Appetite Suppressants - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

APPETITE

SUPPRESSANTS 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., 1960Appetite Suppressants: 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: 0-497-00082-2 1. Appetite Suppressants-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 appetite suppressants. 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 APPETITE SUPPRESSANTS ......................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Appetite Suppressants .................................................................. 5 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. NUTRITION AND APPETITE SUPPRESSANTS................................................................ 17 Overview...................................................................................................................................... 17 Finding Nutrition Studies on Appetite Suppressants ................................................................. 17 Federal Resources on Nutrition ................................................................................................... 18 Additional Web Resources ........................................................................................................... 18 CHAPTER 3. ALTERNATIVE MEDICINE AND APPETITE SUPPRESSANTS ......................................... 21 Overview...................................................................................................................................... 21 National Center for Complementary and Alternative Medicine.................................................. 21 Additional Web Resources ........................................................................................................... 25 General References ....................................................................................................................... 26 CHAPTER 4. PATENTS ON APPETITE SUPPRESSANTS ...................................................................... 27 Overview...................................................................................................................................... 27 Patents on Appetite Suppressants ............................................................................................... 27 Patent Applications on Appetite Suppressants............................................................................ 31 Keeping Current .......................................................................................................................... 35 CHAPTER 5. BOOKS ON APPETITE SUPPRESSANTS .......................................................................... 37 Overview...................................................................................................................................... 37 Book Summaries: Federal Agencies.............................................................................................. 37 Chapters on Appetite Suppressants ............................................................................................. 38 CHAPTER 6. PERIODICALS AND NEWS ON APPETITE SUPPRESSANTS ............................................ 41 Overview...................................................................................................................................... 41 News Services and Press Releases................................................................................................ 41 Newsletter Articles ...................................................................................................................... 43 Academic Periodicals covering Appetite Suppressants................................................................ 44 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 45 Overview...................................................................................................................................... 45 U.S. Pharmacopeia....................................................................................................................... 45 Commercial Databases ................................................................................................................. 46 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 49 Overview...................................................................................................................................... 49 NIH Guidelines............................................................................................................................ 49 NIH Databases............................................................................................................................. 51 Other Commercial Databases....................................................................................................... 53 APPENDIX B. PATIENT RESOURCES ................................................................................................. 55 Overview...................................................................................................................................... 55 Patient Guideline Sources............................................................................................................ 55 Finding Associations.................................................................................................................... 58 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 61 Overview...................................................................................................................................... 61 Preparation................................................................................................................................... 61 Finding a Local Medical Library.................................................................................................. 61 Medical Libraries in the U.S. and Canada ................................................................................... 61 ONLINE GLOSSARIES.................................................................................................................. 67 Online Dictionary Directories ..................................................................................................... 67

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APPETITE SUPPRESSANTS DICTIONARY............................................................................. 69 INDEX ................................................................................................................................................ 91

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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 appetite suppressants 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 appetite suppressants, 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 appetite suppressants, 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 appetite suppressants. 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 appetite suppressants, 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 appetite suppressants. 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 APPETITE SUPPRESSANTS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on appetite suppressants.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and appetite suppressants, 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 “appetite suppressants” (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: •

Diabetes Mellitus: Guide to Implementing Intensive Therapy Source: Consultant. 36(11): 2353-2356, 2359-2360, 2362. November 1996. Contact: Available from Consultant. Cliggott Publishing Company, 55 Holly Hill Lane, Box 4010, Greenwich, CT 06831-0010. Summary: In this article, the author outlines strategies for primary care physicians wishing to help their patients with diabetes implement intensive diabetes management. For Type 1 (insulin-dependent, or IDDM) diabetes, several schedules of multiple daily insulin injections are available; an insulin pump should be considered if it is affordable and suits the patient's lifestyle. Patients need to be taught how to adjust insulin doses according to glycemic changes. The author stresses the importance of teaching patients

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(and persons close to them) to recognize early signs of hypoglycemia and to know how to inject glucagon if necessary. For patients with Type 2 diabetes (noninsulin-dependent, or NIDDM), weight reduction remains a prime target. Appetite suppressants may prove useful but are untested in diabetes. Physicians may consider recommending gastric reduction surgery for the morbidly obese. Metformin, alone or added to a sulfonylurea, can decrease hemoglobin A1c by nearly 2 percent. Acarbose, alone or in combination with another oral hypoglycemic, also reduces hemoglobin A1c, but less so than metformin. If these agents fail, bedtime NPH insulin should be added. If all else fails, these patients should be placed on a regimen of two daily injections of insulin. A patient management algorithm is included in the article. 1 figure. 3 tables. 16 references. (AA-M). •

Current Status of Fenfluramine/Dexfenfluramine-Induced Cardiac Valvulopathy Source: CDA Journal. Journal of the California Dental Association. 27(5): 400-404. May 1999. Contact: Available from California Dental Association (CDA). 1201 K Street, Sacramento, CA 95814. (916) 443-0505. Summary: Since publication of the U.S. Department of Health and Human Services' interim recommendations in November 1997 for the management of patients who had taken certain appetite suppressants, a number of studies have evaluated the prevalence of cardiac valvular pathology in such individuals. This article reviews these studies along with a comparison of the three present recommendations and their impact on dental practice. The studies generally support the association of fenfluramine or dexfenfluramine with cardiac valvulopathy, but with significant differences in risk assessment. The analysis of these studies has produced two new guidelines for the management of such patients, including the appropriate use of antibiotic prophylaxis. One table summarizes the recommendations for the dental management of patients who have taken fenfluramine or dexfenfluramine. If valvulopathy is detected (by the physician), the 1997 AHA endocarditis prophylaxis guidelines regarding the management of dental patients with cardiac valvular disorders should be followed. For emergency dental procedures before a cardiac evaluation can be performed, empiric antibiotic prophylaxis should be administered according to the 1997 AHA guidelines. 1 table. 26 references. (AA-M).

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Diet Pills for the Long Haul Source: Diabetes Forecast. 49(7): 25-30. July 1996. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article explores the role of appetite suppressants and other drugs for controlling weight. Because short-term use of these drugs doesn't enable people to lose weight and keep it off, the FDA is now encouraging companies to do long-term tests of their prospective weight-loss drugs and apply for approval for long-term use. The author presents the stories of three people with diabetes who have each experienced weight loss using drug therapy. One sidebar summarizes each type of weight-loss drug presently on the market, including those that affect catecholamines and those that affect serotonin. Another sidebar explores the reasons why weight loss is important, particularly for people with diabetes. 1 figure.

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Unraveling the Riddle of Obesity Source: Diabetes Self-Management. 13(1): 22-24, 26. January-February 1996. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Summary: This article presents an overview of the current theories about obesity. Topics include statistics that document the increase in obesity in the United States; the difficulties of treating obesity; the role of genetics in determining weight levels; animal research in this area; the role of the hypothalamus and serotonin; how diabetes promotes weight gain; and the use of a program that incorporates dietary modification, exercise, and behavioral strategies for effective weight loss. One sidebar summarizes current research in the area of appetite suppressants.

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Medical Implications of Obesity: Losing Pounds, Gaining Years Source: Postgraduate Medicine. 92(1): 151-156, 159-160. July 1992. Summary: This article reviews the medical implications of obesity. Topics covered include fat distribution patterns, factors in obesity, the prevalence of obesity, age at onset of obesity, energy expenditure, eating behavior and its regulating mechanisms, the health risks of obesity, the assessment of obesity, and treatment modalities, including diets, exercise, behavior modification, appetite suppressants, and surgery. Health risks discussed include hyperinsulinemia, noninsulin-dependent diabetes mellitus, hyperlipidemia, hypertension, cardiovascular disease, endocrine changes, gallstones, and malignancy. The authors stress that the goal of physicians caring for obese patients should be to present information about obesity objectively, stress the value of proper diet and exercise, and praise patients for weight loss while continuing to admonish them to lose more. 1 table. 8 references.

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Dieting teens at risk for weight gain Source: Journal of Consulting and Clinical Psychology 1999; 67:p. 967-974. Summary: This article states that teenage girls who try to lose weight through dieting, exercise, and use of laxatives or appetite suppressants, are actually more likely to gain weight over time than their peers, and in fact, are more likely to become obese, report U.S. researchers.

Federally Funded Research on Appetite Suppressants The U.S. Government supports a variety of research studies relating to appetite suppressants. 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.

2 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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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 appetite suppressants. 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 appetite suppressants. The following is typical of the type of information found when searching the CRISP database for appetite suppressants: •

Project Title: CENTRAL SEROTONERGIC PATHWAYS REGULATING ENERGY BALANCE Principal Investigator & Institution: Heisler, Lora K.; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-MAR-2004 Summary: (provided by applicant): Elucidating the basic neurobiology of energy homeostasis is paramount in the prevention and treatment of obesity and type II diabetes. Drugs that increase the activity of central serotonin (5-hydroxytryptamine, 5HT) have been widely used as appetite suppressants. However, these drugs often elicit unwanted side effects because they target multiple 5-HT pathways and receptors. A notable example is d-fenfluramine (d-Fen), a drug that blocks the reuptake of 5-HT and stimulates its release. In the mid-1990's, d-Fen was prescribed to millions of people in the United States for weight loss, frequently in combination with the sympathomimetic phentermine, but was withdrawn from clinical use in 1997 by the Food and Drug Administration due to reports of adverse cardiopulmonary events. The purpose of this proposal is to delineate the central nervous system (CNS) pathways through which drugs such as d-Fen selectively mediate their effects on food intake. We have strong preliminary data indicating that these drugs exert their effect on energy homeostasis by engaging melanocortin pathways. These central melanocortin pathways, through the melanocortin-4 receptors (MC4-Rs), have potent effects on metabolic-hormonal, neuroendocrine, and behavioral parameters associated with energy balance. In this proposal, we will assess whether 5-HT drugs selectively affect energy homeostasis through a necessary downstream activation of MC4-Rs. We propose a model of the mechanism of serotonergic drug action in which activation of specific serotonergic receptors increases the release of the endogenous MC4-R agonist alpha-melanocyte stimulating hormone (alpha-MSH) and inhibits the release of the endogenous antagonist agouti related peptide (AgRP). We will determine whether serotonergic diet drugs require functional downstream MC4-Rs to exert their effect. We offer a series of behavioral, physiological, genetic, and electrophysiological experiments to test components of our model. Data generated from this proposal have the potential to not only delineate the interaction between two key pathways regulating energy homeostasis, but to also identify a promising and very selective target for the prevention and treatment of obesity and type II diabetes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INDOLE ANALOGS AS NOVEL APPETITE SUPPRESSANTS Principal Investigator & Institution: Sard, Howard P.; Organix, Inc. Woburn, Ma 01801 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Obesity affects millions of people in the U.S. and worldwide, and this disease has enormous health and economic consequences for our

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society. Existing treatments show limited efficacy, can possess troubling side effects, and often require long-term therapy. Discovery of a new treatment for obesity would have very considerable scientific and commercial value. We have discovered an indole derivative possessing an encouraging pharmacological profile as a potential appetite suppressant. In Phase One, we propose to synthesize carefully selected analogs of this active lead compound. The pharmacology of these compounds will be evaluated both in vitro and in vivo. From this project we specifically aim to discover one or more indole analogs showing efficacy in an animal model for appetite suppression comparable to that of established therapies. Such a result will strongly support continuation in Phase Two. The long-term goal of this project is to discover new, improved treatments for obesity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISM OF APOPTOSIS IN LUNG VASCULAR SMOOTH MUSCLE Principal Investigator & Institution: Suzuki, Yuichiro J.; Associate Professor of Pharmacology; None; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-DEC-2003 Summary: (provided by applicant): Primary pulmonary hypertension (PPH) is rare, but often fatal, with increased incidence in users of appetite suppressants. It is characterized by increased lung vascular resistance due to thickening of pulmonary arterial walls. The cellular mechanisms that regulate smooth muscle cell number, however, have not been defined. Lack of such knowledge interferes with the development of new therapeutic strategies that are designed to prevent and/or treat this condition. My long-range goal is to identify the mechanisms for the regulation of apoptosis in human pulmonary artery smooth muscle cells (HPASMC). The objective of this application is to evaluate specifically the role of GATA transcription factors. The central hypothesis of the application is that GATA factors regulate apoptosis and survival. The hypothesis has been formulated on the basis of strong preliminary data, which suggest that i) GATA-4 and -6 are expressed in HPASMC, ii) apoptotic stimuli downregulate the GATA activity, and iii) serotonin and endothelin-1 exert antiapoptotic signaling and enhance the GATA activity. The rationale for the proposed research is that, once knowledge of the mechanisms that regulate the lung vascular medial thickening has been obtained, it will lead to new strategies that can be used to prevent and/or treat PPH, thereby reducing the morbidity and mortality that are associated with this condition. I am uniquely prepared to undertake the proposed research because my lab has been studying GATA factors, and many of the techniques and reagents are already available. The central hypothesis will be tested and the objective of the application accomplished by pursuing two specific aims: 1) Identify the mechanisms of HPASMC apoptosis induced by nitric oxide and retinoic acid, and 2) Determine the mechanisms by which serotonin and endothelin-1 exert anti-apoptotic signaling. The proposed work is innovative, because it will investigate novel transcription factors in lung using an approach that has been used in the studies of cardiac muscle. It is my expectation that GATA factors are involved in the regulation of apoptosis of HPASMC. These results will be significant because they are expected to provide new agents for preventative and therapeutic interventions of PPH. In addition, it is expected that the results will fundamentally advance the field of lung cell biology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PHARMACOLOGIC INDUCTION OF WEIGHT LOSS TO TREAT TYPE II DIABETES MELLITUS Principal Investigator & Institution: Bantle, John P.; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002 Summary: Weight loss is an important therapeutic objective for most patients with type II diabetes mellitus. This protocol was a double blind, placebo controlled study of the usefulness of the appetite suppressants fenfluramine and phentermine in the treatment of overweight type II diabetic subjects. However, fenfluramine was withdrawn from the study in September, 1997, when it was withdrawn from the U.S. market. Treatment with appetite suppressants resulted in significant reductions in body weight, body mass index and Hgb AlC at all time points through 10 months. Follow-up of subjects continues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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.3 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 appetite suppressants, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “appetite suppressants” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for appetite suppressants (hyperlinks lead to article summaries): •

A clinical trial of an appetite suppressant in refractory obesity (with a note on assessment of weight loss). Author(s): Peaston MJ. Source: Br J Clin Pract. 1965 September; 19(9): 503-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5318222

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A long-acting appetite suppressant drug studied for 24 weeks in both continuous and sequential administration. Author(s): Le Riche WH, Csima A. Source: Can Med Assoc J. 1967 October 21; 97(17): 1016-20. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6052900

3 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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Appetite suppressant drugs as inhibitors of human cytochromes P450: in vitro inhibition of P450-2D6 by D- and L-fenfluramine, but not phentermine. Author(s): von Moltke LL, Greenblatt DJ, Ciraulo DA, Grassi JM, Granda BW, Duan SX, Harmatz JS, Shader RI. Source: Journal of Clinical Psychopharmacology. 1998 August; 18(4): 338-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9690701

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Appetite suppressant drugs. Author(s): Mashford ML. Source: The Medical Journal of Australia. 1985 December 9-23; 143(12-13): 605-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3831751

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Appetite suppressants and cardiac valvulopathy. Current clinical perspectives. Author(s): Gross SB. Source: Adv Nurse Pract. 1999 October; 7(10): 36-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10808770

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Appetite suppressants and primary pulmonary hypertension in the United Kingdom. Author(s): Thomas SH, Butt AY, Corris PA, Egan JJ, Higenbottam TW, Madden BP, Waller PC. Source: British Heart Journal. 1995 December; 74(6): 660-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8541174

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Appetite suppressants and pulmonary hypertension. Author(s): Voelkel NF. Source: Thorax. 1997 August; 52 Suppl 3: S63-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9381430

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Appetite suppressants and pulmonary hypertension. Author(s): Cahal DA. Source: Lancet. 1969 May 3; 1(7601): 947. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4180930

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Appetite suppressants and valvular heart disease in a population-based sample: the HyperGEN study. Author(s): Palmieri V, Arnett DK, Roman MJ, Liu JE, Bella JN, Oberman A, Kitzman DW, Hopkins PN, Morgan D, de Simone G, Devereux RB. Source: The American Journal of Medicine. 2002 June 15; 112(9): 710-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12079711

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Appetite suppressants and valvular heart disease. Author(s): Seghatol FF, Rigolin VH. Source: Current Opinion in Cardiology. 2002 September; 17(5): 486-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12357124

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Appetite suppressants and valvular heart disease. Author(s): Weissman NJ. Source: The American Journal of the Medical Sciences. 2001 April; 321(4): 285-91. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11307869

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Appetite suppressants and valvular heart disease. Author(s): Devereux RB. Source: The New England Journal of Medicine. 1998 September 10; 339(11): 765-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9731094

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Appetite suppressants as adjuncts in the treatment of obesity. Author(s): Elks ML. Source: The Journal of Family Practice. 1996 March; 42(3): 287-92. Review. Erratum In: J Fam Pract 1996 May; 42(5): 532. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8636681

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Appetite suppressants for obesity. Author(s): Budenholzer B. Source: The Journal of Family Practice. 1997 January; 44(1): 19-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9010359

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Appetite suppressants. A review. Author(s): Silverstone T. Source: Drugs. 1992 June; 43(6): 820-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1379155

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Appetite suppressants: problems and pitfalls of drug discovery. Author(s): Levens N, Della-Zuana O. Source: Curr Opin Investig Drugs. 2003 April; 4(4): 384-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12808875

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Attitudes toward appetite suppressants. A survey of US physicians. Author(s): Lasagna L. Source: Jama : the Journal of the American Medical Association. 1973 July 2; 225(1): 44-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4740304

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Bariatric Society seeks dietitian members, supports appropriate use of appetite suppressants. Author(s): Merker JF. Source: Journal of the American Dietetic Association. 1992 November; 92(11): 1334. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1430714

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Body weight changes in overweight patients following an appetite suppressant in a controlled environment. Author(s): Sandoval RG, Wang RI, Rimm AA. Source: J Clin Pharmacol New Drugs. 1971 March-April; 11(2): 120-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4929289

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Clinical use of appetite suppressants. Author(s): Silverstone T. Source: Drug and Alcohol Dependence. 1986 June; 17(2-3): 151-67. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3527636

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Dangers of certain appetite suppressants. Author(s): Prime FJ. Source: British Medical Journal. 1969 July 19; 3(663): 177. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5792926

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Dangers of certain appetite suppressants. Author(s): Cahal DA. Source: British Medical Journal. 1969 May 3; 2(652): 316. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5780470

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Delayed onset of pulmonary hypertension associated with an appetite suppressant, mazindol: a case report. Author(s): Hagiwara M, Tsuchida A, Hyakkoku M, Nishizato K, Asai T, Nozawa Y, Tsuchihashi K, Shimamoto K. Source: Japanese Circulation Journal. 2000 March; 64(3): 218-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10732856

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Dental considerations of patients taking appetite suppressants. Author(s): Wynn RL. Source: Gen Dent. 1997 July-August; 45(4): 324-8, 330-1. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9515435

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Diabetes disease stage predicts weight loss outcomes with long-term appetite suppressants. Author(s): Khan MA, St Peter JV, Breen GA, Hartley GG, Vessey JT. Source: Obesity Research. 2000 January; 8(1): 43-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10678258

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Diethylpropion hydrochloride: an effective appetite suppressant. Author(s): Bolding OT. Source: Curr Ther Res Clin Exp. 1974 January; 16(1): 40-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4203847

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Double blind cross-over study of a new appetite suppressant AN 448. Author(s): Haugen HN. Source: European Journal of Clinical Pharmacology. 1975; 8(1): 71-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=786676

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Double-blind comparison of placebo and 42-548, a new appetite suppressant, in obese volunteers. Author(s): De Felice EA, Bronstein S, Cohen A. Source: Curr Ther Res Clin Exp. 1969 May; 11(5): 256-62. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4977396

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Effect of dietary manipulation on substrate flux and energy balance in obese women taking the appetite suppressant dexfenfluramine. Author(s): Poppitt SD, Swann DL, Murgatroyd PR, Elia M, McDevitt RM, Prentice AM. Source: The American Journal of Clinical Nutrition. 1998 November; 68(5): 1012-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9808216

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European withdrawal of appetite suppressants. Author(s): Kinnell HG. Source: Obesity Reviews : an Official Journal of the International Association for the Study of Obesity. 2003 May; 4(2): 79-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12760442

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Hazards of the appetite suppressant phenylpropanolamine. Author(s): Bennett WM. Source: Lancet. 1979 July 7; 2(8132): 42-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=87921

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Heart valve lesions in patients treated with appetite suppressants. Author(s): Pi-Sunyer FX. Source: Obesity Research. 1999 July; 7(4): 414-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10440599

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High incidence of primary pulmonary hypertension associated with appetite suppressants in Belgium. Author(s): Delcroix M, Kurz X, Walckiers D, Demedts M, Naeije R. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 1998 August; 12(2): 271-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9727773

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Hypertensive crisis resulting from an MAO inhibitor and an over-the-counter appetite suppressant. Author(s): Smookler S, Bermudez AJ. Source: Annals of Emergency Medicine. 1982 September; 11(9): 482-4U. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7114595

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Letter: Abuse of non-amphetamine appetite suppressants. Author(s): Willis JH. Source: Lancet. 1976 January 3; 1(7949): 37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=54533

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Manic psychosis associated with appetite suppressant medication, phenylpropanolamine. Author(s): Boffi BV, Klerman GL. Source: Journal of Clinical Psychopharmacology. 1989 August; 9(4): 308-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2768545

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Monoclonal endothelial cells in appetite suppressant-associated pulmonary hypertension. Author(s): Tuder RM, Radisavljevic Z, Shroyer KR, Polak JM, Voelkel NF. Source: American Journal of Respiratory and Critical Care Medicine. 1998 December; 158(6): 1999-2001. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9847298

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Nonprescription appetite suppressants. Author(s): Drew R. Source: N C Med J. 1983 September; 44(9): 573-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6579375

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Passive transfer of an appetite suppressant factor. Author(s): Riestra JL, Skowsky WR, Martinez I, Swan L. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1977 November; 156(2): 236-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=337318

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Preliminary clinical evaluation of a new appetite suppressant. A double-blind study. Author(s): Feldman HS. Source: J Med Soc N J. 1966 October; 63(10): 454-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5341753

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Primary pulmonary hypertension and long-term use of appetite suppressants. Author(s): Sztuke-Fournier A. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1997 January 1; 156(1): 89-90, 93-4. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9006574

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Relationship between anorectic and reinforcing properties of appetite suppressant drugs: implications for assessment of abuse liability. Author(s): Griffiths RR, Brady JV, Snell JD. Source: Biological Psychiatry. 1978 April; 13(2): 283-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=96878

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Rhabdomyolysis after ingestion of an appetite suppressant. Author(s): Rumpf KW, Kaiser HF, Horstkotte H, Bahlmann J. Source: Jama : the Journal of the American Medical Association. 1983 October 28; 250(16): 2112. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6620516

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Risks of heart-valve abnormalities with appetite suppressants. Author(s): Baird IM. Source: Lancet. 1998 October 31; 352(9138): 1403-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9807983

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Scleroderma after therapy with appetite suppressants. Report on four cases. Author(s): Aeschlimann A, de Truchis P, Kahn MF. Source: Scandinavian Journal of Rheumatology. 1990; 19(1): 87-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2309108

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Severe hypertension after ingestion of an appetite suppressant (phenylpropanolamine) with indomethacin. Author(s): Lee KY, Beilin LJ, Vandongen R. Source: Lancet. 1979 May 26; 1(8126): 1110-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=86834

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Systemic sclerosis after therapy with appetite suppressants. Author(s): Tomlinson IW, Jayson MI. Source: The Journal of Rheumatology. 1984 April; 11(2): 254. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6726731

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The appetite suppressant d-fenfluramine induces apoptosis in human serotonergic cells. Author(s): Bengel D, Isaacs KR, Heils A, Lesch KP, Murphy DL. Source: Neuroreport. 1998 September 14; 9(13): 2989-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9804303

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The clinical pharmacology of appetite suppressant drugs. Author(s): Silverstone T, Goodall E. Source: Int J Obes. 1984; 8 Suppl 1: 23-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6242052

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The serotonergic appetite suppressant fenfluramine. Reappraisal and rejection. Author(s): Curzon G, Gibson EL. Source: Advances in Experimental Medicine and Biology. 1999; 467: 95-100. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10721044

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The use of an appetite suppressant (diethylpropion hydrochloride) during pregnancy. Author(s): Silverman M, Okun R. Source: Curr Ther Res Clin Exp. 1971 October; 13(10): 648-53. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5004802

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Treatment of obesity. Appetite suppressant drugs and intestinal by-pass surgery. Author(s): Bleehen SS, Edwards IR, Clark RG. Source: The British Journal of Dermatology. 1976 August; 95(2): 219-222. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=782507

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Trial of appetite suppressant. Study of a short-acting and sustained release appetite suppressant on patients paired by initial weight. Author(s): LeRiche WH, Csima A. Source: Appl Ther. 1967 March; 9(3): 260-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6039128

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Urticarial vasculitis induced by centrally acting appetite suppressants. Author(s): Papadavid E, Yu RC, Tay A, Chu AC. Source: The British Journal of Dermatology. 1996 May; 134(5): 990-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8736361

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Use of amphetamine-like appetite suppressants: a cross-sectional survey in Southern Brazil. Author(s): de Lima MS, Beria JU, Tomasi E, Mari JJ. Source: Substance Use & Misuse. 1998 June; 33(8): 1711-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9680089

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Valve replacement for appetite suppressant-induced valvular heart disease. Author(s): Biswas SS, Donovan CL, Forbess JM, Royal SH, Landolfo KP. Source: The Annals of Thoracic Surgery. 1999 June; 67(6): 1819-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10391313

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CHAPTER 2. NUTRITION AND APPETITE SUPPRESSANTS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and appetite suppressants.

Finding Nutrition Studies on Appetite Suppressants 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.4 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 “appetite suppressants” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 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 “appetite suppressants” (or a synonym): •

Prescription appetite suppressants in weight management. Source: Cameron, K.E. Dwyer, J.T. Couris, R. Huff, N. McCloskey, W.W. Nutritiontoday (USA). (October 1997). volume 32(5) page 202-210.

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 appetite suppressants; 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 Weight Loss and Obesity Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND APPETITE SUPPRESSANTS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to appetite suppressants. 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 appetite suppressants 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 “appetite suppressants” (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 appetite suppressants: •

“Diet pills” and major depression in the Canadian population. Author(s): Patten SB. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2001 June; 46(5): 438-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11441784

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A case of positive doping associated with a botanical food supplement. Author(s): Ros JJ, Pelders MG, De Smet PA. Source: Pharmacy World & Science : Pws. 1999 February; 21(1): 44-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10214669

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A comprehensive psychological approach to obesity. Author(s): Fawzy FI, Pasnau RO, Wellisch DK, Ellsworth RG, Dornfeld L, Maxwell M.

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Source: Psychiatr Med. 1983 September; 1(3): 257-73. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6400602 •

A low-fat, whole-food vegan diet, as well as other strategies that down-regulate IGF-I activity, may slow the human aging process. Author(s): McCarty MF. Source: Medical Hypotheses. 2003 June; 60(6): 784-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12699704

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A simultaneous determination of norephedrine, pseudoephedrine, ephedrine and methylephedrine in Ephedrae Herba and oriental pharmaceutical preparations by ion-pair high-performance liquid chromatography. Author(s): Sagara K, Oshima T, Misaki T. Source: Chemical & Pharmaceutical Bulletin. 1983 July; 31(7): 2359-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6640802

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A study on the role of cholinergic and gamma amino butyric acid systems in the antinociceptive effect of gossypin. Author(s): Viswanathan S, Thirugnanasambantham P, Ramaswamy S, Bapna JS. Source: Clinical and Experimental Pharmacology & Physiology. 1993 March; 20(3): 1936. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8467574

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A succulent cure to end obesity. Author(s): Habeck M. Source: Drug Discovery Today. 2002 March 1; 7(5): 280-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11854044

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A survey on consumption of psychotropic drugs among university students. Author(s): Vojtechovsky M. Source: Act Nerv Super (Praha). 1972; 14(2): 139-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5040168

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Abolition of monocular optokinetic nystagmus directional asymmetry after unilateral visual deprivation in adult vertebrates: involvement of the GABAergic mechanism. Author(s): Yucel YH, Kim MS, Jardon B, Bonaventure N. Source: Brain Research. Developmental Brain Research. 1990 May 1; 53(2): 179-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2357790

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Action of fenfluramine, phenylpropanolamine, phentermine and diethylpropion on acoustic startle in rats. Author(s): Kutscher CL.

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Source: Pharmacology, Biochemistry, and Behavior. 1987 August; 27(4): 749-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3659098 •

American Society for Clinical Pharmacology and Therapeutics position statement on the public health risks of ephedra. Author(s): Hollister AS, Kearns GL. Source: Clinical Pharmacology and Therapeutics. 2003 November; 74(5): 403-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14586380

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Analysis and confirmation of synthetic anorexics in adulterated traditional Chinese medicines by high-performance capillary electrophoresis. Author(s): Ku YR, Chang YS, Wen KC, Ho LK. Source: J Chromatogr A. 1999 July 2; 848(1-2): 537-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10427768

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Anorexic activity of cocaine and coca extract in naive and cocaine tolerant rats. Author(s): Vee GL, Fink GB, Constantine GH Jr. Source: Pharmacology, Biochemistry, and Behavior. 1983 April; 18(4): 515-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6867056

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Anorexigenic effects of two amines obtained from Catha edulis Forsk. (Khat) in rats. Author(s): Zelger JL, Carlini EA. Source: Pharmacology, Biochemistry, and Behavior. 1980 May; 12(5): 701-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7393964

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Appetoff: another diet fad. Author(s): Beckerich MJ. Source: Vet Hum Toxicol. 1989 December; 31(6): 540-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2617837

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Are serious adverse cardiovascular events an unintended consequence of the Dietary Supplement Health and Education Act of 1994? Author(s): Lindsay BD. Source: Mayo Clinic Proceedings. 2002 January; 77(1): 7-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11795250

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Association of valvular heart disease with Chinese-herb nephropathy. Author(s): Vanherweghem JL. Source: Lancet. 1997 December 20-27; 350(9094): 1858. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9428286

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Atrioventricular block following overdose of decongestant cold medication. Author(s): Burton BT, Rice M, Schmertzler LE. Source: The Journal of Emergency Medicine. 1985; 2(6): 415-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2418096

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Balancing safety of dietary supplements with the free market. Author(s): Lewis JD, Strom BL. Source: Annals of Internal Medicine. 2002 April 16; 136(8): 616-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11955030

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Bioactivation of Catha edulis alkaloids: enzymatic ketonization of norpseudoephedrine. Author(s): May SW, Phillips RS, Herman HH, Mueller PW. Source: Biochemical and Biophysical Research Communications. 1982 January 15; 104(1): 38-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7073680

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Biochemical effects of Catha edulis, cathine and cathinone on adrenocortical functions. Author(s): Ahmed MB, el-Qirbi AB. Source: Journal of Ethnopharmacology. 1993 August; 39(3): 213-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7903110

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Cannabis and cannabinoids: pharmacology and rationale for clinical use. Author(s): Pertwee RG. Source: Forschende Komplementarmedizin. 1999 October; 6 Suppl 3: 12-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10575283

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The eating disorders medicine cabinet revisited: a clinician's guide to appetite suppressants and diuretics. Author(s): Roerig JL, Mitchell JE, de Zwaan M, Wonderlich SA, Kamran S, Engbloom S, Burgard M, Lancaster K. Source: The International Journal of Eating Disorders. 2003 May; 33(4): 443-57. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12658674

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Treatment of obesity in the Bantu: value of a low-carbohydrate diet with and without an appetite suppressant. Author(s): Kew MC. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1970 September 5; 44(35): 1006-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5469433

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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 appetite suppressants; 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 Insulin Resistance Syndrome Source: Healthnotes, Inc.; www.healthnotes.com

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Herbs and Supplements Gymnema Sylvestre Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10034,00.html Mixed Amphetamines Source: Healthnotes, Inc.; www.healthnotes.com Tyrosine Source: Integrative Medicine Communications; www.drkoop.com

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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. PATENTS ON APPETITE SUPPRESSANTS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “appetite suppressants” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on appetite suppressants, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Appetite Suppressants By performing a patent search focusing on appetite suppressants, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 5Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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The following is an example of the type of information that you can expect to obtain from a patent search on appetite suppressants: •

Appetite suppressant chewing gum containing chromic picolinate Inventor(s): Bernstein; Richard (Toluca, CA) Assignee(s): Bernstein Brothers Marketing Corp. (Burbank, CA) Patent Number: 5,534,272 Date filed: January 3, 1995 Abstract: A chewing gum containing an appetite suppressant quantity of chromic picolinate. Excerpt(s): The present invention relates to an appetite suppressant, and more specifically to a chewing gum containing an appetite suppressant quantity of chromic picolinate. Chewing gums containing various flavors and additives are known. However, a chewing gum containing an appetite suppressant quantity of chromic picolinate is not presently available. In accordance with the invention, an appetite suppressant quantity of chromic picolinate is contained in a chewing gum base. When the chewing gum is chewed, the chromic picolinate is sublingually assimilated and functions as an effective appetite suppressant. Web site: http://www.delphion.com/details?pn=US05534272__

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Appetite suppressant composition and method relating thereto Inventor(s): Mann; Morris A. (3310 W. Bell Rd., Suite 1001, Phoenix, AZ 85023) Assignee(s): none reported Patent Number: 5,273,754 Date filed: March 27, 1992 Abstract: There is disclosed an appetite suppressant composition for oral administration. The composition includes a heating and a cooling carminative substance, and may also include an amino acid and an anxiolytic substance. Also disclosed are methods for decreasing appetite by oral administration of the appetite suppressant composition, and for manufacture of the appetite suppressant composition. Excerpt(s): This invention relates generally to an appetite suppressant and methods related thereto, and more specifically to a composition which decreases appetite thereby reducing food and caloric intake and leading to a decrease in weight. Obesity caused by excessively high caloric intake and accumulation of surplus fat often leads to various types of degenerative diseases. Dieting, bariatrics and cytotherapy is of major concern to patients who suffer from obesity-caused diseases and also to healthy people who, for cosmetic reasons, wish to control their caloric intake and thereby decrease their weight. Dieting often requires that significant limitations be placed on the amount of caloric intake, and the amount of fat and carbohydrates consumed by an individual are invariably diminished in a successful dietary plan. However, due to the inherent causes of obesity and overeating, dieting by itself is often unsuccessful in achieving the patient's goals. There are two primary reasons for this. First, there is an immense amount of patience required by the dieter to lose significant amounts of weight. Second,

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and perhaps more important, are the inherent reasons that people eat to excess. For example, it is well known that the vast majority of over-eating is done to satisfy anxiety. Thus, caloric intake often is not engaged in for the purpose of satisfying hunger and meeting metabolic needs, but to satisfy secondary needs in the individual's life. Web site: http://www.delphion.com/details?pn=US05273754__ •

Appetite suppressant dentifrice Inventor(s): Curtis; John P. (Piscataway, NJ), De Pierro; Karen J. (Piscataway, NJ), Wieckowski; Susan E. (Iselin, NJ) Assignee(s): Colgate-Palmolive Company (New York, NY) Patent Number: 4,913,894 Date filed: May 1, 1989 Abstract: An appetite suppressant oral composition containing Benzocaine, high impact flavor and a sweetening agent, in the form of a dental cream or a mouthspray. A novel method of reducing appetite and thereby intended for controlling weight of consumers, which comprises applying to the oral cavity a high impact flavor in a dentrifrice or mouthspray. Excerpt(s): The present invention relates to the formulation of an appetite suppressant oral composition in the form of a dentifrice and mouthspray comprising as essential ingredients Benzocaine, a high impact flavor and a sweetening agent, which coacts to control the appetite and permit reduction in body weight by simply brushing or spraying before or after meals, preferably before meals. It has been found that the combination of about 0.075-1.5% by weight Benzocaine, about 0.5-1.5% by weight of a high impact flavor, such as chocolate chip mint, and about 0.2-0.6% sweetening agent functions as an appetite suppressant agent in a dentifrice formulation. This unexpected use of present novel dentifrice to suppress appetite and promote weight loss provides a new secondary benefit to the oral hygiene function of a dentifrice. Current products to suppress appetite and control weight are generally drugs with undesirable side effects, often with a propensity to be addictive; whereas present novel appetite suppressant dentifrice provides a non-pharmacological means to suppress appetite. Web site: http://www.delphion.com/details?pn=US04913894__

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Herbal appetite suppressant and weight loss composition Inventor(s): Haveson; Brian (Yardley, PA) Assignee(s): HPF, L.L.C. (Horsham, PA) Patent Number: 5,798,101 Date filed: May 1, 1997 Abstract: The present invention is directed to herbal compositions which reduce weight, maintain weight loss over an extended period of time, and act as an appetite suppressant. The composition consists of St. John's Wort with or without caffeine or other appetite suppressants known in the art, and also a composition comprising St. John's Wart (hypericin) and Mahuang (Ephedra sinica or ephedrine). Another composition disclosed comprises a combination of the above herbs with caffeine.

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Excerpt(s): This application claims the benefit under 35 USC 119(e) of provisonal application Ser. Nos.60/036,339, filed Jan. 22, 1997 and 60/038,128 filed Mar. 3, 1997. The invention relates to compositions for reducing weight in humans and/or animals and more particularly to herbal compositions for achieving the desired result. This invention relates to herbal compositions for reducing weight, maintaining weight loss over an extended period of time and suppressing appetite in a human or a domestic animal. Web site: http://www.delphion.com/details?pn=US05798101__ •

Prolonged acting appetite suppressant and anti-obesity compositions containing amphetamine adipate, dextroamphetamine adipate, amphetamine sulfate and dextroamphetamine sulfate as the active agents Inventor(s): Cohen; Louis (Yonkers, NY) Assignee(s): Delco Chemical Company, Inc. (Mount Vernon, NY) Patent Number: 4,049,791 Date filed: January 26, 1976 Abstract: A prolonged acting appetite suppressant and anti-obesity composition in oral administration form which comprises an effective amount of a synergistic combination of amphetamine adipate, dextroamphetamine adipate, amphetamine sulfate and dextroamphetamine sulfate in equal or substantially equal amounts as the active agents in combination with a pharmaceutically acceptable carrier and is useful in suppressing one's appetite and in treating obesity. Excerpt(s): The present invention is concerned with prolonged-acting appetite suppressant and anit-obesity compositions. More particularly, the present invention is concerned with compositions in oral administration form which comprise an effective amount of a combination of at least two active agents selected from the group consisting of amphetamine adipate, dextroamphetamine adipate, amphetamine sulfate and dextroamphetamine sulfate in combination with a pharmaceutically-acceptable solid vehicle or carrier. The compositions are preferably in the form of tablets or capsules. The compositions of the present invention are effective for diminishing the rate of excretion by prolonging blood levels above the minimum effective concentration while avoiding peak concentrations and those side effects which may be encountered with respect to prior known amphetamine preparations. The use of a combination of the active agents set forth above have a stabilizing effect on the enzyme d-amino oxidase thereby prolonging appetite-suppressant effect of amphetamine and dextroamphetamine in the treatment of exogenous obesity while reducing undesired or adverse side effects encountered with amphetamine and dextroamphetamine. Web site: http://www.delphion.com/details?pn=US04049791__

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Transdermal delivery of appetite suppressant drug Inventor(s): Ganslaw; Stuart (Simsbury, CT), Lhila; Ramesh (South Windsor, CT), Serra; Eleanor (West Springfield, MA) Assignee(s): Coating Sciences, Inc. (Bloomfield, CT) Patent Number: 5,498,417 Date filed: May 12, 1994 Abstract: A medical device for the transdermal delivery of an appetite suppressant drug wherein said device comprises a silicone-coated release layer, a coating containing a mixture of a pressure-sensitive adhesive, an appetite suppressant drug, a permeation enhancer and a PH control additive wherein said coated release layer is laminated to a carrier layer. Excerpt(s): This invention relates to a medical device for delivery of a drug to the body through intact skin. More particularly, the invention relates to the transdermal delivery of an appetite suppressant drug through the skin. The use of transdermal patches for the delivery of drugs through the skin is well-known. For example, transdermal patches have been used to deliver drugs in all of the major therapeutic areas including, but not limited to, antibiotic and antiviral agents, analgesics, antidepressants, antihistomines, antinauseants, antispasmodics, diuretics, vasodialators, appetite suppresssants, stimulants, etc. Although the transdermal delivery of drugs is rapidly becoming the preferred method of delivery of drugs, it is not without problems. For example, some drugs cause undesirable skin reactions, while other drugs do not readily permeate the skin. In the latter case, permeation enhancers are usually added to the drug in order to enhance the transfer of the drug through the skin; however, in some cases some drugs are difficult to use in an effective manner even when combined with a permeation enhancer. This has been found to be the case with the use of an appetite suppressant drug known as phenylpropanolamine HCL, i.e. PPA, as well as similar drugs of the same class. Web site: http://www.delphion.com/details?pn=US05498417__

Patent Applications on Appetite Suppressants As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to appetite suppressants: •

Agent having prolonged stomach retention time used to produce a longlasting saturation effect, and the use thereof Inventor(s): Beisel, Gunther; (Monheim, DE), Groning, Rudiger; (Munster, DE) Correspondence: Friedrick Kueffner; Suite 910; 317 Madison Avenue; New York; NY; 10017; US Patent Application Number: 20030161885 Date filed: February 28, 2003

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This has been a common practice outside the United States prior to December 2000.

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Abstract: The present invention relates to a composition for oral intake to generate a long-lasting satiation effect, and its use as additive to food products, for producing food supplements, appetite suppressants and/or satiating agents. Excerpt(s): The present invention relates to a composition for oral intake to generate a long-lasting satiation effect, comprising at least one substance which increases the viscosity of a liquid, and at least one other compound which increases the retention time of the viscosity-increasing substance in the stomach. Preparations with gel-forming substances which, in the form of tablets, granules, suspensions or solutions, display their long-lasting, satiating effect via the gastrointestinal tract are employed for the treatment for example of obesity and disorders caused by obesity. Corresponding preparations comprise vegetable mucilages and swelling agents such as, for example, alginates, pectin, wheat bran, starch gels or guar gum. Together with an ingested liquid or in the presence of gastric fluid, these substances form a gelatinous structure, called hydroyds or hydrocolloids, which may serve inter alia for satiation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Appetite suppressant toothpaste Inventor(s): Zuckerman, Arthur; (New York, NY) Correspondence: Michael I. Kroll; 171 Stillwell Lane; Syosset; NY; 11791; US Patent Application Number: 20020122777 Date filed: December 27, 2000 Abstract: An appetite suppressant toothpaste formulations which simultaneously suppresses the users appetite while promoting intraoral cleanliness. The toothpaste composition includes toothpaste base ingredients; and at least one of appetite suppressant and appetite depressant herbs. The toothpaste base ingredients include a combination of known amounts of Vegetable Glycerin; Sorbitol, Hydrated Silica; Purified Water; Xylitol; Carrageenan; Sodium Lauryl Sulfate; and Titanium Dioxide and a flavoring agent. The appetite suppressing and depressing herbs include at least one of Garcinia Cambogia; Gymnema Sylvestre; Kola Nut; Citrus Aurantium; Yerba Mate; and Griffonia Simplicifolia and comprise a range of substantially 5.5% to substantially 22% by weight of the composition. The appetite suppressing and depressing herbs may further include at least one of Guarana, Green Tea, myrrh, guggul Lipid and black current seed oil. Alternatively, the toothpaste composition may be in the form of a dental cream or mouthspray. Excerpt(s): The present invention relates to toothpaste and, more particularly, to a formulation of an appetite suppressant oral composition in the form of a toothpaste comprising ingredients which co-act to control the appetite and permit reduction in body weight by brushing the teeth of a user with the composition. It has been found that the combination of about 5.50-22.0% by weight natural herbs functions as an appetite suppressant agent in a standard toothpaste formulation. This unexpected result from the novel toothpaste composition of the present invention to suppress appetite and promote weight loss provides a new secondary benefit to the promoting intraoral cleanliness with toothpaste. Numerous types of appetite suppressants have been provided in the prior art. Current products to suppress appetite and control weight are generally drugs with undesirable side effects, often with a propensity to be addictive; whereas the instant novel appetite suppressant toothpaste provides a non-

Patents 33

pharmacological means to suppress the appetite of a user by adding natural herbs to a standard toothpaste formulation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Composition for suppressing the appetite of a human being comprising L-theanine and method of administering same Inventor(s): Spiegel, Peter; (Austin, TX) Correspondence: Sutherland Asbill & Brennan Llp; 999 Peachtree Street, N.E.; Atlanta; GA; 30309; US Patent Application Number: 20040082657 Date filed: October 24, 2002 Abstract: The present invention is a method and composition for suppressing the appetite of a human being using L-theanine. The method comprises the step of orally administering a composition comprising an appetite-suppressing amount of L-theanine. The L-theanine composition used as an appetite suppressant in accordance with the invention can be provided in solid form or liquid form and can be further combined with one or more inert ingredients or one or more additional active ingredients. The appetite suppressant composition of the invention provides a natural way of suppressing the appetite of a human being without causing the side effects associated with conventional appetite suppressants. Excerpt(s): The present invention relates to a composition for suppressing the appetite of a human being comprising L-theanine and to a method for suppressing the appetite of a human being comprising orally administering a composition comprising L-theanine. In today's society, people are often less active than their ancestors and spend more time using cars and other vehicles to get around and spend less time walking from place to place. In addition, food and particularly "fast food" is more readily available than it once was. As a result of these societal changes and other factors, the number of people suffering from being overweight or obese has increased in recent times. In an attempt to keep this problem under control, people are more often turning to diets and appetite suppressants to control their weight. Many of the appetite suppressants that have been on the market in recent years have been found to be unsafe because they produce adverse side effects. Stimulants and thermogenic compounds such as ephedrine, phenylpropanolamine (PPA), amphetamines, fenfluramine and caffeine have been used as appetite suppressants and to increase metabolism and energy levels. However, these compounds typically have undesirable and sometimes dangerous side effects. For example, caffeine, the most common and perhaps the safest compound in this group, can cause dehydration, restlessness, nervousness, gastrointestinal disturbances, muscle twitching, and in some extreme cases, cardiac arrhythmia. Therefore, there is a need in the art for appetite suppressants that do not produce adverse side effects in the body. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Appetite Suppressants

Pharmaceutical compositions having appetite suppressant activity Inventor(s): Horak, Roelof Marthinus; (Elardus Park, ZA), Learmonth, Robin Alec; (Elardus Park, ZA), Maharaj, Vinesh; (Heuweloord, ZA), Van Heerden, Fanie Retief; (Fairland, ZA), Vleggaar, Robert; (Faerie Glen, ZA), Whittal, Rory Desmond; (Heuweloord, ZA) Correspondence: Morgan Lewis & Bockius Llp; 1111 Pennsylvania Avenue NW; Washington; DC; 20004; US Patent Application Number: 20020168427 Date filed: February 13, 2002 Abstract: A pharmaceutical composition contains an extract obtainable from a plant of the genus Trichocaulon or Hoodia containing an appetite suppressant agent having the formula (1). A process for obtaining the extract and a process for synthesizing compound (1) and its analogues and derivatives is also provided. The invention also extends to the use of such extracts and compound (1) and its analogues for the manufacture of medicaments having appetite suppressant activity. The invention further provides novel intermediates for the synthesis of compound (1). Excerpt(s): THIS INVENTION relates to steroidal glycosides, to compositions containing such steroidal glycosides and to a new use for these steroidal glycosides and the compositions containing them. The invention further relates to a method of extracting and isolating these steroidal glycosides from plant material, to a method of synthetically producing these steroidal glycosides, and to the products of such an extraction and such a synthesis process. In a particular application, the invention relates to an appetite suppressant agent, to a process for synthetically producing the appetite suppressant agent, to a process for extracting the appetite suppressant agent from plant material, to an appetite suppressant composition containing the appetite suppressant agent, and to a method of suppressing an appetite. According to the invention, there is provided a process for preparing an extract of a plant of the genus Trichocaulon or of the genus Hoodia, the extract comprising an appetite suppressant agent, the process including the steps of treating collected plant material with a solvent to extract a fraction having appetite suppressant activity, separating the extraction solution from the rest of the plant material, removing the solvent from the extraction solution and recovering the extract. The extract so recovered may be further purified, eg by way of suitable solvent extraction procedures. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Pharmaceutical compositions having appetite suppressant activity Inventor(s): Horak, Roelof Marthinus; (Elardus Park, ZA), Learmonth, Robin Alec; (Elardus Park, ZA), Maharaj, Vinesh; (Heuweloord, ZA), Van Heerden, Fanie Retief; (Fairland, ZA), Vleggaar, Robert; (Faerie Glen, ZA), Whittal, Rory Desmond; (Heuweloord, ZA) Correspondence: Morgan Lewis & Bockius Llp; 1111 Pennsylvania Avenue NW; Washington; DC; 20004; US Patent Application Number: 20030086984 Date filed: June 14, 2002

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Abstract: 1A pharmaceutical composition which contains an extract obtainable from a plant of the genus Trichocualon or Hoodia containing an appetite suppressant agent having the formula (1). A process for obtaining the extract and a process for synthesizing compound (1) and its analogues and derivatives is also provided. The invention also extends to the use of such extracts and compound (1) and its analogues for the manufacture of medicaments having appetite suppressant activity. The invention further provides novel intermediates for the synthesis of compound (1). Excerpt(s): This application is a Continuation of application Ser. No. 10/073,357, filed Feb. 13, 2002 which is a Divisional of application Ser. No. 09/402,962 filed on Oct. 13, 1999, now issued as U.S. Pat. No. 6,376,657 which is the U.S. national phase of PCT International Application No. PCT/GB98/01100, filed Apr. 15, 1998, which claims priority to South African Application No. 97/3201, filed Apr. 15, 1997. This invention relates to steroidal glycosides, to compositions containing such steroidal glycosides and to a new use for these steroidal glycosides and the compositions containing them. The invention further relates to a method of extracting and isolating these steroidal glycosides from plant material, to a method of synthetically producing these steroidal glycosides, and to the products of such an extraction and such a synthesis process. In a particular application, the invention relates to an appetite suppressant agent, to a process for synthetically producing the appetite suppressant agent, to a process for extracting the appetite suppressant agent from plant material, to an appetite suppressant composition containing the appetite suppressant agent, and to a method of suppressing an appetite. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with appetite suppressants, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “appetite suppressants” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on appetite suppressants. You can also use this procedure to view pending patent applications concerning appetite suppressants. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON APPETITE SUPPRESSANTS Overview This chapter provides bibliographic book references relating to appetite suppressants. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on appetite suppressants 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 “appetite suppressants” (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 appetite suppressants: •

What You Can Do to Prevent Diabetes: Simple Changes to Improve Your Life Source: Somerset, NJ: John Wiley and Sons, Inc. 2000. 146 p. Contact: Available from John Wiley and Sons. One Wiley Drive, Somerset, NJ 08875. (800) 225-5945 or (732) 469-4400. Fax (732) 302-2300. E-mail: [email protected]. Website: www.wiley.com. PRICE: $12.95 plus shipping and handling. ISBN: 0471347965. Summary: This book outlines lifestyle changes that people can make to prevent diabetes. Steps that people can take to reduce their chance of getting type 2 diabetes include managing body weight, becoming active, and establishing healthier eating habits. In part one, readers rate their risk for developing diabetes and learn how diabetes develops. Part two provides guidelines and encouragement for helping people make lasting lifestyle changes. Part three focuses on managing body weight. Topics include understanding the connection between diabetes and excess body weight, using body

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mass index and body shape to determine if one's current weight is healthy, avoiding the use of over the counter appetite suppressants, and dealing with binge eating. Part four provides nutrition guidelines that people can use to achieve better health, including following the 80/20 rule that advocates making healthful food choices 80 percent of the time and allowing less desirable choices on holidays, vacations, and special occasions; getting less than 30 percent of each day's calories from fat; establishing consistent eating habits; keeping calories in check; monitoring portion size; assessing one's hunger; eating intuitively; learning one's food triggers; and eating five servings of fruits and vegetables throughout the day. Part five stresses the importance of exercise and offers suggestions for incorporating more physical activity into daily living. Topics include performing aerobic exercises, adding strength training to an exercise program, and balancing a fitness routine with both aerobic exercise and strength training. Part six focuses on balancing one's lifestyle by monitoring and managing stress, finding support, thinking positively, and visualizing success. The final two parts discuss the advantages of getting the entire family involved in making positive lifestyle changes and offer guidelines for staying on track with a diabetes prevention plan. The book concludes with an index. 30 references.

Chapters on Appetite Suppressants In order to find chapters that specifically relate to appetite suppressants, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and appetite suppressants 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 “appetite suppressants” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on appetite suppressants: •

Pathogenesis: Environmental Source: in Clements, P.J.; Furst, D.E., Eds. Systemic Sclerosis. Baltimore, MD: Williams and Wilkins. 1996. p. 203-228. Contact: Available from Williams and Wilkins, Special Sales Department. (800) 358-3583. Summary: This chapter for health professionals explores the pathogenesis of environmental sclerodermas. Definitions of environmental sclerodermas are provided. The joint contribution of an environmental etiologic agent and host factors to the pathogenesis of environmental sclerodermas is considered. The concept of proof of cause and effect in environmental disease is discussed. Characteristics of the environmental agent and the host contributing to disease variability are described, focusing on chemical characteristics; route of chemical exposure; dose, potency, and duration of exposure to environmental chemicals; and clinical, cellular, immunological, biochemical, and molecular responses in the host. The characteristics of compounds associated with the development of scleroderma-like syndrome are discussed. These compounds include therapeutic agents, antineoplastic agents, sympathomimetics and appetite suppressants, opioid derivatives, amino acids and related compounds, other therapeutic devices, organic solvents, inorganic chemicals, and unknown toxins. Repeated vibration injury has also been associated with the development of scleroderma-like illnesses. 88 references, 6 figures, and 5 tables.

Books

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CHAPTER 6. PERIODICALS AND NEWS ON APPETITE SUPPRESSANTS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover appetite suppressants.

News Services and Press Releases One of the simplest ways of tracking press releases on appetite suppressants 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 “appetite suppressants” (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 appetite suppressants. 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 “appetite suppressants” (or synonyms).

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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 “appetite suppressants” (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 “appetite suppressants” (or synonyms). If you know the name of a company that is relevant to appetite suppressants, 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/. 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 “appetite suppressants” (or synonyms).

Periodicals and News

43

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “appetite suppressants” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on appetite suppressants: •

New Study Revisits Heart Valve Abnormalities Associated With Diet Drugs Source: WIN Notes. p. 3. Spring 2001. Contact: Weight-control Information Network. 1-877-WIN-4627. Summary: Julius Gardin, M.D., of the Division of Cardiology, the University of California, Irvine, examined the causal relationship between the appetite suppressants fenfluramine and dexfenfluramine and heart valve abnormalities. The study, originally published in the April 5, 2000, issue of the Journal of the American Medical Association (JAMA), found that these antiobesity agents are associated with an increase in the prevalence of some, but not all, valvular abnormalities. The study also explored whether these drugs are unrelated to serious cardiac events like heart attack, congestive heart failure, or ventricular arrhythmia. Participants were white obese females in their forties. Among patients who took the drugs for less than 3 months, no statistically significant difference in the prevalence of aortic regurgitation (AR) occurred between patients taking the appetite suppressants and those in the control group. With increasing exposure, prevalence rates increased. An accompanying JAMA editorial by Hershel Jick, M.D., of the Boston University School of Medicine, finds this duration effect as evidence of the causal relationship between the drugs and heart valve abnormalities. Jick agrees with Gardin and his colleagues that most drug-related cardiac abnormalities are minor and unlikely to advance to clinical disease.

•

Medication Treatments for Binge Eating Disorder Source: Weight Control Digest. 7(4):633, 636-639; July/Aug 1997. Contact: Weight Control Digest, 1555 W. Mockingbird Lane, Suite 203, Dallas, TX 75235. (800) 736-7323. Summary: This article examines the use of medications in treating overweight individuals with binge eating disorder. The authors first describe what binge eating disorder (BED) is, and how it differs from the bingeing and purging syndrome. They then review studies done with antidepressants, appetite suppressants, combinations of these medications and psychotherapy, and behavior modification. The authors then offer guidelines for the use of medications in the treatment of BED and suggest what the future treatment of BED might be. They conclude that any treatment plan for BED should include medication, behavior modification, and diet and lifestyle changes.

•

Scleroderma and the Environment Source: The Beacon. 4(2):1,5. Spring 1996.

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Appetite Suppressants

Contact: Available from Scleroderma Foundation. 12 Kent Way, Suite 101, Byfield, MA 01922. (800) 722-4673 or (978) 463-5843. Fax (978) 463-5809. E-mail: [email protected]. Website: www.scleroderma.org. Summary: This newsletter article for individuals with scleroderma identifies the environmental agents that have been implicated in scleroderma and pseudoscleroderma. The earliest environmental agent to be implicated as a cause of scleroderma was silica dust. Many studies have confirmed a relationship between silica exposure and diffuse cutaneous scleroderma. The association between silicone exposure and scleroderma is less clear because case-control studies have not found a real association but case reports have suggested a link between silicone exposure and scleroderma. Examples of pseudoscleroderma occurring after ingestion of chemicals or drugs are the toxic oil syndrome epidemic that occurred in Spain in 1981 and the contaminated L-tryptophan epidemic that occurred mainly in the United States in 1989. In addition, exposure to vinyl chloride monomer; organic solvents; and drugs such as bleomycin , pentazocine , and various appetite suppressants have been associated with scleroderma or pseudoscleroderma.

Academic Periodicals covering Appetite Suppressants Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to appetite suppressants. In addition to these sources, you can search for articles covering appetite suppressants 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.”

45

CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for appetite suppressants. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with appetite suppressants. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to appetite suppressants: Appetite Suppressants, Sympathomimetic •

Systemic - U.S. Brands: Adipex-P; Adipost; Bontril PDM; Bontril Slow-Release; Didrex; Fastin; Ionamin; Mazanor; Melfiat; Obenix; Obezine; Phendiet; Phendiet105; Phentercot; Phentride; Plegine; Prelu-2; Pro-Fast; PT 105; Sanorex; Tenuate; Tenuate Dospan; Tepanil Ten-Tab; Teramine; Zantryl http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202069.html

Sibutramine •

Systemic - U.S. Brands: Meridia http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203725.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

47

APPENDICES

49

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 Institute7: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

7

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

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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.8 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:9 •

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

8 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). 9 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 Gateway10 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.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “appetite suppressants” (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 5314 43 991 1 58 6407

HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 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.14 Simply search by “appetite suppressants” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

10

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

11

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). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14

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.

Physician Resources

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Coffee Break: Tutorials for Biologists15 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.16 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.17 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/.

15 Adapted 16

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. 17 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.

55

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 appetite suppressants 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 appetite suppressants. 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 appetite suppressants. 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 “appetite suppressants”:

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Appetite Suppressants

Bipolar Disorder http://www.nlm.nih.gov/medlineplus/bipolardisorder.html Lupus http://www.nlm.nih.gov/medlineplus/lupus.html Postpartum Depression http://www.nlm.nih.gov/medlineplus/postpartumdepression.html Seasonal Affective Disorder http://www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder.html Weight Loss and Dieting http://www.nlm.nih.gov/medlineplus/weightlossanddieting.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 appetite suppressants. 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: •

FAQs: Food and Weight Source: Scotts Valley, CA: ETR Associates. 2003. 4 p. Contact: Available from ETR Associates. 4 Carbonero Way, Scotts Valley, CA 950664200. (800) 321-4407. Fax (800) 435-8433. Website: www.etr.org. PRICE: Single copy free; $16.00 for 50 copies, discounts for larger orders. Item number: R372. Summary: Students in eight states submitted anonymous questions about food and weight. In this brochure, a health expert answers the questions asked most often. Topics covered include natural ways to boost the metabolism, how to help a friend with an eating disorder, the use of over-the-counter appetite suppressants, the impact of weight cycling ('yo-yo' dieting) on the body, weight gain and how it happens, the importance of eating a variety of foods, safe ways to lose weight, how to determine appropriate amounts of exercise, the role of low-fat or non-fat foods, and the factors that affect body weight levels and rates of weight loss. The brochure concludes with the web site addresses for three organizations that can provide readers more information about food and weight loss.

•

Nonprescription Drugs: Bayer Care Health Facts Source: Tarrytown, NY: Bayer Corporation. 2000. [7 p.].

Patient Resources

57

Contact: Available from Bayer Corporation. Diagnostics Division, 511 Benedict Avenue, Tarrytown, NY 10591-5097. (800) 445-5901. PRICE: Single copy free. Summary: This brochure uses a question and answer format to provide people who have diabetes with information on nonprescription drugs. People who have diabetes should check with their health care team about nonprescription drug choices that are best for them. The brochure explains how various nonprescription drugs may affect a person or his or her blood glucose, focusing on alcohol, aspirin, caffeine, cold medicines, and tobacco. This is followed by a list of tips for choosing nonprescription drugs, herbals, supplements, or self treatment items. In addition, the brochure identifies pain and fever relievers, cough medicines, cough and cold medicines, cold and allergy medications, sore throat products, vitamins, antacids, antidiarrheals, laxatives, motion sickness medicines, and appetite suppressants that contain no sugar and little or no alcohol. •

Weight Control: Losing Weight and Keeping It Off Source: Kansas City, MO: American Academy of Family Physicians. 2001. 4 p. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. PRICE: $12.50 for 50 copies for members, $18.75 for 50 copies for nonmembers. Order number: 1522. Summary: This brochure, which is presented in question and answer format, provides information about weight control. The brochure notes that a regular exercise program, a regular eating pattern, and support may help a person lose weight. Topics include ideal weight, eating and emotions, the role of exercise, types of exercise, making exercise a habit, changing eating habits, the drawbacks of skipping meals and eating foods high in fat, social pressure, and diet drugs. Sidebars address causes of being overweight, tips on losing weight, and foods high in fat. According to the brochure, heredity, social pressure, a low metabolism, and problems with hormone levels are several causes of being overweight. The brochure concludes that appetite suppressants are ineffective at keeping weight off. (AA-M). 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 appetite suppressants. 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.

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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 appetite suppressants. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with appetite suppressants. 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 appetite suppressants. 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 “appetite suppressants” (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

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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 “appetite suppressants”. 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 “appetite suppressants” (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 “appetite suppressants” (or a synonym) into the search box, and click “Submit Query.”

61

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.18

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

18

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)19: •

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/

19

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/

•

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

67

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

69

APPETITE SUPPRESSANTS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [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] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

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 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] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Alginates: Salts of alginic acid that are extracted from marine kelp and used to make dental impressions and as absorbent material for surgical dressings. [NIH]

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Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [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] Alum: A type of immune adjuvant (a substance used to help boost the immune response to a vaccine). Also called aluminum sulfate. [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] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Analgesics: Compounds capable of relieving pain without the loss of consciousness or without producing anesthesia. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] 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] 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] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several monoamine oxidase inhibitors are useful

Dictionary 71

as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents also appear to act through brain catecholamine systems. A third group (antidepressive agents, secondgeneration) is a diverse group of drugs including some that act specifically on serotonergic systems. [NIH] Antidiarrheals: Miscellaneous agents found useful in the symptomatic treatment of diarrhea. They have no effect on the agent(s) that cause diarrhea, but merely alleviate the condition. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]

Antispasmodics: Medicines that help reduce or stop muscle spasms in the intestines. Examples are dicyclomine (dy-SY-klo-meen) (Bentyl) and atropine (AH-tro-peen) (Donnatal). [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Antiviral Agents: Agents used in the prophylaxis or therapy of virus diseases. Some of the ways they may act include preventing viral replication by inhibiting viral DNA polymerase; binding to specific cell-surface receptors and inhibiting viral penetration or uncoating; inhibiting viral protein synthesis; or blocking late stages of virus assembly. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] 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] Aqueous: Having to do with water. [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] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriosus: Circle composed of anastomosing arteries derived from two long posterior ciliary and seven anterior ciliary arteries, located in the ciliary body about the root of the iris. [NIH]

Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants,

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mainly Solanaceae. [NIH] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [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] 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] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [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] Bleomycin: A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [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] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Butyric Acid: A four carbon acid, CH3CH2CH2COOH, with an unpleasant odor that occurs in butter and animal fat as the glycerol ester. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central

Dictionary 73

nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [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] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Cannabidiol: Compound isolated from Cannabis sativa extract. [NIH] Cannabinoids: Compounds extracted from Cannabis sativa L. and metabolites having the cannabinoid structure. The most active constituents are tetrahydrocannabinol, cannabinol, and cannabidiol. [NIH] Cannabinol: A physiologically inactive constituent of Cannabis sativa L. [NIH] 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] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] 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 Disulfide: A colorless, flammable, poisonous liquid, CS2. It is used as a solvent, and is a counterirritant and has local anesthetic properties but is not used as such. It is highly toxic with pronounced CNS, hematologic, and dermatologic effects. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] 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] 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] Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group. [NIH]

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Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are 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] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] 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] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] 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] Chromic: Catgut sterilized and impregnated with chromium trioxide. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [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] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Colloidal: Of the nature of a colloid. [EU] 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

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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 '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] 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] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] 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] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Conus: A large, circular, white patch around the optic disk due to the exposing of the sclera as a result of degenerative change or congenital abnormality in the choroid and retina. [NIH] 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 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

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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] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyanates: Organic salts of cyanic acid containing the -OCN radical. [NIH] Cyanides: Inorganic salts of hydrogen cyanide containing the -CN radical. The concept also includes isocyanides. It is distinguished from nitriles, which denotes organic compounds containing the -CN radical. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] 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] Decongestant: An agent that reduces congestion or swelling. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Dexfenfluramine: The S-isomer of fenfluramine. It is a serotonin agonist and is used as an anorectic. Unlike fenfluramine, it does not possess any catecholamine agonist activity. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [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] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dicyclomine: A muscarinic antagonist used as an antispasmodic and in urinary incontinence. It has little effect on glandular secretion or the cardiovascular system. It does have some local anesthetic properties and is used in gastrointestinal, biliary, and urinary tract spasms. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

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Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Diuresis: Increased excretion of urine. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [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] Duodenum: The first part of the small intestine. [NIH] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] 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 latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Empiric: Empirical; depending upon experience or observation alone, without using scientific method or theory. [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 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] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium,

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vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [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] Enhancer: Transcriptional element in the virus genome. [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] Ephedrine: An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extraction: The process or act of pulling or drawing out. [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] Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] 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] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [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.

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[NIH]

Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [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] 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]

Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Hallucinogens: Drugs capable of inducing illusions, hallucinations, delusions, paranoid ideations, and other alterations of mood and thinking. Despite the name, the feature that distinguishes these agents from other classes of drugs is their capacity to induce states of altered perception, thought, and feeling that are not experienced otherwise. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or 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] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [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] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Holidays: Days commemorating events. Holidays also include vacation periods. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to

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remain balanced and stable. [NIH] 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] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Hypoglycemic: An orally active drug that produces a fall in blood glucose concentration. [NIH]

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] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [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] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Infections: The illnesses caused by an organism that usually does not cause disease in a person with a normal immune system. [NIH] 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] Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Inorganic Chemicals: A broad class of substances encompassing all those that do not include carbon and its derivatives as their principal elements. However, carbides, carbonates, cyanides, cyanates, and carbon disulfide are included in this class. [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

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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] Intestinal: Having to do with the intestines. [NIH] 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] Involuntary: Reaction occurring without intention or volition. [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] 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] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Neoplasms: Tumors or cancer of the liver. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Mazindol: Tricyclic anorexigenic agent unrelated to and less toxic than amphetamine, but with some similar side effects. It inhibits uptake of catecholamines and blocks the binding of cocaine to the dopamine uptake transporter. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] 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]

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Membranes: Thin layers of tissue which cover parts of the body, separate adjacent cavities, or connect adjacent structures. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] 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] 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] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monocular: Diplopia identified with one eye only; it may be induced with a double prism, or it may occur either as a result of double imagery due to an optical defect in the eye, or as a result of simultaneous use of normal and anomalous retinal correspondence. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [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] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nephropathy: Disease of the kidneys. [EU] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nervousness: Excessive excitability and irritability, with mental and physical unrest. [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] 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] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant

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tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

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] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nystagmus: An involuntary, rapid, rhythmic movement of the eyeball, which may be horizontal, vertical, rotatory, or mixed, i.e., of two varieties. [EU] 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 mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [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] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] 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]

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Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phentermine: A central nervous system stimulant and sympathomimetic with actions and uses similar to those of dextroamphetamine. It has been used most frequently in the treatment of obesity. [NIH] Phenylpropanolamine: A sympathomimetic that acts mainly by causing release of norepinephrine but also has direct agonist activity at some adrenergic receptors. It is most commonly used as a nasal vasoconstrictor and an appetite depressant. [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] 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]

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] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [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] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [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] Precursor: Something that precedes. In biological processes, a substance from which

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another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [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] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Psychotropic Drugs: A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents). [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among

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alternatives to guide and determine present and future decisions. [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 hypertension: Abnormally high blood pressure in the arteries of the lungs. [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] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [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] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refractory: Not readily yielding to treatment. [EU] Refractory obesity: Obesity that is resistant to treatment. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Satiation: Full gratification of a need or desire followed by a state of relative insensitivity to that particular need or desire. [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] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH]

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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] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [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] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social pressure: A strategy used in behavior therapy in which individuals are told that they possess the basic self-control ability to lose weight, but that coming to group meetings will strengthen their abilities. The group is asked to listen and give advice, similar to the way many self-help groups, based on social support, operate. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [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] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [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] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

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] 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]

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Substrate: A substance upon which an enzyme acts. [EU] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [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] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] 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] 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] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [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]

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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] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Tranquilizing Agents: A traditional grouping of drugs said to have a soothing or calming effect on mood, thought, or behavior. Included here are the anti-anxiety agents (minor tranquilizers), antimanic agents, and the antipsychotic agents (major tranquilizers). These drugs act by different mechanisms and are used for different therapeutic purposes. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] 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] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] 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] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinyl Chloride: A gas that has been used as an aerosol propellant and is the starting material for polyvinyl resins. Toxicity studies have shown various adverse effects,

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particularly the occurrence of liver neoplasms. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [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] Virus Diseases: A general term for diseases produced by viruses. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] 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] 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]

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INDEX A Acetylcholine, 69, 74, 83 Acoustic, 22, 69 Adenosine, 69, 73 Adrenergic, 69, 70, 77, 78, 84, 88 Adverse Effect, 69, 87, 89 Aerobic, 38, 69 Aerobic Exercise, 38, 69 Aerosol, 69, 88, 89 Affinity, 69 Age of Onset, 69, 89 Agonist, 6, 69, 76, 77, 78, 84 Alertness, 69, 73 Alginates, 32, 69 Algorithms, 70, 72 Alkaloid, 70, 71, 74 Alternative medicine, 42, 70 Alum, 70, 74 Amino Acids, 38, 70, 84, 85 Amphetamine, 13, 16, 30, 70, 76, 81 Analgesics, 31, 70 Anatomical, 70, 80, 87 Anesthesia, 70 Animal model, 7, 70 Antagonism, 70, 73 Anti-Anxiety Agents, 70, 85, 89 Antibiotic, 4, 31, 70 Antibiotic Prophylaxis, 4, 70 Antidepressive Agents, 70, 85 Antidiarrheals, 57, 71 Anti-inflammatory, 71, 80 Anti-Inflammatory Agents, 71 Antineoplastic, 38, 71, 72 Antineoplastic Agents, 38, 71 Antispasmodics, 31, 71 Antiviral, 31, 71 Antiviral Agents, 31, 71 Anxiety, 29, 70, 71 Anxiolytic, 28, 71 Apoptosis, 7, 15, 71 Aqueous, 71, 72, 76 Arginine, 71, 83 Arterial, 7, 71, 80, 85, 88 Arteries, 71, 72, 75, 86 Arterioles, 71, 72, 73, 89 Arteriosus, 71, 86 Artery, 71 Aspirin, 57, 71

Atropine, 71 Autacoids, 72, 80 B Bacteria, 70, 72, 89 Base, 28, 32, 72, 81 Behavior Therapy, 72, 87 Biochemical, 24, 38, 72, 87 Biotechnology, 8, 42, 51, 72 Bleomycin, 44, 72 Blood Glucose, 57, 72, 79, 80, 81 Blood Platelets, 72, 87 Blood pressure, 72, 73, 80, 86 Blood vessel, 72, 73, 74, 77, 87, 89 Body Mass Index, 8, 38, 72, 83 Bradykinin, 72, 83 Buccal, 72, 81 Butyric Acid, 22, 72 C Caffeine, 29, 33, 57, 72 Calcium, 73, 74 Caloric intake, 28, 73 Cannabidiol, 73 Cannabinoids, 24, 73 Cannabinol, 73 Capillary, 23, 72, 73, 89 Capsules, 30, 73 Carbohydrate, 24, 73, 79 Carbon Disulfide, 73, 80 Cardiac, 4, 7, 9, 33, 43, 73, 77, 78 Cardiopulmonary, 6, 73 Cardiorespiratory, 69, 73 Cardiovascular, 5, 23, 70, 73, 76, 87 Cardiovascular disease, 5, 73 Case report, 11, 44, 73 Case-Control Studies, 44, 73 Catecholamine, 71, 74, 76, 77 Caudal, 74, 80 Causal, 43, 74 Cell, 7, 69, 71, 72, 74, 75, 76, 77, 78, 80, 81, 82, 84, 86 Cell Death, 71, 74, 82 Central Nervous System, 6, 69, 70, 73, 74, 76, 78, 79, 84, 87 Cerebrovascular, 73, 74 Character, 74, 76 Cholinergic, 22, 74 Chromatin, 71, 74 Chromic, 28, 74

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Chromium, 74 Chronic, 74, 86 Clinical trial, 6, 8, 51, 74, 75, 77, 85, 86 Cloning, 72, 74 Coca, 23, 74 Cocaine, 23, 74, 81 Colloidal, 74, 77, 88 Complement, 74, 75 Complementary and alternative medicine, 21, 26, 75 Complementary medicine, 21, 75 Computational Biology, 51, 75 Congestion, 75, 76 Congestive heart failure, 43, 75 Consciousness, 70, 75, 85 Contraindications, ii, 75 Control group, 43, 75 Controlled study, 8, 75 Conus, 75, 86 Coronary, 73, 75 Coronary heart disease, 73, 75 Curative, 76, 83, 88 Cutaneous, 44, 76, 81 Cyanates, 76, 80 Cyanides, 76, 80 Cyclic, 73, 76, 79, 83 Cytoplasm, 71, 76 D Decongestant, 24, 76 Degenerative, 28, 75, 76 Dehydration, 33, 76 Deletion, 71, 76 Delusions, 76, 79, 85 Deprivation, 22, 76 Dermis, 76, 89 Dexfenfluramine, 4, 12, 43, 76 Dextroamphetamine, 30, 70, 76, 84 Diabetes Mellitus, 3, 5, 8, 76, 79 Diagnostic procedure, 27, 42, 76 Diarrhea, 71, 76 Diastolic, 76, 80 Dicyclomine, 71, 76 Dietitian, 11, 76 Digestion, 77, 81, 87 Direct, iii, 45, 77, 84, 86 Diuresis, 73, 77 Dopamine, 70, 74, 76, 77, 81, 82 Double-blind, 12, 14, 77 Drug Interactions, 46, 77 Duodenum, 77, 87 E Eating Disorders, 24, 77

Efficacy, 7, 77 Electrons, 72, 77, 81 Electrophoresis, 23, 77 Empiric, 4, 77 Endocarditis, 4, 77 Endocardium, 77 Endocrine System, 77, 82 Endogenous, 6, 77, 89 Endothelial cell, 13, 77 Endothelium, 77, 78, 83 Endothelium-derived, 78, 83 Energy balance, 6, 12, 78 Enhancer, 31, 78 Environmental Health, 50, 52, 78 Enzymatic, 24, 73, 75, 78, 86 Enzyme, 30, 78, 79, 80, 82, 84, 88, 90 Ephedrine, 22, 29, 33, 78 Epidemic, 44, 78 Esophagus, 78, 87 Excitability, 78, 82 Exogenous, 30, 77, 78, 89 Extraction, 34, 35, 78 F Family Planning, 51, 78 Fat, 5, 22, 28, 38, 56, 57, 72, 76, 78, 81, 83 Fenfluramine, 4, 6, 8, 9, 15, 22, 33, 43, 76, 78 Fibrosis, 78, 87 G Gas, 78, 80, 83, 88, 89 Gastric, 4, 32, 78 Gastrin, 78, 80 Gastrointestinal, 32, 33, 72, 76, 78, 87 Gastrointestinal tract, 32, 78, 87 Gels, 32, 78 Gene, 72, 78 Genetics, 5, 79 Glucose, 72, 74, 76, 79, 80 Glucose Intolerance, 76, 79 Glycerol, 72, 79, 84 Governing Board, 79, 84 Guanylate Cyclase, 79, 83 H Hallucinogens, 79, 85 Headache, 73, 79 Heart attack, 43, 73, 79 Heart failure, 78, 79 Hemoglobin, 4, 79 Hemostasis, 79, 87 Heredity, 57, 78, 79 Holidays, 38, 79 Homeostasis, 6, 79

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Hormonal, 6, 80 Hormone, 6, 57, 78, 80 Hydrogen, 72, 73, 76, 80, 82 Hyperlipidemia, 5, 80 Hypertension, 5, 15, 73, 79, 80 Hypoglycemia, 4, 80 Hypoglycemic, 4, 80 Hypothalamus, 5, 80, 88 I Impairment, 80, 82, 85 In vitro, 7, 9, 80 In vivo, 7, 80 Incontinence, 76, 78, 80 Indomethacin, 15, 80 Infections, 70, 79, 80 Inflammation, 71, 78, 80, 84, 86, 89 Ingestion, 14, 15, 44, 80 Initiation, 80, 89 Inorganic, 38, 76, 80 Inorganic Chemicals, 38, 80 Insulin, 3, 25, 80, 89 Insulin-dependent diabetes mellitus, 80 Intestinal, 15, 81 Intestines, 71, 78, 81 Intoxication, 81, 90 Intracellular, 73, 81, 83, 86 Involuntary, 81, 83 Ions, 72, 80, 81 K Kb, 50, 81 L Linkages, 79, 81 Lipid, 32, 79, 80, 81 Liver, 81, 90 Liver Neoplasms, 81, 90 Localized, 81, 84, 86 Lupus, 56, 81 Lymph, 77, 78, 81 M Malignancy, 5, 81 Malignant, 71, 81, 82 Manic, 13, 81, 85 Manic-depressive psychosis, 81, 85 Mazindol, 11, 81 Medial, 7, 81, 83 Mediate, 6, 77, 81 Mediator, 81, 87 MEDLINE, 51, 81 Membranes, 73, 82, 84 Meninges, 74, 82 Mental, iv, 5, 50, 52, 82, 85, 86 Mental Disorders, 82, 85

Mental Health, iv, 5, 50, 52, 82, 85 Mitosis, 71, 82 Modification, 5, 43, 82 Molecular, 38, 51, 53, 72, 75, 82, 86 Molecule, 72, 75, 78, 82, 86 Monoamine, 70, 76, 82 Monocular, 22, 82 Motility, 80, 82, 87 Motion Sickness, 57, 82 Mucosa, 81, 82 N Narcolepsy, 76, 78, 82 Necrosis, 71, 82 Neoplasms, 71, 82 Nephropathy, 23, 82 Nervous System, 70, 74, 81, 82, 88 Nervousness, 33, 82 Neuroendocrine, 6, 82 Neurons, 74, 82, 88 Niacin, 82, 89 Nitric Oxide, 7, 83 Nitrogen, 70, 83, 89 Nonverbal Communication, 83, 85 Norepinephrine, 69, 77, 78, 83, 84 Nucleus, 71, 74, 76, 83 Nystagmus, 22, 83 O Optic Chiasm, 80, 83 Oral Health, 83 Oral Hygiene, 29, 83 Overdose, 24, 83 Overweight, 8, 11, 18, 33, 43, 57, 83 P Palliative, 83, 88 Pancreas, 80, 83 Patch, 75, 83, 89 Pathologic, 71, 75, 83, 84 Pathologic Processes, 71, 84 Patient Education, 56, 62, 64, 67, 84 Peptide, 6, 84, 85 Pharmaceutical Preparations, 22, 84 Pharmacologic, 70, 72, 84, 89 Phentermine, 6, 8, 9, 22, 84 Phenylpropanolamine, 12, 13, 15, 22, 31, 33, 84 Phospholipids, 78, 84 Physiologic, 69, 84, 86 Plants, 70, 71, 74, 79, 83, 84, 89 Plasma, 79, 84 Platelet Aggregation, 83, 84 Platelets, 83, 84 Pneumonia, 75, 84

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Polymerase, 71, 84 Practice Guidelines, 52, 84 Precursor, 77, 78, 83, 84, 89 Prevalence, 4, 5, 43, 85 Progression, 70, 85 Prophylaxis, 4, 71, 85 Prostaglandins, 80, 85 Prostaglandins A, 80, 85 Protein S, 71, 72, 85 Proteins, 70, 74, 82, 83, 84, 85, 86, 89 Protocol, 8, 85 Psychoactive, 85, 88, 90 Psychosis, 13, 85 Psychotherapy, 43, 85 Psychotomimetic, 70, 76, 85 Psychotropic, 22, 85 Psychotropic Drugs, 22, 85 Public Health, 23, 52, 85 Public Policy, 51, 85 Pulmonary, 7, 9, 11, 13, 14, 72, 86, 89 Pulmonary Artery, 7, 72, 86, 89 Pulmonary hypertension, 7, 9, 11, 13, 14, 86 R Randomized, 77, 86 Reality Testing, 85, 86 Receptor, 77, 86, 87 Receptors, Serotonin, 86, 87 Refer, 1, 72, 74, 85, 86 Refractory, 8, 86 Refractory obesity, 8, 86 Regimen, 4, 77, 86 Regurgitation, 43, 86 Retinal, 82, 83, 86 Rhinitis, 78, 86 S Satiation, 32, 86 Schizoid, 86, 90 Schizophrenia, 86, 90 Schizotypal Personality Disorder, 86, 90 Scleroderma, 14, 38, 43, 44, 86 Sclerosis, 15, 38, 87 Screening, 74, 87 Self-Help Groups, 87 Serotonin, 4, 5, 6, 7, 76, 78, 86, 87, 89 Side effect, 6, 7, 29, 30, 32, 33, 45, 69, 81, 87, 88 Small intestine, 77, 80, 81, 87 Smooth muscle, 7, 72, 73, 87 Social pressure, 57, 87 Social Support, 87 Solid tumor, 72, 87

Solvent, 34, 73, 79, 87 Specialist, 58, 87 Spinal cord, 74, 82, 87, 88 Statistically significant, 43, 87 Stimulant, 70, 73, 76, 84, 87 Stomach, 31, 32, 78, 80, 81, 87 Stress, 5, 38, 74, 87 Stroke, 50, 73, 87 Substrate, 12, 88 Suppression, 7, 88 Suspensions, 32, 88 Sympathetic Nervous System, 88 Sympathomimetic, 6, 46, 70, 76, 77, 83, 84, 88 Symptomatic, 70, 71, 88 Symptomatic treatment, 70, 71, 88 Synergistic, 30, 88 Systemic, 15, 38, 46, 72, 86, 88, 89 Systolic, 80, 88 T Tetrahydrocannabinol, 73, 88 Therapeutics, 23, 46, 88 Third Ventricle, 80, 88 Threshold, 78, 80, 88 Tissue, 73, 76, 78, 81, 82, 83, 87, 88 Tone, 83, 88 Toxic, iv, 44, 71, 73, 81, 88, 89 Toxicity, 77, 88, 89 Toxicology, 52, 89 Toxins, 38, 89 Tranquilizing Agents, 85, 89 Transcription Factors, 7, 89 Transdermal, 31, 89 Transfection, 72, 89 Tryptophan, 44, 87, 89 Tuberculosis, 81, 89 Type 2 diabetes, 4, 37, 89 Tyrosine, 25, 77, 89 U Urinary, 76, 78, 80, 89 V Vaccine, 70, 85, 89 Vascular, 7, 76, 78, 83, 89 Vascular Resistance, 7, 89 Vasculitis, 16, 89 Vasodilators, 83, 89 Ventricle, 86, 88, 89 Ventricular, 43, 89 Venules, 72, 73, 89 Veterinary Medicine, 51, 89 Vinyl Chloride, 44, 89 Viral, 71, 90

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Virus, 71, 78, 90 Virus Diseases, 71, 90 Viscosity, 32, 90 Vitro, 90 Vivo, 90

W Withdrawal, 12, 90 X Xenograft, 70, 90

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