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

OLOSTOMY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES J AMES N. P ...

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OLOSTOMY 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 Ó2004 by ICON Group International, Inc. Copyright Ó2004 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., 1960Colostomy: 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: 0-597-84380-5 1. Colostomy-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on colostomy. 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 COLOSTOMY.............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Colostomy ..................................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 6 CHAPTER 2. NUTRITION AND COLOSTOMY .................................................................................... 35 Overview...................................................................................................................................... 35 Finding Nutrition Studies on Colostomy .................................................................................... 35 Federal Resources on Nutrition ................................................................................................... 37 Additional Web Resources ........................................................................................................... 38 CHAPTER 3. ALTERNATIVE MEDICINE AND COLOSTOMY ............................................................. 39 Overview...................................................................................................................................... 39 National Center for Complementary and Alternative Medicine.................................................. 39 Additional Web Resources ........................................................................................................... 40 General References ....................................................................................................................... 41 CHAPTER 4. DISSERTATIONS ON COLOSTOMY ............................................................................... 43 Overview...................................................................................................................................... 43 Dissertations on Colostomy ......................................................................................................... 43 Keeping Current .......................................................................................................................... 43 CHAPTER 5. CLINICAL TRIALS AND COLOSTOMY .......................................................................... 45 Overview...................................................................................................................................... 45 Recent Trials on Colostomy ......................................................................................................... 45 Keeping Current on Clinical Trials ............................................................................................. 45 CHAPTER 6. PATENTS ON COLOSTOMY .......................................................................................... 47 Overview...................................................................................................................................... 47 Patents on Colostomy .................................................................................................................. 47 Patent Applications on Colostomy............................................................................................... 79 Keeping Current .......................................................................................................................... 82 CHAPTER 7. BOOKS ON COLOSTOMY .............................................................................................. 83 Overview...................................................................................................................................... 83 Book Summaries: Federal Agencies.............................................................................................. 83 Book Summaries: Online Booksellers ........................................................................................... 84 Chapters on Colostomy ................................................................................................................ 85 CHAPTER 8. MULTIMEDIA ON COLOSTOMY ................................................................................... 87 Overview...................................................................................................................................... 87 Video Recordings ......................................................................................................................... 87 Audio Recordings......................................................................................................................... 88 CHAPTER 9. PERIODICALS AND NEWS ON COLOSTOMY ................................................................ 89 Overview...................................................................................................................................... 89 News Services and Press Releases................................................................................................ 89 Newsletters on Colostomy............................................................................................................ 90 Newsletter Articles ...................................................................................................................... 91 Academic Periodicals covering Colostomy................................................................................... 92 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 95 Overview...................................................................................................................................... 95 NIH Guidelines............................................................................................................................ 95 NIH Databases............................................................................................................................. 97 Other Commercial Databases....................................................................................................... 99 APPENDIX B. PATIENT RESOURCES ............................................................................................... 101 Overview.................................................................................................................................... 101

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Patient Guideline Sources.......................................................................................................... 101 Finding Associations.................................................................................................................. 109 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 ................................................................................................... 120 COLOSTOMY DICTIONARY .................................................................................................... 121 INDEX .............................................................................................................................................. 147

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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 colostomy 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 colostomy, 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 colostomy, 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 colostomy. 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 colostomy, 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 colostomy. The Editors

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

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

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

Colostomy Irrigation: An Option Worth Considering Source: Professional Nurse. 7(2): 15-16, 18-19. October 1991. Summary: Colostomy irrigation has been used as a method of controlling colostomy output since the 1920s, but a recent survey of stoma care nurses and their patients showed that only 4.7 percent of colostomists in the United Kingdom used the irrigation technique. This article reviews the procedure of colostomy irrigation and concludes that colostomy irrigation has many advantages over alternative appliances and also is more cost-effective. Topics include a brief description of the method of irrigation, the equipment and supplies needed, patient education, home care, and common problems and complications. The author notes that during the initial teaching period, which will vary depending on the individual, the presence and encouragement of a stoma care

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nurse or appropriately experienced nurse is vital until the person with the colostomy is confident enough to practice the procedure alone. 3 tables. 6 references. ·

Pursuit of Colostomy Continence Source: Journal of WOCN. Journal of the Wound, Ostomy and Continence Nurses Society. 24(2): 92-97. March 1997. Contact: Available from Journal of WOCN, Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 453-4351 or (314) 453-4351. Summary: The lifelong management required by patients with permanent colostomies leads to dissatisfaction with quality of life for many. Through the years, multiple techniques have been attempted to improve the quality of life by pursuing colostomy continence. This article describes some of these endeavors, including surgical interventions, nonsurgical devices and management (including the practice of irrigation), and behavior modification techniques. Selection criteria have been developed to predict successful management of a colostomy by irrigation. The author cautions that the time necessary to maintain irrigation schedules may be seen as a deterrent to this method (up to 1 hour per day may be required). The author also notes that, when nonsurgical methods are compared on the basis of degree of continence realized, the risk of complications, and ease of use, the colostomy plug offers significant advantages. Although the costs are higher than some other methods, the positive impact of the increased continence associated with use of the colostomy plug on self-esteem, on social and intimate relationships, and on the anxiety associated with fear of odor or an incontinent episode may provide a compelling reason for a patient to assume the additional costs of the device. Efforts in research and development continue, and the desire to achieve continence of the stoma remains a common goal among persons with an ostomy and those involved in their care.

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Alternative to the Colostomy: Electrically Stimulated Neoanal Sphincter for the Treatment of Faecal Incontinence Source: Professional Nurse. 8(6): 354-358. March 1993. Summary: This article describes the electrically stimulated neoanal sphincter (ESNS), a new operation that offers many patients fecal continence control, and may represent an alternative to colostomy. Topics include the ESNS and how it works; patient selection for this procedure; operative management; the three stages of the ESNS procedure, including vascular delay and defunctioning stoma, gracilis (muscle) transposition and implantation of stimulator, and closure of the stoma; use of the magnet; and patient discharge. The author concludes with a brief description of the present uses of the ESNS, some problems that have been encountered, and hopes for the future uses of ESNS. 2 figures. 3 references.

Federally Funded Research on Colostomy The U.S. Government supports a variety of research studies relating to colostomy. 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 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

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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 colostomy. 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 colostomy. The following is typical of the type of information found when searching the CRISP database for colostomy: ·

Project Title: ACUPUNCTURE TO PREVENT POSTOPERATIVE PARALYTIC LLEUS Principal Investigator & Institution: Chiang, Joseph S.; Anesthesiology; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 15-JUN-2003; Project End 28-FEB-2005 Summary: (provided by applicant): The primary aim of this prospective randomized trial is to determine if acupuncture is effective in preventing postoperative paralytic ileus (PPI) among cancer survivors undergoing colostomy/ileostomy closure. Additional objectives are to: 1) compare post-surgical quality of life status between treatment and control groups in terms of pain, use of opioid analgesics, nausea, vomiting, insomnia, abdominal distention/fullness, activity, and sense of well-being; and 2) compare costs due to extended hospital stay and care related to ileus between patients who develop PPI and those who do not. This study will also provide preliminary data for subsequent large scale projects and serve as a basis for future research in an area where existing evidence is sparse, yet potential benefits to patient care are considerable. The treatment group will receive acupuncture with electrical stimulation twice each day for 20 minutes beginning on postoperative day 1 and ending on postoperative day 4 for a total of 8 treatments. With each treatment session, 10 needles will be placed on points LI-4, Sp-6, St-36, St-25, CV-6, and CV-12, and electroacupuncture will be applied at points LI-4 and St-36. A bowel motility index including bowel sounds, passage of flatus, bowel movement, and diet tolerance will be recorded for both groups until 72 hours after acupuncture treatments have been stopped or until hospital discharge. Information regarding pain, use of opioid analgesics, nausea, vomiting, insomnia, abdominal distention/fullness, activity, and general sense of wellbeing will be compared between groups. Time (in hours) for each bowel motility indicator (bowel sounds, passage of flatus, and bowel movement) and time to hospital discharge will be compared between groups using standard survival techniques both as Kaplan-Meier analysis and adjusting for the other measured parameters in the study using proportional hazards analyses. Contingency table methods and logistic regression will be used to determine related parameters. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SMART SEAL OSTOMY APPLIANCE Principal Investigator & Institution: Schoess, Jeffrey N.; Korosensor.Com, Inc. 3421 50Th St, Ne Buffalo, Mn 55313

(FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 30-JUN-2004 Summary: (provided by applicant): Korosensor.com proposes to develop a smart seal system for ostomy appliance. Korosensor proposes to develop a low cost appliance that detects the possibility of leakage prior to occurring for patients of all age groups. A smart seal ostomy appliance is a medical device, which incorporates smart seal diagnostics capability to extend ostomy system change interval times, provides patient confidence and peace of mind. Korosensor's approach to demonstrating smart seal monitoring incorporating polymer thick film (PTF) conductive elastomer materials, low power support electronics and piezo vibrating alert technology. PTF technology offers the benefits of low cost manufacturing using ink jet printing methods with elastomer materials to provide conforming comfort for ostomy users. The proposed ostomy system will permit a patient to identify ostomy leakage due to skin barrier problems, stoma construction, stoma ulceration, improper appliance usage, or inadequate fitting. A 1.0 mil thick leak detector will be incorporated into the ostomy appliance flange using a polymer thick film circuit and hydroscopic dressing assembly to sense leakage problems. A simple set of support electronics will identify flange leakage conditions and alert the appliance user of potential leakage problems via a built-in piezo vibrating alert device. PROPOSED COMMERCIAL APPLICATION: Over 1 million ostomy surgeries are performed each year. Patients undergoing ostomy surgery need intensive physical and emotional care to return to a normal life. Effective seals for colostomy, ileostomy and urostomy, are critical to physical and emotional well-being as well as functional abilities of an individual with ostomies. An ineffective seal leads to a cycle of misery for the ostomy patient. Leakage causes skin breakdown which causes further leakage, thus perpetuating the cycle. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with colostomy, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “colostomy” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for colostomy (hyperlinks lead to article summaries):

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

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A case of obstructive colitis caused by possible colostomy dysfunction. Author(s): Isogai M, Yamaguchi A, Hori A, Kaneoka Y. Source: Hepatogastroenterology. 1998 September-October; 45(23): 1598-600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9840113&dopt=Abstract

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A comparison of end and loop colostomy for fecal diversion in gynecologic patients with colonic fistulas. Author(s): Segreti EM, Levenback C, Morris M, Lucas KR, Gershenson DM, Burke TW. Source: Gynecologic Oncology. 1996 January; 60(1): 49-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8557227&dopt=Abstract

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A look at the purpose and outcomes of colostomy irrigation. Author(s): Turnbull GB. Source: Ostomy Wound Manage. 2003 February; 49(2): 19-20. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12598698&dopt=Abstract

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A multidimensional modeling of predictors influencing the adjustment to a colostomy. Author(s): Piwonka MA, Merino JM. Source: Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society / Wocn. 1999 November; 26(6): 298305. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10865614&dopt=Abstract

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A new approach to extraperitoneal rectal injuries: laparoscopy and diverting loop colostomy. Author(s): Namias N. Source: The Journal of Trauma. 2002 April; 52(4): 811; Author Reply 811. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11956410&dopt=Abstract

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A new approach to extraperitoneal rectal injuries: laparoscopy and diverting loop sigmoid colostomy. Author(s): Navsaria PH, Graham R, Nicol A. Source: The Journal of Trauma. 2001 September; 51(3): 532-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11535905&dopt=Abstract

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A new universal colostomy tip for barium enemas of the colon. Author(s): Williams JT, Scott RL. Source: Ajr. American Journal of Roentgenology. 2003 May; 180(5): 1330-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12704045&dopt=Abstract

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A population-based study of rectal cancer: permanent colostomy as an outcome. Author(s): Paszat LF, Brundage MD, Groome PA, Schulze K, Mackillop WJ. Source: International Journal of Radiation Oncology, Biology, Physics. 1999 December 1; 45(5): 1185-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10613311&dopt=Abstract

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A simple method to minimize spillage on retrograde examination of the bowel in patients with an ileostomy or colostomy: technical note. Author(s): Torreggiani WC, Lyburn ID, Harris AC, Zwirewich CV. Source: Canadian Association of Radiologists Journal = Journal L'association Canadienne Des Radiologistes. 2001 June; 52(3): 196-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11436416&dopt=Abstract

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A simple technique for obliteration of the paracolostomy recess in iliac colostomy. Author(s): Ananthakrishnan N, Srinivasan K. Source: Surg Gynecol Obstet. 1993 July; 177(1): 82-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8322158&dopt=Abstract

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A simplified procedure for creating a urinary conduit in patients with a colostomy. Author(s): Kellogg Parsons J, Malkowicz B, Torosian MH. Source: Oncol Rep. 1999 March-April; 6(2): 451-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10023020&dopt=Abstract

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A simplified technique for creating a stapled colostomy. Author(s): Quirke TE, Degroote R, Rush B. Source: Journal of Surgical Oncology. 1994 August; 56(4): 252-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8057654&dopt=Abstract

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A stake through the heart of colostomy. Author(s): Nance ML, Nance FC. Source: The Journal of Trauma. 1995 November; 39(5): 811-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7473993&dopt=Abstract

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A study of attitudes of colostomy patients towards a stoma. Author(s): Majola SG, Ntombela BB, Zungu BM. Source: Curationis. 1995 March; 18(1): 49-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7600630&dopt=Abstract

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A totally diverting loop colostomy. Author(s): Merrett ND, Gartell PC. Source: Annals of the Royal College of Surgeons of England. 1993 July; 75(4): 272-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8379632&dopt=Abstract

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Abdominoperineal excision of the rectum and anal canal with perineal colostomy. Author(s): da Silva AL. Source: The European Journal of Surgery = Acta Chirurgica. 1995 October; 161(10): 7614. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8555345&dopt=Abstract

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Abdominoperineal resection and perineal colostomy for low rectal cancer. The Lazaro da Silva technique. Author(s): Velitchkov NG, Kirov GK, Losanoff JE, Kjossev KT, Grigorov GI, Mironov MB, Klenov IS. Source: Diseases of the Colon and Rectum. 1997 May; 40(5): 530-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9152178&dopt=Abstract

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Acute obstruction from tumour in the left colon without spread. A randomized trial of emergency colostomy versus resection. Author(s): Kronborg O. Source: International Journal of Colorectal Disease. 1995; 10(1): 1-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7745314&dopt=Abstract

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Anal transposition without colostomy: functional results and complications. Author(s): Demirbilek S, Atayurt HF. Source: Pediatric Surgery International. 1999; 15(3-4): 221-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10370028&dopt=Abstract

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Anorectal reconstruction after abdominoperineal excision: a state-of-the-art alternative to a conventional colostomy. Author(s): Violi V, Roncoroni L, Boselli AS, De Cesare C, Trivelli M, Peracchia A. Source: Ital J Gastroenterol Hepatol. 1999 April; 31(3): 267-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10379494&dopt=Abstract

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Antiperistaltic transverse colostomy for massive bowel necrosis following surgery for an abdominal aortic aneurysm: report of a case. Author(s): Yagi T, Nakagawa K, Sadamori H, Hashimoto M, Kamikawa Y, Tanaka N. Source: Surgery Today. 1997; 27(6): 554-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9306551&dopt=Abstract

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Appendicostomy irrigation for facilitating colonic evacuation in colostomy patients. Preliminary report. Author(s): Kotanagi H, Koyama K, Sato Y, Takahashi K. Source: Diseases of the Colon and Rectum. 1998 August; 41(8): 1050-2; Discussion 10523. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9715163&dopt=Abstract

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Avoidance of colostomy placement in advanced colorectal cancer with twice weekly hypofractionated radiation plus continuous infusion 5-fluorouracil. Author(s): Janjan NA, Breslin T, Lenzi R, Rich TA, Skibber J. Source: Journal of Pain and Symptom Management. 2000 October; 20(4): 266-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11027908&dopt=Abstract

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Bullous pemphigoid at colostomy site: report of a case. Author(s): Vande Maele DM, Reilly JC. Source: Diseases of the Colon and Rectum. 1997 March; 40(3): 370-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9118756&dopt=Abstract

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Button-pexy fixation for repair of ileostomy and colostomy prolapse. Author(s): Canil K, Fitzgerald P, Lau G, Cameron G, Walton M. Source: Journal of Pediatric Surgery. 1995 August; 30(8): 1148-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7472969&dopt=Abstract

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Changes in diet following the formation of a colostomy. Author(s): Bulman J. Source: British Journal of Nursing (Mark Allen Publishing). 2001 February 8-21; 10(3): 179-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12170663&dopt=Abstract

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Chemical colostomy irrigation with glyceryl trinitrate solution. Author(s): O'Bichere A, Bossom C, Gangoli S, Green C, Phillips RK. Source: Diseases of the Colon and Rectum. 2001 September; 44(9): 1324-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11584209&dopt=Abstract

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Chest wall peritoneal dialysis catheter placement in infants with a colostomy. Author(s): Chadha V, Jones LL, Ramirez ZD, Warady BA. Source: Adv Perit Dial. 2000; 16: 318-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11045319&dopt=Abstract

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Choosing the right stoma appliance for a colostomy. Author(s): Taylor P. Source: Community Nurse. 2000 October; 6(9): 35-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11982145&dopt=Abstract

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Classification of anorectal malformations--initial approach, diagnostic tests, and colostomy. Author(s): Shaul DB, Harrison EA. Source: Semin Pediatr Surg. 1997 November; 6(4): 187-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9368270&dopt=Abstract

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Clinical study: peristomal skin irritation in colostomy patients. Author(s): Burt-McAliley D, Eberhardt D, van Rijswijk L. Source: Ostomy Wound Manage. 1994 July-August; 40(6): 28-30, 32-4, 36-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7880370&dopt=Abstract

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Clinically relevant leakage in percutaneous colostomy. Author(s): Clark JA. Source: Journal of Vascular and Interventional Radiology : Jvir. 1997 May-June; 8(3): 480. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9152926&dopt=Abstract

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Closure of transverse loop colostomy and loop ileostomy. Author(s): Edwards DP, Chisholm EM, Donaldson DR. Source: Annals of the Royal College of Surgeons of England. 1998 January; 80(1): 33-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9579124&dopt=Abstract

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Colonic injury: does colostomy still have a place? Author(s): Miller BJ. Source: Injury. 2001 July; 32(6): 433-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11476805&dopt=Abstract

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Colonic resection in trauma: colostomy versus anastomosis. Author(s): Murray JA, Demetriades D, Colson M, Song Z, Velmahos GC, Cornwell EE 3rd, Asensio JA, Belzberg H, Berne TV. Source: The Journal of Trauma. 1999 February; 46(2): 250-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10029029&dopt=Abstract

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Colonoscopy-assisted colostomy--an alternative to laparotomy: report of two cases. Author(s): Mukherjee A, Parikh VA, Aguilar PS. Source: Diseases of the Colon and Rectum. 1998 November; 41(11): 1458-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9823816&dopt=Abstract

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Colonoscopy-assisted 'trephine' sigmoid colostomy. Author(s): Parithivel VS, Schein M, Gerst PH. Source: Digestive Surgery. 2003; 20(2): 103-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12686776&dopt=Abstract

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Colostomy closure after Hartmann's procedure with fast-track rehabilitation. Author(s): Basse L, Jacobsen DH, Billesbolle P, Kehlet H. Source: Diseases of the Colon and Rectum. 2002 December; 45(12): 1661-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12473891&dopt=Abstract

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Colostomy closure using local anesthesia. Author(s): Cantele H, Mendez A, Leyba J. Source: Surgery Today. 2001; 31(8): 678-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11510602&dopt=Abstract

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Colostomy closure. Ochsner Clinic experience. Author(s): Khoury DA, Beck DE, Opelka FG, Hicks TC, Timmcke AE, Gathright JB Jr. Source: Diseases of the Colon and Rectum. 1996 June; 39(6): 605-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8646942&dopt=Abstract

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Colostomy closure: impact of preoperative risk factors on morbidity. Author(s): Ghorra SG, Rzeczycki TP, Natarajan R, Pricolo VE. Source: The American Surgeon. 1999 March; 65(3): 266-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10075307&dopt=Abstract

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Colostomy complications in infants and children. Author(s): Nour S, Beck J, Stringer MD. Source: Annals of the Royal College of Surgeons of England. 1996 November; 78(6): 52630. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8943638&dopt=Abstract

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Colostomy for anorectal anomalies: high incidence of complications. Author(s): Patwardhan N, Kiely EM, Drake DP, Spitz L, Pierro A. Source: Journal of Pediatric Surgery. 2001 May; 36(5): 795-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11329592&dopt=Abstract

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Colostomy in conflict: military colonic surgery. Author(s): Edwards DP, Galbraith KA. Source: Annals of the Royal College of Surgeons of England. 1997 July; 79(4): 243-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9244064&dopt=Abstract

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Colostomy in neonates with a massively distended abdomen due to an imperforate anus. Author(s): Budhiraja S. Source: Trop Doct. 2001 January; 31(1): 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11205595&dopt=Abstract

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Colostomy in penetrating colon injury: is it necessary? Author(s): Gonzalez RP, Merlotti GJ, Holevar MR. Source: The Journal of Trauma. 1996 August; 41(2): 271-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8760535&dopt=Abstract

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Colostomy in the newborn: technical pitfalls. Author(s): Ameh EA. Source: Niger Postgrad Med J. 2002 December; 9(4): 240-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690687&dopt=Abstract

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Colostomy in trauma surgery: friend or foe? Author(s): Rehm CG, Talucci RC, Ross SE. Source: Injury. 1993 October; 24(9): 595-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8288377&dopt=Abstract

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Colostomy irrigation--a safe practice? Author(s): Taylor P. Source: Journal of Clinical Nursing. 1995 May; 4(3): 203-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7773530&dopt=Abstract

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Colostomy vs tube cecostomy for protection of a low anastomosis in rectal cancer. Author(s): Tschmelitsch J, Wykypiel H, Prommegger R, Bodner E. Source: Archives of Surgery (Chicago, Ill. : 1960). 1999 December; 134(12): 1385-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10593339&dopt=Abstract

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Colostomy. Author(s): Black PK. Source: Prof Nurse. 1998 September; 13(12): 851-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10095680&dopt=Abstract

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Colostomy: its place in the management of colorectal injuries in civilian practice. Author(s): Baako BN. Source: West Afr J Med. 1998 April-June; 17(2): 109-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9715117&dopt=Abstract

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Colostomy--the Port Harcourt experience. Author(s): Adotey JM. Source: West Afr J Med. 1998 July-September; 17(3): 179-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9814088&dopt=Abstract

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Continent perineal colostomy after abdominoperineal resection: outcome after 63 cases. Author(s): Gamagami RA, Chiotasso P, Lazorthes F. Source: Diseases of the Colon and Rectum. 1999 May; 42(5): 626-30; Discussion 630-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10344685&dopt=Abstract

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Continent perineal colostomy by electrostimulated graciloplasty in abdominoperineal resection. A preliminary report. Author(s): Violi V, Roncoroni L, Boselli AS, De Cesare C, Livrini M, Peracchia A. Source: Acta Biomed Ateneo Parmense. 1996; 67(3-4): 131-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10021696&dopt=Abstract

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Continent perineal colostomy by transposition of gracilis muscles. Technical remarks and results in 14 cases. Author(s): Santoro E, Tirelli C, Scutari F, Garofalo A, Silecchia G, Scaccia M, Santoro E. Source: Diseases of the Colon and Rectum. 1994 February; 37(2 Suppl): S73-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8313798&dopt=Abstract

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Conversion of loop colostomy to end colostomy: is dismantling necessary? Author(s): Behera A, Gupta NM, Attri AK. Source: Indian J Gastroenterol. 1995 April; 14(2): 69-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7797282&dopt=Abstract

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Current indications for blow-hole colostomy:ileostomy procedure. A single center experience. Author(s): Remzi FH, Oncel M, Hull TL, Strong SA, Lavery IC, Fazio VW. Source: International Journal of Colorectal Disease. 2003 July; 18(4): 361-4. Epub 2003 January 03. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12774252&dopt=Abstract

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Defunctioning colostomy for low anterior resection: a selective approach. Author(s): Grabham JA, Moran BJ, Lane RH. Source: The British Journal of Surgery. 1995 October; 82(10): 1331-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7489155&dopt=Abstract

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Diffuse malignant mesothelioma arising in a paracolostomy hernial sac. Author(s): Bethwaite PB, Evans R, Naik DK, Delahunt B, Teague CA. Source: Histopathology. 1996 September; 29(3): 282-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8884360&dopt=Abstract

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Disposable plastic liners for a colostomy appliance: a controlled trial and follow-up survey of convenience, satisfaction, and costs. Author(s): Kelly AW, Nelson ML, Heppell J, Weaver A, Hentz J. Source: Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society / Wocn. 2000 September; 27(5): 272-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10999966&dopt=Abstract

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Diversion colitis: a cause of abdominal discomfort in spinal cord injury patients with colostomy. Author(s): Lai JM, Chuang TY, Francisco GE, Strayer JR. Source: Archives of Physical Medicine and Rehabilitation. 1997 June; 78(6): 670-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9196478&dopt=Abstract

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Diverticulosis in the defunctioned limb of a long-standing colostomy. Author(s): Moorthy K, Mihssin N, Houghton PW. Source: Journal of the Royal Society of Medicine. 1999 July; 92(7): 359-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10615275&dopt=Abstract

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Diverting loop colostomy for the treatment of refractory gastrointestinal bleeding secondary to radiation proctitis. Author(s): Ayerdi J, Moinuddeen K, Loving A, Wiseman J, Deshmukh N. Source: Military Medicine. 2001 December; 166(12): 1091-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11778411&dopt=Abstract

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Do we still need a permanent colostomy in XXI-st century? Author(s): Szczepkowski M. Source: Acta Chir Iugosl. 2002; 49(2): 45-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587470&dopt=Abstract

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Does a colostomy alter quality of life in patients with spinal cord injury? A controlled study. Author(s): Randell N, Lynch AC, Anthony A, Dobbs BR, Roake JA, Frizelle FA. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 2001 May; 39(5): 279-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11438845&dopt=Abstract

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Does the difference in muscle structure of the rectus abdominis muscle of patients wearing a colostomy or ileostomy explain the different frequency of parastomal hernias? Author(s): Ortiz H. Source: International Journal of Colorectal Disease. 1995; 10(1): 55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7745327&dopt=Abstract

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Does the frequency of paracolostomy hernias depend on the position of the colostomy in the abdominal wall? Author(s): Ortiz H, Sara MJ, Armendariz P, de Miguel M, Marti J, Chocarro C. Source: International Journal of Colorectal Disease. 1994 May; 9(2): 65-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8064191&dopt=Abstract

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Does type of colostomy influence outcome of colostomy closure? Author(s): Madiba TE, Mahomva O, Haffejee AA. Source: S Afr J Surg. 1998 May; 36(2): 57-9; Discussion 59-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9711133&dopt=Abstract

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Double-barreled wet colostomy. A simple method of urinary diversion for patients undergoing pelvic exenteration. Author(s): Takada H, Yoshioka K, Boku T, Yoshida R, Nakagawa K, Matsuda T, Hioki K. Source: Diseases of the Colon and Rectum. 1995 December; 38(12): 1325-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7497847&dopt=Abstract

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Double-barreled wet colostomy: a safe and simple method after pelvic exenteration. Author(s): Osorio Gullon A, de Oca J, Lopez Costea MA, Virgili J, Ramos E, del Rio C, Marti Rague J. Source: International Journal of Colorectal Disease. 1997; 12(1): 37-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9112149&dopt=Abstract

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Early enteral feeding after closure of colostomy in pediatric patients. Author(s): Sangkhathat S, Patrapinyokul S, Tadyathikom K. Source: Journal of Pediatric Surgery. 2003 October; 38(10): 1516-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14577078&dopt=Abstract

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Effect of different infusion regimens on colonic motility and efficacy of colostomy irrigation. Author(s): Gattuso JM, Kamm MA, Myers C, Saunders B, Roy A. Source: The British Journal of Surgery. 1996 October; 83(10): 1459-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8944473&dopt=Abstract

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Effective pelvic symptom control using initial chemoradiation without colostomy in metastatic rectal cancer. Author(s): Crane CH, Janjan NA, Abbruzzese JL, Curley S, Vauthey J, Sawaf HB, Dubrow R, Allen P, Ellis LM, Hoff P, Wolff RA, Lenzi R, Brown TD, Lynch P, Cleary K, Rich TA, Skibber J. Source: International Journal of Radiation Oncology, Biology, Physics. 2001 January 1; 49(1): 107-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11163503&dopt=Abstract

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Eighteen years' experience with neonatal Hirschsprung's disease treated by endorectal pull-through without colostomy. Author(s): So HB, Becker JM, Schwartz DL, Kutin ND. Source: Journal of Pediatric Surgery. 1998 May; 33(5): 673-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9607466&dopt=Abstract

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Elective colostomy closure in an AIDS patient. Author(s): Pasquale MD, Kenkel JM, Holt RW. Source: Journal of the National Medical Association. 1994 June; 86(6): 469-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8078085&dopt=Abstract

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Elective colostomy in the patient with a spinal cord injury: an ET nurse's perspective. Author(s): Edgar LV. Source: Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society / Wocn. 1999 January; 26(1): 18-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10036420&dopt=Abstract

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End colostomy using stapling device. Author(s): Aoki Y, Uesaka K, Nakamura M, Donishi H. Source: Nippon Geka Hokan. 1994 March 1; 63(2): 66-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7857173&dopt=Abstract

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Erosion and perforation of colon by synthetic mesh in a recurrent paracolostomy hernia. Author(s): Aldridge AJ, Simson JN. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 June; 5(2): 110-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11505648&dopt=Abstract

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Experience with ileostomy and colostomy in Crohn's disease. Author(s): Post S, Herfarth C, Schumacher H, Golling M, Schurmann G, Timmermanns G. Source: The British Journal of Surgery. 1995 December; 82(12): 1629-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8548223&dopt=Abstract

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Factors influencing the safety of colostomy closure in the elderly. Author(s): Wong RW, Rappaport WD, Witzke DB, Putnam CW, Hunter GC. Source: The Journal of Surgical Research. 1994 August; 57(2): 289-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8028338&dopt=Abstract

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Failure of the unopened colostomy to protect high-risk rectal anastomoses. Author(s): Dixon AR, Thomson WH. Source: The British Journal of Surgery. 1996 January; 83(1): 45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8653360&dopt=Abstract

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Fine-tuning colostomies for patients with spinal cord injury. Author(s): Ahmed N, Frisbie JH. Source: J Spinal Cord Med. 2003 Spring; 26(1): 96; Author Reply 96. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830977&dopt=Abstract

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Fluctuation of blood pressure and pulse rate during colostomy irrigation. Author(s): Sadahiro S, Noto T, Tajima T, Mitomi T, Miyazaki T, Numata M. Source: Diseases of the Colon and Rectum. 1995 June; 38(6): 615-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7774473&dopt=Abstract

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Functional perineal colostomy with pudendal nerve anastomosis following anorectal resection: a cadaver operation study on a new procedure. Author(s): Sato T, Konishi F, Kanazawa K. Source: Surgery. 1997 May; 121(5): 569-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9142157&dopt=Abstract

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Further evaluation of colostomy in penetrating colon injury. Author(s): Gonzalez RP, Falimirski ME, Holevar MR. Source: The American Surgeon. 2000 April; 66(4): 342-6; Discussion 346-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10776870&dopt=Abstract

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Gasless laparoscopic-assisted ileostomy or colostomy closure using an abdominal wall-lifting device. Author(s): Bossotti M, Bona A, Borroni R, Mattio R, Coda A, Ferri F, Martino F, Dellepiane M. Source: Surgical Endoscopy. 2001 June; 15(6): 597-9. Epub 2001 March 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11591949&dopt=Abstract

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Hand-made colostomy bag. Author(s): Zafar A, Malik E. Source: Trop Doct. 2002 October; 32(4): 241. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405314&dopt=Abstract

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Hidden colostomy. Author(s): Kyzer S, Gordon PH. Source: Surg Gynecol Obstet. 1993 August; 177(2): 181-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7688147&dopt=Abstract

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Hyaluronidase in the reduction of prolapsed colostomy. Author(s): Chaudhuri A, Prasai A. Source: Annals of the Royal College of Surgeons of England. 2003 May; 85(3): 209. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12836660&dopt=Abstract

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Hyperbaric oxygen therapy in a woman who declined colostomy. Author(s): Hamour AA, Denning DW. Source: Lancet. 1996 July 20; 348(9021): 197. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8684174&dopt=Abstract

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Ileostomy and colostomy support groups. Author(s): Lyons AS. Source: The Mount Sinai Journal of Medicine, New York. 2001 March; 68(2): 110-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11268150&dopt=Abstract

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Inflammatory fibroid polyp of the ileum with the appearance of a Borrmann type II lesion, caused by colostomy irrigation: report of a case. Author(s): Ojima Y, Okajima M, Asahara T, Arita M, Kobayashi R, Nakahara M, Masaoka Y, Toyota K, Fujitaka T, Kawahori K, Shimamoto F, Dohi K. Source: Surgery Today. 1997; 27(11): 1061-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9413061&dopt=Abstract

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Is colostomy always necessary in the treatment of open pelvic fractures? Author(s): Pell M, Flynn WJ Jr, Seibel RW. Source: The Journal of Trauma. 1998 August; 45(2): 371-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9715198&dopt=Abstract

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Is temporary loop colostomy of the right transverse colon appropriate for complete obstruction by colorectal cancer? Author(s): Mukai M, Himeno S, Mukoyama S, Tajima T, Saito Y, Ito I, Nakasaki H, Makuuchi H. Source: Oncol Rep. 2003 May-June; 10(3): 693-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684645&dopt=Abstract

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Laparoscopic colostomy for a gunshot wound to the rectum. Author(s): Namias N, Kopelman T, Sosa JL. Source: J Laparoendosc Surg. 1995 August; 5(4): 251-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7579679&dopt=Abstract

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Laparoscopic creation of loop ileostomy and sigmoid colostomy. Author(s): Almqvist PM, Bohe M, Montgomery A. Source: The European Journal of Surgery = Acta Chirurgica. 1995 December; 161(12): 907-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8775634&dopt=Abstract

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Laparoscopic descending colostomy in three patients with cervical carcinoma. Author(s): Boike GM, Lurain JR. Source: Gynecologic Oncology. 1994 September; 54(3): 381-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8088618&dopt=Abstract

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Laparoscopic enterocolostomy for palliation of malignant bowel obstruction. Author(s): Lauter DM. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 2000 October; 10(5): 275-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11071408&dopt=Abstract

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Laparoscopic ileostomy and colostomy. Author(s): Khoo RE, Cohen MM. Source: Annals of Surgery. 1995 February; 221(2): 207-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7710541&dopt=Abstract

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Laparoscopic ileostomy and colostomy. Author(s): Lyerly HK, Mault JR. Source: Annals of Surgery. 1994 March; 219(3): 317-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8147614&dopt=Abstract

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Laparoscopic ileus operation due to paracolostomy hernia. Author(s): Iwakuma N, Araki Y, Tsuji Y, Matsumoto A, Isomoto H, Shirouzu K. Source: Kurume Med J. 2001; 48(4): 331-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11830934&dopt=Abstract

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Laparoscopic loop colostomy for advanced ovarian cancer, rectal cancer, and rectovaginal fistulas. Author(s): Hallfeldt K, Schmidbauer S, Trupka A. Source: Gynecologic Oncology. 2000 March; 76(3): 380-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10684714&dopt=Abstract

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Laparoscopic repair of paracolostomy hernia. Author(s): Bickel A, Shinkarevsky E, Eitan A. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 1999 August; 9(4): 353-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10488832&dopt=Abstract

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Laparoscopic-assisted colostomy closure after Hartmann's procedure. Author(s): Sosa JL, Sleeman D, Puente I, McKenney MG, Hartmann R. Source: Diseases of the Colon and Rectum. 1994 February; 37(2): 149-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8306835&dopt=Abstract

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Laparoscopy-assisted colostomy. Author(s): Hashizume M, Haraguchi Y, Ikeda Y, Kajiyama K, Fujie T, Sugimachi K. Source: Surgical Laparoscopy & Endoscopy. 1994 February; 4(1): 70-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8167873&dopt=Abstract

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Life table analysis of stomal complications following colostomy. Author(s): Londono-Schimmer EE, Leong AP, Phillips RK. Source: Diseases of the Colon and Rectum. 1994 September; 37(9): 916-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8076492&dopt=Abstract

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Limited role of barium enema examination preceding colostomy closure in trauma patients. Author(s): Sola JE, Buchman TG, Bender JS. Source: The Journal of Trauma. 1994 February; 36(2): 245-6; Discussion 247. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8114145&dopt=Abstract

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Limited utility of preoperative studies in preparation for colostomy closure. Author(s): Pokorny RM, Heniford T, Allen JW, Tuckson WB, Galandiuk S. Source: The American Surgeon. 1999 April; 65(4): 338-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10190359&dopt=Abstract

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Loop end colostomy: a new technique. Author(s): Bumin C, Yerdel MA. Source: The British Journal of Surgery. 1996 June; 83(6): 811. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8696748&dopt=Abstract

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Loop ileostomy versus loop colostomy for defunctioning low anastomoses during rectal cancer surgery. Author(s): Rullier E, Le Toux N, Laurent C, Garrelon JL, Parneix M, Saric J. Source: World Journal of Surgery. 2001 March; 25(3): 274-7; Discussion 277-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11343175&dopt=Abstract

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Management of Hirschsprung's disease with reference to one-stage pull-through without colostomy. Author(s): Ramesh JC, Ramanujam TM, Yik YI, Goh DW. Source: Journal of Pediatric Surgery. 1999 November; 34(11): 1691-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10591572&dopt=Abstract

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Managing oversight of colostomy irrigation in long term-care. Author(s): Turnbull GB. Source: Ostomy Wound Manage. 2003 October; 49(10): 13-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14652416&dopt=Abstract

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Metachronous adenocarcinoma occurring at a colostomy site after abdominoperineal resection for rectal carcinoma. Author(s): Shibuya T, Uchiyama K, Kokuma M, Shioya T, Watanabe Y, Moriyama Y, Matsumoto K, Yokosuka I. Source: Journal of Gastroenterology. 2002; 37(5): 387-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12051539&dopt=Abstract

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Minimally invasive, endoscopically assisted colostomy can be performed without general anesthesia or laparotomy. Author(s): Mattingly M, Wasvary H, Sacksner J, Deshmukh G, Kadro O. Source: Diseases of the Colon and Rectum. 2003 February; 46(2): 271-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12576903&dopt=Abstract

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Minimally raised end colostomy. Author(s): Stephenson BM, Myers C, Phillips RK. Source: International Journal of Colorectal Disease. 1995; 10(4): 232-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8568411&dopt=Abstract

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Morbidity and timing of colostomy closure in trauma patients. Author(s): Sola JE, Bender JS, Buchman TG. Source: Injury. 1993 August; 24(7): 438-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8406758&dopt=Abstract

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Morbidity of ileostomy and colostomy closure: impact of surgical technique and perioperative treatment. Author(s): Riesener KP, Lehnen W, Hofer M, Kasperk R, Braun JC, Schumpelick V. Source: World Journal of Surgery. 1997 January; 21(1): 103-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8943186&dopt=Abstract

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MSJAMA. Colostomy. Author(s): Veysman B. Source: Jama : the Journal of the American Medical Association. 2003 February 5; 289(5): 615-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578500&dopt=Abstract

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Multicentre study of a continent colostomy plug. Author(s): Codina Cazador A, Pinol M, Marti Rague J, Montane J, Nogueras FM, Sunol J. Source: The British Journal of Surgery. 1993 July; 80(7): 930-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8369943&dopt=Abstract

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New method for paracolostomy hernia repair? Author(s): Stelzner S, Hellmich G, Ludwig K. Source: Diseases of the Colon and Rectum. 1999 June; 42(6): 823. Erratum In: Dis Colon Rectum 1999 July; 42(7): 880. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10378610&dopt=Abstract

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New technique for mesh repair of paracolostomy hernias. Author(s): Hofstetter WL, Vukasin P, Ortega AE, Anthone G, Beart RW Jr. Source: Diseases of the Colon and Rectum. 1998 August; 41(8): 1054-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9715164&dopt=Abstract

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Non-prolapsing colostomy in a massively dilated colon. Author(s): Budhiraja S. Source: Trop Doct. 2002 January; 32(1): 31-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11991023&dopt=Abstract

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On the technique of colostomy. 1888. Author(s): Maydl K. Source: Diseases of the Colon and Rectum. 2001 February; 44(2): 280-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11227947&dopt=Abstract

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Perineal reconstruction with continent colostomy after the Miles operation. Author(s): Santoro E, Santoro R, Santoro E. Source: Seminars in Surgical Oncology. 1994 May-June; 10(3): 208-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8085098&dopt=Abstract

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Peristomal lichen sclerosus affecting colostomy sites. Author(s): Weng AA, CHarles-Holmes R. Source: The British Journal of Dermatology. 2000 January; 142(1): 177-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10819544&dopt=Abstract

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Placement of a colonic stent by percutaneous colostomy in a case of malignant stenosis. Author(s): Gomez Herrero H, Paul Diaz L, Pinto Pabon I, Lobato Fernandez R. Source: Cardiovascular and Interventional Radiology. 2001 January-February; 24(1): 679. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11178718&dopt=Abstract

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Pneumatic intussusception reduction via a colostomy: case report. Author(s): Mushtaq I, Misra D, Gordon I, Wright VM. Source: Journal of Pediatric Surgery. 1996 December; 31(12): 1701-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8986995&dopt=Abstract

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Postoperative ascitic leak after colostomy. Author(s): Lipsett PA, Yeo CJ. Source: Surgery. 1993 June; 113(6): 719. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8506533&dopt=Abstract

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Postoperative hernias in the site of colostomy. Author(s): Gorka Z, Lampe P, Slota J, Drenda P. Source: Zentralblatt Fur Chirurgie. 1998; 123 Suppl: 53-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9586173&dopt=Abstract

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Practical points in the care of patients recovering from a colostomy. Author(s): Carabajal B. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 1997 June; 12(3): 188-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9214943&dopt=Abstract

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Preparing the patient for colostomy care: a lesson well learned. Author(s): Schultz JM. Source: Ostomy Wound Manage. 2002 October; 48(10): 22-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12378000&dopt=Abstract

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Prevention of colostomy prolapse by peritoneal tethering. Author(s): Ng WT, Book KS, Wong MK, Cheng PW, Cheung CH. Source: Journal of the American College of Surgeons. 1997 March; 184(3): 313-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9060932&dopt=Abstract

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Primary anastomosis and diverting colostomy in diffuse diverticular peritonitis. Author(s): Landen S, Nafteux P. Source: Acta Chir Belg. 2002 February; 102(1): 24-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11925735&dopt=Abstract

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Primary anastomosis with transverse colostomy as an alternative to Hartmann's procedure. Author(s): Maddern GJ, Nejjari Y, Dennison A, Siriser F, Bardoxaglou E, Launois B. Source: The British Journal of Surgery. 1995 February; 82(2): 170-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7749677&dopt=Abstract

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Primary repair of 58 consecutive penetrating injuries of the colon: should colostomy be abandoned? Author(s): Jacobson LE, Gomez GA, Broadie TA. Source: The American Surgeon. 1997 February; 63(2): 170-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9012432&dopt=Abstract

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Primary repair or colostomy in the management of civilian colonic trauma. Author(s): Kulkarni MS, Hindlekar MM. Source: Indian J Gastroenterol. 1995 April; 14(2): 54-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7797278&dopt=Abstract

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Protective transverse loop colostomy associated with low colo-rectal anastomoses. Author(s): Guivarc'h M, Mosnier H, Roullet-Audy JC. Source: International Journal of Colorectal Disease. 1997; 12(6): 340-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9457527&dopt=Abstract

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Pseudocontinent perineal colostomy following abdominoperineal resection: technique and findings in 49 patients. Author(s): Lasser P, Dube P, Guillot JM, Elias D. Source: European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2001 February; 27(1): 49-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11237492&dopt=Abstract

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Pseudomembranous colitis as a cause of early colostomy dysfunction. Author(s): Stein HD, Sirota RA, Yudis M, Snipes E, Saris A. Source: Journal of Clinical Gastroenterology. 1994 March; 18(2): 165-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8189018&dopt=Abstract

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Pseudomembranous colitis in a patient with a colostomy. Author(s): Fraser GM, Inbar-Yanai I, Niv Y. Source: Isr J Med Sci. 1995 June; 31(6): 370-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7607859&dopt=Abstract

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Purse-string closure of a mucous fistula in loop colostomy. Author(s): Dalal UR, Dalal AK, Singh RB, Pavithran NM. Source: Asian J Surg. 2002 July; 25(3): 236-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12376222&dopt=Abstract

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Quality of life after surgery for rectal cancer: do we still need a permanent colostomy? Author(s): Renner K, Rosen HR, Novi G, Holbling N, Schiessel R. Source: Diseases of the Colon and Rectum. 1999 September; 42(9): 1160-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10496556&dopt=Abstract

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Quality of life of stoma patients: temporary ileostomy versus colostomy. Author(s): Silva MA, Ratnayake G, Deen KI. Source: World Journal of Surgery. 2003 April; 27(4): 421-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658485&dopt=Abstract

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Quality of life with a temporary stoma: ileostomy vs. colostomy. Author(s): Gooszen AW, Geelkerken RH, Hermans J, Lagaay MB, Gooszen HG. Source: Diseases of the Colon and Rectum. 2000 May; 43(5): 650-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10826426&dopt=Abstract

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Radio-contrast imaging of the rectum prior to colostomy closure for rectal trauma--is routine use still justified? Author(s): Madiba TE, Mahomva O, Haffejee AA, Nene B. Source: S Afr J Surg. 2000 May; 38(1): 17-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365114&dopt=Abstract

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Randomized clinical trial comparing loop ileostomy and loop transverse colostomy for faecal diversion following total mesorectal excision (Br J Surg 2002; 89: 704-8). Author(s): Arumugam PJ, Beynon J, Morgan AR, Carr ND. Source: The British Journal of Surgery. 2002 November; 89(11): 1480-1; Author Reply 1481. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436494&dopt=Abstract

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Randomized clinical trial comparing loop ileostomy and loop transverse colostomy for faecal diversion following total mesorectal excision (Br J Surg 2002; 89: 704-8). Author(s): Edwards A, Weale AR. Source: The British Journal of Surgery. 2002 November; 89(11): 1480; Author Reply 1481. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436493&dopt=Abstract

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Randomized clinical trial comparing loop ileostomy and loop transverse colostomy for faecal diversion following total mesorectal excision (Br J Surg 2002; 89: 704-8). Author(s): Edwards DP, Sexton R, Moran BJ. Source: The British Journal of Surgery. 2002 November; 89(11): 1480; Author Reply 1481. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12390404&dopt=Abstract

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Randomized clinical trial comparing loop ileostomy and loop transverse colostomy for faecal diversion following total mesorectal excision. Author(s): Law WL, Chu KW, Choi HK. Source: The British Journal of Surgery. 2002 June; 89(6): 704-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12027979&dopt=Abstract

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Recent advances in colostomy care. Author(s): Yu DH. Source: Patient Education and Counseling. 1995 September; 26(1-3): 349-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7494749&dopt=Abstract

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Recurrent sigmoid volvulus treated by percutaneous endoscopic colostomy. Author(s): Daniels IR, Lamparelli MJ, Chave H, Simson JN. Source: The British Journal of Surgery. 2000 October; 87(10): 1419. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11044170&dopt=Abstract

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Relation of hospital volume to colostomy rates and survival for patients with rectal cancer. Author(s): Hodgson DC, Zhang W, Zaslavsky AM, Fuchs CS, Wright WE, Ayanian JZ. Source: Journal of the National Cancer Institute. 2003 May 21; 95(10): 708-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759388&dopt=Abstract

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Repositioning the misplaced colostomy for high imperforate anus: report of a new technique. Author(s): Perdzynski W, Zarzycka E, Zmijewski Z, Kalicki B. Source: Journal of Pediatric Surgery. 1994 November; 29(11): 1483. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7844727&dopt=Abstract

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Resection of an end-colostomy stricture with a circular stapling device. Author(s): Ramia JM, Ibarra A, Alcalde J. Source: The British Journal of Surgery. 1996 November; 83(11): 1581. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9014680&dopt=Abstract

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Reversal of Hartmann's colostomy. Author(s): Khan AL, Ah-See AK, Crofts TJ, Heys SD, Eremin O. Source: Journal of the Royal College of Surgeons of Edinburgh. 1994 August; 39(4): 23942. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7807457&dopt=Abstract

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Reversible colostomy--what is the outcome? Author(s): Mealy K, O'Broin E, Donohue J, Tanner A, Keane FB. Source: Diseases of the Colon and Rectum. 1996 November; 39(11): 1227-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8918429&dopt=Abstract

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Reversion to normal defecation after combined excision operation and end colostomy for rectal cancer. Author(s): Shafik A. Source: Diseases of the Colon and Rectum. 1996 January; 39(1): 112-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8601350&dopt=Abstract

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Revision of transverse colostomy prolapse without stoma resiting. Author(s): Agrez MV. Source: Annals of the Royal College of Surgeons of England. 1997 September; 79(5): 3834. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9326134&dopt=Abstract

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Role of the stoma care nurse: patients with cancer and colostomy. Author(s): Comb J. Source: British Journal of Nursing (Mark Allen Publishing). 2003 July 24-August 13; 12(14): 852-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12951536&dopt=Abstract

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Same admission colostomy closure (SACC). A new approach to rectal wounds: a prospective study. Author(s): Renz BM, Feliciano DV, Sherman R. Source: Annals of Surgery. 1993 September; 218(3): 279-92; Discussion 292-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8373271&dopt=Abstract

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Seromuscular spiral cuff perineal colostomy: an alternative to abdominal wall colostomy after abdominoperineal excision for rectal cancer. Author(s): Schlag PM, Slisow W, Moesta KT. Source: Recent Results Cancer Res. 1998; 146: 95-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9670253&dopt=Abstract

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Sigmoidoscopy-assisted colostomy--an adapted trephine stoma formation. Author(s): Beilman GJ, Jonson GM. Source: Digestive Surgery. 2002; 19(4): 327-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12207079&dopt=Abstract

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Simple technique for laparoscopic paracolostomy hernia repair. Author(s): Voitk A. Source: Diseases of the Colon and Rectum. 2000 October; 43(10): 1451-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11052526&dopt=Abstract

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Simultaneous radical prostatectomy and partial rectum resection without colostomy. Author(s): Baur H, Frimberger M, Altwein JE. Source: European Urology. 1997; 31(3): 380-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9129936&dopt=Abstract

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Split loop colostomy: a modification. Author(s): Roy S, Hughes O, Stephenson BM. Source: Annals of the Royal College of Surgeons of England. 1996 January; 78(1): 72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8659987&dopt=Abstract

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Split loop colostomy: a modification. Author(s): Kelly MJ. Source: Annals of the Royal College of Surgeons of England. 1995 July; 77(4): 313-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7574327&dopt=Abstract

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Split notochord syndrome with prolapsed congenital colostomy. Author(s): Kiristioglu I, Teitelbaum DH, Dogruyol H. Source: Journal of Pediatric Surgery. 1998 March; 33(3): 525-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9537574&dopt=Abstract

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Stapled colonic J-pouch-anal anastomosis without a diverting colostomy for rectal carcinoma. Author(s): Wang JY, You YT, Chen HH, Chiang JM, Yeh CY, Tang R. Source: Diseases of the Colon and Rectum. 1997 January; 40(1): 30-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9102258&dopt=Abstract

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Stoma management in a tropical country: colostomy irrigation versus natural evacuation. Author(s): Leong AF, Yunos AB. Source: Ostomy Wound Manage. 1999 November; 45(11): 52-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10687658&dopt=Abstract

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Stoma related complications are more frequent after transverse colostomy than loop ileostomy: a prospective randomized clinical trial. Author(s): Bhalerao S, Scriven MW, da Silva A. Source: The British Journal of Surgery. 2002 April; 89(4): 495. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952610&dopt=Abstract

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Stoma-related complications are more frequent after transverse colostomy than loop ileostomy: a prospective randomized clinical trial. Author(s): Edwards DP, Leppington-Clarke A, Sexton R, Heald RJ, Moran BJ. Source: The British Journal of Surgery. 2001 March; 88(3): 360-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11260099&dopt=Abstract

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Subcutaneous bridge support for defunctioning loop colostomy. Author(s): Atkinson SW, Bentley PG. Source: The British Journal of Surgery. 1996 October; 83(10): 1458. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8944472&dopt=Abstract

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Successful local repair of paracolostomy hernia with a newly developed prosthetic device. Author(s): de Ruiter P, Bijnen AB. Source: International Journal of Colorectal Disease. 1994 August; 9(3): 165. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7814993&dopt=Abstract

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Successful overlapping anal sphincter repair: relationship to patient age, neuropathy, and colostomy formation. Author(s): Young CJ, Mathur MN, Eyers AA, Solomon MJ. Source: Diseases of the Colon and Rectum. 1998 March; 41(3): 344-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9514430&dopt=Abstract

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Survival after resection and duodenocolostomy for massive mesenteric infarction after aortic surgery. Author(s): Williams IM, Scriven MW, Burgess NA, Davies CJ, Lewis MH. Source: Annals of the Royal College of Surgeons of England. 1996 January; 78(1): 69-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8659982&dopt=Abstract

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Taking action on the volume-quality relationship: how long can we hide our heads in the colostomy bag? Author(s): Smith TJ, Hillner BE, Bear HD. Source: Journal of the National Cancer Institute. 2003 May 21; 95(10): 695-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759377&dopt=Abstract

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Tampon occlusion of colostomy stoma during laparotomy. Author(s): Fischer RP, Gervin AS. Source: The American Surgeon. 1994 September; 60(9): 709-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8060046&dopt=Abstract

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Teaching a blind patient colostomy irrigation. Author(s): Santiago E. Source: Ostomy Wound Manage. 2000 March; 46(3): 18. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10788915&dopt=Abstract

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Techniques for determining the ideal stoma site in laparoscopic colostomy. Author(s): Sakai T, Yamashita Y, Maekawa T, Watanabe K, Shirakusa T. Source: Int Surg. 1999 July-September; 84(3): 239-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10533784&dopt=Abstract

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Temporary colostomy in supralevator pelvic exenteration. A comparative study between stapled loop and loop colostomy. Author(s): De Wever I, Van de Moortel M, Stas M. Source: European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 1996 February; 22(1): 84-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8846875&dopt=Abstract

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Temporary decompression after colorectal surgery: randomized comparison of loop ileostomy and loop colostomy. Author(s): Torkington J, Khetan N, Jamison MH. Source: The British Journal of Surgery. 1998 October; 85(10): 1452. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9782041&dopt=Abstract

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Temporary decompression after colorectal surgery: randomized comparison of loop ileostomy and loop colostomy. Author(s): Gooszen AW, Geelkerken RH, Hermans J, Lagaay MB, Gooszen HG. Source: The British Journal of Surgery. 1998 January; 85(1): 76-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9462389&dopt=Abstract

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Colostomy

·

Temporary transverse colostomy vs loop ileostomy in diversion: a case-matched study. Author(s): Sakai Y, Nelson H, Larson D, Maidl L, Young-Fadok T, Ilstrup D. Source: Archives of Surgery (Chicago, Ill. : 1960). 2001 March; 136(3): 338-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11231858&dopt=Abstract

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The application of percutaneous endoscopic colostomy to the management of obstructed defecation. Author(s): Church JM. Source: Techniques in Coloproctology. 2003 July; 7(2): 121. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14619874&dopt=Abstract

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The application of percutaneous endoscopic colostomy to the management of obstructed defecation. Author(s): Heriot AG, Tilney HS, Simson JN. Source: Diseases of the Colon and Rectum. 2002 May; 45(5): 700-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12004226&dopt=Abstract

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The double-barreled wet colostomy: long-term experience with the first 11 patients. Author(s): Carter MF, Dalton DP, Garnett JE. Source: The Journal of Urology. 1994 December; 152(6 Pt 2): 2312-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7966730&dopt=Abstract

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The effects of colostomy on the quality of life in patients with spinal cord injury: a retrospective analysis. Author(s): Rosito O, Nino-Murcia M, Wolfe VA, Kiratli BJ, Perkash I. Source: J Spinal Cord Med. 2002 Fall; 25(3): 174-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12214904&dopt=Abstract

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The high morbidity of colostomy closure after trauma: further support for the primary repair of colon injuries. Author(s): Berne JD, Velmahos GC, Chan LS, Asensio JA, Demetriades D. Source: Surgery. 1998 February; 123(2): 157-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9481401&dopt=Abstract

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The place of colostomy after late detection of a colonic injury and faecal peritonitis. Author(s): Edwards DP, Watkins MJ. Source: The European Journal of Surgery = Acta Chirurgica. 2000 September; 166(9): 747-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11034474&dopt=Abstract

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The pursuit of colostomy continence. Author(s): Roberts DJ. Source: Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society / Wocn. 1997 March; 24(2): 92-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9204858&dopt=Abstract

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The role of barium enema in colostomy closure in trauma patients. Author(s): Swenson K, Stamos M, Klein S. Source: The American Surgeon. 1997 October; 63(10): 893-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9322667&dopt=Abstract

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The use of temporary diverting colostomy to manage elderly individuals with extensive perineal burns. Author(s): Nakazawa H, Ito H, Morioka K, Kikuchi Y, Honda T, Isago T. Source: Burns : Journal of the International Society for Burn Injuries. 2002 September; 28(6): 595-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12220920&dopt=Abstract

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Transanal self-expanding metal stents as an alternative to palliative colostomy in selected patients with malignant obstruction of the left colon. Author(s): Turegano-Fuentes F, Echenagusia-Belda A, Simo-Muerza G, Camunez F, Munoz-Jimenez F, Del Valle Hernandez E, Quintans-Rodriguez A. Source: The British Journal of Surgery. 1998 February; 85(2): 232-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9580077&dopt=Abstract

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Transcolostomy hydrostatic reduction of intussusception. Author(s): Khong PL, Peh WC, Cheng W. Source: The British Journal of Radiology. 1998 February; 71(842): 242-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9579194&dopt=Abstract

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Treatment of war injuries to the colon: primary resection and anastomosis without relieving colostomy. Author(s): Komanov I, Kejla Z. Source: Acta Med Croatica. 1995; 49(2): 65-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7580041&dopt=Abstract

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Trephine colostomy: a warning. Author(s): Frizelle FA. Source: Annals of the Royal College of Surgeons of England. 1996 March; 78(2): 157. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8678460&dopt=Abstract

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Colostomy

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Trephine colostomy: a warning. Author(s): Loder PB, Thomson JP. Source: Annals of the Royal College of Surgeons of England. 1995 November; 77(6): 462. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8540670&dopt=Abstract

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Turnbull-Blowhole colostomy for toxic ulcerative colitis in pregnancy: report of two cases. Author(s): Ooi BS, Remzi FH, Fazio VW. Source: Diseases of the Colon and Rectum. 2003 January; 46(1): 111-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544530&dopt=Abstract

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Two-trocar technique for terminal sigmoid colostomy in a patient with complex pelvic fracture. Author(s): Barrientos-Fortes T, Urbina-De la Vega F. Source: Surgical Endoscopy. 1998 June; 12(6): 884-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9602013&dopt=Abstract

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Ureterosigmoidostomy with colocolostomy for urinary diversion. Author(s): Shafik A. Source: Urology. 2002 September; 60(3): 552; Author Reply 552. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12350516&dopt=Abstract

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Use or misuse of colostomy to heal pressure ulcers. Author(s): Deshmukh GR, Barkel DC, Sevo D, Hergenroeder P. Source: Diseases of the Colon and Rectum. 1996 July; 39(7): 737-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8674363&dopt=Abstract

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Wartime colon injuries: primary repair or colostomy? Author(s): Moreels R, Pont M, Ean S, Vitharit M, Vuthy C, Roy S, Boelaert M. Source: Journal of the Royal Society of Medicine. 1994 May; 87(5): 265-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8207721&dopt=Abstract

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

Finding Nutrition Studies on Colostomy The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “colostomy” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4

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

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Colostomy

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

Abdominoperineal resection and perineal colostomy for low rectal cancer. The Lazaro da Silva technique. Author(s): Department of Emergency Surgery, Military Medical Academy, Sofia, Bulgaria. Source: Velitchkov, N G Kirov, G K Losanoff, J E Kjossev, K T Grigorov, G I MiroNovember, M B Klenov, I S Dis-Colon-Rectum. 1997 May; 40(5): 530-3 0012-3706

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Absorption of theophylline administered via colostomy. Author(s): College of Pharmacy, University of Georgia, Athens. Source: Hooker, K D DiPiro, J T Stanfield, J A DeLaurier, G A Lampert, B M Stewart, J T Knapp, F F Clin-Pharm. 1989 May; 8(5): 354-8 0278-2677

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An assessment of colostomy irrigation. Author(s): Ferguson Clinic, Grand Rapids, Michigan 49503. Source: Laucks, S S 2nd Mazier, W P Milsom, J W Buffin, S E Anderson, J M Warwick, M K Surrell, J A Dis-Colon-Rectum. 1988 April; 31(4): 279-82 0012-3706

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Changes in diet following the formation of a colostomy. Author(s): Good Hope NHS Trust, Sutton Coldfield. Source: Bulman, J Br-J-Nurs. 2001 February 8-21; 10(3): 179-86 0966-0461

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Colonic pH: a comparison between patients with colostomies due to trauma and colorectal cancer. Author(s): Department of Surgery, Baragwanath Hospital, Johannesburg, South Africa. Source: Charalambides, D Segal, I Am-J-Gastroenterol. 1992 January; 87(1): 74-8 00029270

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Comparative bioavailability of a morphine suppository given rectally and in a colostomy. Author(s): Department of Anaesthesiology, Hvidovre Hospital, Copenhagen, Denmark. Source: Hojsted, J Rubeck Petersen, K Rask, H Bigler, D Broen Christensen, C Eur-J-ClinPharmacol. 1990; 39(1): 49-50 0031-6970

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Dietary management in patients with a colostomy. Source: Baisi, A Maruotti, R A Zannini, P Negri, G Voci, C Rebuffat, C Pietrojusti, M Panminerva-Med. 1987 Apr-June; 29(2): 119-21 0031-0808

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Effect of colostomy on nitrogen nutrition in the chicken fed a low protein diet plus urea. Author(s): Laboratory of Animal Nutrition and Feed Science, Faculty of Agriculture, Shinshu University, Nagano-ken, Japan. Source: Karasawa, Y J-Nutr. 1989 October; 119(10): 1388-91 0022-3166

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Effects of caecal ligation and colostomy on water intake and excretion in chickens. Source: Son, J.H. Karasawa, Y. Br-poult-sci. Oxfordshire : Carfax Publishing Ltd. March 2001. volume 42 (1) page130-133. 0007-1668

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Quality of life with a temporary stoma: ileostomy vs. colostomy. Author(s): Department of Surgery, University Hospital Utrecht, The Netherlands. Source: Gooszen, A W Geelkerken, R H Hermans, J Lagaay, M B Gooszen, H G DisColon-Rectum. 2000 May; 43(5): 650-5 0012-3706

Nutrition

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Randomized clinical trial comparing loop ileostomy and loop transverse colostomy for faecal diversion following total mesorectal excision. Author(s): Department of Surgery, Queen Mary Hospital, University of Hong Kong Medical Centre, 102 Pokfulam Road, Hong Kong. Source: Law, W L Chu, K W Choi, H K Br-J-Surg. 2002 June; 89(6): 704-8 0007-1323

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Rates of morbidity and mortality after closure of loop and end colostomy. Author(s): Department of Surgery, Northwestern University Medical School, Chicago, Illinois. Source: Mileski, W J Rege, R V Joehl, R J Nahrwold, D L Surg-Gynecol-Obstet. 1990 July; 171(1): 17-21 0039-6087

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Temporary decompression after colorectal surgery: randomized comparison of loop ileostomy and loop colostomy. Author(s): Department of Surgery, University Hospital of Utrecht, The Netherlands. Source: Gooszen, A W Geelkerken, R H Hermans, J Lagaay, M B Gooszen, H G Br-JSurg. 1998 January; 85(1): 76-9 0007-1323

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The true cost of protective loop colostomy. Author(s): Department of Surgery, Mount Sinai Medical Center, New York, New York. Source: Peller, C A Froymovich, O Tartter, P I Am-J-Gastroenterol. 1989 September; 84(9): 1034-7 0002-9270

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Use of oral opiates and diet modification as an alternative to surgical colostomy after complex anorectal procedures. Author(s): Southern School of Pharmacy, Mercer University, Atlanta, GA. Source: Asbury, W H Hooks, V H 3rd DiPiro, J T Bowden, T A Clin-Pharm. 1987 August; 6(8): 649-51 0278-2677

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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·

Colostomy

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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WebMDÒHealth: http://my.webmd.com/nutrition

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

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

A method for determining fecal continence prior to closure of colostomy. Author(s): Pittman RD, Medwell SJ, Friend WG. Source: Surg Gynecol Obstet. 1985 October; 161(4): 388-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4049211&dopt=Abstract

·

Biofeedback training to obtain continence in permanent colostomy. Experience of two centers. Author(s): Reboa G, Frascio M, Zanolla R, Pitto G, Riboli EB. Source: Diseases of the Colon and Rectum. 1985 June; 28(6): 419-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3159556&dopt=Abstract

·

Colostomies and their management. Author(s): Borwell B.

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Colostomy

Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 1996 November 13; 11(8): 49-53; Quiz 54-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9000911&dopt=Abstract ·

Colostomy care. Maintaining an active life. Author(s): Jones H. Source: Nurs Times. 1985 February 13-19; 81(7): 36-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3844790&dopt=Abstract

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Construction of a continent perineal colostomy by using electrostimulated gracilis muscles after abdominoperineal resection: personal technique and experience with 32 cases. Author(s): Cavina E, Seccia M, Evangelista G, Chiarugi M, Buccianti P, Chirico A, Lenzi M, Bortolotti P, Bellomini G, Arganini M, et al. Source: Ital J Surg Sci. 1987; 17(4): 305-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3448042&dopt=Abstract

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Continent perineal colostomy by electrostimulated graciloplasty in abdominoperineal resection. A preliminary report. Author(s): Violi V, Roncoroni L, Boselli AS, De Cesare C, Livrini M, Peracchia A. Source: Acta Biomed Ateneo Parmense. 1996; 67(3-4): 131-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10021696&dopt=Abstract

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Ileostomy and colostomy support groups. Author(s): Lyons AS. Source: The Mount Sinai Journal of Medicine, New York. 2001 March; 68(2): 110-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11268150&dopt=Abstract

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Statistical survey of problems in patients with colostomy or ileostomy. Author(s): Biermann HJ, Tocker AM, Tocker LR. Source: American Journal of Surgery. 1966 November; 112(5): 647-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5923391&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.comÒ: http://www.drkoop.com/InteractiveMedicine/IndexC.html

Alternative Medicine 41

·

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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WebMDÒHealth: 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 colostomy; 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 Colorectal Cancer Source: Integrative Medicine Communications; www.drkoop.com Inflammatory Bowel Disease Source: Integrative Medicine Communications; www.drkoop.com Ulcerative Colitis Source: Integrative Medicine Communications; www.drkoop.com

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

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CHAPTER 4. DISSERTATIONS ON COLOSTOMY Overview In this chapter, we will give you a bibliography on recent dissertations relating to colostomy. 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 “colostomy” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on colostomy, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Colostomy 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 colostomy. 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: ·

Effects of a Preoperative Video Tape Intervention on Psychological and Medical Recovery of Colostomy Patients by Fitzgerald, Douglas Tim, PhD from University of Kentucky, 1983, 164 pages http://wwwlib.umi.com/dissertations/fullcit/8322704

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 COLOSTOMY Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning colostomy.

Recent Trials on Colostomy The following is a list of recent trials dedicated to colostomy.5 Further information on a trial is available at the Web site indicated. ·

Acupuncture to prevent postoperative bowel paralysis (paralytic ileus) Condition(s): Colostomy; Ileostomy; Bowel Cancer; Postoperative Paralytic Ileus Study Status: This study is not yet open for patient recruitment. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The purpose of this study is to determine if acupuncture is effective in preventing prolonged postoperative paralysis of the gastrointestinal tract among patients undergoing colostomy/ileostomy closure. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00065234

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.

5

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 “colostomy” (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 COLOSTOMY 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.6 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 “colostomy” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on colostomy, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Colostomy By performing a patent search focusing on colostomy, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 6Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on colostomy: ·

Adhesive composition and method of use Inventor(s): Douglas; William (2321 Stone Dr., Ann Arbor, MI 48105), Rhodes; John (25 Nant Fawr Rd. Cyncoed, Cardiff, GB7) Assignee(s): None Reported Patent Number: 4,222,923 Date filed: April 18, 1978 Abstract: An adhesive composition consisting essentially of a poly (lower alkyl) methacrylate, a liquid plasticizer, an inert particulate filler, and a chlorinated rubber; and a method of using the same to secure the pouch of an ileostomy, ureterostomy, colostomy or the like appliance to the skin. Excerpt(s): This invention relates to medical appliances and materials suitable therefor. More particularly, it relates to an adhesive composition which, inter alia, is useful for adhering medical appliances to an animal body. It is often necessary to make an adhesive bond to an animal body, usually a human body, in order to attach a medical appliance or device. Although many adhesive compositions are known, very few of these are suitable for application to human skin. The requirements for such as adhesive are stringent; it must bond strongly to human skin, yet be peelable without damage to the skin's surface. Furthermore, it must cause no inflammation, even on prolonged contact, and should have a minimal tendency to provoke allergy. It must be free of any substances which may be carcinogenic. The requirement to be non-allergenic is particularly difficult to meet, and most adhesives currently available are prone to cause allergies in a significant proportion of patients. When the patient has a tendency to allergy, it may be necessary to test a number of adhesives before one is found which is compatible. This is time-consuming for the doctor, and in the meantime the patient is caused distress by allergic reactions. (4) a chlorinated rubber. Web site: http://www.delphion.com/details?pn=US04222923__

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Anti-back flow bag for waste Inventor(s): Denard; Ruthie (74 Garfield, No. 305, Detroit, MI 48201) Assignee(s): None Reported Patent Number: 5,364,378 Date filed: July 1, 1993 Abstract: A unique colostomy or ileostomy bag includes an anti-back flow member provided by a thin plastic tube. The structure of the thin plastic tube reduces any likelihood of waste contacting a patient's skin. The thin plastic tube has a relatively large opening compared to a seal positioned adjacent the patient. Thus, any waste passing through the seal tends not to contact the thin plastic member adjacent an entrance to the thin plastic member. Rather, the waste contacts the thin plastic member at a downstream position. At the downstream position, any waste on the thin plastic member would not be adjacent to patient, and would tend to not contact the patient. The thin plastic member has relatively little rigidity such that it presents little resistant to flow of the waste material between the sides of the thin plastic member. In this way, the waste

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moves easily between the sides of the thin plastic member and into a bag for storage. In further features of the invention, belt loops are positioned on each side of the bag to assist in carrying the bag on a patient. Further, various structures for rolling and securing the bag such that the bag may be periodically opened for removable of waste are also disclosed. Excerpt(s): This application in general relates to a bag for waste which has a unique antiback flow structure. In the prior art, colostomy bags and ileostomy bags are utilized for patients who have had the portion of their intestines surgically bypassed such that wastes exit through a opening in their body called a stoma. Patients utilizing such devices are often subject to extreme discomfort since the wastes often contact the skin in the area of the stoma. The waste products are aggravating to the skin since they will contain fecal matter, or possibly digestive juices. Prior art bags have attempted to prevent contact between the waste matter and the skin in the area of the stoma by utilizing various types of check valves which prevent back flow of the waste through the opening in the bag. The known structures for achieving these goals have not been entirely successful, however, and it would be desirable to develop an improved bag which would significantly reduce any contact between the waste matter and the skin in the area of the stoma. Web site: http://www.delphion.com/details?pn=US05364378__ ·

Anus closure tampon and method of manufacture Inventor(s): Hennig; Gerhard (Ammerseestrasse 28, D-8035 Gauting 2, DE) Assignee(s): None Reported Patent Number: 4,209,009 Date filed: May 16, 1978 Abstract: To provide reliable holding of a closure tampon for incontinent natural anus or an artificial anus after colostomy, an elongated essentially cylindrical body of cellular material, for example similar to a catamenial tampon, is provided with nonhomogeneous sections, taken in longitudinal direction, and having differential diametrical compressibility, so that a section of low compressibility can be inserted in the exit opening for internal expansion to thereby hold its position in the artificial anus, the section of high compressibility permitting constriction to provide, after insertion of the low-compressibility section first, a plug effect. Excerpt(s): Reference to prior application: Ser. No. 801,326, filed May 27, 1977, HENNIG et al now U.S. Pat. No. 4,154,226. The present invention relates to a medical device, and more specifically to a closure tampon for a natural or an artificial anus constructed, for example, by colostomy. Various types of closure arrangements and devices for an artifical excretory opening have been proposed. Such openings are surgically constructed after operations for cancer of the colon extending, for example, through the abdominal wall. Some devices of this type use magnets to hold closure plugs in place (see German Patent Disclosure Documents DE-OS Nos. 23 63 563; 24 47 682; 26 25 243; 27 17 608; U.S. Ser. No. 801,326. In such arrangements, a ring-shaped permanent magnet is implanted in the abdominal wall surrounding the colon in the vicinity of the exit opening. Magnetic closure arrangements then cooperate with the magnet implanted in the abdominal wall. One such arrangement may include a closure cover. Such arrangements have found acceptance, but still require improvement; if, for example, the patient is obese, or the colon is led downwardly at an inclination with respect to the

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abdominal wall, difficulties may arise. Magnetic closure arrangements have also been proposed in which a rubbery elastic material is used which has a sealing surface, matched to the shape of the region surrounding the excretory opening of the colon. Such arrangements are difficult to fit and must be individually made to fit the particular patient involved. Web site: http://www.delphion.com/details?pn=US04209009__ ·

Appliance for the treatment of colostomy and the like Inventor(s): Marsan; Arthur E. (240 Ferrari Ct., El Paso, TX 79912) Assignee(s): None Reported Patent Number: 4,326,521 Date filed: February 28, 1980 Abstract: This invention provides modified forms of an improved appliance for the treatment of colostomy and the like designed to be manufactured at a low cost and to be economical and advantageous to the user. The appliance is unique in that it has a gasket molded in a single operation to form a unitary structure having plural portions which have different functions. The pouch has a receiving end and a drain end. One plural portion of the gasket forms a snap-ring hinged to the gasket when the gasket is molded and adapted to be moved by hand on its hinge to connect the receiving end of the pouch to the gasket at the outlet end of the stoma opening. Another portion of the gasket forms means for locking the drain end of the pouch to the gasket. At each opposite side of the gasket another portion has openings for threading the ends of a belt to the gasket to hold the appliance on a patient. In a modified form of the appliance one plural portion forms a diaphragm extending diametrically across the stoma opening forming the rear wall of a compartment for gel. This feature serves to extend the time between the application of fresh gel and extends the life of the appliance. Also, it serves to prevent excoriation of abdominal skin around the stoma and makes for a more satisfactory appliance. Another feature provides novel means for connecting the drain end of a tubular pouch to the gasket. Excerpt(s): The present invention is the result of applicant's association with the treatment of colostomy continuously over a period upward of 40 years. His father had colostomy for 17 years. Applicant made many inventions in this art during this period and was granted 14 United States patents and was also engaged in the manufacture and sale of colostomy appliances. This invention provides an improved appliance comprising only three components, a pouch for receiving the fecal discharge from the stoma, a gasket of unique construction, and a belt for holding the appliance on a patient. The gasket is unique in that it is molded in a single operation to form a unitary structure having plural portions which have different functions serving all the requirements of the appliance without the use or need of extra or extraneous parts or devices. The term "ostomy" has come into use to define, in a broad sense, the surgical procedures known as colostomy, ileostomy, cecostomy, ureterostomy, ileal conduct, ileal bladder, wet colostomy, etc. This surgery usually results in an artificial opening through the abdominal wall for the terminal end of the intestine or duct called a stoma to discharge the body wastes of feces or urine. Many devices have been developed through the years to aid in the treatment of ostomy patients, but none has been suitable for all patients. This is due to the lack of satisfactory appliances and to the differences in surgical techniques and the physiological condition of patients.

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Web site: http://www.delphion.com/details?pn=US04326521__ ·

Colostomy appliance Inventor(s): Pontifex; Edward J. (Virginia Beach, VA) Assignee(s): Fine; Louis B. (norfolk, Va) Patent Number: 4,296,749 Date filed: July 18, 1980 Abstract: An improved colostomy appliance includes a first pouch for receiving solid and liquid waste and a second separable pouch for containing gas. The two pouches are connected by a releasable coupling which provides a gas flow path therebetween and which includes valve structure for automatically closing each pouch upon disconnection of the two pouches. Excerpt(s): This invention relates to colostomy appliances and more particularly to a colostomy appliance having an improved closable gas collecting means. The accumulation of gas in colostomy bags, or pouches, and the escape of gas from such pouches has presented difficulties and embarrassment to persons using the device, and numerous devices have been developed in an effort to solve the problem. Initially, it was the practice to provide small openings near the top of such pouches to permit the escape of gas more or less continuously. While this arrangement generally avoided discomfort resulting from pressure in the pouch, it nevertheless was not satisfactory in that venting could not be controlled and the escaping gas was frequently embarrassing. U.S. Pat. No. 3,055,368 to Baxter discloses a colostomy drainage pouch including an integral vent in the form of a labyrinth-type seal at the top designed to facilitate the discharge of gas upon squeezing or applying pressure to the pouch. This seal arrangement theortically avoided the escape of liquids which was a further problem with the prior pouches having simple punctures or openings at the top. While this arrangement was an improvement, it nevertheless presented a problem in that the venting of gas could not always be controlled. Web site: http://www.delphion.com/details?pn=US04296749__

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Colostomy bag Inventor(s): Hulett; Jeannine (4110 NE. 3rd Ave., Pompano Beach, FL 33064) Assignee(s): Hulett; Jeannine (pompano Beach, Fl), Medi-south Products Inc. (pompano Beach, Fl) Patent Number: 6,231,553 Date filed: May 17, 1999 Abstract: A colostomy bag includes a bag member having top and bottom ends, each end having an opening. The opening at the bottom end is sealable with a sliding tab ziplock type closure means allowing the bag to be easily drained and reused. Mounted to the exterior of the bag member is a pouch having an auxiliary colostomy bag received therein for use in the event that the reuseable bag suddenly ruptures or begins leaking. Also attached to the exterior surface of the bag is a deodorizing means that emits a pleasant odor upon the bag member being moved or shifted.

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Excerpt(s): The present invention relates to a colostomy bag having a quick release type closure means, allowing the bag to be quickly and conveniently emptied, as well as an emergency bag storage and a deodorizing means. A colostomy is a surgical procedure in which a patient's colon is provided with an artificial opening, referred to as a stoma, through which the colon may be artificially evacuated. A disposable colostomy bag is coupled with the stoma to receive the contents from the colon. The bag is typically constructed with plastic, rubber or a similar liquid impermeable material and has an opening thereon for receiving the stoma. Once the bag is full, it is usually detached from the stoma, discarded, and replaced. The frequent removal and replacement is burdensome, inconvenient, and often irritating to the patient. Accordingly, there is currently a need for a colostomy bag which may be periodically emptied and reused, eliminating the need for frequent replacement. Although at least one reuseable colostomy bag exists in the prior art, the frequent reuse of the bag makes it susceptible to wear, puncturing or tears. In such event, there is a need for an emergency or replacement bag to minimize spillage. Web site: http://www.delphion.com/details?pn=US06231553__ ·

Colostomy bag belt Inventor(s): Galjour; David M. (3408 Arizona St., Kenner, LA 70065) Assignee(s): None Reported Patent Number: 5,947,942 Date filed: July 18, 1997 Abstract: A colostomy bag belt which utilizes: an inner comfort belt which holds a skin patch against the wearer's skin, the skin patch being connected to a connector forming a conduit through the comfort belt; an exterior belt which forms a pouch therein and has a leak-proof safety pouch within the belt and has a connector forming a conduit through the exterior belt and into the safety pouch and which has a sealable opening through which as colostomy bag can be inserted into the safety pouch and secured to the connector; a flexible intermediate connector which completes the conduit from the skin patch to the safety pouch; and a colostomy bag placed in the safety pouch and connected to the conduit to receive the waste which exits the stoma and passes through the conduit. Excerpt(s): The present invention relates to medical devices and more particularly to medical devices for supporting colostomy bags that utilize an inner comfort belt and an exterior belt, the comfort belt holding a skin patch against the wearer's skin, the exterior belt forming a pouch and having a leak-proof safety pouch therein, the skin patch being connected to a colostomy bag through a connector in the comfort belt, an expandable intermediate connector and a connector in the exterior belt. Following the surgical removal of the colon (a "colostomy"), patients require means for removing bodily waste from their intestinal tracts. Typically, this is accomplished by routing the waste through a stoma which exits the body. The waste then empties into a colostomy bag secured at the external end of the stoma. The arrangement described above can be uncomfortable and unattractive and can create an unpleasant smell. Existing means for supporting a colostomy bag are somewhat fragile and must be handled with care in order to avoid detaching the colostomy bag and damaging the stoma. These existing means are prone to leakage and may prevent the wearer from participating in activities which could jar or damage the colostomy bag or support. The invention provides a means for

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preventing leakage and odor from the colostomy bag and also prevents damage to the stoma. Web site: http://www.delphion.com/details?pn=US05947942__ ·

Colostomy bag cleaning device Inventor(s): Bugajski; Mark J. (338 E. Front St., Traverse City, MI 49684) Assignee(s): None Reported Patent Number: 5,738,668 Date filed: May 22, 1997 Abstract: A cleansing device (10) for use with a colostomy or other body waste bag. The device (10) includes a valve body (12) having a passage (14) and a gate valve (20) positioned in the passage (14), an elongated handle (34) controlling the gate valve (20), a hose (28) connected to the inlet (16) of the valve body passage and adapted to be secured to a source of irrigating water, and a tube (22) attached to the outlet (18) of the valve body passage including a main body portion (22a) and a nozzle portion (22b) bent backwardly with respect to the main body portion (22b) into the colostomy bag. The patient may grasp the valve body (12) with one hand to move the nozzle portion (22b) of the tube (22) upwardly into the discharge opening of the colostomy bag and may thereafter use the same hand to squeeze the handle (34) and direct a flow of irrigating fluid into the interior of the bag. Excerpt(s): This invention concerns the field of fecal incontinence devices and, more particularly, to a device for and a method of effectively cleaning out said devices. The use of incontinence devices such as ostomy pouches, colostomy bags, urostomy bags, as well as incontinence devices used in conjunction with natural body orifices, has been increasing in recent years. Patients with cancerous lesions, as well as other conditions of the gastrointestinal and urinary tracts, are often subjected to surgical procedures which remove parts of these systems, thus rendering the natural body orifices ineffective. It is frequently necessary to surgically create stoma or openings for the passage of, for example, fecal material. Thus, waste passing through these surgically created stoma must be collected via the now-familiar ostomy pouch or colostomy bag. Since the number of persons subjected to such surgical intervention has greatly increased in recent years, the problem of effectively cleaning these incontinence devices has become increasingly urgent. A number of prior art devices are known for washing such incontinence devices. Examples include U.S. Pat. Nos.: 3,736,934; 4,194,506; 4,692,159; and 4,941,878. However, none of these prior art efforts are convenient or effective in use. Web site: http://www.delphion.com/details?pn=US05738668__

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Colostomy or ileastomy applicance Inventor(s): McLeod; Patrick H. (London, GB2) Assignee(s): Matburn (holdings) Limited (london, Gb2) Patent Number: 4,318,406 Date filed: July 24, 1979 Abstract: A filter is provided for a colostomy or ileostomy bag. The filter has a first layer of material which is gas permeable and water impermeable and forms the gas inlet side

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of the filter, a second layer of material which is gas permeable or is rendered gas permeable by the presence of at least one aperture therethrough. A layer of carbon cloth is sandwiched between the first and second layers, the first and second layers being secured to the carbon cloth by a weld which extends through the periphery of the carbon cloth. Excerpt(s): This invention relates to a filter for use in venting a colostomy or ileostomy bag, and a method of making such a filter. When colostomy and ileostomy bags are used there is often a build up of flatus and it is desirable to include some means for releasing this. However, if a vent is provided it should also include a means for removing the unpleasant odours from the flatus. A number of ways of achieving this have been proposed in the past, including the use of a filter containing carbon particles or granules on a support. A disadvantage of this type of filter is that a long pathway is needed through the carbon for the filter to be effective. According to the present invention there is provided a filter for a colostomy or ileostomy bag, which comprises a first layer of material which is gas permeable and water impermeable and forms the gas inlet side of the filter, a second layer of material which is gas permeable or is rendered gas permeable by the presence of at least one aperture therethrough, and a layer of carbon cloth sandwiched between the said first and second layers, the said first and second layers being secured to the carbon cloth by a weld which extends through the periphery of the carbon cloth. Web site: http://www.delphion.com/details?pn=US04318406__ ·

Colostomy pouch rinsing device Inventor(s): Rodriguez; Ernest L. (15736 Wedgeworth Dr., Hacienda Heights, CA 91745) Assignee(s): None Reported Patent Number: 5,709,236 Date filed: November 1, 1996 Abstract: A colostomy pouch rinsing device comprises a faucet coupling assembly including a central elbow member having an upper section including faucet coupling devices and a lower section including a first compression unit; a water control handle including a main body and a control lever coupled thereto; a rubber hose having an inboard end being coupled to the faucet coupling assembly, the outboard end of the hose being coupled to the water control handle; a spray head formed in a hollow, generally cylindrical configuration with an upper end including a plurality of water apertures projecting therethrough; and copper tubing with an inboard end being threadedly coupled to the projection member of the handle and an outboard end formed contiguously with the spray head. Excerpt(s): The present invention relates to an colostomy pouch rinsing device and more particularly pertains to hygienically cleansing colostomy pouches. The use of body waste container cleaning devices is known in the prior art. More specifically, body waste container cleaning devices heretofore devised and utilized for the purpose of cleaning various types of body waste containers are known to consist basically of familiar, expected and obvious structural configurations, notwithstanding the myriad of designs encompassed by the crowded prior art which have been developed for the fulfillment of countless objectives and requirements. By way of example, U.S. Pat. No. 4,194,506 to Voorhies discloses a kit for an ostomate. Web site: http://www.delphion.com/details?pn=US05709236__

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Colostomy pouche with vent valve Inventor(s): Colacello; Albert A. (4 Cranbrook Rd., Hamilton Square, NJ 08690), Colacello; Michael A. (543 Emmett, Trenton, NJ 08629) Assignee(s): None Reported Patent Number: 5,372,594 Date filed: August 2, 1993 Abstract: A manual gas vent assembly for use in venting gas from the interior of a conventional unvented ostomy collection pouch include a valve assembly having an open position, which permits gas to pass therethrough and a closed position, for preventing gas to pass therethrough. The valve assembly has an input portion for communicating with the interior of the ostomy collection pouch and an output portion for communicating with the atmosphere and a mounting device for mounting the valve assembly to a selected portion of the wall of the ostomy collection pouch. The mounting device releasably contains therein a portion of the valve assembly so as to position the input portion thereof proximate the interior of the ostomy collection pouch, and the output portion of the valve assembly proximate to the atmosphere. Also included is an absorbent pad suitable for receiving an antiseptic and/or deodorant.Also provided is a method for installing a valve assembly on an unvented ostomy collection pouch which includes the steps of providing a valve assembly; providing means for removably retaining a valve assembly; puncturing a hole through a selected portion of the ostomy collection pouch; inserting the valve assembly through the hole and removably affixing the valve assembly in place to the ostomy collection pouch with the removable retaining means. Excerpt(s): The present invention relates to ostomy collection pouches and more particularly to means for manually venting ostomy collection pouches into the surrounding atmosphere so that gas build up therein can be released. A colostomy is a surgical procedure in which an artificial anus is formed to accommodate persons whose colon has become infected or cancerous and can no longer function. In such cases the patient is left with no normal bowel function and as a result of the colostomy, body wastes pass through the artificial anus into the colostomy collection bag. A colostomy can be permanent or temporary but in either event the person must use a pouch system to collect bowel wastes. In some cases after the colon is healed, the surgical procedure is reversed for the temporary colostomy user, normal bowel function follows and the pouch is no longer needed. Unfortunately, permanent colostomy users need a pouch for the rest of their life to handle their body wastes. Web site: http://www.delphion.com/details?pn=US05372594__

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Colostomy protection device Inventor(s): Baker; Freddie R. (2104 Rose Cliff Dr., Nashville, TN 37206) Assignee(s): None Reported Patent Number: 5,338,315 Date filed: April 28, 1992 Abstract: A device for use by a person wearing a colostomy, ileostomy or ureterostomy bag which protects the bag from binding by clothes and being noticed as readily by others. The device is a semirigid guard worn by the person below the stoma at the level

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of his or her waistband or belt line. The inner portion of the guard conforms to fit snugly and comfortably against the person's body. The outer portion of the guard is semirigid and curved to permit the waistband of the person's clothing to fit smoothly around the guard. The inner and outer portions may be separate pieces, removably attached to one another, as with hook and loop fasteners. Between the inner and outer portions of the guard is an opening through which the bag hangs freely. The outer portion may extend up to a level so that it covers and protects the stoma. Excerpt(s): Colostomies and colostomy bags are quite well known, and obviously are of great benefit to those who require them. One inconvenience frequently encountered by one wearing a colostomy bag is that one's clothing may bind the colostomy bag, interfering with its ability to properly and completely fill. A second inconvenience is that the stoma--the point of connection between the person's body and the colostomy bag--may be irritated by the rubbing of clothing, seat belts, etc., against the connection during the course of a day's activities. Similar situations are involved with the use of ureterostomy bags. This invention is a device to be worn by a person with a ileostomy, colostomy or ureterostomy bag. Examples and embodiments given herein will be for ileostomy bags, but are applicable to colostomy and ureterostomy bags. The invention is intended to reduce or eliminate binding and constriction of the bag by the person's clothing, and to reduce or eliminate noticeable changes in the person's appearance to others. In certain embodiments the invention is intended to reduce or eliminate irritation of the stoma caused by rubbing, contact, movement, etc. The invention is a semirigid guard worn by the person below the stoma. The inner portion of the guard is curved to fit snugly and comfortably against the person's body. The outer portion of the guard is similarly curved to permit the waistband of the person's clothing to fit smoothly around the guard and to minimize its effect upon the person's appearance The inner and outer portions may be separate pieces, removably attached to one another, as with hook and loop fasteners. Between the inner and outer portions of the guard is an opening through which the colostomy bag hangs freely. The pressure of the person's clothing at the waistband is borne by the guard rather than the colostomy bag. Further, as the colostomy bag fills, because it hangs freely through the guard, it does not create additional bulges beneath the person's clothing. Web site: http://www.delphion.com/details?pn=US05338315__ ·

Colostomy seal Inventor(s): Carpenter; Steven (Chichester, GB2) Assignee(s): Matburn (holdings) Ltd. (london, Gb2) Patent Number: 4,252,120 Date filed: March 19, 1979 Abstract: A device for sealing an ostomy bag to the skin of a patient, comprises a sheet of material capable of adhering to the skin of a patient so as to provide a substantially liquid tight seal. The sheet has a slit or cut extending as a spiral or the like. An aperture may then be produced in the sheet as desired by unwinding the coil defined by the spiral slit or cut. The sheet may be of a gelatinous material having a basis of Karaya gum and/or another hydrophilic material. Excerpt(s): It is well known that some abdominal surgery may result in the formation of a faecal or urinary stoma and that the contents of the intestine or bladder will flow from the stoma outside the control of the patient. This will also be the case when a fistula

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develops between an internal organ and the abdominal surface or when an abdominal (or other) wound site breaks down allowing leakage of fluid from within the cavity. In all such cases it will be necessary to provide the patient with a means of collecting the waste material; this usually takes the form of a pouch or bag which is commonly called an "ostomy" bag. The material to be collected is often corrosive to the skin of the patient and protection must be provided to prevent leakage around the stoma. In order to protect this area of skin, it is commonplace for the patient to apply to the skin a suitable covering which is often a gelatinous ring of a material the base of which is Karaya gum. These rings are sometimes separate items over which the collection bags also fit, or, sometimes, the rings are actually incorporated as part of the construction of a collection bag. There are considerable variations in the size of the stoma from patient to patient and it is therefore necessary for manufacturers of ostomy products to provide a significant range of protective rings of varying diameters. An object of the present invention is to provide a way of avoiding the need to supply such a range of rings, and provide a wider ringe of variations to the size of the aperture of the ring. Accordingly, the invention provides a device for sealing an ostomy bag to the skin of a patient, the said device comprising a sheet of material capable of adhering to the skin of a patient so as to provide a substantially liquid tight seal, wherein the said sheet has a slit or cut extending as a spiral or the like whereby an aperture can be produced in the sheet as desired by unwinding the coil defined by the spiral slit or cut. The depth of cut depends on the nature of the material of the sheet and may penetrate only partially through the thickness of the sheet although it preferably pentrates completely through the sheet at the centre of the coil. Web site: http://www.delphion.com/details?pn=US04252120__ ·

Concealed colostomy apparatus and method Inventor(s): Wheeler; Alton D. (3940 Fox Meadow La., Pasadena, TX 77504) Assignee(s): None Reported Patent Number: 6,050,982 Date filed: November 3, 1997 Abstract: A concealed colostomy apparatus comprising a sleeve insertible into the bowel via a discharge opening thereof for retention therein, the sleeve then having a discharge end; a cap removably interfitting the discharge end of the sleeve; and a flexible pouch received in collapsed position into the sleeve to in turn receive feces from the bowel, the cap being removable to allow distending of the pouch outside the sleeve and continued filling of fecal matter into the pouch. Excerpt(s): This invention relates generally to colostomy, and more particularly, to improved colostomy apparatus and its method of use. There is continual need for improvements in colostomy techniques and apparatus; and in particularly, there is great need for simplified and reliable apparatus, which is unobtrusive in its application to the colon and its method of use. c) and a flexible pouch received in collapsed position into the sleeve to in turn receive feces from the bowel, the cap being removable to allow distending of the pouch outside the sleeve and continued filling of fecal matter into the pouch. Web site: http://www.delphion.com/details?pn=US06050982__

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Containers of aminopolymers Inventor(s): Deibig; Heinrich (Guensberg, CH), Dinkelaker; Albrecht (Biberist, CH) Assignee(s): Belland AG (solothurn, Ch) Patent Number: 4,990,146 Date filed: December 12, 1988 Abstract: The invention relates to amino group-containing polymers, which are produced by the polymerization of acrylates with aminoacrylates in the forms of esters of acrylic or methacrylic acid with amino alcohols. Polymers of this type are insoluble in the neutral to basic aqueous medium, but are soluble in the acid medium. They are particularly suitable for the production of colostomy bags. Excerpt(s): European Pat. No. 32 244 describes a composite film or sheet, in which one layer is made from a material which is insoluble in water, but soluble in acid or basic aqueous media. The material is preferably a copolymer of an unsaturated organic carboxylic acid with a neutral monomer. The object of the present invention is to make available polymers, which are insoluble in a neutral and basic medium, but can be dissolved in acid, aqueous media. Polymers with the above composition represent a valuable supplement to the known polymers soluble in basic media and make available numerous new possible uses. Web site: http://www.delphion.com/details?pn=US04990146__

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Diapers Inventor(s): Webster; Patricia Mae (914 124th Pl. NW., Marysville, WA 98271) Assignee(s): None Reported Patent Number: 6,423,047 Date filed: June 16, 2000 Abstract: A reusable diaper product created to fit premature and newborn babies, toddlers, young youth, young adults, adults, the elderly, and patients with special problems such as a colostomy bag. The diaper comprises an all fabric stretchable shell which in the preferred embodiment is secured to the wearer by an encased elastic waistband with hook and loop VELCRO tabs. The legholes on the shell are encased elastic designed to fit many different leg sizes. Within the shell is disposed a soft breathable liquid impervious layer encasing multiple layers of a absorbent material. The sides of the absorbent material are permanently affixed to the shell and finished with elastic edges forming a body gusset of sorts. Several embodiments of the diaper are disclosed to fit special needs. Excerpt(s): The present invention relates to a comfortable reusable cloth diaper and the like, capable of being fitted to premature and newborn babies, babies, toddlers, young youth, young adults, and the elderly. Embodiments for special needs are disclosed. Historically the diaper has been a flat piece of cloth folded to a desired fit to contain bodily waste. Few substantial changes have been made over the years. When disposable diapers came into being more absorbancy was required since users wore them for longer and longer periods of time. With the advent of environmental issues the reusable cloth diaper came upon the scene with a mass absorbtion problem and fitting of the wearer without pins.

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Web site: http://www.delphion.com/details?pn=US06423047__ ·

Drainable pouch for colostomy patients Inventor(s): Canela; Heriberto (8027 W. 14th Ave., Hialeah, FL 33014) Assignee(s): None Reported Patent Number: 5,690,621 Date filed: March 26, 1996 Abstract: A drainable pouch for colostomy patients with a stoma and that includes a valve for selectively releasing the gases trapped within the pouch. The valve assembly is removably mounted permitting a user to rinse the interior of the pouch from the uppermost portion. The valve also contains an odor suppresant filter that may include an impregnated fragrance. A cap member is used to cover the outlet spout. A sheet having cooperative dimensions and made out of a non-transparent material is used to conceal said pouch from public view. Excerpt(s): The present invention relates to a drainable pouch for colostomy patients, and more particularly, to the type that includes a escape gas valve and a protective cap for the pouch outlet spout. Several designs of drainable pouch for colostomy patients exist in the market, however none of them disclose the features included in the present invention. The drainable pouch claimed in the present application overcomes some of the shortcomings present in the existing pouches, such as the inconvenience of having a practically sealed pouch that does not have any outlet, orifice, vent or breathing port that allows a user to selectively permit the gas to escape from the pouch while a user is carrying it. The present invention overcomes this shortcoming providing a valve mounted in the pouch that permits a user to selectively free the gas accumulated as the result of the excrement and the valve also includes a fragrance impregnated filter. Another inconvenience frequently encountered by colostomy patients in their daily use of pouches is that the cleaning procedure is uncomfortable having to rinse the pouch with water through the pouch tail, in the lower portion thereof, requiring a user to bend in an uncomfortable position. In contrast, the present invention discloses an opening located in the uppermost portion of the pouch through which the water flows rinsing the pouch. The water is then drained through the lower pouch outlet spout by gravity. Finally, a protective cap covers the pouch tail thus avoiding any possible escape of odor or direct contact with excrement particles left in the pouch tail after the interior of the pouch was rinsed. It is one of the main objects of the present invention to provide a drainable pouch that has a valve assembly that permits a user to selectively release the gas contained in the pouch through an odor-removal or fragrance impregnated filter. Web site: http://www.delphion.com/details?pn=US05690621__

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Encapsulated expandible continence device Inventor(s): Berman; Irwin R. (2301 Parkwood Dr., Brunswick, GA 31520) Assignee(s): None Reported Patent Number: 4,979,947 Date filed: October 10, 1985

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Excerpt(s): A continence device in the form of a cube or block of resilient foam material capable of being collapsed into a small volume condition and encapsulated in a capsule of gelatin or the like and which includes a string or cord passing through the material and connected with a traction bead engaged with a distal surface of the block or cube of foam material. The continence device provides for voluntary trapping or blockage of gastrointestinal effluent when voluntary and natural control is lacking such as when a person has had a colostomy, ileostomy, or in other situations involving fecal incontinence. An introducer is provided for inserting the capsule, the reduced volume soft foam material therein and the line or cord and traction bead into a body orifice such as a stomal orifice, anus or the like. The introducer is in the form of a tubular member, such as a straw which is passed over the cord or string and has one end engaged with the capsule and is provided with a flexible section to facilitate insertion of the device into the desired body orifice with the gelatin capsule then being dissolved in the presence of body warmth and moisture to enable the compressed soft foam material to expand to a predetermined size and shape for blockage and temporary retention of gastrointestinal content in the body orifice. Various devices are known which can be inserted into a body orifice while in a reduced volume condition, permitted to expand and then retracted. Such devices include inflatable hollow resilient members and other expandable members for use in obtaining specimen material for diagnostic procedures, absorption of body fluids such as catamenial devices and the like. Also, it is known to provide collection bags for receiving body fluids and effluent which are involuntarily discharged by persons that are incapable of controlling the discharge of gastrointestinal effluent for various reasons. An object of the present invention is to provide a continence device in the form of an encapsulated and expandable block or cube of soft, resilient foam material that is compressed into a small volume condition and received in a capsule of gelatin or similar material which facilitates intubation of the device into a body orifice, hollow organ or the like with body warmth and moisture dissolving the capsule for expansion into a predetermined shape and size to provide voluntary trapping or blockage of organ effluent when voluntary natural control of discharge of such effluent is lacking. Web site: http://www.delphion.com/details?pn=US04979947__ ·

Faster irrigation set for controlling colostomy Inventor(s): Hu; Hsueh-Shun (4th Fl., No. 16, Lane 220, Section 2, Hsin-Lung Rd., Taipei, TW) Assignee(s): None Reported Patent Number: 4,319,569 Date filed: January 28, 1980 Abstract: A faster irrigation set for controlling Colostomy, has a water speed controlling device and an excrement suction device provided between the irrigating bag and the catheter which has a plurality of holes formed on the surface thereof for passing excrement. The excrement suction device has a valve regulating the performance of the inserted catheter either for excrement suction or irrigation. Excerpt(s): The present invention relates to the improvements in a stoma irrigation set for controlling Colostomy. The conventional stoma irrigation sets for controlling Colostomy cannot be operated both for irrigating and drawing-off excrement with the catheter. It takes much time for a patient to perform the irrigating and withdrawal of excrement procedures using those well-known irrigation sets. Generally the whole

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procedure including irrigation with physiological salt solution and complete withdrawal of excrement takes about 1-2 hours or even more. Furthermore, the speed of the flowing irrigation solution cannot be easilly controlled and sometimes the flowing may interrupt, and even worse a counterflowing of the irrigating solution may occur due to the inner pressure of the large intestine. Besides, irrigation using such known set has the problem of unexpected excrement taking place during the period of irrigation and the disadvantage of not being capable of completing the excretion of withdrawal in single performance. The primary object of the present invention, therefore is to provide a device which can facilitate the procedure of irrigation and shorten the withdrawal time of excrement. Web site: http://www.delphion.com/details?pn=US04319569__ ·

Filtering and deodorizing device for use with colostomy pouch Inventor(s): Martell; Joseph A. (517-20th Avenue, Deux-Montagnes, Quebec, CA) Assignee(s): None Reported Patent Number: 6,007,525 Date filed: July 29, 1997 Abstract: The invention relates to a filtering and deodorizing device for use with a colostomy pouch. The device of the invention comprises a housing having first and second chambers in gas flow communication with one another; gas inlet means adapted for connection to the colostomy pouch, for introducing into the first chamber gas flowing from the pouch; filtering means in the first chamber for filtering gas flowing through the inlet means; deodorizing means in the second chamber for deodorizing the filtered gas flowing from the first chamber; gas control means positioned downstream of the deodorizing means and operative between open and closed positions for regulating gas build-up in the pouch; and gas outlet means for discharging the gas flowing from the second chamber when the gas control means is in the open position. Gas build-up in the pouch is released when the gas control means is in the open position so that the gas flows from the pouch through the first chamber and then through the second chamber and is evacuated as a filtered and deodorized gas through the gas outlet means. Excerpt(s): The present invention pertains to improvements in the field of colostomy products. More particularly, the invention relates to a filtering and deodorizing device for use with a colostomy pouch. Colostomy is the surgical formation of an artificial anus by making an opening from the colon through the abdominal wall. A person having undergone colostomy must constantly keep a colostomy pouch in position against such an opening or stoma by means of a flange attachment to receive feces discharged through the stoma. An abdominal belt support placed over the colostomy pouch is generally used to hold the pouch in position. When such a belt is used, the person cannot release gas build-up accumulated in the closed pouch unless the pouch is disconnected from the flange surrounding the stoma, which can only be accomplished by the removal of clothing and the belt. Since 1990, colostomy pouches have been provided with perforations defining a vent for gas buildup release. However, there is no control of the gas release which provides an offensive odor. With no control of the gas release, the pouch will completely deflate and come into contact with the stoma. The pouch touching the stoma causes the puddling and accumulation of discharged feces around the attachment flange. The accumulation of feces, on the other hand, causes irritation of the skin around the stoma if the feces are not removed and the skin washed.

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Web site: http://www.delphion.com/details?pn=US06007525__ ·

Flushing nozzle and dilater for colostomy irrigation Inventor(s): Reda; Emil T. (5808 Waycross Rd., Baltimore, MD 21206) Assignee(s): None Reported Patent Number: 4,343,307 Date filed: December 16, 1980 Abstract: A flushing nozzle and seal for colostomy irrigation, comprising a flushing nozzle having a flushing section at the leading end thereof which can be inserted through a stoma opening, a metering section, and a sealing flange positioned intermediate said flushing and metering sections. The flushing section has a flushing orifice and the metering section has a metering orifice, with the flushing orifice being of relatively larger diameter so as to improve the flushing action. A stoma seal is adapted to fit over the nozzle and has an opening such that the flushing section fits relatively tightly within the opening but permits the stoma seal to be moved longitudinally along the peripheral surface of the flushing section. The stoma seal is generally cup-shaped and includes a leading peripheral edge adapted to contact the abdominal wall around the stoma. Excerpt(s): The present invention relates as indicated to a flushing nozzle and dilater for colostomy irrigation. A colostomy is one form of surgical operation that creates an outside opening through the body wall to accommodate body waste. Such opening is referred to as a "stoma", and the stoma is created by extending an unobstructed portion of the colon or ileum through such opening and then stitching the walls of the colon or ileum to the abdominal wall. The type of "ostomy" depends upon the area in the body from which the section has been severed, with a colostomy referring to a surgical operation on the colon or large intestine and resulting in a colostomy stoma. An ileostomy is an operation on the small intestine. Regardless of the type of operation, it will be understood by those in the art that, for one reason or another, a section of the intestinal tract is diverted to an opening through the stoma. Although a colostomy normally necessarily results in lack of voluntary control over waste discharge, the type of discharge itself depends to a great degree upon the area of the large intestine from which the stoma was diverted. In any event, a stoma bag or disposable pouch is almost inevitably required due to the lack of voluntary control. Web site: http://www.delphion.com/details?pn=US04343307__

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Gas filter Inventor(s): Allan; Andrew M. (Blairgowrie, GB), Katsakoglou; Akis (Arbroath, GB) Assignee(s): W. L. Gore & Associates (uk) Ltd. (london, Gb) Patent Number: 5,496,396 Date filed: September 16, 1994 Abstract: An ostomy filter for colostomy and ileostomy bags is gas-permeable to allow venting, and liquid-impermeable to prevent leakage. It includes a hydrogen sulphide adsorbent to remove smells. The filter comprises 9 to 50% by weight of particles of unsintered granular polytetrafluoroethylene (PTFE), 30 to 82% by weight of particles of

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comminuted sintered expanded porous PTFE, and 9 to 30% by weight of particulate water-insoluble H.sub.2 S adsorbent. The particles are fused together by baking at elevated temperature to form a gas-permeable liquid-impermeable network. The comminuted sintered expanded porous PTFE is preferably formed by comminuting uniaxially expanded PTFE fibre. Excerpt(s): The present invention relates to an ostomy filter which allows gas to be vented from colostomy and ileostomy bags, whilst at the same time filtering out any unpleasant smell, particularly hydrogen sulphide. After undergoing a colostomy or ileostomy operation, the patient is fitted with a disposable bag which receives the waste contents of the intestine. The bag is disposable and is emptied or replaced at regular intervals. To avoid the bag becoming over inflated by virtue of gas generated by the fermenting food matter, it is desirable to provide a vent. However, the vent requires to be filtered in order to prevent embarrassing smells being released. It is currently conventional practise in colostomy bags to provide an activated charcoal filter in the form of a disc as the vent. For example the disc may have a diameter of 23.5 mm and be formed of activated carbon contained within a foamed polyurethane material, having polypropylene net facings on either or both sides to improve its strength and other mechanical properties. However, this conventional filter material has the significant disadvantage of being liquid-permeable, so that if the patient sits or lies down there is a significant danger of leakage of liquid through the filter onto the patient's skin or his clothing. This is particularly the case with ileostomy bags, where the bag is connected into the early part of the intestine where the food matter is largely undigested and still fermenting, and has a high liquid content. In fact conventional ileostomy bags are not provided with vents, and the filters used for colostomy bags would be quickly saturated with liquid if used for ileostomy. Web site: http://www.delphion.com/details?pn=US05496396__ ·

Hole cutter for ostomy adhesive wafers Inventor(s): Shelton; Jack A. (511 Wellesley Dr., Apt. 104, Corona, CA 91714), Shelton; Jay G. (3114 Newell St., Riverside, CA 92507), Shelton; Joseph A. (626 S. Columbus Blvd., Tucson, AZ 85711) Assignee(s): None Reported Patent Number: 5,079,843 Date filed: December 26, 1990 Abstract: An adjustable size hole cutter for ostomy adhesive wafers is disclosed having firstly a cylindrical body adapted to hold a cutting blade, a cylindrical pilot protruding outward from the bottom circular face of the cylindrical body to reside in a preformed hole in the colostomy wafer, and a Tee handle protruding outward from the top face. Adjustment of the blade's distance from the center of the cylindrical body for cutting different sized holes is accomplished by means of removable adjustment spacers situated in a radial slot formed in the wall of the cylindrical body, the cutting blade secured to the outside adjustment spacer by a set screw passing through a hole in the blade and aligned holes in the adjustment spacers. A circular base plate with centrally located hole receives the pilot of the adjustable hole cutter. The ostomy wafer is placed between the bottom face of the cylindrical body and the base plate whereupon the blade cuts into the wafer and the circular hole cut as the cutter is rotated. In alternate embodiments, slots are selectively situated in the bottom circular face of the cylindrical

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body to receive a blade at the diameter of choice. In addition, a cylindrical cutter provides for initially making the pilot hole in ostomy wafers not furnished with one. Excerpt(s): The field of the invention is devices adapted to enlarge holes in the ostomy adhesive wafers for use by colostomy, ileostomy, and urostomy patients. In patients who have had extensive medical problems with their colon, ileum, bladder, or kidneys, it is sometimes necessary that the colon, ileum, or tubes from the bladder or kidneys be routed from their normal attachments to an opening on the body in the lower abdomen region, many times in about the area immediately below where a person wears their belt. A stoma is an opening made in the skin covering the abdomen to which the lower end of the colon, ileum, or other tube has been attached. Many times the patient is given no means by which to control the flow of wastes through the upper or lower bowels or bladder and out the opening or stoma made in the stomach or abdomen wall. As a consequence, measures must be made to receive and hold these waste products. To accomplish this, various medical supply companies distribute apparatus for the collection of urine and feces. This apparatus generally consists of an ostomy bag which is supported upon the body of the patient, the bag having an upper opening which encompasses the stoma opening. Most ostomy wafers are provided with a nominal 1/2 inch diameter central pilot opening which, in the majority of the patients cases, must be enlarged to accommodate the size of the particular patient's stoma since it is not desirable or sanitary to block or partially block the flow of the wastes from the patient's body into the ostomy bag. Web site: http://www.delphion.com/details?pn=US05079843__ ·

Ileostomy and colostomy plug Inventor(s): Chernov; Merrill S. (4151 N. 32nd St., Phoenix, AZ 85018) Assignee(s): None Reported Patent Number: 4,241,735 Date filed: January 24, 1980 Abstract: A plug type closure for insertion into a body opening and employing a surrounding elongated balloon which when inflated expands to form a soft, nonerosive, relatively large surface contact in sealing engagement within the lumen of the body opening to prevent the unexpected release of odor and body waste materials. Excerpt(s): This invention relates to surgical appliances for closing artificial body openings, such as artificial abdominal openings and the like, and in particular, to a surgical closure plug means adapted for ileostomy and colostomy use which may be dependably, conveniently and comfortably used by a patient without a belt, bag or any other unsightly attachment on the surface of the body and which will quickly rehabilitate a patient psychologically to a normal way of life and its pursuits within a minimum of time after the above related operations. Generally, colostomy patients are those individuals who have had their lower bowels (rectum and anus) removed surgically due to cancer or other malignant infections of the colon or of like areas. The bowel (small or large) is, therefore, brought out by the surgeon through an aperture in the side of the abdominal wall of the patient and surgically attached to the outer skin for the purpose of serving as a means for the elimination of body wastes. In the medical field, the artificial body aperture or opening is termed a "stoma". Although a person can function quite well after this type of operation, there are no voluntary muscles or sphincter to control passage of body waste materials, liquids or gases. Pads, various

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receptacles and several means of bag attachments are either taped over the opening or attached thereto by means of a belt worn around the body to cover the stoma and to collect (not control) the escape of fecal waste or body liquid waste material. These means of waste elimination control are very inefficient and ineffective and present a great physiological problem to a recovering patient or to the rehabilitating of a recovered patient in that they must wear an external and clumsy outer bag to prevent the patient from soiling themselves. Although plug type openings have been known, they have either applied pressure to a small area of the body opening thereby irritating the periphery of this opening, or have been difficult to apply and uncomfortable to wear and are not in use today. Web site: http://www.delphion.com/details?pn=US04241735__ ·

Irrigation sleeve and attachment therefor Inventor(s): Jensen; Ole R. (Rivervale, NJ) Assignee(s): E. R. Squibb & Sons, Inc. (princeton, Nj) Patent Number: 4,586,927 Date filed: August 17, 1981 Abstract: An irrigation sleeve for colostomy patients is adapted such that it can be selectively and removeably attached to any one of a plurality of different snap-on attachments, such as an irrigation attachment or a rinsing or flushing attachment. The sleeve is basically funnel-shaped so that it may more effectively direct the flow of irrigating fluid and waste material therethrough. The sleeve has an opening adapted to receive a stoma of a colostomy patient and an opening adapted to receive one of the attachments. The opening for the attachments can be moved out of alignment with the opening for the stoma in order to inhibit soiling of the attachment by irrigating fluid and waste material discharged from the stoma without requiring the attachment to be removed from the sleeve. Excerpt(s): The present invention relates to irrigation devices, and, more particularly, to such devices which are especially adapted for use by colostomy patients to facilitate regular irrigation of the bowel through a stoma. Tumors commonly develop in the large intestine of an individual, thereby requiring the surgical removal of a section of the bowel and the rectum and the surgical formation of an artificial rectal opening or stoma. Such a surgical procedure is called a colostomy. The stoma does not have a sphincter muscle, which permits a person to voluntarily open and close the rectum. Accordingly, a colostomy patient cannot control the opening and closing of the stoma, which is therefore always open and, hence, susceptible to discharge without warning and without the patient's control. Web site: http://www.delphion.com/details?pn=US04586927__

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Irrigator for colostomy patients Inventor(s): Barth; Reinhardt (Maintal, DE) Assignee(s): Pardes Spezialstrumpfe Gmbh (maintal, De) Patent Number: 5,330,447 Date filed: August 27, 1992

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Abstract: An irrigator for colostomy patients consists of a bag for receiving a flushing liquid, the bag having a membrane dividing the bag into an air chamber on one side and a closable flushing liquid chamber on the other side. A drainage line is connected to the bag, and a pump is connected to the air chamber is provided for pressurizing the same. Excerpt(s): The present invention relates to an irrigator for colostomy patients comprised of a bag for receiving flushing liquid and a drainage line. Such an irrigator is used by colostomy patients in order to perform an intestinal flushing or irrigation. With a careful irrigation a secretion-free period of up to 48 hours may be achieved whereby this secretion-free period depends greatly on the remaining length of the patient's intestine and further patient-specific parameters. The commonly used irrigators are comprised essentially of a bag which at its upper portion is provided with at least one suspending eye. The bag is further provided with a funnel-shaped means so that filling with tap water is possible without difficulties. A drainage line is connected to the lower portion of the bag which widens into a cone and can be closed off with a clamp, for example, a roller clamp. For performing an intestinal flushing the bag is filled with water and suspended from a wall hook so that due to the elevational difference between the bag and the cone a pressure is generated which is sufficient for the intestinal flushing process. Web site: http://www.delphion.com/details?pn=US05330447__ ·

Laminated film with a starchy matrix and low permeability and methods for its production Inventor(s): Bastioli; Catia (Novara, IT), Bellotti; Vittorio (Fontaneto D'Agogna, IT), Romano; Giancarlo (Novara, IT), Tosin; Maurizio (Serravalle Sesia, IT) Assignee(s): Novamont S.p.a. (milan, It) Patent Number: 5,384,170 Date filed: June 24, 1993 Abstract: A laminated film including at least one first layer of a polymeric material which has a starchy matrix and is insoluble in water or at most expands in water, constituted by destructured starch and an olefinic copolymer and a second layer of a hydrophobic material adhering to the first. Applications are for the packaging of food products and for colostomy containers, for which a very effective barrier against gases and vapours is needed. Excerpt(s): The present invention relates in general to biodegradable films based on starchy materials and in particular to a film which is substantially insoluble in water and suitable for forming an effective varrier against liquids, gases and vapours, at least for a certain period of time, and which at the same time is rapidly biodegradable after use. Patent application No. EP-A-0 327 505 describes polymeric materials based on destructured starch and a synthetic thermoplastic polymeric material, which are useful, in particular, for the production of molded articles having better dimensional stability after exposure to moisture than corresponding articles made of starch alone. More specifically, as regards the production of films, self-supporting and biodegradable flexible films formed from compositions including starchy substances and an ethyleneacrylic acid copolymer are known from EP-A-0 032 802. Web site: http://www.delphion.com/details?pn=US05384170__

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Mechanical continent ileostomy or colostomy Inventor(s): Lerman; Sheldon H. (2202 Ken Oak Rd., Baltimore, MD 21209) Assignee(s): None Reported Patent Number: 4,338,937 Date filed: December 5, 1980 Abstract: A mechanical continent ileostomy or colostomy device adapted for permanent insertion at the time of operation including a body portion having a flexible flange at one end, an insert portion attachable to the body portion and a stopper member having a central plug fitting into the insert. A plurality of permanent magnets embedded in a rim of the insert portion and in the stopper rim holds the stopper in sealing relationship to the insert. Excerpt(s): This invention relates to a mechanical continent ileostomy or colostomy adapted for long-term employment in human beings. The object of this invention is to provide a continent cannula for the ileum or colon useful for evacuation of liquid and solid waste. The cannula may be inserted into the patient during the same operation as for the surgical construction of an ostomy, i.e., ileostomy or colostomy. There is a need for a mechanical continent ileostomy and colostomy that is easy to insert at the time of operation. Insofar as is known to the inventor hereof, there currently is no mechanical continent ileostomy and only one mechanical continent colostomy utilized clinically. This mechanical continent colostomy is described in an article by H. Feustal and G. Henning entitled, "Kintinente Kolostomie durch Magnetverschluss" which appeared in Dtsch. Med. Wochenschr., Vol. 100: p. 1063 (1975), and further discussed by Golligher, et al., Brit. J. Surg. 64 (1977), pp. 501-507. Web site: http://www.delphion.com/details?pn=US04338937__

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Multilayer films with quiet film layer having noise dampening properties Inventor(s): Bonekamp; Jeffrey E. (Midland, MI), Regnier; Francois J. F. (Weyersheim, FR), Tung; Harvey C. (Newark, OH), Woods; Rochelle A. (Midland, MI) Assignee(s): Dow Global Technologies Inc. (midland, Mi) Patent Number: 6,620,474 Date filed: September 20, 2002 Abstract: Multilayer films comprising a quiet film layer having noise dampening properties and at least one second layer which are particularly useful for, ostomy bags (colostomy, ileostomy), trans-dermal delivery systems (TDDS), cosmetic patches, incontinence bags, medical collection bags, parenteral solution bags, and food packaging, as well as for protective clothing and soil fumigation applications. The quiet layer comprises a polymer resin or polymer resin composition having a Tangent Delta value of at least 0.25 at a temperature within the range of -5.degree. C. and 15.degree. C. or at least 0.32 at a temperature within the range of -12.degree. C. to -5.degree. C., and the at least one second layer has a storage modulus G' equal to or greater than 2.times.10.sup.4 N/cm.sup.2. Excerpt(s): This invention relates to essentially amorphous, non-chlorinated polymeric films and to the use of such films as effective barriers to odors and organic molecules. Multilayer structures, which are substantially impervious to gases and/or moisture, are well known in the medical and food packaging industries. Currently, poly(vinylidene

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chloride) (PVDC) is used as one of the materials of choice for the gas barrier component of barrier films. For ostomy applications (i.e., colostomy and ileostomy), a film of PVDC sandwiched between opposing layers of low density polyethylene (LDPE) is widely used, with PVDC functioning as the gas barrier, and LDPE as the structural and sealant layer. Also, polyvinyl chloride (PVC) or chlorinated polyethylene (CPE) blended with ethylene-vinyl acetate copolymer (EVA) can be used in the structural and sealant layer, or other layers, of such a structure. However, disposal of these chlorine-containing materials presents a number of potential environmental concerns, especially relating to incineration of these materials after use in hospitals or otherwise. In addition, exposure to di-2-ethylhexyl-phthalate (DEHP), a common plasticizer utilized with PVDC and PVC, may present a number of health-related concerns, including reduced blood platelet efficacy, and potential links to liver cancer. Web site: http://www.delphion.com/details?pn=US06620474__ ·

Multilayered structure and colostomy bag made therefrom Inventor(s): Kawasaki; Akihiko (Amagasaki, JP), Moritani; Tohei (Kurashiki, JP), Yamamoto; Yoshio (Kurashiki, JP) Assignee(s): Kuraray Co., Ltd. (kurashiki, Jp) Patent Number: 5,582,820 Date filed: January 5, 1994 Abstract: A multilayered structure comprising at least 2 layers of a gas barrier resin layer and a protective layer, at least 1 layer thereof containing a deodorant, and a colostomy bag having excellent odor barrier properties (skatole and ammonia barrier properties) made of the film of the multilayered structure. Excerpt(s): The present invention relates to a multilayered structure and colostomy bag made therefrom having excellent odor barrier properties. High barrier properties against odorous materials are required for plastic films for packaging odorous wastes, such as colostomy bags and garbage bags, and plastic films for packaging fish, fruits, vegetables, and the like. Single-layer films of low-density polyethylene, plasticized polyvinyl chloride and the like have been used for colostomy bags. However, singlelayer films of low density polyethylene, plasticized polyvinyl chloride and the like, have insufficient odor barrier properties, and the odor of the contents emanates outward to cause the wearer to become uncomfortable. There is a need for a film having high odor barrier properties. The use of multilayered films comprising a barrier layer of ethylenevinyl alcohol copolymer (hereinafter referred to as EVOH) or polyvinylidene chloride resin having odor barrier properties have been proposed. Japanese Utility Model Application Laid-open No. 175248/1985 discloses a colostomy bag comprising EVOH as a barrier layer. However, colostomy bags comprising EVOH as an odor barrier layer have not been put into practical use, because the barrier properties of EVOH against low-molecular weight amines such as ammonia are somewhat insufficient. The use of polyvinylidene resin has been disclosed, for example, in Japanese Patent Kohyo No. 501631/1982 and Japanese Patent Application Laid-open No. 137368/1985. However, commercially available colostomy bags utilizing polyvinylidene chloride are still unsatisfactory in odor barrier properties. Web site: http://www.delphion.com/details?pn=US05582820__

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Multipurpose colostomy device having balloons on an end thereof Inventor(s): Kim; Jae H. (Bosung Hwangsil Town 109-701, Namsan-Dong, Joong-Ku, Taegu, KR) Assignee(s): None Reported Patent Number: 5,569,216 Date filed: November 30, 1994 Abstract: A multipurpose colostomy device for fixing in the stoma or rectum of a human body, includes an internal balloon, a ring configured external balloon surrounding the internal balloon, a connecting tube disposed under the both internal and external balloons, a joint tube operatively connected to a drainage hose and disposed under connecting tube, a supporting plate disposed between the connecting and joint tubes for fixing the colostomy to the abdominal wall, and an L-shaped supply tube containing a pair of air passages, a washing fluid passage and an enema fluid passage. Excerpt(s): The present invention relates to a multipurpose colostomy device for fixing in the stoma or rectum and more particularly, to a colostomy device having balloons on an end thereof for preventing leakage particularly of liquids and gases, irrigating a stool through a drainage tube thereof, and assembling an enema device and a fluid container therewith. Various types of colostomy bags are well known in the art. Such colostomy bags can be securely coupled to an adhesive dressing that fits around the stoma as a kind of collector from the anal canal. Such colostomy bags are shown in British Patent No. 1,099,455, British Patent 1,212,904, and U.S. Pat. No. 4,460,363. However, since such conventional colostomy bags are only a collecting container of waste materials from the stoma, they do not have a drainage hose and an enema device for patients who cannot control the bowel movement and who should not move for emptying the bowel. Furthermore, such conventional colostomy bags suffer from a number of problems. For example, it is difficult to attach the colostomy bag on the outside of the abdomen and to carry the colostomy bag having the stool, and it is complicated to apply the enema device or replace the same on the colostomy bag. Accordingly, it is an object of the present invention to provide a multipurpose colostomy device for fixing in the stoma of patients with colostomy or ileostomy, which eliminates the above problems for controlling stool passage encountered with conventional colostomy devices, and the rectum of the patient who cannot control his bowel movement such as hepatic coma, CVA in ICU, pelvic bone, spine, and other long bone fractures. Web site: http://www.delphion.com/details?pn=US05569216__

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Noise-attenuating device for colostomy Inventor(s): Curutcharry; Jean (Guethary, FR) Assignee(s): Laboratoires Biotrol S.a. (fr) Patent Number: 4,406,657 Date filed: April 3, 1981 Abstract: A device reducing noise resulting from the emission of intestinal gas by persons who have undergone enterostomy.Basically, it comprises an oblong body made of an open-cell porous material and/or optionally provided with an absorbent material, such as activated charcoal, and sheathed in a casing made of a material that does ot

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adhere to the stoma walls, and the upstream and downstream portions of which each comprises at least one opening suited to allow passage of the intestinal gases emitted, and which can be connected to a collecting bag, or secured to the stoma of persons practising irrigation.Application to improving the comfort and the social rehabilitation of persons who have undergone enterostomy. Excerpt(s): This invention relates to the abolishment or the reduction of noise emitted from an artificial anus. Patients who have undergone enterostomy, particularly those who have undergone colostomy and ileostomy, have an intestinal opening emerging through the abdominal wall. The evacuation of intestinal residues usually cannot be controlled by these patients. Generally speaking, the excreta is collected in plastic bags, which are secured to the patient's abdomen by adhesives or by joints, usually made of natural or synthetic paste, used with a belt system. Web site: http://www.delphion.com/details?pn=US04406657__ ·

One-piece ileostomy or colostomy bag connector Inventor(s): Iacone; Daniel J. (Box 849, Berryville, VA 22611) Assignee(s): None Reported Patent Number: 5,098,420 Date filed: November 9, 1990 Abstract: A one-piece bag connector for an ileostomy bag, colostomy bag or the like comprises an annular body portion, lip portion and a belt attachment. The body portion is adapted to surround a stoma of a user and the lip portion is connectable to a bag such that material may be discharged from the stoma to the bag without leakage. The body portion is made of resilient material and directly contacts the user thus avoiding the use of any gels or adhesive materials. The belt attachment connects a belt to the body portion such that a slight pressure is exerted against the user. This pressure plus the resilient nature of the body portion assures a proper seal between the user and the bag connector. Further, an easily attachable/detachable snap or screw connection is provided between the lip portion and the bag to assure a proper seal as well as convenience and ease in changing and/or removing the bag. The annular body portion, lip portion and belt attachment can be molded from plastic or the like to form the onepiece connector. Excerpt(s): The present invention relates to a one-piece connector for an ileostomy bag, a colostomy bag or the like. This one-piece connector includes an annular body portion, a lip portion and a belt attachment means. In the treatment of human diseases and ailments, it is sometimes necessary to form an opening in the patient's anatomy and to maintain that opening for an indefinite period of time. For instance, diseases involving different parts of the gastro-intestinal and urinary tract can result in a patient being left with an abdominal stoma. The three most common types of abdominal stomas are the colostomy, the ileostomy and the ileal conduit. In the case of an ileostomy, ileal conduit and many colostomy operations, the patient is unable to control the passage of bodily waste material and must rely upon an appliance attached to the body to collect this material. Various appliances have been proposed in the prior art. A majority of these appliances involve the use of gels or other adhesive materials which must be placed between the skin of the user and the bag connector. However, these gels are often messy to apply and are often inadequate to prevent leaks. For instance, if a user perspires, such

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as after exercise or on a hot day, these gels or adhesive materials are often ineffective in providing a leak-proof seal. Web site: http://www.delphion.com/details?pn=US05098420__ ·

Ostomy bag Inventor(s): Buongiorno; Livio (Milan, IT), Perego; Vittorio (Busto Arsizio, IT), Quacquarella; Cesare (Milan, IT) Assignee(s): Cryovac, Inc. (duncan, Sc) Patent Number: 5,989,235 Date filed: July 31, 1997 Abstract: The invention provides a drainage bag (colostomy, ileostomy or urostomy bag) comprising a bag of thermoplastic material having means to define an opening for receiving waste material from a stoma and means to secure the bag in place with the opening connected to the stoma, characterized in that at least the surface of the bag in contact with the skin of the wearer is flocked. Also described is an ostomy appliance comprising a re-usable outer bag and a disposable inner bag, means for securing the two bags together and to the stoma, means for inserting and removing the inner bag from the outer one, and means for closing, the outer bag once the inner one is in place, characterized in that at least the surface of the outer bag in contact with the skin of the wearer is flocked. Excerpt(s): The present invention relates to ostomy bags that can be confortably worn by the patients. An ostomy bag is a pouch that is employed to collect waste material that exits a person's body through a stoma, i.e. through an artificial, permanent, opening, surgically created in the ostomate's skin and connected to the intestine or to the bladder. Colostomy, ileostomy, and urostomy bags, herein collectively referred to as ostomy bags, typically comprise a pouch of plastic, moisture-impermeable and odor-barrier, material; an opening in said bag to allow waste material to enter into the plastic envelope; and means to secure the bag in place with the opening connected to the stoma. This can be obtained by means of a tape that is heat bonded to the ostomy bag around the opening; said tape has an opening which is positioned in-line with the opening of the bag and the side of said tape which is adjacent to the ostomate's body is coated with an adhesive which allows adhesion of the ostomy appliance to the "peristomal area", i.e., the skin area surrounding the stoma. Web site: http://www.delphion.com/details?pn=US05989235__

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Ostomy patient equipment Inventor(s): Butterwegge; Hans (1637 Pontiac, Grand Rapids, MI 49506), Mracna; Kellie (1637 Pontiac, SE, Grand Rapids, MI 49506) Assignee(s): None Reported Patent Number: 6,015,399 Date filed: April 2, 1997 Abstract: A vented colostomy pouch includes a water proof bag having a waste aperture and a vent aperture, with an annular member being secured to the vent aperture and a plug type closure being removably connectable to the annular member to

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seal the vent opening. The plug and annular member are integrally formed as a unitary member from a plastic material with a flexible attachment interconnecting the annular member and plug. The attachment is deflectable to permit the plug to be inserted and removed from the annular member. The plug has cylindrical side walls that resiliently fit into mating sidewalls in the annular member, with sidewall friction being sufficient to prevent dislodgment without manually moving the plug. The plug is at least slightly longer than the annular member so that the plug clears the opening in the annular member when fully inserted. Excerpt(s): This invention relates to ostomy products, i.e., appliances and apparatus to be used by colostomy patients. Medical patients who have contracted colon disease such as cancer must frequently undergo radical colostomy surgery, which results in removal of a substantial amount of the lower intestine and resulting formation of a surgically implemented waste outlet through the abdominal wall, called a "stoma." Such patients must then wear a specially designed pouch-like container, typically of thin, flexible plastic sheet material, which mounts over the stoma to receive and collect body eliminations. Typically, this pouch is releasably attached to a patch-like mounting member called the "appliance," which is adhesively secured to the patient in a secure manner over the stoma and has an opening communicating with the latter. Usually, the patient-mounted "appliance" has a ring-like attachment member, and the pouch has a complementary ring-like portion defining a pair of spaced annular walls which snap over the ring on the appliance to thereby secure the pouch to the appliance in a leakproof manner. Each such ring-like member has a large central aperture through which eliminated body waste passes to enter the pouch. One problem which arises in use of such apparatus is the accumulation of gas within the pouch, which inflates the latter in an undesirable manner and may cause leakage or even rupture, etc. The basic practice for dealing with this problem is for the user to retire to a place of privacy and partially disengage the attachment ring, allowing the gas to escape. This is inconvenient and may occasionally cause inadvertent and undesirable spills; furthermore, it also risks unexpected complete separation of the attachment rings, with corresponding detachment of the pouch and probable spilling of its contents. In order to improve on this situation, various vents have been proposed for the pouch, usually in the form of an air filter of one type or another, often incorporating activated charcoal for absorbing odors, permanently or otherwise mounted over a vent opening located somewhere in the top portion of the pouch. Supposedly, such vent filters allow the interior of the pouch to continuously communicate with the exterior through the filter, such that any gas accumulation may automatically pass outward through the filter as function of pressure differentials. In actual practice, however, such filters have experienced substantial difficulty and lack of success, since they often become clogged from the materials inside the pouch, and thus rendered inoperative, leaving the user with no alternative but the old conventional one indicated above. In other instances, such filters have sometimes leaked fluid through them from the inside, causing obviously undesirable results, or else they have simply not been effective or reliable in permitting passage of the accumulated gas outwardly. Accordingly, colostomy patients continue to experience the basic underlying difficulty and associated problems, giving rise to a continuing need for an ostomy pouch having a truly reliable and effective vent device. Web site: http://www.delphion.com/details?pn=US06015399__

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Ostomy plug-pouch Inventor(s): D'Amico; Ben A. (563 Emily Dr., Lilburn, GA 30093) Assignee(s): None Reported Patent Number: 4,941,869 Date filed: October 17, 1988 Abstract: An ostomy pouch having a plug for the stoma and a pouch to collect natural discharges. The plug stops the natural discharges from collecting in the pouch. The pouch is employed to catch any discharges that might leak through the plug and to form a reservoir when the plug is dislodged. Such a reservoir is especially required when one is in training for the use of the stoma plug. The pouch has an openable top through which the user can reach to remove the stoma plug so that the contents of the colon can be drained into the pouch. The bottom of the pouch is also openable, allowing the user, when sitting on a water closet, to drain the pouch into the toilet without undressing any more than would a person without a colostomy. After discharge of the pouch, the bottom drain can be resealed, the plug placed back into the stoma, and the top of the pouch closed.The pouch is detachably mounted on a person's body. As confidence and control in the use of the ostomy plug is developed, the pouch can be used less and less. Excerpt(s): This invention relates to medical and patient care apparatus for colostomy patients. The use of a plug in the stoma allows colostomy patients freedom from having to wear a pouch attached to their person to collect natural discharges. McDonnell, U.S. Pat. No. 4,121,589, discloses a plug that is insertable into the stoma. The plug, which is held in place by a flange with an adhesive surface on the side thereof facing the patient, protrudes only slightly from the wearer's body. McDonnell's device closely parallels one known as the Conseal Plug marketed by Coloplast, Inc. The Conseal plug when under pressure from fluids inside the intestine has been found, however, to leak through the adhesive mounting of the flange. This leakage is especialy common in the case of persons just learning to use such a plug. The embarrassment to the patient from the leakage detracts from his trying the plug long enough to become accustomed to its use. The invention is an unique combination of a stoma plug and a colostomy pouch which answers the needs of a colostomy patient who wants not only freedom from the restraint and embarrassment of having to wear a bulging, partially filled colostomy pouch but also from the leakage that may occur when only a stoma plug is worn. Web site: http://www.delphion.com/details?pn=US04941869__

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Pillow for colostomy Inventor(s): MacDonald; J. Bradford (511 Skyview Ave., Clearwater, FL 33516) Assignee(s): None Reported Patent Number: 4,234,974 Date filed: September 27, 1978 Abstract: A seating device is disclosed for use with a water closet to aid a patient in recovering from a rectum operation such as a colostomy operation or the like. The device is suitable for use with a conventional water closet comprising a bowl having an upper terminating ring. The improvement comprises seat means being positionable above the terminating ring of the bowl for providing a seating surface. The seating surface includes a first support extending around the terminating ring of the bowl in a

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conventional manner. The invention comprises a second support portion extending across the bowl to substantially cover the back region of the bowl to support the area of incision of the patient. The device may comprise a resilient pillow or a plastic member for positioning on a conventional water closet seat. In the alternative, the device may be permanently mounted to replace the conventional water closet seat. The foregoing abstract is merely a resume of one general application, is not a complete discussion of all principles of operation or applications, and is not to be construed as a limitation on the scope of the claimed subject matter. Excerpt(s): This invention relates to water closets and more particularly to an improved seating device for water closets to aid a patient in recovering from a rectum operation. Various types of seating devices have been devised to aid in the comfort and support of a person using a water closet. Other seating devices have been specifically designed to present a more favorable ornamental appearance. Still other seating devices have been devised for aiding the comfort of small children in the use of a water closet. The prior art has also developed specific seating devices and accessories to conventional seating devices for aiding the recovery of a hemerrhoid patient and the like. Further, apparati have been devised for relieving constipation by providing accessory supporting members for the person using the water closet. An important area of concern is the comfort and recovery of patients after a rectum operation such as a colostomy operation or the like. The recovery from such an operation is extremely painful and is aggrevated by the present design of conventional water closet seats. The conventional water closet seats do not provide adequate support for the recovering patient from a colostomy operation. Accordingly, the patient undergoes severe pain while sitting on a conventional water closet seat as a result of inadequate support of the area of incision from the colostomy operation. Web site: http://www.delphion.com/details?pn=US04234974__ ·

Post-operative fitting device for a lateral colostomy Inventor(s): Matysiak; Lucien (32 rue Henri Lebert, 68000 Colmar, FR) Assignee(s): None Reported Patent Number: 5,026,361 Date filed: August 9, 1989 Abstract: A device for a side colostomy post-operation installation includes a pair of half-rings. The half-rings include tenons and mortises which fit together to form a ring. The device also includes a solid tube segment and a hollow tube segment which fit together to form a rod. Excerpt(s): The object of the present invention concerns a post-operation fitting device for a side colostomy commonly called "on rod". We known of many different types of "rods" allowing to maintain the colon in place after externalization. Some of these "rods" consist of fragments of rubber or silicone tubes, others are made of glass but all present the major inconvenience that they require a fixation on the skin on each side of the intestine, such fixation being ofter performed with a thread. In addition these "rods" render difficult the installation of a pouch because they require more or less important cut-outs in the cutaneous protection on which this pouch is generally fixed, whose effect is to hinger the system sealing. Web site: http://www.delphion.com/details?pn=US05026361__

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Safety device for colostomy having a wetness detector and alarm Inventor(s): Millot; Philippe (Orgeux, FR), Tavernier; Laurent (Dijon, FR) Assignee(s): Plasto SA (chenove, Fr) Patent Number: 6,171,289 Date filed: October 29, 1999 Abstract: This disposable device for securing an ostomy bag to a stoma created in a patient, of the type comprising means for joining the ostomy bag to an adhesive seal (5) which is applied on the patient via a contact face, a through-passage (8) communicating with the stoma being formed in the adhesive seal (5), of which the contact face on the patient is at least partially covered by an adhesive composition, is characterized in that the adhesive seal (5) additionally comprises means (15, 16, 17, 18, 19) for detecting wetness of the adhesive composition and means for triggering an alarm when a predetermined level of wetness is reached in the adhesive composition. Excerpt(s): The present invention concerns a novel device intended to prevent the risk of inadvertent detachment of an adhesive seal providing for the leaktightness of a colostomy. In certain diseases such as cancer of the colon, it may be necessary to modify the natural course of the intestine and to perform a colostomy, that is to say establish an artificial outlet from the intestine through the abdomen wall, the orifice created being called a stoma and having to be connected to an exchangeable plastic ostomy bag. In practice, the plastic bag must be connected in a leaktight manner to the stoma and, in order to do this, use is made of an adhesive seal which is fixed directly on the patient's skin. This adhesive seal can be directly integral with the bag, which means that the whole assembly must be detached from the skin each time the bag is changed. A system made up of two parts is now more often preferred: a first part comprises the adhesive part to be fixed on the skin, integral with a joining device on which the exchangeable ostomy bag is fixed; this assembly allows the adhesive part to be left in place for several days, which limits the risks of skin irritation caused by repeated removal and fitting of an adhesive. However, there is the problem of knowing at what time it becomes necessary to change the adhesive seal; indeed the adhesive layer of the seal gradually loses its effectiveness until such time as the possible appearance of leaks with unpleasant consequences; it therefore seemed desirable to have a system capable of signalling the need to change the adhesive seal. It is also known that the adhesive part of the device in direct contact with the skin is preferably an adhesive composition charged with hydrocolloid, the said adhesive composition charged with hydrocolloid being generally well tolerated by the skin in the case of long-term applications. Moreover, as the hydrocolloid is hydrophilic, it gradually absorbs the biological fluids present in the environment, which eliminates one of the causes of the deterioration in the adhesive power of the device as a whole. Web site: http://www.delphion.com/details?pn=US06171289__

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Safety latch for a removable clip for a colostomy bag Inventor(s): Klinck; Barry W. (4680 Brandywine Dr., Baco Raton, FL 33487) Assignee(s): None Reported Patent Number: 5,619,775 Date filed: January 11, 1996

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Abstract: A safety latch for a clip that is conventionally used to sealably close the opening in an ostomy or colostomy bag. The purpose of the safety latch is to prevent the accidental disengagement of the clip arms when engaged to the colostomy bag opening, forming a seal therein. The safety latch includes a resilient latch that, when engaged between the arms of the clip, is in a stretched condition, putting the clip arms in tension. The safety latch can be removed manually by additional stretching of the resilient member that holds the arms together. Excerpt(s): This invention relates generally to ostomy and colostomy bag clips which are removable and that form seals on openings in a colostomy bag and specifically, to a safety latch for the ostomy bag closure clip to prevent accidental disengagement of the clip from the bag. Colostomy and ostomy bags are used with patients to allow for disposal of bodily waste which collects in the ostomy bag. The bag typically has a lower opening end which has traditionally been sealed by a clip. When the bag is to be emptied, the clip is manually removed, allowing the bag contents to be disposed of. Because of the physical demands on such clips to only be released when required, it is imperative that the clip remain firmly in place, regardless of the movements of the user, at all times, until manually disengaged by the user. Web site: http://www.delphion.com/details?pn=US05619775__ ·

Sound-insulated gas-diverting colostomy container Inventor(s): Lancaster; Frank R. (157 Hamtom Rd., Eighty-Four, PA 15330), Moore; Diane (1633 Cordwell Dr., Library, PA 15129) Assignee(s): None Reported Patent Number: 6,050,983 Date filed: October 27, 1998 Abstract: A colostomy container that is worn by individuals who are in need of a means of passing feces and urine. The container isolates flatus from fecal matter and is capable of containing both excrement elements in separate chambers. Particularly, the stool is collected in a bottom chamber that is disposable, and a spring actuated ball check prohibits reverse flow of fecal matter back into the stoma. The flatus is collected in a top chamber where it is deodorized with a graphite filter and vented. The center of the container is insulated with foam to reduce noise resulting from waste products exiting the stoma and entering the container. Excerpt(s): The present invention is an accessory for use by individuals who have been inflicted with cancers, stomach or bowel wounds, or other bowel disorders, and who then must rely on an alternate means of removing excrement and gas from the body. The device is a portable and inexpensive, Sound-Insulated Gas-Diverting Colostomy Container. It provides a means of diverting gas from fecal matter while the colostomy bag operates to isolate the colon, intestine, or anus during defecation. The instant invention is worn by the patients who are in need of a short or long-term means of passing feces and urine. It can be contoured to the body for comfort and easily disposed of and replaced. Lightweight, sound and odor-insulating, and relatively inconspicuous, the container provides the user proper, quiet, and convenient care. The Prior Art encompasses a variety of colostomy and enterostomy related appliances. Also included are accompanying devices developed to improve ostomy care. Web site: http://www.delphion.com/details?pn=US06050983__

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Support device for emptying colostomy bag Inventor(s): Middlestead; Robert E. (HC #3 Box 78, Tionesta, PA 16353) Assignee(s): None Reported Patent Number: 5,671,485 Date filed: September 29, 1995 Abstract: A device which is specifically adapted to support a colostomy bag over the opening of a toilet. This device, which facilitates the cleaning of the bag by a user or a care giver, includes a support formed from a metallic wire. This metallic wire support has a first grasping end, a second grasping end and a circular spring formed therebetween. The first grasping end is adapted to removably grasp one rim of a toilet. Oppositely positioned from the first grasping end is a second grasping end. The second grasping end is adapted to removably grasp the opposite rim of the toilet. The centrally disposed spring functions to support the upper end of a colostomy bag. Thus what has been described is a device which can support a colostomy bag over the opening of a toilet. Excerpt(s): The present invention relates to third hand and more particularly pertains to a device for use in supporting a colostomy bag over a toilet. The use of disposable bag toilets is known in the prior art. More specifically, disposable bag toilets heretofore devised and utilized for the purpose of disposing of waste are known to consist basically of familiar, expected, and obvious structural configurations, notwithstanding the myriad of designs encompassed by the crowded prior art which has been developed for the fulfillment of countless objectives and requirements. For example, U.S. Pat. No. 4,203,172 to Goncalves discloses a support for a toilet bowl deodorizer block. Web site: http://www.delphion.com/details?pn=US05671485__

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Surgical method for using an intraintestinal bypass graft Inventor(s): Ravo; Biagio (c/o Nassau Hospital, 259 First St., Mineola, NY 11501) Assignee(s): None Reported Patent Number: 4,905,693 Date filed: November 16, 1988 Abstract: A technique whereby leakage from an anastomosis and problems directly resulting from such leakage are eliminated. The technique is an anastomosis procedure for securing intraintestinal bypass graft formed preferably of a soft latex or silastic tube with a radiopaque axial line for x-ray observation after implantation. The ends of the tube are sutured or stapled to the mucosal or submucosal linings, and after a period of about 10 to 15 days during which the anastomosis is healing, the bypass graft separates naturally from the wall of the intestine, and is finally expelled naturally from the anus. This graft prevents leakage at the anastomosis and thus substitutes for and makes unnecessary a colostomy or any other diversionary procedure. Excerpt(s): The invention is in the field of surgery and particularly in the field of intestinal surgical procedures concerning resection, anastomosis, colostomy, esophagostomy, and the like. The technique of surgical colostomy as a temporary solution to various colonic disorders has become an accepted and standard procedure for temporarily resolving the problems where a section of diseased colon must be removed for reasons such as diverticulitis, cancerous obstruction, perforation, trauma,

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etc. The technique of surgical cervical esophagotomy and tube gastrotomy are also accepted temporary procedures designed to protect esophageal anastomoses. The major problem with intestinal anastomoses, especially those of the colon and esophagus are anastomotic dehiscences which are associated with high morbidity and mortality. Web site: http://www.delphion.com/details?pn=US04905693__ ·

Temporary colostomy apparatus Inventor(s): Eisenberg; Melvin I. (3849 Swanson Ct., Gurnee, IL 60031), Polin; Stanton G. (8620 N. Keeler Ave., Skokie, IL 60076) Assignee(s): None Reported Patent Number: 5,261,898 Date filed: November 13, 1990 Abstract: A temporary colostomy apparatus for diverting the fecal stream and comprising an open ended excrement tube including a fecal receiving end having a liquid inflatible balloon on the outside thereof. A dissolvable and absorbable band is snugly wrapped around the outside of the colon at a preselected location. The tube is inserted inside the colon through a slit opening, so that the balloon is further inward but adjacent the band. The balloon is inflated so that the outer circular periphery thereof contacts the inside surface of the arrested colon and has a circumference slightly larger than the band. The inflated balloon and the band are in an abutting relationship with a common area of the colon sandwiched therebetween, to prevent outward movement of the tube. A retainer ring is positioned on the disposal end of the tube and pressed against the outside of the body to prevent inward movement of the tube. A disposable bag is secured to the disposal end of the tube on the outside of the body for collecting the fecal stream fully diverted into the receiving end of the tube. The colon is sutured to the abdominal wall adjacent the surgical openings in the colon and abdomen, to further stabilize the position of the tube inside the colon. When normal colon and rectal bowel functions could be resumed and prior to any substantial dissolving of the band, the balloon is deflated and the excrement tube is removed from the colon. The band remains encircled around the colon and in time the band is dissolved, absorbed and excreted from the body. Excerpt(s): This invention relates generally to a colostomy apparatus for evacuating fecal matter, and more particularly relates to a temporary colostomy apparatus for totally diverting the fecal stream. A colostomy is a vent in the colon for the purpose of evacuating fecal matter and gas. Depending upon the patient's specific condition, the colostomy may be permanent or temporary. A temporary colostomy can be constructed to partially or totally divert the fecal stream. In the past, a colostomy generally required that the bowel be extended out from an abdominal incision. A colostomy pouch usually supported by a belt or girdle was kept constantly in position to receive the fecal matter discharged during the colostomy. This arrangement is extremely objectionable due to the frequent escapage of foul odors and leakage of the fecal matter onto the body and wearing apparel. Sometimes instead of a belt or girdle, the colostomy bag was fixidly positioned against the outside of the abdominal wall with an adhesive. The adhesive often caused irritation, which chafed or maserated the abdominal skin. Web site: http://www.delphion.com/details?pn=US05261898__

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Patent Applications on Colostomy As of December 2000, U.S. patent applications are open to public viewing.7 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 colostomy: ·

Closed drainage system for irrigating ostomies Inventor(s): King, Lori L.; (Danville, VA) Correspondence: Littman Law Offices, LTD.; P.O. Box 15035 Crystal City Station; Arlington; VA; 22215; US Patent Application Number: 20030229324 Date filed: June 11, 2002 Abstract: A closed drainage system for irrigating ostomies which consists of 1) a standard hospital enema bag and tube, 2) a colostomy bag with a stop cock valve and with a flapped opening for receiving an enema bag tube, 3) a collection bag tube, and 4) a collection bag with hanging hooks and a drain spout. The system allows for large volume ostomy irrigation and, further, allows for the products of irrigation to be enclosed until their controlled removal thereby containing offensive odors, preventing soiled sheets and reducing the risk of spreading infectious diseases. Excerpt(s): The present invention relates to medical devices for ostomy irrigation and, more particularly, to a closed drainage system which allows for the irrigation of an ostomy without requiring the user to stand over a toilet or subjecting the user, and others in his or her vicinity, to offensive odor, soiled sheets or unsightly drainage of human waste. Significantly, in a hospital or other health care facility setting, the invention decreases the likelihood of spreading infectious disease--such as HIV, MRSA, VRE, and hepatitis--by minimizing or eliminating contact with human waste related to ostomy irrigation. A colostomy is a surgical procedure in which the colon or a portion thereof is removed and the digestive track is attached to an opening created in the abdominal wall, thereby, allowing digestive waste to pass through the abdomen. Typically, the waste is then collected by an impervious bag that is secured over the opening. The opening which results from a colostomy is known as an ostomy or a stoma, and the impervious bag that collects the digestive waste is known as a colostomy bag. An individual who has had a colostomy must typically remove and empty the colostomy bag several times a day, and must irrigate the ostomy at least every other day to maintain good health and sanitation. An ostomy is irrigated by applying flowing water into the ostomy, and then allowing the water to drain. The prior art discloses several devices for irrigating an ostomy in a sanitary manner in which the user must stand over or sit on a toilet. However, in a hospital or other health care facility setting, an individual with an ostomy may be confined to bed and therefore may be unable to position his or herself near a toilet. In such circumstance, flowing water is typically applied to the ostomy via a standard enema bag and enema bag tube. A basin or bed pan is typically placed under the individual to collect the water as it drains from the ostomy. Unfortunately though, irrigating an ostomy in this manner usually results in soiled sheets, unpleasant odors, unsightly and unsanitary drainage of human waste and, significantly, the increased chance of contact with human waste by a health care provider such as a nurse or nurse's aid. Furthermore, irrigation performed in this

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

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manner is often humiliating and embarrassing to the patient and/or the patient's guests or visitors. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Colostomy bag with gas release valve and method for releasing gas collected in the colostomy bag Inventor(s): Silvestrini, Edgar Ignacio; (Chicago, IL) Correspondence: Patents+tms; A Professional Corporation; 1914 North Milwaukee Avenue; Chicago; IL; 60647; US Patent Application Number: 20030236509 Date filed: June 25, 2002 Abstract: A colostomy bag with a release valve and a method for releasing gas from the colostomy bag is provided. The release valve is attached to a colostomy bag for release of gas in the colostomy bag. The gas may be released manually by a person with the use of one hand. Accordingly, a person who is disabled or otherwise incapable of using two hands, may release gas from the colostomy bag and prolong the use of a single bag by extending the time it may take for the bag to fill. In addition, a method for releasing gas collected in a colostomy bag is provided such that the frequency of replacing and/or intermittently cleaning the colostomy bag is reduced. Excerpt(s): The present invention generally relates to a colostomy bag with a release valve and a method for releasing gas collected in the colostomy bag. More specifically, the present invention relates to a gas release valve attached to a colostomy bag for releasing gas trapped in the bag. In addition, the present invention relates to a method for releasing gas collected in a colostomy bag such that replacement and/or cleaning of the colostomy bag is reduced. After the surgical removal of the large intestine of a patient due to, for example, colon cancer, severe acute obstruction, trauma, gunshot wounds, and/or the like, a patient may require a means for removing bodily waste. A colostomy bag is generally used by a patient after the surgical removal of the large intestine performed during a colostomy. A colostomy is a surgical procedure in which an artificial permanent opening, referred to as a stoma, is provided and through which the colon may be artificially evacuated. Bodily waste exits the body by passing through the stoma into a colostomy bag. After the bag is full, the bag is usually detached from the stoma, discarded, and replaced. The frequent removal and replacement is burdensome, inconvenient, and often irritating to the patient. Further, the colostomy bag is generally fitted with a clamp such that the waste may be removed while the bag is still attached to the body of the user. During use, gases and other waste from the body fill the bag and may be released through removal of the clamp. The gas causes the bag to blow up and becomes uncomfortable and very bulky when worn by the user. The gas can be so great as to pull the bag away from the body. This causes discomfort to the user and/or exposes the user to infection. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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COLOSTOMY PUMP AND AID Inventor(s): LAPCEVIC, MILOS; (SYDNEY, AU) Correspondence: Bruce S. Londa; Norris, Mclaughlin & Marcus P.A.; 220 East 42nd Street; 30th Floor; New York; NY; 10017; US Patent Application Number: 20010023337 Date filed: September 10, 1998 Abstract: A waste evacuator (2) to vacate waste products from a stoma having an inlet (3) adapted to seal over the stoma and when operated to vacate waste products from the shortened bowel. The waste evacuator could be battery or manually operated. Excerpt(s): The present invention relates to an aid for patients who have undergone a colostomy, and in particular to a means to vacate and a method of vacating the waste products from patients who have undergone a colostomy, and an improved colostomy flange and plug cover. This wafer is provided with a sealing lip to which the various appliances, such as waste collection pouches, necessary for the well being of the ostimist is connected. The only existing means of collecting waste from the ostimist is by means of collection pouches, which must be removed and replaced with a fresh collection bag. Also it is necessary to replace the wafers at the required intervals. This is usually a messy and time consuming operation, for the ostimist, as less viscous wastes leak from the stoma. The present invention seeks to provide an improved apparatus for vacating waste products from the stoma by providing a colostomy evacuator, which is adapted to seal over the stoma and when operated to vacate the waste products held in the shortened bowel. This would lessen or remove the need for the use of a collection pouch. Further the ostimist, could vacate the less viscous wastes, from the shortened bowel, before the wafer is removed to make the replacement of the wafer cleaner and easier. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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SANITARY POUCH WASHER Inventor(s): Deecki, Robert George; (Archbald, PA) Correspondence: Joseph Debenedictis; Bacon & Thomas; 625 Slaters Lane - 4th Floor; Alexandria; VA; 22314; US Patent Application Number: 20030034055 Date filed: April 17, 2002 Abstract: A device for cleaning the interior and exterior of a colostomy pouch or the like. The device includes a middle water sprayer for cleaning the interior of the pouch and two lateral water sprayers for cleaning the exterior of the pouch. The water sprayers are attached to a conduit which is connected to a source of water such as a flexible hose connected to a faucet. A water shield is provided to prevent the operator from being sprayed during the cleaning procedure. The waste material cleaned from the pouch is discharged through the spray shield into a conventional toilet where the water and waste is removed by flushing the toilet. Excerpt(s): This application claims the benefit of provisional application no. 60/313,351 filed on Aug. 8, 2001. The present invention pertains to the cleaning of colostomy pouches or bags and related bags which become contaminated with waste. More particularly, this invention relates to a device for cleaning such bags or pouches and a

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method for cleaning such bags or pouches, particularly a colostomy bag or pouch. Certain diseases and physical conditions require surgical intervention which involves the creation of an opening or orifice in the patient's body for the elimination of human waste therefrom. The waste, such as fecal material exits through the surgically created orifice or opening. Since the opening for the elimination of waste has been surgically created, the patient does not have any muscular control which could be used to effectively open and close the opening. Therefore, the patient is forced to wear a waste collection bag or pouch which is adapted to receive the waste from the opening in a sanitary manner so that the waste can be collected in the bag without leakage therefrom. Periodically, the bag must be detached from the opening so that the waste contents can be eliminated. It is therefore necessary to periodically clean the bag before it is used again. Typical surgical procedures which result in the creation of an orifice in the body for waste elimination include colostomy, surgical procedures, ileostomy surgical procedures and the like. These surgical procedures are generally referred to as ostomies and the waste collection containers are generally called ostomy pouches. Thus, for example, the pouch used by a colostomy patient is typically referred to as a colostomy pouch. 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 colostomy, 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 “colostomy” (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 colostomy. You can also use this procedure to view pending patent applications concerning colostomy. 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 COLOSTOMY Overview This chapter provides bibliographic book references relating to colostomy. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on colostomy include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

You and Your Colostomy: Simple Explanations of Psychological and Physical Problems. Revised edition Source: Akron, OH: Worldwide Home Health Center, Inc. 1995. 135 p. Contact: Available from Worldwide Home Health Center. 926 East Tallmadge Avenue, Akron, OH 44310. (800) 621-5938 or (330) 633-0366. PRICE: $12.00 plus $4.00 shipping and handling. Summary: This book provides basic explanations of psychological and physical issues that may face persons with colostomies. Seventeen chapters cover an introduction, colostomy types, post-operative care, care of the colostomy, information about appliances, deciding about irrigation, irrigation of the colostomy (enema), odor barriers, skin problems, miscellaneous problems that might be encountered, miscellaneous information for the person with a colostomy, nutrition, everyday living with a colostomy, sources of help, professional and volunteer organizations, a manufacturer's

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index, and a glossary. The book is written in an easy-to-read, friendly style, with line drawings and photographs illustrating many of the concepts presented. The book is spiral bound to facilitate updates. 14 references. ·

Ostomy Book: Living Comfortably with Colostomies, Ileostomies, and Urostomies Source: Palo Alto, CA: Bull Publishing Company. 1992. 343 p. Contact: Available from Bull Publishing Company. P.O. Box 208, Palo Alto, CA 94302. (415) 322-2855. PRICE: $12.95 plus shipping and handling. ISBN: 0923521127. Also available from United Ostomy Association, Inc. Attn: Publications, 19772 MacArthur Boulevard, Suite 200, Irvine, CA 92612. (800) 826-0826 or (714) 660-8624. E-mail: [email protected]. PRICE: $12.95. Summary: This handbook provides detailed information and practical guidelines to aid patients with colostomies, ileostomies, and urostomies. The 28 text chapters address: the nature of an ostomy; what to expect before and after surgery; adjusting to lifestyle changes; permanent colostomies; ileostomies and alternatives; urostomies; skin care; pouch skills; temporary ostomies; nutritional guidelines; personal appearance; sex and pregnancy; children and teenagers with ostomies; checkups and follow-up care; getting back to work; sports and exercise; travel; enterostomal therapy; and the history of the United Ostomy Association. Resources for further information and assistance, a glossary, and a subject index are appended.

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Don't Die of Embarrassment: Life After Colostomy and Other Adventures Source: New York, NY: Simon and Schuster. 1997. 256 p. Contact: Available from Simon and Schuster. Mail Order, 100 Front Street, Riverside, NJ 08075. (800) 331-6531. E-mail: [email protected]. Website: www.simonsays.com. PRICE: $12.00 plus shipping and handling. ISBN: 0684846241. Summary: When the successful actress Barbara Barrie received a diagnosis of colorectal cancer in 1993, she knew that this was the greatest crisis she and her family would face. But it also became an adventure that, through courage and humor, brought new joys and a greater appreciation to her life. More than just a memoir, this book provides valuable information about the ostomy experience. Throughout the book, Barrie gives essential information about the occurrence of colon cancer, its symptoms, and treatment options, and guidelines for people learning to adjust to an altered lifestyle after surgery. The book is written in a conversational, story style, with Barrie sharing her thoughts and fears. The book includes an afterword, written by Dr. Otis W. Brawley, that offers some practical information about diagnosis, screening, warning signs, prevention, and treatment of colon cancer. The book concludes with a chapter describing additional sources of information, and a subject index.

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 PrintÒ). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical

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books. When searching for “colostomy” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “colostomy” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “colostomy” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): ·

All about a colostomy by E. S. R. Hughes; ISBN: 020795285X; http://www.amazon.com/exec/obidos/ASIN/020795285X/icongroupinterna

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Colostomy: a Guide for Cancer; ISBN: 0949015180; http://www.amazon.com/exec/obidos/ASIN/0949015180/icongroupinterna

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Colostomy: A Second Chance. by Sylvene Dillon. Happenie; ISBN: 0398007756; http://www.amazon.com/exec/obidos/ASIN/0398007756/icongroupinterna

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DON'T DIE OF EMBARRASSMENT : LIFE AFTER COLOSTOMY AND OTHER ADVENTURES by Barbara Barrie (Author); ISBN: 0684846241; http://www.amazon.com/exec/obidos/ASIN/0684846241/icongroupinterna

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Living With a Colostomy; ISBN: 0722506813; http://www.amazon.com/exec/obidos/ASIN/0722506813/icongroupinterna

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Living With a Colostomy: Practical Advice on Overcoming the Problems by Margaret Schindler; ISBN: 0855002220; http://www.amazon.com/exec/obidos/ASIN/0855002220/icongroupinterna

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Living With Colostomy by Margaret Schindler; ISBN: 0809570912; http://www.amazon.com/exec/obidos/ASIN/0809570912/icongroupinterna

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Second Act: Life After Colostomy and Other Adventures by Barbara Barrie; ISBN: 0684835878; http://www.amazon.com/exec/obidos/ASIN/0684835878/icongroupinterna

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The care of your colostomy by J. C. Goligher; ISBN: 070200278X; http://www.amazon.com/exec/obidos/ASIN/070200278X/icongroupinterna

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The First Step: A Book for Colostomy Patients by Kay Marshall; ISBN: 0916999068; http://www.amazon.com/exec/obidos/ASIN/0916999068/icongroupinterna

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The Ostomy Book: Living Comfortably With Colostomies, Ileostomies, and Urostomies by Barbara Dorr Mullen, Kerry Anne McGinn (Contributor); ISBN: 0923521127; http://www.amazon.com/exec/obidos/ASIN/0923521127/icongroupinterna

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What should I know about my colostomy? (SuDoc VA 1.2:C 71) by Cynthia Bowles; ISBN: B00010CHSM; http://www.amazon.com/exec/obidos/ASIN/B00010CHSM/icongroupinterna

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

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Colostomy Source: in Carlson, K.J.; Eisenstat, S.A.; Ziporyn, T. Harvard Guide to Women's Health. Cambridge, MA: Harvard University Press. 1996. p. 164-165. Contact: Available from Harvard University Press. Customer Service Department, 79 Garden Street, Cambridge, MA 02138. (800) 448-2242. Fax (800) 962-4983. PRICE: $24.95 (paperback). ISBN: 0674367693 (paperback). Summary: This chapter on colostomy is from a consumer handbook on women's health. The chapter explains when colostomy surgery may be necessary, how the procedure is performed, what happens after the surgery, possible complications, and risk factors. The authors also discuss postoperative problems with sexual dysfunction, and pregnancy and childbearing in women who have had a colostomy. The chapter concludes with a reference to related chapters in the book.

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Colostomy Types Source: in Gill-Thompson, N.N.; Thompson, S.J. You and Your Colostomy: Simple Explanations of Psychological and Physical Problems. Akron, OH: Worldwide Home Health Center, Inc. 1990. p. 5-15. Contact: Available from Worldwide Home Health Center, Inc. 926 East Tallmadge Avenue, Akron, OH 44310. (216) 633-0366 or (800) 621-5938 (Ohio); (800) 223-5938 (National). PRICE: $12 plus $3 postage. Summary: This chapter, from a book about the psychological and physical issues facing people who have colostomies, describes the different types of colostomies that surgeons create. The authors stress that it is useful for the patient to learn the difference both in the colostomies themselves and in the nature of the discharge coming from each type. Sections discuss colostomy, cecostomy, transverse colostomy, descending colostomy, and sigmoid colostomy. The second half of the chapter consists of line drawings of each of the different types of colostomies.

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Recent Advances in Colostomy Care Source: in Assal, J., Golay, A., and Visser, A.P., eds. New Trends in Patient Education: A Trans-Cultural and Inter-Disease Approach. Amsterdam, The Netherlands: Elsevier Science B.V. 1995. p. 349-352. Contact: Available from Elsevier Science. Regional Sales Office, Customer Support Department, 655 Avenue of the Americas, New York, NY 10010. (212) 633-3730. Fax (212) 633-3680. E-mail: [email protected]. PRICE: $209.50. ISBN: 0444822348. Summary: This chapter, from the proceedings of an international patient education conference, describes recent advances in colostomy care. The author discusses three kinds of stoma care, paying particular attention to several advances and setbacks. These include the natural evacuation method, the irrigation management of sigmoid colostomy, and the Conseal Colostomy Plug. The chapter describes special conditions of colostomy care in China. 2 tables. (AA-M).

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CHAPTER 8. MULTIMEDIA ON COLOSTOMY Overview In this chapter, we show you how to keep current on multimedia sources of information on colostomy. 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 colostomy is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “colostomy” 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 “colostomy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on colostomy: ·

Living With a Colostomy Source: Plainfield, NJ: Patient Education Press. 1993. Contact: Available from Patient Education Press. 417 Cleveland Avenue, Plainfield, NJ 07060. (800) 633-5007 or (908) 757-9089. PRICE: $79.95 plus shipping and handling (as of 1995). Summary: This patient education videotape provides information about a colostomy. The video is designed to help build confidence in people facing the procedure. It can also be used as a patient resource after hospitalization. The surgery is explained through animation. Patients and medical professionals discuss the following topics: the role of the enterostomal therapist (ET); care of the stoma; diet; exercise; emotional adjustment; and quality of life. (AA-M).

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Changing A Colostomy Bag Source: Evanston, IL: Altschul Group Corporation. 1990.

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Contact: Available from Altschul Group Corporation. Health Division, 930 Pitner Avenue, Evanston, IL 60202. (800) 421-2363 or (708) 328-6700. PRICE: $250. Order Number ME-9975. Summary: This videocassette reviews the basics of the procedures required in changing an ostomy bag. The proper techniques are demonstrated using patient models. This videocassette is appropriate for all health care professionals, especially students and returning practitioners. (AA-M).

Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio 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 “Sound Recordings.” Type “colostomy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on colostomy: ·

Guidebooks on Audio Cassette Tape Source: Irvine, CA: United Ostomy Association (UOA). 1994. (audiocassettes). Contact: Available from United Ostomy Association, Inc. Attn: Publications, 19772 MacArthur Boulevard, Suite 200, Irvine, CA 92612. (800) 826-0826 or (714) 660-8624. Email: [email protected]. PRICE: $8.00 for set of four tapes. Summary: This set of audiocassettes corresponds with four patient education guidebooks from the United Ostomy Association covering colostomy, urostomy, continent urostomy, and ileostomy. For each type of ostomy, the cassettes cover the ostomate Bill of Rights; facts about that type of ostomy; the variations within that type of ostomy; methods of ostomy care; helpful ideas and practical tips; ostomy complications, including when to contact the health care provider; living with a colostomy; and resource organizations. Each tape concludes with a glossary of terms.

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CHAPTER 9. PERIODICALS AND NEWS ON COLOSTOMY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover colostomy.

News Services and Press Releases One of the simplest ways of tracking press releases on colostomy 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 “colostomy” (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 colostomy. 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 “colostomy” (or synonyms). The following was recently listed in this archive for colostomy: ·

Need for diversion/colostomy questioned in management of penetrating colon injuries Source: Reuters Medical News Date: May 31, 2001

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine.

Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name.

Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “colostomy” (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 “colostomy” (or synonyms). If you know the name of a company that is relevant to colostomy, 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 “colostomy” (or synonyms).

Newsletters on Colostomy Find newsletters on colostomy using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following

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hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “colostomy.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “colostomy” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: ·

Anorectal Malformations Source: TEF/VATER Support Newsletter. p. 3-4. Spring 1993. Contact: Available from TEF-VATER Support Network. c/o Terri Burke, 15301 Grey Fox Road, Upper Marlboro, MD 20772. (301) 627-2131. Summary: This newsletter article, written for parents, provides information about neonatal anorectal malformations. The author stresses that, although there is wide variety in the types of anorectal defects, there are certain categories or types of defects with similar prognoses and management. Topics include general neonatal management; minimal defects that do not require a colostomy; colostomy as a first therapeutic step; main repair operations, notably the procedure of posterior sagittal anorectoplasty; colostomy closure; toilet training, including both urinary and bowel control; and the role of reoperations. The author includes a brief glossary of medical terms. One sidebar reviews basic embryonic development.

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

What Is the Role of the Pediatric Surgeon in the Care of Children With Motility Disorders? Source: Messenger: Newsletter of the American Pseudo-Obstruction and Hirschsprung's Disease Society, Inc. 7(2): 8-9. Summer 1995. Contact: Available from APHS. 158 Pleasant Street, North Andover, MA 01845-2797. (508) 685-4477. Fax (508) 685-4488. E-mail: [email protected]. Summary: In this article, the author describes the various roles that the pediatric surgeon may play in the care of children with motility disorders. Topics include Hirschsprung's disease; neuronal intestinal dysplasia (NID); gastroesophageal reflux; gastrostomy and jejunostomy; laparoscopic surgery; and the use of central venous catheters. The author notes that pediatric surgeons may become involved in the care of a child suffering from a motility disorder in order to establish a diagnosis, to perform a therapeutic procedure such as a pull-through for Hirschsprung's disease or a fundoplication for gastroesophageal reflux, or to provide ancillary and supportive measures such as a central venous catheter or gastrostomy. The author also provides

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readers with an update on recent advances in surgery for motility disorders in children, such as primary pull-through without colostomy, and laparoscopic surgery. ·

Disorders of Defecation in Children: What is the Role of the Surgeon? Source: Digestive Health in Children. 2(1): 1-3. Spring 2002. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. Website: www.iffgd.org. Summary: This article answers some common questions about the role of the surgeon in managing disorders of defecation in children. The inability to defecate in children is usually due either to a problem with formation of the anus or with the inability of the colon to push the stool from one end to the other. The inability to control the passage of stool may be due to inadequate muscle, impaired sensation, or severe constipation (with overflow incontinence). The author first reviews the physiology of normal defecation and the pathology that might cause defecation disorders. The author then describes the symptoms of different causes of defecation disorders and the types of surgical procedures that may be used to correct those disorders. Topics include low anorectal malformations, high anorectal malformations, the indications for colostomy, Hirschsprung's disease, persistent constipation, colonic motility disorders, the inability to control defecation (fecal incontinence), techniques to improve sphincter function, and surgical aids to bowel management.

Academic Periodicals covering Colostomy Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to colostomy. In addition to these sources, you can search for articles covering colostomy 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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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

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

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

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

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

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

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

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

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

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

8

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

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

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

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

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

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

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

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

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

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

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

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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

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

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

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

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

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

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

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

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

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

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

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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

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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/

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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

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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

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

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

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

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

The NLM Gateway11 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “colostomy” (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 7700 192 47 5 10 7954

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

11

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

12

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

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

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

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

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

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

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

16 Adapted from 17

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

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

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on colostomy 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 colostomy. 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 colostomy. 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 “colostomy”:

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Other guides Colonic Diseases http://www.nlm.nih.gov/medlineplus/colonicdiseases.html Colorectal Cancer http://www.nlm.nih.gov/medlineplus/colorectalcancer.html Crohn's Disease http://www.nlm.nih.gov/medlineplus/crohnsdisease.html Ulcerative Colitis http://www.nlm.nih.gov/medlineplus/ulcerativecolitis.html

Within the health topic page dedicated to colostomy, the following was listed: ·

General/Overviews Ostomies: What Are They and How Do They Work? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=GA00005 Ostomy FAQs Source: United Ostomy Association http://www.uoa.org/ostomy_faqs.htm What Is an Ostomy? Source: United Ostomy Association http://www.uoa.org/ostomy_main.htm

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Coping Coping With a Colostomy: One Man's Story Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_2_1x_Coping_With_a_Colo stomy_One_Mans_Story.asp Sex and the Female Ostomate Source: United Ostomy Association http://www.uoa.org/ostomy_facts_woman.htm Sex and the Male Ostomate Source: United Ostomy Association http://www.uoa.org/ostomy_facts_man.htm Sex and the Single Ostomate Source: United Ostomy Association http://www.uoa.org/ostomy_facts_single.htm

·

Specific Conditions/Aspects Colostomy http://www.nlm.nih.gov/medlineplus/tutorials/colostomyloader.html Colostomy Source: United Ostomy Association http://www.uoa.org/ostomy_facts_colostomy.htm

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Ileostomy Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00528 Ileostomy Source: United Ostomy Association http://www.uoa.org/ostomy_facts_ileostomy.htm Laparoscopic Intestinal Surgery: A Guide for Patients Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/health/healthinfo/docs/0900/0962.asp?index=4356 Ostomy Products: Selection Considerations, Problems, and Customized Options Source: United Ostomy Association http://www.uoa.org/supplies_main.htm Stomas Source: American Cancer Society http://www.cancer.org/docroot/MBC/content/MBC_3_2X_Stomas.asp?sitearea= MBC Urostomy Source: United Ostomy Association http://www.uoa.org/ostomy_facts_urostomy.htm ·

From the National Institutes of Health Ileostomy, Colostomy and Ileoanal Reservoir Surgery Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/ileostomy/index.htm

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Law and Policy Insurance and Medicare Issues and Rights Source: United Ostomy Association http://www.uoa.org/supplies_medicare.htm

·

Organizations American Society of Colon and Rectal Surgeons http://ascrs.affiniscape.com/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/

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.

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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 colostomy. 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: ·

Guide to Living with a Colostomy Source: Ottawa, ON: Canadian Association for Enterostomal Therapy. 1996. 19 p. Contact: Available from Canadian Association for Enterostomal Therapy (CAET). C/O Canadian Nurses Association, 50 The Driveway, Ottawa, ON K2P 1E2. Website: www.caet.ca. PRICE: Contact publisher for price. Summary: A colostomy is a surgically created opening into the colon. This booklet provides information for patients adjusting to living with a colostomy. The booklet begins with a description of the anatomy and function of the digestive tract and the colon in particular. The booklet then discusses the different types of colostomies, the stoma and different types of colostomy stomas (end colostomy, end colostomy with a mucus fistula or rectal stump, loop colostomy); the pouching systems that are used to contain stool, odor, and gas, and to protect the skin; preoperative preparation; postoperative expectations; colostomy irrigations; gaining independence postoperatively; discharge from the hospital; resuming one's lifestyle (including sexual relations, work, activities, bathing, clothing, and travel); medications; skin care; dietary management (handling excessive gas, odor, diarrhea, and constipation); and postsurgical visits to the health care provider. The booklet concludes with a glossary of related terms, a list of the task force members who participated in the creation of the booklet, and a list of Canadian resources through which readers can obtain additional information. Blank space is available for listing the telephone numbers of the reader's health care providers. 6 figures.

·

Your Colostomy Source: Atlanta, GA: Pritchett and Hull Associates, Inc. 2002 2 p. Contact: Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340-3079. (770) 451-0602 or (800) 241-4925. Fax (800) 752-0510. Website: www.p-h.com. Email: [email protected]. PRICE: Sample copy available online at no charge; $10.50 for tearpad of 50 sheets; plus shipping and handling. Item number: 442. Summary: A colostomy is done when the large intestine can no longer handle waste matter (stool) passing through it. The stool is rerouted around a diseased or damaged area of the colon, and a surgically created opening (a colostomy) is made. This patient education fact sheet helps patients understand colostomies and their care. Written in nontechnical language and illustrated with friendly, colorful graphics, the fact sheet describes colostomy and its indications, everyday activities with a colostomy, and the different types of colostomies (ascending, transverse, descending, and sigmoid). One section reviews practical strategies for patient self-care. 6 figures.

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Colostomy Guide Source: Irvine, CA: United Ostomy Association. 2001. 27 p. Contact: Available from United Ostomy Association, Inc. 19772 MacArthur Boulevard, Suite 200, Irvine, CA 92612-2405. (800) 826-0826. Fax: (949) 660-8624. E-mail: [email protected]. Website: www.uoa.org. PRICE: $3.50. Summary: An colostomy is a surgically created opening in the large intestine (colon), through the abdominal wall, for discharge of bowel contents following disease or injury. This booklet offers colostomy patients suggestions and ideas for managing their colostomy. Topics covered include basic facts about colostomies, different types of colostomies, methods of colostomy care, diet, odor, gas and noise, constipation, diarrhea, equipment and supplies, colostomy complications, and activities of daily life with a colostomy. A brief review of the activities, goals, and contact information of the United Ostomy Association (www.uoa.org); the Wound, Ostomy and Continence Nurses Society(www.wocn.org); and the American Cancer Society (www.cancer.org) is provided. The booklet concludes with a glossary of terms. Simple line drawings illustrate the booklet. 12 figures.

·

Instructions for Colostomy Irrigation Source: Rochester, MN: Mayo Clinic, Patient and Health Education Center. 1991. 2 p. Contact: Available from Mayo Clinic,Patient and Health Education Center. 200 First Street, SW, Rochester, MN 55905. (507) 284-2511. PRICE: $0.15 plus shipping and handling (for health care professionals). Order Number: MC199206. Summary: Colostomy irrigation is one method of managing a colostomy. This patient education fact sheet provides detailed instructions for colostomy irrigation. After a brief explanation of the purpose of colostomy irrigation, the fact sheet lists sixteen instructions in a step-by-step fashion. Topics include equipment and supplies; timing of the procedure; the procedure itself; cleaning the stoma; and reapplying the appliance after the procedure. The publication is printed on cardstock for durability.

·

Colostomy, Ileostomy Rectal Pouch Diet Source: Camp Hill, PA: Chek-Med Systems, Inc. 199x. 7 p. Contact: Available from Chek-Med Systems, Inc. 200 Grandview Avenue, Camp Hill, PA 17011-1706. (800) 451-5797 or (717) 761-1170. Fax (717) 761-0216. PRICE: $0.95 each; minimum order of 10 brochures. Summary: Surgery is often needed to treat certain conditions of the colon (large bowel). Sometimes the surgeon must make an opening on the abdominal wall through which intestinal waste (feces) can pass; this is known as colostomy and ileostomy (depending on where the opening is made). The patient may use a disposable bag to collect the waste matter, or may have an internal pouch created from the small intestine. The brochure reviews the recommended diet for patients who have these type of surgeries. After all of these surgeries, the stool consistency, amount, and frequency will depend on the type and amount of foods eaten. Most patients return to a fairly normal diet, but some foods may have an undesirable effect on the patient's stool. The brochure lists suggestions, including to eat foods at a regular time each day; try eating the main dinner meal at noon; introduce one type of food at a time; chew foods completely to help the digestive process; be aware that fresh fruit may cause loose stool; drink 2 to 3 quarts of water a day; maintain an ideal body weight; limit foods that caused problems prior to

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surgery; and avoid foods that contain large amounts of fiber and bran for 6 to 8 weeks after surgery. The brochure lists foods that are poorly or incompletely digested, foods that tend to form gas, odor reducing foods and medications, odor producing foods, foods that tend to thicken stool, foods that tend to cause diarrhea, and things that cause excess swallowed air and then gas (flatulence). The brochure also includes a sample menu that may be useful for the patient following these guidelines. Ample room is included for patient notes and questions. 1 figure. 2 tables. ·

Colostomy: Postoperative Information Source: Rochester, MN: Mayo Clinic Patient and Health Education Center. 1991. 33 p. Contact: Available from Mayo Clinic. Patient and Health Education Center, 200 First Street SW, Rochester, MN 55905. (507) 284-2511. PRICE: $3; plus shipping and handling. Order Number: MC1992-09. Distribution may be limited to health professionals. Summary: This booklet provides postoperative information to people about to undergo colostomy surgery. Three sections cover postoperative care; the types of colostomies; management of the colostomy; nutritional guidelines; getting ready to go home; resuming daily activities; suggestions for ostomy management, including colostomy irrigation, managing constipation and diarrhea, and locating equipment and supplies; resources; medication identification; preparing for digestive and urinary tract examinations; and the side effects of chemotherapy and radiation on a colostomy. The brochure concludes with a word list of related terms and blank space for the reader to record notes.

·

Colostomy: Preoperative Information Source: Rochester, MN: Mayo Clinic. 1991. 18 p. Contact: Available from Mayo Clinic. Patient and Health Education Center, 200 First Street SW, Rochester, MN 55905. (507) 284-2511. PRICE: $1.50; plus shipping and handling. Order Number: MC1992/R1191. Distribution may be limited to health professionals. Summary: This booklet provides preoperative information to people about to undergo colostomy surgery. Nine sections cover the role of the enterostomal therapist; the digestive system; indications for surgery; the colostomy itself; the surgery; the types of colostomies; preoperative preparation; postoperative routines; and resuming regular activities. The booklet includes blank space for patients to record questions that they might have for their health care providers. A word list of related terms is included. 7 figures.

·

Colostomy Digest Source: Bradenton, FL: CompCare. 1992. 36 p. Contact: Available from CompCare. 5534 Cortez Road West, Bradenton, FL 34210. (800) 877-7317. PRICE: Single copy free. Summary: This booklet serves as a resource guide for patient care following colostomy surgery. After an introductory section explaining the anatomy and function of the lower digestive tract, the booklet discusses sigmoid colostomies, transverse colostomies, ascending colostomies, the stoma and its care, peristomal skin and skin problems, pouches, colostomy irrigations, diet and fluids, medications, sexuality, daily activities,

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travel, financial aid, and follow-up care. The booklet focuses on the step-by-step details of patient self-care and concludes with a glossary of related terms. ·

United Ostomy Association: Mutual Aid, Moral Support and Education for People with Colostomy, Ileostomy or Urostomy Surgery Source: Irvine, CA: United Ostomy Association. 199x. 2 p. Contact: Available from United Ostomy Association, Inc. Attn: Publications, 19772 MacArthur Boulevard, Suite 200, Irvine, CA 92612. (800) 826-0826 or (714) 660-8624. Email: [email protected]. PRICE: Free. Summary: This brochure describes the United Ostomy Association (UOA). After a brief review of ostomy surgery and its prevalence, the purpose and activities of the UOA are detailed. UOA is dedicated to helping every person with an ostomy and related surgeries return to normal living. Sections discuss local Ostomy Association chapters; international affiliation; benefits of membership; publications, including the journal, The Ostomy Quarterly; and conferences. A request form for additional information is included.

·

You Have a Colostomy Source: Atlanta, GA: Pritchett and Hull Associates, Inc. 1996. 16 p. Contact: Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340. (800) 241-4925. PRICE: $1.45 each. Summary: This brochure provides basic information for people who have just received a colostomy. The brochure, written in nontechnical language, encourages readers to learn how to care for their colostomy and to take an active part in their return to good health. The brochure lists and illustrates the four types of colostomies: ascending, transverse, descending, and sigmoid. The brochure then outlines pouch and skin care, including emptying and changing the pouch, the use of an emergency kit, tips for pouch care, and when to contact a health care provider to help manage skin problems. One section describes the use of irrigation, or an enema through the stoma. The brochure concludes with a section on diet, including lists of foods that may cause gas, foods that may thicken the stool, and foods that may loosen the stool. The back cover of the brochure lists contact information for the United Ostomy Association, and the Wound, Ostomy and Continence Nurses Society. The brochure is illustrated with line drawings.

·

General Information About Colostomy Irrigation Source: Santa Barbara, CA: Mentor Urology. 1992. 5 p. Contact: Available from Mentor Urology. 5425 Hollister Avenue, Santa Barbara, CA 93111. (800) 328-3863 or (805) 681-6000. PRICE: Single copy free. Order No. 97014301. Summary: This brochure, written in question-and-answer format, provides information about colostomy irrigation. Topics include why colostomy irrigations are performed, the purpose of an irrigation, which types of colostomies need to be irrigated, the equipment and supplies needed to perform the irrigation process, a step-by-step guide to the procedure, how much water should be used, the best time to irrigate, how to avoid cramps during the procedure, how to treat diarrhea and constipation problems, and supplies used between irrigations. The brochure also provides a guide to the producer's products, noting item numbers next to the line drawings of any item described.

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Living With Your Colostomy: A Guide to Self-Care Source: San Bruno, CA: StayWell Company. 1999. 24 p. Contact: Available from StayWell Company. 1100 Grundy Lane, San Bruno, CA 940663030. (800) 333-3032. Fax (650) 244-4512. Website: www.staywell.com. PRICE: $1.75 each; discounts available for larger quantities. Summary: This patient education booklet provides information for people who have just received a colostomy and for people who are about to undergo colostomy surgery. After an introductory section that emphasizes the important role the patient plays on the health care team, the booklet covers: the anatomy of the digestive tract, how a colostomy works, pouch selection, stoma care, emptying and changing the pouch, irrigating a colostomy to time the bowel movements, avoiding digestive problems, what to do if a food blockage occurs, and psychosocial adjustment to the physical changes accompanying a colostomy. Step-by-step details of the care and maintenance of a stoma and the required supplies are provided. The booklet concludes with a list of common questions and answers, a glossary of terms, and a list of resource organizations. The booklet is illustrated with full-color line drawings that support the concepts and that depict a range of ethnic groups and ages.

·

Colostomy: General Information About Irrigation Source: Santa Barbara, CA: Mentor Corporation. 199x. 10 p. Contact: Available from Mentor Corporation. 600 Pine Avenue, Santa Barbara, CA 93117. (800) 328-3863. PRICE: Single copy free. Summary: This patient education brochure addresses colostomy irrigation, a procedure designed to stimulate the large intestine or colon, for a bowel movement. Written in a question-and-answer format, the brochure covers topics including the purpose of an irrigation; deciding whether or not irrigation is a good choice; the equipment and supplies used for colostomy irrigation; and specific questions about the procedure itself including cramping, diarrhea, and constipation. The brochure also provides a step-bystep guide to performing a colostomy irrigation, including the supplies. The brochure concludes with information about supplies to use between irrigations.

·

Irrigating Your Colostomy Source: San Bruno, CA: Krames Communications. 1997. 2 p. Contact: Available from Krames Communications. Order Department, 1100 Grundy Lane, San Bruno, CA 94066. (800) 333-3032. Fax (415) 244-4512. PRICE: $9.95 for pad of 50 sheets. Summary: This patient education fact sheet provides information for people who have a colostomy. The fact sheet describes the recommended technique of irrigating a colostomy. Irrigating a colostomy allows patients to time their bowel movements. Once a day, or once every other day, the patient flushes the colostomy with warm water. Equipment required for irrigation includes an irrigation kit, hook, and water soluble lubricant. The fact sheet describes and illustrates the five steps for irrigation: filling the bag, putting on the sleeve, inserting the cone, removing the cone and clamping the sleeve, and cleaning the cone and the sleeve. The back side of the fact sheet also provides blank space for individualized patient instructions. The fact sheet is illustrated with full-color line drawings that depict each step described.

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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: ·

Ileostomy, Colostomy, and Ileoanal Reservoir Surgery Summary: This document defines the types of surgeries involved for patients with digestive diseases requiring partial or total removal of the intestines. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1999

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 colostomy. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: ·

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

·

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

·

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

·

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

·

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

·

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

·

WebMDÒHealth: 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 colostomy. By consulting all of associations listed in

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this chapter, you will have nearly exhausted all sources for patient associations concerned with colostomy.

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 colostomy. 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 “colostomy” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information.

The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “colostomy”. 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 “colostomy” (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 “colostomy” (or a synonym) into the search box, and click “Submit Query.”

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

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

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

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

19

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

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

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

·

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

·

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

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

·

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

·

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

·

California: Gateway Health Library (Sutter Gould Medical Foundation)

·

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

·

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

·

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

·

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

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

·

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

·

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

·

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

·

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

·

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

·

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

20

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

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·

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

·

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

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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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

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·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

·

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

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·

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

·

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

·

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

·

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

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

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

·

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

·

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

·

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

·

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

·

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

·

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

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

Basic Guidelines for Colostomy Colostomy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002942.htm

·

Signs & Symptoms for Colostomy Groin lump Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003100.htm Breathing difficulty Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm

·

Surgery and Procedures for Colostomy Bowel resection Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002941.htm

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Background Topics for Colostomy Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.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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COLOSTOMY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adhesives: Substances that cause the adherence of two surfaces. They include glues (properly collagen-derived adhesives), mucilages, sticky pastes, gums, resins, or latex. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [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] Adverse Effect: An unwanted side effect of treatment. [NIH] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allo: A female hormone. [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] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (-

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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] Amino Alcohols: Compounds possessing both a hydroxyl (-OH) and an amino group (NH2). [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [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] Anomalies: Birth defects; abnormalities. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] 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] 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] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH]

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Aortic Aneurysm: Aneurysm of the aorta. [NIH] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Aqueous: Having to do with water. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Asbestos: Fibrous incombustible mineral composed of magnesium and calcium silicates with or without other elements. It is relatively inert chemically and used in thermal insulation and fireproofing. Inhalation of dust causes asbestosis and later lung and gastrointestinal neoplasms. [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] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Barium enema: A procedure in which a liquid with barium in it is put into the rectum and colon by way of the anus. Barium is a silver-white metallic compound that helps to show the image of the lower gastrointestinal tract on an x-ray. [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]

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 Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood 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] 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]

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Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Cadaver: A dead body, usually a human body. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

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] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cecostomy: Surgical construction of an opening into the cecum with a tube through the abdominal wall (tube cecostomy) or by skin level approach, in which the cecum is sewn to the surrounding peritoneum. Its primary purpose is decompression of colonic obstruction. [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] 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

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the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] 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] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] 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] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Colorectal Surgery: A surgical specialty concerned with the diagnosis and treatment of disorders and abnormalities of the colon, rectum, and anal canal. [NIH] Colostomy: An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix

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'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] 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] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Continence: The ability to hold in a bowel movement or urine. [NIH] Continent Ileostomy: An operation to create a pouch from part of the small intestine. Stool that collects in the pouch is removed by inserting a small tube through an opening made in the abdomen. [NIH] Continuous infusion: The administration of a fluid into a blood vessel, usually over a prolonged period of time. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group.

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[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] 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] 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] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Decubitus: An act of lying down; also the position assumed in lying down. [EU] Decubitus Ulcer: An ulceration caused by prolonged pressure in patients permitted to lie too still for a long period of time. The bony prominences of the body are the most frequently affected sites. The ulcer is caused by ischemia of the underlying structures of the skin, fat, and muscles as a result of the sustained and constant pressure. [NIH] Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH]

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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] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU] Diuresis: Increased excretion of urine. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried

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until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]

Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Enterostomal therapist: A health professional trained in the care of persons with urostomies and other stomas. [NIH] Enterostomal Therapy: A nurse who cares for patients with an ostomy. [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]

Enzymes: Biological molecules that possess catalytic activity. They may occur naturally or be synthetically created. Enzymes are usually proteins, however catalytic RNA and catalytic DNA molecules have also been identified. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Equipment and Supplies: Expendable and nonexpendable equipment, supplies, apparatus, and instruments that are used in diagnostic, surgical, therapeutic, scientific, and experimental procedures. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagostomy: Surgical formation of an external opening (stoma) into the esophagus. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Evacuation: An emptying, as of the bowels. [EU] Faecal: Pertaining to or of the nature of feces. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated

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from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibroid: A benign smooth muscle tumor, usually in the uterus or gastrointestinal tract. Also called leiomyoma. [NIH] Filler: An inactive substance used to make a product bigger or easier to handle. For example, fillers are often used to make pills or capsules because the amount of active drug is too small to be handled conveniently. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Food Packaging: Containers, packaging, and packaging materials for processed and raw foods and beverages. It includes packaging intended to be used for storage and also used for preparation of foods such as microwave food containers versus cooking and eating utensils. Packaging materials may be intended for food contact or designated non-contact, for example, shipping containers. Food labeling is also available. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fumigation: The application of smoke, vapor, or gas for the purpose of disinfecting or destroying pests or microorganisms. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored

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in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [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] 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] Grafting: The operation of transfer of tissue from one site to another. [NIH] Graphite: An allotropic form of carbon that is used in pencils, as a lubricant, and in matches and explosives. It is obtained by mining and its dust can cause lung irritation. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [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] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless,

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odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hygienic: Pertaining to hygiene, or conducive to health. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Ileal: Related to the ileum, the lowest end of the small intestine. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Ileus: Obstruction of the intestines. [EU] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Imperforate Anus: A birth defect in which the anal canal fails to develop. The condition is treated with an operation. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Incineration: High temperature destruction of waste by burning with subsequent reduction to ashes or conversion to an inert mass. [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called

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intravenous infusion. [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] In-line: A sexually-reproducing population derived from a common parentage. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [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] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Intussusception: A rare disorder. A part of the intestines folds into another part of the intestines, causing blockage. Most common in infants. Can be treated with an operation. [NIH]

Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] 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] Irrigation: The washing of a body cavity or surface by flowing solution which is inserted and then removed. Any drug in the irrigation solution may be absorbed. [NIH] Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Laparotomy: A surgical incision made in the wall of the abdomen. [NIH] 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

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colon. [NIH] Leiomyoma: A benign tumor derived from smooth muscle tissue, also known as a fibroid tumor. They rarely occur outside of the uterus and the gastrointestinal tract but can occur in the skin and subcutaneous tissues, probably arising from the smooth muscle of small blood vessels in these tissues. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]

Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lumen: The cavity or channel within a tube or tubular organ. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant mesothelioma: A rare type of cancer in which malignant cells are found in the sac lining the chest or abdomen. Exposure to airborne asbestos particles increases one's risk of developing malignant mesothelioma. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] 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] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to

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the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Mesothelioma: A benign (noncancerous) or malignant (cancerous) tumor affecting the lining of the chest or abdomen. Exposure to asbestos particles in the air increases the risk of developing malignant mesothelioma. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methacrylate: A vinyl monomer. [NIH] 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] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] 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] 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] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] 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,

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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] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasm: A new growth of benign or malignant tissue. [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] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] 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] Notochord: The rod-shaped body, composed of cells derived from the mesoblast and defining the primitive axis of the embryo. In lower vertebrates, it persists throughout life as the main axial support of the body, but in higher vertebrates it is replaced by the vertebral column. [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] 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] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH]

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Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Ostomate: A person who has an ostomy. Called ostomist in some countries. [NIH] Ostomy: Surgical construction of an artificial opening (stoma) for external fistulization of a duct or vessel by insertion of a tube with or without a supportive stent. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Patient Discharge: The administrative process of discharging the patient, live or dead, from hospitals or other health facilities. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Pelvic: Pertaining to the pelvis. [EU] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [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] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs

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are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [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] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Phallic: Pertaining to the phallus, or penis. [EU] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [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] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]

Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polyp: A growth that protrudes from a mucous membrane. [NIH] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polytetrafluoroethylene: Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may

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be infused without repeated needle sticks. Also called a port. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postoperative: After surgery. [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] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] 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] Prolapse: The protrusion of an organ or part of an organ into a natural or artificial orifice. [NIH]

Prone: Having the front portion of the body downwards. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] 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] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Protective Clothing: Clothing designed to protect the individual against possible exposure to known hazards. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] 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

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of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Punctures: Incision of tissues for injection of medication or for other diagnostic or therapeutic procedures. Punctures of the skin, for example may be used for diagnostic drainage; of blood vessels for diagnostic imaging procedures. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radical prostatectomy: Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy and perineal prostatectomy. [NIH] Radioactive: Giving off radiation. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [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] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectovaginal Fistula: Abnormal communication between the rectum and the vagina. [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] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH]

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Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Retropubic prostatectomy: Surgery to remove the prostate through an incision made in the abdominal wall. [NIH] Retrospective: Looking back at events that have already taken place. [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] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Sagittal: The line of direction passing through the body from back to front, or any vertical plane parallel to the medial plane of the body and inclusive of that plane; often restricted to the medial plane, the plane of the sagittal suture. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sanitary: Relating or belonging to health and hygiene; conductive to the restoration or maintenance of health. [NIH]

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Sanitation: The development and establishment of environmental conditions favorable to the health of the public. [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] Seat Belts: Restraining belts fastened to the frame of automobiles, aircraft, or other vehicles, and strapped around the person occupying the seat in the car or plane, intended to prevent the person from being thrown forward or out of the vehicle in case of sudden deceleration. [NIH]

Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [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] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoid Colon: The lower part of the colon that empties into the rectum. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin Care: Maintenance of the hygienic state of the skin under optimal conditions of cleanliness and comfort. Effective in skin care are proper washing, bathing, cleansing, and the use of soaps, detergents, oils, etc. In various disease states, therapeutic and protective solutions and ointments are useful. The care of the skin is particularly important in various occupations, in exposure to sunlight, in neonates, and in decubitus ulcer. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Smooth Muscle Tumor: A tumor composed of smooth muscle tissue, as opposed to leiomyoma, a tumor derived from smooth muscle. [NIH] Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are

Dictionary 143

obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Sprayer: A device for converting a medicated liquid into a vapor for inhalation; an instrument for applying a spray which is a jet of fine medicated vapor used either as an application to a diseased part or to charge the air of a room with a disinfectant. [NIH] 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] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Stoma: A surgically created opening from an area inside the body to the outside. [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] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [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] Stump: The end of the limb after amputation. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [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] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis

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and usually intended for the treatment of local conditions in the rectum. [NIH] Systemic: Affecting the entire body. [NIH] Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Toilet Training: Conditioning to defecate and urinate in culturally acceptable places. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Traction: The act of pulling. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transverse Colon: The part of the colon that goes across the abdomen from right to left. [NIH]

Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU]

Dictionary 145

Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Ureterostomy: Surgical formation of an opening in the ureter for external drainage of the urine; cutaneous route utilizes a ureteral orifice emerging through the skin. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urostomy: An operation to create an opening from inside the body to the outside, making a new way to pass urine. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Veins: The vessels carrying blood toward the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Volvulus: A twisting of the stomach or large intestine. May be caused by the stomach being in the wrong position, a foreign substance, or abnormal joining of one part of the stomach or intestine to another. Volvulus can lead to blockage, perforation, peritonitis, and poor blood

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flow. [NIH] War: Hostile conflict between organized groups of people. [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] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

147

INDEX A Abdomen, 12, 64, 69, 70, 75, 78, 79, 121, 123, 126, 133, 134, 135, 137, 143, 144 Abdominal Pain, 121, 138, 145 Acrylonitrile, 121, 141 Adenocarcinoma, 22, 121 Adenosine, 121, 144 Adhesives, 48, 70, 121 Adjustment, 7, 63, 87, 108, 121 Adjuvant, 121, 131 Adverse Effect, 121, 142 Age Groups, 6, 121 Aged, 80 and Over, 121 Algorithms, 121, 123 Alimentary, 121, 137 Alkaline, 121, 122, 123 Alkaloid, 121, 135, 144 Allo, 121, 131 Alpha Particles, 121, 140 Alternative medicine, 90, 121 Amino Acids, 121, 122, 139, 145 Amino Alcohols, 58, 122 Ammonia, 68, 122, 145 Ampulla, 122, 129 Amputation, 122, 143 Anal, 9, 29, 30, 69, 122, 125, 129, 130, 132 Analgesic, 122, 135, 137 Analog, 122, 130 Anastomosis, 11, 13, 18, 25, 29, 33, 77, 122 Anesthesia, 12, 22, 122 Anomalies, 12, 122 Anorectal, 9, 10, 12, 18, 37, 91, 92, 122 Antagonism, 122, 144 Antibody, 122, 125, 132 Antigen, 122, 126, 132 Antimetabolite, 122, 130 Antineoplastic, 122, 130 Antiseptic, 55, 122 Anus, 49, 55, 60, 61, 64, 70, 76, 77, 92, 122, 123, 124, 129, 130, 137, 140 Anxiety, 4, 122 Aorta, 122, 123, 145 Aortic Aneurysm, 9, 123 Aperture, 54, 56, 57, 64, 71, 72, 123 Aqueous, 58, 123, 129, 134 Arteries, 122, 123, 127, 135 Asbestos, 123, 134, 135

B Bacteria, 122, 123, 129 Barium, 7, 21, 33, 123 Barium enema, 7, 21, 33, 123 Base, 57, 63, 123, 127, 133 Benign, 123, 130, 134, 135, 136 Bile, 123, 130, 131, 134 Bile Acids, 123, 131 Bioavailability, 36, 123 Biopsy, 123, 137 Biotechnology, 6, 90, 97, 123 Bladder, 50, 56, 64, 71, 123, 132, 139, 141, 145 Blood pressure, 18, 123 Blood vessel, 123, 124, 126, 134, 135, 140, 142, 143, 144, 145 Body Fluids, 60, 123, 124, 128, 136 Bowel Movement, 5, 69, 108, 124, 126, 128, 143 Branch, 117, 124, 143, 144 Breakdown, 6, 124, 128, 131 Bronchi, 124, 144 Bronchial, 124, 144 Burns, 33, 124 Burns, Electric, 124 Bypass, 77, 124 C Cadaver, 18, 124 Cannula, 67, 124 Capsules, 124, 130, 131 Carbon Dioxide, 124, 130 Carcinogenic, 48, 124 Carcinoma, 20, 22, 29, 124 Case report, 24, 124 Catheterization, 124, 133 Catheters, 91, 124 Caudal, 124, 139 Cecostomy, 13, 50, 86, 124 Cecum, 124, 133 Cell, 69, 123, 124, 126, 133, 136, 140, 146 Central Nervous System, 124, 135, 144 Cervical, 20, 78, 124 Cervix, 124, 125 Chemotherapy, 106, 125 Chlorine, 68, 125 Chronic, 125, 132, 143, 145 Clamp, 66, 80, 125

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Clinical trial, 5, 45, 46, 97, 125, 126, 137, 140 Cloning, 123, 125 Colitis, 7, 15, 25, 26, 41, 102, 125 Collagen, 121, 125, 131 Collapse, 124, 125 Colorectal, 9, 10, 13, 14, 15, 16, 19, 22, 25, 30, 31, 36, 37, 41, 84, 102, 125 Colorectal Cancer, 10, 19, 36, 41, 84, 102, 125 Colorectal Surgery, 31, 37, 125 Complement, 125, 126 Complementary and alternative medicine, 39, 41, 126 Complementary medicine, 39, 126 Computational Biology, 97, 126 Cone, 66, 108, 126, 143 Connective Tissue, 125, 126, 131, 134 Consciousness, 122, 126 Constipation, 74, 92, 104, 105, 106, 107, 108, 126, 138 Constriction, 49, 56, 126 Continence, 4, 7, 14, 17, 33, 39, 59, 60, 105, 107, 126 Continent Ileostomy, 67, 126 Continuous infusion, 10, 126 Contraindications, ii, 126 Control group, 5, 126 Controlled study, 15, 126 Coronary, 127, 135 Coronary Thrombosis, 127, 135 Curative, 127, 144 Cutaneous, 74, 127, 145 Cyclic, 127, 144 D Databases, Bibliographic, 97, 127 Deamination, 127, 145 Decompression, 31, 37, 124, 127 Decompression Sickness, 127 Decubitus, 127, 142 Decubitus Ulcer, 127, 142 Defecation, 28, 32, 76, 92, 127 Degenerative, 127, 131 Density, 68, 127, 136, 138 Dermal, 67, 127 Detergents, 127, 142 Deuterium, 127, 132 Diagnostic Imaging, 127, 140 Diagnostic procedure, 47, 60, 90, 127 Diaphragm, 50, 128 Diarrhea, 104, 105, 106, 107, 108, 128 Digestion, 121, 123, 128, 133, 134, 143

Digestive system, 46, 106, 128 Digestive tract, 104, 106, 108, 128, 142 Direct, iii, 53, 59, 65, 75, 128, 140 Disinfectant, 128, 143 Distal, 60, 128, 131, 140 Distention, 5, 128 Diuresis, 128, 144 Diverticula, 128 Diverticulitis, 77, 128 Diverticulum, 128 Dorsal, 128, 139 Drug Interactions, 128 Drug Tolerance, 128, 144 Duct, 50, 122, 124, 128, 137, 141 Duodenum, 123, 128, 129, 133, 137, 143 Dysplasia, 91, 128 E Efficacy, 16, 68, 128 Electrons, 123, 128, 133, 140 Embolus, 128, 132 Embryo, 129, 136 Emulsion, 129, 130 Encapsulated, 59, 60, 129 Endoscope, 129 Endoscopic, 27, 32, 129 Enema, 69, 79, 83, 107, 129 Enterostomal therapist, 87, 106, 129 Enterostomal Therapy, 84, 104, 129 Environmental Health, 96, 98, 129 Enzymes, 129, 136, 137 Epithelial, 121, 129, 131 Equipment and Supplies, 3, 105, 106, 107, 108, 129 Esophageal, 78, 129 Esophagostomy, 77, 129 Esophagus, 78, 128, 129, 131, 134, 138, 140, 143 Ethnic Groups, 108, 129 Evacuation, 9, 30, 67, 70, 86, 126, 129 F Faecal, 4, 26, 27, 32, 37, 56, 129 Family Planning, 97, 129 Fecal Incontinence, 53, 60, 92, 129, 132 Feces, 50, 57, 61, 64, 76, 105, 126, 129, 143 Fibrin, 130, 138, 144 Fibroid, 19, 130, 134 Filler, 48, 130 Fistula, 26, 56, 104, 130 Fixation, 10, 74, 130 Flatulence, 106, 130 Flatus, 5, 54, 76, 129, 130, 131 Fluorouracil, 10, 130

Index 149

Flushing, 62, 65, 66, 81, 130 Fold, 130, 134 Food Packaging, 67, 130 Forearm, 123, 130 Fovea, 130 Friction, 72, 130 Fumigation, 67, 130 G Gallbladder, 121, 128, 130 Gastric, 131 Gastroesophageal Reflux, 91, 131 Gastrointestinal, 15, 45, 53, 60, 92, 123, 130, 131, 134, 143 Gastrointestinal tract, 45, 123, 130, 131, 134, 143 Gastrostomy, 91, 131 Gelatin, 60, 131, 143 Gels, 70, 131 Gene, 123, 131 Gland, 131, 134, 137, 139, 142 Governing Board, 131, 139 Graft, 77, 131 Grafting, 131, 132 Graphite, 76, 131 Growth, 122, 131, 134, 136, 138, 144 H Hemorrhage, 131, 143 Hepatic, 69, 131 Hepatitis, 79, 131 Hepatocytes, 131 Hernia, 17, 20, 21, 23, 29, 30, 131 Homogeneous, 49, 131 Hydrogen, 62, 63, 123, 127, 131, 135, 136, 140 Hydrophilic, 56, 75, 127, 132 Hydrophobic, 66, 127, 132 Hygienic, 132, 142 I Id, 38, 40, 102, 103, 109, 116, 118, 132 Ileal, 50, 70, 132 Ileum, 19, 62, 64, 67, 124, 132, 133 Ileus, 5, 20, 45, 132 Immunosuppressant, 130, 132 Impairment, 132, 134 Imperforate Anus, 12, 27, 132 Implantation, 4, 77, 132 Incineration, 68, 132 Incision, 74, 78, 132, 133, 139, 140, 141 Incompetence, 131, 132 Incontinence, 4, 53, 67, 92, 132 Indicative, 85, 132, 145 Infant, Newborn, 121, 132

Infarction, 30, 127, 132, 135 Infection, 80, 132, 134, 136, 143, 146 Inflammation, 48, 125, 128, 131, 132, 138, 145 Infusion, 16, 132 Inhalation, 123, 133, 138, 143 In-line, 71, 133 Inorganic, 133, 135 Insomnia, 5, 133 Intermittent, 133, 138 Intestinal, 52, 62, 66, 69, 70, 77, 91, 103, 105, 133 Intestine, 50, 56, 62, 63, 66, 71, 72, 73, 74, 75, 76, 77, 80, 123, 125, 133, 145 Intoxication, 133, 146 Intracellular, 132, 133 Intramuscular, 133, 137 Intravenous, 133, 137 Intubation, 60, 124, 133 Intussusception, 24, 33, 133 Invasive, 22, 133 Involuntary, 129, 133, 135 Ions, 123, 132, 133 Irrigation, 3, 4, 7, 9, 10, 13, 16, 18, 19, 22, 30, 31, 36, 60, 62, 65, 66, 70, 79, 83, 86, 105, 106, 107, 108, 133 J Jejunostomy, 91, 133 Jejunum, 133 Joint, 69, 127, 133 K Kb, 96, 133 L Labyrinth, 51, 133 Laparoscopy, 7, 21, 133 Laparotomy, 11, 22, 31, 133 Large Intestine, 61, 62, 65, 80, 104, 105, 108, 124, 125, 128, 133, 140, 142, 145 Leiomyoma, 130, 134, 142 Lens, 134, 141 Lesion, 19, 134, 145 Library Services, 116, 134 Ligation, 36, 134 Lip, 70, 81, 134 Liver, 68, 121, 123, 128, 129, 130, 131, 134, 145 Liver cancer, 68, 134 Localized, 129, 130, 132, 134, 145 Loop, 7, 8, 11, 14, 15, 19, 20, 21, 25, 26, 27, 29, 30, 31, 32, 37, 56, 58, 104, 131, 132, 134 Lower Esophageal Sphincter, 131, 134

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Lumen, 64, 124, 134 Lymph, 124, 134 Lymph node, 124, 134 Lymphatic, 132, 134 M Malignant, 14, 20, 24, 33, 64, 121, 122, 134, 135, 136 Malignant mesothelioma, 14, 134, 135 Medial, 134, 141 MEDLINE, 97, 134 Membrane, 66, 126, 134, 138, 141 Mental Disorders, 46, 134, 140 Mesenteric, 30, 134 Mesentery, 134, 135, 138 Mesothelioma, 134, 135 Metastasis, 135 Metastatic, 16, 135 Methacrylate, 48, 135 MI, 48, 53, 67, 71, 120, 135 Mitochondrial Swelling, 135, 136 Modeling, 7, 135 Modification, 4, 29, 37, 135, 140 Molecular, 68, 97, 99, 123, 126, 135, 141 Molecule, 122, 123, 126, 135, 140 Morphine, 36, 135, 137 Motility, 5, 16, 91, 92, 135 Motion Sickness, 135 Mucus, 104, 135, 145 Myocardium, 135 N Narcotic, 135 Nausea, 5, 135 NCI, 1, 46, 95, 135 Necrosis, 9, 132, 135, 136 Neonatal, 16, 91, 136 Neoplasm, 136, 144 Nerve, 18, 122, 136, 141 Nervous System, 124, 136, 143 Neuronal, 91, 136 Neurons, 136 Neuropathy, 30, 136 Neutrons, 121, 136, 140 Nitrogen, 36, 121, 127, 130, 136 Notochord, 29, 136 Nuclear, 128, 136 Nucleic acid, 136 Nutritional Support, 131, 136 O Ointments, 136, 142, 143 Opacity, 127, 136 Ophthalmology, 130, 136 Opium, 135, 137

Ostomate, 54, 71, 88, 102, 137 P Palliative, 33, 137, 144 Pancreas, 121, 128, 137 Pancreatic, 131, 137 Pancreatic Juice, 131, 137 Paralysis, 45, 137 Parenteral, 67, 137 Patch, 52, 72, 137 Patient Discharge, 4, 137 Patient Education, 3, 27, 86, 87, 88, 104, 105, 108, 114, 116, 120, 137 Patient Selection, 4, 137 Pelvic, 16, 19, 31, 34, 69, 137, 139 Perception, 126, 137, 142 Percutaneous, 11, 24, 27, 32, 137 Perforation, 17, 77, 123, 137, 145 Perineal, 9, 13, 14, 18, 23, 25, 29, 33, 36, 40, 137, 140 Perineum, 137 Perioperative, 22, 137 Peritoneal, 10, 24, 137, 138 Peritoneal Cavity, 137, 138 Peritoneal Dialysis, 10, 138 Peritoneum, 124, 135, 137, 138 Peritonitis, 25, 32, 138, 145 Phallic, 130, 138 Pharmaceutical Preparations, 131, 138 Pharmacologic, 122, 138, 144 Pharynx, 131, 138 Physiology, 92, 138 Plasma, 131, 138 Platinum, 134, 138 Poisoning, 133, 135, 138 Polyethylene, 68, 138 Polymers, 58, 138, 139, 143 Polyp, 19, 138 Polyposis, 125, 138 Polytetrafluoroethylene, 62, 138 Port, 13, 59, 138 Port-a-cath, 138 Posterior, 91, 122, 128, 137, 139 Postoperative, 5, 24, 45, 86, 104, 106, 139 Practice Guidelines, 98, 139 Prevalence, 107, 139 Progressive, 128, 131, 136, 139, 144 Projection, 54, 139 Prolapse, 10, 24, 28, 139 Prone, 48, 52, 139 Proportional, 5, 139 Prospective study, 28, 139 Prostate, 139, 140, 141

Index 151

Prostatectomy, 139, 140 Protective Clothing, 67, 139 Protein C, 139, 145 Protein S, 123, 139 Proteins, 122, 125, 129, 135, 136, 138, 139, 142, 144 Protons, 121, 132, 139, 140 Proximal, 128, 140 Psychiatry, 130, 140 Public Policy, 97, 140 Pulmonary, 123, 125, 140, 145 Pulmonary Artery, 123, 140, 145 Pulmonary Edema, 125, 140 Pulse, 18, 140 Punctures, 51, 140 Q Quality of Life, 4, 5, 15, 32, 87, 140 R Radiation, 8, 10, 15, 16, 106, 140, 146 Radical prostatectomy, 29, 140 Radioactive, 132, 136, 140 Radiological, 137, 140 Randomized, 5, 9, 26, 27, 30, 31, 37, 128, 140 Randomized clinical trial, 26, 27, 30, 37, 140 Reagent, 125, 140 Receptor, 122, 126, 140 Rectal, 7, 8, 9, 13, 16, 17, 20, 21, 22, 25, 26, 27, 28, 29, 36, 65, 78, 103, 104, 105, 140 Rectovaginal Fistula, 20, 140 Rectum, 9, 10, 11, 12, 13, 14, 16, 18, 19, 21, 22, 23, 26, 28, 29, 30, 32, 34, 36, 39, 64, 65, 69, 73, 74, 122, 123, 124, 125, 127, 128, 130, 131, 132, 133, 139, 140, 142, 144 Refer, 1, 125, 130, 136, 140 Reflux, 91, 131, 140 Refractory, 15, 141 Regimen, 128, 141 Regurgitation, 131, 141 Resection, 9, 11, 13, 14, 18, 22, 25, 28, 29, 30, 33, 36, 40, 77, 119, 139, 141 Resolving, 77, 141 Restoration, 141 Retina, 134, 141 Retinal, 126, 141 Retrograde, 8, 141 Retropubic, 139, 140, 141 Retropubic prostatectomy, 140, 141 Retrospective, 32, 141 Rigidity, 48, 141 Risk factor, 12, 86, 139, 141

Rod, 74, 125, 136, 141 Rubber, 48, 52, 54, 74, 121, 141 S Sagittal, 91, 141 Salivary, 128, 141 Salivary glands, 128, 141 Sanitary, 64, 79, 82, 141 Sanitation, 79, 142 Schizoid, 142, 146 Schizophrenia, 142, 146 Schizotypal Personality Disorder, 142, 146 Screening, 84, 125, 142 Seat Belts, 56, 142 Secretion, 66, 135, 142 Serum, 125, 138, 142 Shock, 142, 144 Side effect, 106, 121, 142, 144 Sigmoid, 7, 11, 20, 27, 34, 86, 104, 106, 107, 142 Sigmoid Colon, 142 Skeletal, 125, 142 Skeleton, 133, 142 Skin Care, 84, 104, 107, 142 Small intestine, 62, 105, 124, 126, 128, 132, 133, 142 Smooth muscle, 130, 134, 135, 142, 143 Smooth Muscle Tumor, 130, 142 Soaps, 142 Social Environment, 140, 143 Specialist, 110, 143 Sphincter, 4, 30, 64, 65, 92, 143 Spinal cord, 15, 17, 18, 32, 124, 136, 143 Sprayer, 81, 143 Steel, 125, 143 Stent, 24, 137, 143 Stomach, 64, 76, 121, 128, 129, 131, 134, 135, 137, 138, 140, 142, 143, 145 Stool, 69, 76, 92, 104, 105, 107, 126, 132, 133, 143 Stress, 86, 130, 135, 141, 143 Stricture, 28, 143 Stroke, 46, 96, 143 Stump, 104, 143 Styrene, 141, 143 Subacute, 132, 143 Subclinical, 132, 143 Subcutaneous, 30, 134, 137, 143 Substance P, 142, 143 Suction, 60, 143 Support group, 19, 40, 143 Suppositories, 131, 143 Systemic, 122, 123, 132, 144

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T Theophylline, 36, 144 Therapeutics, 144 Thoracic, 128, 144 Thorax, 121, 144 Thrombosis, 139, 143, 144 Thrombus, 127, 132, 144 Tissue, 122, 123, 126, 127, 128, 129, 131, 134, 135, 136, 137, 141, 142, 144 Toilet Training, 91, 144 Tolerance, 5, 144 Torsion, 132, 144 Toxic, iv, 34, 136, 143, 144 Toxicity, 128, 144 Toxicology, 98, 144 Toxins, 122, 132, 144 Traction, 60, 125, 144 Transfection, 123, 144 Transverse Colon, 19, 144 Trauma, 7, 8, 11, 12, 13, 19, 21, 22, 25, 26, 32, 33, 36, 77, 80, 136, 144 Trees, 141, 144 Tumour, 9, 144 U Ulcer, 127, 145 Ulceration, 6, 127, 145 Ulcerative colitis, 34, 145 Unconscious, 132, 145

Urea, 36, 145 Ureter, 145 Ureterostomy, 48, 50, 55, 56, 145 Urethra, 139, 145 Urinary, 8, 16, 34, 53, 56, 70, 91, 106, 132, 139, 141, 145 Urinary tract, 53, 70, 106, 145 Urinate, 144, 145 Urine, 50, 64, 76, 123, 126, 128, 132, 145 Urostomy, 6, 53, 64, 71, 88, 103, 107, 145 Uterus, 125, 130, 134, 145 V Vagina, 125, 140, 145 Valves, 49, 145 Vascular, 4, 11, 132, 144, 145 Veins, 123, 145 Venous, 91, 139, 145 Ventricle, 140, 145 Vertebrae, 143, 145 Vertebral, 136, 145 Veterinary Medicine, 97, 145 Volvulus, 27, 145 W War, 33, 146 White blood cell, 122, 135, 146 Withdrawal, 60, 146 X X-ray, 77, 123, 136, 146

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