BOTULISM A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES
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 ©2003 by ICON Group International, Inc. Copyright ©2003 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., 1960Botulism: 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: 0-597-83771-6 1. Botulism-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.
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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 botulism. 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 BOTULISM .................................................................................................. 3 Overview........................................................................................................................................ 3 Federally Funded Research on Botulism ........................................................................................ 3 E-Journals: PubMed Central ....................................................................................................... 16 The National Library of Medicine: PubMed ................................................................................ 17 CHAPTER 2. NUTRITION AND BOTULISM ........................................................................................ 61 Overview...................................................................................................................................... 61 Finding Nutrition Studies on Botulism....................................................................................... 61 Federal Resources on Nutrition ................................................................................................... 63 Additional Web Resources ........................................................................................................... 64 CHAPTER 3. ALTERNATIVE MEDICINE AND BOTULISM.................................................................. 65 Overview...................................................................................................................................... 65 National Center for Complementary and Alternative Medicine.................................................. 65 Additional Web Resources ........................................................................................................... 67 General References ....................................................................................................................... 68 CHAPTER 4. DISSERTATIONS ON BOTULISM.................................................................................... 69 Overview...................................................................................................................................... 69 Dissertations on Botulism............................................................................................................ 69 Keeping Current .......................................................................................................................... 69 CHAPTER 5. CLINICAL TRIALS AND BOTULISM .............................................................................. 71 Overview...................................................................................................................................... 71 Recent Trials on Botulism............................................................................................................ 71 Keeping Current on Clinical Trials ............................................................................................. 71 CHAPTER 6. PATENTS ON BOTULISM .............................................................................................. 73 Overview...................................................................................................................................... 73 Patents on Botulism..................................................................................................................... 73 Patent Applications on Botulism ................................................................................................. 75 Keeping Current .......................................................................................................................... 77 CHAPTER 7. BOOKS ON BOTULISM .................................................................................................. 79 Overview...................................................................................................................................... 79 Book Summaries: Online Booksellers........................................................................................... 79 The National Library of Medicine Book Index ............................................................................. 80 Chapters on Botulism................................................................................................................... 81 CHAPTER 8. MULTIMEDIA ON BOTULISM ....................................................................................... 85 Overview...................................................................................................................................... 85 Video Recordings ......................................................................................................................... 85 Bibliography: Multimedia on Botulism ....................................................................................... 86 CHAPTER 9. PERIODICALS AND NEWS ON BOTULISM .................................................................... 87 Overview...................................................................................................................................... 87 News Services and Press Releases................................................................................................ 87 Academic Periodicals covering Botulism ..................................................................................... 90 CHAPTER 10. RESEARCHING MEDICATIONS ................................................................................... 91 Overview...................................................................................................................................... 91 U.S. Pharmacopeia....................................................................................................................... 91 Commercial Databases ................................................................................................................. 95 Researching Orphan Drugs ......................................................................................................... 96 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 101 Overview.................................................................................................................................... 101 NIH Guidelines.......................................................................................................................... 101 NIH Databases........................................................................................................................... 103
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Other Commercial Databases..................................................................................................... 105 APPENDIX B. PATIENT RESOURCES ............................................................................................... 107 Overview.................................................................................................................................... 107 Patient Guideline Sources.......................................................................................................... 107 Finding Associations.................................................................................................................. 111 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 113 Overview.................................................................................................................................... 113 Preparation................................................................................................................................. 113 Finding a Local Medical Library................................................................................................ 113 Medical Libraries in the U.S. and Canada ................................................................................. 113 ONLINE GLOSSARIES................................................................................................................ 119 Online Dictionary Directories ................................................................................................... 121 BOTULISM DICTIONARY ......................................................................................................... 123 INDEX .............................................................................................................................................. 157
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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 botulism 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 botulism, 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 botulism, 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 botulism. 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 botulism, 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 botulism. The Editors
1 From
the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON BOTULISM Overview In this chapter, we will show you how to locate peer-reviewed references and studies on botulism.
Federally Funded Research on Botulism The U.S. Government supports a variety of research studies relating to botulism. 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 botulism. 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 botulism. The following is typical of the type of information found when searching the CRISP database for botulism: •
Project Title: ALPHA2-MACROGLOBULIN-PA COMPLEXES: NOVEL ANTHRAX VACCIN* Principal Investigator & Institution: Pizzo, Salvatore V.; Professor and Chairman; Pathology; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2004
2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
4
Botulism
Summary: (provided by applicant): An urgent need exists for the identification and development of novel approaches for delivering protective antigens as more effective vaccines against a variety of agents which might be used as biological weapons, including anthrax, botulism and plague. The long-term objective of the proposed application is to develop a new generation of vaccines against biological agents based on a totally natural, non-reactogenic adjuvant, alpha2-Macroglobulin (alpha2M). Alpha2M has been shown to greatly enhance immunogenicity of a number of antigens. The development of alpha2M adjuvanted vaccines will significantly impact healthcare in both the U.S. and the world, as it will allow a new generation of vaccines, both prophylactic and therapeutic, based on protein subunits, which can be produced inexpensively and are intrinsically safer to use. PA, recognized as the major protective antigen in the current anthrax vaccine (AVA, Anthrax Vaccine Absorbed), will be used as a prototypical subunit candidate for the proposed studies. The specific aims of the proposed studies are to (1) identify the optimal size of Bacillus anthracis PA and the optimal conditions for its covalent incorporation into rabbit alpha2M; (2) determine the ability of various complexes of PA covalently coupled with a2M to generate neutralizing antibodies to anthrax toxin; and (3) determine if the immunogenicity of PA complexed with alpha2M can be enhanced by combination with existing adjuvants. Specifically, full-Iength PA (83 kDa, rPA83) will be expressed in E. coli and purified to homogeneity. Proteolysis of rPA83 will be used to generate "nicked PA" (63 kDa, rPA63), or a carboxyterminal fragment containing the receptor-binding domain (47 kDa, rPA47). a2M will be purified to homogeneity from rabbit plasma. Studies will determine the efficiency of incorporation of rPA of varying size into rabbit a2M under various conditions. Complexes of rabbit a2M and rPA (alpha2M-rPA) will be then be used to immunize rabbits and will be compared for immunogenicity against rPA alone absorbed onto alum. Sera from immunized rabbits will be evaluated for anti-rPA titers (based on ELISA), immunoglobulin isotypes, and ability to block anthrax toxin mediated macrophage cytotoxicity (neutralizing activity). Alpha2M-rPA complexes, which generate neutralizing titers, will be further evaluated in combination with other adjuvants. These studies will provide a new anthrax vaccine candidate with both improved immunogenicity and decreased reactogenicity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIOCOMBINATORIAL STRATEGIES AGAINST BOTULINUM TOXIN Principal Investigator & Institution: Janda, Kim D.; Ely R. Callaway Professor of Chemistry; Scripps Research Institute 10550 N Torrey Pines Rd La Jolla, Ca 920371000 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant): The current warfare and terrorist activities around the world, in particular directed against the American people and infrastructure, necessitates a vastly enhanced defense against potential weapons of mass destruction. Among the most lethal and readily deployed means that must be considered are the various toxins of biological origin. In this regard, an often cited scenario is the use of botulinum toxin (BoTox), the causative agent of the clinical condition of botulism, which can have a high fatality rate by either oral consumption or inhalation. New and improved methods of rapidly and conveniently detecting small amounts of BoTox in its various forms are needed, as well as therapeutics for protection against its deadly effects. We propose "biocombinatorial strategies" developed in our laboratory, which refer to human antibodies and cyclic peptides derived from novel phage-display libraries using various selection techniques, against the threat of BoTox. Each of these
Studies
5
biotechnological reagents could serve for diagnostic and medicinal purposes, in other words, for detection and/or protection. Specifically, we will use our proprietary antibody and peptide libraries for (1) selection of antibodies and cyclic peptides against BoTox by routine panning, (2) selection of antibodies and cyclic peptides against BoTox by BIAcore panning, (3) characterization of selected antibodies and cyclic peptides by ELISA, (4) characterization of selected antibodies and cyclic peptides using BIAcore, (5) detection of trace amounts of BoTox using antibodies/peptides and BIAcore, and (6) evaluation of selected antibodies and cyclic peptides using the PC12 cell line. The research described provides a foundation for highly sensitive detection and monitoring of BoTox in progenitor and toxic forms and for passive immunotherapy against the active toxin. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BOTULINUM TOXIN PLANTIBODIES Principal Investigator & Institution: Wycoff, Keith L.; Research Director; Planet Biotechnology, Inc. 25571 Clawiter Rd Hayward, Ca 94545 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 30-NOV-2003 Summary: (provided by applicant): Our overall goal in this project is to make available inexpensive neutralizing antibodies against Botulinum neurotoxin in large quantity. We will combine our experience in producing functional antibodies in transgenic plants with three neutralizing antibodies isolated by our collaborator, Dr. James D. Marks of the UC San Francisco School of Medicine. Botulinum toxins (BoNT) are extremely potent neurotoxins produced by the anaerobic bacterium Clostridium botulinum. BoNT is a major biological threat agent that may be used by bioterrorists to threaten troops in the battlefield or civilians here at home. A polyvalent vaccine has been developed, but protective immunity takes months to develop and may be directed against only one or two of the seven distinct serotypes. Polyvalent equine or human immune globulin protect experimental animals and appear to protect humans against BoNT intoxication. However, equine immune globulin has a high incidence of side effects, including serum sickness and anaphylaxis, and human immune globulin is not available in large quantities. Dr. James Marks has generated murine and human single chain Fv (scFv) phage antibody libraries from individuals immunized against BoNT, and has identified three groups of scFv that bound non-overlapping epitopes on BoNT/A and neutralized toxin in vitro and in vivo. At present, plants offer the best system for the large scale, inexpensive production of these antibodies. Codon-optimized genes encoding the three best antibodies will be cloned into vectors designed for the expression of human IgG1 in transgenic plants. Plants will be transformed with these constructs, regenerated and screened for expression of antibody. Plants expressing high levels of the antibodies will be identified and used to purify enough to test for neutralization activity against BoNT. We estimate that plants will facilitate the production of metric ton quantities of antibodies at 1-5% of the cost of steel tank bioreactors. Plantibody technology will greatly reduce the costs to stockpile antibodies for protection of the population from this serious threat. These antibodies will also be available to treat the approximately 100 yearly cases of naturally occurring botulism in the USA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: CORE--CLOSTRIDIUM BOTULINUM AND NEUROTOXIN FACILITY Principal Investigator & Institution: Johnson, Eric A.; University of Chicago 5801 S Ellis Ave Chicago, Il 60637
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Botulism
Timing: Fiscal Year 2003; Project Start 04-SEP-2003; Project End 29-FEB-2008 Summary: The neurotoxins of Clostridium botulinum (BoNTs) are the most toxic proteins to humans and are Category A agents. BoNTs (approximately 150,000 kDa) are zinc-dependent proteases that comprise a group of seven proteins designated as serotypes A through G. BoNT(A-G) share similar AB structure-function properties, but possess limited primary amino acid homology. BoNTs elicit flaccid paralysis through the cleavage of SNARE proteins that are part of the trafficking and docking components of fusion vesicles. The B component of BoNT binds to receptors located on neuronal cells, yielding the trophism of this intoxication. While the paralysis elicited by the A-G serotypes of BoNT is clinically similar, each serotype of BoNT cleaves individual SNARE proteins at specific amino acids. NIAID has identified the development of therapeutics and vaccines against BoNT as high priority for bio-defense products. This core facility will support the research efforts of two research proposals within Region 5: "Vaccines and therapeutics against botulism" and "Nanofluidic Transduction of Stochastic Biomolecular Recognition of BoNT". While investigators involved in these proposals have expertise in specific aspects of bacterial pathogenesis, Dr. Johnson provides expertise in BoNT biology and genetics. The core facility will: Maintain strains of Clostridium botulinum and nontoxigenic derivatives of C. botulinum for genetic studies; Produce and purify BoNTs; Provide expertise on stabilization of BoNTs to retain high specific toxicity; Provide BoNTs and genetic materials from C. botulinum and nontoxigenic derivatives of C. botulinum to members of the RCE; Conduct genetic conjugation/transformation and recombinant DNA manipulations on C. botulinum; Produce and purify mutated forms of BoNT in C. botulinum; Conduct animal studies, including mouse LD50s, mouse challenges, and neutralization analyses; and maintain biosafety environment for research with C. botulinum and BoNTs. Developing this core will provide the platform for current research efforts of the RCE and facilitate future projects related to BoNT research within Region 5. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEVELOPMENT IMMUNOTHERAPY
OF
BOTULINUM
NEUROTOXIN
Principal Investigator & Institution: Marks, James D.; Professor; Anesthesia and Perioperative Care; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Botulinum neurotoxins (BoNTs) are classified as one of the six highest-risk threat agents for bioterrorism (the 'Category A agents'). BoNTs have been produced and weaponized by rogue nations and deployed by terrorist groups. The overall aim of this application is to generate neutralizing human compatible monoclonal antibodies (mAbs) to the BoNTs for prevention and treatment of botulism resulting from intentional exposure to toxin. Achievement of this goal requires three components: 1) determination of the extent of BoNT gene diversity of the seven toxin serotypes (A-G); 2) generation of panels of broadly neutralizing human compatible mAbs to the seven BoNT serotypes; and 3) in vitro and in vivo characterization of mAbs with respect to serotype cross reactivity and neutralization. These goals will be achieved by an inter-institutional team of botulism experts who have worked in this field for more than ten years: Eric Johnson, BoNT genetics and toxin production; James D. Marks, antibody engineering; and Leonard Smith, BoNT vaccine development and animal models of toxin neutralization. They will be assisted by one of the pioneers of microbial genetic characterization, Paul J. Jackson. The extent of toxin genetic diversity will be
Studies
7
determined by establishment of a large repository of geographically disperse Clostridial strains that produce BoNTs. Strains will be characterized by pulsed field gel electrophoresis and amplified fragment length polymorphism (AFLP). These results will guide sequencing of selected BoNT genes to determine the extent of toxin diversity within and between serotypes. Based on these results, BoNT's and recombinant BoNT fragments will be expressed and purified and used as immunogens for mAb generation. Phage antibody libraries will be constructed from the V-genes of immunized mice, humans, and mice transgenic for the human irnmunoglobulin locus. High affinity, potently neutralizing human compatible (human or humanized) antibodies to each of the BoNT serotypes will be selected from these libraries. Where necessary, murine antibodies will be humanized and mAb affinity increased by molecular evolution to achieve potent toxin neutralization. It is anticipated that at the end of the five year project period, a panel of mAbs will have been generated which in the relevant animal models broadly neutralize each of the seven BoNT serotypes. All antibodies will be human compatible (either humanized or fully human in sequence) and will be ready for transfer to a manufacturing facility for cGMP production, toxicology studies, and human testing. It is also anticipated that the project will define the range of BoNT diversity and determine how this diversity affects immunogenicity and antibody recognition. Such information will be invaluable for vaccine development as well as diagnostic testing and microbial forensics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DYNAMIC NEUROTOXINS
DRUG
DESIGN
TARGETING
BOTULINUM
Principal Investigator & Institution: Briggs, James M.; Assistant Professor; Biology and Biochemistry; University of Houston 4800 Calhoun Rd Houston, Tx 77004 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Botulinum neurotoxins (BoNTs) are a dangerous bioterrorism threat due to their extreme potency and lethality, as well as their ease of production and transport. If untreated, poisoning by the BoNTs can progress to flaccid paralysis and death due to respiratory failure. However, timely post-exposure intervention can limit the effects of the circulating toxin. Our overall, long-term research objective is to generate a novel class of therapeutics that can be administered to individuals who have been poisoned by BoNT. Each BoNT is composed of a catalytic light chain whose entry into neurons is mediated by the heavy chain. Our strategy is based on the model that botulism-related flaccid paralysis is a downstream consequence of the zinc-dependent endopeptidase activity elaborated by the BoNT light chain. One of the most powerful approaches to inactivate the endopeptidase function of the BoNT light chains is rational design of inhibitors targeting the active site. To achieve this, we wilt combine computational and experimental approaches to develop lead inhibitor templates. In Specific Aim 1, we will use a powerful computational approach called dynamic pharmacophore modeling to identify computational leads to block the endopeptidase activities of the BoNTs. In this approach, the conformational flexibility of the protein and active site are taken into account through molecular dynamics simulations and the generation of a consensus, or dynamic, pharmacophore model using an ensemble of molecular dynamics-generated protein conformations. The dynamic pharmacophore model is then used to search databases of commercially available small molecules to generate computational lead compounds. In Specific Aim 2, we will test each computational lead for inhibitory activity using enzyme assays and in vitro cellular assays. A milestone of this work will be the identification of one or more
8
Botulism
lead inhibitor templates that block the action of wild type toxin using in vitro model systems. The results from this research will establish the groundwork and justification for future development and in vivo testing of these novel inhibitors using established animal models. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FORESPORE ENGULFMENT DURING B. SUBTILIS SPORULATION Principal Investigator & Institution: Pogliano, Kit J.; Biology; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2003; Project Start 01-JAN-1998; Project End 31-DEC-2006 Summary: (provided by applicant): Bacteria from the genera Bacillus and Clostridium produce unusually durable and long-lived spores that are the infectious agent of Anthrax and Botulism, and which are assembled in the cytoplasm of another cell. This unique cell within a cell structure is produced by the phagocytosis-like process of engulfment, during which the membrane of the larger mother cell migrates around the smaller forespore, until it is completely enclosed within the mother cell cytoplasm. Engulfment provides a dramatic example of the dynamic capabilities of the bacterial cell, but its mechanism remains unclear. Previously, the only engulfment mutants blocked septal thinning, during which peptidoglycan within the septum is thinned in preparation for membrane migration. We have developed new tools for the study of engulfment, and identified mutants defective in membrane migration, and in the final step of engulfment, membrane fusion. The membrane fusion defective mutants affect a protein that is both highly conserved and essential in many species. This protein localizes to site of division and is involved in the final stages of chromosome segregation, suggesting that it may also be involved in membrane fusion at the completion of cell division, a process about which little is known. Sporulation-specific enzymes are required to hydrolyze peptidoglycan during septal thinning, and we will test if vegetative autolysins can partially substitute for the sporulation specific enzymes. Autolysins are found in all bacteria (the Bacillus subtilis genome is predicted encode more than 30such enzymes), and are thought to allow peptidoglycan remodeling for cell elongation and division. However, these enzymes are potentially lethal, since unless they are tightly regulated both spatially and temporally, their activity can result in cell lysis. Indeed, the lethality of many commercial antibiotics requires autolysins. Engulfment provides an ideal system for understanding how bacteria control these potentially lethal enzymes, which are attractive targets for novel antibiotics. We will take a combined cell biological, genetic and biochemical approach to study the spatial regulation of peptidoglycan hydrolysis, the mechanism of membrane fusion in bacterial cells, as well as to understand how bacteria move and localize macromolecules within their cells Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: LIVE ATTENUATED SALMONELLA VACCINE FOR BOTULISM Principal Investigator & Institution: Galen, James E.; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2008 Summary: Botulinum neurotoxin (BoNT) is the most toxic substance known to science. Recent advances in molecularly engineered vaccines have shown that multiple doses of recombinant C-terminal domains (Hc) of BoNT confer protection in animals challenged with 10(6) LD50. The goal of this Project is to develop a more efficient vaccination
Studies
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schedule: live vector-based multivalent botulinum vaccines will be developed to prime vaccinees such that they will mount responses that are faster, higher and stronger than without such priming. We will develop 2 "generations" of S. Typhi-based live vector vaccines. The first generation (Category 1) consists of live vectors expressing individual Hc domains from 4 serotypes; the second generation (Category 2), will yield single live vector strains expressing up to 4 different Hc serotypes. It is our intention to coadminister the final mutivalent product with a cholera-based vaccine (Project 4) against the remaining 3 serotypes. Products 1 - 4: The attenuated S. Typhi vaccine CVD 908htrA will be used as a live vector to individually express BoNT/A-Hc, BoNT/B-Hc BoNT/E-Hc. and BoNT/F-Hc from a genetically stabilized expression plasmid. The individual Hc serotypes will be targeted to the periplasmic space, the bacterial cell surface, or will be exported out of CVD 908-htrA into the extracellular environment. Products 5 - 7: Using the constructs and information generated in development of Products 1- 4, we will proceed to co-express subcellular location-optimized BoNT/AHc, B-Hc and F-Hc simultaneously from a single operon, encoded by a genetically stabilized expression plasmid in CVD 908-htrA (Product 5). Related to Product 5, Product 6 will co-express subcellular location-optimized BoNT/B-Hc, E-Hc, and F-Hc from a single operon encoded by a genetically stabilized expression plasmid. Product 7 will comprise CVD 908-htrA in which the four Hc serotypes are encoded by a single operon contained on a stabilized expression plasmid, on which transcriptional control of the operon has been optimized. These remaining 3 products will be ready for human testing by the end of the fifth year of this proposal. We expect that one or more of the second generation vaccines should result in excellent priming of the human immune system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LIVE VECTOR VACCINES AGAINST AGENTS OF BIOTERROR Principal Investigator & Institution: Nataro, James P.; Professor; Pediatrics; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JAN-2008 Summary: (provided by applicant): The United States is under a genuine threat of biological attack. Whereas it has long been known that our enemies were capable of biological assault, only since September 2001 has it become clear that this threat is real. Unfortunately, the US is woefully unprepared to respond to biological attack. While rapid identification of released agents, novel therapeutic interventions and passive immunization will have vital roles to play in biodefense, there is no substitute for preexisting immunity to the major threats. This immunity can either be provided before such agents are released, or can be provided soon after release has been detected. Unfortunately, for most infectious agents it is not currently feasible to provide rapid administration of vaccines that provide equally rapid protection. Moreover, it will be vital to ensure that any immunization program have both a high level of safety as well as public acceptance. We therefore envision a response strategy which includes live attenuated enteric bacterial vaccines. These vaccines would be very safe, and would elicit both mucosal and systemic responses. After just a single dose, they would protect many exposed to bioattack, and within one week of immunization. The protected would likely be those exposed to small or natural levels of exposure, such as postal workers handling contaminated mail. However, it is anticipated that some victims would be exposed to supra-normal inocula, typically by the aerosol or gastrointestinal routes. For these individuals, a protective vaccination regimen could include priming with the mucosal agent, followed by on-demand boosting with parenterally administered
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subunit vaccine. After boosting, the recipients would be expected to generate fast, vigorous, balanced immune responses, which would protect them at the level of the mucosa and via both Th1 and Th2 systemic components. This U19 will combine the vast experience of the University of Maryland School Center for Vaccine Development and the Chemical and Biological Defence Center, Porton Down in the development of enteric vaccines against anthrax, plague and botulism. The products developed will be tested in animals and the characteristics of prime-boost responses determined. During the term of the award, we will generate a series of vaccine candidates for immediate Phase 1 human trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MECHANISM OF BOTULINUM TOXIN ACTION Principal Investigator & Institution: Simpson, Lance L.; Professor; Medicine; Thomas Jefferson University Office of Research Administration Philadelphia, Pa 191075587 Timing: Fiscal Year 2001; Project Start 01-SEP-1984; Project End 30-APR-2003 Summary: The long-term objective of the proposed research is to determine the mechanism of action of botulinum toxin, the agent responsible for the disease botulism. As part of this objective, the proposed research will seek ways to prevent the disease and to treat the disease. Most cases of botulism are due to ingestion of food contaminated with pre-formed toxin or to ingestion of food contaminated with bacteria that can produce the toxin in the gut. In either case, botulinum toxin escapes from the gastrointestinal system to reach the general circulation (blood and lymph). Toxin in the blood is then distributed to peripheral cholinergic nerve endings, which are the target cells for toxin action. The toxin enters these cells, where it acts to produce blockade of exocytosis. The progression of events in a typical case of botulism requires that botulinum toxin cross two major cell barriers. First, the toxin must cross from the mucosal to the serosal side of gut endothelial cells. Next, the toxin must penetrate cell membranes and endosomal membranes to reach the cytosol of cholinergic nerves. Therefore the specific aim of the proposed research will be to characterize the mechanisms by which the toxin binds to an penetrates gut and nerve cells. The proposed research will be composed of three major elements. First, the techniques of protein chemistry and molecular biology will be used to generate intact toxin or toxin fragments. Next, human T-84 cells will be used as a model to analyze toxin movement across gut cells. Simultaneously, mouse phrenic nerve-hermidiapragm preparations will be used as a model to assess toxin movement across nerve cells. The results of these experiments will be used to: 1) compare toxin binding and transport in gut and nerve cells, and 2) identify mechanisms for blocking toxin transport in both types of cells. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MOLECULAR STRUCTURE OF THE 900 KD BOTULINUM NEUROTOXIN COMPLEX Principal Investigator & Institution: Stevens, Raymond C.; University of Calif-Lawrenc Berkeley Lab Lawrence Berkeley National Laboratory Berkeley, Ca 94720 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2002 Summary: Botulinum neurotoxin complex serotype A is a 900 kiloDalton (kDa) protein produced as one of eight serotypes (A-G) by the anaerobic bacterium Clostridium botulinum. Among the most potent biological toxins known to man, botulinum neurotoxin causes inhibition of synaptic vesicle release at the neuromuscular junction resulting in flaccid paralysis and ultimately death. Botulinum neurotoxin type A
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(BoNT/A) is a potent disease agent in both food-borne botulism and Sudden Infant Death Syndrome (SIDS), an established biological weapon, and a novel therapeutic in the treatment of involuntary muscle disorders. Previously, we have determined the 3-D structure of the 150 kDNA neurotoxin component of the 900 kDa complex by x-ray crystallography. We have also completed antibody mapping experiments to determine how the 150 kDa neurotoxin is bound into the 900 kDa toxin complex. We have conducted a series of biophysical stability experiments in order to understand how the two assemblies (150 kDa toxin and 750 kDa non-toxic component) combine and stabilize the 900 kDa complex. Lastly, based on the work above, and preliminary electron microscopy work, we are designing an alternative vaccine strategy for botulism. Current vaccine programs for botulism are not very effective. The preliminary objective of this proposal is to obtain a three- dimensional structure of the 900 kDa botulinum neurotoxin complex, and understand how the neurotoxin component fits into the complex. To accomplish this goal, we will use a 2-D crystals of the 900 kDa complex to conduct 3-D image reconstruction experiments. We have already obtained 2-D crystals of the 900 kDa complex to conduct 3-D image reconstruction experiments. We have already obtained 2-D crystals of the 900 kDa complex that diffract weakly to 14 Angstroms resolution in negative strain, and a density projection map has been produced at 30 Angstroms resolution. Based on the crystal quality and the frequency with which defects were observed in the crystals used in our earlier investigation, it appears as though much higher quality crystals can be obtained. Specifically, our transfer technique is presently crude due to our new venture into this area of research, and several suggestions have been made by other program project members on how to improve our transfer techniques. We are also investigating alternative buffer conditions to help stabilize the protein further. Once optimization of the 2-D crystals has been completed, we will complete the negative stain work at the maximum resolution possible using data collection in a tilt series followed by 3-D image reconstruction. This work will be followed by attempting higher resolution studies with cryo-techniques. We will crystallize the 900 kDa complex in the presence of scFv antibody molecules that have a high affinity for exposed regions of the neurotoxin when bound to the 900 kDn complex. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MULTIPLEX PCR DETECTION OF CDC 'A' BIOTERRORISM AGENTS Principal Investigator & Institution: Henrickson, Kelly J.; Associate Professor; Pediatrics; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2006 Summary: (provided by applicant): Anthrax and other agents of biological warfare have recently received intense publicity. These weapons are an increasingly fearsome danger to our civilization. Agents identified by the CDC (category "A") to pose the greatest threat include Variola major (smallpox), Bacillus anthracis (anthrax), Yersinia pestis (plague), Clostridium botulinum toxin (botulism), Francisella tularensis (tularemia), and a group of RNA viruses that cause hemorrhagic fevers (VHFs, e.g., Ebola). Accurate and efficient techniques to identify and diagnose these agents are severely limited. This lack of good diagnostic tests hampers the majority of goals set forth by the NIAID and CDC to prepare the U.S. to counter future bioterrorism attacks. Available older techniques have proven unreliable. Modern molecular tests like individual PCR assays have been developed for some agents. These offer increased speed and sensitivity but because there are so many bioterrorism agents it is prohibitive to run dozens of "singleplex"
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arrays on each specimen. Similarly, recently reported microchip (MAGI Chip) arrays and other microarrays suffer from either needing PCR amplification first, or from the high cost to make the arrays, and the need for sophisticated equipment. A single assay (or two) that could detect a large number of bioterrorism agents rapidly, sensitively, specifically, and cheaply would greatly enhance antiterrorism planning and biodefense. Our laboratory has pioneered a method of multiplex PCR that can accomplish this goal. This proprietary method (two U.S. patents) has been used commercially in the Hexaplex(r) Assay, which can detect seven common respiratory viruses in a single test. The Specific Aims of this project are: 1) To determine if a multiplex PCR-enzyme hybridization assay (EHA) can be made using our unique technology that will identify all of the CDC Category "A" Bioterrorism agents that are DNA based; 2) RNA based; and finally 3) a single combined multiplex (RNA/DNA) PCR assay with an analytical sensitivity equal to "singleplex" real time assays as developed by the CDC. Specific Aim 4: To determine if this multiplex assay is equivalent to these "singleplex" assays in a clinical trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NANOFLUIDIC DEVICES FOR RECOGNITION OF NEUROTOXINS Principal Investigator & Institution: Bohn, Paul W.; University of Illinois Urbana Champaign, Il 61820 Timing: Fiscal Year 2003; Project Start 04-SEP-2003; Project End 29-FEB-2008 Summary: Effectiveness of antitoxin therapy in the treatment of botulism and tetanus is significantly reduced, if the treatment is not administered shortly after exposure or onset of disease. Rapid diagnosis and early administration of antitoxin therapy is therefore essential for a patient's recovery. Development of detection devices capable of selectively sensing minute quantities of neurotoxins in body fluids will be critical for providing rapid diagnostic assessment. This proposal outlines a program of research leading to the construction and use of a multidimensional nanofluidic device, specifically designed to manipulate samples, which must be handled in extremely small quantities, e.g., the potent neurotoxins from the Clostridium botulinum and C. tetani families. In the proposed approach, electrokinetic and other standard microfluidic flows are exploited to move reactant and product species among the separate compartments of the device, which are integrated using a new biofluidic device, the molecular gate, based on novel membranes developed at UIUC capable of performing important biomolecular manipulations, e.g. affinity binding and molecular sieving, while simultaneously functioning as the switching elements between microfluidic compartments. The specific aims are: Specific Aim 1. Determine the optimum reaction and separation conditions for the toxins. A set of neurotoxin-specific recognition agents will be developed such that the molecular recognition event results in the generation of highly specific and isolatable reaction products. The separation and detection behavior of these reaction products will be investigated under conditions appropriate to the nanoscale device to be explored in Specific Aims 2 and 3. Specific Aim 2. Incorporate the separation, reaction and detection processes into the micro/nanofluidic device. Miniaturize the molecular recognition, separation, and detection events and incorporate them into a multidimensional hybrid nanofluidic/microfluidic architecture capable of performing sequential chemical manipulations on ultrasmall volumes of complex biomolecular samples. Specific Aim 3. Multiplex the preseparation, molecular recognition, separation, and detection events appropriate to each of the 7 neurotoxins into a single device. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROMUSCULAR TARGETS OF BOTULINUM TOXIN Principal Investigator & Institution: Coffield, Julie A.; Associate Professor; Physiology and Pharmacology; University of Georgia 617 Boyd, Gsrc Athens, Ga 306027411 Timing: Fiscal Year 2003; Project Start 01-MAR-2000; Project End 31-JUL-2007 Summary: (provided by applicant): Botulinum toxin targets the neuromuscular junction (NMJ) producing the fatal paralytic disease botulism. Environmental exposure occurs primarily from contaminated foodstuffs, or from contaminated soil. Exposure to botulinum toxin can also occur through inhalation of aerosolized toxin used as a biological weapon. There are no effective treatment measures for botulism once symptoms appear, and death occurs due to respiratory muscle paralysis. Ironically, botulinum toxin is also a valued drug used to treat neuromuscular diseases characterized by muscle spasticity. Our long range goal is to understand how this toxin selectively targets cholinergic nerve terminals of NMJs, in order to reduce its risk to human health and improve its clinical utility. The objective of this particular application is to define the molecular targets on the nerve terminal membrane that are responsible for the selective action of botulinum toxin serotypes A, B and E at the mammalian NMJ. Substantial evidence indicates that productive binding of botulinum toxins requires both polysialogangliosides and glycoproteins. A number of studies have confirmed the role of Glb gangliosides in toxin binding. The search for the identity of the protein receptors has been far less conclusive. Recently, the nerve terminal proteins synaptotagmin I and II have been proposed as receptors for serotypes A, B and E. However, functional studies in a mammalian NMJ preparation have not been done. To more fully resolve the biochemical interactions of botulinum toxin at its target site, we propose the following specific aims. 1) examine biochemically and functionally the interactions of serotypes A, B, and E with synaptotagmins I and II at the NMJ; 2) determine the identity of NMJ proteins other than synaptotagmins I and II that bind serotypes A, B and/or E. The results of these studies will impact clinical medicine by defining the membrane targets at the NMJ that may serve as templates for the development of effective pharmacologic countermeasures to botulinum intoxication and safer toxin-like therapeutics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEW GENETIC VACCINE TO PROTECT AGANIST BOTULISM Principal Investigator & Institution: Zeng, Mingtao; Microbiology and Immunology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Botulism is a severe neuroparalytic disease caused by one of seven botulinum neurotoxins (BoNTs), produced by the anaerobic, sporeforming bacterium Clostridium botulinum. These protein neurotoxins are the most potent toxins known to man. There are BoNT toxoid vaccines available currently as Investigational New Drugs. However, due to the numerous shortcomings associated with the toxoid vaccines (i.e., dangerous to produce, high cost of manufacturing, high reactogenicity), there is an urgent need to develop new generation vaccines for the prevention of botulism. The goals of this research are to develop a new botulism vaccine using the carboxyl-terminal 50 kDa C-fragments (Hc) of the heavy chains in BoNTs as antigens and to study the delivery of the vaccine utilizing a replicationdefective adenoviral vector via the intranasal and transcutaneous routes. These noninvasive vaccine delivery methods will undoubtedly enhance the compliance of a vaccination program, which is especially critical in response to a potential bioterrorist
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attack using BoNTs. After construction of replication-defective adenoviral vectors encoding the immunogenic C-fragments of the heavy chains in BoNTs, vaccination protocols in mice comparing the intranasal and transcutaneous delivery modes with the subcutaneous injection of the currently available pentavalent botulinum toxoid vaccine (PBT) will be studied. The specific aims of this project are: Specific Aim #1: To construct replication-defective adenoviral vectors encoding the C-fragments of the heavy chains in BoNTs. Specific Aim #2: To study the mucosal and systemic immunity elicited by the vectored vaccine developed in aim #1 through intranasal and transcutaneous immunization in a mouse model. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOVEL RECOMBINANT PROTEIN THERAPEUTICS OF BOTULISM Principal Investigator & Institution: Yang, David C.; Professor; Chemistry; Georgetown University Washington, Dc 20057 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant): Botulinum toxins are among the most deadly biological agents with the capacity of mass destruction. The tripartite toxin consists of a receptor binding domain, a membrane translocation domain and a proteolytic catalytic domain. Botulinum toxins bind specifically to synapses at the neuromuscular junctions by the receptor binding domain, penetrate the nerve cells by the translocation domain, destroy secretary protein assembly by the catalytic domain, and result in paralysis and possible death. No therapeutic drugs are currently available to treat affected individuals. In view of notable recent successes of peptide and recombinant protein therapeutics of anthrax, breast cancer, arthritis, etc., the objective of the proposed project is to develop recombinant protein drugs for botulism. The Specific Aims for the granting period will be first isolating peptides that will not only specifically inhibit the proteolysis but will also rescue damaged nerve cells and, secondly, to develop a targeting and delivery system for such peptides. Peptides that bind the catalytic domain will be initially isolated through combinatorial phage display peptide libraries based on structures of existing inhibitors as well as random search. A high throughput assay of the protease activity in botulinum toxins will then be used to identify inhibitory peptides. Further modifications and expansion of the inhibitory peptide structure will be made to improve the affinity and the specificity of the peptides. Peptides that rescue damaged cells from the toxicity will be selected. Recombinant proteins will then be synthesized that 1) have identical synaptic binding properties as botulinum toxins; 2) contain the intact translocation domain; 3) contain an inactive proteolytic catalytic domain; and 4) fuse with toxin inhibitors, neutralizing proteins, and rescue peptides. The effectiveness of the recombinant proteins in neutralizing and inhibiting botulinum toxin will be examined in vitro and in vivo. Such recombinant proteins are expected to bind to the same target nerve cells as botulinum toxins, to translocate the catalytic domain across the membranes, and eventually to specifically inhibit the degradation of synaptic proteins by the toxins and rescue damaged cells in vivo. The results could be readily applicable to other toxins of the same family and helpful for vaccine development. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RAPID DETECTION OF MULTIPLE BIOTERRORISM AGENTS Principal Investigator & Institution: Sulk, Roberta A.; Cc Technology, Inc. Box 3136, 813 S 2Nd St Laramie, Wy 82071
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Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2003 Summary: (provided by applicant): The long terms goal of this research is the development of a portable instrument that will allow a relatively untrained operator to determine the presence and amount of up to twenty bioterrorism agents in a matter of fifteen to twenty minutes. The assay will be simple and very nearly immune to operator error. The principle application of the device will be for the rapid analysis of suspected bioterrorism samples at sites remote from conventional analytical laboratories. The speed and ease with which these assays can be performed, coupled with the portability and anticipated low cost. should lead to wide-spread use in postal offices, police stations, state and federal governmental offices and other locations that are at risk from either real, or simulated bioterrorism attack.The specific goals of the Phase I grant period will be the demonstration that a Surface Enhanced Raman lmmunoAssay (SERIA) can be developed that is capable of simultaneously determining the presence and amount of bioterrorism simulants for yersina pestis (plague) and botulism toxin. Associated goals of the project are the demonstration of increased sensitivity of the SERIA assays through matching of the spectral characteristics of dye-tags for antibodies with the excitation frequency of the laser of the instrument, and the implementation of a system that allows for the error-free presentation of samples and reporting of bioterrorism agent levels. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSMITTER REPLETION: KEY TO PHRENIC-DIAPHRAGM FUNCTION Principal Investigator & Institution: Van Lunteren, Erik; None; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2002; Project Start 08-JUL-2002; Project End 31-MAY-2006 Summary: (provided by applicant): Failure of phrenic nerve-diaphragm neuromuscular transmission leads to hypercapnic respiratory failure. This occurs not only in overtly diseased neuromuscular junctions (eg. myasthenia gravis, botulism), but also in normal junctions subjected to high intensity activation during mechanical loading by lung disease (eg. COPD) or during exposure to systemic factors such as hypoxia and hypothermia. Neurotransmission requires sufficient prejunctional release of acetylcholine (ACh) to ensure muscle contraction. During repetitive activation, ACh release diminishes, which when severe leads to transmission failure. Restoration of ACh available for release depends on two separate but interrelated processes: recycling of transmitter from the synaptic cleft, and repletion of the immediately releaseable vesicle pool from one or more reserve pools. Respiratory muscles are active continuously, so that transmitter replenishment needs to be sufficiently robust to ensure that a constant supply of ACh is available for release. The overall objective of this proposal is to further examine the role of transmitter replenishment, and the factors which regulate replenishment, in determining the integrity of transmission in respiratory neuromuscular junctions. The specific hypotheses to be tested are as follows. 1) The rapidity of, and time available for, ACh replenishment are critical determinants of transmission at the phrenic-diaphragm neuromuscular junction, especially in diseased neuromuscular junctions. 2) ACh replenishment is hastened by high frequency stimulation, an accommodation to the adverse effects of high frequency activation on release and depletion. Furthermore, the acceleration of replenishment is mediated by elevated presynaptic [Ca+ +]. 3) Hypoxia and hypothermia impair neurotransmission to a large extent by slowing transmitter replenishment, rather than primarily by a direct inhibition of transmitter release. 4) Presynaptic K+ channels regulate not only Ach
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release but also transmitter replenishment, providing two mechanisms of improving neurotransmission by pharmacologic manipulation of K- channel conductances. Neuromuscular transmission will be assessed using a combination of force measurements to quantify the neuromuscular component of fatigue, electrophysiological recording to determine ACh release and recovery from transmitter rundown, and optical approaches using fluorescent styry1 dyes ( FM1-43, FM2-10) to assess vesicle pool dynamics. These studies may lead to novel therapeutic approaches to respiratory muscle impairment and resulting hypercapnic respiratory failure for conditions which produce neuromuscular junction dysfunction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VACCINES AND THERAPIES FOR BOTULISM Principal Investigator & Institution: Barbieri, Joseph T.; Professor; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2003; Project Start 04-SEP-2003; Project End 29-FEB-2008 Summary: The neurotoxins of Clostridium (BoNT) are the most toxic proteins to humans and are Category A reagents. BoNTs (approximately 150,000 kDa) are zincdependent proteases that comprise a group of seven proteins designated as serotypes A through G. BoNT(A-G) share similar AB structure-function properties, but possess limited primary amino acid homology. BoNTs elicit flaccid paralysis through the cleavage of SNARE proteins that are part of the docking components of fusion vesicles. The B component of BoNT binds to receptors located on neuronal cells, yielding the trophism of this intoxication. While the paralysis elicited by each A-G serotype of BoNT is clinically similar, each serotype of BoNT cleaves individual SNARE proteins at specific amino acids. NIAID has identified the development of therapeutics and vaccines against BoNT as high priority bio-defense products. This research proposal is an inter-institutional effort to develop vaccine and therapeutic interventions against inhalation botulism. The focus on BoNT link the expertise of Eric Johnson, Sc.D., who has 17 years of research experience on the genetics and molecular biology of BoNT with researches whose expertise span the fields of immunology, bacterial pathogenesis, and combinatorial chemistry. The specific aims of the proposal are to (i) engineer a recombinant holo-BoNT toxoid for vaccine and basic research on intoxication; (ii)identify epitopes within BoNT that can be targeted to neutralize toxin action and small molecular-weight inhibitors of BoNT catalysis, which can be used for therapeutic intervention; and (iii) identify the BoNT receptor on neuronal cells to subsequently generate soluble receptor peptides for intoxication intervention. Completion of the goals of this proposal will address the immediate needs of our populous with respect to vaccine and therapeutic interventions against inhalation botulism and identify new avenues of research to address the pathology associated with this intoxication. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National
3 Adapted
from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
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Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “botulism” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for botulism in the PubMed Central database: •
Botulism Due to Clostridium baratii Type F Toxin. by Harvey SM, Sturgeon J, Dassey DE.; 2002 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=130751
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Botulism in Canada. by Weir E.; 2001 Feb 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=80803
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Characterization of a neurotoxigenic Clostridium butyricum strain isolated from the food implicated in an outbreak of food-borne type E botulism. by Meng X, Karasawa T, Zou K, Kuang X, Wang X, Lu C, Wang C, Yamakawa K, Nakamura S.; 1997 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=229926
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Characterization of Clostridium botulinum Type B Neurotoxin Associated with Infant Botulism in Japan. by Kozaki S, Kamata Y, Nishiki TI, Kakinuma H, Maruyama H, Takahashi H, Karasawa T, Yamakawa K, Nakamura S.; 1998 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=108594
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Emergence of Clostridium botulinum type B-like nontoxigenic organisms in a patient with type B infant botulism. by Yamakawa K, Karasawa T, Kakinuma H, Maruyama H, Takahashi H, Nakamura S.; 1997 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=229927
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Update: infant botulism. by Midura TF.; 1996 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172885
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. 4 With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 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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To generate your own bibliography of studies dealing with botulism, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “botulism” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for botulism (hyperlinks lead to article summaries): •
A botulism case of a 12-year-old girl caused by intestinal colonization of Clostridium botulinum type Ab. Author(s): Kobayashi H, Fujisawa K, Saito Y, Kamijo M, Oshima S, Kubo M, Eto Y, Monma C, Kitamura M. Source: Japanese Journal of Infectious Diseases. 2003 April; 56(2): 73-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824692&dopt=Abstract
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A case if infant botulism due to neurotoxigenic Clostridium butyricum type E associated with Clostridium difficile colitis. Author(s): Fenicia L, Da Dalt L, Anniballi F, Franciosa G, Zanconato S, Aureli P. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2002 October; 21(10): 7368. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479171&dopt=Abstract
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A case of botulism due to an infected traumatic injury. Author(s): Romanello R, De Santis F, Caione R, Fenicia L, Aureli P. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 1998 April; 17(4): 295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9707318&dopt=Abstract
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A case of infant botulism associated with honey feeding in Italy. Author(s): Fenicia L, Ferrini AM, Aureli P, Pocecco M. Source: European Journal of Epidemiology. 1993 November; 9(6): 671-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8150073&dopt=Abstract
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A case of infant botulism in South Australia. Author(s): Holland R. Source: Commun Dis Intell. 1998 June 11; 22(6): 110. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9648371&dopt=Abstract
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A comparison of human and animal botulism: a review. Author(s): Critchley EM. Source: Journal of the Royal Society of Medicine. 1991 May; 84(5): 295-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2041009&dopt=Abstract
Studies
19
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A continuing common-source outbreak of botulism in a family. Author(s): Horwitz MA, Marr JS, Merson MH, Dowell VR, Ellis JM. Source: Lancet. 1975 November 1; 2(7940): 861-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=53340&dopt=Abstract
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A large outbreak of botulism: the hazardous baked potato. Author(s): Angulo FJ, Getz J, Taylor JP, Hendricks KA, Hatheway CL, Barth SS, Solomon HM, Larson AE, Johnson EA, Nickey LN, Ries AA. Source: The Journal of Infectious Diseases. 1998 July; 178(1): 172-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9652437&dopt=Abstract
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A large outbreak of type E botulism in Iran. Author(s): Rouhbakhsh-Khaleghdoust A, Pourtaghva M. Source: Trans R Soc Trop Med Hyg. 1977; 71(5): 444. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=595101&dopt=Abstract
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A massive outbreak of type E botulism associated with traditional salted fish in Cairo. Author(s): Weber JT, Hibbs RG Jr, Darwish A, Mishu B, Corwin AL, Rakha M, Hatheway CL, el Sharkawy S, el-Rahim SA, al-Hamd MF, et al. Source: The Journal of Infectious Diseases. 1993 February; 167(2): 451-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8421179&dopt=Abstract
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A recent reminder of botulism. Author(s): Williams G. Source: Aust Crit Care. 1992 June; 5(2): 8-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1392460&dopt=Abstract
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A review of botulism in China. Author(s): Gao QY, Huang YF, Wu JG, Liu HD, Xia HQ. Source: Biomed Environ Sci. 1990 September; 3(3): 326-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2252552&dopt=Abstract
•
A second case of infant botulism type F caused by Clostridium baratii. Author(s): Paisley JW, Lauer BA, Arnon SS. Source: The Pediatric Infectious Disease Journal. 1995 October; 14(10): 912-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8584326&dopt=Abstract
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AAEM case report 16. Botulism. American Association of Electrodiagnostic Medicine. Author(s): Maselli RA, Bakshi N. Source: Muscle & Nerve. 2000 July; 23(7): 1137-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10883013&dopt=Abstract
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Adult botulism. Author(s): Shapiro BE, Soto O, Shafqat S, Blumenfeld H. Source: Muscle & Nerve. 1997 January; 20(1): 100-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8995590&dopt=Abstract
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Adult-onset “infant” botulism: an unusual cause of weakness in the intensive care unit. Author(s): Li LY, Kelkar P, Exconde RE, Day J, Parry GJ. Source: Neurology. 1999 September 11; 53(4): 891. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10489068&dopt=Abstract
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Airway complications of infant botulism: ten-year experience with 60 cases. Author(s): Anderson TD, Shah UK, Schreiner MS, Jacobs IN. Source: Otolaryngology and Head and Neck Surgery. 2002 March; 126(3): 234-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11956530&dopt=Abstract
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An outbreak in Italy of botulism associated with a dessert made with mascarpone cream cheese. Author(s): Aureli P, Di Cunto M, Maffei A, De Chiara G, Franciosa G, Accorinti L, Gambardella AM, Greco D. Source: European Journal of Epidemiology. 2000; 16(10): 913-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11338122&dopt=Abstract
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An outbreak of foodborne botulism associated with contaminated hazelnut yoghurt. Author(s): O'Mahony M, Mitchell E, Gilbert RJ, Hutchinson DN, Begg NT, Rodhouse JC, Morris JE. Source: Epidemiology and Infection. 1990 June; 104(3): 389-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2347382&dopt=Abstract
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An outbreak of food-borne botulism associated with contaminated locally made cheese in Iran. Author(s): Pourshafie MR, Saifie M, Shafiee A, Vahdani P, Aslani M, Salemian J. Source: Scandinavian Journal of Infectious Diseases. 1998; 30(1): 92-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9670367&dopt=Abstract
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An outbreak of food-borne botulism. Author(s): Erol S, Kursat H, Parlak M, Cetin K, Alici HA, Gorgun S. Source: European Journal of Anaesthesiology. 1999 July; 16(7): 500-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10457885&dopt=Abstract
Studies
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An outbreak of type A botulism associated with a commercial cheese sauce. Author(s): Townes JM, Cieslak PR, Hatheway CL, Solomon HM, Holloway JT, Baker MP, Keller CF, McCroskey LM, Griffin PM. Source: Annals of Internal Medicine. 1996 October 1; 125(7): 558-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8815754&dopt=Abstract
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Anthrax, botulism and tularemia in Italy. Author(s): Serraino D, Puro V, Bidoli E, Piselli P, Girardi E, Ippolito G. Source: Infection. 2003 March; 31(2): 128-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749299&dopt=Abstract
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Antidiuretic hormone excess in infant botulism. Author(s): Kurland G, Seltzer J. Source: Am J Dis Child. 1987 November; 141(11): 1227-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3673978&dopt=Abstract
•
Apnea in infantile botulism. Author(s): McMahon M. Source: The Journal of Pediatrics. 1994 January; 124(1): 161. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8283369&dopt=Abstract
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Application of nested polymerase chain reaction for the rapid diagnosis of infant botulism type B. Author(s): Kakinuma H, Maruyama H, Yamakawa K, Nakamura S, Takahashi H. Source: Acta Paediatr Jpn. 1997 June; 39(3): 346-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9241898&dopt=Abstract
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Association between honey consumption and infant botulism. Author(s): Tanzi MG, Gabay MP. Source: Pharmacotherapy. 2002 November; 22(11): 1479-83. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12432974&dopt=Abstract
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Attempts to quantity Clostridium botulinum type A toxin and antitoxin in serum of two cases of infant botulism in Japan. Author(s): Takahashi M, Noda H, Takeshita S, Fujiwara T, Nakanoin H, Mizunoya T, Sakaguchi G. Source: Jpn J Med Sci Biol. 1990 December; 43(6): 233-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2101138&dopt=Abstract
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Audiologic findings in botulism poisoning. Author(s): Pijl S. Source: Ear and Hearing. 1991 August; 12(4): 281-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1783230&dopt=Abstract
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Autonomic dysfunction in botulism B: a clinical report. Author(s): Jenzer G, Mumenthaler M, Ludin HP, Robert F. Source: Neurology. 1975 February; 25(2): 150-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1167643&dopt=Abstract
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Biological agents as weapons 1: smallpox and botulism. Author(s): Whitby M, Street AC, Ruff TA, Fenner F. Source: The Medical Journal of Australia. 2002 May 6; 176(9): 431-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12056996&dopt=Abstract
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Biphasic course of infant botulism. Author(s): Ravid S, Maytal J, Eviatar L. Source: Pediatric Neurology. 2000 October; 23(4): 338-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11068167&dopt=Abstract
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Botulism among Alaska natives in the Bristol Bay area of southwest Alaska: a survey of knowledge, attitudes, and practices related to fermented foods known to cause botulism. Author(s): Chiou LA, Hennessy TW, Horn A, Carter G, Butler JC. Source: Int J Circumpolar Health. 2002 February; 61(1): 50-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12002947&dopt=Abstract
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Botulism and sudden infant death syndrome. Author(s): Pottgen P, Hillegass LH. Source: Jama : the Journal of the American Medical Association. 1977 October 10; 238(15): 1629. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=578239&dopt=Abstract
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Botulism and sudden infant death. Author(s): Pottgen P, Hillegass LM. Source: Lancet. 1977 January 15; 1(8003): 147-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=64684&dopt=Abstract
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Botulism beaten. Author(s): Buckland J. Source: Nature Reviews. Immunology. 2002 September; 2(9): 628. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240638&dopt=Abstract
Studies
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Botulism due to Clostridium baratii type F toxin. Author(s): Harvey SM, Sturgeon J, Dassey DE. Source: Journal of Clinical Microbiology. 2002 June; 40(6): 2260-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12037104&dopt=Abstract
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Botulism from peyote. Author(s): Hashimoto H, Clyde VJ, Parko KL. Source: The New England Journal of Medicine. 1998 July 16; 339(3): 203-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9669923&dopt=Abstract
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Botulism in a heroin addict. Author(s): Sawalha W. Source: East Mediterr Health J. 2001 May; 7(3): 556-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690780&dopt=Abstract
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Botulism in Alaska, 1947 through 1974. Early detection of cases and investigation of outbreaks as a means of reducing mortality. Author(s): Eisenberg MS, Bender TR. Source: Jama : the Journal of the American Medical Association. 1976 January 5; 235(1): 35-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=945998&dopt=Abstract
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Botulism in Canada, 1971-74. Author(s): Bowmer FJ, Wilkinson DA. Source: Can Med Assoc J. 1976 December 4; 115(11): 1084-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1000437&dopt=Abstract
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Botulism in Canada. Author(s): Weir E. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2001 February 20; 164(4): 538. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11233878&dopt=Abstract
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Botulism in Canada--summary for 1997. Author(s): Austin J, Blanchfield B, Ashton E, Lorange M, Proulx JF, Trinidad A, Winther W. Source: Can Commun Dis Rep. 1999 July 15; 25(14): 121-2. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10458064&dopt=Abstract
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Botulism in critical care: a case study in wound botulism. Author(s): Baymiller S. Source: American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses. 2001 May; 10(3): 172-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11340740&dopt=Abstract
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Botulism in the United States, 1976. Author(s): Black RE, Arnon SS. Source: The Journal of Infectious Diseases. 1977 December; 136(6): 829-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=336804&dopt=Abstract
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Botulism in the United States: a clinical and epidemiologic review. Author(s): Shapiro RL, Hatheway C, Swerdlow DL. Source: Annals of Internal Medicine. 1998 August 1; 129(3): 221-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9696731&dopt=Abstract
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Botulism Reference Service for Canada. Author(s): Austin J, Dodds K. Source: Can Commun Dis Rep. 1996 November 1; 22(21): 183-4. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8972961&dopt=Abstract
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Botulism surveillance in Italy: 1992-1996. Author(s): Squarcione S, Prete A, Vellucci L. Source: European Journal of Epidemiology. 1999 November; 15(10): 917-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10669126&dopt=Abstract
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Botulism used as biological warfare. Author(s): Ripple M, Rasmussen H. Source: Nutrition in Clinical Care : an Official Publication of Tufts University. 2002 MayJune; 5(3): 138-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12134571&dopt=Abstract
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Botulism with respiratory insufficiency requiring extra corporeal carbon dioxide removal. Author(s): Buchmann T, Kabatnik M, Sander A, Peters J. Source: European Journal of Anaesthesiology. 1999 May; 16(5): 346-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10390672&dopt=Abstract
Studies
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Botulism with sensory symptoms diagnosed by neuromuscular transmission studies associated with edrophonium responsiveness. Author(s): Kuruoglu R, Cengiz B, Tokcaer A. Source: Electromyogr Clin Neurophysiol. 1996 December; 36(8): 477-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8985675&dopt=Abstract
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Botulism. Author(s): Coleman EA, Yergler ME. Source: The American Journal of Nursing. 2002 September; 102(9): 44-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394018&dopt=Abstract
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Botulism. Author(s): Sureka ON, Taylor RG, Fowler WM. Source: Archives of Physical Medicine and Rehabilitation. 1976 December; 57(12): 607. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=999488&dopt=Abstract
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Botulism. Author(s): Jasmin AM. Source: Vet Med Small Anim Clin. 1975 July; 70(7): 797-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1041087&dopt=Abstract
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Botulism: a case associated with pyramidal signs. Author(s): Santini M, Fabri S, Sagnelli P, Manfredi M, Francia A. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 1999 January; 6(1): 91-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10209356&dopt=Abstract
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Botulism: a case report. Author(s): Rosenthal NP, Belafsky M. Source: Bull Los Angeles Neurol Soc. 1975 October; 40(4): 165-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1233092&dopt=Abstract
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Botulism: a laboratory investigation on biological and food samples from cases and outbreaks in Brazil (1982-2001). Author(s): Gelli DS, Jakabi M, Souza A. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2002 NovemberDecember; 44(6): 321-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12532215&dopt=Abstract
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Botulism: heart rate variation, sympathetic skin responses, and plasma norepinephrine. Author(s): Chen JT, Chen CC, Lin KP, Wang SJ, Wu ZA, Liao KK. Source: The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques. 1999 May; 26(2): 123-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10352872&dopt=Abstract
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Botulism-like syndrome after botulinum toxin type A injections for focal hyperhidrosis. Author(s): Tugnoli V, Eleopra R, Quatrale R, Capone JG, Sensi M, Gastaldo E. Source: The British Journal of Dermatology. 2002 October; 147(4): 808-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12366438&dopt=Abstract
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Botulism-like syndrome after injections of botulinum toxin. Author(s): Cobb DB, Watson WA, Fernandez MC. Source: Vet Hum Toxicol. 2000 June; 42(3): 163. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10839321&dopt=Abstract
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Cardiac arrest due to succinylcholine-induced hyperkalemia in a patient with wound botulism. Author(s): Chakravarty EF, Kirsch CM, Jensen WA, Kagawa FT. Source: Journal of Clinical Anesthesia. 2000 February; 12(1): 80-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10773516&dopt=Abstract
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Cardiovascular-reflex testing and single-fiber electromyography in botulism. A longitudinal study. Author(s): Vita G, Girlanda P, Puglisi RM, Marabello L, Messina C. Source: Archives of Neurology. 1987 February; 44(2): 202-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3028344&dopt=Abstract
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Case in point. Wound botulism. Author(s): Fred HL. Source: Hosp Pract (Off Ed). 1994 January 15; 29(1): 39. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8288687&dopt=Abstract
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Case of infant botulism in Texas. Author(s): Edmond BJ, Guerra FA, Blake J, Hempler S. Source: Tex Med. 1977 October; 73(10): 85-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=929444&dopt=Abstract
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Central nervous system involvement in infantile botulism. Author(s): Jones S, Huma Z, Haugh C, Young Y, Starer F, Sinclair L. Source: Lancet. 1990 January 27; 335(8683): 228. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1967693&dopt=Abstract
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Characterization of a neurotoxigenic Clostridium butyricum strain isolated from the food implicated in an outbreak of food-borne type E botulism. Author(s): Meng X, Karasawa T, Zou K, Kuang X, Wang X, Lu C, Wang C, Yamakawa K, Nakamura S. Source: Journal of Clinical Microbiology. 1997 August; 35(8): 2160-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9230405&dopt=Abstract
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Characterization of an organism that produces type E botulinal toxin but which resembles Clostridium butyricum from the feces of an infant with type E botulism. Author(s): McCroskey LM, Hatheway CL, Fenicia L, Pasolini B, Aureli P. Source: Journal of Clinical Microbiology. 1986 January; 23(1): 201-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3517043&dopt=Abstract
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Characterization of Clostridium botulinum type B neurotoxin associated with infant botulism in japan. Author(s): Kozaki S, Kamata Y, Nishiki T, Kakinuma H, Maruyama H, Takahashi H, Karasawa T, Yamakawa K, Nakamura S. Source: Infection and Immunity. 1998 October; 66(10): 4811-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9746583&dopt=Abstract
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Characterization of the neurotoxin isolated from a Clostridium baratii strain implicated in infant botulism. Author(s): Gimenez JA, Gimenez MA, DasGupta BR. Source: Infection and Immunity. 1992 February; 60(2): 518-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1730484&dopt=Abstract
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Clarification of dietary risk factors and religion in a botulism outbreak. Author(s): Weber JT, Hatheway CL, Blake PA, Tauxe RV. Source: The Journal of Infectious Diseases. 1993 July; 168(1): 258. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8515129&dopt=Abstract
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Classics in infectious diseases. A new anaerobic bacillus and its relation to botulism. E. van Ermengem. Originally published as “Ueber einen neuen anaeroben Bacillus und seine Beziehungen zum Botulismus” in Zeitschrift fur Hygiene und Infektionskrankheiten 26: 1-56, 1897. Author(s): van Ermengem E. Source: Reviews of Infectious Diseases. 1979 July-August; 1(4): 701-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=399378&dopt=Abstract
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Clinical and laboratory comparison of botulism from toxin types A, B, and E in the United States, 1975-1988. Author(s): Woodruff BA, Griffin PM, McCroskey LM, Smart JF, Wainwright RB, Bryant RG, Hutwagner LC, Hatheway CL. Source: The Journal of Infectious Diseases. 1992 December; 166(6): 1281-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1431246&dopt=Abstract
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Clinical characteristics of infant botulism in the United States: a study of the nonCalifornia cases. Author(s): Wilson R, Morris JG Jr, Snyder JD, Feldman RA. Source: Pediatr Infect Dis. 1982 May-June; 1(3): 148-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7145727&dopt=Abstract
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Clinical electrophysiology of infantile botulism. Author(s): Cornblath DR, Sladky JT, Sumner AJ. Source: Muscle & Nerve. 1983 July-August; 6(6): 448-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6312310&dopt=Abstract
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Clinical features of types A and B food-borne botulism. Author(s): Hughes JM, Blumenthal JR, Merson MH, Lombard GL, Dowell VR Jr, Gangarosa EJ. Source: Annals of Internal Medicine. 1981 October; 95(4): 442-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7283294&dopt=Abstract
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Clinical predictors of respiratory failure and long-term outcome in black tar heroinassociated wound botulism. Author(s): Sandrock CE, Murin S. Source: Chest. 2001 August; 120(2): 562-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11502659&dopt=Abstract
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Clinical spectrum of botulism. Author(s): Cherington M. Source: Muscle & Nerve. 1998 June; 21(6): 701-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9585323&dopt=Abstract
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Clinical trial of botulism immune globulin for infant botulism. Author(s): Frankovich TL, Arnon SS. Source: The Western Journal of Medicine. 1991 January; 154(1): 103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2024505&dopt=Abstract
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Clinical, laboratory, and environmental features of infant botulism in Southeastern Pennsylvania. Author(s): Long SS, Gajewski JL, Brown LW, Gilligan PH. Source: Pediatrics. 1985 May; 75(5): 935-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3887319&dopt=Abstract
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Clostridium botulinum and the ophthalmologist: a review of botulism, including biological warfare ramifications of botulinum toxin. Author(s): Caya JG. Source: Survey of Ophthalmology. 2001 July-August; 46(1): 25-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11525787&dopt=Abstract
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Clostridium difficile colitis associated with infant botulism: near-fatal case analogous to Hirschsprung's enterocolitis. Author(s): Schechter R, Peterson B, McGee J, Idowu O, Bradley J. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1999 August; 29(2): 367-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10476744&dopt=Abstract
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Cluster of wound botulism in California: clinical, electrophysiologic, and pathologic study. Author(s): Maselli RA, Ellis W, Mandler RN, Sheikh F, Senton G, Knox S, Salari-Namin H, Agius M, Wollmann RL, Richman DP. Source: Muscle & Nerve. 1997 October; 20(10): 1284-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9324085&dopt=Abstract
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Commentary: infant botulism and the honey connection. Author(s): Brown LW. Source: The Journal of Pediatrics. 1979 February; 94(2): 337-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=368302&dopt=Abstract
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Commentary: where Marco Polo meets Meckel: type E botulism from Clostridium butyricum. Author(s): Schechter R, Arnon SS. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1999 December; 29(6): 1388-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10585783&dopt=Abstract
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Complete bilateral internal ophthalmoplegia as sole clinical sign of botulism: confirmation of diagnosis by single fibre electromyography. Author(s): Ehrenreich H, Garner CG, Witt TN. Source: Journal of Neurology. 1989 May; 236(4): 243-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2760637&dopt=Abstract
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Coproexamination for botulinal toxin and clostridium botulinum. A new procedure for laboratory diagnosis of botulism. Author(s): Dowell VR Jr, McCroskey LM, Hatheway CL, Lombard GL, Hughes JM, Merson MH. Source: Jama : the Journal of the American Medical Association. 1977 October 24; 238(17): 1829-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=333132&dopt=Abstract
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Cranial nerve palsies and descending paralysis in a drug abuser resulting from wound botulism. Author(s): Martin C, Schaller MD, Lepori M, Liaudet L. Source: Intensive Care Medicine. 1999 July; 25(7): 765. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10470586&dopt=Abstract
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Cultural and physiological characteristics and antimicrobial susceptibility of Clostridium botulinum isolates from foodborne and infant botulism cases. Author(s): Dezfulian M, Dowell VR Jr. Source: Journal of Clinical Microbiology. 1980 June; 11(6): 604-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7000811&dopt=Abstract
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Current perspectives and priorities for research in infant botulism. Author(s): Nelson JD. Source: Reviews of Infectious Diseases. 1979 July-August; 1(4): 698-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=551515&dopt=Abstract
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Current trends in botulism in the United States. Author(s): Merson MH, Hughes JM, Dowell VR, Taylor A, Barker WH, Gangarosa EJ. Source: Jama : the Journal of the American Medical Association. 1974 September 2; 229(10): 1305-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4604287&dopt=Abstract
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Descending paralysis resulting from occult wound botulism. Author(s): Rapoport S, Watkins PB. Source: Annals of Neurology. 1984 September; 16(3): 359-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6486740&dopt=Abstract
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Development of infant botulism in a 3-year-old female with neuroblastoma following autologous bone marrow transplantation: potential use of human botulism immune globulin. Author(s): Shen WP, Felsing N, Lang D, Goodman G, Cairo MS. Source: Bone Marrow Transplantation. 1994 March; 13(3): 345-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8199579&dopt=Abstract
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Diagnosing infant botulism. Author(s): Cadou SG. Source: The Nurse Practitioner. 2001 March; 26(3): 76-8, 81-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11270163&dopt=Abstract
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Diagnosis and management of infant botulism. Author(s): Johnson RO, Clay SA, Arnon SS. Source: Am J Dis Child. 1979 June; 133(6): 586-93. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=375717&dopt=Abstract
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Differential diagnosis of infant botulism. Author(s): Brown LW. Source: Reviews of Infectious Diseases. 1979 July-August; 1(4): 625-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=233167&dopt=Abstract
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Difficulties in the diagnosis and management of infant botulism. Author(s): May M, Coulthard M, Delbridge G, McEniery J, Burke C, Nissen M. Source: Journal of Paediatrics and Child Health. 2002 August; 38(4): 425-6; Author Reply 426-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174014&dopt=Abstract
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Diphenylhydantoin intoxication mimicking botulism. Author(s): Wand M, Mather JA. Source: The New England Journal of Medicine. 1972 January 13; 286(2): 88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5006881&dopt=Abstract
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Distinct characters of Clostridium botulinum type A strains and their toxin associated with infant botulism in Japan. Author(s): Sakaguchi G, Sakaguchi S, Kamata Y, Tabita K, Asao T, Kozaki S. Source: International Journal of Food Microbiology. 1990 December; 11(3-4): 231-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2126444&dopt=Abstract
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Distinction between Clostridium botulinum type A strains associated with foodborne botulism and those with infant botulism in Japan in intraintestinal toxin production in infant mice and some other properties. Author(s): Tabita K, Sakaguchi S, Kozaki S, Sakaguchi G. Source: Fems Microbiology Letters. 1991 April 15; 63(2-3): 251-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1905658&dopt=Abstract
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Early and late pulmonary complications of botulism. Author(s): Schmidt-Nowara WW, Samet JM, Rosario PA. Source: Archives of Internal Medicine. 1983 March; 143(3): 451-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6830381&dopt=Abstract
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Early antitoxin treatment in wound botulism results in better outcome. Author(s): Chang GY, Ganguly G. Source: European Neurology. 2003; 49(3): 151-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646758&dopt=Abstract
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Early severe infantile botulism. Author(s): Hurst DL, Marsh WW. Source: The Journal of Pediatrics. 1993 June; 122(6): 909-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8501568&dopt=Abstract
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Economic impact of a botulism outbreak. Importance of the legal component in foodborne disease. Author(s): Mann JM, Lathrop GD, Bannerman JA. Source: Jama : the Journal of the American Medical Association. 1983 March 11; 249(10): 1299-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6827706&dopt=Abstract
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Effect of guanidine on the neuromuscular block of botulism: an electrophysiological study. Author(s): Messina C, Dattola R, Girlanda P. Source: Acta Neurol (Napoli). 1979 December; 1(6): 459-63. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=231901&dopt=Abstract
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Effect of guanidine, germine, and steroids in a case of botulism. Author(s): Cherington M, Schultz D. Source: Clin Toxicol. 1977; 11(1): 19-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=872538&dopt=Abstract
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Electrodiagnosis in the evaluation of progressive hypotonia in infancy with particular reference to infant botulism. Author(s): Schrager GO, Diamond M, Rosnowski SZ, Waran SP. Source: J Med Soc N J. 1982 February; 79(2): 125-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6950120&dopt=Abstract
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Electrodiagnosis of botulism. Author(s): Gutmann L, Bodensteiner J, Gutierrez A. Source: The Journal of Pediatrics. 1992 November; 121(5 Pt 1): 835. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1294122&dopt=Abstract
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Electrodiagnosis of infantile botulism. Author(s): Gutmann L, Gutierrez A, Bodensteiner J. Source: Journal of Child Neurology. 2000 September; 15(9): 630. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11019796&dopt=Abstract
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Electrodiagnosis of infantile botulism. Author(s): Gutierrez AR, Bodensteiner J, Gutmann L. Source: Journal of Child Neurology. 1994 October; 9(4): 362-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7822724&dopt=Abstract
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Electrodiagnosis reliability in the diagnosis of infant botulism. Author(s): Graf WD, Hays RM, Astley SJ, Mendelman PM. Source: The Journal of Pediatrics. 1992 May; 120(5): 747-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1315854&dopt=Abstract
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Electrophysiologic methods as an aid in diagnosis of botulism: a review. Author(s): Cherington M. Source: Muscle & Nerve. 1982; 5(9S): S28-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6763148&dopt=Abstract
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Electrophysiologic study in benign human botulism type B. Author(s): Cruz Martinez A, Anciones B, Ferrer MT, Diez Tejedor E, Perez Conde MC, Bescansa E. Source: Muscle & Nerve. 1985 September; 8(7): 580-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2995805&dopt=Abstract
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Electrophysiological studies of a child with presumed botulism. Author(s): Hatanaka T, Owa K, Yasunaga M, Kamezaki S, Suehiro Y, Yasuhara A, Shinomiya K. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2000 February; 16(2): 84-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10663812&dopt=Abstract
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Emergence of Clostridium botulinum type B-like nontoxigenic organisms in a patient with type B infant botulism. Author(s): Yamakawa K, Karasawa T, Kakinuma H, Maruyama H, Takahashi H, Nakamura S. Source: Journal of Clinical Microbiology. 1997 August; 35(8): 2163-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9230406&dopt=Abstract
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Emergency department presentation of type A botulism. Author(s): Ruthman JC, Hendricksen DK, Bonefeld R. Source: The American Journal of Emergency Medicine. 1985 May; 3(3): 203-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3994797&dopt=Abstract
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Endemic food-borne botulism: clinical experience, 1973-1986 at Alaska Native Medical Center. Author(s): Barrett DH. Source: Alaska Med. 1991 July-September; 33(3): 101-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1957979&dopt=Abstract
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Endogenous antibody production to botulinum toxin in an adult with intestinal colonization botulism and underlying Crohn's disease. Author(s): Griffin PM, Hatheway CL, Rosenbaum RB, Sokolow R. Source: The Journal of Infectious Diseases. 1997 March; 175(3): 633-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9041335&dopt=Abstract
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Enzyme-linked immunosorbent assay for detection of Clostridium botulinum type A and type B toxins in stool samples of infants with botulism. Author(s): Dezfulian M, Hatheway CL, Yolken RH, Bartlett JG. Source: Journal of Clinical Microbiology. 1984 September; 20(3): 379-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6490825&dopt=Abstract
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Epidemiologic study of infant botulism in Pennsylvania: Report of the Infant Botulism Study group. Author(s): Long SS. Source: Pediatrics. 1985 May; 75(5): 928-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3991282&dopt=Abstract
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Equine antitoxin use and other factors that predict outcome in type A foodborne botulism. Author(s): Tacket CO, Shandera WX, Mann JM, Hargrett NT, Blake PA. Source: The American Journal of Medicine. 1984 May; 76(5): 794-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6720725&dopt=Abstract
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Evaluation of fluorescent-antibody tests as a means of confirming infant botulism. Author(s): Glasby C, Hatheway CL. Source: Journal of Clinical Microbiology. 1984 December; 20(6): 1209-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6394626&dopt=Abstract
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Examination of feces and serum for diagnosis of infant botulism in 336 patients. Author(s): Hatheway CL, McCroskey LM. Source: Journal of Clinical Microbiology. 1987 December; 25(12): 2334-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3323228&dopt=Abstract
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Experience with the use of an investigational F(ab')2 heptavalent botulism immune globulin of equine origin during an outbreak of type E botulism in Egypt. Author(s): Hibbs RG, Weber JT, Corwin A, Allos BM, Abd el Rehim MS, Sharkawy SE, Sarn JE, McKee KT Jr. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1996 August; 23(2): 337-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8842274&dopt=Abstract
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Extracorporeal adsorption as a new approach to treatment of botulism. Author(s): Sato Y, Kimata N, Miyahara S, Nihei H, Agishi T, Takahashi M. Source: Asaio Journal (American Society for Artificial Internal Organs : 1992). 2000 November-December; 46(6): 783-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11110282&dopt=Abstract
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Failure of guanidine therapy in botulism A. Author(s): Faich GA, Graebner RW, Sato S. Source: The New England Journal of Medicine. 1971 September 30; 285(14): 773-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5567262&dopt=Abstract
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Fish botulism--Hawaii, 1990. Author(s): Kershaw P, Dioso M, Wong B, Ibara C, Robertson D, Tamao W, Sugi M, Pon EW. Source: Mmwr. Morbidity and Mortality Weekly Report. 1991 June 21; 40(24): 412-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2046648&dopt=Abstract
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Food and environmental aspects of infant botulism in California. Author(s): Chin J, Arnon SS, Midura TF. Source: Reviews of Infectious Diseases. 1979 July-August; 1(4): 693-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=399377&dopt=Abstract
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Food-borne botulism cases in Van region in eastern Turkey: importance of electromyography in the diagnosis. Author(s): Anlar O, Irmak H, Tombul T, Akdeniz H, Caksen H, Kose D, Ceylan A. Source: Electromyogr Clin Neurophysiol. 2003 September; 43(6): 373-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14535050&dopt=Abstract
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Foodborne botulism in a six-month-old infant caused by home-canned baby food. Author(s): Armada M, Love S, Barrett E, Monroe J, Peery D, Sobel J. Source: Annals of Emergency Medicine. 2003 August; 42(2): 226-9. Erratum In: Ann Emerg Med. 2003 October; 42(4): 600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12883510&dopt=Abstract
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Food-borne botulism in Alaska, 1947-1985: epidemiology and clinical findings. Author(s): Wainwright RB, Heyward WL, Middaugh JP, Hatheway CL, Harpster AP, Bender TR. Source: The Journal of Infectious Diseases. 1988 June; 157(6): 1158-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3373020&dopt=Abstract
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Food-borne botulism in Canada, 1971-84. Author(s): Hauschild AH, Gauvreau L. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1985 December 1; 133(11): 1141-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2866023&dopt=Abstract
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Foodborne botulism in Italy. Author(s): Aureli P, Franciosa G, Pourshaban M. Source: Lancet. 1996 December 7; 348(9041): 1594. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8950913&dopt=Abstract
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Food-borne botulism in the United States, 1970-1975. Author(s): Horwitz MA, Hughes JM, Merson MH, Gangarosa EJ. Source: The Journal of Infectious Diseases. 1977 July; 136(1): 153-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=886204&dopt=Abstract
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Foodborne botulism outbreaks following consumption of home-canned bamboo shoots in Northern Thailand. Author(s): Swaddiwudhipong W, Wongwatcharapaiboon P. Source: J Med Assoc Thai. 2000 September; 83(9): 1021-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11075968&dopt=Abstract
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Foodborne botulism. Author(s): Hutchinson DN. Source: Bmj (Clinical Research Ed.). 1992 August 1; 305(6848): 264-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1392853&dopt=Abstract
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Food-borne botulism. A review of 13 outbreaks. Author(s): Lecour H, Ramos H, Almeida B, Barbosa R. Source: Archives of Internal Medicine. 1988 March; 148(3): 578-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3341859&dopt=Abstract
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Foodborne botulism: an international outbreak. Author(s): Slater PE, Addiss DG, Cohen A, Leventhal A, Chassis G, Zehavi H, Bashari A, Costin C. Source: International Journal of Epidemiology. 1989 September; 18(3): 693-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2807675&dopt=Abstract
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Food-borne botulism: an uncommon disorder. Author(s): Bernasconi C, Nadal D, Wust J, Lips U, Boltshauser E. Source: Helv Paediatr Acta. 1989 June; 43(5-6): 515-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2745147&dopt=Abstract
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Four outbreaks of botulism in Ungava Bay, Nunavik, Quebec. Author(s): Proulx JF, Milor-Roy V, Austin J. Source: Can Commun Dis Rep. 1997 February 15; 23(4): 30-2. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9136226&dopt=Abstract
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Garlic-in-oil associated botulism: episode leads to product modification. Author(s): Morse DL, Pickard LK, Guzewich JJ, Devine BD, Shayegani M. Source: American Journal of Public Health. 1990 November; 80(11): 1372-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2240308&dopt=Abstract
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Generalised botulism-like syndrome after intramuscular injections of botulinum toxin type A: a report of two cases. Author(s): Bakheit AM, Ward CD, McLellan DL. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1997 February; 62(2): 198. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9048725&dopt=Abstract
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Genetic confirmation of identities of neurotoxigenic Clostridium baratii and Clostridium butyricum implicated as agents of infant botulism. Author(s): Suen JC, Hatheway CL, Steigerwalt AG, Brenner DJ. Source: Journal of Clinical Microbiology. 1988 October; 26(10): 2191-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3183004&dopt=Abstract
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Guanidine for botulism. Author(s): Robineau M, Modai J. Source: The New England Journal of Medicine. 1972 January 20; 286(3): 162. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5007165&dopt=Abstract
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Guanidine in botulism. Author(s): Werner SB, Arnon SS, Chin J. Source: Jama : the Journal of the American Medical Association. 1979 July 20; 242(3): 237-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=448906&dopt=Abstract
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Guanidine in botulism. Author(s): Cherington M, Ryan DW. Source: Lancet. 1967 December 23; 2(7530): 1360. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4170043&dopt=Abstract
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Guanidine in type B botulism. Author(s): Oh SJ, Halsey JH Jr, Briggs DD Jr. Source: Archives of Internal Medicine. 1975 May; 135(5): 726-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1052669&dopt=Abstract
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Guillain-Barre syndrome mimicking botulism. Author(s): Susuki K, Takahashi H, Yuki N, Ohsawa H, Hirata K, Sakata I. Source: Journal of Neurology. 2001 August; 248(8): 720-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11569908&dopt=Abstract
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Honey and other environmental risk factors for infant botulism. Author(s): Arnon SS, Midura TF, Damus K, Thompson B, Wood RM, Chin J. Source: The Journal of Pediatrics. 1979 February; 94(2): 331-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=368301&dopt=Abstract
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Honey, infant botulism and the sudden infant death syndrome. Author(s): Arnon SS. Source: The Western Journal of Medicine. 1980 January; 132(1): 58-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7376645&dopt=Abstract
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Human botulism (type F)--a rare type. Author(s): Green J, Spear H, Brinson RR. Source: The American Journal of Medicine. 1983 November; 75(5): 893-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6638057&dopt=Abstract
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Human botulism caused by Clostridium botulinum type E: the Birmingham outbreak. Author(s): Ball AP, Hopkinson RB, Farrell ID, Hutchison JG, Paul R, Watson RD, Page AJ, Parker RG, Edwards CW, Snow M, Scott DK, Leone-Ganado A, Hastings A, Ghosh AC, Gilbert RJ. Source: The Quarterly Journal of Medicine. 1979 July; 48(191): 473-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=575566&dopt=Abstract
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Human botulism in Canada (1919-1973). Author(s): Dolman CE. Source: Can Med Assoc J. 1974 January 19; 110(2): 191-7 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4855671&dopt=Abstract
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Human botulism studied with single-fiber electromyography. Author(s): Schiller HH, Stalberg E. Source: Archives of Neurology. 1978 June; 35(6): 346-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=655906&dopt=Abstract
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Human botulism. Author(s): Critchley EM, Mitchell JD. Source: Br J Hosp Med. 1990 April; 43(4): 290-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2346826&dopt=Abstract
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Human type A botulism and treatment with 3,4-diaminopyridine. Author(s): Davis LE, Johnson JK, Bicknell JM, Levy H, McEvoy KM. Source: Electromyogr Clin Neurophysiol. 1992 July-August; 32(7-8): 379-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1526219&dopt=Abstract
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Human type A botulism. Author(s): Ryan DW, Cherington M. Source: Jama : the Journal of the American Medical Association. 1971 April 19; 216(3): 513-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5107938&dopt=Abstract
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Human-derived immune globulins for the treatment of botulism. Author(s): Metzger JF, Lewis GE Jr. Source: Reviews of Infectious Diseases. 1979 July-August; 1(4): 689-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=399376&dopt=Abstract
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Immunological characterization of the neurotoxin produced by Clostridium botulinum type A associated with infant botulism in Japan. Author(s): Kozaki S, Nakaue S, Kamata Y. Source: Microbiology and Immunology. 1995; 39(10): 767-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8577267&dopt=Abstract
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Index of suspicion. Case 3. Infantile botulism. Author(s): Kornfeld H. Source: Pediatrics in Review / American Academy of Pediatrics. 1999 January; 20(1): 29, 32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9919052&dopt=Abstract
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Infant botulism and honey in Europe: a commentary. Author(s): Aureli P, Franciosa G, Fenicia L. Source: The Pediatric Infectious Disease Journal. 2002 September; 21(9): 866-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12352811&dopt=Abstract
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Infant botulism during a one year period in San Luis, Argentina. Author(s): Puig de Centorbi O, Centorbi HJ, Demo N, Pujales G, Fernandez R. Source: Zentralbl Bakteriol. 1998 January; 287(1-2): 61-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9532265&dopt=Abstract
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Infant botulism in a 10-week-old male: a wolf in sheep's clothing. Author(s): Taylor S. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2002 December; 28(6): 581-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12509743&dopt=Abstract
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Infant botulism. Author(s): Cox N, Hinkle R. Source: American Family Physician. 2002 April 1; 65(7): 1388-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11996423&dopt=Abstract
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Infant botulism. Author(s): Long SS. Source: The Pediatric Infectious Disease Journal. 2001 July; 20(7): 707-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11465845&dopt=Abstract
Studies
41
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Infant botulism. Author(s): Muensterer OJ. Source: Pediatrics in Review / American Academy of Pediatrics. 2000 December; 21(12): 427. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11121502&dopt=Abstract
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Infant botulism. Author(s): Glatman-Freedman A. Source: Pediatrics in Review / American Academy of Pediatrics. 1996 May; 17(5): 185-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8935918&dopt=Abstract
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Infant botulism. Author(s): Bechler-Karsch A, Berro EA. Source: Mcn. the American Journal of Maternal Child Nursing. 1994 September-October; 19(5): 275-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7990673&dopt=Abstract
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Infant botulism. Identification of Clostridium botulinum and its toxins in faeces. Author(s): Midura TF, Arnon SS. Source: Lancet. 1976 October 30; 2(7992): 934-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=62164&dopt=Abstract
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Infant botulism: a rare cause of colonic ileus. Author(s): Kothare SV, Kassner EG. Source: Pediatric Radiology. 1995; 25(1): 24-6; Discussion 27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7761156&dopt=Abstract
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Infant botulism: case reports and review. Author(s): Krishna S, Puri V. Source: J Ky Med Assoc. 2001 April; 99(4): 143-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11324189&dopt=Abstract
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Infant botulism--is it that rare? Author(s): Cochran DP, Appleton RE. Source: Developmental Medicine and Child Neurology. 1995 March; 37(3): 274-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7890133&dopt=Abstract
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Infantile botulism: an atypical case of an uncommon disease. Author(s): Rick JR, Ascher DP, Smith RA. Source: Pediatrics. 1999 May; 103(5 Pt 1): 1038-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10224186&dopt=Abstract
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Infantile botulism: clinical and laboratory observations of a rare neuroparalytic disease. Author(s): Urdaneta-Carruyo E, Suranyi A, Milano M. Source: Journal of Paediatrics and Child Health. 2000 April; 36(2): 193-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10760026&dopt=Abstract
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Infantile botulism: pitfalls in electrodiagnosis. Author(s): Sheth RD, Lotz BP, Hecox KE, Waclawik AJ. Source: Journal of Child Neurology. 1999 March; 14(3): 156-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10190265&dopt=Abstract
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Intestinal toxemia botulism in two young people, caused by Clostridium butyricum type E. Author(s): Fenicia L, Franciosa G, Pourshaban M, Aureli P. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1999 December; 29(6): 1381-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10585782&dopt=Abstract
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Intracellular targets and metalloprotease activity of tetanus and botulism neurotoxins. Author(s): Schiavo G, Rossetto O, Tonello F, Montecucco C. Source: Curr Top Microbiol Immunol. 1995; 195: 257-74. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8542757&dopt=Abstract
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Is there a link between infant botulism and sudden infant death? Bacteriological results obtained in central Germany. Author(s): Bohnel H, Behrens S, Loch P, Lube K, Gessler F. Source: European Journal of Pediatrics. 2001 October; 160(10): 623-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11686509&dopt=Abstract
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Laboratory aspects of infant botulism in California. Author(s): Midura TF. Source: Reviews of Infectious Diseases. 1979 July-August; 1(4): 652-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=399372&dopt=Abstract
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Laboratory diagnosis in a large outbreak of type A botulism: confirmation of the value of coproexamination. Author(s): Mann JM, Hatheway CL, Gardiner TM. Source: American Journal of Epidemiology. 1982 April; 115(4): 598-605. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7041634&dopt=Abstract
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Laboratory diagnosis of botulism complicated by pyridostigmine treatment of the patient. A method for selectively removing interfering substances from clinical specimens. Author(s): Horwitz MA, Hatheway CL, Dowell VR. Source: American Journal of Clinical Pathology. 1976 October; 66(4): 737-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=970375&dopt=Abstract
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Laboratory findings in four cases of adult botulism suggest colonization of the intestinal tract. Author(s): McCroskey LM, Hatheway CL. Source: Journal of Clinical Microbiology. 1988 May; 26(5): 1052-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3290234&dopt=Abstract
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Laboratory procedures for cases of suspected infant botulism. Author(s): Hatheway CL. Source: Reviews of Infectious Diseases. 1979 July-August; 1(4): 647-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=551514&dopt=Abstract
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Letter: Observations of an infant born to a mother with botulism. Author(s): St Clair EH, DiLiberti JH, O'Brien ML. Source: The Journal of Pediatrics. 1975 October; 87(4): 658. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1159598&dopt=Abstract
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Long-term follow-up of symptoms, pulmonary function, respiratory muscle strength, and exercise performance after botulism. Author(s): Wilcox P, Andolfatto G, Fairbarn MS, Pardy RL. Source: Am Rev Respir Dis. 1989 January; 139(1): 157-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2912336&dopt=Abstract
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Management of botulism. Author(s): Robinson RF, Nahata MC. Source: The Annals of Pharmacotherapy. 2003 January; 37(1): 127-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503947&dopt=Abstract
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Massive azoturia and failure to achieve positive nitrogen balance in a botulism patient. Author(s): Cashman MD, Wightkin WT, Madden JE, Phillips RS. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1986 May-June; 10(3): 316-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3712722&dopt=Abstract
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Mormons, honey, and infant botulism. Author(s): Brawley RL. Source: Am J Dis Child. 1984 August; 138(8): 794-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6741900&dopt=Abstract
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Mosaic type of the nontoxic-nonhemaggulutinin component gene in Clostridium botulinum type A strain isolated from infant botulism in Japan. Author(s): Kubota T, Shirakawa S, Kozaki S, Isogai E, Isogai H, Kimura K, Fujii N. Source: Biochemical and Biophysical Research Communications. 1996 July 25; 224(3): 843-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8713133&dopt=Abstract
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Myths and facts.about botulism. Author(s): McConnell EA. Source: Nursing. 1998 September; 28(9): 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9775872&dopt=Abstract
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Neuromuscular physiology of wound botulism. Author(s): de Jesus PV Jr, Slater R, Spitz LK, Penn AS. Source: Archives of Neurology. 1973 December; 29(6): 425-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4357216&dopt=Abstract
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Neuro-ophthalmic findings in botulism type B. Author(s): Simcock PR, Kelleher S, Dunne JA. Source: Eye (London, England). 1994; 8 ( Pt 6): 646-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7867820&dopt=Abstract
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Neurophysiological and pharmacological differentiation of botulism and myasthenia. Author(s): Ricker K, Doll W. Source: Electroencephalography and Clinical Neurophysiology. 1971 March; 30(3): 260. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4103193&dopt=Abstract
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Neurophysiological assessment in the diagnosis of botulism: usefulness of singlefiber EMG. Author(s): Padua L, Aprile I, Monaco ML, Fenicia L, Anniballi F, Pauri F, Tonali P. Source: Muscle & Nerve. 1999 October; 22(10): 1388-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10487905&dopt=Abstract
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Neurophysiological tests in human botulism. Author(s): Valli G, Barbieri S, Scarlato G. Source: Electromyogr Clin Neurophysiol. 1983 January-February; 23(1-2): 3-11. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6301806&dopt=Abstract
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No evidence that botulism causes sudden infant deaths. Author(s): Pottgen P, Davis ER. Source: The New England Journal of Medicine. 1977 January 6; 296(1): 55-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=830280&dopt=Abstract
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Nursing care study. Botulism: a team effort to save the poison salmon victims. Author(s): Panrucker R. Source: Nurs Mirror. 1978 December 14; 147(24): 32-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=252047&dopt=Abstract
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Ocular findings in botulism type B. Author(s): Terranova W, Palumbo JN, Breman JG. Source: Jama : the Journal of the American Medical Association. 1979 February 2; 241(5): 475-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=366187&dopt=Abstract
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Ocular involvement in benign botulism B. Author(s): Konig H, Gassman HB, Jenzer G. Source: American Journal of Ophthalmology. 1975 September; 80(3 Pt 1): 430-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1163591&dopt=Abstract
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Ocular involvement in wound botulism. Author(s): Miller NR, Moses H. Source: Archives of Ophthalmology. 1977 October; 95(10): 1788-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=911250&dopt=Abstract
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On the first systematic descriptions of botulism and botulinum toxin by Justinus Kerner (1786-1862). Author(s): Erbguth FJ, Naumann M. Source: Journal of the History of the Neurosciences. 2000 August; 9(2): 218-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11232521&dopt=Abstract
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Opiate withdrawal and botulism: stigma delayed treatment. Author(s): Marlowe K. Source: Bmj (Clinical Research Ed.). 2003 April 12; 326(7393): 822. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12689986&dopt=Abstract
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Outbreak of botulism in Kenya after ingestion of white ants. Author(s): Knightingale KW, Ayim EN. Source: British Medical Journal. 1980 December 20-27; 281(6256): 1682-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7448568&dopt=Abstract
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Outbreak of botulism in Kenyan nomads. Author(s): Smith DH, Timms GL, Refai M. Source: Annals of Tropical Medicine and Parasitology. 1979 April; 73(2): 145-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=573988&dopt=Abstract
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Outbreak of botulism in north west England and Wales, June, 1989. Author(s): Critchley EM, Hayes PJ, Isaacs PE. Source: Lancet. 1989 October 7; 2(8667): 849-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2571770&dopt=Abstract
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Outbreak of suspected Clostridium butyricum botulism in India. Author(s): Chaudhry R, Dhawan B, Kumar D, Bhatia R, Gandhi JC, Patel RK, Purohit BC. Source: Emerging Infectious Diseases. 1998 July-September; 4(3): 506-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9716988&dopt=Abstract
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Outbreak of type A botulism and development of a botulism surveillance and antitoxin release system in Argentina. Author(s): Villar RG, Shapiro RL, Busto S, Riva-Posse C, Verdejo G, Farace MI, Rosetti F, San Juan JA, Julia CM, Becher J, Maslanka SE, Swerdlow DL. Source: Jama : the Journal of the American Medical Association. 1999 April 14; 281(14): 1334-8, 1340. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10208152&dopt=Abstract
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Outbreak of type A botulism caused by a commercial food product in Taiwan: clinical and epidemiological investigations. Author(s): Tsai SJ, Chang YC, Wang JD, Chou JH. Source: Zhonghua Yi Xue Za Zhi (Taipei). 1990 July; 46(1): 43-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2176923&dopt=Abstract
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Pathogenesis of human botulism. Author(s): Maselli RA. Source: Annals of the New York Academy of Sciences. 1998 May 13; 841: 122-39. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9668232&dopt=Abstract
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Pathophysiologic aspects of human botulism. Author(s): Gutmann L, Pratt L. Source: Archives of Neurology. 1976 March; 33(3): 175-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1252159&dopt=Abstract
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Patient recovery from type A botulism: morbidity assessment following a large outbreak. Author(s): Mann JM, Martin S, Hoffman R, Marrazzo S. Source: American Journal of Public Health. 1981 March; 71(3): 266-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7468858&dopt=Abstract
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Physical and psychosocial health status 3 years after catastrophic illness--botulism. Author(s): Cohen FL, Hardin SB, Nehring W, Keough MA, Laurenti S, McNabb J, Platis C, Weber C. Source: Issues in Mental Health Nursing. 1988; 9(4): 387-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3229985&dopt=Abstract
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Pigbel, cholera and infant botulism--a new paradigm for gut disease. Author(s): Murrell TG. Source: Australas Nurses J. 1979 September; 8(11): 14-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=230800&dopt=Abstract
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Plasmapheresis as an adjunct treatment in severe botulism. Author(s): Atabek ME, Yavuz H, Oran B, Karaaslan S, Erkul I. Source: Intensive Care Medicine. 2002 June; 28(6): 814. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12269246&dopt=Abstract
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Plastic bags and botulism: a new twist to an old hazard of the North. Author(s): Eisenberg MS, Bender TR. Source: Alaska Med. 1976 July; 18(4): 47-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=970583&dopt=Abstract
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Potentiation of neuromuscular weakness in infant botulism by aminoglycosides. Author(s): L'Hommedieu C, Stough R, Brown L, Kettrick R, Polin R. Source: The Journal of Pediatrics. 1979 December; 95(6): 1065-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=501488&dopt=Abstract
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Preventing complications in infant botulism. Author(s): Wise EJ. Source: Dimensions of Critical Care Nursing : Dccn. 1995 March-April; 14(2): 86-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7889803&dopt=Abstract
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Proceedings: Pupillographic and electromyographic findings in botulism. Author(s): Hagenah R, Muller-Jensen A. Source: Electroencephalography and Clinical Neurophysiology. 1975 November; 39(5): 532. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=52455&dopt=Abstract
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Progression of clinical signs in severe infant botulism. Therapeutic implications. Author(s): L'Hommedieu C, Polin RA. Source: Clinical Pediatrics. 1981 February; 20(2): 90-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6257443&dopt=Abstract
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Prolonged recovery from type A botulism. Author(s): Mann J. Source: The New England Journal of Medicine. 1983 December 15; 309(24): 1522-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6646180&dopt=Abstract
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Prolonged respiratory paralysis in wound botulism. Author(s): Lewis SW, Pierson DJ, Cary JM, Hudson LD. Source: Chest. 1979 January; 75(1): 59-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=421526&dopt=Abstract
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Protective role of human milk against sudden death from infant botulism. Author(s): Arnon SS, Damus K, Thompson B, Midura TF, Chin J. Source: The Journal of Pediatrics. 1982 April; 100(4): 568-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7038077&dopt=Abstract
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Psychosocial effects of a catastrophic botulism outbreak. Author(s): Hardin SB, Cohen FL. Source: Archives of Psychiatric Nursing. 1988 June; 2(3): 173-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3395152&dopt=Abstract
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Quantification of Clostridium botulinum type A toxin and organisms in the feces of a case of infant botulism and examination of other related specimens. Author(s): Takahashi M, Shimizu T, Ooi K, Noda H, Nasu T, Sakaguchi G. Source: Jpn J Med Sci Biol. 1988 February; 41(1): 21-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3057266&dopt=Abstract
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Quantitation of Clostridium botulinum organisms and toxin in the feces of an infant with botulism. Author(s): Paton JC, Lawrence AJ, Manson JI. Source: Journal of Clinical Microbiology. 1982 January; 15(1): 1-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6764763&dopt=Abstract
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Quantitative evidence of intestinal colonization by Clostridium botulinum in four cases of infant botulism. Author(s): Wilcke BW Jr, Midura TF, Arnon SS. Source: The Journal of Infectious Diseases. 1980 April; 141(4): 419-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6989924&dopt=Abstract
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Quantities of Clostridium botulinum organisms and toxin in feces and presence of Clostridium botulinum toxin in the serum of an infant with botulism. Author(s): Paton JC, Lawrence AJ, Steven IM. Source: Journal of Clinical Microbiology. 1983 January; 17(1): 13-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6338033&dopt=Abstract
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Rapid diagnosis of a case of infant botulism by enzyme immunoassay. Author(s): Dezfulian M, Yolken R, Bartlett J. Source: Pediatr Infect Dis. 1985 July-August; 4(4): 399-401. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3895179&dopt=Abstract
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Recovery of the ventilatory and upper airway muscles and exercise performance after type A botulism. Author(s): Wilcox PG, Morrison NJ, Pardy RL. Source: Chest. 1990 September; 98(3): 620-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2394140&dopt=Abstract
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Relapse of infant botulism. Author(s): Glauser TA, Maguire HC, Sladky JT. Source: Annals of Neurology. 1990 August; 28(2): 187-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2221848&dopt=Abstract
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Repeated type E botulism in an Alaskan Eskimo. Author(s): Beller M, Middaugh JP. Source: The New England Journal of Medicine. 1990 March 22; 322(12): 855. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2308624&dopt=Abstract
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Resident rounds on infant botulism. Author(s): Bodensteiner J. Source: Clinical Pediatrics. 1998 March; 37(3): 211. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9545612&dopt=Abstract
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Respiratory care in acute botulism: a report of four cases. Author(s): Paust JC. Source: Anesthesia and Analgesia. 1971 November-December; 50(6): 1003-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5166883&dopt=Abstract
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Respiratory reanimation in extremely severe course of botulism. Author(s): Popova LM. Source: Int J Neurol. 1978; 11(4): 342-55. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=757789&dopt=Abstract
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Response to letters on infant botulism. Author(s): Arnon SS. Source: Pediatrics. 1982 June; 69(6): 830-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7079057&dopt=Abstract
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Restaurant-associated type A botulism: transmission by potato salad. Author(s): Seals JE, Snyder JD, Edell TA, Hatheway CL, Johnson CJ, Swanson RC, Hughes JM. Source: American Journal of Epidemiology. 1981 April; 113(4): 436-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7010999&dopt=Abstract
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Retrospective study of 108 cases of botulism in Poitiers, France. Author(s): Roblot P, Roblot F, Fauchere JL, Devilleger A, Marechaud R, Breux JP, Grollier G, Becq-Giraudon B. Source: Journal of Medical Microbiology. 1994 June; 40(6): 379-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8006928&dopt=Abstract
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Reversible esophageal motor dysfunction in botulism. Author(s): Nix WA, Eckardt VF, Kramer G. Source: Muscle & Nerve. 1985 November-December; 8(9): 791-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4079957&dopt=Abstract
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Ribotyping as an identification tool for Clostridium botulinum strains causing human botulism. Author(s): Hielm S, Bjorkroth J, Hyytia E, Korkeala H. Source: International Journal of Food Microbiology. 1999 March 1; 47(1-2): 121-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10357280&dopt=Abstract
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Risk factors for infant botulism in the United States. Author(s): Spika JS, Shaffer N, Hargrett-Bean N, Collin S, MacDonald KL, Blake PA. Source: Am J Dis Child. 1989 July; 143(7): 828-32. Erratum In: Am J Dis Child 1990 January; 144(1): 60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2741856&dopt=Abstract
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Risk of infant botulism from corn syrup. Author(s): Olsen SJ, Swerdlow DL. Source: The Pediatric Infectious Disease Journal. 2000 June; 19(6): 584-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10877185&dopt=Abstract
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Sequence of the gene coding for the neurotoxin of Clostridium botulinum type A associated with infant botulism: comparison with other clostridial neurotoxins. Author(s): Willems A, East AK, Lawson PA, Collins MD. Source: Research in Microbiology. 1993 September; 144(7): 547-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8310180&dopt=Abstract
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Sequence of the gene for Clostridium botulinum type B neurotoxin associated with infant botulism, expression of the C-terminal half of heavy chain and its binding activity. Author(s): Ihara H, Kohda T, Morimoto F, Tsukamoto K, Karasawa T, Nakamura S, Mukamoto M, Kozaki S. Source: Biochimica Et Biophysica Acta. 2003 January 3; 1625(1): 19-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12527421&dopt=Abstract
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Serum antibody response to Clostridium botulinum toxin in infant botulism. Author(s): Rubin LG, Dezfulian M, Yolken RH. Source: Journal of Clinical Microbiology. 1982 October; 16(4): 770-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7153329&dopt=Abstract
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Serum positive botulism with neuropathic features. Author(s): Chang VH, Robinson LR. Source: Archives of Physical Medicine and Rehabilitation. 2000 January; 81(1): 122-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10638887&dopt=Abstract
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Severe adult botulism. Author(s): Mackle IJ, Halcomb E, Parr MJ. Source: Anaesthesia and Intensive Care. 2001 June; 29(3): 297-300. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11439805&dopt=Abstract
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Severe botulism after eating home-preserved asparagus. Author(s): Paterson DL, King MA, Boyle RS, Pond SM, Whitby M, Wright M, Henderson A. Source: The Medical Journal of Australia. 1992 August 17; 157(4): 269-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1435446&dopt=Abstract
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Single fiber EMG and cardiovascular reflexes in botulism: a follow-up study. Author(s): Vita G, Girlanda P, Russo P, Scuderi D, Puglisi RM, Marabello L. Source: Italian Journal of Neurological Sciences. 1986 February; 7(1): 71-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3957635&dopt=Abstract
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Single fibre EMG in 6 cases of botulism. Author(s): Girlanda P, Dattola R, Messina C. Source: Acta Neurologica Scandinavica. 1983 February; 67(2): 118-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6845977&dopt=Abstract
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Slow recovery from severe foodborne botulism. Author(s): Colebatch JG, Wolff AH, Gilbert RJ, Mathias CJ, Smith SE, Hirsch N, Wiles CM. Source: Lancet. 1989 November 18; 2(8673): 1216-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2572925&dopt=Abstract
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Some preliminary studies on low incidence of infant botulism in the United Kingdom. Author(s): Berry PR, Gilbert RJ, Oliver RW, Gibson AA. Source: Journal of Clinical Pathology. 1987 January; 40(1): 121. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3546387&dopt=Abstract
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Staphylococcal food poisoning and botulism. Author(s): Gilbert RJ. Source: Postgraduate Medical Journal. 1974 October; 50(588): 603-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4619651&dopt=Abstract
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Stimulated single-fiber electromyography in wound botulism. Author(s): Mandler RN, Maselli RA. Source: Muscle & Nerve. 1996 September; 19(9): 1171-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8761277&dopt=Abstract
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Stimulation single-fiber EMG in infant botulism. Author(s): Chaudhry V, Crawford TO. Source: Muscle & Nerve. 1999 December; 22(12): 1698-703. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10567083&dopt=Abstract
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Surveillance for botulism in the United States, 1968-1969. Author(s): Donadio JA, Gangarosa EJ. Source: The Journal of Infectious Diseases. 1970 July-August; 122(1): 122-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5433707&dopt=Abstract
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Suspected botulism in dairy cows and its implications for the safety of human food. Author(s): Cobb SP, Hogg RA, Challoner DJ, Brett MM, Livesey CT, Sharpe RT, Jones TO. Source: The Veterinary Record. 2002 January 5; 150(1): 5-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11817867&dopt=Abstract
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Syndrome if infant botulism. Author(s): Berg BO. Source: Pediatrics. 1977 March; 59(3): 321-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=320547&dopt=Abstract
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Syndrome of botulism in infancy: clinical and electrophysiologic study. Author(s): Pickett J, Berg B, Chaplin E, Brunstetter-Shafer MA. Source: The New England Journal of Medicine. 1976 September 30; 295(14): 770-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=785257&dopt=Abstract
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Tetanus and botulism neurotoxins: a new group of zinc proteases. Author(s): Montecucco C, Schiavo G. Source: Trends in Biochemical Sciences. 1993 September; 18(9): 324-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7901925&dopt=Abstract
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The botulism hazard. Author(s): Sacks HS. Source: Annals of Internal Medicine. 1997 June 1; 126(11): 918-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9163303&dopt=Abstract
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The challenge of infant botulism. Author(s): Miller DK. Source: Mcn. the American Journal of Maternal Child Nursing. 1982 May-June; 7(3): 1803. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6804736&dopt=Abstract
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The changing epidemiology of adult botulism in the United States. Author(s): MacDonald KL, Cohen ML, Blake PA. Source: American Journal of Epidemiology. 1986 November; 124(5): 794-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3766512&dopt=Abstract
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The first case of type B infant botulism in Japan. Author(s): Kakinuma H, Maruyama H, Takahashi H, Yamakawa K, Nakamura S. Source: Acta Paediatr Jpn. 1996 October; 38(5): 541-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8942019&dopt=Abstract
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The history of botulism. Author(s): Geiges ML. Source: Current Problems in Dermatology. 2002; 30: 77-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12471701&dopt=Abstract
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The large intestine as the site of Clostridium botulinum colonization in human infant botulism. Author(s): Mills DC, Arnon SS. Source: The Journal of Infectious Diseases. 1987 December; 156(6): 997-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3316418&dopt=Abstract
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The mechanism of botulism. Author(s): Chao LP. Source: Medical Hypotheses. 1986 January; 19(1): 83-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3634904&dopt=Abstract
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The metallo-proteinase activity of tetanus and botulism neurotoxins. Author(s): Rossetto O, Deloye F, Poulain B, Pellizzari R, Schiavo G, Montecucco C. Source: Journal of Physiology, Paris. 1995; 89(1): 43-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7581298&dopt=Abstract
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Transient paralysis of the bladder due to wound botulism. Author(s): Sautter T, Herzog A, Hauri D, Schurch B. Source: European Urology. 2001 May; 39(5): 610-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11464047&dopt=Abstract
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Transient tonic pupils in botulism type B. Author(s): Monaco S, Freddi N, Francavilla E, Meneghetti F, Fenicia L, Franciosa G, Cadrobbi P. Source: Journal of the Neurological Sciences. 1998; 156(1): 96-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9559994&dopt=Abstract
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Treatment of two unusual cases of type A and E botulism following consumption of salted fish. Author(s): Vahdani P, Pourshafie MR, Aminzadeh Z. Source: Intensive Care Medicine. 2002 August; 28(8): 1189. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400518&dopt=Abstract
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Two cases of foodborne botulism type E and review of epidemiology in France. Author(s): Boyer A, Girault C, Bauer F, Korach JM, Salomon J, Moirot E, Leroy J, Bonmarchand G. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2001 March; 20(3): 192-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11347670&dopt=Abstract
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Two cases of type E infant botulism caused by neurotoxigenic Clostridium butyricum in Italy. Author(s): Aureli P, Fenicia L, Pasolini B, Gianfranceschi M, McCroskey LM, Hatheway CL. Source: The Journal of Infectious Diseases. 1986 August; 154(2): 207-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3722863&dopt=Abstract
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Two fatal cases of type E adult food-borne botulism with early symptoms and terminal neurologic signs. Author(s): Badhey H, Cleri DJ, D'Amato RF, Vernaleo JR, Veinni V, Tessler J, Wallman AA, Mastellone AJ, Giuliani M, Hochstein L. Source: Journal of Clinical Microbiology. 1986 March; 23(3): 616-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3514662&dopt=Abstract
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Two outbreaks of botulism associated with fermented salmon roe--British Columbia, August 2001. Author(s): Dawar M, Moody L, Martin JD, Fung C, Isaac-Renton J, Patrick DM. Source: Can Commun Dis Rep. 2002 March 15; 28(6): 45-9. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11925710&dopt=Abstract
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Type A botulism from commercially canned beef stew. Author(s): Blake PA, Horwitz MA, Hopkins L, Lombard GL, McCroan JE, Prucha JC, Merson MH. Source: Southern Medical Journal. 1977 January; 70(1): 5-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=320672&dopt=Abstract
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Type A botulism from sauteed onions. Clinical and epidemiologic observations. Author(s): MacDonald KL, Spengler RF, Hatheway CL, Hargrett NT, Cohen ML. Source: Jama : the Journal of the American Medical Association. 1985 March 1; 253(9): 1275-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3968852&dopt=Abstract
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Type E botulism associated with vacuum-packaged hot-smoked whitefish. Author(s): Korkeala H, Stengel G, Hyytia E, Vogelsang B, Bohl A, Wihlman H, Pakkala P, Hielm S. Source: International Journal of Food Microbiology. 1998 August 18; 43(1-2): 1-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9761332&dopt=Abstract
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Type F botulism due to neurotoxigenic Clostridium baratii from an unknown source in an adult. Author(s): McCroskey LM, Hatheway CL, Woodruff BA, Greenberg JA, Jurgenson P. Source: Journal of Clinical Microbiology. 1991 November; 29(11): 2618-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1774272&dopt=Abstract
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Ultrastructural study of the motor end-plate in botulism and Lambert-Eaton myasthenic syndrome. Author(s): Tsujihata M, Kinoshita I, Mori M, Mori K, Shirabe S, Satoh A, Nagataki S. Source: Journal of the Neurological Sciences. 1987 November; 81(2-3): 197-213. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3694228&dopt=Abstract
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Update: infant botulism. Author(s): Midura TF. Source: Clinical Microbiology Reviews. 1996 April; 9(2): 119-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8964030&dopt=Abstract
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Upper airway obstruction and infant botulism. Author(s): Oken A, Barnes S, Rock P, Maxwell L. Source: Anesthesia and Analgesia. 1992 July; 75(1): 136-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1616141&dopt=Abstract
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Vascular thrombi and neuronal alterations in human botulism. Author(s): Tyler HR. Source: Acta Neuropathologica. 1968 January 2; 10(1): 82-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5640118&dopt=Abstract
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What's next? It could be smallpox, botulism or other equally deadly biological agents. Author(s): Golden F. Source: Time. 2001 November 5; 158(20): 44-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11710156&dopt=Abstract
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Wound botulism among black tar heroin users--Washington, 2003. Author(s): Centers for Disease Control and Prevention (CDC). Source: Mmwr. Morbidity and Mortality Weekly Report. 2003 September 19; 52(37): 8856. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13679792&dopt=Abstract
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Wound botulism associated with a positive tensilon test. Author(s): Edell TA, Sullivan CP Jr, Osborn KM, Gambin JP, Brenman RD. Source: The Western Journal of Medicine. 1983 August; 139(2): 218-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6636734&dopt=Abstract
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Wound botulism associated with black tar heroin and lower extremity cellulitis. Author(s): Mitchell PA, Pons PT. Source: The Journal of Emergency Medicine. 2001 May; 20(4): 371-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11348817&dopt=Abstract
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Wound botulism associated with black tar heroin. Author(s): Horowitz BZ, Swensen E, Marquardt K. Source: Jama : the Journal of the American Medical Association. 1998 November 4; 280(17): 1479-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9809721&dopt=Abstract
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Wound botulism associated with black tar heroin. Author(s): Bamberger J, Terplan M. Source: Jama : the Journal of the American Medical Association. 1998 November 4; 280(17): 1479; Author Reply 1480. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9809720&dopt=Abstract
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Wound botulism associated with subcutaneous drug use. Author(s): Merrison AF, Chidley KE, Dunnett J, Sieradzan KA. Source: Bmj (Clinical Research Ed.). 2002 November 2; 325(7371): 1020-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411365&dopt=Abstract
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Wound botulism in a patient with a tooth abscess: case report and review. Author(s): Weber JT, Goodpasture HC, Alexander H, Werner SB, Hatheway CL, Tauxe RV. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1993 May; 16(5): 635-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8507754&dopt=Abstract
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Wound botulism in an injecting drug abuser. Author(s): Thomas GL, Haji-Michael PG. Source: Intensive Care Medicine. 2003 May; 29(5): 857. Epub 2003 April 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682717&dopt=Abstract
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Wound botulism in California, 1951-1998: recent epidemic in heroin injectors. Author(s): Werner SB, Passaro D, McGee J, Schechter R, Vugia DJ. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 October; 31(4): 1018-24. Epub 2000 October 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11049786&dopt=Abstract
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Wound botulism in drug addicts in the United Kingdom. Author(s): Mulleague L, Bonner SM, Samuel A, Nichols P, Khan M, Shaw S, Gruning T. Source: Anaesthesia. 2001 February; 56(2): 120-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11167471&dopt=Abstract
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Wound botulism in injecting drug users. Author(s): McGarrity L. Source: Anaesthesia. 2002 March; 57(3): 301-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11892652&dopt=Abstract
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Wound botulism in the UK. Author(s): Athwal BS, Gale AN, Brett MM, Youl BD. Source: Lancet. 2001 January 20; 357(9251): 234. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11213130&dopt=Abstract
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Wound botulism in UK. Author(s): Athwal BS, Gale AN, Brett MM, Youl BD. Source: Lancet. 2000 December 9; 356(9246): 2011-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11130548&dopt=Abstract
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Wound botulism. Author(s): Cherington M, Ginsburg S. Source: Archives of Surgery (Chicago, Ill. : 1960). 1975 April; 110(4): 436-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1147760&dopt=Abstract
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Wound botulism. Author(s): Burningham MD, Walter FG, Mechem C, Haber J, Ekins BR. Source: Annals of Emergency Medicine. 1994 December; 24(6): 1184-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7978607&dopt=Abstract
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Wound botulism. Author(s): Mechem CC, Walter FG. Source: Vet Hum Toxicol. 1994 June; 36(3): 233-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8066973&dopt=Abstract
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Wound botulism. Author(s): Weber JT. Source: Hosp Pract (Off Ed). 1994 April 15; 29(4): 16, 26. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8144719&dopt=Abstract
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Wound botulism. Author(s): Swedberg J, Wendel TH, Deiss F. Source: The Western Journal of Medicine. 1987 September; 147(3): 335-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3314158&dopt=Abstract
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CHAPTER 2. NUTRITION AND BOTULISM Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and botulism.
Finding Nutrition Studies on Botulism The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “botulism” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7 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 “botulism” (or a synonym): •
Are milk and milk products able to cause human diseases due to Clostridium butyricum, a possible pathogenic bacterium for man [Progress report of IDF Group A19]. Author(s): INRA, Thiverval-Grignon (France). Lab. de Technologie Source: Bergere, J.L. Bulletin-FIL-IDF (Belgium). Federation Internationale de Laiterie International Dairy Federation. (1995). (no.302) page 6-9. milk milk products clostridium butyricum human diseases infants foodborne diseases botulism colitis enteritis 02505118
•
Botulinum toxin: a poison that can heal. Source: Vangelova, L. FDA-consumer (USA). (December 1995). volume 29(10) page 1619. botulism toxins foodborne diseases poisoning medicinal properties food technology handling food safety 0362-1332
Additional physician-oriented references include: •
A comparison of human and animal botulism: a review. Author(s): Department of Neurology, Royal Preston Hospital. Source: Critchley, E M J-R-Soc-Med. 1991 May; 84(5): 295-8 0141-0768
•
Botulism associated with Clostridium botulinum sinusitis after intranasal cocaine abuse. Author(s): Olive View Medical Center, Sylmar, California. Source: Kudrow, D B Henry, D A Haake, D A Marshall, G Mathisen, G E Ann-InternMed. 1988 December 15; 109(12): 984-5 0003-4819
•
Botulism from chopped garlic: delayed recognition of a major outbreak. Author(s): Enteric Diseases Branch, Centers for Disease Control, Atlanta, Georgia. Source: St Louis, M E Peck, S H Bowering, D Morgan, G B Blatherwick, J Banerjee, S Kettyls, G D Black, W A Milling, M E Hauschild, A H et al. Ann-Intern-Med. 1988 March; 108(3): 363-8 0003-4819
•
Botulism outbreak associated with poultry litter consumption in three Brazilian cattle herds. Author(s): Department of Clinical Sciences, College of Veterinary Medicine, University of Sao Paulo, Brazil. Source: Ortolani, E L Brito, L A Mori, C S Schalch, U Pacheco, J Baldacci, L Vet-HumToxicol. 1997 April; 39(2): 89-92 0145-6296
•
Botulism risk from post-processing contamination of commercially canned foods in metal containers. Source: J-Food-Prot. Ames, Iowa : International Association of Milk, Food, and Environmental Sanitarians. October 1984. volume 47 (10) page 801-816. charts. 0362028X
•
Botulism risk of refrigerated, processed foods of extended durability. Source: Notermans, S. Dufrenne, J. Lund, B.M. J-Food-Prot. Des Moines, Iowa : International Association of Milk, Food, and Environmental Sanitarians. December 1990. volume 53 (12) page 1020-1024. 0362-028X
•
Epizootic botulism of cattle in Brazil. Author(s): Empresa Brasileira de Pesquisa Agropecuaria (EMBRAPA), Projeto Saude Animal Embrapa/UFRRJ, Rio de Janeiro.
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Source: Dobereiner, J Tokarnia, C H Langenegger, J Dutra, I S Dtsch-TierarztlWochenschr. 1992 May; 99(5): 188-90 0341-6593 •
Garlic-in-oil associated botulism: episode leads to product modification. Author(s): Bureau of Communicable Disease Control, New York State Department of Health and State University, Albany. Source: Morse, D L Pickard, L K Guzewich, J J Devine, B D Shayegani, M Am-J-PublicHealth. 1990 November; 80(11): 1372-3 0090-0036
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Infant botulism. Source: Nutr-and-M.D. Van Nuys : PM, Inc. December 1982. volume 8 (12) page 3-4.
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Infant botulism: case report and clinical update. Author(s): Department of Emergency Medicine, Bethesda Naval Hospital, MD. Source: Jagoda, A Renner, G Am-J-Emerg-Med. 1990 July; 8(4): 318-20 0735-6757
•
The history of botulism. Author(s): Department of Dermatology, University Hospital of Zurich, Switzerland.
[email protected] Source: Geiges, M L Curr-Probl-Dermatol. 2002; 30: 77-93 0070-2064
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Type B botulism associated with roasted eggplant in oil--Italy, 1993. Source: Anonymous MMWR-Morb-Mortal-Wkly-Repage 1995 January 20; 44(2): 33-6 0149-2195
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Wound botulism associated with black tar heroin. Author(s): Department of Emergency Medicine, Denver Health Medical Center, CO 80204, USA. Source: Anderson, M W Sharma, K Feeney, C M Acad-Emerg-Med. 1997 August; 4(8): 805-9 1069-6563
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Wound botulism--California, 1995. Source: Anonymous MMWR-Morb-Mortal-Wkly-Repage 1995 December 8; 44(48): 88992 0149-2195
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMD®Health: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to botulism; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Food and Diet Honey Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,283,00.html Natural Sweeteners Source: Healthnotes, Inc.; www.healthnotes.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND BOTULISM Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to botulism. 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 botulism 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 “botulism” (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 botulism: •
“Belladonna” poisoning confused with botulism. Author(s): Eichner ER, Gunsolus JM, Powers JF. Source: Jama : the Journal of the American Medical Association. 1967 August 28; 201(9): 695-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6071829&dopt=Abstract
•
An aggressive approach to limb dystonia: a case report. Author(s): Moberg-Wolff EA. Source: Archives of Physical Medicine and Rehabilitation. 1998 May; 79(5): 589-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9596405&dopt=Abstract
•
Approach to generalized weakness and peripheral neuromuscular disease. Author(s): LoVecchio F, Jacobson S.
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Source: Emergency Medicine Clinics of North America. 1997 August; 15(3): 605-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9255135&dopt=Abstract •
Bacterial food poisoning: what to do if prevention fails. Author(s): Goldfrank L, Weisman R. Source: Postgraduate Medicine. 1982 September; 72(3): 171-5, 178-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6812033&dopt=Abstract
•
Botulism from chopped garlic: delayed recognition of a major outbreak. Author(s): St Louis ME, Peck SH, Bowering D, Morgan GB, Blatherwick J, Banerjee S, Kettyls GD, Black WA, Milling ME, Hauschild AH, et al. Source: Annals of Internal Medicine. 1988 March; 108(3): 363-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3341673&dopt=Abstract
•
Botulism in China. Author(s): Shih Y, Chao SY. Source: Reviews of Infectious Diseases. 1986 November-December; 8(6): 984-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3797939&dopt=Abstract
•
Detection of preformed type A botulinal toxin in hash brown potatoes by using the mouse bioasssay and a modified ELISA test. Author(s): Ferreira JL, Eliasberg SJ, Harrison MA, Edmonds P. Source: J Aoac Int. 2001 September-October; 84(5): 1460-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11601465&dopt=Abstract
•
Differentiation between types and strains of Clostridium botulinum by riboprinting. Author(s): Skinner GE, Gendel SM, Fingerhut GA, Solomon HA, Ulaszek J. Source: J Food Prot. 2000 October; 63(10): 1347-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11041133&dopt=Abstract
•
Effect of guanidine and germine on the neuromuscular block of botulism. Author(s): Cherington M, Soyer A, Greenberg H. Source: Curr Ther Res Clin Exp. 1972 February; 14(2): 91-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4335307&dopt=Abstract
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Food-borne infections and intoxications--recent trends and prospects for the future. Author(s): Gilbert RJ. Source: Soc Appl Bacteriol Symp Ser. 1983; 11: 47-66. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6417799&dopt=Abstract
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•
Garlic-in-oil associated botulism: episode leads to product modification. Author(s): Morse DL, Pickard LK, Guzewich JJ, Devine BD, Shayegani M. Source: American Journal of Public Health. 1990 November; 80(11): 1372-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2240308&dopt=Abstract
•
Guanidine and germine in botulism. Author(s): Cherington M, Greenberg H, Soyer A. Source: Clin Toxicol. 1973; 6(1): 83-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4709574&dopt=Abstract
•
Inadequate stocking of antidotes in Taiwan: is it a serious problem? Author(s): Ong HC, Yang CC, Deng JF. Source: Journal of Toxicology. Clinical Toxicology. 2000; 38(1): 21-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10696920&dopt=Abstract
•
Role of zinc in the structure and toxic activity of botulinum neurotoxin. Author(s): Fu FN, Lomneth RB, Cai S, Singh BR. Source: Biochemistry. 1998 April 14; 37(15): 5267-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9548758&dopt=Abstract
•
The effect of toosendanin on monkey botulism. Author(s): Zou J, Miao WY, Ding FH, Meng JY, Ye HJ, Jia GR, He XY, Sun GZ, Li PZ. Source: J Tradit Chin Med. 1985 March; 5(1): 29-30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3849628&dopt=Abstract
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 botulism; 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 Food Poisoning Source: Integrative Medicine Communications; www.drkoop.com
•
Herbs and Supplements Hibiscus Alternative names: Hibiscus, Roselle; Hibiscus sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org
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 BOTULISM Overview In this chapter, we will give you a bibliography on recent dissertations relating to botulism. 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 “botulism” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on botulism, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Botulism 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 botulism. 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: •
Type C Avian Botulism with Reference to the Role of Bacteriophages by Hariharan, Harihar; Phd from University of Guelph (canada), 1976 http://wwwlib.umi.com/dissertations/fullcit/NK28078
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. CLINICAL TRIALS AND BOTULISM Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning botulism.
Recent Trials on Botulism The following is a list of recent trials dedicated to botulism.8 Further information on a trial is available at the Web site indicated. •
Study of Human Botulism Immunoglobulin in Infants With Botulism Condition(s): Infant Botulism; Botulism Study Status: This study is currently recruiting patients. Sponsor(s): FDA Office of Orphan Products Development; California Department of Health Services Purpose - Excerpt: Objectives: I. Determine the safety of human botulism immune globulin (BIG) in patients with infant botulism by monitoring side effects (e.g., rash, fever, hypotension, and anaphylaxis). II. Assess the efficacy of BIG in these patients by monitoring disease severity, incidence of complications (respiratory arrest, aspiration, pneumonia, etc.), and length of hospital stay. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004401
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. 8 These
are listed at www.ClinicalTrials.gov.
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The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “botulism” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON BOTULISM 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.9 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 “botulism” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on botulism, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Botulism By performing a patent search focusing on botulism, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We
9Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on botulism: •
Botulinum toxin neutralizer Inventor(s): Mutai; Masahiko (Highashiyamato, JP), Nagai; Yoshitaka (Setagaya, JP), Sakurai; Toshizo (Mitaka, JP), Takamizawa; Koutaro (Irima, JP), Takayama; Hiroo (Tokorozawa, JP), Tanaka; Ryuichiro (Tachikawa, JP) Assignee(s): Kabushiki Kaisha Yakult Honsha (Tokyo, JP) Patent Number: 5,306,730 Date filed: May 26, 1992 Abstract: A botulinum toxin neutralizer comprising at least one fatty acid having the number of carbon atoms of at least 12. Such a fatty acid may be any of saturated fatty acids such as lauric acid, myristic acid, palmitic acid, stearic acid, nonadecanoic acid, arachidic acid, and behenic acid or any of unsaturated fatty acids such as oleic acid. The toxin neutralizer acts as if it were an antagonistic receptor for botulinum toxin and, when encountering botulinum toxin in human body, directly combines with the toxin and disables the toxin from combining with the neuromuscular tissues of human body to prevent the outbreak of botulism. The toxin thus neutralized and affixed to the botulinum toxin neutralizer is excreted from the human body. The botulinum toxin neutralizer can be manufactured easily and economically from a naturally occurring glyceride and is thus far less costly then the known antitoxin of ganglioside GT1b produced from bovine brain. Excerpt(s): The present invention relates to a botulinum toxin neutralizer which is effective for the prevention and treatment of botulinum intoxication. Botulinum toxin is a proteinous exotoxin secreted by Clostridium botulinum broadly distributed in soil and acts at the tips of the motor nerve endings at the neuromuscular junctions. When orally ingested into human body, the botulinum toxin gives rise to intoxication called botulism which is accompanied by paralytic symptoms. The botulism breaks out when the neurotoxin is absorbed from the alimentary tract and combines selectively with the presynaptic membranes at the peripheries of the neuromuscular junctions. The toxin thus interferes with the release of acetylcholine from the chlorinergic motor nerve endings and eventually with conduction of nerve impulses in the terminal branches of the motor nerves to cause neuromuscular relaxing and paralysis characteristic of the botulism. Death may occur from paralysis of respiratory muscles in the worst case. As to the pathogenic mechanism of the botulinum toxin, it is established that the ganglioside GTlb, an acidic glycolipid present in the presynaptic membrane acts as a receptor for the toxin. While other types of gangliosides such as the gangliosides GQlb, GDlb and GDla also have the abilities of combining with botulinum toxin, these gangliosides are less potent than the ganglioside GTlb in combining with botulinum toxin and are, for this reason, considered less responsible for botulism. Web site: http://www.delphion.com/details?pn=US05306730__
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•
Composition active against botulism Inventor(s): Dell'Acqua; Ernani (Milan, IT), Johnson; Eric A. (Madison, WI) Assignee(s): Solchem Italiana S.p.A. (Milan, IT) Patent Number: 5,393,545 Date filed: February 3, 1993 Abstract: This invention relates to a composition of food having animal and/or vegetable origin which contains lysozyme and a chelating agent in amounts that are effective at preventing contamination of the food by Clostridium botulinum. Excerpt(s): The present invention relates to a specific use of lysozyme to combat the contamination of use of lysozyme to combat the contamination of foods having animal and/or vegetal origin caused by particular microorganisms. Foods intoxications caused by Clostridium botulinum are well known since a long time and they are among the most serious intoxications. The first cases happened because of sausages consumption and it has been believed for a long time that Clostridium botulinum could be transmitted only by proteins having an animal origin. Nevertheless it has been then demonstrated that also the foods having a vegetal origin could be responsible for this type of toxoinfection. Clostridium botulinum is a sporigen mesophile germ. It has bacillary form and rounded ends. It presents itself as isolated, coupled or in chains, sometimes even long chains. It has ovoidal spores. It is gram-positive, gas producer and anaerobic. Different types thereof are known: A, B, C, D, E, F and G (some of which are proteolytic and some others are non-proteolytic). Web site: http://www.delphion.com/details?pn=US05393545__
Patent Applications on Botulism As of December 2000, U.S. patent applications are open to public viewing.10 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 botulism: •
Recombinant vaccine against botulinum neurotoxin Inventor(s): Brown, Douglas R.; (Gaithersburg, MD), Byrne, Michael P.; (New Market, MD), Clayton, Michael A.; (Mt. Airy, MD), Lapenotiere, Hugh; (Charlestown, WV), Middlebrook, John L.; (Middletown, MD), Smith, Leonard A.; (Clarksburg, MD) Correspondence: BAKER & BOTTS; 30 ROCKEFELLER PLAZA; NEW YORK; NY; 10112 Patent Application Number: 20030009025 Date filed: July 20, 2001 Abstract: This invention is directed to preparation and expression of synthetic genes encoding polypeptides containing protective epitopes of botulinum neurotoxin (BoNT). The invention is also directed to production of immunogenic peptides encoded by the synthetic genes, as weel as recovery and purification of the immunogenic peptides from
10
This has been a common practice outside the United States prior to December 2000.
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recombinant organisms. The invention is also directed to methods of vaccination against botulism using the expressed peptides. Excerpt(s): This application is based on U.S. Provisional Application Nos. 60/133,866, 60/133,868, 60/133,869, 60/133,865, 60/133,873, 60/133,867, all filed May 12, 1999, and U.S. Provisional Application No. 60/146,192, filed Jul. 29, 1999, all of which are incorporated herein in their entirety. This invention is directed to preparation and expression of synthetic genes encoding polypeptides containing protective epitopes of botulinum neurotoxin (BoNT). The invention is also directed to methods of vaccination against botulism using the expressed peptides. The sporulating, obligate anaerobic, gram-positive bacillus Clostridium produces eight forms of antigenically distinct exotoxins. Tetanus neurotoxin (TeNT) is produced by Clostridium tetani while Clostridium botulinum produces seven different neurotoxins which are differentiated serologically by specific neutralization. The botulinum neurotoxins (BoNT) have been designated as serotypes A, B, C.sub.1, D, E, P, and G. Botulinum neurotoxins (BoNT) are the most toxic substances known and are the causative agents of the disease botulism. BoNT exert their action by inhibiting the release of the neurotransmitter acetylcholine at the neuromuscular junction (Habermann, E., et al., (1986), "Clostridial Neurotoxins: Handling and Action at the Cellular and Molecular Level," Cur. Top. Microbiol. Immunol., 129:93-179; Schiavo, G., et al., (1992a), "Tetanus and Botulinum-B Neurotoxins Block Neurotransmitter Release by Proteolytic Cleavage of Synaptobrevin," Nature, 359:832-835; Simpson, L. L., (1986), "Molecular Pharmacology of Botulinum Toxin and Tetanus Toxin," Annu. Rev. Pharmacol. Toxicol., 26:427-453) which leads to a state of flaccid paralysis. Indeed, only a few molecules of toxin can abolish the action of a nerve cell. Polyclonal antibodies derived for a specific neurotoxin can neutralize the toxic effects of that toxin but will not cross-neutralize another toxin serotype. Thus, to protect against all seven toxins, one needs seven vaccines. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
THERAPEUTIC MONOCLONAL BOTULINUM NEUROTOXINS
ANTIBODIES
THAT
NEUTRALIZE
Inventor(s): AMERSDORFER, PETER; (BOSTON, MA), MARKS, JAMES D.; (KENSINGTON, CA) Correspondence: LAW OFFICES OF JONATHAN ALAN QUINE; P O BOX 458; ALAMEDA; CA; 94501 Patent Application Number: 20020155114 Date filed: August 31, 1998 Abstract: This invention provides antibodies that specifically bind to and neutralize botulinum neurotoxin type A (BoNT/A) and the epitopes bound by those antibodies. The antibodies and derivatives thereof and/or other antibodies that specifically bind to the neutralizing epitopes provided herein can be used to neutralize botulinum neurotoxin and are therefore also useful in the treatment of botulism. Excerpt(s): This invention relates antibodies that neutralize botulinum neurotoxin type A (BoNT/A) and their use in the treatment of botulism. Botulism is a life-threatening, flaccid paralysis caused by a neurotoxin produced by the anaerobic bacterium Clostridium botulinum. The disease typically results from ingestion of pre-formed toxin present in contaminated food (Dowell (1984) Rev. Infect. Dis. 6(Suppl. 1): S202-S207), from toxin produced in vivo from infected wounds (Weber (1993) Clin. Infect. Dis., 16:
Patents 77
635-639, in the intestines of infants (Arnon (1992) in Textbook of pediatric infectious diseases, R. D. Feigen and J. D. Cherry (ed.), 3rd ed., Saunders, Philadelphia, Pa.), or occasionally in adults. In severe cases, patients require prolonged hospitalization in an intensive-care unit and mechanical ventilation. Specific therapy consists of administration of botulism antitoxin trivalent (equine) (Tacket et al. Am. J. Med., 76: 794-798); however, this product has a high incidence of side effects, including serum sickness and anaphylaxis (Black, et al. (1980) Am. J. Med., 69: 567-570). To avoid these side effects, human BIG has been produced from immunized volunteers and its efficacy is being determined in a prospective randomized trial in infants with botulism (Arnon (1993) pages 477-482 in Botulinum and tetanus neurotoxins: neurotransmission and biomedical aspects, B. R. DasGupta (ed.), Plenum, New York, N.Y.). While theoretically nontoxic, human BIG also has limitations, largely related to production issues. These include potential transmission of blood-borne infectious diseases, variability in potency and specificity between lots, and the need to immunize humans. The latter issue has taken on increased importance with the use of BoNTs for the treatment of a range of neuromuscular diseases (Jankovic et al. (1994) Therapy with botulinum toxin. Marcel Dekker, New York, N.Y.; Moore (1995) Handbook of botulinum toxin treatment, Blackwell Science, Oxford, United Kingdom). Immunization of volunteers for production of BIG would deprive them of subsequent botulinum therapy. 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 botulism, 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 “botulism” (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 botulism. You can also use this procedure to view pending patent applications concerning botulism. 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 7. BOOKS ON BOTULISM Overview This chapter provides bibliographic book references relating to botulism. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on botulism 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 “botulism” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “botulism” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “botulism” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Avian Botulism: An International Perspective by Melvin W. Eklund, et al; ISBN: 0398053111; http://www.amazon.com/exec/obidos/ASIN/0398053111/icongroupinterna
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Biomedical Aspects of Botulism by George Lewis; ISBN: 0124471803; http://www.amazon.com/exec/obidos/ASIN/0124471803/icongroupinterna
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Bioterrorism and Biology of Botulism Clostridium Botulinum: Index of New Information and Guide-Book for Consumers, Reference and Research by John C., Dr Bartone (2001); ISBN: 0788327119; http://www.amazon.com/exec/obidos/ASIN/0788327119/icongroupinterna
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Botulism (1988); ISBN: 0398035431; http://www.amazon.com/exec/obidos/ASIN/0398035431/icongroupinterna
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Botulism by Maxine Rosaler; ISBN: 0823941973; http://www.amazon.com/exec/obidos/ASIN/0823941973/icongroupinterna
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•
Botulism: The Organism, Its Toxins, the Disease by Louis De Spain Smith, Hiroshi Sugiyama; ISBN: 0398054460; http://www.amazon.com/exec/obidos/ASIN/0398054460/icongroupinterna
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Clostridial Neurotoxins: the Molecular Pathogenesis of Tetanus and Botulism by C. Montecucco (Editor), Cesare Monteucco; ISBN: 3540584528; http://www.amazon.com/exec/obidos/ASIN/3540584528/icongroupinterna
•
The Official Patient's Sourcebook on Botulism: A Revised and Updated Directory for the Internet Age by Icon Health Publications; ISBN: 0597832870; http://www.amazon.com/exec/obidos/ASIN/0597832870/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “botulism” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 •
An outbreak of botulism in [Tucumcari] New Mexico, November, 1937, caused by eating home-canned chili. Author: Douthirt, Cranford Haywood,; Year: 1937; [Santa Fe, State Dept. of Public Health, 1937?]
•
Bibliography on botulism and Clostridium botulinum. Author: United States. Army. Chemical Corps. Technical Library.; Year: 1988; Frederick, Md., 1952
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Botulism in the United States; review of cases, 1899-1969, and handbook for epidemiologists, clinicians, and laboratory workers. Author: United States. Public Health Service.; [Washington, 1970?]
•
Botulism 1966. Proceedings, ed. by M. Ingram and T. A. Roberts. Author: Ingram, M. (Maurice); Year: 1974; London, Chapman and Hall, 1967
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Botulism and food preservation. (The Loch Maree tragedy) by Gerald Leighton. Author: Leighton, Gerald,; Year: 1981; London [etc.] W. Collins sons; co., ltd. [1923]
•
Botulism in the United States, 1899-1973; handbook for epidemiologists, clinicians, and laboratory workers. Author: Centers for Disease Control and Prevention (U.S.).; Year: 1985; [Atlanta] 1974
•
Botulism; proceedings of a symposium, sponsored by the Division of Environmental Engineering and Food Protection and the Robert A. Taft Sanitary Engineering Center, January 13-15, 1964. Editors: Keith H. Lewis and Kenneth Cassel, Jr. Author: United States. Public Health Service. Division of Environmental Engineering and Food Protection.; Year: 1966; Cincinnati, 1964
11
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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•
Control of waterfowl botulism. Author: Rosen, Merton N.; Year: 1953; Sacramento, California Dept. of Fish and Game [1965]
•
Fifty years of botulism in the United States and Canada, by K. F. Meyer and B. Eddie. Author: Meyer, K. F. (Karl Friedrich),; Year: 1971; San Francisco, George Williams Hooper Foundation, 1950
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Infant botulism: January 1977 through June 1981, 65 citations Author: Kenton, Charlotte.; Year: 1964; [Bethesda, Md.]: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, [1981]
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Report of the circumstances attending the deaths of eight persons from botulism at Loch Maree (Ross-Shire) Author: Leighton, Gerald,; Year: 1984; Edinburgh: H.M.S.O., 1923
•
Sixty-five years of human botulism in the United States and Canada; epidemiology and tabulations of reported cases, 1899 through 1964 [by] K. F. Meyer and B. Eddie. Author: Meyer, K. F. (Karl Friedrich),; Year: 1970; San Francisco, George Williams Hooper Foundation, 1965
•
Toxic micro-organisms, mycotoxins, botulism, under the U. S.-Japan Cooperative Program in Natural Resources (UJNR) at Honolulu, Hawaii, October 7-10, 1968. Edited by Mendel Herzberg. Author: Herzberg, Mendel,; Year: 1970; [Washington], Published by the UJNR Joint Panels on Toxic Micro-Organisms and the U. S. Dept. of the Interior; [for sale by the Supt. of Docs., U. S. Govt. Print. Off., 1970]
Chapters on Botulism In order to find chapters that specifically relate to botulism, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and botulism 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 “botulism” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on botulism: •
Food-Borne Illness Source: in Hagan, P.T., ed. Mayo Clinic Guide to Self-Care: Answers for Everyday Health Problems. New York, NY: Kensington Publishers. 1999. p. 26-27. Contact: Available from Mayo Clinic. 200 First Street, S.W., Rochester, MN 55905. (800) 291-1128 or (507) 284-2511. Fax (507) 284-0161. Website: www.mayo.edu. PRICE: $16.95 plus shipping and handling. ISBN: 0962786578. Summary: Foodborne illness is a growing problem in the U.S. This chapter on foodborne illness is from a self care handbook on everyday health problems published by the Mayo Clinic. The handbook offers readers a guide to symptoms, diagnosis, and treatment for common problems (particularly self care strategies and tips for handling these problems in children). All foods naturally contain small amounts of bacteria. When food is poorly handled, improperly cooked, or inadequately stored, bacteria can multiply in great enough numbers to cause illness. Parasites, viruses, and chemicals can also contaminate food, but foodborne illness from these sources is less common. Eating contaminated food can result in illness, depending on the organism, the amount of exposure, one's age, and health status. As people age, their immune cells may not respond as quickly
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and effectively to infectious organisms. Young children are at increased risk of illness because their immune systems haven't developed fully. Conditions such as diabetes, AIDS, and cancer treatment also reduce the immune response, making one more susceptible to foodborne illness. The chapter briefly lists self care strategies, particularly for handling short lived (less than 12 hours) food poisoning. One section cautions readers about botulism, a potentially fatal food poisoning. A side bar reviews how to handle food safely. The chapter concludes with a chart of common troublesome bacteria, how each is spread, the symptoms caused by infection, and prevention strategies. Bacteria included are Campylobacter jejuni, Clostridium perfringens, Escherichia coli 0157:H7, Salmonella, Staphylococcus aureus, and Vibrio vulnificus. The book is focused on how to prevent illness, how to detect illness before it becomes a serious and costly problem, and how to avoid unnecessary trips to the clinic or emergency room. 1 table. •
Infectious Diarrhea and Bacterial Food Poisoning Source: in Feldman, M.; Friedman, L.S.; Sleisenger, M.H. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 2002. p. 1864-1913. Contact: Available from Elsevier. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 545-2522. Fax (800) 568-5136. Website: www.us.elsevierhealth.com. PRICE: $229.00 plus shipping and handling. ISBN: 0721689736. Summary: This chapter on infectious diarrhea and bacterial food poisoning is from a comprehensive and authoritative textbook that covers disorders of the gastrointestinal tract, biliary tree, pancreas, and liver, as well as the related topics of nutrition and peritoneal disorders. Topics include changes in normal flora caused by diarrhea; classification of bacterial diarrhea; toxigenic diarrheas, including cholera, other vibrios, Aeromonas, Plesiomonas shigelloides, and Escherichia coli; invasive pathogens, including Shigella, nontyphoidal Salmonellosis, typhoid fever, Campylobacter, and Yersinia; viral diarrhea, including that due to rotavirus, calicivirus, enteric andenovirus, astrovirus, and torovirus; traveler's diarrhea, including microbiology, epidemiology, clinical features, and prevention; diarrhea in the elderly; diagnosis of infectious diarrheal disease; treatment of infectious diarrhea, including with fluid therapy, diet, antimicrobial drugs, and nonspecific therapy; tuberculosis of the gastrointestinal tract; and bacterial food poisoning, including that from Clostridium perfringers, Saphylococcus auerus, Listeria, Bacillus cereus, botulism, and Bacillus anthracis. The chapter includes a mini-outline with page citations, illustrations, and extensive references. 8 figures. 16 tables. 329 references.
•
Xerostomia Source: in Bork, K., et al. Diseases of the Oral Mucosa and the Lips. Philadelphia, PA: W.B. Saunders Company. 1993. p. 222-224. Contact: Available from W.B. Saunders Company. Book Orders Fulfillment Department, 6277 Sea Harbor Drive, Orlando, FL 32821-9854. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $95.00 plus shipping and handling. ISBN: 0721640397. Summary: This chapter on xerostomia is from a textbook of diseases of the oral mucosa and the lips. Xerostomia (dry mouth) is a clinical symptom that requires investigation. The patient typically complains of dryness, possibly burning, and pain. When xerostomia is associated with marked thirst, this suggests underlying systemic dehydration and not an abnormality of the salivary glands. If xerostomia persists, there
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is usually atrophy of the oral mucosa or of the epithelium of the tongue, or both. Xerostomia is especially common in older people. The chapter covers the etiology and therapy of xerostomia. The causes of xerostomia are numerous and include side effects of medications, salivary gland inflammation, sialolithiasis (salivary duct stone), emotional reaction, systemic dehydration, aging, radiation therapy, systemic disorders (diabetes mellitus, for one), primary salivary gland disease (tumors, Sjogren's syndrome), poisoning (botulism, zinc), and iron deficiency anemia or other nutritional disorders. Therapy is rarely satisfactory. Artificial salivas may be helpful, especially at night. Increased intake of fluids, or gargling with harmless substances, such as water, may help. It is also crucial to increase the attention paid to oral hygiene and professional dental care because of problems with dental caries (cavities). 1 figure. 1 table. 4 references.
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CHAPTER 8. MULTIMEDIA ON BOTULISM Overview In this chapter, we show you how to keep current on multimedia sources of information on botulism. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on botulism is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “botulism” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, 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 “Videorecording (videotape, videocassette, etc.).” Type “botulism” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on botulism: •
Food Borne Illnesses and Their Prevention Source: Charleston, WV: Cambridge Educational. 1995. (videocassette). Contact: Available from Cambridge Educational. P.O. Box 2153, Dept. D23, Charleston, WV 25328-2153. (800) 468-4227. Fax (800) FAX ON US. Website: www.cambridgeeducational.com. PRICE: $79.00 plus shipping and handling. Summary: This videotape program takes an indepth look at the recommended practices for food handlers (at home or commercially) to follow in order to prevent the spread of bacteria and other pathogens that can cause foodborne illness. The program investigates the causes, symptoms, and treatment of foodborne illnesses, with emphasis placed on their prevention. The program discusses the more common and severe illnesses in some detail. These include Salmonella, Campylobacter jejuni, Escherichia coli, Botulism, and Listeriosis. For each infectious organism, the narrator describes why the pathogen causes illness, how long the illness should be expected to last, safe and proper treatments, and when to contact a health care provider. The program then reviews
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shopping, food preparation, and hygiene issues that can help prevent foodborne illness. The final section of the videotape reviews the recommended internal cooking temperatures for a variety of foods. The program stresses that almost all foodborne illnesses can be avoided if people who handled food are educated about causes and the proper procedures to avoid contamination. The USDA Food Hotline number (800-5354555) is provided for viewers who would like to obtain additional information.
Bibliography: Multimedia on Botulism The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in botulism (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on botulism: •
Foodborne disease outbreak investigation [electronic resource]: botulism in Argentina Source: Department of Health & Human Services, CDC; a product of the Public Health Training Network (PHTN); Year: 2002; Format: Electronic resource; [Washington, D.C.: Public Health Foundation], 2002
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CHAPTER 9. PERIODICALS AND NEWS ON BOTULISM Overview In this chapter, we suggest a number of news sources and present various periodicals that cover botulism.
News Services and Press Releases One of the simplest ways of tracking press releases on botulism is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “botulism” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to botulism. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “botulism” (or synonyms). The following was recently listed in this archive for botulism: •
DOR acquires botulism vaccine technology from Thomas Jefferson University Source: Reuters Industry Breifing Date: May 07, 2003
•
Unusual number of cases of infantile botulism reported in Staten Island Source: Reuters Medical News Date: January 16, 2003
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Beached whale source of Alaska botulism cases: CDC Source: Reuters Health eLine Date: January 16, 2003
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Britain warns of botulism risk in heroin users Source: Reuters Health eLine Date: November 06, 2002
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Britain alerts doctors to botulism risk in injecting drug users Source: Reuters Medical News Date: November 06, 2002
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UK agency tests four suspected botulism cases Source: Reuters Health eLine Date: February 22, 2002
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Aventis negotiating to replenish federal stockpile of botulism antitoxin Source: Reuters Industry Breifing Date: January 14, 2002
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Botulism risk spurs canned clams recall Source: Reuters Health eLine Date: January 11, 2002
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Botulism toxin investigated as pain reliever Source: Reuters Health eLine Date: September 07, 2001
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US company recalls chili linked to botulism Source: Reuters Health eLine Date: September 04, 2001
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UK baby formula recalled over botulism fear Source: Reuters Health eLine Date: August 14, 2001
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Infant formula recalled over botulism link Source: Reuters Medical News Date: August 14, 2001
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Home-pickled eggs gave man botulism Source: Reuters Health eLine Date: August 31, 2000
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Botulism product can stop axillary hyperhidrosis Source: Reuters Medical News Date: October 06, 1998
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Tracheostomy avoidable in management of infant botulism Source: Reuters Medical News Date: September 15, 1998
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Botulism contamination in Italian vegetables Source: Reuters Health eLine Date: September 03, 1998
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Botulism linked to peyote use Source: Reuters Health eLine Date: July 15, 1998
Periodicals and News
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Foil-wrapped potatoes source of '94 outbreak of botulism in Texas Source: Reuters Medical News Date: June 25, 1998
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Botulism linked to baked potatoes Source: Reuters Health eLine Date: June 25, 1998
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Heroin-Linked Botulism Epidemic Source: Reuters Health eLine Date: March 19, 1998
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Black Tar Heroin Source Of Wound Botulism Epidemic In California Source: Reuters Medical News Date: March 18, 1998
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Botulism Outbreaks Need Quick Diagnosis Source: Reuters Health eLine Date: October 01, 1996
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Botulism Can Mimic Other Illnesses Source: Reuters Medical News Date: October 01, 1996
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Imported Italian Cheese Linked To Three Cases Of Botulism Source: Reuters Medical News Date: September 12, 1996
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Botulism Risk Linked To Ingestion Of "Big E Tea" Source: Reuters Medical News Date: December 08, 1995
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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to
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Market Wire’s home page at http://www.marketwire.com/mw/home, type “botulism” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “botulism” (or synonyms). If you know the name of a company that is relevant to botulism, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “botulism” (or synonyms).
Academic Periodicals covering Botulism Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to botulism. In addition to these sources, you can search for articles covering botulism that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for botulism. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with botulism. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to botulism: Bacillus Calmette-Guйrin (Bcg) Live for Cancer •
Mucosal-Local - U.S. Brands: Pacis; TheraCys http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202079.html
Baclofen •
Mucosal-Local - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202079.html
•
Systemic - U.S. Brands: Lioresal http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202080.html
Balsalazide •
Systemic - U.S. Brands: Colazal http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500233.html
Barbiturates •
Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500233.html
Barbiturates, Aspirin, and Codeine •
Systemic - U.S. Brands: Ascomp with Codeine No.3; Butalbital Compound with Codeine; Butinal with Codeine No.3; Fiorinal with Codeine No.3; Idenal with Codeine; Isollyl with Codeine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202104.html
Barium Sulfate •
Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202104.html
Basiliximab •
Systemic - U.S. Brands: Simulect http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203592.html
Becaplermin •
Topical - U.S. Brands: Regranex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203460.html
Belladonna Alkaloids and Barbiturates •
Systemic - U.S. Brands: Antrocol; Barbidonna; Barbidonna No. 2; Barophen; Bellalphen; Butibel; Donnamor; Donnapine; Donnatal; Donnatal Extentabs; Donnatal No. 2; Donphen; Hyosophen; Kinesed; Malatal; Relaxadon; Spaslin; Spasmolin; Spasmophen; Spasquid; Susano http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202082.html
Bentiromide •
Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202082.html
Researching Medications
Bentoquatam •
Topical - U.S. Brands: IvyBlock http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202901.html
Benznidazole •
Topical - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202901.html
Benzodiazepines •
Systemic - U.S. Brands: Alprazolam Intensol; Ativan; Dalmane; Diastat; Diazepam Intensol; Dizac; Doral; Halcion; Klonopin; Librium; Lorazepam Intensol; Paxipam; ProSom; Restoril; Serax; Tranxene T-Tab; Tranxene-SD; Tranxene-SD Half Strength; Valium; Xanax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html
Benzonatate •
Systemic - U.S. Brands: Tessalon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202085.html
Benzoyl Peroxide •
Topical - U.S. Brands: Triaz http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202086.html
Benzyl Benzoate •
Topical - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202086.html
Beta-Adrenergic Blocking Agents •
Systemic - U.S. Brands: Betapace; Blocadren; Cartrol; Corgard; Inderal; Inderal LA; Kerlone; Levatol; Lopressor; Normodyne; Sectral; Tenormin; Toprol-XL; Trandate; Visken; Zebeta http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202087.html
Beta-Adrenergic Blocking Agents and Thiazide Diuretics •
Systemic - U.S. Brands: Corzide 40/5; Corzide 80/5; Inderide; Inderide LA; Lopressor HCT; Tenoretic 100; Tenoretic 50; Timolide 10-25; Ziac http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202088.html
Beta-Carotene •
Systemic - U.S. Brands: Lumitene; Max-Caro http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202623.html
Betaine •
Systemic - U.S. Brands: Cystadane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203077.html
Bethanechol •
Systemic - U.S. Brands: Duvoid; Urabeth; Urecholine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202090.html
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Bexarotene •
Systemic - U.S. Brands: Targretin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500095.html
Biotin •
Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500095.html
Bismuth Subsalicylate •
Oral - U.S. Brands: Bismatrol; Pepto-Bismol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202092.html
Bismuth Subsalicylate, Metronidazole, and Tetracycline--for H. Pylori •
Systemic - U.S. Brands: Helidac http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203633.html
Bleomycin •
Systemic - U.S. Brands: Blenoxane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202093.html
Botulinum Toxin Type A •
Parenteral-Local - U.S. Brands: Botox http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202608.html
Botulinum Toxin Type B •
Parenteral-Local - U.S. Brands: Myobloc http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500271.html
Brimonidine •
Ophthalmic - U.S. Brands: Alphagan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203130.html
Brinzolamide •
Ophthalmic - U.S. Brands: Azopt http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203544.html
Bromocriptine •
Systemic - U.S. Brands: Parlodel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202094.html
Bronchodilators, Adrenergic •
Inhalation - U.S. Brands: Adrenalin Chloride; Airet; Alupent; Arm-a-Med Isoetharine; Arm-a-Med Metaproterenol; Asthmahaler Mist; AsthmaNefrin; Beta2; Brethaire; Bronkaid Mist; Bronkaid Suspension Mist; Bronkometer; Bronkosol; Dey-Lute Isoetharine; Dey-Lute Metaproterenol; Isupr http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202095.html
Researching Medications
•
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Oral/Injection - U.S. Brands: Adrenalin; Alupent; Ana-Guard; Brethine; Bricanyl; EpiPen Auto-Injector; EpiPen Jr. Auto-Injector; Isuprel; Proventil; Proventil Repetabs; Ventolin; Volmax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202096.html
Bronchodilators, Theophylline •
Systemic - U.S. Brands: Aerolate Sr; Asmalix; Choledyl; Choledyl SA; Elixophyllin; Lanophyllin; Phyllocontin; Quibron-T Dividose; Quibron-T/SR Dividose; Respbid; Slo-Bid Gyrocaps; Slo-Phyllin; Theo-24; Theobid Duracaps; Theochron; Theo-Dur; Theolair; Theolair-SR; Theo-Time; Th http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/201945.html
Bupropion •
Systemic - U.S. Brands: Wellbutrin; Zyban http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202098.html
Buspirone •
Systemic - U.S. Brands: BuSpar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202100.html
Busulfan •
Systemic - U.S. Brands: Busulfex; Myleran http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202101.html
Butalbital and Acetaminophen •
Systemic - U.S. Brands: Note: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202102.html
Butalbital and Aspirin •
Systemic - U.S. Brands: Axotal; Butalgen; Fiorgen; Fiorinal; Fiormor; Fortabs; Isobutal; Isobutyl; Isolin; Isollyl; Laniroif; Lanorinal; Marnal; Vibutal http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202103.html
Butenafine •
Topical - U.S. Brands: Mentax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203496.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing
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information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.
Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to botulism by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “botulism” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for botulism: •
Botulism immune globulin http://www.rarediseases.org/nord/search/nodd_full?code=631
If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA
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through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute12: •
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/
12
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
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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.13 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:14 •
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
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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/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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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
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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
13
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). 14 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 Gateway15 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.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “botulism” (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 2254 57 17 0 0 2328
HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 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.19 Simply search by “botulism” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
15
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
16
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). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19
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 Biologists20 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.21 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.22 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/.
20 Adapted 21
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. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on botulism 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 botulism. 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 botulism. 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 “botulism”:
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•
Guides on botulism Botulism http://www.nlm.nih.gov/medlineplus/botulism.html
•
Other guides Biodefense and Bioterrorism http://www.nlm.nih.gov/medlineplus/biodefenseandbioterrorism.html Chemical Weapons http://www.nlm.nih.gov/medlineplus/chemicalweapons.html Food Contamination/Poisoning http://www.nlm.nih.gov/medlineplus/foodcontaminationpoisoning.html Stroke http://www.nlm.nih.gov/medlineplus/stroke.html
Within the health topic page dedicated to botulism, the following was listed: •
General/Overviews Botulism: Frequently Asked Questions Source: National Center for Infectious Diseases http://www.cdc.gov/ncidod/dbmd/diseaseinfo/botulism_g.htm Facts about Botulism Source: Centers for Disease Control and Prevention http://www.bt.cdc.gov/DocumentsApp/FactSheet/Botulism/about.asp
•
Children Honey: Why You Shouldn't Feed It to Infants Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00854 Infant Botulism Source: Nemours Foundation http://kidshealth.org/parent/infections/bacterial_viral/botulism.html
•
From the National Institutes of Health Botulism Source: National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/publications/botulism.htm Foodborne Diseases Source: National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/factsheets/foodbornedis.htm
•
Organizations Food and Drug Administration http://www.fda.gov/
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National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases http://www.cdc.gov/ncidod/dbmd/ National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/ •
Prevention/Screening Frozen, Fully-Cooked Products and Botulism--Food Safety Advisory Source: Dept. of Agriculture, Food Safety and Inspection Service http://www.fsis.usda.gov/OA/pubs/frozenbot.htm
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 botulism. 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: •
Is Your Food Safe? Source: Santa Cruz, CA: ETR Associates. 1998. 6 p. Contact: Available from ETR Associates. 4 Carbonero Way, Scotts Valley, CA 950664200. (800) 321-4407. Fax (800) 435-8433. Website: www.etr.org. PRICE: Single copy free; bulk copies available. Order number: R027. Summary: This brochure describes foodborne illnesses and their prevention. If food is poorly handled or not cooked or stored properly, bacteria can multiply and cause illness. Not everyone who eats contaminated food will become sick. The symptoms depend on which organism was eaten, how much was eaten, and what the age and general health of the person are. Symptoms of food poisoning are similar to those of stomach flu and include nausea, vomiting, diarrhea, stomach pain or cramps, and fever, fatigue, and feelings of weakness. The brochure lists nine organisms and how they are usually transmitted; organisms and diseases discussed are botulism, Campylobacter, Crytosporidiosis, cyclospora, E. coli (0157:H7), hepatitis A, listeriosis, Salmonella, and Vibrio vulnificus. The brochure notes that mild illness usually gets better on its own and provides basic strategies for handling symptoms of mild food poisoning. The brochure also lists symptoms that would indicate the need to contact a health care provider and notes people more at risk for problems from food poisoning. The centerpiece of the brochure offers U.S. Department of Agriculture strategies for keeping food safe: the six areas covered are buying, storing, preparing, cooking, and serving food, and eating out.
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A chart summarizes the time that fresh meat, fish, poultry, cheese, eggs, and milk will last in the refrigerator or in the freezer. One sidebar lists safe kitchen tips (primarily relating to hygiene). Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
Bioterrorism: U.S. Food and Drug Administration Summary: This bioterrorism page from the FDA provides general information about anthrax, smallpox, botulism and other biological agents. Source: U.S. Food and Drug Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6375
•
FAQs--Botulism Summary: These FAQs from the CDC cover botulism and its prevention, symptoms, diagnosis, and treatment. Technical information is provided as well. Source: National Center for Infectious Diseases, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6342 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 botulism. 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. NORD (The National Organization of Rare Disorders, Inc.) NORD provides an invaluable service to the public by publishing short yet comprehensive guidelines on over 1,000 diseases. NORD primarily focuses on rare diseases that might not be covered by the previously listed sources. NORD’s Web address is http://www.rarediseases.org/. A complete guide on botulism can be purchased from NORD for a nominal fee.
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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMD®Health: http://my.webmd.com/health_topics
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to botulism. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with botulism. 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 botulism. 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 “botulism” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received
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your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “botulism”. 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 “botulism” (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 “botulism” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.23
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
23
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)24: •
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
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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/
24
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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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
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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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
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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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
119
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 botulism: •
Basic Guidelines for Botulism Botulism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000598.htm
•
Signs & Symptoms for Botulism Abdominal cramps Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Breathing difficulty Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Constipation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003125.htm Diarrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm
120 Botulism
Difficulty swallowing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003115.htm Dizziness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm Double vision Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003029.htm Dysarthria Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003204.htm Dysphagia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003115.htm Eyelid drooping Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003035.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Hypotension Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm Malaise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm Muscle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Paralysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003190.htm Speech impairment Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003204.htm Swallowing difficulties Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003115.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm •
Diagnostics and Tests for Botulism AMP Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003368.htm
Online Glossaries 121
ANA Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003535.htm Stool culture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003758.htm •
Background Topics for Botulism Intravenous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002383.htm Respiratory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002290.htm Spores Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002307.htm Wounds Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000043.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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BOTULISM 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] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Actin: Essential component of the cell skeleton. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adsorption: The condensation of gases, liquids, or dissolved substances on the surfaces of solids. It includes adsorptive phenomena of bacteria and viruses as well as of tissues treated with exogenous drugs and chemicals. [NIH] Adsorptive: It captures volatile compounds by binding them to agents such as activated carbon or adsorptive resins. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]
Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Obstruction: Any hindrance to the passage of air into and out of the lungs. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps
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to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [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] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alum: A type of immune adjuvant (a substance used to help boost the immune response to a vaccine). Also called aluminum sulfate. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans.
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Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]
Anthrax: An acute bacterial infection caused by ingestion of bacillus organisms. Carnivores may become infected from ingestion of infected carcasses. It is transmitted to humans by contact with infected animals or contaminated animal products. The most common form in humans is cutaneous anthrax. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antiserum: The blood serum obtained from an animal after it has been immunized with a particular antigen. It will contain antibodies which are specific for that antigen as well as antibodies specific for any other antigen with which the animal has previously been immunized. [NIH] Antitoxin: A purified antiserum from animals (usually horses) immunized by injections of a toxin or toxoid, administered as a passive immunizing agent to neutralize a specific bacterial toxin, e.g., botulinus, tetanus or diphtheria. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arthralgia: Pain in the joint. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the
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biological or pharmacological potency of a drug. [EU] Astrovirus: A genus of small, circular RNA viruses in the family Astroviridae. They cause gastroenteritis and are found in the stools of several vertebrates including humans. Transmission is by the fecal-oral route. There are at least seven human serotypes and the type species is human astrovirus 1. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autologous bone marrow transplantation: A procedure in which bone marrow is removed from a person, stored, and then given back to the person after intensive treatment. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]
Bacillus: A genus of Bacillaceae that are spore-forming, rod-shaped cells. Most species are saprophytic soil forms with only a few species being pathogenic. [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] Bacterial toxin: A toxic substance, made by bacteria, that can be modified to kill specific tumor cells without harming normal cells. [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] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Warfare: Warfare involving the use of living organisms or their products as disease etiologic agents against people, animals, or plants. [NIH] Biomolecular: A scientific field at the interface between advanced computing and biotechnology. [NIH]
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Bioreactors: Tools or devices for generating products using the synthetic or chemical conversion capacity of a biological system. They can be classical fermentors, cell culture perfusion systems, or enzyme bioreactors. For production of proteins or enzymes, recombinant microorganisms such as bacteria, mammalian cells, or insect or plant cells are usually chosen. [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] Bioterrorism: The use of biological agents in terrorism. This includes the malevolent use of bacteria, viruses, or toxins against people, animals, or plants. [NIH] Bladder: The organ that stores urine. [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 Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Botulinum Toxins: Toxins produced by Clostridium botulinum. There are at least seven different substances, most being proteins. They have neuro-, entero-, and hemotoxic properties, are immunogenic, and include the most potent poisons known. The most commonly used apparently blocks release of acetylcholine at cholinergic synapses. [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] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Calicivirus: A genus in the family Caliciviridae containing many species including feline calicivirus , vesicular exanthema of swine virus, and San Miguel sea lion viruses. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH]
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Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carboxy-terminal: The end of any polypeptide or protein that bears a free carboxyl group. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [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] Catalytic Domain: The region of an enzyme that interacts with its substrate to cause the enzymatic reaction. [NIH] Catastrophic Illness: An acute or prolonged illness usually considered to be life-threatening or with the threat of serious residual disability. Treatment may be radical and is frequently costly. [NIH] Cecum: The beginning of the large intestine. The cecum is connected to the lower part of the small intestine, called the ileum. [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] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [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] Cervical Plexus: A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholera: An acute diarrheal disease endemic in India and Southeast Asia whose causative
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agent is vibrio cholerae. This condition can lead to severe dehydration in a matter of hours unless quickly treated. [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] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chromosome Segregation: The orderly segregation of chromosomes during meiosis or mitosis. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Civilization: The distinctly human attributes and attainments of a particular society. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clostridium: A genus of motile or nonmotile gram-positive bacteria of the family Bacillaceae. Many species have been identified with some being pathogenic. They occur in water, soil, and in the intestinal tract of humans and lower animals. [NIH] Clostridium botulinum: The etiologic agent of botulism in man, wild ducks, and other waterfowl. It is also responsible for certain forms of forage poisoning in horses and cattle. The bacterium produces a powerful exotoxin that is resistant to proteolytic digestion. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colitis: Inflammation of the colon. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Combinatorial: A cut-and-paste process that churns out thousands of potentially valuable compounds at once. [NIH]
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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, 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] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with
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some substance in the body to form a detoxified product, which is then eliminated. [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] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [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] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclospora: A genus of coccidian parasites in the family Eimeriidae. Cyclospora cayetanensis is pathogenic in humans, probably transmitted via the fecal-oral route, and causes nausea and diarrhea. [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] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [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] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH]
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Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] 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] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]
DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Diphtheria: A localized infection of mucous membranes or skin caused by toxigenic strains of Corynebacterium diphtheriae. It is characterized by the presence of a pseudomembrane at the site of infection. Diphtheria toxin, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is
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roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Edrophonium: A rapid-onset, short-acting cholinesterase inhibitor used in cardiac arrhythmias and in the diagnosis of myasthenia gravis. It has also been used as an antidote to curare principles. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [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] Electrodiagnosis: Diagnosis of disease states by recording the spontaneous electrical activity of tissues or organs or by the response to stimulation of electrically excitable tissue. [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] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]
Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said
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of a disease or agent. Called also endemial. [EU] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Enteric bacteria: Single-celled microorganisms that lack chlorophyll. Some bacteria are capable of causing human, animal, or plant diseases; others are essential in pollution control because they break down organic matter in the air and in the water. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [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] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epigastric: Having to do with the upper middle area of the abdomen. [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] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exocrine: Secreting outwardly, via a duct. [EU] Exocytosis: Cellular release of material within membrane-limited vesicles by fusion of the vesicles with the cell membrane. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotoxin: Toxic substance excreted by living bacterial cells. [NIH] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH]
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Extracellular: Outside a cell or cells. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciculation: A small local contraction of muscles, visible through the skin, representing a spontaneous discharge of a number of fibres innervated by a single motor nerve filament. [EU]
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] Flaccid: Weak, lax and soft. [EU] Flatus: Gas passed through the rectum. [NIH] Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Food Technology: The application of knowledge to the food industry. [NIH] Foodborne Illness: An acute gastrointestinal infection caused by food that contains harmful bacteria. Symptoms include diarrhea, abdominal pain, fever, and chills. Also called food poisoning. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglioside: Protein kinase C's inhibitor which reduces ischemia-related brain damage. [NIH]
Gangrenous: A circumscribed, deep-seated, suppurative inflammation of the subcutaneous tissue of the eyelid discharging pus from several points. [NIH] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body
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through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gavage: Feeding by a tube passed into the stomach; called also tube feeding. [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]
Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Gram-Positive Bacteria: Bacteria which retain the crystal violet stain when treated by Gram's method. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its
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earliest stage to maturity. [NIH] Guanidine: A strong organic base existing primarily as guanidium ions at physiological pH. It is found in the urine as a normal product of protein metabolism. It is also used in laboratory research as a protein denaturant. (From Martindale, the Extra Pharmacopoeia, 30th ed and Merck Index, 12th ed) It is also used in the treatment of myasthenia and as a fluorescent probe in HPLC. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see
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also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperhidrosis: Excessive sweating. In the localized type, the most frequent sites are the palms, soles, axillae, inguinal folds, and the perineal area. Its chief cause is thought to be emotional. Generalized hyperhidrosis may be induced by a hot, humid environment, by fever, or by vigorous exercise. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Hypotonia: A condition of diminished tone of the skeletal muscles; diminished resistance of muscles to passive stretching. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Ileus: Obstruction of the intestines. [EU] Immune adjuvant: A drug that stimulates the immune system to respond to disease. [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] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
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] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunoglobulin Isotypes: The classes of immunoglobulins found in any species of animal. In man there are nine classes that migrate in five different groups in electrophoresis; they each consist of two light and two heavy protein chains, and each group has distinguishing
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structural and functional properties. [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] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infectious Diarrhea: Diarrhea caused by infection from bacteria, viruses, or parasites. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Inhalation: The drawing of air or other substances into the lungs. [EU] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility.
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[NIH]
Intercostal: Situated between the ribs. [EU] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intramuscular injection: IM. Injection into a muscle. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] 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] 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] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] 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] Keratolytic: An agent that promotes keratolysis. [EU] Laceration: 1. The act of tearing. 2. A torn, ragged, mangled wound. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lethal: Deadly, fatal. [EU] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Litter: Appliance consisting of an oblong frame over which is stretched a canvas or other material, used for carrying an injured or disabled person. [NIH] 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] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic
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method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [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] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mastitis: Inflammatory disease of the breast, or mammary gland. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]
Mechanical ventilation: Use of a machine called a ventilator or respirator to improve the exchange of air between the lungs and the atmosphere. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Fusion: The adherence of cell membranes, intracellular membranes, or artifical membrane models of either to each other or to viruses, parasites, or interstitial particles through a variety of chemical and physical processes. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH]
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MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Evolution: Multiple rounds of selection, amplification, and mutation leading to molecules with the desired properties. [NIH] 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] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]
Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multivalent: Pertaining to a group of 5 or more homologous or partly homologous
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chromosomes during the zygotene stage of prophase to first metaphasis in meiosis. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Muscle Hypertonia: Abnormal increase in skeletal or smooth muscle tone. Skeletal muscle hypertonicity may be associated with pyramidal tract lesions or basal ganglia diseases. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle Spasticity: Strongly marked hypertonicity of muscles. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mycotoxins: Toxins derived from bacteria or fungi. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroblastoma: Cancer that arises in immature nerve cells and affects mostly infants and children. [NIH] Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH]
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Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Diseases: A general term encompassing lower motor neuron disease; peripheral nervous system diseases; and certain muscular diseases. Manifestations include muscle weakness; fasciculation; muscle atrophy; spasm; myokymia; muscle hypertonia, myalgias, and musclehypotonia. [NIH] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuromuscular Junction Diseases: Conditions characterized by impaired transmission of impulses at the neuromuscular junction. This may result from disorders that affect receptor function, pre- or postsynaptic membrane function, or acetylcholinesteraseactivity. The majority of diseases in this category are associated with autoimmune, toxic, or inherited conditions. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neutralization: An act or process of neutralizing. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleocapsid: A protein-nucleic acid complex which forms part or all of a virion. It consists of a capsid plus enclosed nucleic acid. Depending on the virus, the nucleocapsid may correspond to a naked core or be surrounded by a membranous envelope. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the
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chromosomes. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Opacity: Degree of density (area most dense taken for reading). [NIH] Operon: The genetic unit consisting of a feedback system under the control of an operator gene, in which a structural gene transcribes its message in the form of mRNA upon blockade of a repressor produced by a regulator gene. Included here is the attenuator site of bacterial operons where transcription termination is regulated. [NIH] Ophthalmic: Pertaining to the eye. [EU] Ophthalmologist: A medical doctor specializing in the diagnosis and medical or surgical treatment of visual disorders and eye disease. [NIH] Ophthalmoplegia: Paralysis of one or more of the ocular muscles due to disorders of the eye muscles, neuromuscular junction, supporting soft tissue, tendons, or innervation to the muscles. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Orderly: A male hospital attendant. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palmitic Acid: A common saturated fatty acid found in fats and waxes including olive oil, palm oil, and body lipids. [NIH] Palsies: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [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] Paralysis: Loss of ability to move all or part of the body. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]
Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [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] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Peptide: Any compound consisting of two or more amino acids, the building blocks of
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proteins. Peptides are combined to make proteins. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perineal: Pertaining to the perineum. [EU] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phrenic Nerve: The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm. [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]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Plague: An acute infectious disease caused by Yersinia pestis that affects humans, wild rodents, and their ectoparasites. This condition persists due to its firm entrenchment in sylvatic rodent-flea ecosystems throughout the world. Bubonic plague is the most common form. [NIH] Plant Diseases: Diseases of plants. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation
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of, or exposure to a deleterious agent. [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] Polymorphism: The occurrence together of two or more distinct forms in the same population. [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] Polyvalent: Having more than one valence. [EU] 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] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [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] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progeny: The offspring produced in any generation. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH]
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Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] 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 Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [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] Protein Subunits: Single chains of amino acids that are the units of a multimeric protein. They can be identical or non-identical subunits. [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] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [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 macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons,
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alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombinant Proteins: Proteins prepared by recombinant DNA technology. [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] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] 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]
Repressor: Any of the specific allosteric protein molecules, products of regulator genes, which bind to the operator of operons and prevent RNA polymerase from proceeding into the operon to transcribe messenger RNA. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH]
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Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Respiratory Muscles: These include the muscles of the diaphragm and the intercostal muscles. [NIH] Respiratory Paralysis: Complete or severe weakness of the muscles of respiration. This condition may be associated with motor neuron diseases; peripheral nerve disorders; neuromuscular junction diseases; spinal cord diseases; injury to the phrenic nerve; and other disorders. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] 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] Rotavirus: A genus of Reoviridae, causing acute gastroenteritis in birds and mammals, including humans. Transmission is horizontal and by environmental contamination. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saturated fat: A type of fat found in greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils, including coconut, palm kernel, and palm oils. Saturated fat raises blood cholesterol more than anything else eaten. On a Step I Diet, no more than 8 to 10 percent of total calories should come from saturated fat, and in the Step II Diet, less than 7 percent of the day's total calories should come from saturated fat. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [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] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septicaemia: A term originally used to denote a putrefactive process in the body, but now usually referring to infection with pyogenic micro-organisms; a genus of Diptera; the severe type of infection in which the blood stream is invaded by large numbers of the causal. [NIH] Septum: A dividing wall or partition; a general term for such a structure. The term is often used alone to refer to the septal area or to the septum pellucidum. [EU]
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Septum Pellucidum: A triangular double membrane separating the anterior horns of the lateral ventricles of the brain. It is situated in the median plane and bounded by the corpus callosum and the body and columns of the fornix. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotypes: A cause of haemorrhagic septicaemia (in cattle, sheep and pigs), fowl cholera of birds, pasteurellosis of rabbits, and gangrenous mastitis of ewes. It is also commonly found in atrophic rhinitis of pigs. [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] 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] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smallpox: A generalized virus infection with a vesicular rash. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] 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] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of
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a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spores: The reproductive elements of lower organisms, such as protozoa, fungi, and cryptogamic plants. [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] 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] 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] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Succinylcholine: A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for. [NIH]
Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH]
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Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Vesicles: Membrane-bound compartments which contain transmitter molecules. Synaptic vesicles are concentrated at presynaptic terminals. They actively sequester transmitter molecules from the cytoplasm. In at least some synapses, transmitter release occurs by fusion of these vesicles with the presynaptic membrane, followed by exocytosis of their contents. [NIH] Systemic: Affecting the entire body. [NIH] Teichoic Acids: Bacterial polysaccharides that are rich in phosphodiester linkages. They are the major components of the cell walls and membranes of many bacteria. [NIH] Tetani: Causal agent of tetanus. [NIH] Tetanic: Having the characteristics of, or relating to tetanus. [NIH] Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by Clostridium tetani. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thoracic: Having to do with the chest. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] 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]
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Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Torovirus: A genus of the family Coronaviridae characterized by enveloped, peplomerbearing particles containing an elongated tubular nucleocapsid with helical symmetry. Toroviruses have been found in association with enteric infections in horses (Berne virus), cattle (Breda virus), and humans. Transmission takes place probably via the fecal-oral route. [NIH]
Toxemia: A generalized intoxication produced by toxins and other substances elaborated by an infectious agent. [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] Toxoid: The material resulting from the treatment of toxin in such a way that the toxic properties are inactivated whilst the antigenic potency remains intact. [NIH] Transcutaneous: Transdermal. [EU] 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] Translocate: The attachment of a fragment of one chromosome to a non-homologous chromosome. [NIH] Translocation: The movement of material in solution inside the body of the plant. [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] Trivalent: Having a valence of three. [EU] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tularemia: A plague-like disease of rodents, transmissible to man. It is caused by Francisella tularensis and is characterized by fever, chills, headache, backache, and weakness. [NIH] Typhoid fever: The most important member of the enteric group of fevers which also includes the paratyphoids. [NIH] Typhoid fever: The most important member of the enteric group of fevers which also
Dictionary 155
includes the paratyphoids. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [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] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vegetative: 1. Concerned with growth and with nutrition. 2. Functioning involuntarily or unconsciously, as the vegetative nervous system. 3. Resting; denoting the portion of a cell cycle during which the cell is not involved in replication. 4. Of, pertaining to, or characteristic of plants. [EU] Venous: Of or pertaining to the veins. [EU] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventilator: A breathing machine that is used to treat respiratory failure by promoting ventilation; also called a respirator. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vesicular Exanthema of Swine: A calicivirus infection of swine characterized by hydropic degeneration of the oral and cutaneous epithelia. [NIH] Vesicular Exanthema of Swine Virus: The type species of the genus Calicivirus, an RNA virus infecting pigs. The resulting infection is an acute febrile disease which is clinically indistinguishable from foot and mouth disease. Transmission is by contaminated food. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vibrio: A genus of Vibrionaceae, made up of short, slightly curved, motile, gram-negative rods. Various species produce cholera and other gastrointestinal disorders as well as abortion in sheep and cattle. [NIH] Vibrio cholerae: The etiologic agent of cholera. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or
156 Botulism
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] 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] Volition: Voluntary activity without external compulsion. [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]
Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Zygote: The fertilized ovum. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
157
INDEX A Abdomen, 123, 127, 134, 140, 146, 152 Abdominal, 119, 123, 132, 135, 136, 145, 146 Abscess, 57, 123, 150 Accommodation, 15, 123 Acetylcholine, 15, 74, 76, 123, 127, 129 Actin, 123, 143 Adjuvant, 4, 123 Adrenal Medulla, 123, 134, 144 Adsorption, 35, 123 Adsorptive, 123 Adverse Effect, 15, 123, 151 Aerosol, 9, 123 Affinity, 7, 11, 12, 14, 123 Airway, 20, 49, 56, 123 Airway Obstruction, 56, 123 Algorithms, 123, 127 Alimentary, 74, 124 Alkaloid, 124, 129 Alpha Particles, 124, 149 Alternative medicine, 89, 124 Alum, 4, 124, 129 Aluminum, 124 Amino Acid Sequence, 124, 125 Amino Acids, 6, 16, 124, 145, 147, 148 Amphetamines, 124, 129 Amplification, 12, 124, 142 Anaerobic, 5, 10, 13, 27, 75, 76, 124 Anal, 124, 140 Analogous, 29, 124, 154 Anaphylaxis, 5, 71, 77, 124 Anatomical, 124, 133, 139 Anemia, 83, 124 Anesthesia, 6, 26, 49, 56, 123, 124, 131 Animal model, 6, 8, 124 Annealing, 125, 147 Anthrax, 4, 8, 10, 11, 14, 21, 110, 125 Antibacterial, 125, 151 Antibiotic, 125, 151 Antibodies, 4, 5, 7, 15, 76, 125, 134, 137, 138, 141, 142, 146 Antibody, 5, 6, 11, 34, 35, 51, 123, 125, 130, 137, 138, 139, 142, 149, 151 Anticoagulant, 125, 148 Antidote, 125, 133 Antigen, 4, 123, 124, 125, 130, 134, 137, 138, 139
Antimicrobial, 30, 82, 125 Antiserum, 125 Antitoxin, 12, 21, 32, 34, 46, 74, 77, 88, 125 Anus, 124, 125, 127 Aqueous, 125, 126, 131 Arterial, 125, 148 Arteries, 125, 127, 131, 142 Arthralgia, 125, 151 Aspiration, 71, 125 Assay, 12, 14, 15, 34, 125, 138 Astrovirus, 82, 126 Atrophy, 83, 126, 144 Attenuated, 9, 126 Atypical, 41, 126 Autologous, 30, 126 Autologous bone marrow transplantation, 30, 126 Autonomic, 22, 123, 126, 144, 146 Axillary, 88, 126 B Bacillus, 4, 8, 11, 27, 76, 82, 92, 125, 126 Bacteria, 8, 10, 81, 85, 109, 123, 125, 126, 127, 130, 132, 134, 135, 136, 139, 142, 143, 146, 151, 153, 155 Bacterial toxin, 125, 126 Bacterium, 5, 10, 13, 62, 76, 126, 129, 130 Base, 126, 132, 137, 140 Benign, 33, 45, 126, 137, 149 Bilateral, 29, 126 Bile, 126, 135, 140 Bile Ducts, 126 Biliary, 82, 126 Biochemical, 8, 13, 44, 53, 126 Biological Warfare, 11, 24, 29, 126 Biomolecular, 6, 12, 126 Bioreactors, 5, 127 Biotechnology, 5, 16, 17, 80, 89, 103, 126, 127 Bioterrorism, 6, 7, 11, 15, 79, 108, 110, 127 Bladder, 54, 127, 155 Blood pressure, 127, 138 Blood vessel, 127, 128, 134, 140, 141, 146, 152, 153, 155 Body Fluids, 12, 127, 133, 135 Bone Marrow, 30, 126, 127, 138, 141 Bone Marrow Transplantation, 30, 127 Botulinum Toxins, 13, 14, 127 Bowel, 124, 127, 132, 134, 140, 146, 152
158 Botulism
Bowel Movement, 127, 132, 152 Brachytherapy, 127, 140, 149 Branch, 62, 117, 127, 133, 141, 145, 151, 153 Breakdown, 127, 132, 135 C Calicivirus, 82, 127, 155 Carbohydrates, 127, 128 Carbon Dioxide, 24, 128, 136, 149 Carboxy, 4, 128 Carboxy-terminal, 4, 128 Cardiac, 26, 128, 133, 134, 143, 152 Cardiovascular, 26, 52, 128 Case report, 19, 25, 41, 57, 63, 65, 128 Catalytic Domain, 14, 128 Catastrophic Illness, 47, 128 Cecum, 128, 140 Cell Cycle, 128, 155 Cell Division, 8, 126, 128, 141, 142, 146, 147, 150 Cell membrane, 10, 128, 134, 135, 141 Cellulitis, 57, 128 Cellulose, 127, 128, 146 Central Nervous System, 123, 124, 128, 129, 135, 137 Cervical, 128, 146 Cervical Plexus, 128, 146 Chlorophyll, 128, 134 Cholera, 9, 47, 82, 128, 151, 155 Cholesterol, 126, 129, 150 Cholinergic, 10, 13, 127, 129 Chromosomal, 124, 129, 146 Chromosome, 8, 129, 130, 137, 150, 154 Chromosome Segregation, 8, 129 Chronic, 129, 139, 151, 152 Civilization, 11, 129 Clear cell carcinoma, 129, 132 Clinical Medicine, 13, 129 Clinical trial, 3, 12, 28, 71, 72, 103, 129, 149 Cloning, 127, 129 Coca, 129 Cocaine, 62, 129 Cofactor, 129, 148, 153 Colitis, 18, 29, 62, 129 Collapse, 124, 127, 129 Colloidal, 129, 133 Combinatorial, 14, 16, 129 Complement, 130 Complementary and alternative medicine, 65, 68, 130 Complementary medicine, 65, 130 Computational Biology, 103, 130 Conduction, 74, 130
Conjugated, 130 Conjugation, 6, 130 Connective Tissue, 127, 128, 131, 135, 141 Constitutional, 131, 143 Consumption, 4, 21, 36, 54, 62, 75, 131, 136, 149 Contamination, 62, 75, 86, 88, 108, 131, 150 Contraindications, ii, 131 Coronary, 131, 142 Coronary Thrombosis, 131, 142 Critical Care, 24, 47, 131 Curare, 131, 133, 143 Curative, 131, 153 Cutaneous, 125, 128, 131, 155 Cyclic, 4, 131 Cyclospora, 109, 131 Cytoplasm, 8, 128, 131, 153 Cytotoxicity, 4, 131 D Dairy Products, 131, 150 Data Collection, 11, 131 Databases, Bibliographic, 103, 131 Degenerative, 132, 137 Dehydration, 82, 129, 132 Denaturation, 132, 147 Dendrites, 132, 144 Density, 11, 132, 145, 151 Dental Care, 83, 132 Dental Caries, 83, 132 DES, 132 Diabetes Mellitus, 83, 132, 136, 137 Diagnostic procedure, 73, 90, 132 Diaphragm, 15, 128, 132, 146, 150 Diarrhea, 82, 109, 119, 131, 132, 135, 139 Digestion, 124, 126, 127, 129, 132, 140, 152 Digestive system, 72, 132 Diphtheria, 125, 132 Diploid, 132, 146 Direct, iii, 15, 91, 129, 132, 133, 149, 153 Dissociation, 123, 132 Dopamine, 129, 133 Drug Interactions, 96, 133 Duct, 83, 133, 134, 150 Duodenum, 126, 133, 152 Dyes, 16, 133 Dystonia, 65, 133 E Edrophonium, 25, 133 Effector, 123, 130, 133, 143 Efficacy, 71, 77, 133 Electrodiagnosis, 32, 33, 42, 133 Electrolyte, 133, 135
Index 159
Electromyography, 26, 29, 36, 39, 52, 133 Electrons, 126, 133, 140, 148, 149 Electrophoresis, 7, 133, 138 Electrophysiological, 16, 32, 33, 133 Enamel, 132, 133 Endemic, 34, 128, 133 Endothelial cell, 10, 134, 153 Enteric bacteria, 9, 134 Enteritis, 62, 134 Enterocolitis, 29, 134 Environmental Health, 102, 104, 134 Enzymatic, 128, 130, 132, 134, 147 Enzyme, 7, 12, 34, 49, 127, 128, 133, 134, 147, 148, 152, 153, 156 Epidemic, 58, 89, 134 Epidemiological, 46, 134 Epigastric, 134, 145 Epinephrine, 133, 134, 144 Epithelial, 134, 137 Epithelial Cells, 134, 137 Epithelium, 83, 134 Epitopes, 5, 16, 75, 76, 134 Erythrocytes, 124, 127, 134 Esophageal, 50, 134 Esophagus, 132, 134, 152 Excitation, 15, 124, 134 Exocrine, 134, 145 Exocytosis, 10, 134, 153 Exogenous, 123, 134 Exotoxin, 74, 129, 134 External-beam radiation, 134, 149 Extracellular, 9, 131, 135 Extremity, 57, 135 F Family Planning, 103, 135 Fasciculation, 135, 144 Fat, 127, 135, 150 Fatigue, 16, 109, 135 Fatty acids, 74, 135 Feces, 27, 35, 48, 49, 135, 152 Flaccid, 6, 7, 10, 16, 76, 135 Flatus, 135, 136 Fluid Therapy, 82, 135 Food Technology, 62, 135 Foodborne Illness, 81, 85, 109, 135 Fungi, 130, 135, 142, 143, 152 G Gallbladder, 123, 126, 132, 135 Gamma Rays, 135, 149 Ganglia, 123, 135, 143, 146 Ganglioside, 74, 135 Gangrenous, 135, 151
Gap Junctions, 135, 153 Gas, 75, 128, 135, 136, 144, 150, 155 Gas exchange, 136, 150, 155 Gastrin, 136, 137 Gastroenteritis, 126, 136, 150 Gastrointestinal, 9, 10, 82, 134, 135, 136, 155 Gastrointestinal tract, 82, 136 Gavage, 135, 136 Gene, 6, 44, 51, 80, 127, 136, 145, 150 Genetic testing, 136, 147 Genetics, 6, 16, 130, 136 Gland, 83, 123, 136, 141, 145, 152 Glucose, 128, 132, 136, 137 Glucose Intolerance, 132, 136 Governing Board, 136, 147 Graft, 136, 137, 139 Graft Rejection, 136, 139 Gram-positive, 75, 76, 129, 136 Gram-Positive Bacteria, 129, 136 Gravis, 15, 133, 136 Growth, 125, 136, 146, 155 Guanidine, 32, 35, 38, 66, 67, 137 H Haploid, 137, 146 Haptens, 123, 137, 151 Headache, 137, 154 Health Status, 47, 81, 137 Heartbeat, 137, 152 Hemoglobin, 124, 134, 137 Hemorrhage, 137, 152 Hepatitis, 109, 137 Hepatocytes, 137 Heredity, 136, 137 Heterogeneity, 123, 137 Homologous, 137, 142, 150, 153, 154 Hormonal, 126, 137 Hormone, 21, 132, 134, 136, 137 Host, 137, 138, 139, 155, 156 Hybrid, 12, 137, 138 Hybridization, 12, 138 Hydrolysis, 8, 138, 147, 148 Hyperhidrosis, 26, 88, 138 Hypersensitivity, 124, 138 Hypotension, 71, 120, 138 Hypothermia, 15, 138 Hypotonia, 32, 138 Hypoxia, 15, 138 I Id, 64, 67, 108, 111, 116, 118, 138 Ileus, 41, 138 Immune adjuvant, 124, 138
160 Botulism
Immune response, 10, 82, 123, 124, 125, 136, 137, 138, 139, 155, 156 Immune Sera, 138 Immune system, 9, 82, 138, 139, 141, 155, 156 Immunity, 5, 9, 14, 27, 138, 154 Immunization, 9, 14, 77, 138, 139 Immunoassay, 49, 138 Immunogenic, 14, 75, 127, 138 Immunoglobulin, 4, 71, 125, 138, 142 Immunoglobulin Isotypes, 4, 138 Immunologic, 138, 139, 149 Immunology, 13, 16, 22, 40, 123, 139 Immunosuppressive, 139 Immunosuppressive therapy, 139 Immunotherapy, 5, 139 Impairment, 16, 120, 139, 141 Implant radiation, 139, 140, 149 In vitro, 5, 6, 7, 14, 139, 147 In vivo, 5, 6, 8, 14, 76, 139 Incision, 139, 140 Indicative, 79, 139, 145, 155 Infancy, 32, 53, 139 Infantile, 21, 27, 28, 32, 33, 40, 41, 42, 87, 139 Infarction, 131, 139, 142 Infection, 20, 21, 27, 82, 123, 125, 128, 132, 135, 136, 138, 139, 141, 150, 151, 152, 155, 156 Infectious Diarrhea, 82, 139 Inflammation, 83, 128, 129, 134, 135, 136, 137, 139, 150, 152 Ingestion, 10, 46, 76, 89, 125, 139, 146 Inguinal, 138, 139 Inhalation, 4, 13, 16, 94, 123, 139, 146 Innervation, 139, 145 Intensive Care, 20, 30, 47, 51, 54, 58, 139 Intercostal, 140, 150 Intermittent, 135, 140 Internal radiation, 140, 149 Interstitial, 127, 140, 141 Intestinal, 18, 34, 42, 43, 49, 129, 134, 140 Intestine, 127, 134, 140 Intoxication, 5, 6, 13, 16, 31, 74, 140, 154, 156 Intracellular, 42, 139, 140, 141 Intracellular Membranes, 140, 141 Intramuscular, 37, 140 Intramuscular injection, 37, 140 Intrinsic, 123, 140 Invasive, 13, 82, 138, 140 Involuntary, 11, 140, 143, 149, 151
Ions, 126, 132, 133, 137, 140 Ischemia, 126, 135, 140 K Kb, 102, 140 Keratolytic, 132, 140 L Laceration, 140, 153 Large Intestine, 54, 128, 132, 140, 149, 151 Lethal, 4, 8, 140 Library Services, 116, 140 Litter, 62, 140 Liver, 82, 123, 126, 132, 135, 137, 140 Localized, 132, 138, 139, 140, 146, 153, 155 Locomotion, 140, 146 Longitudinal study, 26, 140 Lymph, 10, 126, 128, 134, 141, 151 Lymph node, 126, 128, 141 Lymphadenopathy, 141, 151 Lymphatic, 139, 141, 153 Lymphatic system, 141, 153 Lymphocyte, 125, 141 Lymphoid, 125, 141 M Macrophage, 4, 141 Malnutrition, 126, 141 Mastitis, 141, 151 Meat, 110, 141, 150 Mechanical ventilation, 77, 141 MEDLINE, 103, 141 Meiosis, 129, 141, 143, 153 Membrane, 8, 13, 14, 74, 128, 130, 134, 141, 142, 144, 145, 150, 151, 153 Membrane Fusion, 8, 141 Mental Disorders, 72, 141 MI, 46, 121, 142 Microbe, 142, 154 Microbiology, 13, 18, 23, 27, 30, 31, 34, 35, 38, 40, 43, 48, 49, 50, 51, 55, 56, 82, 126, 142 Microorganism, 129, 142, 145, 156 Micro-organism, 81, 132, 142, 150 Microscopy, 11, 142 Migration, 8, 142 Mitosis, 129, 142 Modeling, 7, 142 Modification, 37, 63, 67, 142 Molecular, 7, 10, 11, 12, 13, 16, 76, 80, 103, 105, 124, 127, 130, 142 Molecular Evolution, 7, 142 Molecule, 125, 126, 130, 132, 133, 134, 138, 142, 144, 146, 149, 155 Monoclonal, 6, 142, 149
Index 161
Monoclonal antibodies, 6, 142 Motion Sickness, 142, 143 Motor nerve, 74, 135, 142, 143, 146 Mucociliary, 142, 151 Mucosa, 10, 82, 134, 142 Multivalent, 9, 142 Muscle Contraction, 15, 143 Muscle Hypertonia, 143, 144 Muscle relaxant, 143, 152 Muscle Relaxation, 124, 143, 152 Muscle Spasticity, 13, 143 Myasthenia, 15, 44, 133, 137, 143 Mycotoxins, 81, 143 Myocardium, 142, 143 Myosin, 143 N Nausea, 109, 120, 131, 136, 143 NCI, 1, 72, 101, 143 Necrosis, 139, 142, 143 Need, 4, 12, 13, 77, 81, 85, 89, 96, 109, 112, 143 Nerve Endings, 10, 74, 143 Nervous System, 27, 33, 128, 143, 144, 146, 153, 155 Neuroblastoma, 30, 143 Neuroeffector Junction, 143 Neurologic, 55, 143 Neuromuscular, 10, 13, 14, 15, 25, 32, 44, 47, 65, 66, 74, 76, 77, 123, 144, 145, 150 Neuromuscular Diseases, 13, 77, 144 Neuromuscular Junction, 10, 13, 14, 15, 74, 76, 123, 144, 145, 150 Neuromuscular Junction Diseases, 144, 150 Neuronal, 6, 16, 56, 144 Neurons, 7, 129, 132, 135, 143, 144, 153 Neurotoxin, 5, 8, 10, 12, 17, 27, 40, 51, 67, 74, 75, 76, 144 Neutralization, 5, 6, 76, 144 Neutrons, 124, 144, 148, 149 Nitrogen, 43, 124, 144 Norepinephrine, 26, 133, 144 Nuclear, 130, 133, 135, 143, 144 Nuclei, 124, 130, 133, 142, 144, 148 Nucleic acid, 138, 144 Nucleic Acid Hybridization, 138, 144 Nucleocapsid, 144, 154 Nucleus, 131, 135, 141, 144, 147, 148, 152 O Occult, 30, 145 Ocular, 45, 145 Opacity, 132, 145
Operon, 9, 145, 149 Ophthalmic, 44, 94, 145 Ophthalmologist, 29, 145 Ophthalmoplegia, 29, 145 Oral Health, 145 Oral Hygiene, 83, 145 Orderly, 129, 145 Organelles, 131, 145 P Palliative, 145, 153 Palmitic Acid, 74, 145 Palsies, 30, 145 Pancreas, 82, 123, 132, 145 Paralysis, 6, 7, 10, 13, 14, 16, 30, 54, 74, 76, 120, 131, 145 Paranasal Sinuses, 145, 151 Pathogen, 85, 145 Pathogenesis, 6, 16, 46, 80, 145 Pathologic, 29, 131, 138, 145, 152 Patient Education, 109, 114, 116, 121, 145 Peptide, 5, 14, 145, 147, 148 Perfusion, 127, 138, 146 Perineal, 138, 146 Peripheral Nervous System, 144, 145, 146, 147 Peripheral Nervous System Diseases, 144, 146 Peritoneal, 82, 146 Peritoneum, 146 Phagocytosis, 8, 146 Pharmacologic, 13, 16, 124, 146, 154 Phrenic Nerve, 10, 15, 146, 150 Physiologic, 146, 149 Physiology, 13, 44, 54, 133, 146, 155 Plague, 4, 10, 11, 15, 146, 154 Plant Diseases, 134, 146 Plants, 5, 124, 126, 127, 128, 129, 136, 144, 146, 152, 154, 155 Plasma, 4, 26, 125, 128, 136, 137, 146 Plasma cells, 125, 146 Plasmid, 9, 146, 155 Poisoning, 7, 22, 52, 62, 65, 66, 68, 82, 83, 108, 109, 129, 135, 136, 140, 143, 146 Polymerase, 21, 147, 149 Polymerase Chain Reaction, 21, 147 Polymorphism, 7, 147 Polypeptide, 124, 128, 138, 147, 148, 156 Polysaccharide, 125, 128, 147 Polyvalent, 5, 147 Posterior, 124, 145, 147 Postsynaptic, 143, 144, 147, 153 Practice Guidelines, 104, 147
162 Botulism
Presynaptic, 15, 74, 143, 147, 153 Presynaptic Terminals, 143, 147, 153 Probe, 137, 147 Progeny, 130, 147 Progression, 10, 48, 125, 147 Progressive, 32, 136, 143, 147 Projection, 11, 144, 147 Prophase, 143, 147, 153 Prophylaxis, 147, 155 Prospective study, 140, 148 Protease, 14, 148 Protein C, 7, 10, 124, 138, 148, 151 Protein Conformation, 7, 124, 148 Protein S, 4, 80, 127, 148 Protein Subunits, 4, 148 Proteins, 6, 13, 14, 16, 75, 124, 125, 127, 128, 130, 135, 138, 142, 144, 146, 148, 149, 151, 154 Proteolytic, 14, 75, 76, 129, 130, 148 Protons, 124, 148 Protozoa, 130, 142, 148, 152 Proximal, 147, 148, 150 Public Policy, 103, 148 Publishing, 17, 110, 148 Pulmonary, 32, 43, 127, 131, 148, 155 Purulent, 123, 148 Q Quaternary, 148, 152 R Race, 142, 148 Radiation, 83, 134, 135, 140, 148, 149, 156 Radiation therapy, 83, 134, 140, 149 Radioactive, 139, 140, 142, 144, 149 Radiolabeled, 149 Radiotherapy, 127, 149 Randomized, 77, 133, 149 Receptor, 4, 14, 16, 74, 125, 133, 144, 149 Recombinant, 6, 7, 8, 14, 16, 75, 76, 127, 149, 155 Recombinant Proteins, 14, 149 Recombination, 130, 149 Rectum, 125, 127, 132, 135, 136, 140, 149 Refer, 1, 4, 130, 135, 140, 144, 149, 150 Reflex, 149 Refraction, 149, 151 Regimen, 9, 133, 149 Relaxant, 149, 152 Reliability, 33, 149 Repressor, 145, 149 Respiration, 128, 131, 149, 150 Respirator, 141, 149, 155 Respiratory failure, 7, 15, 28, 150, 155
Respiratory Muscles, 74, 150 Respiratory Paralysis, 48, 150 Rhinitis, 150, 151 Rigidity, 146, 150 Risk factor, 27, 38, 50, 148, 150 Rod, 126, 150 Rotavirus, 82, 150 S Saliva, 150 Salivary, 82, 132, 150, 156 Salivary glands, 82, 132, 150 Saturated fat, 74, 145, 150 Schizoid, 150, 156 Schizophrenia, 150, 156 Schizotypal Personality Disorder, 150, 156 Screening, 129, 150 Secretory, 143, 150, 153 Segregation, 129, 149, 150 Self Care, 81, 150 Septal, 8, 150 Septicaemia, 150, 151 Septum, 8, 150, 151 Septum Pellucidum, 150, 151 Sequencing, 7, 147, 151 Serologic, 138, 151 Serotypes, 5, 6, 9, 10, 13, 16, 76, 126, 151 Serum, 5, 21, 35, 49, 51, 77, 125, 130, 138, 151 Serum Sickness, 5, 77, 151 Shock, 124, 151 Side effect, 5, 71, 77, 83, 91, 96, 123, 151, 154 Sinusitis, 62, 151 Skeletal, 131, 138, 143, 151, 152 Small intestine, 126, 128, 133, 134, 137, 140, 151 Smallpox, 11, 22, 56, 110, 151 Sound wave, 130, 151 Spasm, 144, 151 Specialist, 111, 151 Species, 8, 12, 126, 127, 129, 131, 134, 136, 137, 138, 141, 142, 148, 151, 152, 154, 155, 156 Specificity, 14, 77, 123, 151 Spectrum, 28, 151 Sperm, 129, 152 Spinal cord, 128, 129, 143, 146, 149, 150, 152 Spinal Cord Diseases, 150, 152 Spores, 8, 75, 121, 152 Stabilization, 6, 152 Steel, 5, 152
Index 163
Steroids, 32, 152 Stimulus, 134, 139, 149, 152 Stomach, 109, 123, 132, 134, 136, 137, 143, 151, 152 Stool, 34, 121, 140, 152 Strand, 147, 152 Stress, 136, 143, 152, 155 Stroke, 72, 102, 108, 152 Subacute, 139, 151, 152 Subclinical, 139, 152 Subcutaneous, 14, 57, 128, 135, 152 Subspecies, 151, 152 Substrate, 128, 152 Succinylcholine, 26, 152 Sudden death, 48, 152 Suppurative, 128, 135, 152 Sympathomimetic, 133, 134, 144, 153 Synapses, 14, 127, 143, 153 Synapsis, 153 Synaptic, 10, 14, 15, 153 Synaptic Vesicles, 153 Systemic, 9, 14, 15, 82, 92, 93, 94, 95, 124, 127, 132, 134, 139, 149, 153, 154 T Teichoic Acids, 136, 153 Tetani, 12, 76, 153 Tetanic, 153 Tetanus, 12, 42, 53, 54, 76, 77, 80, 125, 153 Therapeutics, 4, 6, 7, 13, 14, 16, 96, 153 Thermal, 132, 144, 147, 153 Thoracic, 132, 153 Thrombin, 148, 153 Thrombomodulin, 148, 153 Thrombosis, 148, 152, 153 Thymus, 138, 141, 153 Tissue, 125, 126, 127, 131, 133, 135, 136, 138, 140, 141, 143, 144, 145, 146, 149, 151, 154 Tonic, 54, 154 Tonicity, 133, 154 Torovirus, 82, 154 Toxemia, 42, 154 Toxic, iv, 5, 6, 8, 11, 16, 67, 76, 81, 126, 130, 131, 132, 134, 138, 144, 154 Toxicity, 6, 14, 133, 154 Toxicology, 7, 67, 104, 154 Toxins, 4, 5, 10, 12, 13, 14, 34, 41, 62, 76, 80, 125, 127, 139, 142, 143, 154 Toxoid, 13, 16, 125, 154 Transcutaneous, 13, 154
Transfection, 127, 154 Transfer Factor, 138, 154 Translocate, 14, 154 Translocation, 14, 154 Transmitter, 15, 123, 133, 144, 153, 154 Transplantation, 138, 154 Trivalent, 77, 154 Tuberculosis, 82, 131, 154 Tularemia, 11, 21, 154 Typhoid fever, 82, 154 U Ulcer, 128, 155 Unconscious, 138, 155 Urine, 127, 137, 155 Urticaria, 124, 151, 155 V Vaccination, 8, 9, 13, 76, 155 Vaccine, 4, 5, 6, 9, 10, 11, 13, 14, 16, 75, 87, 123, 124, 155 Vagina, 132, 155 Vascular, 56, 124, 139, 152, 155 Vector, 9, 13, 155 Vegetative, 8, 155 Venous, 148, 155 Ventilation, 155 Ventilator, 141, 149, 155 Vesicular, 127, 151, 155 Vesicular Exanthema of Swine, 127, 155 Vesicular Exanthema of Swine Virus, 127, 155 Veterinary Medicine, 62, 103, 155 Vibrio, 82, 109, 129, 155 Vibrio cholerae, 129, 155 Viral, 82, 108, 155 Virulence, 126, 154, 155 Virus, 144, 151, 154, 155, 156 Vitro, 8, 156 Vivo, 14, 156 Volition, 140, 156 W White blood cell, 125, 141, 146, 156 Withdrawal, 45, 156 X Xenograft, 125, 156 Xerostomia, 82, 156 X-ray, 11, 135, 144, 149, 156 Z Zygote, 130, 156 Zymogen, 148, 156
164 Botulism
