis, and aspergillosis. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketoconazole: Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large

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intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lipoprotein Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. The enzyme hydrolyzes triacylglycerols in chylomicrons, very-low-density lipoproteins, low-density lipoproteins, and diacylglycerols. It occurs on capillary endothelial surfaces, especially in mammary, muscle, and adipose tissue. Genetic deficiency of the enzyme causes familial hyperlipoproteinemia Type I. (Dorland, 27th ed) EC 3.1.1.34. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum

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cholesterol and both are directly correlated with CHD risk. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lymphoproliferative: Disorders characterized by proliferation of lymphoid tissue, general or unspecified. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megestrol: 17-Hydroxy-6-methylpregna-3,6-diene-3,20-dione. A progestational hormone used most commonly as the acetate ester. As the acetate, it is more potent than progesterone

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both as a progestagen and as an ovulation inhibitor. It has also been used in the palliative treatment of breast cancer. [NIH] Megestrol Acetate: A drug that belongs to the group of hormones called progestins, used as hormone therapy to block estrogen and to suppress the effects of estrogen and androgens. [NIH]

Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Mineralocorticoid: 1. Any of the group of C21 corticosteroids, principally aldosterone, predominantly involved in the regulation of electrolyte and water balance through their effect on ion transport in epithelial cells of the renal tubules, resulting in retention of sodium and loss of potassium; some also possess varying degrees of glucocorticoid activity. Their secretion is regulated principally by plasma volume, serum potassium concentration and angiotensin II, and to a lesser extent by anterior pituitary ACTH. 2. Of, pertaining to, having the properties of, or resembling a mineralocorticoid. [EU] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH]

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Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Multiple Trauma: Physical insults or injuries occurring simultaneously in several parts of the body. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Myelofibrosis: A disorder in which the bone marrow is replaced by fibrous tissue. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nephrectomy: Surgery to remove a kidney. Radical nephrectomy removes the kidney, the adrenal gland, nearby lymph nodes, and other surrounding tissue. Simple nephrectomy removes only the kidney. Partial nephrectomy removes the tumor but not the entire kidney. [NIH]

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Nephropathy: Disease of the kidneys. [EU] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroendocrinology: The study of the anatomical and functional relationships between the nervous system and the endocrine system. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurosecretory Systems: A system of neurons that has the specialized function to produce and secrete hormones, and that constitutes, in whole or in part, an endocrine organ or system. [NIH] Neurotoxic: Poisonous or destructive to nerve tissue. [EU] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Oral Health: The optimal state of the mouth and normal functioning of the organs of the

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mouth without evidence of disease. [NIH] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Organogenesis: Clonal propagation which involves culturing explants from roots, leaves, or stems to form undifferentiated callus tissue; after the cells form shoots, they are separated and rooted. Alternatively, if the callus is put in liquid culture, somatic embryos form. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of spinal cord diseases; peripheral nervous system diseases; muscular diseases; intracranial hypertension; parasagittal brain lesions; and other conditions. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Parturition: The act or process of given birth to a child. [EU] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs.

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[NIH]

Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peroxisomal Disorders: A heterogeneous group of inherited metabolic disorders marked by absent or dysfunctional peroxisomes. Peroxisomal enzymatic abnormalities may be single or multiple. Biosynthetic peroxisomal pathways are compromised, including the ability to synthesize ether lipids and to oxidize long-chain fatty acid precursors. Diseases in this category include Zellweger syndrome; infantile Refsum disease; rhizomelic chondrodysplasia (chondrodysplasia punctata, rhizomelic); hyperpipecolic acidemia; neonatal adrenoleukodystrophy; and adrenoleukodystrophy (X-linked). Neurologic dysfunction is a prominent feature of most peroxisomal disorders. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

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Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Piloerection: Involuntary erection or bristling of hairs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Apoplexy: Sudden hemorrhage or ischemic necrosis involving the pituitary gland which may be associated with acute visual loss, severe headache, meningeal signs, cranial nerve palsies, panhypopituitarism, and rarely coma. The most common cause is hemorrhage (intracranial hemorrhages) related to a pituitary adenoma. Ischemia, meningitis, intracranial hypertension, and other disorders may be associated with this condition. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Pituitary Neoplasms: Neoplasms which arise from or metastasize to the pituitary gland. The majority of pituitary neoplasms are adenomas, which are divided into non-secreting and secreting forms. Hormone producing forms are further classified by the type of hormone they secrete. Pituitary adenomas may also be characterized by their staining properties (adenoma, basophil; adenoma, acidophil; and adenoma, chromophobe). Pituitary tumors may compress adjacent structures, including the hypothalamus, several cranial nerves, and the optic chiasm. Chiasmal compression may result in bitemporal hemianopsia. [NIH]

Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plague: An acute infectious disease caused by Yersinia pestis that affects humans, wild rodents, and their ectoparasites. This condition persists due to its firm entrenchment in sylvatic rodent-flea ecosystems throughout the world. Bubonic plague is the most common form. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma Volume: Volume of plasma in the circulation. It is usually measured by indicator dilution techniques. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working

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kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Pontine: A brain region involved in the detection and processing of taste. [NIH] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Postural: Pertaining to posture or position. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] Pregnenolone: Steroid hormone. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prone Position: The posture of an individual lying face down. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the

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nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH]

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Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal cell carcinoma: A type of kidney cancer. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic

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nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Rheumatic Heart Disease: Disease of the heart resulting from rheumatic fever and characterized by inflammatory changes in the myocardium or scarring of the valves. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH]

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Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Sella: A deep depression in the shape of a Turkish saddle in the upper surface of the body of the sphenoid bone in the deepest part of which is lodged the hypophysis cerebri. [NIH] Sella Turcica: A bony prominence situated on the upper surface of the body of the sphenoid bone. It houses the pituitary gland. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequence Analysis: A multistage process that includes the determination of a sequence (protein, carbohydrate, etc.), its fragmentation and analysis, and the interpretation of the resulting sequence information. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU]

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Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatotropin: A small peptide hormone released by the anterior pituitary under hypothalamic control. Somatotropin, or growth hormone, stimulates mitosis, cell growth, and, for some cell types, differentiation in many tissues of the body. It has profound effects on many aspects of gene expression and metabolism. [NIH] Soybean Oil: Oil from soybean or soybean plant. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sphenoid: An unpaired cranial bone with a body containing the sphenoid sinus and forming the posterior part of the medial walls of the orbits. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH]

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Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU]

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Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tamponade: The inserting of a tampon; a dressing is inserted firmly into a wound or body cavity, as the nose, uterus or vagina, principally for stopping hemorrhage. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Thalassemia: A group of hereditary hemolytic anemias in which there is decreased synthesis of one or more hemoglobin polypeptide chains. There are several genetic types with clinical pictures ranging from barely detectable hematologic abnormality to severe and fatal anemia. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thoracic: Having to do with the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombopenia: Reduction in the number of platelets in the blood. [NIH] Thromboses: The formation or presence of a blood clot within a blood vessel during life. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH]

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Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyroiditis: Inflammation of the thyroid gland. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Topical: On the surface of the body. [NIH] Toxaemia: 1. The condition resulting from the spread of bacterial products (toxins) by the bloodstream. 2. A condition resulting from metabolic disturbances, e.g. toxaemia of pregnancy. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH]

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Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasopressor: 1. Stimulating contraction of the muscular tissue of the capillaries and arteries. 2. An agent that stimulates contraction of the muscular tissue of the capillaries and arteries. [EU]

VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs

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and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virilization: The induction or development of male secondary sec characters, especially the induction of such changes in the female, including enlargement of the clitoris, growth of facial and body hair, development of a hairline typical of the male forehead, stimulation of secretion and proliferation of the sebaceous glands (often with acne), and deepening of the voice. Called also masculinization) [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral fat: One of the three compartments of abdominal fat. Retroperitoneal and subcutaneous are the other two compartments. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Waist circumference: To define the level at which the waist circumference is measured, a bony landmark is first located and marked. The subject stands, and the technician, positioned to the right of the subject, palpates the upper hip bone to locate the right ileum. Just above the uppermost lateral border of the right ileum, a horizontal mark is drawn and then crossed with a vertical mark on the midaxillary line. The measuring tape is then placed around the trunk, at the level of the mark on the right side, making sure that it is on a level horizontal plane on all sides. The tape is then tightened slightly without compressing the skin and underlying subcutaneous tissues. The measure is recorded in centimeters to the nearest millimeter. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to

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treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

145

INDEX A Abdomen, 20, 99, 124, 130, 135, 137, 138 Abdominal, 99, 107, 129, 135, 142 Abdominal fat, 99, 107, 142 Ablate, 11, 99 Ablation, 99, 121 Acidemia, 99, 130 Acne, 99, 112, 142 Acquired Immunodeficiency Syndrome, 24, 42, 45, 50, 53, 99 Adenocarcinoma, 99, 119 Adenoma, 5, 99, 131 Adipocytes, 99, 124 Adipose Tissue, 66, 99, 124 Adrenal Cortex, 10, 13, 38, 74, 89, 99, 100, 111, 112, 120, 132 Adrenal Glands, 6, 10, 12, 18, 21, 22, 46, 65, 66, 74, 88, 99, 100 Adrenal Medulla, 74, 99, 115 Adrenergic, 99, 116, 138 Adrenoleukodystrophy, 63, 64, 65, 66, 67, 99, 130 Adverse Effect, 11, 14, 99, 136 Afferent, 8, 99, 124 Affinity, 99, 136 Airway, 72, 100 Airway Obstruction, 72, 100 Aldosterone, 14, 43, 52, 100, 126 Algorithms, 100, 104 Alkaline, 100, 105 Alleles, 5, 100 Allergic Rhinitis, 100, 105 Alternative medicine, 76, 100 Amino Acid Sequence, 100, 101 Amino Acids, 100, 101, 128, 130, 132, 133, 141 Ammonia, 100, 138, 141 Amyloidosis, 38, 41, 100 Anaesthesia, 100, 122 Analog, 101, 117 Anaphylatoxins, 101, 110 Anatomical, 101, 103, 108, 121, 128, 135 Androgens, 7, 14, 99, 101, 111, 126 Anemia, 101, 139 Anesthesia, 35, 44, 64, 100, 101, 114 Anesthetics, 4, 101, 116 Angina, 73, 101 Angina Pectoris, 73, 101

Angiotensinogen, 101, 134 Animal model, 6, 101 Antagonism, 25, 101 Antiallergic, 101, 111 Antibacterial, 101, 137 Antibiotic, 101, 130, 137 Antibodies, 14, 24, 37, 42, 45, 56, 89, 101, 102, 103, 118, 131, 134 Antibodies, Anticardiolipin, 101, 102 Antibodies, Antiphospholipid, 102 Antibody, 18, 21, 100, 102, 109, 118, 120, 121, 122, 125, 134, 137 Anticoagulant, 38, 45, 49, 102, 133 Antidiuretic, 15, 54, 57, 102 Antifungal, 29, 102, 116, 123 Antigen, 100, 101, 102, 106, 110, 120, 121, 122, 125, 134 Antigen-Antibody Complex, 102, 110 Antihistamine, 30, 102 Anti-inflammatory, 102, 111, 113, 116, 118 Anti-Inflammatory Agents, 102, 111 Antimetabolite, 102, 117 Antineoplastic, 102, 111, 117 Antiphospholipid Syndrome, 26, 46, 102 Anus, 102, 109, 123, 134 Anxiety, 9, 102 Apolipoproteins, 103, 124 Aponeurosis, 103, 117 Apoptosis, 11, 103 Arginine, 24, 101, 103 Arterial, 22, 102, 103, 108, 111, 120, 133, 139 Arteries, 103, 104, 105, 111, 124, 127, 133, 141 Artery, 103, 111, 129 Aspergillosis, 103, 123 Aspiration, 29, 103 Assay, 103, 134 Asymptomatic, 17, 103, 129 Atrial, 103, 111, 140 Atrioventricular, 103, 111 Atrium, 103, 111, 140, 142 Attenuation, 7, 103 Auricular, 42, 103 Autoantibodies, 30, 102, 103 Autoantigens, 36, 103 Autodigestion, 103, 129 Autopsy, 5, 9, 41, 103

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B Bacteria, 101, 102, 103, 117, 136, 137, 140, 141 Basal Ganglia, 103, 108, 117 Basal Ganglia Diseases, 103, 108 Base, 104, 113, 123, 131, 141 Benign, 99, 104, 117, 118, 127, 134 Bilateral, 16, 18, 22, 25, 26, 29, 41, 54, 66, 67, 104, 129 Bile, 104, 124, 137 Biliary, 104, 129 Biliary Tract, 104, 129 Biochemical, 10, 11, 29, 31, 52, 63, 67, 100, 102, 104 Biotechnology, 14, 15, 76, 83, 104 Biotransformation, 104 Bladder, 104, 141 Blast phase, 104, 108 Blastocyst, 104, 131 Blastomycosis, 29, 104, 123 Blood Coagulation, 104, 105 Blood Glucose, 72, 104, 119, 122 Blood pressure, 5, 9, 72, 104, 106, 120, 121, 127, 133, 136 Blood vessel, 104, 105, 106, 107, 108, 109, 111, 119, 138, 139, 141 Blot, 6, 105 Body Composition, 27, 105 Body Fluids, 105, 136 Bone Marrow, 104, 105, 108, 125, 127 Bone Resorption, 25, 105 Bronchi, 105, 116, 140 Bronchial, 105, 120 Bronchopulmonary, 31, 105 Bronchopulmonary Dysplasia, 31, 105 Buccal, 105, 125 Budesonide, 17, 35, 105 C Cachexia, 39, 105 Calcium, 7, 36, 105, 109 Calcium Channels, 7, 105 Callus, 105, 129 Candidiasis, 105, 116 Capillary, 106, 124 Carbohydrate, 106, 111, 118, 136 Carbon Dioxide, 106, 120, 131 Carcinogenic, 106, 122, 132, 137 Carcinoma, 54, 106, 112 Cardiac, 16, 23, 60, 72, 73, 106, 111, 115, 116, 119, 127, 137 Cardiac arrest, 72, 106 Cardiolipins, 102, 106

Cardiomyopathy, 21, 48, 106 Cardiopulmonary, 73, 106 Cardiopulmonary Resuscitation, 73, 106 Cardiovascular, 23, 105, 106, 107 Cardiovascular disease, 106, 107 Carrier Proteins, 106, 134 Case report, 9, 16, 18, 20, 21, 22, 34, 35, 41, 44, 45, 46, 54, 66, 68, 106 Catecholamines, 99, 106 Caudal, 106, 121 Cell Death, 103, 107, 127 Cell Differentiation, 9, 10, 107 Cell membrane, 105, 106, 107, 123, 130 Central fat distribution, 8, 107 Central Nervous System, 8, 105, 107, 114, 117, 119 Cerebral, 12, 28, 103, 107, 111, 116, 137, 138, 139 Cerebral Palsy, 12, 107, 137 Cerebrospinal, 5, 107 Cerebrospinal fluid, 5, 107 Cerebrovascular, 73, 103, 106, 107 Cerebrum, 107 Character, 101, 107, 108, 112 Chelation, 64, 107 Chemoembolization, 22, 107 Chemotactic Factors, 107, 110 Chest Pain, 72, 107 Chin, 39, 108, 126 Cholesterol, 6, 12, 25, 33, 104, 108, 111, 114, 120, 124, 137 Cholesterol Esters, 108, 124 Chondrodysplasia Punctata, 108, 130 Chorea, 24, 108 Choreatic Disorders, 108 Chromaffin System, 108, 115 Chromatin, 103, 108, 115, 125 Chromosome, 13, 99, 108 Chronic Disease, 105, 108, 109 Chronic myelogenous leukemia, 104, 108 Chronic phase, 9, 108 Chronic renal, 41, 72, 73, 108, 132, 141 Chylomicrons, 108, 124 Circadian, 11, 15, 32, 108 Circadian Rhythm, 11, 32, 108 Circulatory system, 109, 115 Clinical Medicine, 6, 109, 132 Clinical trial, 4, 83, 109, 114, 127, 134 Cloning, 104, 109 Coagulation, 102, 104, 109 Cognition, 27, 109 Collagen, 109, 110, 116, 120

147

Collagen disease, 109, 120 Collapse, 43, 109 Colon, 54, 109, 124 Complement, 6, 7, 37, 101, 109, 110, 117 Complementary and alternative medicine, 63, 69, 110 Complementary medicine, 63, 110 Complete remission, 110, 134 Computational Biology, 83, 110 Concomitant, 13, 110 Confounding, 11, 110 Confusion, 110, 121, 141 Congestive heart failure, 72, 73, 110 Connective Tissue, 102, 105, 109, 110, 116, 125, 135, 139 Connective Tissue Diseases, 102, 110 Consciousness, 72, 110, 113, 133, 138 Consolidation, 32, 110 Contracture, 31, 110 Contraindications, ii, 111 Convulsions, 111, 114, 121, 132 Cor, 10, 24, 25, 28, 31, 47, 56, 57, 111, 112, 121 Coronary, 8, 101, 106, 107, 111, 127 Coronary Circulation, 101, 111 Coronary heart disease, 8, 106, 107, 111 Coronary Thrombosis, 111, 127 Cortex, 74, 111 Cortical, 111, 136 Corticosteroid, 22, 25, 40, 54, 76, 111, 137 Corticotropin-Releasing Hormone, 10, 28, 31, 47, 56, 111 Cortisol, 5, 7, 8, 9, 12, 14, 17, 25, 28, 29, 30, 32, 38, 47, 51, 53, 57, 64, 112 Cortisone, 51, 89, 112, 113 Cosyntropin, 33, 112 Critical Illness, 5, 112 Cryptococcosis, 29, 112 Cues, 11, 112 Curative, 112, 139 Cutaneous, 26, 104, 105, 112, 125 Cyproterone, 46, 112 Cyproterone Acetate, 46, 112 Cyst, 54, 112 Cytogenetic Analysis, 29, 112 Cytokine, 5, 112 Cytomegalovirus, 26, 112, 117 Cytomegalovirus Infections, 112, 117 Cytoplasm, 103, 107, 112, 115, 118, 125 Cytotoxic, 112, 134 D Deamination, 112, 141

Decidua, 112, 131 Degenerative, 112, 135 Dehydroepiandrosterone, 27, 51, 67, 69, 75, 112 Deletion, 30, 35, 45, 103, 112 Delivery of Health Care, 113, 119 Dementia, 99, 113 Dendrites, 113, 128 Deoxyribonucleic, 35, 113 Deoxyribonucleic acid, 35, 113 Deoxyribonucleotides, 113 Deprivation, 30, 113 Dexamethasone, 11, 113 Diabetes Mellitus, 18, 35, 58, 67, 72, 73, 113, 118, 119 Diagnostic procedure, 76, 113 Diastolic, 113, 120 Dietary Fats, 113, 124 Diffusion, 113, 122, 123 Digestion, 104, 113, 124, 130, 138 Dihydrotachysterol, 25, 113 Dihydrotestosterone, 112, 113, 134 Direct, iii, 10, 109, 113, 134, 138 Dissociation, 29, 64, 100, 113 Dissociative Disorders, 113 Distal, 113, 130 Diuresis, 15, 50, 114 Diurnal, 38, 114 Dorsum, 114, 117 Double-blind, 9, 114 Drug Interactions, 74, 114 Drug Tolerance, 114, 140 Duodenum, 104, 114, 130, 138 Dura mater, 114, 126, 129 Dyslipidemia, 8, 107, 114 Dysplasia, 13, 15, 114 Dystrophy, 29, 30, 114 E Eclampsia, 114, 132 Edema, 114, 123, 132, 141 Effector, 8, 109, 114 Efferent, 8, 114 Elastic, 114, 138 Electric shock, 106, 114 Electroacupuncture, 67, 114 Electrolyte, 53, 100, 111, 114, 126, 132, 136, 141 Electrons, 104, 114, 123, 134 Emaciation, 99, 115 Embryo, 104, 107, 115, 122 Emollient, 115, 118 Endocarditis, 72, 73, 105, 115

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Endocardium, 115 Endocrine Glands, 74, 115 Endocrine System, 65, 115, 128 Endogenous, 8, 103, 115, 140 Endotoxins, 110, 115 End-stage renal, 108, 115, 132 Energy balance, 115, 124 Environmental Health, 82, 84, 115 Enzymatic, 12, 105, 110, 115, 119, 130 Enzyme, 8, 25, 33, 114, 115, 118, 124, 126, 130, 133, 134, 138, 142 Eosinophilia, 30, 48, 76, 115 Eosinophils, 115, 118 Epidermis, 115, 120 Epidural, 64, 115 Epinephrine, 74, 99, 115 Epithelial, 99, 112, 116, 126 Epithelial Cells, 116, 126 Erucic Acids, 64, 116 Erythrocytes, 36, 101, 105, 116 Esophagus, 116, 130, 138 Estrogen, 8, 112, 116, 126, 132 Ether, 116, 130 Eukaryotic Cells, 116, 122 Exhaustion, 101, 116 Exogenous, 104, 115, 116, 141 Extracellular, 110, 116, 136 Extracellular Matrix, 110, 116 Extremity, 116, 129 F Facial, 116, 129, 142 Family Planning, 83, 116 Fat, 8, 99, 105, 107, 111, 116, 124, 132, 138 Fatigue, 9, 21, 24, 31, 88, 116, 119 Fatty acids, 31, 107, 116 Febrile, 51, 116 Fetus, 116, 131, 141 Fibroblasts, 65, 116 Fibrosis, 110, 116, 135 Fluconazole, 32, 43, 116 Fludrocortisone, 89, 116 Fluorouracil, 36, 58, 117 Forearm, 104, 117 Free Radicals, 113, 117 Fungus, 105, 112, 117 G Gamma Rays, 117, 134 Ganciclovir, 53, 54, 117 Ganglion, 74, 117 Gas, 100, 106, 113, 117, 128, 133, 141, 142 Gastric, 45, 103, 117, 119, 130 Gastric Juices, 117, 130

Gastrin, 117, 120 Gastrointestinal, 72, 73, 88, 116, 117, 138 Gene, 8, 9, 10, 13, 25, 33, 100, 104, 117, 120, 137 Gene Expression, 8, 9, 117, 137 Genetic Engineering, 4, 104, 109, 117 Genetics, 4, 5, 20, 29, 52, 117 Genotype, 117, 130 Gestation, 117, 131 Glucocorticoid, 4, 7, 10, 15, 26, 30, 32, 44, 48, 56, 105, 113, 118, 120, 126 Glucose, 7, 104, 107, 113, 118, 119, 120, 122, 135 Glucose Intolerance, 7, 113, 118 Glucose tolerance, 118 Glucose Tolerance Test, 118 Glycerol, 29, 30, 106, 118, 130 Glycerol Kinase, 29, 30, 118 Glycoproteins, 105, 118 Gonad, 118 Gonadal, 8, 36, 118, 137 Gonadotropin, 5, 118 Governing Board, 118, 132 Granulocytes, 118, 142 H Haptens, 100, 118, 134 Headache, 118, 120, 131 Health Care Costs, 11, 119 Health Expenditures, 119 Health Status, 4, 119 Heart Arrest, 106, 119 Heart failure, 72, 119 Hemodynamics, 5, 119 Hemoglobin, 101, 116, 119, 139 Hemolytic, 119, 139 Hemorrhage, 22, 25, 26, 49, 119, 131, 138, 139 Hepatic, 22, 55, 118, 119 Hepatocellular, 19, 119 Hepatocellular carcinoma, 19, 119 Hereditary, 108, 110, 119, 139 Heredity, 117, 119 Hirsutism, 112, 119 Histamine, 101, 102, 119 Homeobox, 5, 120 Homeostasis, 11, 120 Homologous, 100, 120, 138 Hormonal, 5, 8, 13, 111, 120 Hormone therapy, 120, 126 Hydrocortisone, 5, 9, 12, 38, 48, 51, 120 Hydrophobic, 120, 124 Hypercholesterolemia, 114, 120

149

Hyperlipidemia, 114, 120 Hyperlipoproteinemia, 120, 124 Hyperpigmentation, 42, 120 Hyperplasia, 7, 14, 120 Hypersecretion, 7, 40, 53, 120 Hypertension, 8, 45, 72, 73, 74, 106, 107, 120, 123, 132, 141 Hyperthyroidism, 14, 120 Hyperthyroxinemia, 49, 120 Hypertriglyceridemia, 114, 120 Hypertrophy, 6, 111, 120, 140 Hyperventilation, 72, 120 Hypoglycaemia, 54, 120 Hypoglycemia, 15, 32, 43, 61, 72, 121 Hypogonadism, 5, 16, 46, 121 Hypophysis, 121, 136 Hypopituitarism, 9, 52, 72, 121 Hypoplasia, 13, 121 Hypotension, 5, 35, 72, 111, 121 Hypothalamic, 5, 8, 9, 11, 15, 25, 28, 35, 40, 46, 52, 57, 121, 137 Hypothalamus, 8, 11, 111, 121, 131, 139 Hypothermia, 120, 121 Hypovolemia, 50, 121 I Idiopathic, 22, 33, 36, 42, 50, 56, 121, 135 Ileostomy, 17, 121 Ileum, 121, 142 Immune response, 14, 102, 103, 111, 112, 118, 121, 138, 142 Immune system, 121, 141, 142 Immunity, 14, 99, 121 Immunodeficiency, 16, 99, 121 Immunogenic, 121, 124, 134 Immunologic, 107, 121, 134 Immunosuppressant, 117, 121 Immunosuppressive, 118, 121 Impairment, 9, 36, 121, 126 In situ, 6, 8, 121 In Situ Hybridization, 6, 8, 121 In vitro, 6, 122 In vivo, 6, 11, 122 Incision, 122, 123 Induction, 6, 101, 122, 132, 142 Infantile, 122, 130 Infarction, 121, 122 Infection, 17, 20, 45, 72, 73, 74, 89, 99, 104, 105, 107, 112, 121, 122, 125, 128, 130, 138, 142 Infection Control, 72, 73, 74, 122 Infiltration, 22, 122

Inflammation, 11, 99, 100, 102, 116, 120, 122, 126, 129, 131, 135, 137, 139, 140, 141 Initiation, 122, 140 Insight, 9, 122 Insulin, 8, 15, 28, 36, 50, 56, 118, 122, 141 Insulin-dependent diabetes mellitus, 50, 122 Intensive Care, 5, 23, 30, 32, 57, 122 Interleukin-2, 22, 122 Intermittent, 123, 124 Internal Medicine, 10, 19, 23, 24, 25, 28, 33, 38, 39, 44, 45, 46, 49, 51, 55, 115, 123 Interstitial, 30, 123 Intestines, 99, 117, 123 Intoxication, 123, 142 Intracellular, 122, 123, 132 Intracranial Hypertension, 119, 123, 129, 131 Intrathecal, 50, 123 Intravenous, 40, 123 Invasive, 3, 121, 123, 125 Ion Transport, 123, 126 Ionizing, 123, 134 Ions, 104, 105, 113, 114, 123 Itraconazole, 35, 123 K Kb, 82, 123 Ketoconazole, 43, 49, 123 Kidney Disease, 18, 82, 123 Kinetic, 123 L Labile, 109, 123 Lactation, 107, 123, 132 Large Intestine, 123, 134, 136 Leptin, 27, 38, 124 Lesion, 104, 124 Leukemia, 46, 53, 68, 108, 124 Libido, 101, 124 Ligaments, 111, 124 Ligands, 7, 124 Lipase, 8, 124 Lipid, 8, 103, 107, 118, 122, 124 Lipid A, 107, 124 Lipoprotein, 8, 72, 114, 124 Lipoprotein Lipase, 8, 124 Liver, 66, 72, 73, 99, 100, 104, 112, 118, 119, 124, 135, 141 Lobe, 4, 124 Localization, 7, 124 Localized, 100, 119, 122, 124, 131 Long-Term Care, 13, 124 Loop, 8, 121, 124

150

Adrenal insufficiency

Low-density lipoprotein, 114, 124 Lupus, 38, 45, 102, 125, 139 Lutein Cells, 125, 132 Lymph, 109, 125, 127, 135 Lymph node, 125, 127, 135 Lymphatic, 122, 125, 137 Lymphocyte Count, 99, 125 Lymphocytes, 89, 99, 102, 122, 125, 137, 142 Lymphocytic, 108, 125 Lymphoid, 101, 125 Lymphoma, 16, 18, 21, 22, 26, 38, 41, 45, 46, 53, 65, 66, 67, 68, 125 Lymphoproliferative, 48, 125 M Magnetic Resonance Imaging, 5, 31, 125 Maintenance therapy, 50, 125 Malignant, 45, 53, 99, 102, 125, 127, 134, 135 Malnutrition, 105, 125 Mammary, 124, 125 Mediate, 6, 125 Mediator, 122, 125 MEDLINE, 4, 83, 125 Megestrol, 24, 39, 76, 125, 126 Megestrol Acetate, 39, 76, 126 Meiosis, 126, 138 Melanocytes, 120, 126 Membrane, 6, 100, 107, 110, 116, 121, 126, 127, 130, 134 Memory, 9, 113, 126 Meninges, 107, 114, 126, 137 Meningitis, 29, 116, 123, 126, 131 Mental, iv, 4, 12, 66, 82, 84, 108, 109, 110, 113, 116, 126, 133, 135, 141 Mental Processes, 113, 126, 133 Mental Retardation, 12, 126 Mentors, 6, 126 Metabolic disorder, 126, 130 Metastasis, 47, 126 Metastatic, 19, 58, 121, 126, 135 Microscopy, 7, 126 Mineralocorticoid, 15, 48, 57, 116, 126 Mitochondrial Swelling, 126, 127 Mitosis, 103, 127, 137 Mobilization, 107, 127 Modification, 10, 117, 127, 133 Molecular, 4, 7, 10, 11, 17, 29, 67, 83, 85, 104, 110, 127, 132, 140 Molecule, 102, 104, 106, 110, 113, 114, 127, 131, 134 Monitor, 127, 128

Mucinous, 117, 127 Mucosa, 125, 127, 132 Multicenter study, 66, 127 Multiple Trauma, 5, 127 Muscular Diseases, 127, 129 Myelofibrosis, 34, 127 Myocardial infarction, 73, 111, 127 Myocardial Ischemia, 101, 127 Myocardium, 101, 127, 135 N Necrosis, 5, 9, 103, 122, 127, 131, 135 Neonatal, 6, 20, 40, 65, 127, 130 Neoplasm, 127, 135, 141 Nephrectomy, 16, 127 Nephropathy, 123, 128 Nervous System, 99, 107, 125, 128, 130, 138 Neural, 99, 128 Neuroendocrine, 5, 10, 11, 128 Neuroendocrinology, 6, 128 Neurologic, 72, 73, 128, 130 Neuronal, 105, 128 Neurons, 11, 113, 128, 138 Neuropathy, 128, 130 Neuropeptide, 111, 128 Neurosecretory Systems, 115, 128 Neurotoxic, 6, 128 Nitrogen, 101, 128 Nuclear, 10, 11, 103, 115, 116, 117, 127, 128 Nuclei, 114, 117, 125, 127, 128 Nucleic acid, 121, 128 Nucleus, 11, 103, 108, 112, 115, 116, 117, 125, 126, 128, 133 O Opportunistic Infections, 99, 128 Optic Chiasm, 121, 128, 131 Oral Health, 71, 128 Organ Transplantation, 72, 73, 74, 129 Organogenesis, 4, 13, 129 Osteoporosis, 74, 129 Ovary, 118, 129 Overdose, 73, 129 Ovulation, 126, 129 Ovum, 112, 118, 129, 132 P Pachymeningitis, 126, 129 Palliative, 112, 126, 129, 139 Pancreas, 20, 99, 122, 124, 129 Pancreatic, 129 Pancreatitis, 20, 129 Paralysis, 129, 137 Paraparesis, 47, 129

151

Parotid, 129, 135 Paroxysmal, 101, 129 Partial remission, 129, 134 Parturition, 129, 132 Pathologic, 103, 111, 129, 137, 141 Pathologic Processes, 103, 129 Pathophysiology, 24, 25, 73, 74, 129 Patient Education, 88, 92, 94, 97, 129 Pelvis, 99, 130, 141 Penicillin, 101, 130 Pepsin, 130 Peptic, 74, 130 Peptic Ulcer, 74, 130 Peptide, 7, 11, 30, 124, 130, 132, 133, 137, 140 Peripheral Nervous System, 129, 130, 138 Peripheral Nervous System Diseases, 129, 130 Peripheral Neuropathy, 31, 130 Peroxisomal Disorders, 66, 130 Pharmacokinetic, 130 Pharmacologic, 7, 101, 130, 140 Phenotype, 4, 130 Phospholipids, 102, 106, 116, 124, 130 Phosphorus, 105, 130 Phosphorylation, 10, 42, 130 Physiologic, 12, 130, 134 Physiology, 11, 25, 35, 115, 131, 141 Pigment, 126, 131 Pigmentation, 52, 88, 120, 131 Piloerection, 120, 131 Pilot study, 12, 131 Pituitary Apoplexy, 121, 131 Pituitary Gland, 4, 9, 111, 121, 131, 136 Pituitary Neoplasms, 121, 131 Placenta, 6, 131, 132, 133 Plague, 9, 131 Plants, 106, 118, 131, 132, 135, 140 Plasma, 30, 31, 37, 42, 43, 57, 101, 106, 107, 108, 118, 119, 120, 126, 131, 134, 136 Plasma cells, 101, 131 Plasma Volume, 126, 131 Platelets, 67, 131, 139 Pneumonia, 111, 131 Point Mutation, 10, 131 Polycystic, 18, 131 Polypeptide, 100, 109, 112, 132, 139 Polyunsaturated fat, 66, 132 Pontine, 23, 31, 132 Postmenopausal, 129, 132 Postnatal, 13, 132 Postoperative, 48, 132

Post-traumatic, 5, 9, 132 Postural, 72, 132 Potassium, 100, 126, 132 Practice Guidelines, 84, 132 Preclinical, 14, 132 Precursor, 12, 101, 114, 115, 132 Preeclampsia, 44, 132 Pregnenolone, 6, 132 Progesterone, 125, 132, 137 Progression, 101, 132 Progressive, 46, 47, 88, 107, 108, 113, 114, 127, 132, 141 Prolactin, 4, 132 Promoter, 11, 132 Prone, 72, 132 Prone Position, 72, 132 Prophase, 132, 138 Prophylaxis, 12, 47, 133 Protein C, 100, 103, 124, 133, 141 Protein S, 104, 133 Proteins, 100, 102, 103, 105, 106, 107, 108, 109, 127, 128, 130, 131, 133, 136, 140 Proteinuria, 132, 133 Proteolytic, 109, 133 Psychiatric, 72, 73, 133 Psychiatry, 133, 142 Psychic, 124, 126, 133, 136 Psychoactive, 133, 142 Psychology, 113, 133 Puberty, 5, 63, 72, 133 Public Policy, 83, 133 Publishing, 3, 14, 133 Puerperium, 16, 133 Pulmonary, 15, 72, 73, 104, 105, 111, 120, 133, 138, 142 Pulmonary Artery, 104, 133, 142 Pulmonary Edema, 72, 133 Pulmonary hypertension, 111, 133 Pulmonary Ventilation, 120, 133 Q Quality of Life, 9, 133 R Radiation, 101, 117, 121, 123, 134, 142 Radioactive, 128, 134 Radioimmunoassay, 7, 134 Radioimmunotherapy, 134 Radiotherapy, 39, 134 Randomized, 5, 9, 12, 134 Receptor, 6, 10, 11, 14, 26, 102, 112, 134 Rectal, 48, 51, 134 Rectum, 102, 109, 117, 123, 134 Recurrence, 108, 134

152

Adrenal insufficiency

Reductase, 12, 134 Refer, 1, 105, 109, 124, 134, 140 Refraction, 134, 137 Remission, 38, 125, 134 Renal cell carcinoma, 26, 134 Renin, 43, 48, 57, 101, 134 Resection, 17, 134 Respiratory distress syndrome, 105, 134 Retina, 128, 134, 135 Retinopathy, 37, 135 Retroperitoneal, 99, 135, 142 Rheumatic Heart Disease, 72, 73, 135 Risk factor, 9, 135 S Saponins, 135, 137 Sarcoidosis, 35, 135 Sarcoma, 38, 135 Schizoid, 135, 142 Schizophrenia, 135, 142 Schizotypal Personality Disorder, 135, 142 Sclerosis, 28, 29, 109, 135 Screening, 13, 50, 52, 109, 135 Sebaceous, 135, 142 Sebaceous gland, 135, 142 Secondary tumor, 126, 135 Secretory, 47, 121, 135 Seizures, 72, 129, 136 Sella, 5, 9, 21, 48, 51, 114, 131, 136 Sella Turcica, 114, 131, 136 Senile, 129, 136 Sepsis, 20, 136 Septic, 19, 20, 26, 37, 136 Sequence Analysis, 5, 136 Serum, 5, 12, 13, 27, 28, 37, 51, 57, 101, 109, 118, 124, 126, 134, 136 Serum Albumin, 134, 136 Sex Characteristics, 101, 133, 136, 139 Sexually Transmitted Diseases, 72, 73, 136 Shock, 19, 20, 26, 37, 64, 120, 121, 136, 140 Side effect, 58, 71, 99, 136, 140 Signs and Symptoms, 73, 74, 134, 136, 141 Skeletal, 101, 127, 136 Small intestine, 108, 114, 120, 121, 123, 136 Social Environment, 133, 136 Sodium, 15, 19, 100, 126, 136, 138 Solvent, 118, 136 Somatic, 126, 127, 129, 130, 137 Somatotropin, 121, 137 Soybean Oil, 132, 137 Spastic, 47, 137 Spasticity, 137 Specialist, 72, 90, 137

Species, 8, 112, 116, 126, 127, 129, 137, 138, 140, 141, 142 Specificity, 100, 105, 137 Spectrum, 39, 55, 123, 137 Sperm, 101, 108, 137 Sphenoid, 136, 137 Spinal cord, 107, 108, 114, 115, 117, 123, 126, 128, 129, 130, 137 Spinal Cord Diseases, 129, 137 Spleen, 100, 112, 125, 135, 137 Stasis, 45, 137 Steroid, 7, 8, 12, 14, 40, 50, 53, 112, 132, 135, 137 Steroid therapy, 40, 137 Stomach, 99, 103, 116, 117, 118, 120, 123, 130, 136, 137, 138 Stool, 109, 124, 138 Stress, 5, 10, 48, 89, 112, 138 Stroke, 34, 73, 82, 106, 107, 138 Subacute, 122, 138 Subclinical, 40, 122, 136, 138 Subcutaneous, 99, 114, 138, 142 Subspecies, 137, 138 Substance P, 135, 138 Substrate, 48, 138 Supplementation, 4, 25, 67, 138 Suppression, 10, 111, 138 Surfactant, 6, 138 Sweat, 120, 138 Sympathomimetic, 115, 138 Symptomatic, 54, 129, 138 Synapse, 99, 138 Synapsis, 138 Synaptic, 7, 138 Syncope, 72, 138 Synergistic, 132, 139 Systemic, 5, 55, 100, 102, 104, 105, 109, 116, 119, 122, 123, 135, 139, 140 Systemic lupus erythematosus, 55, 102, 109, 139 Systolic, 120, 139 T Tachycardia, 43, 139 Tamponade, 23, 139 Tendon, 117, 137, 139 Testicular, 58, 139 Testis, 139 Testosterone, 134, 139 Thalassemia, 64, 139 Therapeutics, 139 Thermal, 113, 139 Third Ventricle, 121, 139

153

Thoracic, 58, 139, 142 Threshold, 120, 139 Thrombocytes, 131, 139 Thrombopenia, 102, 139 Thromboses, 102, 139 Thrombosis, 36, 133, 138, 139 Thyroid, 4, 18, 42, 57, 72, 73, 88, 120, 139, 140 Thyroid Gland, 73, 120, 139, 140 Thyroid Hormones, 139, 140 Thyroiditis, 18, 140 Thyrotropin, 30, 52, 140 Thyroxine, 120, 140 Tidal Volume, 120, 140 Tolerance, 28, 118, 140 Topical, 18, 140 Toxaemia, 132, 140 Toxic, iv, 121, 128, 140 Toxicity, 114, 140 Toxicokinetics, 140 Toxicology, 84, 140 Toxin, 22, 140 Trachea, 105, 139, 140 Transcription Factors, 5, 10, 140 Transfection, 104, 140 Transplantation, 41, 50, 52, 53, 108, 140 Trauma, 89, 104, 119, 127, 129, 140 Tricuspid Atresia, 111, 140 Tuberculosis, 17, 125, 141 Tumour, 117, 141 Type 2 diabetes, 107, 141 U Ulceration, 130, 141 Unconscious, 101, 141 Uraemia, 129, 141 Urea, 42, 138, 141 Urethra, 141

Urinary, 12, 58, 141 Urine, 13, 102, 104, 114, 133, 141 Uterus, 112, 132, 139, 141 V Vaccine, 14, 141 Vagina, 105, 139, 141 Valves, 135, 141 Vascular, 5, 9, 22, 66, 72, 73, 122, 131, 137, 139, 141 Vasculitis, 129, 141 Vasoconstriction, 116, 141 Vasopressor, 5, 9, 141 VE, 38, 141 Vein, 123, 128, 129, 141 Venous, 102, 133, 140, 141 Ventilation, 105, 106, 141 Ventricle, 103, 111, 133, 139, 140, 142 Ventricular, 43, 58, 111, 140, 142 Veterinary Medicine, 83, 142 Virilization, 7, 142 Virus, 16, 99, 117, 142 Visceral, 8, 142 Visceral fat, 8, 142 Vitro, 142 Vivo, 6, 142 W Waist circumference, 107, 142 White blood cell, 73, 102, 104, 108, 125, 131, 142 Windpipe, 139, 142 Withdrawal, 32, 142 X Xenograft, 101, 142 X-ray, 117, 128, 134, 142 Y Yeasts, 117, 130, 143

154

Adrenal insufficiency

155

156

Adrenal insufficiency