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

ARTHRALGIA A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N...

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ARTHRALGIA 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., 1960Arthralgia: 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: 0-497-00092-X 1. Arthralgia-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 arthralgia. 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 ARTHRALGIA ............................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Arthralgia...................................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 7 CHAPTER 2. NUTRITION AND ARTHRALGIA .................................................................................. 25 Overview...................................................................................................................................... 25 Finding Nutrition Studies on Arthralgia .................................................................................... 25 Federal Resources on Nutrition ................................................................................................... 26 Additional Web Resources ........................................................................................................... 27 CHAPTER 3. ALTERNATIVE MEDICINE AND ARTHRALGIA ............................................................ 29 Overview...................................................................................................................................... 29 National Center for Complementary and Alternative Medicine.................................................. 29 Additional Web Resources ........................................................................................................... 31 General References ....................................................................................................................... 42 CHAPTER 4. DISSERTATIONS ON ARTHRALGIA .............................................................................. 43 Overview...................................................................................................................................... 43 Dissertations on Arthralgia ......................................................................................................... 43 Keeping Current .......................................................................................................................... 43 CHAPTER 5. PATENTS ON ARTHRALGIA ......................................................................................... 45 Overview...................................................................................................................................... 45 Patent Applications on Arthralgia............................................................................................... 45 Keeping Current .......................................................................................................................... 48 CHAPTER 6. BOOKS ON ARTHRALGIA ............................................................................................ 49 Overview...................................................................................................................................... 49 Book Summaries: Online Booksellers........................................................................................... 49 Chapters on Arthralgia ................................................................................................................ 49 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 53 Overview...................................................................................................................................... 53 NIH Guidelines............................................................................................................................ 53 NIH Databases............................................................................................................................. 55 Other Commercial Databases....................................................................................................... 57 APPENDIX B. PATIENT RESOURCES ................................................................................................. 59 Overview...................................................................................................................................... 59 Patient Guideline Sources............................................................................................................ 59 Finding Associations.................................................................................................................... 62 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 65 Overview...................................................................................................................................... 65 Preparation................................................................................................................................... 65 Finding a Local Medical Library.................................................................................................. 65 Medical Libraries in the U.S. and Canada ................................................................................... 65 ONLINE GLOSSARIES.................................................................................................................. 71 Online Dictionary Directories ..................................................................................................... 72 ARTHRALGIA DICTIONARY ..................................................................................................... 73 INDEX .............................................................................................................................................. 103

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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 arthralgia 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 arthralgia, 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 arthralgia, 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 arthralgia. 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 arthralgia, 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 arthralgia. 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 ARTHRALGIA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on arthralgia.

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

Arthralgia in Women: Strategies for Early Diagnosis Source: Journal of Musculoskeletal Medicine. 18(2): 69-72,75-77,81. February 2001. Summary: This journal article, the seventh in a special series on orthopedic and musculoskeletal problems in women, provides health professionals with information on arthralgia in women. Many diseases that cause arthralgia, including osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SS), and fibromyalgia (FM), are significantly more prevalent in women than in men. Early detection often depends on clinical findings, since radiographic changes may be minimal or absent. Morning stiffness is a clue to OA and RA. SLE often begins as a malar or diskoid rash accompanied by systemic symptoms and arthralgia. The constellation of arthralgia and muscle pain, weakness, and fatigue is a clue to SS. FM presents as fatigue and chronic bilateral musculoskeletal pain. The diagnosis is

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confirmed by the presence of pain in at least 11 of 18 tender points. Since many joint diseases first present with vague musculoskeletal symptoms, including arthralgias and stiffness accompanied by systemic symptoms such as generalized weakness and fatigue, identification of the underlying disorder may be difficult. Nonetheless, careful evaluation is needed to avoid inappropriate treatment and unnecessary diagnostic tests. 2 figures, 6 tables, and 14 references. (AA-M). •

Arthralgia as an Early Extraintestinal Symptom of Whipple's Disease: Report of Five Cases Source: Journal of Clinical Gastroenterology. 24(1): 18-20. January 1997. Contact: Available from Subscription Department, Lippincott-Raven Publishers. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2300. Summary: Whipple's disease is a bacterial infection with a systemic manifestation that is fatal if left untreated. This article describes arthralgia as an early extraintestinal symptom of Whipple's disease. The authors describe five patients with Whipple's disease who all suffered from arthralgia for a long time (15 years in one case) before developing gastrointestinal or other symptoms. In all patients, arthralgia was seronegative, and there was no evidence of joint destruction. The authors present a detailed case report on one of the five patients. The authors note that Whipple's disease is part of the differential diagnosis of enteropathic arthralgia. Therefore, the polymerase chain reaction can be a helpful tool to prove Whipple's disease in difficult differential diagnosis. The authors conclude with a brief discussion of choice of antibiotics to treat Whipple's disease. Treatment with cotrimoxazole was shown in research to be superior to therapy with tetracyclines, even if the former did not prevent central nervous system (CNS) involvement in all cases. 2 figures. 1 table. 16 references. (AA-M).

Federally Funded Research on Arthralgia The U.S. Government supports a variety of research studies relating to arthralgia. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to arthralgia. 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 arthralgia. The following is typical of the type of information found when searching the CRISP database for arthralgia:

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

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Project Title: MECHANISMS MICROTUBLES

OF

PAIN

CAUSED

BY

Studies

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DISRUPTION

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Principal Investigator & Institution: Levine, Jon D.; Professor; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002 Summary: The chemotherapeutic agent paclitaxel (Taxol) is widely used for the treatment of many different types of carcinomas. At present, the dose of paclitaxel that can be tolerated by patients is limited primarily by the development of a painful peripheral neuropathy characterized by paresthesias, myalgia and arthralgia. Similar dose-limiting painful neuropathies are produced by other microtubule-disrupting chemotherapeutic drugs, dose-limiting painful neuropathies are produced by other microtubule-disrupting chemotherapeutic drugs, including vincristine therapy, but also increase the effectiveness of their treatment by permitting the use of higher doses of the drugs. We propose a series of experiments to elucidate the cellular mechanisms of paclitaxel- and vincristine-induced painful neuropathy. Specifically, we will establish a model of paclitaxel-induced painful peripheral neuropathy in the rat, and then analyze paclitaxel-induced changes in the excitability of nociceptive nerve fibers in this model. Our interpretation of those data will be greatly enhanced by our extensive knowledge of the effects of vincristine on nerve fiber excitability. Because taxol stabilizes microtubules while vincristine stimulates microtubule depolymerization, comparison of similarities and differences in the effects of the two agents may provide valuable insights into the mechanisms by which microtuble disruption causes nociceptor hyperexcitability. Guided by these in vivo electrophysiological analyses, we will employ patch clamp recording of cultured sensory neurons to study the effects of both drugs on specific transduction molecules and ion channels. Finally, we will investigate intracellular second messenger pathways that participate in the production of hyperalgesia and nociceptor hyperexcitability induced by paclitaxel and vincristine. The proposed in vitro studies may identify specific molecules to be targeted by new pharmacological strategies to treat chemotherapy-induced neuropathic pain caused by chemotherapy. By improving our understanding of the cellular mechanisms of neuropathic pain, these studies can potentially provide important insights into the pathophysiology and treatment of orofacial neuropathies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PAIN IN ADOLESCENTS: BIOLOGIC/PSYCHOSOCIAL RISK FACTORS Principal Investigator & Institution: Leresche, Linda A.; Research Professor; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002 Summary: We propose a five-year program of research aimed at assessing the prevalence and incidence of temporomandibular disorder (TMD) pain, headache, back pain, and abdominal pain in adolescents., and identifying risk factors for onset of each of these common pain {{symptoms}}. Because the prevalence of headache and TMD pain is much higher in adult women than in adult men, the studies are designed to test the global hypothesis that this prevalence differences begin in adolescence and are associated with the hormonal change of puberty. The specific aims of study 1 are: 1) In a telephone survey, assess the prevalence, severity and temporal characteristics of TMD pain, headache, backpain and abdominal pain in an age- and sex-stratified random sample of adolescents, ages 11- 17 (final n= 2970) from a defined population; 2) Identify

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potential risk factors for pain at each of these four sites; 3) Conduct standardized examinations and interviews for all respondents reporting TMD pain, as well as a sample of those without TMD pain (expected n's = 130 per respondents reporting TMD pain, as well as a sample of those without TMD pain (expected n's = 130 peer group) in order to: a) compare the rates of clinical signs and symptoms of temporomandibular disorders in cases and controls, and b) estimate the prevalence of specific clinical subtypes of TMD (myofascial pain, disc displacements, arthralgia, arthritis/arthrosis) using standardized examination methods and diagnostic algorithms. Examinations will be conducted in subjects' homes by Registered Dental Hygienists training and calibrated for reliability. The specific aims of Study 2 are: 1) Follow the cohort of 11 year old respondents from Study 1 (n= 1902) over a 3-year follow up period, using brief mail-in surveys and more extensive follow up data collection at 18 months and 3 years. Monitor rates of onset of TMD pain, headache, back pain and abdominal pain. Assess the impact of these pain problems in terms of interference with activities, use of medications and rates of health care use for pain; 2) Identify risk factors for onset of {{TMD pain, headache, back and abdominal pain}}> Hypothesized risk factors for all pains include: female gender, number of existing pain complaints, and other somatic symptoms, numbers of health care visits in the prior year, and psychological distress; in addition, we hypothesize that sexual maturity is a risk factor for onset of TMD pain and headache; 3) Estimate rates of offset and recurrence of each of the pain c9ompliants over the 3-year follow up period; and, 4) Conduct examinations of the incidence cases of TMD pain, using examination methods and diagnostic algorithms as described for Study 1, to estimate the prevalence of specific subtypes of TMD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PILOT--DNA AND LIPID INDUCE TH1 MEDIATED PULMONARY INFLAMMATION Principal Investigator & Institution: Van Ginkel, Frits; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002 Summary: Description (adapted from the application): This pilot project deals with elucidation of mechanisms involved in the DNA/lipid complex-induced toxicity in CF patient during cationic liposome-mediated gene therapy. The symptoms observed include fever, myalgia and arthralgia, occurring at six hours with full recovery between 24-48 hours after the administration of DNA/lipid 67 complexes. The applicant believes that the toxic effects of DNA/lipid complexes are caused by unmethylated CpG motif in plasmid DNA. It is hypothesized that CpG motif activates T lymphocytes and macrophages to release inflammatory cytokines (TNF-a and IL-1), Th1-inducing cytokines (IL-12 and IL-18), Th-1 cytokine (IFN-r), leading to fever, myalgia, arthralgia and activation of NK and B cells. The applicant has proposed two Specific Aims to test his hypothesis. Aim 1 is to explore the effect of methylated and unmethylated CpG motifs of plasmid DNA in the presence or absence of lipid 67 on the production of specific cytokines in human peripheral blood cells (PBMCs) in vitro, and to test the effect of anti-inflammatory cytokines IL-10 and IL-4 on the production of the specific cytokines. Aim 2 deals with similar experiments in vivo using IL-12 or IFN-r knock out mice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

Studies

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Project Title: TOGAVIRUS TROPISM FOR BONES, JOINTS, AND CNS Principal Investigator & Institution: Heise, Mark T.; Microbiology and Immunology; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 31-JUL-2005 Summary: Togavirus infection of humans is characterized by acute and persistent arthritis/arthralgia, as well as viral encephalitis. Infection of adult mice with S.A.AR86, an alphavirus in the family Togaviridae, provides an excellent and unique model system to examine the molecular basis for both of these human disease pathologies. Attractive features of these models include: a) S.A.AR86 and related viruses cause acute and persistent arthralgia in humans. b) We have sequenced the genomes of S.A.AR86 and several of its closest relatives, constructed an authentic S.A.AR86 infectious cDNA clone, and successfully utilized expression systems based on S.A.AR86 for in vitro and in vivo experiments. c) Preliminary data demonstrated acute S.A.AR86 tropism for mouse bone and joint tissue following peripheral inoculation and persistence in these tissues for at least 3 months. d) Unlike other members of the Sindbis-group of alphaviruses, S.A.AR86 is neurovirulent in mice of all ages, and this phenotype maps to the viral nonstructural genes responsible for RNA synthesis. We propose the following Specific Aims. 1) Identify cellular targets of S.A.AR86 replication within bone/joint tissue, characterize S.A.AR86 persistence within these tissues, and evaluate other arthritis/arthralgia associated Togaviruses, including rubella and Ross River virus, for replication and/or persistence in bone/joint tissue. 2) Nine putative genetic determinants of neurovirulence within the nonstructural genes will be evaluated by changing these codons within the S.A.AR86 genome to the codons found in non-neurovirulent viruses and screening for loss of neurovirulence. In addition, the candidate S.A.AR86 codons will be introduced into non-neurovirulent virus genomes and screened for gain of virulence. 3) The mechanism(s) by which mutations modulate neurovirulence in adult mice will be examined using the nonstructural gene mutants identified in Aim 2, as well as a mutation at nsP1 538, which has already been identified, cloned and partially characterized. 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 arthralgia, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “arthralgia” (or 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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synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for arthralgia (hyperlinks lead to article summaries): •

A comparative trial of clomipramine and placebo as adjunctive therapy in arthralgia. Author(s): Ganvir P, Beaumont G, Seldrup J. Source: J Int Med Res. 1980; 8 Suppl 3: 60-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7009255

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A man with intermittent fever and arthralgia. Author(s): Quinn M, Gough A. Source: Annals of the Rheumatic Diseases. 1999 October; 58(10): 659-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10577377

•

A man with intermittent fever and arthralgia. Author(s): Knight SM, Symmons DP. Source: Annals of the Rheumatic Diseases. 1998 December; 57(12): 711-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10070269

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A marathon runner with high fever, arthralgia. Author(s): Bluestone R. Source: Hosp Pract (Off Ed). 1983 July; 18(7): 114-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6407965

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A puzzling arthralgia. Author(s): Cimis R. Source: Hosp Pract. 1978 September; 13(9): 139-40, 145, 148. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=711213

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A vesico-pustular rash and arthralgia. Author(s): Dawe RS, Sweeney G, Munro CS. Source: Clinical and Experimental Dermatology. 2001 January; 26(1): 113-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11260198

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Acne arthralgia. Author(s): Lane JMLeyden JJ, Spiegel RJ. Source: The Journal of Bone and Joint Surgery. American Volume. 1976 July; 58(5): 6735. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=132449

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Acute arthralgia (gout?) after tricrynafen. Author(s): King RS, Wichman BA. Source: The New England Journal of Medicine. 1979 November 8; 301(19): 1065. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=492241

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Acute renal failure, arthralgia and chronic pulmonary symptoms in a 59-year-old woman. Author(s): Rosenmann E. Source: Isr J Med Sci. 1967 January-February; 3(1): 184-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6030422

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Aethritis and arthralgia in infection with Mycoplasma pneumoniae. Author(s): Jones MC. Source: Thorax. 1970 November; 25(6): 748-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5494683

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An open-label trial of the selective cyclo-oxygenase-2 inhibitor, rofecoxib, in inflammatory bowel disease-associated peripheral arthritis and arthralgia. Author(s): Reinisch W, Miehsler W, Dejaco C, Harrer M, Waldhoer T, Lichtenberger C, Vogelsang H. Source: Alimentary Pharmacology & Therapeutics. 2003 June 1; 17(11): 1371-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12786631

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Anteromedial displacement of the tibial tubercle for patellofemoral arthralgia. Author(s): Cameron HU, Huffer B, Cameron GM. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1986 November; 29(6): 456-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3779552

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Aromatase inhibitors and arthralgia. Author(s): Donnellan PP, Douglas SL, Cameron DA, Leonard RC. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 May 15; 19(10): 2767. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11352973

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Arthralgia and crystal deposits in Crohn's disease. Author(s): Heuman R, Boeryd B, Gillquist J, Sjodahl R, Tagesson C. Source: Scandinavian Journal of Rheumatology. 1981; 10(4): 313-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6275499

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Arthralgia and myalgia in mumps. Author(s): Ghosh SK, Reddy TA. Source: Rheumatol Rehabil. 1973 May; 12(2): 97-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4741427

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Arthralgia and rubella immunization. Author(s): Lerman SJ, Silver MR, Nankervis GA. Source: Annals of Internal Medicine. 1978 January; 88(1): 131. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=619745

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Arthralgia as a side effect of methyldopa therapy. Author(s): Peterson SH. Source: J Am Osteopath Assoc. 1977 January; 76(5): 376. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=584225

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Arthralgia as an early extraintestinal symptom of Whipple's disease. Report of five cases. Author(s): Schilling D, Adamek HE, Kaufmann V, Maier M, Riemann JF. Source: Journal of Clinical Gastroenterology. 1997 January; 24(1): 18-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9013344

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Arthralgia as the initial manifestation of malignant lymphoma. Author(s): Ando T, Shinohara K, Nomiyama J, Toyosawa M, Inoue H. Source: American Journal of Hematology. 1995 October; 50(2): 152. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7573003

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Arthralgia associated with acute urinary retention. A syndrome of probable viral etiology. Author(s): Murphy TF, Senterfit LB, Christian CL. Source: The American Journal of Medicine. 1980 March; 68(3): 386-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7361806

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Arthralgia associated with beta-adrenergic blockade. Author(s): Sills JM, Bosco L. Source: Jama : the Journal of the American Medical Association. 1986 January 10; 255(2): 198-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2867233

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Arthralgia associated with calcium-channel blockers. Author(s): Smith KM. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2000 January 1; 57(1): 55-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10630559

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Arthralgia associated with captopril. Author(s): Malnick SD, Schattner A. Source: Bmj (Clinical Research Ed.). 1989 August 5; 299(6695): 394. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2506991

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Arthralgia associated with hypercarotenemia. Author(s): Sperber AD, Shoenfeld Y. Source: The Journal of Rheumatology. 1988 January; 15(1): 151-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3258381

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Arthralgia from parvovirus infection. Author(s): Rowlands S. Source: J R Coll Gen Pract. 1986 June; 36(287): 288, 290. No Abstract Available. Erratum In: J R Coll Gen Pract 1986 August; 36(289): 386. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3020242

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Arthralgia. Author(s): Hart FD. Source: Ann Phys Med. 1970 May; 10(6): 257-61. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4393302

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Arthralgia: a diagnostic strategy. Author(s): Murtagh J. Source: Aust Fam Physician. 1990 October; 19(10): 1530-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2248564

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Arthralgia-purpura-weakness-cryoglobulinemia. Author(s): Lapes MJ, Davis JS 4th. Source: Archives of Internal Medicine. 1970 August; 126(2): 287-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4194228

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Arthritis and arthralgia associated with toxocaral infestation. Author(s): Bethel RG. Source: British Medical Journal (Clinical Research Ed.). 1981 September 12; 283(6293): 729. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6793143

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Arthritis and arthralgia associated with toxocaral infestation. Author(s): Williams D, Roy S. Source: British Medical Journal (Clinical Research Ed.). 1981 July 18; 283(6285): 192. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6789960

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Arthritis/arthralgia and hypermobility of the joints in schoolchildren. Author(s): Arroyo IL, Brewer EJ, Giannini EH. Source: The Journal of Rheumatology. 1988 June; 15(6): 978-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3418649

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Association between terbinafine and arthralgia, fever and urticaria: symptoms or syndrome? Author(s): van Puijenbroek EP, Egberts AC, Meyboom RH, Leufkens HG. Source: Pharmacoepidemiology and Drug Safety. 2001 March-April; 10(2): 135-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11499852

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Back pain and arthralgia before and after lengthening. 75 patients questioned after 6 (1-11) years. Author(s): Tjernstrom B, Rehnberg L. Source: Acta Orthopaedica Scandinavica. 1994 June; 65(3): 328-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8042488

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Case report: diabetic muscle infarction presenting as knee arthralgia. Author(s): Yoo WH, Kim CH, Park JH, Kim HK, Kim JR, Park TS, Baek HS. Source: Rheumatology International. 2001 September; 21(1): 36-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11678301

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Case report: generalized arthralgia following Gd-DTPA administration. Author(s): Wexler DM, Spencer JD. Source: Clinical Radiology. 1993 July; 48(1): 68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8370226

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Chronic fatigue syndrome and arthralgia following parvovirus B19 infection. Author(s): Kerr JR, Bracewell J, Laing I, Mattey DL, Bernstein RM, Bruce IN, Tyrrell DA. Source: The Journal of Rheumatology. 2002 March; 29(3): 595-602. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11911112

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Chronic fatigue, arthralgia, and malaise. Author(s): Gompels MM, Spickett GP. Source: Annals of the Rheumatic Diseases. 1996 August; 55(8): 502-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8774176

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Chronic urticaria, arthralgia, raised erythrocyte sedimentation rate and IgG paraproteinaemia: a variant of Schnitzler's syndrome? Author(s): Nashan D, Sunderkotter C, Bonsmann G, Luger T, Goerdt S. Source: The British Journal of Dermatology. 1995 July; 133(1): 132-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7669625

Studies

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Clinico-pathological diagnostic problems: fever, arthralgia and renal disease in a young woman. Author(s): Chung EB, Dillard MG. Source: Journal of the National Medical Association. 1973 November; 65(6): 546-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4762158

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Clubbing, arthralgia and haemoptysis in a patient with metastatic carcinoma of the breast. Author(s): Gregory RK, Chang J, Singh R, Powles TJ. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 1996 September; 7(7): 756-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8905039

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Cyclosporin relieves arthralgia, causes angioedema. Author(s): Isenberg DA, Snaith ML, Al-Khader AA, Cohen SL, Fisher C, Morrow WJ, Mowbray J. Source: The New England Journal of Medicine. 1980 September 25; 303(13): 754. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7402275

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Cyclosporine-associated arthralgia. Author(s): Bailie GR, Eisele G. Source: Clinical Nephrology. 1990 May; 33(5): 256-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2354565

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Defective leukocyte interferon response in children with recurrent infections accompanied by arthralgia. Author(s): Bondestam M, Funa K, Alm GV. Source: Acta Paediatr Scand. 1985 March; 74(2): 219-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3993368

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Delay in the diagnosis of SLE: the importance of arthritis/arthralgia as the initial symptom. Author(s): Ozbek S, Sert M, Paydas S, Soy M. Source: Acta Medica Okayama. 2003 August; 57(4): 187-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14627070

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Delayed hypersensitivity and systemic arthralgia following transurethral collagen injection for stress urinary incontinence. Author(s): Stothers L, Goldenberg SL. Source: The Journal of Urology. 1998 May; 159(5): 1507-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9554343

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Diagnostic values of tests for acromioclavicular joint pain. Author(s): Walton J, Mahajan S, Paxinos A, Marshall J, Bryant C, Shnier R, Quinn R, Murrell GA. Source: The Journal of Bone and Joint Surgery. American Volume. 2004 April; 86-A(4): 807-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15069148

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Different conservative modalities of treatment of T.M.J. arthralgia. Author(s): Mounir RM, Hindy AM, Shaker MA. Source: Egypt Dent J. 1995 July; 41(3): 1247-52. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9497664

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Diffuse arthralgia and myalgia as the first manifestation of benign myeloradiculopathy due to cytomegalovirus infection in an immunocompetent patient. Author(s): Etaouil N, Benyahya E, Janani S, el Fatimi A, Bennis R, Mkinsi O. Source: Rev Rhum Engl Ed. 1997 January; 64(1): 57-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9051861

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Diphtheria presenting as abdominal pain and arthralgia. Author(s): Havaldar PV, Shanthala CC. Source: The Pediatric Infectious Disease Journal. 1993 June; 12(6): 538-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8345989

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Dose-limiting toxicity of rifabutin in AIDS-related complex: syndrome of arthralgia/arthritis. Author(s): Siegal FP, Eilbott D, Burger H, Gehan K, Davidson B, Kaell AT, Weiser B. Source: Aids (London, England). 1990 May; 4(5): 433-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2164820

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Double blind controlled comparison of aspirin, allopurinol and placebo in the management of arthralgia during pyrazinamide administration. Author(s): Horsfall PA, Plummer J, Allan WG, Girling DJ, Nunn AJ, Fox W. Source: Tubercle. 1979 March; 60(1): 13-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=377739

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Drug-induced arthritis and arthralgia. Author(s): Hart FD. Source: Drugs. 1984 October; 28(4): 347-54. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6386428

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Effectiveness of new push/pull hemodiafiltration for arthralgia in long-term hemodialysis patients. Author(s): Shinzato T, Miwa M, Kobayakawa H, Morita H, Nakai S, Miyata T, Maeda K. Source: Contrib Nephrol. 1995; 112: 111-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7554982

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Episodes of sudden weight gain, arthralgia, and hematuria in a middle aged woman. Author(s): Saylor JD, Gluck JC, Bahna SL. Source: Ann Allergy. 1990 April; 64(4): 336-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2321806

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Essential cryoglobulinaemia (type 1) in three patients characterised by Raynaud's phenomenon, arthralgia-arthritis, and skin lesions. Author(s): den Hollander JG, Swaak AJ. Source: Annals of the Rheumatic Diseases. 2002 January; 61(1): 88-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11779772

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Evaluation of arthritis and arthralgia in the pediatric patient. Author(s): McCarthy PL, Wasserman D, Spiesel SZ, Dolan TF, Jekel JF. Source: Clinical Pediatrics. 1980 March; 19(3): 183-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6965625

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Experience with Maquet anterior tibial tubercle advancement for patellofemoral arthralgia. Author(s): Hirsh DM, Reddy DK. Source: Clinical Orthopaedics and Related Research. 1980 May; (148): 136-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7379382

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Facial arthralgia and myalgia: can they be differentiated by trigeminal sensory assessment? Author(s): Eliav E, Teich S, Nitzan D, El Raziq DA, Nahlieli O, Tal M, Gracely RH, Benoliel R. Source: Pain. 2003 August; 104(3): 481-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12927620

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Fever, arthralgia and recurrent solitary pulmonary mass in a 58 year-old woman. Author(s): Flora G, Brown P, Sharma O. Source: Sarcoidosis. 1991 March; 8(1): 63-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2052775

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Fever, myalgia, and arthralgia in a patient on captopril and allopurinol. Author(s): Samanta A, Burden AC. Source: Lancet. 1984 March 24; 1(8378): 679. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6142365

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First report of mirtazapine-induced arthralgia. Author(s): Jolliet P, Veyrac G, Bourin M. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2001 December; 16(8): 503-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11777743

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Fluoroquinolone induced arthralgia and magnetic resonance imaging. Author(s): Loeuille D, Gillet P, Netter P. Source: The Journal of Rheumatology. 1996 July; 23(7): 1313-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8823722

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Frequency of arthralgia in women receiving one of three rubella vaccines. Author(s): Monto AS, Cavallaro JJ, Whale EH. Source: Archives of Internal Medicine. 1970 October; 126(4): 635-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4918712

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Giardiasis-associated arthralgia in children. Author(s): Meza-Ortiz F. Source: Archives of Medical Research. 2001 May-June; 32(3): 248-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11471528

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Head and neck fibromyalgia and temporomandibular arthralgia. Author(s): Truta MP, Santucci ET. Source: Otolaryngologic Clinics of North America. 1989 December; 22(6): 1159-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2689962

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HLA B27 antigens in patients with chronic arthralgia. Author(s): Luukkainen R. Source: Scandinavian Journal of Rheumatology. 1989; 18(3): 177-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2788918

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Hyperbaric arthralgia during helium-oxygen dives from 100 to 850 fsw. Author(s): Bradley ME, Vorosmarti J. Source: Undersea Biomed Res. 1974 June; 1(2): 151-67. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4469187

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Hypermobility of the joints in juvenile episodic arthritis/arthralgia. Author(s): Gedalia A, Person DA, Brewer EJ Jr, Giannini EH. Source: The Journal of Pediatrics. 1985 December; 107(6): 873-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4067743

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Hypoplastic crisis with persistent arthralgia and prolonged parvovirus B19 viraemia detected by polymerase chain reaction. Author(s): Catton MG, Thomas SM, Blacklock HA, Croxson MC. Source: Aust N Z J Med. 1993 April; 23(2): 216-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8517847

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Immune complexes in food-induced arthralgia. Author(s): Carini C, Fratazzi C, Aiuti F. Source: Ann Allergy. 1987 December; 59(6): 422-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3425981

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Improvement of arthritis and arthralgia after treatment with infliximab (Remicade) in a German prospective, open-label, multicenter trial in refractory Crohn's disease. Author(s): Herfarth H, Obermeier F, Andus T, Rogler G, Nikolaus S, Kuehbacher T, Schreiber S. Source: The American Journal of Gastroenterology. 2002 October; 97(10): 2688-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12385472

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Intestinal permeability in patients with chronic urticaria-angioedema with and without arthralgia. Author(s): Paganelli R, Fagiolo U, Cancian M, Scala E. Source: Ann Allergy. 1991 February; 66(2): 181-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1994789

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Intra-articular morphine as analgesic in temporomandibular joint arthralgia/osteoarthritis. Author(s): List T, Tegelberg A, Haraldson T, Isacsson G. Source: Pain. 2001 December; 94(3): 275-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11731064

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Letter: Acute arthralgia after high-dose intravenous methylprednisolone. Author(s): Goldman JA. Source: Lancet. 1974 November 30; 2(7892): 1333. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4139585

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Letter: Acute arthralgia after high-dose intravenous methylprednisolone. Author(s): Bailey RR, Armour P. Source: Lancet. 1974 October 26; 2(7887): 1014. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4138259

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Letter: Acute arthralgia following high-dose intravenous methylprednisolone therapy. Author(s): Newmark KJ, Mitra S, Berman LB. Source: Lancet. 1974 July 27; 2(7874): 229. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4135656

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Letter: Arthralgia after high-dose steroids. Author(s): Bennett WM, Strong D. Source: Lancet. 1975 February 8; 1(7902): 332. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=46470

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Linear IgA dermatosis with severe arthralgia. Author(s): Hepburn DJ, Davis AL, Pigeon GB, Begg EJ. Source: The Australasian Journal of Dermatology. 1991; 32(3): 133-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1823108

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Linear IgA dermatosis with severe arthralgia. Author(s): Williams RE. Source: The British Journal of Dermatology. 1989 October; 121(4): 541-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2696555

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Linear IgA dermatosis with severe arthralgia. Author(s): Leigh G, Marsden RA, Wojnarowska F. Source: The British Journal of Dermatology. 1988 December; 119(6): 789-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3060194

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MRI evidence of high signal intensity and temporomandibular arthralgia and relating pain. Does the high signal correlate to the pain? Author(s): Murakami K, Nishida M, Bessho K, Iizuka T, Tsuda Y, Konishi J. Source: The British Journal of Oral & Maxillofacial Surgery. 1996 June; 34(3): 220-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8818254

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Mucous patches and arthralgia. Author(s): Zawar V, Chuh A. Source: Journal of the Royal Society of Medicine. 2004 February; 97(2): 79-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14749405

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Multicentric reticulohistiocytosis presenting with a rash and arthralgia. Author(s): Hiramanek N, Kossard S, Barnetson RS. Source: The Australasian Journal of Dermatology. 2002 May; 43(2): 136-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11982572

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Myalgia and arthralgia associated with enalapril and ramipril. Author(s): Peppers MP. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 1995 January 15; 52(2): 203-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12879551

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Nalidixic acid arthralgia. Author(s): Bailey RR, Natale R, Linton AL. Source: Can Med Assoc J. 1972 October 7; 107(7): 604 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4541768

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Non-specific arthralgia and myalgia with subclinical neuropathy. A histochemical and histological study. Author(s): Isaacs H, Frere G. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1973 September 8; 47(35): 1581-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4354865

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Norfloxacin induced arthralgia. Author(s): Terry JB. Source: The Journal of Rheumatology. 1995 April; 22(4): 793-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7791191

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Occurrence of arthralgia and specific IgM antibodies three to four years after Ockelbo disease. Author(s): Niklasson B, Espmark A, Lundstrom J. Source: The Journal of Infectious Diseases. 1988 April; 157(4): 832-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2831289

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Ockelbo disease: arthralgia 3-4 years after infection with a Sindbis virus related agent. Author(s): Niklasson B, Espmark A. Source: Lancet. 1986 May 3; 1(8488): 1039-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2871323

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Parvovirus infection causing arthralgia. Author(s): Everett MT. Source: J R Coll Gen Pract. 1985 November; 35(280): 540. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3001303

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Patello-femoral arthralgia in athletes attending a Sports Injury Clinic. Author(s): Devereaux MD, Lachmann SM. Source: British Journal of Sports Medicine. 1984 March; 18(1): 18-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6722419

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Patellofemoral arthralgia. Author(s): Hunter HC. Source: J Am Osteopath Assoc. 1985 September; 85(9): 580-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4055446

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Peripheral neuropathy, polymyalgia and arthralgia: a paraneoplastic syndrome associated with myeloma. Author(s): Evison G. Source: Clinical Rheumatology. 1991 June; 10(2): 215. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1655351

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Peripheral neuropathy, polymyalgia and arthralgia: a paraneoplastic syndrome associated with myeloma. Author(s): Samanta A, Hilton D, Roy S. Source: Clinical Rheumatology. 1990 June; 9(2): 246-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2167810

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Persistent arthralgia and its association with HIV infection in Rwanda. Author(s): Saraux A, Taelman H, Clerinx J, Batungwanayo J, Kagame A, Kabagabo L, Bogaerts J, Van de Perre P, Le Goff P. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 1994 February; 7(2): 158-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8301526

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Persistent fever and arthralgia in adults. Author(s): Pinals RS. Source: Hosp Pract (Off Ed). 1986 November 30; 21(11A): 35-43. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3097036

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Pregnancy associated RPGN (rapidly progressive glomerulonephritis) with repeated attacks of purpura and arthralgia. Author(s): Ishii K, Kobayashi M, Koyama A, Narita M. Source: Nippon Jinzo Gakkai Shi. 1989 June; 31(6): 693-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2795997

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Pressure-pain thresholds and MRI effusions in TMJ arthralgia. Author(s): Shaefer JR, Jackson DL, Schiffman EL, Anderson QN. Source: Journal of Dental Research. 2001 October; 80(10): 1935-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11706955

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Purpura, arthralgia, and IgM-IgM cryoglobulinemia with rheumatoid factor acrivity. Response to cyclophosphamide and splenectomy. Author(s): Mathison DA, Condemi JJ, Leddy JP, Callerame ML, Panner BJ, Vaughan JH. Source: Annals of Internal Medicine. 1971 March; 74(3): 383-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5573157

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Re: Delayed hypersensitivity and systemic arthralgia following transurethral collagen injection for stress urinary incontinence. Author(s): Elson ML. Source: The Journal of Urology. 1999 February; 161(2): 610. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9915463

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Recurrent cutaneous erythralgia and arthralgia. Author(s): Georgouras KE, Wittal RA, Baird PJ. Source: The Australasian Journal of Dermatology. 1992; 33(3): 121-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1303070

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Renal colic, arthralgia in a hypercalcemic man. Author(s): Moss AH. Source: Hosp Pract (Off Ed). 1985 October 30; 20(10A): 31-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3932377

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Role of rifampicin in arthralgia induced by pyrazinamide. Author(s): Sarma GR, Acharyulu GS, Kannapiran M, Murthy PV, Gurumurthy P, Tripathy SP. Source: Tubercle. 1983 June; 64(2): 93-100. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6612796

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Serum uric acid concentrations and arthralgia among patients treated with pyrazinamide-containing regimens in Hong Kong and Singapore. Author(s): Jenner PJ, Ellard GA, Allan WG, Singh D, Girling DJ, Nunn AJ. Source: Tubercle. 1981 September; 62(3): 175-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7314249

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Severe arthralgia, not related to dose, associated with pentavalent antimonial therapy for mucosal leishmaniasis. Author(s): Castro C, Sampaio RN, Marsden PD. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1990 MayJune; 84(3): 362. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2260169

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Severe course of chronic urticaria, arthralgia, fever and elevation of erythrocyte sedimentation rate: Schnitzler's syndrome without monoclonal gammopathy? Author(s): Husak R, Nestoris S, Goerdt S, Orfanos CE. Source: The British Journal of Dermatology. 2000 March; 142(3): 581-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10777274

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Shoulder-hand syndrome and symmetrical arthralgia in patients with tubo-ovarian carcinoma. Author(s): Taggart AJ, Iveson JM, Wright V. Source: Annals of the Rheumatic Diseases. 1984 June; 43(3): 391-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6204600

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Silicone breast implants and drug-induced arthralgia. Author(s): Cadier MA, Hobby JA. Source: Plastic and Reconstructive Surgery. 1997 April; 99(5): 1464. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9105382

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Stevens-Johnson syndrome followed by persistent recurrent severe arthralgia. Author(s): Denman AM. Source: British Journal of Rheumatology. 1990 June; 29(3): 214. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2357505

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Subtalar arthralgia caused by juxtaarticular osteoid osteoma. Author(s): Khurana JS, Mayo-Smith W, Kattapuram SV. Source: Clinical Orthopaedics and Related Research. 1990 March; (252): 205-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2302886

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Successful treatment of arthralgia with tamoxifen citrate in a patient with pachydermoperiostosis. Author(s): Maeda H, Kumagai K, Konishi F, Katayama Y, Hiyama K, Ishioka S, Yamakido M. Source: Rheumatology (Oxford, England). 2000 October; 39(10): 1158-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11035143

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Successful treatment of severe arthralgia associated with palmoplantar pustulosis with low-dose oral cyclosporine A. Author(s): Yamamoto T, Kimura K, Katayama I, Nishioka K. Source: The Journal of Dermatology. 1995 July; 22(7): 512-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7560444

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Survey of gastrointestinal reactions to foods in adults in relation to atopy, presence of mucus in the stools, swelling of joints and arthralgia in patients with gastrointestinal reactions to foods. Author(s): Bengtsson U, Hanson LA, Ahlstedt S. Source: Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology. 1996 December; 26(12): 1387-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9027439

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Technetium-99m labelled human immunoglobulin scintigraphy predicts rheumatoid arthritis in patients with arthralgia. Author(s): de Bois MH, Arndt JW, Speyer I, Pauwels EK, Breedveld FC. Source: Scandinavian Journal of Rheumatology. 1996; 25(3): 155-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8668958

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Temporomandibular arthralgia. Diagnosis and treatment. Author(s): Hartwell SW Jr, Siegel BP, Anderson R. Source: Cleve Clin Q. 1967 October; 34(4): 235-42. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6063132

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The disproportionate impact of chronic arthralgia and arthritis among women. Author(s): Buckwalter JA, Lappin DR. Source: Clinical Orthopaedics and Related Research. 2000 March; (372): 159-68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10738425

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The incidence and course of perianal complications and arthralgia after intestinal resection with restoration of continuity for Crohn's disease. Author(s): Heuman R, Bolin T, Sjodahl R, Tagesson C. Source: The British Journal of Surgery. 1981 August; 68(8): 528-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7272666

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Thermographic diagnosis in athletes with patellofemoral arthralgia. Author(s): Devereaux MD, Parr GR, Lachmann SM, Thomas DP, Hazleman BL. Source: The Journal of Bone and Joint Surgery. British Volume. 1986 January; 68(1): 42-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3941140

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Thromboangiitis obliterans with arthralgia, diarrhea and nodules as the first symptoms. Author(s): Zarnitsky C, Bravard P, Levesque H, Bonnet B, Alcaix D. Source: Rev Rhum Engl Ed. 1997 May; 64(5): 353-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9190014

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Urticaria, arthralgia, and nephropathy without amyloidosis: another variant of the Muckle-Wells syndrome? Author(s): Throssell D, Feehally J, Trembath R, Walls J. Source: Clinical Genetics. 1996 March; 49(3): 130-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8737977

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Value of methylprednisolone in prevention of the arthralgia-myalgia syndrome associated with the total dose infusion of iron dextran: a double blind randomized trial. Author(s): Auerbach M, Chaudhry M, Goldman H, Ballard H. Source: The Journal of Laboratory and Clinical Medicine. 1998 March; 131(3): 257-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9523850

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CHAPTER 2. NUTRITION AND ARTHRALGIA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and arthralgia.

Finding Nutrition Studies on Arthralgia 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 “arthralgia” (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 “arthralgia” (or a synonym): •

Intra-articular injection of hyaluronate (SI-6601D) improves joint pain and synovial fluid prostaglandin E2 levels in rheumatoid arthritis: a multicenter clinical trial. Author(s): Division of Rheumatic Diseases, Tokyo Metropolitan Otsuka Hospital, Japan. [email protected] Source: Goto, M Hanyu, T Yoshio, T Matsuno, H Shimizu, M Murata, N Shiozawa, S Matsubara, T Yamana, S Matsuda, T Clin-Exp-Rheumatol. 2001 Jul-August; 19(4): 377-83 0392-856X

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Relation between the therapeutic effect of moxibustion in treating arthralgia and SP and enkephalin in nervous tissues. Source: Lu, Z S Dong, X T Zhang, T J Cao, W H Deng, Y J-Tradit-Chin-Med. 1989 March; 9(1): 69-74 0254-6272

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Relationships between pain-related mediators and both synovitis and joint pain in patients with internal derangements and osteoarthritis of the temporomandibular joint. Author(s): Department of Oral and Maxillofacial Surgery, Kanazawa Medical University, Ishikawa, Japan. [email protected] Source: Nishimura, M Segami, N Kaneyama, K Suzuki, T Miyamaru, M Oral-Surg-OralMed-Oral-Pathol-Oral-Radiol-Endod. 2002 September; 94(3): 328-32 1079-2104

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/

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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

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

The following is a specific Web list relating to arthralgia; 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: •

Vitamins Provitamin A Source: Integrative Medicine Communications; www.drkoop.com

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Minerals Retinol Source: Integrative Medicine Communications; www.drkoop.com Vitamin A (Retinol) Source: Integrative Medicine Communications; www.drkoop.com

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Food and Diet Burdock Source: Prima Communications, Inc.www.personalhealthzone.com Gluten-Free Diet Source: Healthnotes, Inc.; www.healthnotes.com Omega-3 Fatty Acids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,992,00.html

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

Aromatherapy massage for joint pain and constipation in a patient with Guillian Barre. Author(s): Shirreffs CM. Source: Complementary Therapies in Nursing & Midwifery. 2001 May; 7(2): 78-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11855776

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Arthralgia treated by acupuncture within “Chifu” area. Author(s): Fang Z. Source: J Tradit Chin Med. 1999 September; 19(3): 207-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10921152

•

Glutamine treatment of paclitaxel-induced myalgias and arthralgias. Author(s): Savarese D, Boucher J, Corey B.

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Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1998 December; 16(12): 3918-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9850043 •

Myalgias and arthralgias associated with paclitaxel. Author(s): Garrison JA, McCune JS, Livingston RB, Linden HM, Gralow JR, Ellis GK, West HL. Source: Oncology (Huntingt). 2003 February; 17(2): 271-7; Discussion 281-2, 286-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12632867

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Nettle sting of Urtica dioica for joint pain--an exploratory study of this complementary therapy. Author(s): Randall C, Meethan K, Randall H, Dobbs F. Source: Complementary Therapies in Medicine. 1999 September; 7(3): 126-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10581821

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Relation between the therapeutic effect of moxibustion in treating arthralgia and SP and enkephalin in nervous tissues. Author(s): Lu ZS, Dong XT, Zhang TJ, Cao WH, Deng Y. Source: J Tradit Chin Med. 1989 March; 9(1): 69-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2474727

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Repeated arthralgia associated with granulocyte colony stimulating factor administration. Author(s): Tsukadaira A, Okubo Y, Takashi S, Kobayashi H, Kubo K. Source: Annals of the Rheumatic Diseases. 2002 September; 61(9): 849-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12176817

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Severe arthralgia and myalgia due to high-dose methylprednisolone pulse therapy cured by potassium infusion in a patient with diffuse proliferative lupus nephritis. Author(s): Odabas AR, Cetinkaya R, Selcuk Y, Kaya H. Source: Nephron. 2001 January; 87(1): 95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11174035

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Use of gabapentin in the prevention of taxane-induced arthralgias and myalgias. Author(s): Nguyen VH, Lawrence HJ. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2004 May 1; 22(9): 1767-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15118009

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•

Use of low-dose oral prednisone to prevent paclitaxel-induced arthralgias and myalgias. Author(s): Markman M, Kennedy A, Webster K, Kulp B, Peterson G, Belinson J. Source: Gynecologic Oncology. 1999 January; 72(1): 100-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9889038

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 arthralgia; 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 AIDS and HIV Source: Integrative Medicine Communications; www.drkoop.com Amyloidosis Source: Integrative Medicine Communications; www.drkoop.com Angioedema Source: Integrative Medicine Communications; www.drkoop.com

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Bone Marrow Disorders Source: Integrative Medicine Communications; www.drkoop.com Celiac Disease Source: Healthnotes, Inc.; www.healthnotes.com Chronic Fatigue Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Chronic Myelogenous Leukemia Source: Integrative Medicine Communications; www.drkoop.com Colorectal Cancer Source: Integrative Medicine Communications; www.drkoop.com Erythema Source: Integrative Medicine Communications; www.drkoop.com Fibromyalgia Source: Integrative Medicine Communications; www.drkoop.com Food Poisoning Source: Integrative Medicine Communications; www.drkoop.com Hemophilia Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Source: Integrative Medicine Communications; www.drkoop.com Hypercholesterolemia Source: Integrative Medicine Communications; www.drkoop.com Hyperparathyroidism Source: Integrative Medicine Communications; www.drkoop.com Inflammatory Bowel Disease Source: Integrative Medicine Communications; www.drkoop.com Joint Pain Source: Integrative Medicine Communications; www.drkoop.com Low Back Pain Source: Integrative Medicine Communications; www.drkoop.com Lupus Source: Integrative Medicine Communications; www.drkoop.com

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Malabsorption Source: Healthnotes, Inc.; www.healthnotes.com Myelofibrosis Source: Integrative Medicine Communications; www.drkoop.com Myeloproliferative Disorders Source: Integrative Medicine Communications; www.drkoop.com Osteoarthritis Source: Healthnotes, Inc.; www.healthnotes.com Osteoarthritis Source: Integrative Medicine Communications; www.drkoop.com Osteoarthritis Source: Prima Communications, Inc.www.personalhealthzone.com Polycythemia Vera Source: Integrative Medicine Communications; www.drkoop.com Psoriasis Source: Integrative Medicine Communications; www.drkoop.com Rheumatoid Arthritis Source: Healthnotes, Inc.; www.healthnotes.com Rubella Source: Integrative Medicine Communications; www.drkoop.com Sarcoidosis Source: Integrative Medicine Communications; www.drkoop.com Scleroderma Source: Integrative Medicine Communications; www.drkoop.com Serum Sickness Source: Integrative Medicine Communications; www.drkoop.com Systemic Lupus Erythematosus Source: Healthnotes, Inc.; www.healthnotes.com Systemic Lupus Erythematosus Source: Integrative Medicine Communications; www.drkoop.com Temporomandibular Joint Dysfunction Source: Integrative Medicine Communications; www.drkoop.com Thrombocytosis Source: Integrative Medicine Communications; www.drkoop.com

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TMJ Source: Integrative Medicine Communications; www.drkoop.com Ulcerative Colitis Source: Integrative Medicine Communications; www.drkoop.com Wilson's Disease Source: Healthnotes, Inc.; www.healthnotes.com •

Alternative Therapy Chelation Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,679,00.html Chiropractic Source: Healthnotes, Inc.; www.healthnotes.com Hypnotherapy Source: Integrative Medicine Communications; www.drkoop.com Macrobiotics Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,714,00.html Rolfing Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,732,00.html

•

Chinese Medicine Bajitian Alternative names: Morinda Root; Radix Morindae Officinalis Source: Chinese Materia Medica Beidougen Alternative names: Asiatic Moonseed Rhizome; Rhizoma Menispermi Source: Chinese Materia Medica Cangzhu Alternative names: Atractylodes Rhizome; Rhizoma Atracylodis Source: Chinese Materia Medica Caowu Alternative names: Kusnezoff Monkshood Leaf; Caowuye; Folium Aconiti Kusnezoffii Source: Chinese Materia Medica

Alternative Medicine 35

Chuanmutong Alternative names: Armand Clematis Stem; Caulis Clematidis Armandii Source: Chinese Materia Medica Chuanniuxi Alternative names: Medicinal Cyathula Root; Radix Cyathulae Source: Chinese Materia Medica Chuanshanjia Alternative names: Pangolin Scale; Squama Manitis Source: Chinese Materia Medica Chuanwu Alternative names: Common Monkshood Mother Root; Radix Aconiti Source: Chinese Materia Medica Chuanxiong Alternative names: Szechwan Lovage Rhizome; Rhizoma Chuanxiong Source: Chinese Materia Medica Danggui Alternative names: Chinese Angelica; Radix Angelicae Sinensis Source: Chinese Materia Medica Daxueteng Alternative names: Sargentgloryvine Stem; Caulis Sargentodoxae Source: Chinese Materia Medica Difengpi Alternative names: Difengpi Bark; Cortex Illicii Source: Chinese Materia Medica Dilong Alternative names: Earthworm; Pheretima Source: Chinese Materia Medica Dinggongteng Alternative names: Obtuseleaf Erycibe Stem; Caulis Erycibes Source: Chinese Materia Medica Fangfeng Alternative names: Divaricate Saposhnikovia Root; Radix Saposhnikoviae Source: Chinese Materia Medica Fenbixie Alternative names: Hypoglaucous Collett Yam Rhizome; Rhizoma Dioscoreae Hypoglaucae Source: Chinese Materia Medica Fuzi Alternative names: Beivedere Fruit; Difuzi; Fructus Kochiae Source: Chinese Materia Medica

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Arthralgia

Gaoben Alternative names: Chinese Lovage; Rhizoma Ligustici Source: Chinese Materia Medica Gouji Alternative names: Cibot Rhizome; Rhizoma Cibotii Source: Chinese Materia Medica Guangfangii Alternative names: Southern Fangchi Root; Radix Aristolochiae Fangchi Source: Chinese Materia Medica Guizhi Alternative names: Cassia Twig; Ramulus Cinnamomi Source: Chinese Materia Medica Haifengteng Alternative names: Kadsura Pepper Stem; Caulis Piperis Kadsurae Source: Chinese Materia Medica Hujisheng Alternative names: Colored Mistletoe Herb; Herba Visci Source: Chinese Materia Medica Huzhang Alternative names: Giant Knotweed Rhizome; Rhizoma Polygoni Cuspidati Source: Chinese Materia Medica Jianghuang Alternative names: Turmeric; Rhizoma Curcumae Longae Source: Chinese Materia Medica Jiezi Alternative names: Mustard Seed; Semen Sinapis Source: Chinese Materia Medica Jixueteng Alternative names: Suberect Spatholobus Stem; Caulis Spatholobi Source: Chinese Materia Medica Kanlisha Alternative names: Kanli Coarse Powder Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Laoguancao Alternative names: Common Heron's Bill Herb, Wilford Granesbill Herb; Herba ErodiiHerba Geranii Source: Chinese Materia Medica

Alternative Medicine 37

Liangmianzhen Alternative names: Shinyleaf Pricklyash Root; Radix Zanthoxyli Source: Chinese Materia Medica Liangtoujian Alternative names: Radde Anemone Rhizome; Rhizoma Ahemones Daddeanae Source: Chinese Materia Medica Lulutong Alternative names: Beautiful Sweetgum Fruit; Fructus Liquidambaris Source: Chinese Materia Medica Luxiancao Alternative names: Pyrola Herb; Herba Pyrolae Source: Chinese Materia Medica Maqianzi Alternative names: Nux Vomica; Semen Strychni Source: Chinese Materia Medica Mianbixie Alternative names: Sevenlobed Yam Rhizome; Rhizoma Dioscoreae Septemlobae Source: Chinese Materia Medica Miaoji Wan Alternative names: Miaoji Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Naoyanghua Alternative names: Yellow Azalea Flower; Flos Rhododendri Mollis Source: Chinese Materia Medica Niuxi Alternative names: Twotoothed Achyranthes Root; Radix Achyranthis Bidentatae Source: Chinese Materia Medica Pianjianghuang Alternative names: Wenyujin Concise Rhizome; Rhizoma Wenyujin Concisum Source: Chinese Materia Medica Qiancao Alternative names: Longtube Ground Ivy Herb; Lianqiancao; Herba Glechomae Source: Chinese Materia Medica Qianghou Alternative names: Incised Notopterygium Rhizome or Root; Rhizoma seu Radix Notopterygii Source: Chinese Materia Medica

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Qingfengteng Alternative names: Orientvine Stem; Caulis Sinomenii Source: Chinese Materia Medica Qinjiao Alternative names: Largeleaf Gentian Root; Radix Gentianae Macrophyllae Source: Chinese Materia Medica Sangjisheng Alternative names: Chinese Taxillus Herb; Herba Taxilli Source: Chinese Materia Medica Sangzhi Alternative names: Mulberry Twig; Ramulus Mori Source: Chinese Materia Medica Sanqi Shangyao Pian Alternative names: anqi Shangyao Tablets; Sanqi Shangyao Pian (San Qi Shang Yao Pi An Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shangshi Zhitong Gao Alternative names: hangshi Zhitong Plaster; Shangshi Zhitong Gao (Shang Shi Zhi Tong Gao Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shenjincao Alternative names: Common Clubmoss Herb; Herba Lycopodii Source: Chinese Materia Medica Shouwuteng Alternative names: Tuber Fleeceflower Stem; Caulis Polygoni Multiflori Source: Chinese Materia Medica Shujin Huoluo Jiu Alternative names: hujin Huoluo Wine; Shujin Huoluo Jiu (Shu Jin Huo Luo Jiu Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Sigualuo Alternative names: Luffa Vegetable Sponge; Retinervus Luffae Fructus Source: Chinese Materia Medica Songjieyou Alternative names: Turpentine Oil; Oleum Terebinthinae Source: Chinese Materia Medica Tianxianteng Alternative names: Dutchmanspipe Vine; Herba Aristolochiae Source: Chinese Materia Medica

Alternative Medicine 39

Weilingxian Alternative names: Chinese Clematis Root; Radix Clematidis Source: Chinese Materia Medica Wujiapi Alternative names: Sienderstyle Acanthopanax Bark; Cortex Acanthopanacis Source: Chinese Materia Medica Xiheliu Alternative names: hinese Tamarisk Twig; Xiheliu (Xi He Liu); Cacumen Tamarici Source: Chinese Materia Medica Xixiancao Alternative names: Siegesbeckia Herb; Herba Siegesbeckiae Source: Chinese Materia Medica Xixin Alternative names: Manchurian Wildginger; Herba Asari Source: Chinese Materia Medica Xuchangqing Alternative names: Paniculate Swallowwort Root; Radix Cynanchi Paniculati Source: Chinese Materia Medica Xuduan Alternative names: Himalayan Teasel Root; Radix Dipsaci Source: Chinese Materia Medica Yangjinhua Alternative names: Datura Flower; Flos Daturae Source: Chinese Materia Medica Yinyanghuo Alternative names: Epimedium Herb; Herba Epimedii Source: Chinese Materia Medica Zhuzishen Alternative names: Largeleaf Japanese Ginseng Rhizome; Rhizoma Panacis Majoris Source: Chinese Materia Medica •

Herbs and Supplements Aminoglycosides Source: Integrative Medicine Communications; www.drkoop.com B-Carotene Source: Integrative Medicine Communications; www.drkoop.com Beta-Carotene Alternative names: b-carotene, Trans-beta Carotene; Provitamin A, Betacarotenum Source: Integrative Medicine Communications; www.drkoop.com

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Betacarotenum Source: Integrative Medicine Communications; www.drkoop.com Bile Acid Sequestrants Source: Integrative Medicine Communications; www.drkoop.com Black Cohosh Alternative names: Cimicifuga racemosa (actea), Black Snakeroot Source: Integrative Medicine Communications; www.drkoop.com Black Snakeroot Source: Integrative Medicine Communications; www.drkoop.com Blackberry Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,837,00.html Bloodroot Source: Prima Communications, Inc.www.personalhealthzone.com Brahmi Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Bromelain Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,760,00.html Cayenne Alternative names: Capsicum annuum, Capsicum frutescens Source: Healthnotes, Inc.; www.healthnotes.com Centella Source: Integrative Medicine Communications; www.drkoop.com Centella asiatica Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Chaparral Alternative names: Larrea tridentata Source: Healthnotes, Inc.; www.healthnotes.com Cimicifuga racemosa (Actea) Source: Integrative Medicine Communications; www.drkoop.com

Alternative Medicine 41

Dandelion Source: Prima Communications, Inc.www.personalhealthzone.com Devil's Claw Source: Prima Communications, Inc.www.personalhealthzone.com Gotu Kola Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Hydrocotyle Source: Integrative Medicine Communications; www.drkoop.com Indian Pennywort Source: Integrative Medicine Communications; www.drkoop.com Lubricant Laxatives Source: Integrative Medicine Communications; www.drkoop.com Marsh Pennywort Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Nettle Alternative names: Urtica dioica Source: Healthnotes, Inc.; www.healthnotes.com Nettle Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10048,00.html Paclitaxel Source: Healthnotes, Inc.; www.healthnotes.com Pregnenolone Source: Healthnotes, Inc.; www.healthnotes.com Trans-Beta-Carotene Source: Integrative Medicine Communications; www.drkoop.com Uricosuric Agents Source: Integrative Medicine Communications; www.drkoop.com Wild Yam Source: Prima Communications, Inc.www.personalhealthzone.com

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Wild Yam Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10070,00.html

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. DISSERTATIONS ON ARTHRALGIA Overview In this chapter, we will give you a bibliography on recent dissertations relating to arthralgia. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “arthralgia” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on arthralgia, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Arthralgia ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to arthralgia. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Psychological factors in the development, maintenance, and treatment outcome of temporomandibular joint pain and dysfunction by Schnurr, Robert F; PhD from The University of Western Ontario (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL43275

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. PATENTS ON ARTHRALGIA 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 “arthralgia” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on arthralgia, we have not necessarily excluded non-medical patents in this bibliography.

Patent Applications on Arthralgia 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 arthralgia:

5Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm. 6 This has been a common practice outside the United States prior to December 2000.

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Arthralgia

Composition for the relief of joint pain and myofascial pain and method of preparing same Inventor(s): Knigge, Jan Donald; (St. Petersburg, FL) Correspondence: N. Whitney Wilson; Bryan Cave Llp; 245 Park Avenue; New York; NY; 10167-0034; US Patent Application Number: 20030045503 Date filed: September 30, 2002 Abstract: A stable, formulation comprising glucosamine and chondroitin compounds in a base which can be used for topical application to relieve joint pain and myofascial pain. A method of preparing the composition by adding the glucosamine and chondroitin after the rest of the components of the formulation have been mixed and heated is also disclosed. Excerpt(s): This invention relates to a topically applied composition for the treatment of joint pain and myofascial pain, a process for preparing the composition, and a method of treating joint pain and, myofascial pain using the composition. Joint pain and myofascial pain can be caused by arthritis, cartilage injury or disease, and other sources. Patients can find such pain to be debilitating, and have used a variety of treatments for relief of pain, including formulations administered orally, parenterally, and topically. A popular form of treatment for joint pain and myofascial pain is the topical application of pain relieving ointments which contain menthol. Formulations for topical application can either be water-based or substantially anhydrous. For many applications, anhydrous (i.e. oil-based) formulations are preferable because anhydrous formulations will not evaporate like those containing water or alcohol. Anhydrous formulations, therefore, are easier to use in massaging applications. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Method for determining joint stiffness degradation Inventor(s): Burdisso, Richardo Anibal; (Blacksburg, VA), Jayasuriya, A. Mangala Mahinda; (Bloomfield Hills, MI), Kuo, Everett You-Ming; (Troy, MI), Nikolaidis, Efstratios; (Blacksburg, VA) Correspondence: Kevin G. Mierzwa; Artz & Artz, P.C.; 28333 Telegraph Road, Suite 250; Southfield; MI; 48034; US Patent Application Number: 20020161531 Date filed: March 13, 2001 Abstract: A method of determining joint stiffness degradation in structure 10 is provided including a first exciting of the structure 18, a first measuring of transfer function and frequency response function 20, simulating a mileage accumulation process of the structure 16 performed after the first exciting 18 and the first measuring 20, a second exciting of the structure 22, performed after the simulating a mileage accumulation process 16, a second measuring of frequency response function 24 performed after the simulating a mileage accumulation process 16 and calculating the change in joint stiffness 26 using the first measuring 20 and the second measuring 24. Excerpt(s): The present invention relates generally to a method for determining joint stiffness degradation and more particularly to a non-destructive method for determining joint stiffness degradation. NVH performance can be a major concern in

Patents 47

many product designs. Many products, such as automobiles, may experience NVH degradation over the life of the product. This degradation may result from a combination of age and use (mileage in the case of automobiles). NVH degradation can result in a reduction of product performance and customer satisfaction. This is highly undesirable. In the case of automotive designs, one cause of high mileage NVH degradation is a loss of joint stiffness. The loss of joint stiffness from the body structure can result from fatigue, loosening, aging, wear, corrosion, and a host of other causes. In order to design vehicles with reduced NVH degradation, it often is important to analyze designs to determine locations of body joint stiffness degradation due to high mileage. By isolating such positions, joint stiffness may be modified and improved to avoid future NVH degradation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Preparations and method of producing the same Inventor(s): Higashi, Kiyotsugu; (Osaka-shi, JP), Iida, Kentaro; (Osaka-shi, JP), Miura, Chikara; (Osaka-shi, JP), Nishimori, Tomoharu; (Osaka-shi, JP), Onaka, Yukiko; (Osakashi, JP) Correspondence: Wenderoth, Lind & Ponack, L.L.P.; 2033 K Street N. W.; Suite 800; Washington; DC; 20006-1021; US Patent Application Number: 20020099032 Date filed: November 8, 2001 Abstract: Incorporation of an aminosugar (e.g., glucosamine) to a preparation make a vitamin B1 stable. The content of the aminosugar is an effective amount to stabilize the vitamin B1, and is, for example, not less than 0.1 part by weight relative to 1 part by weight of the vitamin B1. Incorporation of the aminosugar can improve the disintegrativity of a solid preparation comprising a glycosaminoglycan (a hyaluronic acid, a chondroitin or a salt thereof). The content of aminosugars is not less than 0.1 part by weight relative to 1 part by weight of glycosaminoglycans. The solid preparation can inhibit forming gel masses of glycosaminoglycan and can improve the disintegrativity. Moreover, a joint disorder such as arthralgia can be improved by combination of the vitamin B1 and the glucosamine (e.g., glucosamine or a salt thereof). Excerpt(s): This invention relates to a preparation in which a vitamin B1 is stabilized, particularly a preparation (particularly, a solid preparation) improved in disintegrativity (disintegration properties) as well as stabilization of the vitamin B1. This invention further relates to a composition for preventing or treating a joint disorder, which comprises a vitamin B1 and an aminosugar (especially, a glucosamine), if necessary, a glycosaminoglycan. Many pharmaceutical preparations comprising vitamin B1 are commercially available. Concretely, a vitamin B1 is utilized for Wernicke's encephalopathy, peripheral neuropathy (peripheral nervous system disorder), central neuropathy (central nervous system disorder), neuralgia, myalgia, arthralgia (lumbagia, stiff shoulder, frozen shoulder), numbness of hands and feet, therapy of asthenopia, constipation, nutrition, etc. A vitamin B1 is effective in arthralgia, however effective in relatively slight symptom of arthralgia. The joints (of human and animals) are constantly subjected to stress and strain from mechanical forces that can result in a joint disorder such as arthralgia, arthritis, osteoarthritis, and stiffness. The causes of a joint disorder include various kinds such as a joint deformation, bacterium infection (microbism), virus infection, injury, immuno-disease such as allergy, rheumatism and dysbolism caused by nephritis. An inflammatory disorder such as arthriris is caused so

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that a patient suffers from arthralgia and joint stiffness can not maintain normal joint flexibility and mobility, and comfortable joint movement is disturbed by a joint pain and stiffness. Therefore, more effective composition for prevention and treatment of a joint disorder is required. 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 arthralgia, 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 “arthralgia” (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 arthralgia. You can also use this procedure to view pending patent applications concerning arthralgia. 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 6. BOOKS ON ARTHRALGIA Overview This chapter provides bibliographic book references relating to arthralgia. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on arthralgia 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: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “arthralgia” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “arthralgia” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “arthralgia” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

RXDX Joint Pain (Institutional License, Diskette) by Hoffer; ISBN: 0683400274; http://www.amazon.com/exec/obidos/ASIN/0683400274/icongroupinterna

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

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Management of Masticatory Myalgia and Arthralgia Source: in Lund, J.P., et al., eds. Orofacial Pain: From Basic Science to Clinical Management. Chicago, IL: Quintessence Publishing Co, Inc. 2001. p. 235-248. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $38.00 plus shipping and handling. ISBN: 0867153814. Summary: Myalgia and arthralgia refer to muscle and joint pain, respectively. When involving the masticatory muscles, the temporomandibular joint structures, or both, they are collectively called temporomandibular disorders (TMD). This chapter on the management of masticatory (chewing) myalgia and arthralgia is from a textbook that focuses on the topics that would be found in an undergraduate curriculum for dentistry. Most of the chapters in the book were first presented as papers at a symposium for teachers of orofacial pain held in Vancouver, Canada, in March 1999 in conjunction with the American and Canadian Associations of Dental Schools and the International Association for Dental Research. In this chapter, the authors discuss differential diagnosis, including that of masticatory myalgia which should include postexercise myalgia, myofascial pain, fibromyalgia, tension type headache, myositis, muscle contracture, muscle spasm, dyskinesias and dystonias; and that of temporomandibular joint arthralgia, which includes TMJ disc displacement, TMJ subluxation or dislocation, osteoarthritis, TMJ synovitis or capsulitis, rheumatic diseases, fracture and contusion, ankylosis, and tumors or growths. The authors then focus on management strategies, including pharmacotherapy (drugs), physical medicine, intraoral splints, behavioral management including self management, and surgery. The chapter concludes with a brief section discussing referrals to other specialists. 2 tables. 21 references.

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APPENDICES

53

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 “arthralgia” (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 4026 8 712 37 141 4924

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 “arthralgia” (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.

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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.

59

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 arthralgia 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 arthralgia. 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 arthralgia. 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 “arthralgia”:

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Ankylosing Spondylitis http://www.nlm.nih.gov/medlineplus/ankylosingspondylitis.html Arthritis http://www.nlm.nih.gov/medlineplus/arthritis.html Hepatitis C http://www.nlm.nih.gov/medlineplus/hepatitisc.html Hip Injuries and Disorders http://www.nlm.nih.gov/medlineplus/hipinjuriesanddisorders.html Juvenile Rheumatoid Arthritis http://www.nlm.nih.gov/medlineplus/juvenilerheumatoidarthritis.html Knee Injuries and Disorders http://www.nlm.nih.gov/medlineplus/kneeinjuriesanddisorders.html Lupus http://www.nlm.nih.gov/medlineplus/lupus.html Osteoarthritis http://www.nlm.nih.gov/medlineplus/osteoarthritis.html Pets and Pet Health http://www.nlm.nih.gov/medlineplus/petsandpethealth.html Rheumatoid Arthritis http://www.nlm.nih.gov/medlineplus/rheumatoidarthritis.html Vasculitis http://www.nlm.nih.gov/medlineplus/vasculitis.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 arthralgia. 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: •

Arthritis in Children Source: Healthology, Inc. 2003. 4 p. Contact: Available from Healthology, Inc. Website: http://healingwell.healthology.com.

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Summary: This fact sheet provides information about the causes, diagnosis, and treatment of arthritis in children. Arthritis is an inflammatory disease of the joints. Inflammation is caused by fluid accumulating inside the joint or lining of the joint. Common symptoms of arthritis in children include joint pain, joint swelling, limping, holding an affected joint in one position, inability to move the joint, heat over the joint, and stiffness. Symptoms in infants include irritability and crying on handling. Fever rash, mouth sores, or red and watering eyes may also accompany joint symptoms. In children, acute arthritis may be caused by trauma; infection-related arthritis including Lyme disease, septic arthritis, viral arthritis; or by immune-- related arthritis including rheumatic fever, serum sickness, or Kawasaki disease. Causes of chronic arthritis include juvenile rheumatoid arthritis, systemic lupus erythematosus, and psoriasis. Some conditions that mimic arthritis include acute leukemia, neuroblastoma, hypothyroidism, Perthe's Disease, hypermobility of joints, and slipped capital femoral epiphysis. Arthralgia (joint pain without inflammation) may be caused by many different conditions including growing pains, excess physical activity, bone diseases, viral diseases, neurological diseases, leukemia, psychosocial problems, or depression. Diagnosis for arthritis must be based upon a medical history, careful physical examination, and laboratory tests and imaging studies. Treatment depends upon the cause of the arthritis. •

Lupus Guide Patient Information Handouts: Joint Function and Lupus Source: Bethesda, MD: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1998. 2 p. Contact: Available from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1 AMS Circle, Bethesda, MD 20892-3675. (877) 226-4267 or (301) 495-4484. Fax (301) 718-6366. TTY (301) 565-2966. E-mail: [email protected]. Website: www.niams.nih.gov. PRICE: Available only as part of a package of patient information sheets; single copy of package free. Order Number: AR-205. Summary: This fact sheet provides people who have systemic lupus erythematosus (SLE) and the patient care team with information about joint pain and joint complications. Almost all people who have SLE experience joint pain or arthritis at some time during the course of their disease; however, the arthritis of lupus tends to be temporary and is less damaging to the joints than rheumatoid arthritis. The most commonly affected joints are those of the fingers, wrists, and knees. The fact sheet describes various joint problems, including arthralgia, myalgia, or myositis, and other joint complications. It offers self care tips for keeping pain at a tolerable level and maintaining joint function. In addition, the fact sheet provides space for making additional notes.

•

Musculoskeletal Problems Contact: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center, Beth Israel Hospital, 330 Brookline Ave Libby Bldg 317, Boston, MA, 02215, (617) 667-5520, http://www.natip.org. Summary: This fact sheet, written for individuals with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), presents information about HIV/AIDS and musculoskeletal problems. Musculoskeletal problems represent disorders of the muscles (myositis), joints (arthritis), and connective tissues (tendonitis). A variety of rheumatologic conditions such as arthralgia, fibromyalgia syndrome,

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Reiter's syndrome, and myositis, have been described in HIV-positive individuals. Arthralgia refers to pain in the joints without evidence of inflammation. Fibromyalgia syndrome causes widespread pain in the body and characteristic muscle tenderness. Reiter's syndrome includes some combination of arthritis, conjunctivitis, and urethritis. Myositis presents with muscle weakness of the shoulders and upper legs. The most common overall symptoms of musculoskeletal problems include pain of the joints, muscles, and connective tissues; fever; chills; weakness; and swelling or redness of the affected area(s). Musculoskeletal problems are often diagnosed through an analysis of individuals' medical histories, a physical examination, blood serology, arthrocentesis, electromyography, and a muscle or bone biopsy. Most musculoskeletal problems are managed with nonsteroidal anti-inflammatory agents (NSAIDS's) and/or antibiotics. 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 arthralgia. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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63

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 arthralgia. 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 “arthralgia” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “arthralgia”. 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 “arthralgia” (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 “arthralgia” (or a synonym) into the search box, and click “Submit Query.”

65

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.

Finding Medical Libraries

67

•

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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69

•

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

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

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

•

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). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on arthralgia: •

Basic Guidelines for Arthralgia Joint pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm

•

Signs & Symptoms for Arthralgia Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Muscle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Muscle pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003178.htm Numbness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm

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Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm •

Diagnostics and Tests for Arthralgia Blood differential Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Joint X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003810.htm

•

Background Topics for Arthralgia Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Fracture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000001.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Sprains Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000041.htm

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

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ARTHRALGIA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Acromioclavicular Joint: The gliding joint formed by the outer extremity of the clavicle and the inner margin of the acromion process of the scapula. [NIH] Acromion: The lateral extension of the spine of the scapula and the highest point of the shoulder. [NIH] Acute leukemia: A rapidly progressing cancer of the blood-forming tissue (bone marrow). [NIH]

Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [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] 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] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] 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] Allopurinol: A xanthine oxidase inhibitor that decreases uric acid production. [NIH]

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Alopecia: Absence of hair from areas where it is normally present. [NIH] Alphavirus: A genus of Togaviridae, also known as Group A arboviruses, serologically related to each other but not to other Togaviridae. The viruses are transmitted by mosquitoes. The type species is the sindbis virus. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Angioedema: A vascular reaction involving the deep dermis or subcutaneous or submucal tissues, representing localized edema caused by dilatation and increased permeability of the capillaries, and characterized by development of giant wheals. [EU] Anhydrous: Deprived or destitute of water. [EU] Ankylosis: Fixation and immobility of a joint. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH]

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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] Anus: The opening of the rectum to the outside of the body. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthralgia: Pain in the joint. [NIH] Arthrosis: A disease of a joint. [EU] Articular: Of or pertaining to a joint. [EU] 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] Asthenopia: Term generally used to describe complaints related to refractive error, ocular muscle imbalance, including pain or aching around the eyes, burning and itchiness of the eyelids, ocular fatigue, and headaches. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form

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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] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bilateral: Affecting both the right and left side of body. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] 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] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [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 Regions: Anatomical areas of the body. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] 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

Dictionary 77

functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Captopril: A potent and specific inhibitor of peptidyl-dipeptidase A. It blocks the conversion of angiotensin I to angiotensin II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the renin-angiotensin system and inhibits pressure responses to exogenous angiotensin. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [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] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] 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] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] 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] Chromosomal: Pertaining to chromosomes. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clavicle: A long bone of the shoulder girdle. [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,

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prevention, diagnosis, or treatment of a disease. [NIH] Clomipramine: A tricyclic antidepressant similar to imipramine that selectively inhibits the uptake of serotonin in the brain. It is readily absorbed from the gastrointestinal tract and demethylated in the liver to form its primary active metabolite, desmethylclomipramine. [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] Codons: Any triplet of nucleotides (coding unit) in DNA or RNA (if RNA is the carrier of primary genetic information as in some viruses) that codes for particular amino acid or signals the beginning or end of the message. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix '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,

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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] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU] 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] Contusion: A bruise; an injury of a part without a break in the skin. [EU] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corrosion: Irreversible destruction of skin tissue. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Cryoglobulinemia: A condition characterized by the presence of abnormal or abnormal quantities of cryoglobulins in the blood. They are precipitated into the microvasculature on exposure to cold and cause restricted blood flow in exposed areas. [NIH] Cutaneous: Having to do with the skin. [NIH]

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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] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] 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] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dermatosis: Any skin disease, especially one not characterized by inflammation. [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] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dislocation: The displacement of any part, more especially of a bone. Called also luxation. [EU]

Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used

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to designate a position on the dental arch farther from the median line of the jaw. [EU] Dose-limiting: Describes side effects of a drug or other treatment that are serious enough to prevent an increase in dose or level of that treatment. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [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] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [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] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Enalapril: An angiotensin-converting enzyme inhibitor that is used to treat hypertension. [NIH]

Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [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] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH]

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Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Estrogen: One of the two female sex hormones. [NIH] Evacuation: An emptying, as of the bowels. [EU] 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] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flexor: Muscles which flex a joint. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH]

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Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glycoproteins: Conjugated protein-carbohydrate compounds including mucins, mucoid, and amyloid glycoproteins. [NIH] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Haemoptysis: The expectoration of blood or of blood-stained sputum. [EU]

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Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or 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] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Helminths: Commonly known as parasitic worms, this group includes the acanthocephala, nematoda, and platyhelminths. Some authors consider certain species of leeches that can become temporarily parasitic as helminths. [NIH] Hematuria: Presence of blood in the urine. [NIH] Hemodiafiltration: The combination of hemodialysis and hemofiltration either simultaneously or sequentially. Convective transport (hemofiltration) may be better for removal of larger molecular weight substances and diffusive transport (hemodialysis) for smaller molecular weight solutes. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemofiltration: Extracorporeal ultrafiltration technique without hemodialysis for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] 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] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH]

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Hyperaemia: An excess of blood in a part; engorgement. [EU] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [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] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]

Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [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] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease.

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[EU]

Infestation: Parasitic attack or subsistence on the skin and/or its appendages, as by insects, mites, or ticks; sometimes used to denote parasitic invasion of the organs and tissues, as by helminths. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] 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] Intracellular: Inside a cell. [NIH] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [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] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH]

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Leishmaniasis: A disease caused by any of a number of species of protozoa in the genus Leishmania. There are four major clinical types of this infection: cutaneous (Old and New World), diffuse cutaneous, mucocutaneous, and visceral leishmaniasis. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Lipid: Fat. [NIH] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lupus Nephritis: Glomerulonephritis associated with systemic lupus erythematosus. It is classified into four histologic types: mesangial, focal, diffuse, and membranous. [NIH] Luxation: The displacement of the particular surface of a bone from its normal joint, without fracture. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malar: Paired facial bones that help form the lateral und lower orbita. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and

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spread to other parts of the body. [NIH] Mammary: Pertaining to the mamma, or breast. [EU] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Masticatory: 1. subserving or pertaining to mastication; affecting the muscles of mastication. 2. a remedy to be chewed but not swallowed. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [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] Menthol: An alcohol produced from mint oils or prepared synthetically. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methyldopa: An alpha-2 adrenergic agonist that has both central and peripheral nervous system effects. Its primary clinical use is as an antihypertensive agent. Before its alphaadrenergic actions became clear, methyldopa was thought to act by inhibiting decarboxylation of DOPA leading to depletion of norepinephrine or by conversion to and release as the false transmitter alpha-methylnorepinephrine. [NIH] Methylprednisolone: (6 alpha,11 beta)-11,17,21-Trihydroxy-6-methylpregna-1,4-diene-3,2dione. A prednisolone derivative which has pharmacological actions similar to prednisolone. [NIH] Mice Minute Virus: The type species of parvovirus prevalent in mouse colonies and found as a contaminant of many transplanted tumors or leukemias. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] 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] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of

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the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Myalgia: Pain in a muscle or muscles. [EU] Myeloma: Cancer that arises in plasma cells, a type of white blood cell. [NIH] Myositis: Inflammation of a voluntary muscle. [EU] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] 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] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephropathy: Disease of the kidneys. [EU] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neuroblastoma: Cancer that arises in immature nerve cells and affects mostly infants and children. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [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] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] 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

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the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Oxygenase: Enzyme which breaks down heme, the iron-containing oxygen-carrying constituent of the red blood cells. [NIH] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [NIH] Pain Threshold: Amount of stimulation required before the sensation of pain is experienced. [NIH]

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] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Particle: A tiny mass of material. [EU] Parvovirus: A genus of the family Parvoviridae, subfamily Parvovirinae, infecting a variety of vertebrates including humans. Parvoviruses are responsible for a number of important diseases but also can be non-pathogenic in certain hosts. The type species is mice minute virus. [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] Pathologies: The study of abnormality, especially the study of diseases. [NIH]

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Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Peer Group: Group composed of associates of same species, approximately the same age, and usually of similar rank or social status. [NIH] Perianal: Located around the anus. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] 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] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Medicine: A medical specialty concerned with the use of physical agents, mechanical apparatus, and manipulation in rehabilitating physically diseased or injured patients. [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]

Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Plant Oils: Oils derived from plants or plant products. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized

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by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [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] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [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] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] 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

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in the population at a given time. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] 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 C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proto-Oncogene Proteins: Products of proto-oncogenes. Normally they do not have oncogenic or transforming properties, but are involved in the regulation or differentiation of cell growth. They often have protein kinase activity. [NIH] Proto-Oncogene Proteins c-mos: Cellular proteins encoded by the c-mos genes. They function in the cell cycle to maintain maturation promoting factor in the active state and have protein-serine/threonine kinase activity. Oncogenic transformation can take place when c-mos proteins are expressed at the wrong time. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to

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macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]

Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyrazinamide: A pyrazine that is used therapeutically as an antitubercular agent. [NIH] Ramipril: A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat. [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] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and

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progressive renal glomerular tubular or interstitial disease. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme, and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rickettsiae: One of a group of obligate intracellular parasitic microorganisms, once regarded as intermediate in their properties between bacteria and viruses but now classified as bacteria in the order Rickettsiales, which includes 17 genera and 3 families: Rickettsiace. [NIH]

Rifabutin: A broad-spectrum antibiotic that is being used as prophylaxis against disseminated Mycobacterium avium complex infection in HIV-positive patients. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rubella: An acute, usually benign, infectious disease caused by a togavirus and most often affecting children and nonimmune young adults, in which the virus enters the respiratory tract via droplet nuclei and spreads to the lymphatic system. It is characterized by a slight cold, sore throat, and fever, followed by enlargement of the postauricular, suboccipital, and cervical lymph nodes, and the appearances of a fine pink rash that begins on the head and spreads to become generalized. Called also German measles, roetln, röteln, and three-day measles, and rubeola in French and Spanish. [EU] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Sedimentation: The act of causing the deposit of sediment, especially by the use of a centrifugal machine. [EU]

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Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [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] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Sickness: Immune complex disease caused by the administration of foreign serum or serum proteins and characterized by fever, lymphadenopathy, arthralgia, and urticaria. When they are complexed to protein carriers, some drugs can also cause serum sickness when they act as haptens inducing antibody responses. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sindbis Virus: The type species of alphavirus normally transmitted to birds by Culex mosquitoes in Egypt, South Africa, India, Malaya, the Philippines, and Australia. It may be associated with fever in humans. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

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Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenectomy: An operation to remove the spleen. [NIH] Sputum: The material expelled from the respiratory passages by coughing or clearing the throat. [NIH] Stabilization: The creation of a stable state. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroids: Drugs used to relieve swelling and inflammation. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH]

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Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [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] Stress urinary: Leakage of urine caused by actions--such as coughing, laughing, sneezing, running, or lifting--that place pressure on the bladder from inside the body. Stress urinary incontinence can result from either a fallen bladder or weak sphincter muscles. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Fluid: The clear, viscous fluid secreted by the synovial membrane. It contains mucin, albumin, fat, and mineral salts and serves to lubricate joints. [NIH] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Synovitis: Inflammation of a synovial membrane. It is usually painful, particularly on motion, and is characterized by a fluctuating swelling due to effusion within a synovial sac. Synovitis is qualified as fibrinous, gonorrhoeal, hyperplastic, lipomatous, metritic, puerperal, rheumatic, scarlatinal, syphilitic, tuberculous, urethral, etc. [EU] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Tendonitis: Inflammation of tendons attached to the biceps muscle, i. e. the main flexor muscle of the upper arm. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH]

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Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Ticks: Blood-sucking arachnids of the order Acarina. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] 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] 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] Traction: The act of pulling. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Transurethral: Performed through the urethra. [EU] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Tropism: Directed movements and orientations found in plants, such as the turning of the sunflower to face the sun. [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] Tubercle: A rounded elevation on a bone or other structure. [NIH]

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Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urethritis: Inflammation of the urethra. [EU] Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [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] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viraemia: The presence of virus in blood or blood plasma. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU]

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Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] 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] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [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] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Xanthine: An urinary calculus. [NIH] Xanthine Oxidase: An iron-molybdenum flavoprotein containing FAD that oxidizes hypoxanthine, some other purines and pterins, and aldehydes. Deficiency of the enzyme, an autosomal recessive trait, causes xanthinuria. EC 1.1.3.22. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

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INDEX A Abdomen, 73, 76, 87, 97, 101 Abdominal, 5, 14, 73, 78, 90 Abdominal Pain, 5, 14, 73 Acromioclavicular Joint, 14, 73 Acromion, 73 Acute leukemia, 61, 73 Adjunctive Therapy, 8, 73 Adolescence, 5, 73 Adrenal Glands, 73, 74 Adrenergic, 10, 73, 82, 88 Adverse Effect, 73, 96 Agonist, 73, 88, 98 Albumin, 73, 98 Algorithms, 6, 73, 76 Alkaline, 73, 76 Alkaloid, 73, 88 Allopurinol, 14, 16, 73 Alopecia, 74, 80 Alphavirus, 7, 74, 96 Alternative medicine, 74 Amino Acid Sequence, 74 Amyloidosis, 24, 31, 74 Analgesic, 17, 74, 88, 90 Anatomical, 74, 76, 95 Angioedema, 13, 17, 31, 74 Anhydrous, 46, 74 Ankylosis, 50, 74 Annealing, 74, 92 Antibiotic, 74, 76, 95 Antibodies, 19, 74, 84, 85, 92 Antibody, 74, 78, 84, 85, 88, 96 Antidepressant, 74, 78, 85 Antigen, 74, 78, 84, 85, 96 Antihypertensive, 74, 88 Anti-inflammatory, 6, 62, 74, 75, 83, 92 Anti-Inflammatory Agents, 62, 75 Antineoplastic, 75, 80, 90, 100 Anus, 75, 78, 86, 91 Aqueous, 75, 76, 80, 87 Arachidonic Acid, 75, 93 Arterial, 75, 77, 85, 93 Artery, 75, 76, 81, 94, 100 Arthrosis, 6, 75 Articular, 17, 26, 75, 90 Aspirin, 14, 75 Asthenopia, 47, 75 Attenuated, 75, 100

Autonomic Nervous System, 75, 91 Axons, 75, 89 B Back Pain, 5, 32, 75 Bacteria, 74, 75, 81, 82, 88, 92, 95, 99, 100 Bacterium, 47, 75 Basal Ganglia, 75 Basal Ganglia Diseases, 75 Base, 46, 75, 86, 98 Basophils, 76, 83 Benign, 14, 76, 84, 95 Bilateral, 3, 76 Biochemical, 76, 90, 96 Biological response modifier, 76, 86 Biopsy, 62, 76 Biotechnology, 7, 55, 76 Bladder, 76, 85, 89, 98, 100 Blood Coagulation, 76, 77 Blood pressure, 74, 76, 77, 85, 97 Blood vessel, 76, 83, 87, 96, 100 Body Regions, 76, 78 Bone Marrow, 32, 73, 76, 80, 83, 85, 87 Bowel, 32, 76, 86, 97 Broad-spectrum, 76, 95 Buccal, 76, 87 C Calcium, 10, 76, 78 Calculi, 77, 83 Captopril, 11, 16, 77 Carcinoma, 13, 22, 77 Cardiac, 77, 82, 84 Carotene, 39, 41, 77 Case report, 4, 12, 77 Catecholamine, 77, 91 Cell, 73, 75, 76, 77, 78, 80, 82, 83, 85, 86, 88, 89, 92, 93, 99, 101 Central Nervous System, 4, 47, 75, 77, 83, 84, 88, 96 Central Nervous System Infections, 77, 84 Cervical, 77, 95 Chemotherapeutic agent, 5, 77 Chemotherapy, 5, 77 Cholesterol, 32, 77, 98 Chromatin, 77, 81, 87 Chromosomal, 77, 92 Chronic, 3, 9, 12, 16, 17, 22, 23, 32, 61, 75, 77, 85, 94, 98 Clamp, 5, 77

104

Arthralgia

Clavicle, 73, 77 Clinical trial, 4, 26, 55, 77, 80, 94 Clomipramine, 8, 78 Cloning, 76, 78 Codons, 7, 78 Colic, 21, 78 Colitis, 34, 78, 86 Collagen, 13, 21, 78, 93 Colon, 78, 86 Complement, 78, 79 Complementary and alternative medicine, 29, 42, 78 Complementary medicine, 29, 79 Computational Biology, 55, 79 Conjunctiva, 79, 99 Conjunctivitis, 62, 79 Connective Tissue, 61, 76, 78, 79, 80, 82, 83, 87, 95, 98 Connective Tissue Cells, 79 Consciousness, 74, 79 Constipation, 29, 47, 79 Contracture, 50, 79 Contraindications, ii, 79 Contusion, 50, 79 Cornea, 79, 83 Corrosion, 47, 79 Cortisone, 79, 92 Cranial, 79, 84, 89, 91, 99 Craniocerebral Trauma, 75, 79, 84 Cryoglobulinemia, 11, 21, 79 Cutaneous, 21, 79, 87 Cyclic, 80, 93 Cyclophosphamide, 21, 80 Cyclosporine, 13, 23, 80 Cytokine, 6, 80 Cytomegalovirus, 14, 80 Cytoplasm, 76, 80, 81, 87 Cytoskeleton, 80, 88 D Data Collection, 6, 80 Decarboxylation, 80, 88 Degenerative, 80, 89, 90 Denaturation, 80, 92 Dendrites, 80, 89 Dermatosis, 18, 80 Dermis, 74, 80 Diagnostic procedure, 45, 80 Dialyzer, 80, 84 Diarrhea, 24, 80 Direct, iii, 80, 94, 98 Dislocation, 50, 80 Distal, 80, 91

Dose-limiting, 5, 14, 81 Dyskinesia, 81 E Edema, 74, 81 Efficacy, 81, 99 Effusion, 81, 98 Elastin, 78, 81 Electrolyte, 81, 84, 92, 97 Electromyography, 62, 81 Electrons, 76, 81, 86 Embolus, 81, 85 Emollient, 81, 90 Enalapril, 19, 81 Encephalitis, 7, 81 Encephalitis, Viral, 81 Encephalopathy, 47, 81 Enkephalin, 26, 30, 81 Environmental Health, 54, 56, 81 Enzymatic, 77, 78, 81, 92 Enzyme, 81, 83, 88, 90, 92, 94, 95, 101 Eosinophils, 81, 83 Epidermis, 80, 82, 94 Epinephrine, 73, 82, 89 Erythema, 32, 82, 100 Estrogen, 82, 96, 98 Evacuation, 79, 82 Excitability, 5, 82 Exogenous, 77, 82 Extensor, 82, 94 Extracellular, 79, 82, 97 Extracellular Matrix, 79, 82 Extremity, 73, 82 F Facial, 15, 82, 87 Family Planning, 55, 82 Fat, 75, 76, 77, 81, 82, 87, 98 Fatigue, 3, 12, 32, 47, 75, 82 Fatty acids, 73, 82, 93 Feces, 79, 82, 97 Femoral, 20, 61, 82 Femur, 82 Fibrosis, 79, 82, 95 Flexor, 82, 98 G Gallbladder, 73, 82 Ganglia, 75, 83, 89, 91 Gastrointestinal, 4, 23, 78, 82, 83, 96 Gastrointestinal tract, 78, 83, 96 Gene, 6, 7, 76, 83 Gene Expression, 83 Gene Therapy, 6, 83 Genetic testing, 83, 92

105

Genotype, 83, 91 Glomerular, 83, 95 Glomeruli, 83 Glomerulonephritis, 21, 83, 87 Glomerulus, 83, 89 Glucocorticoid, 83, 92 Glycoproteins, 83, 86 Glycosaminoglycan, 47, 83 Gout, 8, 83 Governing Board, 83, 92 Granulocyte, 30, 83 H Haemoptysis, 13, 83 Haptens, 84, 96 Headache, 5, 50, 84 Headache Disorders, 84 Helminths, 84, 86 Hematuria, 15, 84 Hemodiafiltration, 15, 84 Hemodialysis, 15, 80, 84 Hemofiltration, 84 Hemoglobinopathies, 83, 84 Hemorrhage, 79, 84, 94 Heredity, 83, 84 Homologous, 83, 84 Hormonal, 5, 84 Hormone, 79, 82, 84, 95 Hydrogen, 76, 80, 84, 88 Hydroxylysine, 78, 84 Hydroxyproline, 78, 84 Hyperaemia, 79, 85 Hyperalgesia, 5, 85 Hypersensitivity, 13, 21, 85, 95 Hypertension, 81, 84, 85 Hyperuricemia, 83, 85 Hypothalamus, 75, 81, 85 I Imipramine, 78, 85 Immune response, 74, 79, 84, 85, 101 Immune Sera, 85 Immune system, 85, 101 Immunization, 10, 85 Immunodeficiency, 61, 85 Immunologic, 85 Immunosuppressive, 80, 83, 85 In vitro, 5, 6, 7, 83, 85, 92, 96 In vivo, 5, 6, 7, 83, 85 Incontinence, 13, 21, 85, 98 Infarction, 12, 85 Infection, 4, 7, 9, 11, 12, 14, 19, 20, 47, 61, 76, 80, 81, 83, 85, 87, 89, 95, 98, 100, 101 Infestation, 11, 86

Infiltration, 83, 86 Inflammation, 61, 62, 73, 74, 75, 78, 79, 80, 81, 82, 86, 89, 92, 95, 97, 98, 100 Inflammatory bowel disease, 9, 86 Infusion, 24, 30, 86 Inorganic, 86, 89 Interferon, 13, 86 Interferon-alpha, 86 Intermittent, 8, 86 Interstitial, 86, 89, 95 Intestinal, 17, 23, 77, 86 Intestines, 73, 82, 83, 86 Intracellular, 5, 85, 86, 92, 93, 95 Intravenous, 17, 18, 86 Invasive, 86, 87 Involuntary, 75, 86, 97 Ion Channels, 5, 86 Ions, 76, 81, 84, 86 K Kb, 54, 86 Kidney stone, 86, 100 L Leishmaniasis, 22, 87 Leukemia, 32, 61, 83, 87 Lipid, 6, 87 Liposome, 6, 87 Liver, 73, 74, 75, 78, 80, 82, 87, 92, 94, 95 Localized, 74, 85, 87, 92, 100 Lumbar, 75, 87 Lupus, 30, 32, 33, 60, 61, 87, 98 Lupus Nephritis, 30, 87 Luxation, 80, 87 Lymph, 77, 87, 95, 96 Lymph node, 77, 87, 95 Lymphadenopathy, 87, 96 Lymphatic, 85, 87, 95, 97, 99 Lymphatic system, 87, 95, 97, 99 Lymphocytes, 6, 74, 85, 87, 97, 99, 101 Lymphoid, 74, 87 Lymphoma, 10, 87 M Magnetic Resonance Imaging, 16, 87 Malaise, 12, 87 Malar, 3, 87 Malignant, 10, 75, 87 Mammary, 88, 98 Mastication, 88, 99 Masticatory, 50, 88 MEDLINE, 55, 88 Membrane, 78, 79, 80, 82, 86, 88, 89, 98 Meninges, 77, 79, 88 Mental, iv, 4, 54, 56, 82, 88, 94, 100

106

Arthralgia

Menthol, 46, 88 Metabolic disorder, 83, 88 Metabolite, 78, 88, 93, 94 Metastasis, 88 Metastatic, 13, 88 Methyldopa, 10, 88 Methylprednisolone, 17, 18, 24, 30, 88 Mice Minute Virus, 88, 90 Microbe, 88, 99 Microtubules, 5, 88, 90 Mobility, 48, 88 Molecular, 7, 55, 57, 76, 79, 84, 88, 99, 100 Molecule, 74, 76, 78, 83, 84, 88, 92, 100 Monoclonal, 22, 88 Morphine, 17, 88, 89, 90 Movement Disorders, 88 Mucocutaneous, 87, 89 Mucosa, 87, 89 Mucus, 23, 89 Myalgia, 5, 6, 9, 14, 15, 16, 19, 24, 30, 47, 50, 61, 89 Myeloma, 20, 89 Myositis, 50, 61, 89 N Narcotic, 88, 89 Necrosis, 85, 89 Nephritis, 47, 89 Nephropathy, 24, 89 Nerve Fibers, 5, 89 Nervous System, 75, 77, 89, 91 Neuralgia, 47, 89 Neuroblastoma, 61, 89 Neurogenic, 89, 100 Neurons, 5, 80, 83, 89, 98 Neuropathy, 5, 19, 20, 47, 89, 91 Neurotransmitter, 86, 89 Nitrogen, 73, 80, 89, 99 Norepinephrine, 73, 88, 89 Nuclei, 81, 83, 87, 90, 95 Nucleus, 75, 76, 77, 80, 81, 87, 90, 98 O Ocular, 75, 90 Ointments, 46, 90 Opiate, 81, 88, 90 Opium, 88, 90 Orofacial, 5, 50, 90 Osteoarthritis, 3, 17, 26, 33, 47, 50, 60, 90 Oxygenase, 9, 90 P Paclitaxel, 5, 29, 30, 31, 41, 90 Pain Threshold, 21, 90 Pancreas, 73, 90

Parasitic, 84, 86, 90, 95 Paresthesias, 5, 90 Particle, 87, 90, 99 Parvovirus, 11, 12, 17, 20, 88, 90 Patch, 5, 90 Pathologic, 76, 85, 90, 94 Pathologies, 7, 90 Pathophysiology, 5, 91 Patient Care Team, 61, 91 Patient Education, 60, 66, 68, 72, 91 Peer Group, 6, 91 Perianal, 23, 91 Pericardium, 91, 98 Peripheral blood, 6, 86, 91 Peripheral Nervous System, 47, 88, 89, 91 Peripheral Neuropathy, 5, 47, 91 Pharmaceutical Preparations, 47, 91 Pharmacologic, 91, 99, 100 Pharmacotherapy, 50, 91 Phenotype, 7, 91 Phosphorus, 76, 91 Physical Examination, 61, 62, 91 Physical Medicine, 50, 91 Physiologic, 73, 91, 93 Pigments, 77, 91 Plant Oils, 90, 91 Plants, 73, 90, 91, 99 Plasma, 73, 74, 89, 92, 95, 100 Plasma cells, 74, 89, 92 Plasmid, 6, 92, 100 Pneumonia, 79, 92 Polymerase, 4, 17, 92 Polymerase Chain Reaction, 4, 17, 92 Polypeptide, 74, 78, 92 Polysaccharide, 74, 83, 92 Posterior, 75, 90, 92 Potassium, 30, 92 Practicability, 92, 99 Practice Guidelines, 56, 92 Prednisolone, 88, 92 Prednisone, 31, 92 Prevalence, 5, 92 Prodrug, 93, 94 Progressive, 21, 89, 90, 93, 94 Proline, 78, 84, 93 Prophylaxis, 93, 95 Prostaglandin, 26, 93 Prostaglandins A, 93 Protein C, 73, 74, 93, 96 Protein S, 76, 93 Proteins, 74, 77, 78, 88, 89, 92, 93, 96, 99, 100

107

Proto-Oncogene Proteins, 90, 93 Proto-Oncogene Proteins c-mos, 90, 93 Protozoa, 87, 93, 100 Psoriasis, 33, 61, 94 Psychogenic, 94, 100 Puberty, 5, 94 Public Policy, 55, 94 Pulmonary, 9, 15, 76, 84, 94, 100 Pulse, 30, 94 Purpura, 11, 21, 94 Pustular, 8, 94 Pyrazinamide, 14, 21, 22, 94 R Ramipril, 19, 94 Randomized, 24, 81, 94 Recombination, 83, 94 Rectum, 75, 78, 85, 86, 94 Recurrence, 6, 94 Red blood cells, 90, 94 Refer, 1, 50, 76, 78, 94 Refractory, 17, 94 Regimen, 81, 91, 94 Reliability, 6, 94 Remission, 94 Renal failure, 9, 94 Renin, 77, 95 Renin-Angiotensin System, 77, 95 Resection, 23, 95 Retroviral vector, 83, 95 Rheumatic Diseases, 8, 12, 15, 22, 26, 30, 50, 95 Rheumatoid, 3, 21, 23, 26, 33, 60, 61, 95 Rheumatoid arthritis, 3, 23, 26, 61, 95 Rickettsiae, 95, 100 Rifabutin, 14, 95 Risk factor, 5, 95 Rod, 75, 77, 95 Rubella, 7, 10, 16, 33, 95 S Salivary, 80, 95 Salivary glands, 80, 95 Sclerosis, 3, 95 Screening, 7, 77, 95 Secretion, 89, 95 Sediment, 95 Sedimentation, 12, 22, 95, 100 Selective estrogen receptor modulator, 96, 98 Self Care, 61, 96 Sensibility, 85, 96 Septic, 61, 96 Sequencing, 92, 96

Serology, 62, 96 Serotonin, 78, 89, 91, 96, 99 Serum, 22, 33, 61, 73, 78, 85, 96 Serum Sickness, 33, 61, 96 Sex Characteristics, 73, 94, 96 Shock, 96, 99 Side effect, 10, 73, 80, 81, 85, 96, 99 Signs and Symptoms, 6, 94, 96 Sindbis Virus, 74, 96 Skeletal, 77, 96, 97 Skeleton, 82, 93, 96 Skull, 79, 96, 98 Smooth muscle, 79, 88, 95, 96, 97 Sneezing, 97, 98 Sodium, 83, 97 Soma, 97 Somatic, 6, 73, 91, 97 Spasm, 50, 97 Specialist, 63, 97 Species, 74, 82, 84, 87, 88, 90, 91, 96, 97, 99, 100, 101 Sphincter, 97, 98 Spinal cord, 77, 88, 89, 91, 97 Spinal Nerves, 91, 97 Spleen, 74, 80, 87, 97 Splenectomy, 21, 97 Sputum, 83, 97 Stabilization, 47, 97 Steel, 77, 97 Sterility, 80, 97 Steroids, 18, 83, 97 Stimulus, 86, 90, 97, 98 Stomach, 73, 83, 84, 86, 97 Stool, 78, 85, 97 Strand, 92, 98 Stress, 13, 21, 47, 75, 77, 95, 98, 100 Stress urinary, 13, 21, 98 Subacute, 85, 98 Subarachnoid, 84, 98 Subclinical, 19, 85, 98 Subcutaneous, 74, 81, 98 Synapse, 73, 98, 99 Synovial, 26, 98 Synovial Fluid, 26, 98 Synovial Membrane, 98 Synovitis, 26, 50, 98 Systemic, 3, 4, 13, 21, 33, 61, 74, 76, 82, 85, 87, 92, 98, 99 Systemic lupus erythematosus, 3, 61, 87, 98 T Tamoxifen, 23, 96, 98

108

Arthralgia

Temporal, 5, 84, 98 Tendonitis, 61, 98 Thermal, 92, 98 Thigh, 82, 98 Thoracic, 75, 98 Threshold, 82, 85, 98 Thymus, 85, 87, 99 Ticks, 86, 99 Tissue, 7, 73, 74, 76, 79, 81, 82, 85, 86, 87, 88, 89, 95, 96, 97, 98, 99 Topical, 46, 99 Torsion, 85, 99 Toxic, iv, 6, 89, 99 Toxicity, 6, 14, 99 Toxicology, 56, 99 Toxins, 74, 81, 85, 99 Traction, 77, 99 Transduction, 5, 99 Transfection, 76, 83, 99 Transfer Factor, 85, 99 Transmitter, 86, 88, 89, 99 Transplantation, 85, 99 Transurethral, 13, 21, 99 Trauma, 61, 89, 99 Treatment Outcome, 43, 99 Tricyclic, 78, 85, 99 Trigeminal, 15, 99 Tropism, 7, 99 Tryptophan, 78, 96, 99 Tubercle, 9, 14, 15, 21, 22, 99 Tuberculosis, 87, 100 Tubulin, 88, 100 U Uremia, 94, 100

Urethra, 99, 100 Urethritis, 62, 100 Uric, 22, 73, 83, 85, 100 Urinary, 10, 77, 85, 98, 100, 101 Urinary Retention, 10, 100 Urinate, 100 Urine, 76, 84, 85, 86, 98, 100 Urticaria, 12, 17, 22, 24, 96, 100 V Vaccines, 16, 100, 101 Vascular, 74, 80, 84, 85, 100 Vasculitis, 60, 100 Vector, 99, 100 Vein, 86, 100 Ventricle, 85, 94, 100 Veterinary Medicine, 55, 100 Vinca Alkaloids, 100 Vincristine, 5, 100 Viraemia, 17, 100 Viral, 7, 10, 61, 81, 99, 100 Virulence, 7, 75, 99, 101 Virus, 7, 19, 47, 61, 77, 86, 95, 99, 100, 101 Viscera, 97, 101 Visceral, 75, 87, 101 Vitro, 101 Vivo, 101 W White blood cell, 74, 83, 87, 89, 92, 101 X Xanthine, 73, 101 Xanthine Oxidase, 73, 101 Y Yeasts, 91, 101

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