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

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

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COLPOSCOPY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES

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

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2003 by ICON Group International, Inc. Copyright ©2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Colposcopy: 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: 0-597-83837-2 1. Colposcopy-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 colposcopy. 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 COLPOSCOPY............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Colposcopy .................................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 20 The National Library of Medicine: PubMed ................................................................................ 20 CHAPTER 2. NUTRITION AND COLPOSCOPY ................................................................................... 61 Overview...................................................................................................................................... 61 Finding Nutrition Studies on Colposcopy ................................................................................... 61 Federal Resources on Nutrition ................................................................................................... 62 Additional Web Resources ........................................................................................................... 62 CHAPTER 3. ALTERNATIVE MEDICINE AND COLPOSCOPY ............................................................ 65 Overview...................................................................................................................................... 65 National Center for Complementary and Alternative Medicine.................................................. 65 Additional Web Resources ........................................................................................................... 67 General References ....................................................................................................................... 68 CHAPTER 4. BOOKS ON COLPOSCOPY ............................................................................................. 69 Overview...................................................................................................................................... 69 Book Summaries: Federal Agencies.............................................................................................. 69 Book Summaries: Online Booksellers........................................................................................... 70 The National Library of Medicine Book Index ............................................................................. 72 Chapters on Colposcopy ............................................................................................................... 73 CHAPTER 5. MULTIMEDIA ON COLPOSCOPY .................................................................................. 75 Overview...................................................................................................................................... 75 Audio Recordings......................................................................................................................... 75 Bibliography: Multimedia on Colposcopy.................................................................................... 76 CHAPTER 6. PERIODICALS AND NEWS ON COLPOSCOPY ............................................................... 77 Overview...................................................................................................................................... 77 News Services and Press Releases................................................................................................ 77 Academic Periodicals covering Colposcopy.................................................................................. 79 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 83 Overview...................................................................................................................................... 83 NIH Guidelines............................................................................................................................ 83 NIH Databases............................................................................................................................. 85 Other Commercial Databases....................................................................................................... 87 APPENDIX B. PATIENT RESOURCES ................................................................................................. 89 Overview...................................................................................................................................... 89 Patient Guideline Sources............................................................................................................ 89 Finding Associations.................................................................................................................... 93 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 95 Overview...................................................................................................................................... 95 Preparation................................................................................................................................... 95 Finding a Local Medical Library.................................................................................................. 95 Medical Libraries in the U.S. and Canada ................................................................................... 95 ONLINE GLOSSARIES................................................................................................................ 101 Online Dictionary Directories ................................................................................................... 102 COLPOSCOPY DICTIONARY ................................................................................................... 103

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INDEX .............................................................................................................................................. 133

1

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

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

New Instrument for the Visualization and Laser Treatment of the Female Urethra and Trigone Source: International Urogynecology Journal. 3(2): 133-136. June 1992. Summary: This article describes a new instrument used for the visualization and laser treatment of the female urethra and trigone. In this study, the classic Kelly air cystoscope was modified and used to diagnose and treat patients with inflammatory and neoplastic lesions of the urethral mucosa, using direct visualization techniques with and without colposcopy. The authors' study group consisted of 49 patients with inflammatory (20), condylomatous (22), cystic (2), and undiagnosed (5) conditions of the proximal and midurethral mucosa. The simple, inexpensive instrument allowed direct access to the urethral mucosa for diagnostic and therapeutic intervention. Patients

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suffered no significant morbidity from the use of this instrument. 2 figures. 5 references. (AA-M). •

Cervical Dysplasia in HIV - Infected Women Source: PAACNOTES; Dec. 1992. Contact: International Association of Physicians in AIDS Care, 33 N LaSalle St Ste 2600, Chicago, IL, 60602-2601, (312) 795-4930, http://www.iapac.org. St Lukes-Roosevelt Hospital Center, Continuum Health Partners Incorporated, St Lukes - Roosevelt Hospital Center, Center for Comprehensive Care, Samuels Clinic, 1000 10th Ave Rm 2T, New York, NY, 10019, (212) 523-6500, http://wehealny.org/patients/slr_description.html. Summary: This journal article discusses cervical dysplasia in women with HIV. Despite the unusally high rate of abnormal Pap tests indicative of cervical dysplasia among women with HIV/AIDS, few clinical trials have included them. The article suggests that the pathologic effects of HPV are enhanced in the presence of HIV coinfection. It notes a possible connection between women with CD4 lymphocyte counts below 400 and the increased rates of high grade lesions. The article reports on the investigation of drug 5fluorouacil for maintenance therapy for recurrent or potentially recurrent cervical or vaginal lesions. Physicians are encouraged to include Pap tests in routine care of all women with HIV/AIDS and to use a low threshold for referral to colposcopy. The importance of repeating a Pap test within six months of a negative result is stressed. The article also recognizes the need to determine which subgroups of infected women are at greater or lesser risk of the most aggressive manifestations of cervical dysplasia.

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

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

Studies

•

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Project Title: CLINICAL MANAGEMENT OF UTERINE ATYPICAL SQUAMOUS CELLS Principal Investigator & Institution: Guido, Richard R.; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001 Summary: ALTS intends to determine the optimal management of mildly abnormal Pap smears (encompassing LSIL and ASCUS)in women. Specifically, the trial will evaluate three possible management strategies: (1) Immediate colposcopy, the most common management option currently, and the most invasive and expensive; (2) HPV triage, in which participants will be typed for the HPV virus via Hybrid Capture Microtiter testing and triaged to colposcopy based upon the identification of a high-risk (oncogenic) viral type; and (3) conservative management, in which participants will be followed by cytology results at 6 month intervals, and triaged to colposcopy in the event of high-grade cytologic diagnosis. All women enrolled into ALTS will be followed, after the initial visit, at 6 month intervals with cytologic testing for 2 years. Collection of cervical cells, masked HPV tests, and bloodwork and cervical secretions obtained through an immunological component will provide information about both the natural history of mild cervical dysplasia as well as differences among management arms, if they exist. Treatment acceptability and quality of life data will be collected as well. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: CORE--CHEMISTRY Principal Investigator & Institution: Neurath, Alexander R.; Member; New York Blood Center 310 E 67Th St New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 26-SEP-2001; Project End 31-JUL-2005 Description (provided by applicant): The Chemistry Core Unit, Core B, will provide expertise and technical support for all projects as follows: Project I: In vitro Anti-HIV-1 Activity of CAP: a) Stock solutions of CAP for studies on the inhibitory effects of CAP on HIV-l infection, b) Formulations of CAP to study the virucidal activity of the formulations against both cell-free and cell-associated HIV-1, c) Samples of CAP sponges to study the virucidal effect against cell- free and cell-associated HIV-1. Project II: Safety and Efficacy of CAP in vivo: a) Stock solutions of CAP for studies on the inhibitory effect of CAP on infection of dendritic cells, b) CAP formulations for studies on the safety of CAP using colposcopy and detection of pro-inflammatory chemokines and cytokines in vaginal fluids c) Formulations of color tagged CAP for measuring the distribution of CAP monitored by colposcopy, d) CAP formulations containing gadolinium for examinations of CAP distributions by magnetic resonance imaging (MRI). Project III: Anti-HIV -1 Microbicides: Pro-inflammatory Potentials: a) Stock solutions of soluble CAP, b) Quantitation of CAP in tissue culture media, c) Preparation of biotinylated and color tagged CAP. Project IV: Contraceptive Action of Cellulose Acetate Phthalate: a) Soluble CAP to measure its effect on sperm, b) CAP formulations to measure their spermicidal effect and their effect on contraceptive activity measured in a rabbit model, c) Biotinylated CAP for detailed studies on CAP-sperm interactions, d) CAP sponges for studies on their spermicidal activity and contraceptive properties in a rabbit model. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DIAGNOSIS OF CERVICAL & VULVAR PRECANCERS Principal Investigator & Institution: Mahadevan-Jasen, Anita; Assistant Professor; Biomedical Engineering; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2006 Summary: It was estimated that 4,400 deaths would occur in the United States alone from this disease and 12,900 new cases of invasive cervical cancer would be diagnosed in 2001. Existing screening and detection techniques, the Pap smear and colposcopy, have several deficiencies that prevent efficient management of an otherwise controllable disease. An automated diagnostic with improved sensitivity and specificity that could allow for a "See and Treat" protocol would significantly improve the management of the disease. Optical spectroscopy can provide automated, fast and non-intrusive characterization of normal and non-normal tissues. In particular, Raman spectroscopy can be used to provide accurate differential diagnosis of early disease. Preliminary results indicate the potential of using Raman spectroscopy for the diagnosis of cervical precancers and to translate its application for the detection of vulvar disease. In particular, in vitro studies show that Raman spectroscopy can differentiate between cervical precancers and all other tissue categories with a sensitivity and specificity of 91 percent and 90 percent, significantly better than fluorescence spectroscopy. More importantly, the results from the initial 13 patients studied in vivo, indicate that 1 it is possible to measure Raman spectra from cervical tissue in vivo and (2) Raman spectroscopy can identify cervical lesions in vivo I (with spectra similar to that observed in vitro). Thus this proposal seeks to develop a real-time, optical method for the differential diagnosis of cervical precancerous lesions by providing real-time, automated, non-intrusive information of the tissue biochemistry and pathology. In addition, this proposal seeks to extend the capability of this technique to include vulvar disease. The specific aims of the proposed project are as follows; (1) Characterize Raman signatures of cervical tissues in vivo. (2) Develop diagnostic algorithms that separate normal and non- precancerous tissues from precancerous tissues. (3) Study the basis of observed differences in the spectral characteristics using microspectroscopy, cytochemical analysis, and modeling. (4) Conduct retrospective and prospective evaluation of the algorithms developed to obtain estimates of their performance. (5) Assess the feasibility of using optical spectroscopy for vulvar disease and verify the performance capability of this technique for vulvar precancer detection. (6) Develop software interface to implement and automate data acquisition and provide real-time diagnosis and to develop a compact clinical Raman system to reduce the scale of the system while maintaining its accuracy. These objectives when achieved will yield a method of obtaining real-time, non intrusive detection of cervical precancers that will facilitate the immediate management of the disease with high sensitivity and specificity. In addition, the potential of translating the application of Raman spectroscopy to other organs and in the vulva, in particular, will be assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DISTRESS AND IMMUNE FUNCTION IN CERVICAL DYSPLASIA Principal Investigator & Institution: Fang, Carolyn Y.; Assistant Member; Fox Chase Cancer Center Philadelphia, Pa 19111 Timing: Fiscal Year 2001; Project Start 15-JUL-1999; Project End 30-JUN-2004 Summary: The important role of certain types of human papillomavirus (HPV) in the etiology of cervical cancer is well-established. However, the contribution of possible

Studies

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psychosocial and immunological factors to the progression of high-risk HPV-related cervical lesions needs further exploration. The proposed project aims to examine the potential interrelations between psychosocial (i.e., stress, coping processes) and immunologic (e.g., natural killer cell activity) measures in women with mild dysplastic lesions of the cervix due to infection with highly oncogenic subtypes of HPV. Specifically, two studies are proposed. Study 1 is designed to identify potential behavioral and immunologic correlates of stress and coping, with a particular emphasis on the effects of avoidant coping strategies on cancer risk and development. Eighty-four women referred for a follow-up colposcopy will complete baseline psychosocial assessments and provide a blood sample (for immune assays) prior to their colposcopy. Follow-up assessments will be conducted at 6-months and 12-months post-baseline. Psychosocial assessments include measures of stressful life events, cancer-specific intrusive and avoidant ideation, and a variety of coping strategies. Relevant immune measures include T-cell numbers, natural killer cell numbers and functional activity, and lymphocyte proliferative response to mitogen stimulation. In addition, medical outcome (regression, persistence, or progression of cervical lesions), demographic variables, and behavioral risk factors will be assessed. Study 2 will provide a preliminary evaluation of a relaxation and coping skills intervention that is designed to reduce cancer-related distress and provide effective coping skills for facilitating adherence to screening recommendations. The identification of potential interrelations among psychosocial, behavioral, and immunologic variables has important implications for cancer prevention and control programs as they can be used to guide the development of psychological and behavioral interventions aimed at reducing distress and avoidance, which may lead to improved behavioral, immunologic, and health outcomes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEOPLASIA

EPIDEMIOLOGY

OF

HPV16/18

VARIANTS

IN

CERVICAL

Principal Investigator & Institution: Xi, Long F.; Pathology; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 11-JUL-2000; Project End 30-JUN-2004 Summary: (Adapted from applicant's abstract): Human papillomaviruses (HPVs) are classified into "types," "subtypes," and variants." HPV16 and 18 are types known to be central to the pathogenesis of most invasive cervical cancers (ICC) and their precursor lesion, cervical intraepithelial neoplasia (CIN) grade 2-3. However, many women acquire and spontaneously resolve cervical infections with these HPV types. We hypothesize that certain HPV 1 6 and 18 variants differ in their biologic behavior and risk of cervical neoplasia. A number of small studies have examined associations between HPV 1 6 and 18 variants and risk of cervical neoplasia and many, but not all, suggest differences in biologic behaviors. Confirmation of these findings in large, more representative populations is essential. We propose to efficiently examine these issues by performing additional assays on a subset of samples collected during the ongoing NCI-sponsored, multi-center randomized clinical trial: ASCUS/LSIL Triage Study (ALTS). This study, which includes 5,086 women from four different regions of the country, is examining how to best manage women referred with a cytologic diagnosis of atypical squamous cells of uncertain significance (ASCUS) or low- grade squamous intraepithelial lesions (LSIL) of the cervix. The ALTS dataset is extremely rich with results from standardized collection and testing of clinical specimens, detailed questionnaires with information on potential confounders, and histologic and

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colposcopic diagnoses provided by expert panel review. By including data from only those women enrolled in the immediate colposcopy arm of ALTS, we will develop precise estimates of the association between HPV 1 6 and IS variants and cervical neoplasia (aims 1 and 2), and determine whether those variants that are associated with CIN 2-3 have increased DNA levels or specific nucleotide changes in the LCR and E6 regions of the genome (aim 4). Furthermore, using data from women enrolled in the immediate colposcopy and conservative management arms, we will provide the first observations on the relationship between HPV 1 6 variants and risk for recurrence after treatment for CIN 2-3 (aim 3). To address these aims, we will perform PCR-based assays for detection and typing of 7,290 samples, classify (by DNA sequencing) HPV variants present in samples from women infected with HPV16 (n=548) or 18 (n=222), and quantify (by a PCR-based kinetic thermocycling assay) the amount of HPV DNA present in the 1,915 HPV16-positive and 222 HPV18-positive samples. The proposed study is likely to make important contributions to our understanding of the role of HPV 16 and 18 variants in the pathogenesis of cervical cancer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FOLATE, SMOKING, RACE AND CERVICAL CANCER RISK Principal Investigator & Institution: Fillmore, Caprimara; Preventive Medicine; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2002; Project Start 26-JUL-2002; Project End 30-JUN-2005 Summary: (provided by applicant): Nutrition, environment, and race are implicated in the etiology of several cancers. This study will assess the interrelationships of these three factors in cervical cancer, by examining the interaction of folate, smoking, and race. Smoking is an established risk factor for cervical cancer, but poor study designs, small sample sizes, and inadequate folate measurements have interfered with assessment of folate as a cervical cancer risk factor. Smoking has been associated with lower blood levels of folate, but we know of no study designed to test if the interaction between smoking and folate is associated with cancer. Many smoking-related cancers have disproportionately high mortality and incidence rates for black Americans. However, the interaction of nutrition with smoking has been relatively unexplored as a contributor to this racial disparity. By improving study design, increasing sample size, utilizing dietary folate equivalents (DFEs) and homocysteine levels (a functional marker of folate sufficiency) in assessing these inter-relationships, and sub-group analysis by race, our study will make a significant addition to the current body of knowledge. At three colposcopy clinics, 1500 women (50 percent black and 50 percent white race) will fill out a questionnaire on frequency of foods eaten, smoke exposure and other factors affecting folate levels and cervical cancer. Each woman will have blood drawn and cervical testing for 13 oncogenic human papillomavirus (HPV) types. Only women testing positive for these HPV types will be kept in the study. Women with cancer or cervical intraepithelial neoplasms 2 or 3 (CIN 2 or 3) on biopsies will be classified as "high risk". All other oncogenic HPV positive women (with normal or CIN I biopsies) will be classified as "low risk". Plasma will be tested for homocysteine. The interaction between folate (dietary intake or plasma homocysteine) and smoking associated with increased cervical cancer risk will be analyzed using ordinal logistic or logistic regression, including analysis by race. Cervical cancer has a step-wise histologic progression (which allows ordinal analysis or increase in the number of "cases" collected in a short time period). It is one of the few cancers with a known necessary, though not sufficient, cause - HPV. By limiting analyses to women with HPV exposure, this study insures that all women have an equal chance of their smoking and folate exposure affecting whether

Studies

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they acquire the disease. This study may be the first cancer study to utilize DFEs, which reflect dietary folate bioavailability and are more likely to be associated with cancer risk than crude folate intake. Our study will be among the first to analyze the interaction of DFEs (or homocysteine) and cigarette associated with cancer. This study will have implications for smoking cessation, cancer prevention, folate supplementation and duration between Papanicolaou (Pap) smears. It may also explain some of the racial disparity in cervical cancer and possibly other smoking-related cancers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GUIDELINES--MANAGE ABNORMALITIES

CERVICAL

CYTOLOGICAL

Principal Investigator & Institution: Wright, Thomas C.; Associate Professor; Amer Soc of Colposcopy & Cervical Pathol and Cervical Pathology (Asccp) Hagerstown, Md 21740 Timing: Fiscal Year 2001; Project Start 26-SEP-2001; Project End 31-AUG-2002 Summary: (Provided by Applicant): Each year approximately 50 million Papanicolaou smears are taken in the United States and of these, approximately 7% are classified as abnormal. Currently there are no nationally accepted guidelines for management of women with abnormal Papanicolaou smears and cervical cancer precursors. Moreover, most guidelines that have been published by individual societies/organizations are out of date since the do not incorporate recent changes in our understanding of the pathogenesis and natural history of cervical cancer and its precursors, or address recent technological innovations such as liquid-based cytology and HIV DNA testing. The lack of up-to-date national guidelines is causing widespread confusion among both health care providers and patients as to how best to manage abnormal Papanicolaou smears and cervical cancer precursors, and appears to be producing widely varying approaches to clinical care. The American Society of Colposcopy and Cervical Pathology (ASCAP) will hold a workshop on September 6-9, 2001 in Bethesda, MD at the NIH to develop Consensus Guidelines for the Management of Cytological Abnormalities and Cervical Cancer Precursors. The objective of the workshop is to develop comprehensive, evidence-based guidelines to guide clinicians of all subspecialties of medicine and nursing. Representatives from the American Academy of Family Physicians, American Cancer Society , American College Health Association, American College of Obstetricians and Gynecologists, American Society for Clinical Pathologists, American Society for Cytopathology, Am. Social Health Association, Centers for Disease Control and Prevention, Eurogin, International Academy of Cytology, International Federation of Cervical Pathology and Colposcopy, International Society of Gynecologic Pathologists, National Cancer Institutes, Nurse Practitioners in Women's Health, Pan American Health Organization, Planned Parenthood Federation of America, Society of Canadian Colposcopists, and Society of Gynecologic Oncologists will participate in the workshop. The participation of these diverse and prestigious societies/organizations in the development of the management guidelines should insure their widespread acceptance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HPV DNA VACCINE FOR CERVICAL PRE NEOPLASIA Principal Investigator & Institution: Weber, Jeffrey S.; Associate Professor; Medicine; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2001; Project Start 01-JUN-2000; Project End 31-MAY-2004

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Summary: (Adapted from the investigator's abstract) This proposal projects a phase I trial including up to 24 patients with CIN 2-3 treated with a DNA plasmid vaccine directed against the E7 protein of HPV 16. The goals of this trial are to define the toxicity and tolerability of the vaccine given over a four month period of time at three week intervals. This phase I trial will define the MTD for the vaccine (the dose at which 33% of the patients have dose-limiting toxicity. After this, the investigators plan a phase II study designed as a two-phase trial after the method of Simon. This trial will accrue 22 patients with CIN 2-3 who are HLA-A2 positive and HPV 16 positive and have a negative endocervical curettage. If there are at least 8 responders, the trial will proceed to a second phase of accrual of up to 46 patients. The phase II trial will define the clinical, immunological, and anti-viral effects of the MTD. The primary end-point of the phase II trial will be digitally determined regression of the area of CIN determined at colposcopy. Other end-points will include: disappearance of the virus in a specimen resected by LEEP one month after the completion of the vaccine; two-fold increase in release of gamma interferon in the cytokine release assay; and a five-fold increase in CTL frequency in the tetramer assay. To insure that spontaneous regression does not account for a portion of the responses, baseline measurements will be followed one month later by a second set of assessments prior to the start of the vaccine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HUMAN PAPILLOMAVIRUS AS A RISK FACTOR FOR HIV INFECTION Principal Investigator & Institution: Chin-Hong, Peter V.; Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 29-FEB-2008 Summary: (provided by applicant): Human papillomaviruses (HPV) are common sexually transmitted agents throughout the world. The causal association between HPV and anogenital cancer is generally accepted. What has not been well studied is the role of HPV as a risk factor for the acquisition of HIV. Sexually transmitted diseases (STDs) such as gonorrhea and chancroid have been shown to be cofactors for HIV acquisition. Very little information is available regarding the role of HPV infection and anal intraepithelial neoplasia (AIN) or cervical intraepithelial neoplasia (CIN) in facilitating HIV infection. HPV- associated AIN and CIN can enhance susceptibility to HIV infection because of increased microvasculature and bleeding. These lesions are also rich in CD4+ lymphocytes and dendritic cells that are mucosal targets of HIV infection. The specific aims of this study are to: 1) examine the role of AIN and CIN as cofactors for HIV acquisition, 2) examine the association of HPV infection with HIV acquisition, and its role in predicting AIN and CIN, and 3) identify specific bioimmunologic markers of AIN or CIN that predict HIV acquisition. A primary aim of this research is to support the career development of the applicant who is pursuing a career in patient-oriented research through the combination of direct mentoring, supervised study and clinical activities at the General Clinical Research Center and the AIDS Research Institute. The proposed research plan is a case-control study of 140 incident HIV cases that will be identified over 4 years from the ongoing Options Project, an NIAID-funded study of women and men with primary HIV infection (PHI). The referent group will be 140 men and women referred to the Options Project because of possible PHI but found to be HIV -negative. All participants will undergo anal HPV testing, high-resolution anoscopy (HRA) and anal cytology. Women will also undergo the same procedures as well as cervical PAP smears and colposcopy. To control for potential confounding, self reports regarding sexual behavior, drug use, STD history and laboratory data for STDs will be

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collected and included in statistical models of the effects of HPV-associated findings on HIV acquisition. The proposed research is the first to use HRA and cervical colposcopy to examine AIN and CIN as independent risk factors for HIV transmission. If HPVassociated epithelial abnormalities are risk factors for HIV infection, then identification of such lesions may improve assessment of HIV transmission risk and could direct future interventions for HIV prevention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INTERMEDIATE EFFECTS Principal Investigator & Institution: Follen, Michele; Professor; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 15-APR-2003; Project End 30-NOV-2007 Summary: The randomized clinical trial provides the strongest study design for the evaluation of a diagnostic technology. An emerging diagnostic technology should first be compared as an adjunct to the existing technology to show it adds value before comparing it alone to the existing technology. Fluorescence and reflectance spectroscopy are emerging technologies. In this randomized clinical trial, we propose to compare these emerging technologies adjunctivelyto the existingtechnologies to show they add value. We plan to compare: 645 colposcopy alone to colposcopy + fluorescenceand reflectance spectroscopy,of 600 patients referred with abnormal Papanicoloau smears. An Investigational Device Exemption (IDE) will be obtained for the fluorescence and reflectance spectroscopydevice and the results of optical spectroscopy will be used to decide which additional areas to biopsy and whether or not to treat the patient at that visit. The patients will also receive the informationprovided by optical spectroscopy to see if this information reduces anxiety. The costs saved by using this information will also be acquired in a subsequent chart review and used in the cost-effectiveness analysis. Sensitivities, specificities, ROC curves, AUC, and likelihood ratios will be calculated for the colposcopy arm, and for colposcopy and optical spectroscopy in the combined arm. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: LASER PHOTORADIATION THERAPY OF MALIGNANT TUMORS Principal Investigator & Institution: Berns, Michael W.; Professor; Surgery; University of California Irvine Campus Dr Irvine, Ca 92697 Timing: Fiscal Year 2001; Project Start 01-MAY-1982; Project End 31-JAN-2003 Summary: The long term objective of this project is the development of Photodynamic Therapy (PDT) for application in the clinical management of patients with cancer. This goal will be accomplished by (1) gaining a more complete understanding of the basic mechanisms of PDT, and (2) conducting careful clinical studies in order to demonstrate safety and efficacy. The specific aims of the basic science studies are to investigate the fundamental mechanism(s) of PDT action on tumor microvasculature at two levels: (1) Human dermal microvascular endothelial cells (MEC); and (2) tumor-induced capillary proliferation in the rabbit cornea. The specific aims of the clinical studies are to determine the efficacy of PDT in Carcinoma In Situ (CIN) in the female genital tract employing topical (non-systemic) drug application. To elucidate further the mechanism(s) of PDT action on human MEC different photosensitizers will be studied with respect to: (1) cellular uptake/retention kinetics (2) subcellular localization/binding (3) subcellular phototoxicity (4) photosensitizer photobleaching and predictive value of fluorescence for phototoxicity (5) mechanism(s) of cellular

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Colposcopy

uptake. Those photosensitizers that show significantly more PDT activity than PHOTOFRIN/R "standard" in the human MEC culture studies will be evaluated in the rabbit cornea model. The purpose of these studies will be to elucidate the mechanism(s) of PDT action on tumor microvasculature by examining each of the photosensitizers with respect to: (1) light and drug dosimetry parameters for optimal tumor microvasculature destruction (2) light and electron microscopic study of the time course of tumor microvasculature destruction and (3) determination of photosensitizer localization in tumor microvasculature structures using electron microscope autoradiography. Once potential photosensitizers have demonstrated photosensitizing capabilities in cell culture experiments, a determination will be made in the rabbit cornea model of the relevant light and drug dosimetry parameters necessary to produce optimal tumor microvasculature destruction. The parameters to be studied are: (1) time interval between intravenous injection of photosensitizer and light exposure (2) photosensitizer (mg/kg body weight) and total light (J/cm2) doses (3) laser irradiation: power density (mW/cm2) and spot diameter. In order to study topical drug PDT (as opposed to systemic drug injection) in a human clinical setting, a randomized, placebo controlled study in 120-140 patients with CIN II or III of the cervix will be undertaken. Eligible patients will undergo colposcopy, cytology, and photographic documentation, and colposcopic guided biopsy of abnormal lesions. One month later, a repeat colposcopy, cytology and photographic documentation will be done to assure that spontaneous regression has not occurred and patients will then be randomized to PDT or control. Response will be evaluated at 3 month intervals for up to one year post treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MULTIMODAL SPECTROSCOPIC EVALUATION OF CERVICAL CANCER Principal Investigator & Institution: Bambot, Shabbir B.; Spectrx, Inc. 6025-A Unity Dr Norcross, Ga 30071 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2002 Summary: (Verbatim from the Applicant's Abstract): Cervical cancer is the second most common cause of cancer in women worldwide and the leading cause of cancer related mortality in women in developing countries. We have developed real time non-invasive point-of-care devices to detect early cancerous conditions of cervix. Our preliminary analyses on data collected from a total of 133 patients and have shown promising results. We are continuing to collect data and will include the entire data set into the analysis as part of our phase I objective. Given our limited data set, however, it is not possible to project any definite performance benchmark. We will propose this task to the training and validation phase in a Phase 2 proposal. For the present we want to analyze the data for the purpose of determining the optimum clinical device for the validation phase. To support data accrual in the validation phase we will make multiple clones of this device for deployment in a multicenter clinical trial. The objective of the data analysis is to arrive at this validation device by simplifying and consolidating the complexity and the many features built into each prototype. This will also reduce the possibility of overtraining by reducing the number of parameters we build into our algorithm. PROPOSED COMMERCIAL APPLICATION: The product of this research will be a prototype device capable to spectroscopically detecting and/or diagnosing cervical cancer. Our device has, upon commercialization, the potential to replace or aid the current Pap test as well as to replace the current methods of colposcopy, biopsy and histology. The target physician group for the cervical application is the Ob-Gyn

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segment. It is estimated that there are at least 30,000 physicians in this segment and upwards of $6 billion spent each year in the US on cervical disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NATURAL HISTORY OF CIN2 IN ADOLESCENTS Principal Investigator & Institution: Moscicki, Anna-Barbara B.; Professor; Pediatrics; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2006 Summary: This is a 5 year prospective study designed to: 1) examine the natural history of CIN-2 (cervical intra-epithelial lesions) subset of high grade squamous intra-epithelial lesions (HSIL) among adolescents, and 2) identify immunologic and behavioral factors associated with regression of CIN 2 lesions. The study of immunologic and behavioral factors that may influence CIN 2 regression will include: sustained local (cervical) Th-1 like cytokine response, systemic cytotoxic T lymphocyte (CTL) responses to HPV (for HPV 16 positive women only), size of lesion at diagnosis, amount of cervical immaturity (ectopy) at diagnosis, and hormonal contraception. Other factors that will be monitored for possible effects include high risk sexual behavior and outcomes (multiple partners, substance use, pregnancy, sexually transmitted infections, and bacterial vaginosis). Last, this study proposes to compare local immunologic responses among women who at baseline visit are diagnosed with CIN-1, CIN-2 and normal histology on biopsy. Approximately 40,000 young women 19 years or younger are expected to undergo cervical cytology screening within the Northern California Kaiser Permanente clinics over a 24 month period. Adolescents aged 13-19 years with abnormal cytology (estimated N=2680) will be recruited. Baseline examination will include interview and cervical samples for HPV DNA testing and quantitative cytokine studies using reverse transcriptase polymerase chain reaction techniques. Colpophotographs will be obtained to determine lesion size. All samples will be obtained prior to biopsy. Those with biopsy-confirmed CIN 2 (N=416) will be followed every 3 months using interview, colposcopy, HPV DNA testing, and cytology and undergo immune studies (cervical cell cytokine analysis using real-time RT-PCR and peripheral blood CTL assays on women with HPV 16 infection) until the end of the study. Women with CIN-3 are exited for standard therapy. Those with biopsied confirmed low grade (L) SIL or less will exited. Understanding of the natural history of CIN 2 will be critical in efforts to construct costeffective strategies for cancer screening in adolescents. In addition, defining immunologic factors associated with CIN 2 regression will have important implications for vaccine and therapeutic strategies and defining clinical (including repeated HPV DNA testing) and behavioral risks will have important implications for triage and counseling strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PATIENT OUTCOMES Principal Investigator & Institution: Basen-Engquist, Karen M.; Associate Professor; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 15-APR-2003; Project End 30-NOV-2007 Summary: Literature on technology assessment strongly emphasizes the need for evaluating the effect of technology on patient outcomes such as improved physical, functional, or emotional well being. This project is significant and unique because it will evaluate patient outcomes of the emerging screening and diagnostic technologies of optical spectroscopy and quantitative cytology and pathology during the developmental

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Colposcopy

process. Because receiving positive Papanicolaou smear results and undergoing colposcopy and biopsy is associated with patient distress and problematic adherence to treatment and follow-up, we will focus on outcomes related to patient psychological distress, satisfaction, and adherence. In the trial of optical spectroscopy and multispectral digital colposcopy in Project 2 we will evaluate differences in patient pain and anxiety caused by Papanicolaou smear, colposcopy, biopsy, and optical spectroscopy or multispectral digital colposcopy. We also will assess patient satisfaction and preferences for the follow-up and treatment procedures of the various testing strategies. In the randomized clinical trial of optical spectroscopy in Project 3 we will study the impact of adding optical spectroscopy to colposcopy to diagnose high grade SIL, and the effect of immediate treatment on patient adherence, distress, satisfaction, and quality of life. Finally,we will conduct a qualitative study of community health care providers' receptivity to the innovations of optical spectroscopy and quantitative cytohistopathology. Taken together, these studies will assess patient outcomes relevant to optical spectroscopy and quantitativecy to-histopathology, and will be used to improve the technology, facilitate its diffusion and implementation in health care practice, and improve patientcare. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREGNANCY OUTCOME AFTER TREATMENT OF CERVICAL DYSPLASIA Principal Investigator & Institution: Sadler, Lynn C.; University of Auckland Private Bag 92019 Auckland, Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: (Adapted from the Investigator's Abstract) The proposed research will investigate pregnancy outcome after treatment of cervical dysplasia. Cervical dysplasia is a precancerous condition that can be effectively treated to prevent cancer of the uterine cervix. Incidence of cervical dysplasia peaks in women ages 25-35. Those with low-grade lesions are often not treated. The most common conservative treatment procedures are large-loop excision of the transformation zone (LLETZ), carbon dioxide laser conization, and carbon dioxide laser vaporization. There is presently insufficient evidence concerning the potential effect of these procedures on subsequent pregnancy outcome. The proposed research will investigate whether: 1) treatment of cervical dysplasia is associated with increased risk of preterm delivery in subsequent pregnancies; 2) whether treatment of cervical dysplasia is associated with specific subcategories of preterm delivery; 3) whether treatment of cervical dysplasia is associated with infertility, low birthweight, prelabor rupture of membranes at term, duration of labor and cesarean section rate; and 4) whether severity of dysplasia, length of cone, number of cervical treatments and interval between treatment and birth among treated women are related to adverse pregnancy outcome. The proposed research study has a retrospective cohort design. The cohort will consist of all women less than 45 years of age seen at the Colposcopy Clinic of Greenlane Hospital in Auckland, New Zealand, from 1989 through June 1998 who subsequently carried a singleton pregnancy beyond 20 weeks gestation. The cohort will be identified by linkage of the colposcopy and obstetric databases by means of a unique patient identification number. Outcome of the first >/= 20 week pregnancy following diagnosis will be compared for 535 treated women and 535 women not requiring treatment, using multiple logistic and linear regression models to control for confounding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SAFETY AND EFFICACY OF CAP IN VIVO Principal Investigator & Institution: Cheng-Mayer, Cecilia C.; Associate Professor of Microbiology; New York Blood Center 310 E 67Th St New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 26-SEP-2001; Project End 31-JUL-2005 Description (provided by applicant): Cellulose acetate pthalate (CAP) possesses many of the desirable features of a topical microbicide for prevention of HIV-1 infections in humans, foremost of which is its anti-viral activity in vitro. However, the less than complete protection conferred by a CAP topical cream against vaginal transmission of the simian immunodeficiency virus (SIV) in rhesus macaques raises certain important issues that need to be addressed as part of its development. The applicant hypothesizes that distribution and/or epithelial changes induced by CAP affect its efficacy. Furthermore, structural as well as functional differences in the envelope glycoproteins of HIV and SIV may limit the translation of the finding in the SIV/macaque model to that of the human setting. For these reasons, the applicant proposes to conduct detailed irritation and distribution studies of CAP in rhesus macaques and to assess the protective effect conferred by CAP against vaginal challenge with pathogenic SHIVs. SHIVs are simian/human chimeric viruses in which the env, tat and rev genes of the pathogenic SIVmac239 strain were replaced with their corresponding HIV counterparts. SHIVs that carry the envelopes of CXCR4 (X4) and CCR5 (R5) HIV-1 viruses have been developed and shown to cause disease in naive animals when inoculated intravenously or mucosally. Thus, infection of macaques with X4 and R5 SHIVs provides a range of pathogenesis, cellular involvement and coreceptor usages that parallel HIV infection and disease in humans, and is probably one of the best models available to assess the protective effect of CAP. Three specific aims are proposed. (1) Assess the safety of CAP cream in vivo. Colposcopy as well as measurement of pro-inflammatory chemokines and cytokines will be performed to assess the effect of CAP cream on the vaginal epithelium of rhesus macaques. (2) Assess CAP distribution in vivo by colposcopy and magnetic resonance imaging. (3) Evaluate the protective effect of CAP against challenge with pathogenic X4 and R5 SHIVs. Results from the proposed studies should establish the safety as well as efficacy of CAP in vivo. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SENSITIVITY OF THE COLPOSCOPY EXAM AFTER SEXUAL ASSAULT Principal Investigator & Institution: Sommers, Marilyn S.; None; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 28-FEB-2005 Summary: The National Violence Against Women survey reported that 1 of 6 US women have experienced an attempted or completed rape. Each year almost three million women are injured during rape and sexual assault. Because of the success in identifying microscopic genital injury in sexual assaulted children, more practitioners are using a colposcope during the exam of adult females. Colposcopic photos are then used in court testimony to document non-consensual vs. consensual sex. The specific aim of this study is to determine whether experts can accurately predict consensual vs. non-consensual sex from colposcopic photographs. Research questions include: 1) Can experts differentiate between colposcopic photos of women groups of women: those who have experienced consensual vs. non-consensual sex? 2) When viewed as colposcopic photons, what is the difference in number, type and location of injury to the female genitalia and/or anus after consensual versus non-consensual sex? 3) What are

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Colposcopy

the differences in the sensitivity and specificity of colposcopic photos in detecting injury to the female genitalia and/or anus in African-American and White women? The study will involve prospective enrollment of control subjects who will undergo a colposcopic exam following consensual sex. The photographs derived from the exam will be compared to a retrospective review of photographs from unidentified sexual assault survivors. 100 control subjects who are examined after consensual sexual intercourse will be enrolled over the three years of the study. Chart records and colposcopic photos of sexual assault survivors will be reviewed retrospectively and matched to control subjects by ethnicity, age, and time from assault to exam. A panel of five gynecologic and forensic experts will attempt to differentiate between the photographs of women with consensual (n=100) and non-consensual (n=100) attempt to differentiate between the photographs of women with consensual (n=100) and non-consensual (n=100) sex. They will also determine the frequency, type and location of injury to the female genitalia and/or anus after consensual versus non- consensual sex. Sensitivity, specificity, and other statistics describing the raters' ability to differentiate between the two sets of photographs will be calculated. Findings will also support or refute statements by experts that they can differentiate consensual versus non-consensual sex from colposcopy photos. Ultimately the study has the potential to improve evidencebased practice and enhance conviction rates for rape. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SMOKING CESSATION FOR WOMEN AT RISK OF CERVICAL CANCER Principal Investigator & Institution: Whiteley, Jessica A.; Miriam Hospital Providence, Ri 02906 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Cigarette smoking has been found to be associated with a two-fold increased risk of developing cervical neoplasia or squamous cell cancer. The constituents of smoke, in concert with human papillomavirus (HPV), may promote the development or progression of cervical neoplasia. Thus, women who are positive for HPV and who smoke are at increased risk for developing cervical cancer. Counseling regarding smoking cessation may be of particular benefit for women undergoing screening at a colposcopy clinic for the evaluation of an abnormal Papanicolaou (Pap) smear. This is considered to be a "teachable moment" for smoking cessation, in that the perceived risk of progression to cervical cancer is heightened. Smoking cessation can reduce this risk as well as other health risks. Additionally, women at the colposcopy clinic represent underserved female smokers in that they are young, of low socioeconomic status, and are more likely to be ethnic or racial minorities. In Phase I, three focus groups of 8 -10 women each will be conducted to adapt an efficacious groupbased cognitive-behavioral smoking cessation intervention that is tailored to the needs of women. The adaptations will include modifying the intervention from a group to phone-based delivery format and addressing the unique smoking cessation barriers of the women at our study site colposcopy clinic. In Phase II, the refined materials will be used in a randomized pilot study. Thirty women will be randomized either to an AHRQ + Enhanced Smoking Cessation group (n = 15) or to an AHRQ + Contact Control group (n = 15). Both groups will receive the AHRQ guidelines for smoking cessation (self help materials, brief counseling, recommendation for nicotine replacement therapy) plus phone delivery of either the adapted smoking cessation intervention (AHRQ + Enhanced Cessation) or a health education intervention (AHRQ + Contact Control). Our primary hypothesis is that the women randomized to the AHRQ + Enhanced Cessation

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group will have higher quit rates then women in the AHRQ + Contact Control group. Thus, we seek to: 1) conduct the formative work to adapt the cessation materials from a group to phone-based format and to address the needs of this population, 2) pilot the recruitment strategy, and 3) conduct a small randomized pilot trial to determine the preliminary efficacy of the materials for smoking cessation. This study, therefore, will serve as a pilot for a larger clinical trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SMOKING CESSATION TO REDUCE CERVICAL CANCER RISK Principal Investigator & Institution: Greene, Paul G.; Associate Professor of Medicine and Publ; Medicine; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2001; Project Start 30-SEP-1997; Project End 30-JUN-2003 Summary: Cervical cancer is a major source of morbidity and mortality among women, with a particularly high burden evidenced among women in Alabama. Although HPV has been identified as the major causative agent for cervical cancer, most women with HPV do not develop cervical neoplasia, suggesting that progression to cervical cancer may be influenced by other factors. Smoking has consistently been associated with increased risk for cervical cancer, even among women already at elevated risk due to cervical dysplasia and HPV infection. Further, available data suggest that smoking cessation may decrease cervical cancer risk. These data justify a prospective, controlled study, examining the efficacy of smoking cessation in halting the progression of cervical dysplasia. The proposed 5-year clinical trial will evaluate the effect of a theory-based smoking cessation intervention on progression from low-grade squamous intraepithelial lesions (LSIL) to high-grade squamous intraepithelial lesions (HSIL) in female smokers with HPV. The plan is to recruit 220 current smokers ((10 cigarettes/day) with oncogenic HPV from the University of Alabama at Birmingham Colposcopy Clinic and randomly assign them to one of two treatment conditions: 1)usual care (UC); or 2) smoking cessation intervention (SCI). Patients in both groups will receive standard conservative management for LSIL, biannual pap smears and more aggressive treatment, as needed. Additionally, patients in the SCI group will also participate in an intensive smoking cessation intervention which will include: 1) cognitive-behavioral strategies to facilitate changes in smoking behavior; 2) short-term nicotine replacement therapy to minimize discomfort associated with nicotine withdrawal; and 3) a motivational intervention to promote the optimal use of cognitive-behavioral strategies and nicotine replacement therapy. The primary outcome will be rate of biopsyconfirmed progression to HSIL over 18-month follow-up. The investigators also propose to collect self-report and biochemical measures of smoking status and dysplasia progression. Finally, perceptions about cancer risk and cancer control practices will be assessed to examine relationships with smoking cessation program participation and changes in smoking. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SPERMICIDAL AGENTS AND COLPOSCOPY AND VAGINAL MICROFLORA Principal Investigator & Institution: Creinin, Mitchell B.; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001

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Summary: In this efficacy trial of spermicidal agents, patients are randomly assigned to use one of five FDA approved spermicides, three gels, one suppository, and one vaginal film, as their primary method of birth control for 7 months. Four visits (screen, four weeks, sixteen weeks and thirty weeks) are required. Study participants are also asked to record acts of intercourse, spermicide use, and menses on diary cards. Pelvic exams are performed at screen and final visits for all patients. Colposcopy participants also have colposcopy at every visit and microflora patients collect vaginal flora specimens at every visit. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DYSPLASIA

SPONTANEOUS

REGRESSION

BIOMARKERS

IN

CERVIX

Principal Investigator & Institution: Ho, Gloria Y.; Associate Professor; Epidemiology & Population Health; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2001; Project Start 01-APR-1995; Project End 30-APR-2004 Summary: (Adapted from the Investigator's Abstract) The applicants propose to continue an ongoing prospective study in which women with CIN I or II are recruited and followed in order to identify biomarkers associated with regression of CIN. The following factors will be assessed: (1) humoral immune response to virus-like particles (VLPs) of HPV types 6, 16, 18, 31, 53, and 58, (2) cell-mediated immunity (CMI) to HPV 16 E6 and E7 peptides, (3) class II HLA DQB1 and DRB1 alleles, (4) plasma ascorbic acid level, and (5) red blood cell (RBC) folate level. Continuation of this existing study is necessary to increase sample size and thus provide sufficient statistical power to better understand how these host factors may interact to influence the outcome of CIN. Women will be recruited from the colposcopy clinics of 3 hospitals associated with the Albert Einstein College of Medicine and followed at 3-month intervals by Pap smear and colposcopy for 12 months. At this point, an endpoint biopsy will be performed to determine whether CIN lesions are present ('persistence') or absent ('regression'). At each visit, cervico-vaginal lavage specimens will be collected for HPV DNA analyses by Southern blot and polymerase chain reaction (PCR). Blood will be collected for HPV VLP serology, T cell proliferative response (CMI) assay, plasma reduced ascorbic acid by high pressure liquid chromatography, and RBC folate levels by immunoassay. DNA typing of class II HLA alleles by PCR will be performed using blood collected at baseline. Associations between these factors and regression of CIN will be assessed by appropriate univariate and multivariate analyses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TIME-RESOLVED ACETOWHITENING

IMAGING

OF

CERVICAL

CANCER

Principal Investigator & Institution: Kaufman, Howard L.; Associate Professor; Medispectra, Inc. 45 Hartwell Ave Lexington, Ma 02421 Timing: Fiscal Year 2001; Project Start 21-MAR-2001; Project End 30-NOV-2001 Summary: (Provided by Applicant): This study will examine the use of timed image acquisition, wavelength filtered light and ace to whitening kinetics to improve the accuracy of colposcopy for the routine clinical diagnosis of cervical cancer. A colposcopy workstation will be built with enhanced software and wavelength filtered light capability to collect necessary patient data. A cohort of 25 patients with high grade Cervical Intraepitheliel Neoplasia (C/N II/III will be imaged with the modified I workstation to quantify how these image enhancements improve the predictive value of

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colposcopy. The time-dependent and spectral data will be used to improve the accuracy of colposcopy in the discrimination of high grade lesions from other conditions including low grade lesions (C/NI) and normal tissue. A time-sequenced series of images will be collected after the uniform and timed application of 5 percent acetic acid onto the cervix. Images will be processed to find predictive markers such as (1) lifetime and intensity of acetowhitening and resulting temporal decay curves, and (2) spectral changes in reflectance due to acetowhitening. Techniques will be improved for the processing and analysis of temporal curves to enhance their predictive value. PROPOSED COMMERCIAL APPLICATION: Completion of this Phase I program will lay the groundwork for significantly improved digital colposcopic instrumentation. The timed spectral images of cervical acetowhitening will improve the quality of clinical treatment while reducing costs. As with any new technology, market commercialization will depend on the willingness of physicians to accept the new technology. The device developed in this application, however, is similar to existing colposcopes, and the barrier to acceptance should be less as users in the OB/Gyn community are familiar with this equipment. The device will allow for improved accuracy in the mapping and grading of cervical cancer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TOPICAL MICROBICIDES FOR PREVENTION OF STD & HIV INFECTION Principal Investigator & Institution: Patton, Dorothy L.; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001 Summary: In this project we assessed the potential effectiveness of three vaginal microbicides myeloperoxidase delivered with lactobacilli (MPO+LB), a 0.25% chlorhexidine gluconate formulation (CHG), and octylglycerol, a lipid derived from human breast milk. For each microbicidal compound, we assessed baseline vaginal flora, pH, cytology, and colposcopy and collected cervical swabs for chlamydia detection by culture and LCR. We then added a gel containing MPO+LB, 0.25% CHG, octylglycerol, or appropriate placebo gel, while positive control animals were inoculated with chlamydia only. The gel containing MPO+LB appeared to protect 3 of 4 monkeys from chlamydial infection when assessed by culture and LCR. Vaginal flora was not adversely affected in this group of animals, and the exogenous lactobacilli were transiently detected at increased levels in some of the pretreated monkeys. The 0.25%CHG gel protected all 5 pretreated animals, while the chlamydia control animals tested pos iti ve repeatedly after inoculation. Changes in vaginal flora were minimal in all monkeys. 0.25% CHG did not adversely effect vaginal colonization by lactobacilli. Colposcopic observations revealed a brief induction of cervical and vaginal erythema in animals from both groups. Finally, the octylglycerol lipid was shown to protect 5 of 6 monkeys from chlamydial infection when assessed by culture alone, but only 1 of 6 when cervical swabs were assessed by LCR. It is possible that chlamydial infection was suppressed, delayed or rendered non-infectious by the lipid formulation. Monkeys pretreated with the lipid, as well as those given the placebo gel, developed marked changes in their vaginal flora. It is possible that this lipid, when delivered in an improved gel formulation, will prove to be more protective against infection, and less disruptive to the cervicovaginal environment. FUNDING NIH grants RR00166 and AI39061. Patton, D.L., Cosgrove Sweeney, Y.T., McKay, T.L., Clark, A.M., Rabe, L.K., and Hillier, S.L. 0.25% Chlorhexidine gluconate gel A protective topical microbicide. Sex. Trans. Dis. 25:421-424, 1998. Patton, D.L., Cosgrove Sweeney, Y.T., McKay, T.L.,

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Clark, A.M., Rabe, L.K., and Hillier, S.L. Effects of a single application of 0.25% chlorhexidine gluconate on vaginal flora and chlamydial infection in a monkey model. Fertil. Steril. 69:584, 1998. Patton, D.L., Cosgrove Sweeney, Y.T., Clark, A.M., Rabe, L.K., Klebanoff, S.J., and Hillier, S.L. Effects of a myeloperoxidase plus lactobacillus gel on vaginal flora and chlamydial infection in a monkey model. Abstr. 13 Mtg. Int. Soc. for STD Res., Denver, Co., July 11-14, 1999. Patton, D.L., Isaacs, C.E., Cosgrove Sweeney, Y.T., Clark, A.M., Rabe, L.K., and Hillier, S.L. Effects of a gel containing the lipid octylglycerol on vaginal flora and chlamydial infection in a monkey model. Abstr. 13 Mtg. Int. Soc. for STD Res., Denver, Co., July 11-14, 1999. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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

Detection of Cervical Infections in Colposcopy Clinic Patients. by Lanham S, Herbert A, Basarab A, Watt P.; 2001 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=88265

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Evaluation of adjunctive HPV testing by Hybrid Capture II[reg] in women with minor cytological abnormalities for the diagnosis of CIN2/3 and cost comparison with colposcopy. by Guyot A, Karim S, Kyi MS, Fox J.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=222910

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Management guidelines for women with normal colposcopy after low grade cervical abnormalities: population study. by Teale GR, Moffitt DD, Mann CH, Luesley DM.; 2000 Jun 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27411

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 3 4

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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

“I hope I don't have cancer”: colposcopy and minority women. Author(s): Tomaino-Brunner C, Freda MC, Runowicz CD. Source: Oncology Nursing Forum. 1996 January-February; 23(1): 39-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8628710&dopt=Abstract

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A comparative study of cervical cytology, colposcopy and PCR for HPV in female sex workers in Singapore. Author(s): Chan R, Khoo L, Ho TH, Koh CF, Lee IW, Yam KL, Chandra D, Pang M, Chow V. Source: International Journal of Std & Aids. 2001 March; 12(3): 159-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11231868&dopt=Abstract

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A comparison audit of a genitourinary medicine colposcopy service against nationally agreed quality standards. Author(s): Kellock DJ, Hicks DA. Source: International Journal of Std & Aids. 1998 November; 9(11): 700-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9863585&dopt=Abstract

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A comparison between loop diathermy conization and cold-knife conization for management of cervical dysplasia associated with unsatisfactory colposcopy. Author(s): Oyesanya OA, Amerasinghe C, Manning EA. Source: Gynecologic Oncology. 1993 July; 50(1): 84-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8349168&dopt=Abstract

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A comparison of the reliability of repeat cervical smears and colposcopy in patients with abnormal cervical cytology. Author(s): Mayeaux EJ Jr, Harper MB, Abreo F, Pope JB, Phillips GS. Source: The Journal of Family Practice. 1995 January; 40(1): 57-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7807039&dopt=Abstract

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A comparison of uterine cervical cytology and biopsy results: indications and outcomes for colposcopy. Author(s): Swinker M, Cutlip AC, Ogle D. Source: The Journal of Family Practice. 1994 January; 38(1): 40-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8289050&dopt=Abstract

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A cost-benefit analysis of colposcopy for cervical squamous intraepithelial lesions found on Papanicolaou smear. Author(s): Chesebro MJ, Everett WD. Source: Archives of Family Medicine. 1996 November-December; 5(10): 576-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8930229&dopt=Abstract

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A matched prospective study of human immunodeficiency virus serostatus, human papillomavirus DNA, and cervical lesions detected by cytology and colposcopy. Author(s): Eckert LO, Watts DH, Koutsky LA, Hawes SE, Stevens CE, Kuypers J, Kiviat NB. Source: Infectious Diseases in Obstetrics and Gynecology. 1999; 7(3): 158-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10371475&dopt=Abstract

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A phase I comparative study of contraceptive vaginal films containing benzalkonium chloride and nonoxynol-9. Postcoital testing and colposcopy. Author(s): Mauck CK, Baker JM, Barr SP, Abercrombie TJ, Archer DF. Source: Contraception. 1997 August; 56(2): 89-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9315417&dopt=Abstract

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A phase I comparative study of three contraceptive vaginal films containing nonoxynol-9. Postcoital testing and colposcopy. Author(s): Mauck CK, Baker JM, Barr SP, Johanson WM, Archer DF. Source: Contraception. 1997 August; 56(2): 97-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9315418&dopt=Abstract

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A retrospective analysis of 94 patients with CIN and false negative cervical smears taken at colposcopy. Author(s): Beeby AR, Wadehra V, Keating PJ, Wagstaff TI. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 1993; 4(6): 331-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8110972&dopt=Abstract

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A simple colposcopy examination turned into a nightmare. Author(s): Farr H. Source: Nurs Times. 1998 November 18-24; 94(46): 49. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9923381&dopt=Abstract

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Ability of visual tests to predict underlying cervical neoplasia. Colposcopy and speculoscopy. Author(s): Lonky NM, Mann WJ, Massad LS, Mutch DG, Blanco JS, Vasilev SA, Finan MA, Scotti RJ. Source: J Reprod Med. 1995 July; 40(7): 530-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7473444&dopt=Abstract

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Adherence to colposcopy among women with HIV infection. Author(s): Cejtin HE, Komaroff E, Massad LS, Korn A, Schmidt JB, EisenbergerMatiyahu D, Stier E. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 1999 November 1; 22(3): 247-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10770344&dopt=Abstract

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Adolescent sexual assault: documentation of acute injuries using photo-colposcopy. Author(s): Adams JA, Girardin B, Faugno D. Source: Journal of Pediatric and Adolescent Gynecology. 2001 November; 14(4): 175-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11748013&dopt=Abstract

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Adolescents and colposcopy: the use of different procedures to reduce anxiety. Author(s): Rickert VI, Kozlowski KJ, Warren AM, Hendon A, Davis P. Source: American Journal of Obstetrics and Gynecology. 1994 February; 170(2): 504-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8116704&dopt=Abstract

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Adolescents' responses to sexual abuse evaluation including the use of video colposcopy. Author(s): Mears CJ, Heflin AH, Finkel MA, Deblinger E, Steer RA. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 2003 July; 33(1): 18-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834993&dopt=Abstract

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An audit of standards and quality in a teaching hospital colposcopy clinic. Author(s): Teale G, Etherington I, Luesley D, Jordan J. Source: British Journal of Obstetrics and Gynaecology. 1999 January; 106(1): 83-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10426265&dopt=Abstract

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An evaluation of human papillomavirus testing as part of referral to colposcopy clinics. Author(s): Cox JT, Schiffman MH, Winzelberg AJ, Patterson JM. Source: Obstetrics and Gynecology. 1992 September; 80(3 Pt 1): 389-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1323087&dopt=Abstract

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An evaluation of human papillomavirus testing for intermediate- and high-risk types as triage before colposcopy. Author(s): Hatch KD, Schneider A, Abdel-Nour MW. Source: American Journal of Obstetrics and Gynecology. 1995 April; 172(4 Pt 1): 1150-5; Discussion 1155-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7726250&dopt=Abstract

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An introduction to colposcopy. Concepts, controversies and guidelines for practice. Author(s): Palank CL. Source: Adv Nurse Pract. 1998 October; 6(10): 44-8, 50, 91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9849124&dopt=Abstract

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An investigation into the default rate at the Fife colposcopy clinic: implications for target setting. Author(s): Patterson T, Roworth M, Hill M. Source: Journal of Public Health Medicine. 1995 March; 17(1): 65-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7786572&dopt=Abstract

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An observational study of precolposcopy education sessions: what do women want to know? Author(s): Neale J, Pitts MK, Dunn PD, Hughes GM, Redman CW. Source: Health Care for Women International. 2003 May-June; 24(5): 468-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12916149&dopt=Abstract

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An observational study of women with positive HPV-DNA tests and normal cytology and colposcopy. Author(s): Paraskevaidis E, Davidson EJ, Malamou-Mitsi V, Hirsch PM, Pappa L, Koliopoulos G, Lolis E, Zikopoulos K, Paschopoulos M, Doussias V, Agnantis N. Source: Eur J Gynaecol Oncol. 2002; 23(4): 320-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12214732&dopt=Abstract

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Analgesia for colposcopy: double-masked, randomized comparison of ibuprofen and benzocaine gel. Author(s): Church L, Oliver L, Dobie S, Madigan D, Ellsworth A. Source: Obstetrics and Gynecology. 2001 January; 97(1): 5-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11152898&dopt=Abstract

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Annual colposcopies and pap smears recommended for women with HIV. Author(s): Highleyman L. Source: Beta. 1999 April; 12(2): 6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11366700&dopt=Abstract

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Anxiety and the colposcopy experience. Author(s): Nugent LS, Tamlyn-Leaman K, Isa N, Reardon E, Crumley J. Source: Clinical Nursing Research. 1993 August; 2(3): 267-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8401241&dopt=Abstract

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Anxiety levels in women attending colposcopy clinics for treatment for cervical intraepithelial neoplasia: a randomised trial of written and video information. Author(s): Freeman-Wang T, Walker P, Linehan J, Coffey C, Glasser B, Sherr L. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2001 May; 108(5): 482-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11368133&dopt=Abstract

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Association of cervical cryotherapy with inadequate follow-up colposcopy. Author(s): Sparks RA, Scheid D, Loemker V, Stader E, Reilly K, Hamm R, McCarthy L. Source: The Journal of Family Practice. 2002 June; 51(6): 526-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12100775&dopt=Abstract

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Atypical squamous cells of undetermined significance: A cytohistological study in a colposcopy clinic. Author(s): Ettler HC, Joseph MG, Downing PA, Suskin NG, Wright VC. Source: Diagnostic Cytopathology. 1999 September; 21(3): 211-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10450110&dopt=Abstract

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Audit of cervical screening and colposcopy in HIV-positive women at a central London teaching hospital. Author(s): Vonau BU, Boag F, Barton SE. Source: International Journal of Std & Aids. 1999 November; 10(11): 755-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10563567&dopt=Abstract

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Audit of colposcopy biopsy sectioning. Author(s): Johnson J, Hughes R. Source: Journal of Clinical Pathology. 2001 September; 54(9): 735-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11533089&dopt=Abstract

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Avoiding conization for inadequate colposcopy. Suggestions for conservative therapy. Author(s): Yandell RB, Hannigan EV, Dinh TV, Buchanan VS. Source: J Reprod Med. 1996 March; 41(3): 135-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8778408&dopt=Abstract

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Can precolposcopy education increase knowledge and decrease anxiety? Author(s): Tomaino-Brunner C, Freda MC, Damus K, Runowicz CD. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1998 November-December; 27(6): 636-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9836158&dopt=Abstract

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Can pre-colposcopy sessions reduce anxiety at the time of colposcopy? A prospective randomised study. Author(s): Byrom J, Clarke T, Neale J, Dunn PD, Hughes GM, Redman CW, Pitts M. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 July; 22(4): 415-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521468&dopt=Abstract

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Cervical cancer. 2: Colposcopy, treatment and patient education. Author(s): Peate I. Source: British Journal of Nursing (Mark Allen Publishing). 1999 June 24-July 7; 8(12): 805-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10670298&dopt=Abstract

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Cervical cytology and colposcopy in clinics for sexually transmitted diseases--when are they appropriate? Author(s): Wilson JD. Source: Genitourinary Medicine. 1996 December; 72(6): 396-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9038633&dopt=Abstract

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Cervical cytology and colposcopy in young patients attending genitourinary medicine clinics: invalid intrusion or preventive opportunity and definitive audit? Author(s): Moss TR. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 1999 February; 10(1): 2-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10068881&dopt=Abstract

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Cervical disease in women referred to colposcopy following inadequate smears. Author(s): Hollingworth J, Kotecha K, Dobbs SP, Shaw PA, Ireland D. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 2000 February; 11(1): 45-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10714375&dopt=Abstract

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Cervical loop excision: colposcopy limits in pre-surgical assessment of CIN lesions. Author(s): Costa S, De Nuzzo M, Bonavita B, Infante FE, Marinelli M, Rambelli V, Rubino A. Source: Tumori. 2001 September-October; 87(5): S13-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765194&dopt=Abstract

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Cervical screening: management of patients referred for colposcopy with smear abnormalities less severe than dyskaryosis. Author(s): Usman F, Hammond R. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 1998 April; 9(2): 100-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9577736&dopt=Abstract

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Changing the rules of colposcopy. Author(s): Noller KL. Source: Gynecologic Oncology. 1994 May; 53(2): 146-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8188071&dopt=Abstract

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Chemical burns in colposcopy; a hazard in GUM clinics? Author(s): Clarke J, De Silva PA. Source: International Journal of Std & Aids. 1994 March-April; 5(2): 142-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8031919&dopt=Abstract

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Chlamydia trachomatis, herpes simplex virus 2, and human T-cell lymphotrophic virus type 1 are not associated with grade of cervical neoplasia in Jamaican colposcopy patients. Author(s): Castle PE, Escoffery C, Schachter J, Rattray C, Schiffman M, Moncada J, Sugai K, Brown C, Cranston B, Hanchard B, Palefsky JM, Burk RD, Hutchinson ML, Strickler HD. Source: Sexually Transmitted Diseases. 2003 July; 30(7): 575-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12838087&dopt=Abstract

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Clinical value of repeat Pap smear at the time of colposcopy. Author(s): Zardawi IM, Rode JW. Source: Acta Cytol. 2002 May-June; 46(3): 495-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12040643&dopt=Abstract

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Colposcopy 101: a didactic curriculum to complement the clinical experience. Author(s): Deizell JE Jr, Pereira SL, Ruplinger J. Source: Family Medicine. 2001 October; 33(9): 658-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11665901&dopt=Abstract

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Colposcopy and cervical biopsy educational training models. Author(s): Ferris DG, Waxman AG, Miller MD. Source: Family Medicine. 1994 January; 26(1): 30-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8132142&dopt=Abstract

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Colposcopy and directed biopsy reliability during pregnancy: a cohort study. Author(s): Baldauf JJ, Dreyfus M, Ritter J, Philippe E. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1995 September; 62(1): 31-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7493705&dopt=Abstract

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Colposcopy and microcolpohysteroscopy qualification for large loop excision of the transformation zone (LLETZ) in the management of cervical intraepithelial neoplasia. Author(s): Pitynski K, Basta A. Source: Eur J Gynaecol Oncol. 1999; 20(3): 209-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10410888&dopt=Abstract

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Colposcopy and rape. Author(s): Patel HC, Courtney GM, Forster GE. Source: American Journal of Obstetrics and Gynecology. 1993 April; 168(4): 1334-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8475986&dopt=Abstract

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Colposcopy and referral. Author(s): Preston RC. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1997 November-December; 10(6): 447. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9407488&dopt=Abstract

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Colposcopy and treatment of cervical intra-epithelial neoplasia: are national standards achievable? Author(s): Semple D, Saha A, Maresh M. Source: British Journal of Obstetrics and Gynaecology. 1999 April; 106(4): 351-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10426242&dopt=Abstract

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Colposcopy as a primary screening test for cervical cancer. Author(s): Cecchini S, Bonardi R, Iossa A, Zappa M, Ciatto S. Source: Tumori. 1997 September-October; 83(5): 810-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9428912&dopt=Abstract

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Colposcopy as a tool for detection of human papillomavirus infection of uterine cervix in the setting of high prevalence of gynaecologic infections. Author(s): Singh V, Parashari A, Sodhani P, Chattopadhya D, Satyanarayana L, Gupta MM, Sehgal A. Source: Singapore Med J. 1996 December; 37(6): 588-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9104055&dopt=Abstract

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Colposcopy dilemma in Washington. Author(s): Ferris DG. Source: Archives of Family Medicine. 1994 May; 3(5): 401-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8032499&dopt=Abstract

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Colposcopy for cervical squamous intraepithelial lesions found on Papanicolaou smear. Author(s): Reed BD. Source: Archives of Family Medicine. 1996 November-December; 5(10): 582-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8930230&dopt=Abstract

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Colposcopy for family physicians. Author(s): Harper DM. Source: Archives of Family Medicine. 1994 May; 3(5): 400-1, 402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8080538&dopt=Abstract

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Colposcopy for the diagnosis of squamous intraepithelial lesions: a meta-analysis. Author(s): Mitchell MF, Schottenfeld D, Tortolero-Luna G, Cantor SB, Richards-Kortum R. Source: Obstetrics and Gynecology. 1998 April; 91(4): 626-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9540955&dopt=Abstract

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Colposcopy in a private family practice: a one year experience. Author(s): Spoelhof GD. Source: Fam Pract Res J. 1994 March; 14(1): 97-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8048353&dopt=Abstract

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Colposcopy in evaluation of the adult sexual assault victim. Author(s): Lenahan LC, Ernst A, Johnson B. Source: The American Journal of Emergency Medicine. 1998 March; 16(2): 183-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9517700&dopt=Abstract

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Colposcopy in general practice. Author(s): Cherry S, Blackledge D, Russell R. Source: Aust Fam Physician. 1996 November; 25(11): 1737-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8952109&dopt=Abstract

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Colposcopy in pregnancy. Author(s): Campion MJ, Sedlacek TV. Source: Obstetrics and Gynecology Clinics of North America. 1993 March; 20(1): 153-63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8332307&dopt=Abstract

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Colposcopy in pregnancy: directed brush cytology compared with cervical biopsy. Author(s): Krumholz BA. Source: Obstetrics and Gynecology. 1999 December; 94(6): 1054-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10576202&dopt=Abstract

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Colposcopy in pregnancy: directed brush cytology compared with cervical biopsy. Author(s): Lieberman RW, Henry MR, Laskin WB, Walenga J, Buckner SB, O'Connor DM. Source: Obstetrics and Gynecology. 1999 August; 94(2): 198-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10432127&dopt=Abstract

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Colposcopy in the diagnosis of human papilloma virus infection, cervical intraepithelial neoplasia and invasive carcinoma. Author(s): Bajwa R, Khan SA, Qureshi GR, Chaudhry NA. Source: J Pak Med Assoc. 1993 December; 43(12): 257-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8133637&dopt=Abstract

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Colposcopy in women with a normal Papanicolaou smear. Author(s): Peedicayil A, Regi A, Mathai M, Jasper P. Source: Natl Med J India. 1994 September-October; 7(5): 208-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7827598&dopt=Abstract

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Colposcopy may not be clinically relevant. Author(s): Terry RR. Source: J Am Osteopath Assoc. 1999 February; 99(2): 89-90. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10079640&dopt=Abstract

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Colposcopy monitoring in pregnancy complicated by CIN and early cervical cancer. Author(s): Madej JG Jr. Source: Eur J Gynaecol Oncol. 1996; 17(1): 59-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8750518&dopt=Abstract

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Colposcopy of adenocarcinoma in situ and invasive adenocarcinoma of the cervix. Author(s): Lickrish GM, Colgan TJ, Wright VC. Source: Obstetrics and Gynecology Clinics of North America. 1993 March; 20(1): 111-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8332305&dopt=Abstract

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Colposcopy of intraepithelial neoplasia of the vulva and adjacent sites. Author(s): Wright VC, Chapman WB. Source: Obstetrics and Gynecology Clinics of North America. 1993 March; 20(1): 231-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8332309&dopt=Abstract

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Colposcopy of the normal transformation zone. Author(s): Jordan JA. Source: Obstetrics and Gynecology Clinics of North America. 1993 March; 20(1): 69-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8332312&dopt=Abstract

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Colposcopy of vaginal and vulvar human papillomavirus and adjacent sites. Author(s): Hatch K. Source: Obstetrics and Gynecology Clinics of North America. 1993 March; 20(1): 203-15. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8392676&dopt=Abstract

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Colposcopy services provided by Genito-Urinary Medicine clinics in the United Kingdom--British Society for Colposcopy and Cervical Pathology/National Coordinating Network Survey, 1993. Author(s): Shen RN, Hicks DA, Cruickshank ME. Source: International Journal of Std & Aids. 1996 March-April; 7(2): 98-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8737332&dopt=Abstract

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Colposcopy training in residency programs: a new dilemma. Author(s): Nuovo J, Melnikow J. Source: Family Medicine. 1996 July-August; 28(7): 502-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8818622&dopt=Abstract

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Colposcopy, cervical cytology and human papillomavirus detection as screening tools for cervical cancer. Author(s): Al-Alwan NA. Source: East Mediterr Health J. 2001 January-March; 7(1-2): 100-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12596958&dopt=Abstract

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Colposcopy, cervicography, speculoscopy and endoscopy. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial. Author(s): van Niekerk WA, Dunton CJ, Richart RM, Hilgarth M, Kato H, Kaufman RH, Mango LJ, Nozawa S, Robinowitz M. Source: Acta Cytol. 1998 January-February; 42(1): 33-49. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9479322&dopt=Abstract

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Colposcopy, colpocytology and the vaginal ecosystem. Oncological, bacteriological and hormonal evaluation in a series of 400 women. Author(s): Torrisi A, Onnis GL, Minucci D. Source: Clin Exp Obstet Gynecol. 1994; 21(3): 177-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7923799&dopt=Abstract

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Colposcopy, cytology and histology in the diagnosis of squamous intraepithelial lesions of the cervix. Author(s): Carta G, Di Stefano L, Catellani Perelli A, Toro G, Moscarini M. Source: Clin Exp Obstet Gynecol. 1999; 26(2): 60-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10459438&dopt=Abstract

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Colposcopy, cytology and HPV-DNA testing in HIV-positive and HIV-negative women. Author(s): Torrisi A, Del Mistro A, Onnis GL, Merlin F, Bertorelle R, Minucci D. Source: Eur J Gynaecol Oncol. 2000; 21(2): 168-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10843478&dopt=Abstract

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Colposcopy, LEEP, and other procedures: the role for family physicians. Author(s): Pfenninger JL. Source: Family Medicine. 1996 July-August; 28(7): 505-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8818623&dopt=Abstract

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Colposcopy. Author(s): Smith T. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 1997 July 30; 11(45): 49-54; Quiz 55-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9326013&dopt=Abstract

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Colposcopy. Author(s): Smith T. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2000 October 11-17; 15(4): 47-52; Quiz 54-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11971495&dopt=Abstract

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Colposcopy. Author(s): Mazza D. Source: Aust Fam Physician. 1999 March; 28(3): 260-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10098305&dopt=Abstract

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Colposcopy. Author(s): Pfenninger JL, Ferris DG, Apgar BS. Source: The Journal of Family Practice. 1992 September; 35(3): 248. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1517714&dopt=Abstract

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Colposcopy: sensory information for client education. Author(s): Nugent LS, Clark CR. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1996 March-April; 25(3): 225-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8683357&dopt=Abstract

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Combined colposcopy, loop conization, and laser vaporization reduces recurrent abnormal cytology and residual disease in cervical dysplasia. Author(s): Bar-Am A, Daniel Y, Ron IG, Niv J, Kupferminc MJ, Bornstein J, Lessing JB. Source: Gynecologic Oncology. 2000 July; 78(1): 47-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10873409&dopt=Abstract

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Combined cytology and colposcopy to screen for cervical cancer in pregnancy. Author(s): Int J Gynaecol Obstet. 1998 Nov;63(2):228-9 Source: J Reprod Med. 1998 August; 43(8): 647-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9856334

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Comparing two modalities of management of women with cytologic evidence of squamous or glandular atypia: early repeat cytology or colposcopy. Author(s): Cecchini S, Iossa A, Bonardi R, Ciatto S, Cariaggi P. Source: Tumori. 1997 July-August; 83(4): 732-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9349311&dopt=Abstract

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Comparison of an intraoral camera with colposcopy in sexually abused children. Author(s): Siegel RM, Hill TD, Henderson VA, Daniels K. Source: Clinical Pediatrics. 1999 June; 38(6): 375-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10378098&dopt=Abstract

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Comparison of immediate and deferred colposcopy in a cervical screening program. Author(s): Parham GP, Andrews NR, Lee ML. Source: Obstetrics and Gynecology. 2000 March; 95(3): 340-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10711540&dopt=Abstract

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Colposcopy

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Comparison of magnified chemiluminescent examination with incandescent light examination and colposcopy for detection of cervical neoplasia. Author(s): Suneja A, Mahishee, Agarwal N, Misra K. Source: Indian Journal of Cancer. 1998 June; 35(2): 81-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9849029&dopt=Abstract

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Comparison of two signal-amplification DNA tests for high-risk HPV as an aid to colposcopy. Author(s): Pretorius RG, Peterson P, Novak S, Azizi F, Sadeghi M, Lorincz AT. Source: J Reprod Med. 2002 April; 47(4): 290-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12012880&dopt=Abstract

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Computerized colposcopy and conservative management of cervical intraepithelial neoplasia in pregnancy. Author(s): Mikhail MS, Anyaegbunam A, Romney SL. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1995 May; 74(5): 376-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7778432&dopt=Abstract

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Computerized colposcopy: results of a pilot study and analysis of its clinical relevance. Author(s): Cristoforoni PM, Gerbaldo D, Perino A, Piccoli R, Montz FJ, Capitanio GL. Source: Obstetrics and Gynecology. 1995 June; 85(6): 1011-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7770246&dopt=Abstract

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Consequences of current patterns of Pap smear and colposcopy use. Author(s): Kavanagh AM, Santow G, Mitchell H. Source: Journal of Medical Screening. 1996; 3(1): 29-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8861048&dopt=Abstract

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Contribution of human papillomavirus testing by hybrid capture in the triage of women with repeated abnormal pap smears before colposcopy referral. Author(s): Fait G, Kupferminc MJ, Daniel Y, Geva E, Ron IG, Lessing JB, Bar-Am A. Source: Gynecologic Oncology. 2000 November; 79(2): 177-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11063640&dopt=Abstract

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Controversies in colposcopy. Author(s): Walker P. Source: Hosp Med. 1998 August; 59(8): 662. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9829068&dopt=Abstract

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Controversies in colposcopy. Author(s): Shafi MI. Source: Br J Hosp Med. 1997 September 17-30; 58(6): 246-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9488796&dopt=Abstract

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Correlation between atypical colposcopy findings and detection of human papillomavirus (HPV) infection of the uterine cervix. Author(s): Perovic M, Berisavac M, Kuljic-Kapulica N, Jovanovic T. Source: Eur J Gynaecol Oncol. 2002; 23(1): 42-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11876390&dopt=Abstract

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Cytohistologic discrepancies in cervical intraepithelial neoplasia and value of repeat cervical smears taken during colposcopy. Author(s): Smith RC, Nguyen GK. Source: Diagnostic Cytopathology. 1998 April; 18(4): 317-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9557271&dopt=Abstract

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Cytologic-histologic discrepancy in human immunodeficiency virus-positive women referred to a colposcopy clinic. Author(s): Boardman LA, Peipert JF, Cooper AS, Cu-Uvin S, Flanigan T, Raphael SI. Source: Obstetrics and Gynecology. 1994 December; 84(6): 1016-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7970456&dopt=Abstract

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Cytology and colposcopy after loop electrosurgical excision: implications for followup. Author(s): Baldauf JJ, Dreyfus M, Ritter J, Cuenin C, Tissier I, Meyer P. Source: Obstetrics and Gynecology. 1998 July; 92(1): 124-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9649107&dopt=Abstract

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Cytology, histology, and colposcopy in the diagnosis of neoplastic non-invasive epithelial lesions of the cervix. Author(s): Gullotta G, Margariti PA, Rabitti C, Balsamo G, Valle D, Capelli A, Mancuso S. Source: Eur J Gynaecol Oncol. 1997; 18(1): 36-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9061320&dopt=Abstract

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Decision-making in the colposcopy clinic--a critical analysis. Author(s): Bornstein J, Yaakov Z, Pascal B, Faktor J, Baram A, Zarfati D, Abramovici H. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1999 August; 85(2): 219-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10584639&dopt=Abstract

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Detecting premalignant cervical lesions. Contribution of screening colposcopy to cytology. Author(s): Davison JM, Marty JJ. Source: J Reprod Med. 1994 May; 39(5): 388-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8064706&dopt=Abstract

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Detection and genotyping of human papillomavirus DNA by SPF10 and MY09/11 primers in cervical cells taken from women attending a colposcopy clinic. Author(s): Perrons C, Kleter B, Jelley R, Jalal H, Quint W, Tedder R. Source: Journal of Medical Virology. 2002 June; 67(2): 246-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11992586&dopt=Abstract

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Detection of cervical infections in colposcopy clinic patients. Author(s): Lanham S, Herbert A, Basarab A, Watt P. Source: Journal of Clinical Microbiology. 2001 August; 39(8): 2946-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11474018&dopt=Abstract

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Detection of human papillomavirus DNA in patients referred to a family practice colposcopy clinic. Author(s): Holman JR. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1996 May-June; 9(3): 162-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8743228&dopt=Abstract

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Detection of viral and bacterial infections in women with normal and abnormal colposcopy. Author(s): Pisani S, Gallinelli C, Seganti L, Lukic A, Nobili F, Vetrano G, Imperi M, Degener AM, Chiarini F. Source: Eur J Gynaecol Oncol. 1999; 20(1): 69-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10422688&dopt=Abstract

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Diagnostic accuracy of cytology and colposcopy in cervical squamous intraepithelial lesions. Author(s): Kierkegaard O, Byrjalsen C, Frandsen KH, Hansen KC, Frydenberg M. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1994 September; 73(8): 648-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7941991&dopt=Abstract

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Diagnostic value of cytology and colposcopy for squamous and glandular cervical intraepithelial lesions. Author(s): Pajtler M, Audy-Jurkovic S, Ovanin-Rakic A, Makarovic Z, Milojkovic M, Ljubojevic N. Source: Coll Antropol. 2003 June; 27(1): 239-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12974152&dopt=Abstract

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Diagnostic value of endocervical curettage during colposcopy. Author(s): Dreyfus M, Baldauf JJ, Ritter J. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1996 January; 64(1): 101-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8801132&dopt=Abstract

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Digital color imaging colposcopy: a matter of choice. Author(s): Hopman EH, Rozendaal L, Verheijen RH, Kenemans P, Helmerhorst TJ. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1998 April; 77(2): 229-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9578283&dopt=Abstract

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Digital imaging colposcopy, image analysis and quantification of the colposcopic image. Author(s): Shafi MI, Dunn JA, Chenoy R, Buxton EJ, Williams C, Luesley DM. Source: British Journal of Obstetrics and Gynaecology. 1994 March; 101(3): 234-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8193099&dopt=Abstract

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Digital imaging colposcopy: basic concepts and applications. Author(s): Craine BL, Craine ER. Source: Obstetrics and Gynecology. 1993 November; 82(5): 869-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8414341&dopt=Abstract

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Digital imaging colposcopy: corrected area measurements using shape-from-shading. Author(s): Craine BL, Craine ER, O'Toole CJ, Ji Q. Source: Ieee Transactions on Medical Imaging. 1998 December; 17(6): 1003-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10048857&dopt=Abstract

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Dilating the cervix medically to overcome an unsatisfactory colposcopy: 5 year follow up. Author(s): Johnson N, Brady J. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1996 November; 69(2): 125-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8902445&dopt=Abstract

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Do all grade I lesions on colposcopy need to be biopsied? Author(s): Suneja A, Guleria K, Mahishee, Mishra K, Agarwal N. Source: Indian Journal of Cancer. 1999 June-December; 36(2-4): 135-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10921217&dopt=Abstract

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Does a family physician who offers colposcopy and LEEP need to refer patients to a gynecologist? Author(s): Callaway P, Frisch L. Source: The Journal of Family Practice. 2000 June; 49(6): 534-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10923554&dopt=Abstract

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Does the system of Papanicolaou test nomenclature affect the rate of referral for colposcopy? A survey of family physicians. Author(s): Melnikow J, Sierk A, Flocke S, Peters CA. Source: Archives of Family Medicine. 1993 March; 2(3): 253-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8252144&dopt=Abstract

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Early cervical neoplasia confirmed by conization: diagnostic accuracy of cytology, colposcopy and punch biopsy. Author(s): Matsuura Y, Kawagoe T, Toki N, Sugihara K, Kashimura M. Source: Acta Cytol. 1996 March-April; 40(2): 241-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8629405&dopt=Abstract

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Effects of age and human papilloma viral load on colposcopy triage: data from the randomized Atypical Squamous Cells of Undetermined Significance/Low-Grade Squamous Intraepithelial Lesion Triage Study (ALTS). Author(s): Sherman ME, Schiffman M, Cox JT; Atypical Squamous Cells of Undetermined Significance/Low-Grade Squamous Intraepithelial Lesion Triage Study Group. Source: Journal of the National Cancer Institute. 2002 January 16; 94(2): 102-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11792748&dopt=Abstract

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Effects of ball cauterization following loop excision and follow-up colposcopy. Author(s): Paraskevaidis E, Koliopoulos G, Paschopoulos M, Stefanidis K, Navrozoglou I, Lolis D. Source: Obstetrics and Gynecology. 2001 April; 97(4): 617-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11275038&dopt=Abstract

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Effects of coping style on psychological reactions of low-income, minority women to colposcopy. Author(s): Miller SM, Roussi P, Altman D, Helm W, Steinberg A. Source: J Reprod Med. 1994 September; 39(9): 711-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7807485&dopt=Abstract

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Emotional reactions and colposcopy. Author(s): Magherini P, Cecchini S, Catagni CF, Francisca FD, Ciatto S, Grazzini G. Source: Journal of Epidemiology and Community Health. 1996 February; 50(1): 108-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8762369&dopt=Abstract

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Emotional reactions in women attending a UK colposcopy clinic. Author(s): Gath DH, Hallam N, Mynors-Wallis L, Day A, Bond SA. Source: Journal of Epidemiology and Community Health. 1995 February; 49(1): 79-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7707011&dopt=Abstract

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Evaluation of liquid-based cytology in cervical screening of high-risk populations: a split study of colposcopy and genito-urinary medicine populations. Author(s): Ring M, Bolger N, O'Donnell M, Malkin A, Bermingham N, Akpan E, Mulcahy F, Turner MJ, Griffin M, O'Leary JJ. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 2002 June; 13(3): 152-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12060077&dopt=Abstract

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Every woman with an abnormal cervical smear should not be referred for colposcopy: debate. Author(s): Prendiville W, Walker P. Source: Clinical Obstetrics and Gynecology. 1995 September; 38(3): 592-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8612369&dopt=Abstract

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Exophytic cervical warts--an indication for colposcopy? Author(s): Evans BA, Bond RA, Macrae KD. Source: Genitourinary Medicine. 1993 June; 69(3): 244. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8335324&dopt=Abstract

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Exophytic cervical warts--an indication for colposcopy? Author(s): Murphy M, Fairley I, Wilson J. Source: Genitourinary Medicine. 1993 February; 69(1): 81-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8444494&dopt=Abstract

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Expanded cytological referral criteria for colposcopy in cervical screening: comparison with human papillomavirus testing. Author(s): Paraskevaidis E, Malamou-Mitsi V, Koliopoulos G, Pappa L, Lolis E, Georgiou I, Agnantis NJ. Source: Gynecologic Oncology. 2001 August; 82(2): 355-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11531293&dopt=Abstract

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Experience of operating a 'see and treat' policy in a colposcopy clinic in a district general hospital. Author(s): Rodgers CA. Source: International Journal of Std & Aids. 1996 November-December; 7(7): 540. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9116075&dopt=Abstract

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Factors influencing default at a hospital colposcopy clinic. Author(s): Sanders G, Craddock C, Wagstaff I. Source: Quality in Health Care : Qhc. 1992 December; 1(4): 236-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10136870&dopt=Abstract

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Follow-up of a decentralized colposcopy program for the investigation and management of cervical intraepithelial neoplasia in the central Canadian Arctic. Author(s): Martin BD, Smith WL, Orr P, Guijon F. Source: Int J Circumpolar Health. 1998; 57 Suppl 1: 406-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10093315&dopt=Abstract

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Frequency of nondiagnostic findings on colposcopy: implications for management. Author(s): Nuovo J, Kreiter L. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1993 May-June; 6(3): 209-14. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8503290&dopt=Abstract

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Genital human papillomavirus infection among women recruited for routine cervical cancer screening or for colposcopy determined by Hybrid Capture II and polymerase chain reaction. Author(s): Riethmuller D, Gay C, Bertrand X, Bettinger D, Schaal JP, Carbillet JP, Lassabe C, Arveux P, Seilles E, Mougin C. Source: Diagnostic Molecular Pathology : the American Journal of Surgical Pathology, Part B. 1999 September; 8(3): 157-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10565688&dopt=Abstract

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Health literacy, cervical cancer risk factors, and distress in low-income AfricanAmerican women seeking colposcopy. Author(s): Sharp LK, Zurawski JM, Roland PY, O'Toole C, Hines J. Source: Ethn Dis. 2002 Fall; 12(4): 541-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477141&dopt=Abstract

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High fees for colposcopy challenged. Author(s): Garrison RL. Source: Family Medicine. 1996 October; 28(9): 610. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8909957&dopt=Abstract

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High risk human papillomavirus in women with normal cervical cytology prior to the development of abnormal cytology and colposcopy. Author(s): Hopman EH, Rozendaal L, Voorhorst FJ, Walboomers JM, Kenemans P, Helmerhorst TJ. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2000 May; 107(5): 600-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10826572&dopt=Abstract

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History of colposcopy in the United States. Chronology of colposcopy development worldwide. Author(s): Torres JE, Riopelle MA. Source: Obstetrics and Gynecology Clinics of North America. 1993 March; 20(1): 1-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8332304&dopt=Abstract

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HPV detection and measurement of HPV-16, telomerase, and survivin transcripts in colposcopy clinic patients. Author(s): Lanham S, Herbert A, Watt P. Source: Journal of Clinical Pathology. 2001 April; 54(4): 304-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11304848&dopt=Abstract

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Human papillomavirus deoxyribonucleic acid detection in mildly or moderately dysplastic smears: a possible method for selecting patients for colposcopy. Author(s): Bollen LJ, Tjong-A-Hung SP, van der Velden J, Brouwer K, Mol BW, ten Kate FJ, ter Schegget J. Source: American Journal of Obstetrics and Gynecology. 1997 September; 177(3): 548-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9322622&dopt=Abstract

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Human papillomavirus detection in cervical smears and cervical tissue excised by the Loop Electrosurgical Excision Procedure (LEEP). Diagnostic value of cytology, colposcopy and histology. Author(s): Vardar MA, Altintas A, Doran F, Aridogan N, Demir C, Burgut R, Varinli S. Source: Eur J Gynaecol Oncol. 1995; 16(6): 494-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8536765&dopt=Abstract

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Image digitalization and processing: the role of informatics in colposcopy. Author(s): Cristoforoni P. Source: Tumori. 2001 September-October; 87(5): S16-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765198&dopt=Abstract

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Immediate colposcopy or cytological surveillance for women with mild dyskaryosis: a cost effectiveness analysis. Author(s): Flannelly G, Campbell MK, Meldrum P, Torgerson DJ, Templeton A, Kitchener HC. Source: Journal of Public Health Medicine. 1997 December; 19(4): 419-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9467148&dopt=Abstract

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Improved forensic documentation of genital injuries with colposcopy. Author(s): O'Brien C. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 1997 October; 23(5): 460-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9369612&dopt=Abstract

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Ineffectiveness of topical benzocaine spray during colposcopy. Author(s): Clifton PA, Shaughnessy AF, Andrews S. Source: The Journal of Family Practice. 1998 March; 46(3): 242-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9519022&dopt=Abstract

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Information leaflets, verbal information and women's knowledge of abnormal cervical smears and colposcopy. Author(s): Onyeka BA, Martin-Hirsch P. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2003 March; 23(2): 174-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745564&dopt=Abstract

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International standards for training in colposcopy. Author(s): Jordan J. Source: Clinical Obstetrics and Gynecology. 1995 September; 38(3): 662-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8612377&dopt=Abstract

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International terminology of colposcopy: an updated report from the International Federation for Cervical Pathology and Colposcopy. Author(s): Walker P, Dexeus S, De Palo G, Barrasso R, Campion M, Girardi F, Jakob C, Roy M; Nomenclature Committee of the International Federation for Cervical Pathology and Colposcopy. Source: Obstetrics and Gynecology. 2003 January; 101(1): 175-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517664&dopt=Abstract

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Interpretation of colposcopy data. Author(s): Harper DM. Source: The Journal of Family Practice. 2003 May; 52(5): 390, 392; Author Reply 392. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765178&dopt=Abstract

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Introducing colposcopy and vulvovaginoscopy as routine examinations for victims of sexual assault. Author(s): Mancino P, Parlavecchio E, Melluso J, Monti M, Russo P. Source: Clin Exp Obstet Gynecol. 2003; 30(1): 40-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12731743&dopt=Abstract

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Investigating non-attendance at colposcopy clinic. Author(s): Yassin AS, Howell RJ, Nysenbaum AM. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 January; 22(1): 79-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521736&dopt=Abstract

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Investigation of colposcopy information on the internet. Author(s): Kim YT, Kim SH, Kim JW, Shin JS, Park KH. Source: Yonsei Medical Journal. 2003 April 30; 44(2): 307-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12728473&dopt=Abstract

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Is default from colposcopy a problem, and if so what can we do? A systematic review of the literature. Author(s): Lester H, Wilson S. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 1999 March; 49(440): 223-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10343430&dopt=Abstract

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Is the provision of information leaflets before colposcopy beneficial? A prospective randomised study. Author(s): Howells RE, Dunn PD, Isasi T, Chenoy R, Calvert E, Jones PW, Shroff JF, Redman CW. Source: British Journal of Obstetrics and Gynaecology. 1999 June; 106(6): 528-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10426608&dopt=Abstract

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Is the SANE role within the scope of nursing practice? On “pelvics,” “colposcopy,” and “dispensing of medications”. Author(s): Ledray LE. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2000 February; 26(1): 79-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10657807&dopt=Abstract

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Knowledge of cervical cancer screening among women attending urban colposcopy clinics. Author(s): Massad LS, Meyer P, Hobbs J. Source: Cancer Detection and Prevention. 1997; 21(1): 103-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9043770&dopt=Abstract

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Management choice and adherence to follow-up after colposcopy in women with cervical intraepithelial neoplasia 1. Author(s): Hartz LE, Fenaughty AM. Source: Obstetrics and Gynecology. 2001 October; 98(4): 674-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11576587&dopt=Abstract

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Management guidelines for women with normal colposcopy after low grade cervical abnormalities: population study. Author(s): Teale GR, Moffitt DD, Mann CH, Luesley DM. Source: Bmj (Clinical Research Ed.). 2000 June 24; 320(7251): 1693-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10864542&dopt=Abstract

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Management of cervical dyskaryosis. Colposcopy is not cost effective. Author(s): Jones MH, Jones JJ. Source: Bmj (Clinical Research Ed.). 1994 July 23; 309(6949): 268. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8069147&dopt=Abstract

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Management of cervical dyskaryosis. Immediate colposcopy is necessary. Author(s): Thomas MA, Reay LM. Source: Bmj (Clinical Research Ed.). 1994 July 23; 309(6949): 268. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8069148&dopt=Abstract

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Management of women with mild dyskaryosis. Immediate referral to colposcopy is safer. Author(s): Soutter WP. Source: Bmj (Clinical Research Ed.). 1994 September 3; 309(6954): 591-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8086951&dopt=Abstract

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Microcolpohysteroscopy compared with colposcopy in evaluation of abnormal cervical cytology. Author(s): Sharma R, Mittal S, Kriplani A, Buckshee K. Source: Indian Journal of Cancer. 1995 September; 32(3): 131-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8772813&dopt=Abstract

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Microcolposcopy vs colposcopy in evaluating abnormal Pap smear. Comparison with histological findings. Author(s): Framarino dei Malatesta ML, Carraro C, Silvestrini I, Marzetti L, Vecchione A. Source: Clin Exp Obstet Gynecol. 1993; 20(4): 236-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8281705&dopt=Abstract

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Microcolposcopy. When and how to do it. Author(s): Reed TP, Saade G. Source: J Reprod Med. 1993 September; 38(9): 725-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8254597&dopt=Abstract

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More “pointed” discussion held on colposcopy. Author(s): Ferris DG. Source: Family Medicine. 1997 February; 29(2): 86-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9048165&dopt=Abstract

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Natural history of false-negative papanicolaou smears: a prospective study using screening colposcopy in addition to cytology. Author(s): Mannino JR. Source: J Am Osteopath Assoc. 1998 October; 98(10): 542-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9821735&dopt=Abstract

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Nondiagnostic and inconsistent results from colposcopy. Author(s): Newkirk GR. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1993 May-June; 6(3): 318-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8503305&dopt=Abstract

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Nondiagnostic colposcopy findings. Author(s): Ferris DG. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1993 November-December; 6(6): 615-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8285106&dopt=Abstract

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Nurse counselling for women with abnormal cervical cytology improves colposcopy and cytology follow up attendance rates. Author(s): Wilson JD, Hines B. Source: Sexually Transmitted Infections. 2000 August; 76(4): 322. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11026900&dopt=Abstract

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Office procedures. Colposcopy. Author(s): Ferris DG. Source: Primary Care. 1997 June; 24(2): 241-67. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9174038&dopt=Abstract

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On the need to screen for Chlamydia and gonorrhea infections prior to colposcopy in adolescents. Author(s): Harel Z, Riggs S. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 1997 August; 21(2): 87-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9248932&dopt=Abstract

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On-site colposcopy services in a family practice residency clinic: impact on physician test-ordering behavior, patient compliance, and practice revenue generation. Author(s): Prislin MD, Dinh T, Giglio M. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1997 July-August; 10(4): 259-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9228620&dopt=Abstract

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On-site colposcopy services. Author(s): Scarpinato L. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1998 January-February; 11(1): 80-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9456455&dopt=Abstract

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On-site colposcopy services. Author(s): Rodney WM. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1998 January-February; 11(1): 80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9456454&dopt=Abstract

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Operator variability in disease detection and grading by colposcopy in patients with mild dysplastic smears. Author(s): Sideri M, Schettino F, Spinaci L, Spolti N, Crosignani P. Source: Cancer. 1995 November 1; 76(9): 1601-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8635064&dopt=Abstract

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Outcome of colposcopy in women presenting with postcoital bleeding and negative or no cytology--results of a 1-year audit. Author(s): Jha S, Sabharwal S. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 May; 22(3): 299-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521505&dopt=Abstract

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Outcome of women referred to colposcopy for persistently inadequate smears. Author(s): Sen C, Brett MT. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 2000 February; 11(1): 38-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10714374&dopt=Abstract

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Overcoming unsatisfactory colposcopy. Use of osmotic dilators. Author(s): Borgatta L, Lopatinsky I, Shaw FM. Source: J Reprod Med. 1997 May; 42(5): 271-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9172116&dopt=Abstract

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Pap prior to colposcopy. Author(s): Koss LG. Source: Diagnostic Cytopathology. 2002 June; 26(6): 405; Author Reply 406. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12112834&dopt=Abstract

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Patient information: colposcopy. Author(s): Mazza D. Source: Aust Fam Physician. 1999 March; 28(3): 265. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10098306&dopt=Abstract

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Performance of cytology and colposcopy in diagnosis of cervical intraepithelial neoplasia (CIN) in HIV-positive and HIV-negative women. Author(s): Branca M, Rossi E, Alderisio M, Migliore G, Morosini PL, Vecchione A, Sopracordevole F, Mudu P, Leoncini L, Syrjanen K. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 2001 April; 12(2): 84-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11284952&dopt=Abstract

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Pitfalls in cervical colposcopy. Author(s): Powell JL. Source: Obstetrics and Gynecology Clinics of North America. 1993 March; 20(1): 177-88. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8392674&dopt=Abstract

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Positive cervical smear with subsequent normal colposcopy and histology--frequency of CIN in a long-term follow-up. Author(s): Hellberg D, Nilsson S, Valentin J. Source: Gynecologic Oncology. 1994 May; 53(2): 148-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8188072&dopt=Abstract

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Postcolposcopy management strategies for women referred with low-grade squamous intraepithelial lesions or human papillomavirus DNA-positive atypical squamous cells of undetermined significance: a two-year prospective study. Author(s): Guido R, Schiffman M, Solomon D, Burke L; ASCUS LSIL Triage Study (ALTS) Group. Source: American Journal of Obstetrics and Gynecology. 2003 June; 188(6): 1401-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824969&dopt=Abstract

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Predicting compliance with follow-up recommendations after colposcopy among indigent urban women. Author(s): Massad LS, Meyer PM. Source: Obstetrics and Gynecology. 1999 September; 94(3): 371-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10472862&dopt=Abstract

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Predicting nonattendance for colposcopy clinic follow-up after referral for an abnormal Pap smear. Author(s): Kavanagh AM, Simpson JM. Source: Aust N Z J Public Health. 1996 June; 20(3): 266-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8768416&dopt=Abstract

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Preparing for colposcopy. Author(s): Whall M. Source: Lippincott's Primary Care Practice. 1998 May-June; 2(3): 317-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9644449&dopt=Abstract

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Problem of the patient with the abnormal pap smear, in whom a colposcopy and an ECC is negative. Author(s): Townsend DE. Source: Gynecologic Oncology. 1995 January; 56(1): 148. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7821841&dopt=Abstract

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Prospective follow-up suggests similar risk of subsequent cervical intraepithelial neoplasia grade 2 or 3 among women with cervical intraepithelial neoplasia grade 1 or negative colposcopy and directed biopsy. Author(s): Cox JT, Schiffman M, Solomon D; ASCUS-LSIL Triage Study (ALTS) Group. Source: American Journal of Obstetrics and Gynecology. 2003 June; 188(6): 1406-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824970&dopt=Abstract

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Quality assurance in colposcopy using video capture and the internet for individual audit. Author(s): Brenner BN, Donoghue AM. Source: N Z Med J. 2000 February 11; 113(1103): 41-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11482332&dopt=Abstract

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Quality control for colposcopy in the Florence screening program for cervical cancer. Author(s): Cecchini S, Iossa A, Grazzini G, Bonardi R, Ciatto S. Source: Tumori. 1992 October 31; 78(5): 291-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1494802&dopt=Abstract

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Quality control of colposcopy. Author(s): Fattorini G. Source: Tumori. 2001 September-October; 87(5): S8-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765211&dopt=Abstract

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Quality of care by nurse practitioners delivering colposcopy services. Author(s): Hartz LE. Source: Journal of the American Academy of Nurse Practitioners. 1995 January; 7(1): 237. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7742063&dopt=Abstract

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Quality, access, and clinical issues in a nurse practitioner colposcopy outreach program. Author(s): Gifford MS, Stone IK. Source: The Nurse Practitioner. 1993 October; 18(10): 25-9, 33-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8233143&dopt=Abstract

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Reaction to videocolposcopy in the assessment of child sexual abuse. Author(s): Palusci VJ, Cyrus TA. Source: Child Abuse & Neglect. 2001 November; 25(11): 1535-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11766015&dopt=Abstract

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Reducing default from colposcopy clinics. Author(s): Fox R, Rogers C, Fielder H. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2003 March; 23(2): 215. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12751534&dopt=Abstract

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Regarding positive smears with normal colposcopy and the frequency of CIN. Author(s): Townsend DE. Source: Gynecologic Oncology. 1995 July; 58(1): 142-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7789883&dopt=Abstract

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Remote diagnosis of cervical neoplasia: 2 types of telecolposcopy compared with cervicography. Author(s): Ferris DG, Litaker MS, Macfee MS, Miller JA. Source: The Journal of Family Practice. 2003 April; 52(4): 298-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681091&dopt=Abstract

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Repeat cervical cytology at the time of colposcopy. Is there an added benefit? Author(s): Simsir A, Ioffe OB, Bourquin P, Brooks SE, Henry M. Source: Acta Cytol. 2001 January-February; 45(1): 23-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11213500&dopt=Abstract

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Repeat Pap smear at the time of initial colposcopy--another view. Author(s): Korman J. Source: Gynecologic Oncology. 1998 June; 69(3): 269-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9648601&dopt=Abstract

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Residency training in colposcopy: a survey of program directors in obstetrics and gynecology and family practice. Author(s): Spitzer M, Apgar BS, Brotzman GL, Krumholz BA. Source: American Journal of Obstetrics and Gynecology. 2001 August; 185(2): 507-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11518918&dopt=Abstract

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Retrospective audit of standards and quality in colposcopy services in a district hospital. Author(s): Shylasree T, Ashraf M, Jayawickrama N. Source: Journal of Quality in Clinical Practice. 2001 March-June; 21(1-2): 22-4; Discussion 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11422714&dopt=Abstract

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Risk factors for noncompliance in a colposcopy clinic. Author(s): Eger RR, Peipert JF. Source: J Reprod Med. 1996 September; 41(9): 671-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8887192&dopt=Abstract

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Role of colposcopy in the diagnosis and outpatient treatment of cervical intraepithelial neoplasia. Author(s): Tariq TA, Mason WP, Steele T. Source: J Pak Med Assoc. 1993 May; 43(5): 86-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8264081&dopt=Abstract

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Role of colposcopy in the examination of diethylstilbestrol-exposed women. Author(s): Noller KL. Source: Obstetrics and Gynecology Clinics of North America. 1993 March; 20(1): 165-76. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8332308&dopt=Abstract

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Safety analysis: relative risks of ultraviolet exposure from fluorescence spectroscopy and colposcopy are comparable. Author(s): Brookner CK, Agrawal A, Trujillo EV, Mitchell MF, Richards-Kortum RR. Source: Photochemistry and Photobiology. 1997 June; 65(6): 1020-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9188282&dopt=Abstract

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Screening for cervical abnormalities in women with anogenital warts in an STD clinic: an inappropriate use of colposcopy. Author(s): Coker R, Desmond N, Tomlinson D, Bretherton K, Byrne M. Source: International Journal of Std & Aids. 1994 November-December; 5(6): 442-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7849124&dopt=Abstract

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Screening for cervical cancer: experience from the Colposcopy Clinic at Harare Hospital. Author(s): Chirenje ZM, Akino V. Source: Cent Afr J Med. 1993 November; 39(11): 222-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8055551&dopt=Abstract

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Screening for high-grade cervical intra-epithelial neoplasia and cancer by testing for high-risk HPV, routine cytology or colposcopy. Author(s): Schneider A, Hoyer H, Lotz B, Leistritza S, Kuhne-Heid R, Nindl I, Muller B, Haerting J, Durst M. Source: International Journal of Cancer. Journal International Du Cancer. 2000 November 20; 89(6): 529-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11102899&dopt=Abstract

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Screening for human immunodeficiency virus and sexually transmitted diseases in an inner-city colposcopy clinic. Author(s): Dottino PR, Sperling R, Kee R. Source: The Mount Sinai Journal of Medicine, New York. 1993 September; 60(4): 327-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8232380&dopt=Abstract

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Should all women with cervical atypia be referred for colposcopy: a HARNET study. Harrisburgh Area Research Network. Author(s): Slawson DC, Bennett JH, Simon LJ, Herman JM. Source: The Journal of Family Practice. 1994 April; 38(4): 387-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8163964&dopt=Abstract

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Single and multiple exposure tolerance study of cellulose sulfate gel: a Phase I safety and colposcopy study. Author(s): Mauck C, Weiner DH, Ballagh S, Creinin M, Archer DF, Schwartz J, Pymar H, Lai JJ, Callahan M. Source: Contraception. 2001 December; 64(6): 383-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11834238&dopt=Abstract

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Survey of colposcopy practices by obstetrician/gynecologists. Author(s): Gordon P, Hatch K. Source: J Reprod Med. 1992 October; 37(10): 861-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1479569&dopt=Abstract

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Synthetic hygroscopic cervical dilator use in patients with unsatisfactory colposcopy. Author(s): McCord ML, Stovall TG, Summitt RL Jr, Lipscomb GH, Collins KW, Parsons LH. Source: Obstetrics and Gynecology. 1995 January; 85(1): 30-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7800319&dopt=Abstract

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Teaching residents humanistic skills in a colposcopy clinic. Author(s): Mao C. Source: Academic Medicine : Journal of the Association of American Medical Colleges. 2002 July; 77(7): 742. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12114162&dopt=Abstract

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Telecolposcopy - a feasibility study in primary care. Author(s): Etherington IJ. Source: Journal of Telemedicine and Telecare. 2002; 8 Suppl 2: 22-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12217121&dopt=Abstract

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Telemedicine marches on: the efficacy of remote telecolposcopy. Author(s): Susman J. Source: The Journal of Family Practice. 2003 April; 52(4): 264. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12718322&dopt=Abstract

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Ten years of colposcopy in Panama 1982-1992. Author(s): Garrido JL. Source: Clin Exp Obstet Gynecol. 1994; 21(2): 129-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8070117&dopt=Abstract

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The 1993 British Society for Colposcopy and Cervical Pathology/National Coordinating Network United Kingdom Colposcopy Survey. Comparison with 1988 and the response to introduction of guidelines. Author(s): Kitchener HC, Cruickshank ME, Farmery E. Source: British Journal of Obstetrics and Gynaecology. 1995 July; 102(7): 549-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7647057&dopt=Abstract

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The adequacy of cytology and colposcopy in diagnosing cervical neoplasia in HIVseropositive women. Author(s): Bernardes J. Source: Gynecologic Oncology. 1995 September; 58(3): 404-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7672712&dopt=Abstract

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The adequacy of cytology and colposcopy in diagnosing cervical neoplasia in HIVseropositive women. Author(s): Fink MJ, Fruchter RG, Maiman M, Kelly P, Sedlis A, Webber CA, Chen P. Source: Gynecologic Oncology. 1994 October; 55(1): 133-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7959254&dopt=Abstract

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The case for selective 'see and treat' in patients referred for colposcopy. Author(s): Gardeil F, Turner MJ. Source: International Journal of Std & Aids. 1995 November-December; 6(6): 418-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8845399&dopt=Abstract

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The clinician's view: role of human papillomavirus testing in the American Society for Colposcopy and Cervical Pathology Guidelines for the management of abnormal cervical cytology and cervical cancer precursors. Author(s): Cox JT; American Society for Colposcopy and Cervical Pathology. Source: Archives of Pathology & Laboratory Medicine. 2003 August; 127(8): 950-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12952506&dopt=Abstract

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The colposcopy unit. Instrumentation, colposcopic technique, recording of findings, and terminology. Author(s): Shier RM. Source: Obstetrics and Gynecology Clinics of North America. 1993 March; 20(1): 47-67. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8332311&dopt=Abstract

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The effect of directed biopsy on the atypical cervical transformation zone: assessed by digital imaging colposcopy. Author(s): Chenoy R, Billingham L, Irani S, Rollason TP, Luesley DM, Jordan JA. Source: British Journal of Obstetrics and Gynaecology. 1996 May; 103(5): 457-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8624320&dopt=Abstract

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The effect of local anaesthetic spray on the pain associated with local anaesthetic injection, prior to biopsy or loop diathermy to the cervix in the outpatient colposcopy clinic. Author(s): Connell RJ, Creighton SM, Cutner A. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2000 May; 107(5): 686-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10826586&dopt=Abstract

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The effect of time interval between referral and colposcopy on detection of human papillomavirus DNA and on outcome of biopsy. Author(s): Berkova Z, Kaufmann RH, Unger ER, Reeves WC, Adam E. Source: American Journal of Obstetrics and Gynecology. 2003 April; 188(4): 932-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12712088&dopt=Abstract

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The efficacy of telecolposcopy compared with traditional colposcopy. Author(s): Ferris DG, Macfee MS, Miller JA, Litaker MS, Crawley D, Watson D. Source: Obstetrics and Gynecology. 2002 February; 99(2): 248-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11814505&dopt=Abstract

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The feasibility of a one-stop colposcopy clinic in the management of women with low grade smear abnormalities: a prospective study. Author(s): Naik R, Abang-Mohammed K, Tjalma WA, Nordin A, de Barros Lopes A, Cross PA, Hemming JD, Monaghan JM. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 October; 98(2): 205-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11574132&dopt=Abstract

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The importance of colposcopy in the XXI century. Author(s): De Palo G. Source: Eur J Gynaecol Oncol. 2000; 21(3): 223-30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10949381&dopt=Abstract

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The performance of colposcopy for women with atypical and low-grade cervical cytologic abnormalities. Author(s): Massad LS. Source: Gynecologic Oncology. 1999 September; 74(3): 527. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10479525&dopt=Abstract

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The psychological impact of abnormal cytology and colposcopy. Author(s): Rogstad KE. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 April; 109(4): 364-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12013155&dopt=Abstract

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The psychological reaction of women to a colposcopy clinic. Author(s): Ford M. Source: British Journal of Obstetrics and Gynaecology. 1995 May; 102(5): 429. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7612544&dopt=Abstract

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The psychological reaction of women to a colposcopy clinic. Author(s): Mould TA, Rodgers ME, Singer A. Source: British Journal of Obstetrics and Gynaecology. 1995 May; 102(5): 428-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7612543&dopt=Abstract

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The psychological reaction of women to a colposcopy clinic. Author(s): Roberts RA, Blunt SM. Source: British Journal of Obstetrics and Gynaecology. 1994 September; 101(9): 751-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7677811&dopt=Abstract

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The role of colposcopy in modern gynecology. Author(s): Dexeus S, Cararach M, Dexeus D. Source: Eur J Gynaecol Oncol. 2002; 23(4): 269-77. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12214721&dopt=Abstract

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The role of early colposcopy in the management of females with first episode anogenital warts. Author(s): Ward KA, Houston JR, Lowry BE, Maw RD, Dinsmore WW. Source: International Journal of Std & Aids. 1994 September-October; 5(5): 343-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7819352&dopt=Abstract

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The technical performance and clinical feasibility of telecolposcopy. Author(s): Harper DM, Moncur MM, Harper WH, Burke GC, Rasmussen CA, Mumford MC. Source: The Journal of Family Practice. 2000 July; 49(7): 623-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10923572&dopt=Abstract

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The use of colposcopy in assessing vaginal irritation in research. Author(s): Mauck CK, Baker JM, Birnkrant DB, Rowe PJ, Gabelnick HL. Source: Aids (London, England). 2000 October 20; 14(15): 2221-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11089609&dopt=Abstract

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The utility of anoscopy and colposcopy in the evaluation of male sexual assault victims. Author(s): Ernst AA, Green E, Ferguson MT, Weiss SJ, Green WM. Source: Annals of Emergency Medicine. 2000 November; 36(5): 432-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054195&dopt=Abstract

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The value of colposcopy in genitourinary medicine. Author(s): Moss TR. Source: Genitourinary Medicine. 1995 December; 71(6): 417-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8566996&dopt=Abstract

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The value of colposcopy in genitourinary medicine. Author(s): Griffiths M. Source: Genitourinary Medicine. 1995 August; 71(4): 270. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7590729&dopt=Abstract

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The value of colposcopy in screening cervical carcinoma. Author(s): Pete I, Toth V, Bosze P. Source: Eur J Gynaecol Oncol. 1998; 19(2): 120-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9611048&dopt=Abstract

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The value of cytology and colposcopy in the follow up of cervical intraepithelial neoplasia after treatment by laser excision. Author(s): Mahadevan N, Horwell DH. Source: British Journal of Obstetrics and Gynaecology. 1993 June; 100(6): 563-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8334092&dopt=Abstract

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The value of primary colposcopy in genitourinary medicine. Author(s): Griffiths M. Source: Genitourinary Medicine. 1994 December; 70(6): 425-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7705863&dopt=Abstract

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The value of primary colposcopy in genitourinary medicine--a six year review. Author(s): Moss TR, Hawkswell J, Fogarty B, Dadswell C. Source: Genitourinary Medicine. 1994 June; 70(3): 191-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8039784&dopt=Abstract

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The value of repeat cervical cytology at the time of colposcopy. Author(s): Massad LS, Cejtin HE. Source: Gynecologic Oncology. 1998 February; 68(2): 216-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9514815&dopt=Abstract

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The value of repeat Pap smear at the time of initial colposcopy. Author(s): Spitzer M, Ryskin M, Chernys AE, Shifrin A. Source: Gynecologic Oncology. 1997 October; 67(1): 3-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9345348&dopt=Abstract

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Towards a more rational policy for colposcopy. Author(s): Camilleri-Ferrante C, Camilleri AP. Source: Public Health. 1992 September; 106(5): 401-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1410226&dopt=Abstract

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Training in colposcopy: experience with a videocolposcopy test. Author(s): Cecchini S, Bonardi R, Grazzini G, Iossa A, Cianferoni L, Scuderi A, Rossi R, Spaggiari G, Pane A, Ciatto S. Source: Tumori. 1997 May-June; 83(3): 650-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9267481&dopt=Abstract

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Triage of atypical squamous cells of undetermined significance with hybrid capture II: colposcopy and histologic human papillomavirus correlation. Author(s): Lonky NM, Felix JC, Naidu YM, Wolde-Tsadik G. Source: Obstetrics and Gynecology. 2003 March; 101(3): 481-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12636951&dopt=Abstract

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Triage of patients with abnormal cervical smears in the absence of colposcopy. Author(s): Omigbodun AO, Thomas JO, Adewole IF, Ogunlusi ML. Source: Trop Geogr Med. 1993; 45(4): 157-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7694409&dopt=Abstract

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Triage of women with ASCUS and LSIL on Pap smear reports: management by repeat Pap smear, HPV DNA testing, or colposcopy? Author(s): Ferris DG, Wright TC Jr, Litaker MS, Richart RM, Lorincz AT, Sun XW, Borgatta L, Buck H, Kramer L, Rubin R. Source: The Journal of Family Practice. 1998 February; 46(2): 125-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9487318&dopt=Abstract

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Type-specific prevalence of human papillomavirus DNA among Jamaican colposcopy patients. Author(s): Rattray C, Strickler HD, Escoffery C, Cranston B, Brown C, Manns A, Schiffman MH, Palefsky JM, Hanchard B, Blattner WA. Source: The Journal of Infectious Diseases. 1996 March; 173(3): 718-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8627038&dopt=Abstract

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Use of speculoscopy in the evaluation of women with atypical Papanicolaou smears. Improved cost effectiveness by selective colposcopy. Author(s): Massad LS, Lonky NM, Mutch DG, Mann WJ, Blanco JS, Vasilev SA, Finan MA, Scotti RJ. Source: J Reprod Med. 1993 March; 38(3): 163-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8387595&dopt=Abstract

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Using history and colposcopy to select women for endocervical curettage. Results from 2,287 cases. Author(s): Massad LS, Collins YC. Source: J Reprod Med. 2003 January; 48(1): 1-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12611087&dopt=Abstract

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Validation of women's self-reported smoking status in a Sydney colposcopy clinic. Author(s): Donnelly NJ, Ward JE, Dalrymple C. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 2000 February; 40(1): 74-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10870785&dopt=Abstract

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Validity of colposcopy in the diagnosis of early cervical neoplasia--a review. Author(s): Olaniyan OB. Source: Afr J Reprod Health. 2002 December; 6(3): 59-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12685410&dopt=Abstract

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Validity of colposcopy to identify and grade squamous intraepithelial lesions among Venezuelan women. Author(s): Tremont-Lukats IW, Teixeira GM, Vasquez J, Hernandez D. Source: Eur J Gynaecol Oncol. 1997; 18(1): 57-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9061326&dopt=Abstract

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Variables influencing anxiety of patients with abnormal cervical smears referred for colposcopy. Author(s): Bekkers RL, van der Donck M, Klaver FM, van Minnen A, Massuger LF. Source: Journal of Psychosomatic Obstetrics and Gynaecology. 2002 December; 23(4): 257-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12520863&dopt=Abstract

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Visualization techniques (colposcopy, direct visual inspection, and spectroscopic and other visual methods). Summary of task force 7. Author(s): Wright TC Jr, Menton M, Myrtle JF, Chow C, Singer A. Source: Acta Cytol. 2002 September-October; 46(5): 793-800. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365209&dopt=Abstract

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When to suspect squamous cancer at colposcopy. Author(s): Wright VC. Source: The Nurse Practitioner. 2001 September; 26(9): 50-6, 59-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11577533&dopt=Abstract

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Who are the women who default from colposcopy clinics? Author(s): Usha Kiran TS, Jayawickrama NS. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 September; 22(5): 537-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521425&dopt=Abstract

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Who should have colposcopy? Author(s): Grimm KJ, Meadows SE. Source: The Journal of Family Practice. 2003 January; 52(1): 64-6; Discussion 66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540316&dopt=Abstract

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Women with human immunodeficiency virus infection and abnormal Papanicolaou smears: a prospective study of colposcopy and clinical outcome. Author(s): Adachi A, Fleming I, Burk RD, Ho GY, Klein RS. Source: Obstetrics and Gynecology. 1993 March; 81(3): 372-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8437789&dopt=Abstract

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Women's experiences in coping with abnormal Papanicolaou results and follow-up colposcopy. Author(s): Lauver DR, Baggot A, Kruse K. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1999 May-June; 28(3): 283-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10363540&dopt=Abstract

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

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

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

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

Colposcopy staging and treatment of papillomavirus infection of the cervix. Author(s): First Department of Gynecology, Medical Academy, Krakow, Poland. Source: Madej, J Basta, A Madej, J G Strama, M Clin-Exp-Obstet-Gynecol. 1992; 19(1): 349 0390-6663

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Single and multiple exposure tolerance study of cellulose sulfate gel: a Phase I safety and colposcopy study. Author(s): CONRAD Program, Arlington, VA, USA. [email protected] Source: Mauck, C Weiner, D H Ballagh, S Creinin, M Archer, D F Schwartz, J PyMarch, H Lai, J J Callahan, M Contraception. 2001 December; 64(6): 383-91 0010-7824

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

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

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

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

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

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

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

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

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

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

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

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

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

Nutrition

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

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

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

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

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

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

A randomized, double blind, Phase III trial using oral beta-carotene supplementation for women with high-grade cervical intraepithelial neoplasia. Author(s): Keefe KA, Schell MJ, Brewer C, McHale M, Brewster W, Chapman JA, Rose GS, McMeeken DS, Lagerberg W, Peng YM, Wilczynski SP, Anton-Culver H, Meyskens FL, Berman ML. Source: Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. 2001 October; 10(10): 1029-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11588128&dopt=Abstract

•

External genital warts: diagnosis, treatment, and prevention. Author(s): Wiley DJ, Douglas J, Beutner K, Cox T, Fife K, Moscicki AB, Fukumoto L.

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Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 October 15; 35(Suppl 2): S210-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353208&dopt=Abstract •

Family physicians and first-trimester abortion: a survey of residency programs in southern California. Author(s): Lerner D, Taylor F. Source: Family Medicine. 1994 March; 26(3): 157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8026660&dopt=Abstract

•

Genitoanal papillomavirus infection: diagnostic and therapeutic objectives in the light of current epidemiological observations. Author(s): von Krogh G. Source: International Journal of Std & Aids. 1991 November-December; 2(6): 391-404. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1782228&dopt=Abstract

•

Gynecological health screening by means of questionnaire and cytology. Author(s): Kauraniemi T. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1969; : Suppl 4: 1-224. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5393669&dopt=Abstract

•

High risk HPV persists after treatment of genital papillomavirus infection but not after treatment of cervical intraepithelial neoplasia. Author(s): Strand A, Wilander E, Zehbe I, Rylander E. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1997 February; 76(2): 140-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9049287&dopt=Abstract

•

Human papillomavirus infection of the vagina. Author(s): Smotkin D. Source: Clinical Obstetrics and Gynecology. 1993 March; 36(1): 188-94. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7679617&dopt=Abstract

•

Is transcutaneous electrical nerve stimulation of any value during cervical laser treatment? Author(s): Crompton AC, Johnson N, Dudek U, Batra N, Tucker A. Source: British Journal of Obstetrics and Gynaecology. 1992 June; 99(6): 492-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1637766&dopt=Abstract

•

Office gynecology. Author(s): Weed JC.

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Source: Postgraduate Medicine. 1972 October; 52(4): 123-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5070951&dopt=Abstract •

Prevention of cervix cancer. Author(s): Rock CL, Michael CW, Reynolds RK, Ruffin MT. Source: Critical Reviews in Oncology/Hematology. 2000 March; 33(3): 169-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10789491&dopt=Abstract

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Quality, access, and clinical issues in a nurse practitioner colposcopy outreach program. Author(s): Gifford MS, Stone IK. Source: The Nurse Practitioner. 1993 October; 18(10): 25-9, 33-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8233143&dopt=Abstract

•

Results of topical treatment of HPV infection in the uterine cervix using interferon beta, 13-cis-retinoic acid and TFX. Author(s): Markowska J, Nowak M, Niecewicz R, Breborowicz J, Wiese E, Zengteler G. Source: Eur J Gynaecol Oncol. 1994; 15(1): 65-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8206074&dopt=Abstract

•

The use of music to reduce anxiety for patients undergoing colposcopy: a randomized trial. Author(s): Chan YM, Lee PW, Ng TY, Ngan HY, Wong LC. Source: Gynecologic Oncology. 2003 October; 91(1): 213-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14529684&dopt=Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to colposcopy; 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 Cervical Dysplasia 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. BOOKS ON COLPOSCOPY Overview This chapter provides bibliographic book references relating to colposcopy. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on colposcopy 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 “colposcopy” (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 colposcopy: •

General Practitioner's Guide to Genitourinary Medicine and Sexual Health Source: Cambridge, England: Cambridge University Press. 1996. 107 p. Contact: Available from Cambridge University Press. 40 West 20th Street, New York, NY 10011-4211. (800) 872-7423. Fax (212) 691-3239. PRICE: $29.95. ISBN: 0521556562. Summary: This illustrated text provides general practitioners with guidelines for diagnosing and managing the many common genitourinary and sexual health problems seen in general practice. The author provides a symptom-oriented approach. Early chapters provide advice on how to take a patient's sexual history and on indications for referral. Seventeen topical chapters cover bacterial vaginosis; candidiasis; other causes of vaginal discharge; a general approach to the management of vaginal discharge; vulval problems; frequency dysuria syndrome; pelvic pain; cytology and colposcopy; contraception and genital tract infection; dysuria in young men; prostatitis, prostatodynia, and hematospermia; scrotal pain; penile rashes; genital ulceration;

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genital 'lumps'; genital irritation; human immunodeficiency virus (HIV) infection; and genital problems in children. The text is illustrated throughout with black and white photographs; in addition, a section of full-color plates is included. A subject index concludes the volume. 9 references. (AA-M).

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “colposcopy” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “colposcopy” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “colposcopy” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

A Manual of Clinical Colposcopy by Thomas M. Julian, Valle; ISBN: 1850706395; http://www.amazon.com/exec/obidos/ASIN/1850706395/icongroupinterna

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A Practical Guide to Colposcopy (Oxford Medical Publications) by Pat Soutter, W. P. Soutter; ISBN: 0192624350; http://www.amazon.com/exec/obidos/ASIN/0192624350/icongroupinterna

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A Text and Atlas of Integrated Colposcopy by Malcolm Anderson, et al; ISBN: 0815101678; http://www.amazon.com/exec/obidos/ASIN/0815101678/icongroupinterna

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An Illustrated Guide to Integrated Colposcopy: For Colposcopists, Histopathologists and Cytologists (Medical Atlas Series 5) by M. Anderson, et al; ISBN: 0412384906; http://www.amazon.com/exec/obidos/ASIN/0412384906/icongroupinterna

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Atkinson's Correlative Atlas of Colposcopy, Cytology and Histopathology by Giuntoli; ISBN: 0397505892; http://www.amazon.com/exec/obidos/ASIN/0397505892/icongroupinterna

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Atlas of Colposcopy by Per Kolstad; ISBN: 0839117558; http://www.amazon.com/exec/obidos/ASIN/0839117558/icongroupinterna

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Atlas of Colposcopy: Based on the Original by G. Mestwerdt by A. Meier (Editor); ISBN: 0721662684; http://www.amazon.com/exec/obidos/ASIN/0721662684/icongroupinterna

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Cervical Pathology and Colposcopy (International Congress Series, No 644) by Soju Kurihana (Editor); ISBN: 0444806571; http://www.amazon.com/exec/obidos/ASIN/0444806571/icongroupinterna

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Color Atlas of Colposcopy (1990); ISBN: 4260141821; http://www.amazon.com/exec/obidos/ASIN/4260141821/icongroupinterna

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Color Atlas of Colposcopy by Hanskurt Bauer (1990); ISBN: 0896401820; http://www.amazon.com/exec/obidos/ASIN/0896401820/icongroupinterna

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Colposcopy (1986); ISBN: 0398037612; http://www.amazon.com/exec/obidos/ASIN/0398037612/icongroupinterna

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Colposcopy by José María Carrera; ISBN: 0721630502; http://www.amazon.com/exec/obidos/ASIN/0721630502/icongroupinterna

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Colposcopy for Primary Care: Textbook and Atlas by Erich, Md. Burghardt, et al; ISBN: 1588900924; http://www.amazon.com/exec/obidos/ASIN/1588900924/icongroupinterna

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Colposcopy in clinical practice by Louis Burke; ISBN: 080361425X; http://www.amazon.com/exec/obidos/ASIN/080361425X/icongroupinterna

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Colposcopy in Diagnosis and Treatment of Preneoplastic Lesions (1987); ISBN: 354017947X; http://www.amazon.com/exec/obidos/ASIN/354017947X/icongroupinterna

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Colposcopy in Diagnosis and Treatment of Preneoplastic Lesions by M. Coppleson (Editor), Hans-E Stegner; ISBN: 038717947X; http://www.amazon.com/exec/obidos/ASIN/038717947X/icongroupinterna

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Colposcopy of the Cervix, Vagina, and Vulva: A Comprehensive Textbook by Michael S. Baggish, Micheal Baggish (2003); ISBN: 0323018599; http://www.amazon.com/exec/obidos/ASIN/0323018599/icongroupinterna

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Colposcopy Package - Colposcopy Cd-Rom and Integrated Colposcopy by F. Sharp, et al (1997); ISBN: 0412792206; http://www.amazon.com/exec/obidos/ASIN/0412792206/icongroupinterna

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Colposcopy Text and Atlas by Louis Burke, et al; ISBN: 0838505236; http://www.amazon.com/exec/obidos/ASIN/0838505236/icongroupinterna

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Colposcopy, Cervical Pathology; ISBN: 0865771529; http://www.amazon.com/exec/obidos/ASIN/0865771529/icongroupinterna

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Colposcopy: A Scientific and Practical Approach to the Cervix, Vagina & Vulva in Health & Disease by Malcolm Coppleson, et al (1986); ISBN: 0398051534; http://www.amazon.com/exec/obidos/ASIN/0398051534/icongroupinterna

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Colposcopy: Management Options by Walter Prendiville (Editor), et al; ISBN: 0702024910; http://www.amazon.com/exec/obidos/ASIN/0702024910/icongroupinterna

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Colposcopy: Principles and Practice: An Integrated Textbook and Atlas by Barbara S. Apgar (Editor), et al; ISBN: 0721684947; http://www.amazon.com/exec/obidos/ASIN/0721684947/icongroupinterna

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Colposcopy-Cervical Pathology: Textbook and Atlas by Erich Burghardt, et al (1998); ISBN: 0865776342; http://www.amazon.com/exec/obidos/ASIN/0865776342/icongroupinterna

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Handbook of Colposcopy by David M. Luesley (Editor), et al (2002); ISBN: 0340806605; http://www.amazon.com/exec/obidos/ASIN/0340806605/icongroupinterna

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Handbook of Colposcopy Diagnosis and Treatment of Lower Genital Tractneoplasia and Hpv Infections by Kenneth Hatch; ISBN: 0316350281; http://www.amazon.com/exec/obidos/ASIN/0316350281/icongroupinterna

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Integrated Colposcopy: For Colposcopists, Histopathologists, and Cytologists by Malcom Anderson, et al; ISBN: 041270840X; http://www.amazon.com/exec/obidos/ASIN/041270840X/icongroupinterna

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Lower Genital Tract Precancer: Colposcopy, Pathology and Treatment by Albert Singer, et al; ISBN: 0632047690; http://www.amazon.com/exec/obidos/ASIN/0632047690/icongroupinterna

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Manual of Microcolposcopy (1989); ISBN: 0444810021; http://www.amazon.com/exec/obidos/ASIN/0444810021/icongroupinterna

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Manual of Microcolposcopy (Gynecologic Endoscopy, Vol 1) by Thierry Vancaillie; ISBN: 0444810587; http://www.amazon.com/exec/obidos/ASIN/0444810587/icongroupinterna

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Recent Advances in Cervical Pathology and Colposcopy (Advances in Gynecological Research, Vol 3) by Luigi Carenza, et al (1992); ISBN: 1850703752; http://www.amazon.com/exec/obidos/ASIN/1850703752/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “colposcopy” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:8 •

Atlas of colposcopy Author: Kolstad, Per.; Year: 1963; Oslo: Universitetsforlaget; Baltimore: University Park Press, c1977; ISBN: 0839111096 http://www.amazon.com/exec/obidos/ASIN/0839111096/icongroupinterna

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Atlas of colposcopy [by] Per Kolstad [and] Adolf Stafl. Author: Kolstad, Per.; Year: 1969; Baltimore, University Park Press [c1972]; ISBN: 0839105371 http://www.amazon.com/exec/obidos/ASIN/0839105371/icongroupinterna

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Cervical pathology and colposcopy: selected papers from the second World Congress of Cervical Pathology and Colposcopy Author: Jordan, Joseph A.; Year: 1965; Stuttgart: Thieme; [Littleton] Mass.: PSG Pub. Co., 1978; ISBN: 0884162419

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Color atlas of colposcopy Author: Bauer, Hanskurt.; Year: 1978; New York: IgakuShoin, c1979; ISBN: 089640031X http://www.amazon.com/exec/obidos/ASIN/089640031X/icongroupinterna

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Colposcopy; a scientific and practical approach to the cervix in health and disease, by Malcolm Coppleson, Ellis Pixley [and] Bevan Reid. Author: Coppleson, Malcolm.; Year: 1971; Springfield, Ill., Thomas [c1971]

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Introduction to colposcopy; a diagnostic aid in benign and preclinical cancerous lesions of the cervix uteri. Cooperating in pathology: William E. Jaques. Author: Bolten, Karl A.; Year: 1972; New York, Grune; Stratton, 1960

8

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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Lower genital tract precancer: colposcopy, pathology, and treatment Author: Singer, Albert.; Year: 1978; Boston: Blackwell Scientific, 1994; ISBN: 0865422303 http://www.amazon.com/exec/obidos/ASIN/0865422303/icongroupinterna

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Practical colposcopy Author: Cartier, René,; Year: 1977; Stuttgart; New York: Fischer, 1984; ISBN: 3437109480

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

Diagnosing Interstitial Cystitis Source: in Moldwin, R.M. Interstitial Cystitis Survival Guide: Your Guide to the Latest Treatment Options and Coping Strategies. Oakland, CA: New Harbinger Publications, Inc. 2000. p. 9-34. Contact: Available from Interstitial Cystitis Association. 51 Monroe Street, Suite 1402, Rockville, MD 20850. (800) HELP-ICA or (301) 610-5300. Fax (301) 610-5308. E-mail: [email protected]. Website: www.ichelp.org. PRICE: $12.00 plus shipping and handling. ISBN: 1572242108. Summary: More than 700,000 Americans have interstitial cystitis (IC), a condition that includes symptoms of recurring bladder pain and discomfort on urination. This chapter on the diagnosis of IC is from a self care book designed to empower readers by simplifying the diagnostic and treatment process for IC. The primary object of the book is to build a framework for delivering proper care to the IC patient. IC is a disease recognized by its symptoms; there are no specific blood or urine tests that firmly tell a clinician whether IC is present or not. The physician reviews the patient's medical history, the physical exam, and other tests designed to make sure that no other disease is present that might cause identical symptoms. The author reviews the list of questions that the doctor may ask at the initial visit, as well as the reasons the questions are asked. These questions include the presence of blood in the urine, a history of bladder infections, the presence of burning on urination, personal or family history of kidney stones, history of sexually transmitted disease, the presence of urinary leakage, the duration of symptoms, the type of pain present and how it changes through the day and night, the role of stress in symptoms, the impact of foods or beverages on the symptoms, sleep disturbance, the use of vaginal douches or other products, painful sexual intercourse, and the urine flow. The chapter then describes what patients can expect during the physical examination and the tests that may be used to diagnosis IC. Tests discussed include urinalysis, urine culture and sensitivity, urine cytology (cell examination), special cultures, the pelvic ultrasound exam, intravenous pyelogram (IVP), urodynamic evaluation (the function of the lower urinary tract during urination), the post void volume assessment (PVR), the cystometrogram (CMG), colposcopy, laparoscopy, cystoscopy, cystoscopy with hydrodistention of the bladder, bladder biopsy, potassium sensitivity test, the response to anesthetic distillation, and urine

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'markers' for diagnosis of IC. The chapter concludes with a description of the criteria for IC as established by the National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK). 5 figures. 2 tables.

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CHAPTER 5. MULTIMEDIA ON COLPOSCOPY Overview In this chapter, we show you how to keep current on multimedia sources of information on colposcopy. 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.

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 “colposcopy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on colposcopy: •

Gyn Manifestations: National Conference on Women and AIDS/HIV Infection; Washington, D.C., December 13 - 14, 1990 Contact: Triad Media Group, PO Box 778, Frederick, MD, 21701, (301) 663-1471. Summary: This sound recording offers a presentation from the National Conference on Women and AIDS/HIV Infection held December 13-14, 1990, in Washington, D.C., that deals with gynecological manifestations of H uman immunodeficiency virus (HIV) infection. HIV is the cause of Acquired immunodeficiency syndrome (AIDS). The first speaker explains a variety of fungal infections and treatment for them. The second speaker discusses human papilloma virus and its connection with cervical neoplasia. Pap smears should be done frequently on women who are HIV positive because of the possible increased risk of cervical cancer. Colposcopy is seen as an increasingly necessary diagnostic tool for such women. The next speaker analyzes the carcinogenicity of Azidothymidine (AZT) in rats and mice. It appears to increase substantially the number of malignant vaginal tumors. The final speaker describes Sexually transmitted disease (STD) manifestations in women with HIV.

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Bibliography: Multimedia on Colposcopy The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in colposcopy (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on colposcopy: •

Advanced colposcopy [electronic resource] Source: American Society for Colposcopy and Cervical Pathology, American College of Obstetricians and Gynecologists; Year: 2002; Format: Electronic resource; Washington, DC: ACOG/ASCCP, c2002

•

Colposcopy [videorecording] Source: CME Conference Video, Inc.; sponsored by National Procedures Institute; Year: 1994; Format: Videorecording; Mt. Laurel, NJ: CME Conference Video, 1994

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Colposcopy [videorecording]: the wizard of os Source: produced by the Department of Planning and Extramural Programs, University of Texas System Cancer Center M.D. Anderson Hospital and Tumor Institute; Year: 1983; Format: Videorecording; Houston, Tex.: Gulf Pub. Co., Video, [1983]

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Comprehensive review of colposcopy 1996 [electronic resource] Source: authors, Charles J. Dunton, Thomas V. Sedlacek; American Society for Colposcopy and Cervical Pathology; the American College of Obstetricians and Gynecologists; Year: 1996; Format: Electronic resource; Washington, D.C.: The College and the Society, c1996

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Kolposkopie [slide] = Colposcopy = Colposcopie Source: [by Stefan Seidl]; Year: 1980; Format: Slide; Basel: ROCOM, c1980

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Role of colposcopy in lower generative tract pathology [videorecording] Source: Academy of Health Sciences; Year: 1975; Format: Videorecording; Fort Sam Houston, Tex.: The Academy: [for loan by its Health Sciences Media Division, 1975]

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

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

Some practices can delay colposcopy for women with normal Pap, positive speculoscopy Source: Reuters Medical News Date: March 02, 2000

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Colposcopy, Not Repeat Pap, Urged for Low-Grade Cervical Dysplasias Source: Reuters Medical News Date: February 12, 1998

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Colposcopy Unnecessary For Low-Grade Pap Abnormalities During Pregnancy Source: Reuters Medical News Date: September 19, 1997

•

Repeat Pap Smear Plus HPV DNA Test Circumvents Need For Colposcopy After Abnormal Cytology Findings Source: Reuters Medical News Date: February 08, 1995 The NIH

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

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79

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 “colposcopy” (or synonyms).

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

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APPENDICES

83

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 Institute9: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

9

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.10 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:11 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

10

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). 11 See http://www.nlm.nih.gov/databases/databases.html.

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•

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

•

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

The NLM Gateway12 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.13 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “colposcopy” (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 4547 166 26 145 4 4888

HSTAT14 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.15 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.16 Simply search by “colposcopy” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

12

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

13

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). 14 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 15 16

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 Biologists17 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.18 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.19 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

17 Adapted 18

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

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 19 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 colposcopy 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 colposcopy. 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 colposcopy. 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 “colposcopy”:

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•

Other guides AIDS and Infections http://www.nlm.nih.gov/medlineplus/aidsandinfections.html Cervical Cancer http://www.nlm.nih.gov/medlineplus/cervicalcancer.html Female Sexual Dysfunction http://www.nlm.nih.gov/medlineplus/femalesexualdysfunction.html HPV http://www.nlm.nih.gov/medlineplus/hpv.html Vaginal Cancer http://www.nlm.nih.gov/medlineplus/vaginalcancer.html Vaginal Diseases http://www.nlm.nih.gov/medlineplus/vaginaldiseases.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on colposcopy. 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: •

Do I have cancer of the cervix? Source: Rockville, MD: Office of Population Affairs, U.S. Department of Health and Human Services. 1994. 2 pp. Contact: Available from U.S. Office of Population Affairs Clearinghouse, P.O. Box 30686, Bethesda, MD 20824-0686. Telephone: (301) 654-6190 / fax: (301) 215-7731 / Web site: http://dhhs.gov/progorg/opa/. Available at no charge. Summary: This brochure is designed for women with abnormal Pap smears. It explains the meaning of the results and management alternatives. It includes a section for recording biopsy and Pap smear results and the date the next test is due. It was developed by grantees and technical consultants in Public Health Service Region X with support from the U.S. Office of Population Affairs. It was reviewed by Title X family planning clinicians; nurse practitioners and physicians attending colposcopy training; and Title X client focus groups. The reading level has been kept as low as possible, while still maintaining accuracy.

Patient Resources

•

91

HPV and Cervical Cancer Screening Contact: American Social Health Association, PO Box 13827, Research Triangle Park, NC, 27709, (919) 361-8400. Summary: This brochure presents women with information about the human papillomavirus (HPV) and its relationship to cervical cancer. HPV includes a group of viruses generally known to cause warts on the body. Genital HPV types are sexually transmitted and cause genital warts or cause cell changes on the cervix that increase a woman's risk for cervical cancer. The brochure makes recommendations about how to cope with and prevent HPV. HPV is generally detected using a Pap smear. When Pap smears detect abnormal cells, further exams are usually needed such as a biopsy, colposcopy, or endocervical curettage. The types of HPV that cause genital warts are categorized by their risks for cervical cancer. The brochure provides a table to help individuals understand the meaning of their Pap smear results. The HPV testing process is discussed. Some of the options available to women to help them to manage growths of genital warts include cryosurgery, laser removal, electro-cauterization, and a cone biopsy. The brochure provides contact information for services from which individuals can learn more about HPV and other sexually transmitted diseases (STDs).

•

What is a Pap smear? Source: Rockville, MD: Office of Population Affairs, U.S. Department of Health and Human Services. 1994. 2 pp. Contact: Available from U.S. Office of Population Affairs Clearinghouse, P.O. Box 30686, Bethesda, MD 20824-0686. Telephone: (301) 654-6190 / fax: (301) 215-7731 / Web site: http://dhhs.gov/progorg/opa/. Available at no charge. Summary: This brochure provides general information on Pap smears, including what a Pap smear is, how to prevent cancer of the cervix, and how readers can use the Pap smear to protect themselves. It includes a section for recording test results and the date the next test is due. It was developed by grantees and technical consultants in Public Health Service Region X with support from the U.S. Office of Population Affairs. It was reviewed by Title X family planning clinicians; nurse practitioners and physicians attending colposcopy training; and Title X client focus groups. The reading level has been kept as low as possible, while still maintaining accuracy.

•

What You Should Know About Genital Warts and HPVs Contact: Channing L. Bete Company Incorporated, 200 State Rd, South Deerfield, MA, 01373-0200, (800) 477-4776, http://www.channing-bete.com. Summary: This brochure provides information about the sexually transmitted disease (STD), human papillomavirus (HPV), which causes genital warts. Genital warts are caused by viruses called HPVs and can vary in shape and location. HPVs have been linked to cervical cancer, anal cancer, and other cancers in both sexes and can cause problems during pregnancy. The brochure identifies those persons who are at risk for contracting HPV and indicates that warts usually appear within a few months of infection, although certain conditions may encourage their growth at a faster rate. The symptoms of HPV are identified. Individuals who have symptoms should see a physician or go to a clinic to get tested for this infection. Genital warts can be found during a physical exam or through a Pap test or a colposcopy. A health care provider may recommend drug treatments or removal procedures to treat the condition. Persons with HPV should notify their partner(s) immediately, keep the affected area dry, wear

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loose clothing, be patient during the treatment process, exercise, eat healthy foods, have regular checkups, and maintain good hygiene. Because of the health risks posed by HPV, regular Pap tests are recommended for women, and other tests may be necessary for men. To prevent HPV, individuals should practice sexual abstinence or use latex condoms. The brochure briefly differentiates between genital warts and herpes and discusses possible complications during pregnancy and delivery caused by genital warts and partner communication about genital warts. 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: •

Colposcopy Summary: A colposcopy is a way your doctor can examine your genitals, vagina and cervix closely. A colposcope is an instrument that shines a light on the cervix and magnifies the view for your doctor. Source: American Academy of Family Physicians http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6877 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 colposcopy. 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/

Patient Resources

•

93

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

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to colposcopy. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with colposcopy. 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 colposcopy. 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 “colposcopy” (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 “colposcopy”. 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 “colposcopy” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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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 “colposcopy” (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.20

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

20

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)21: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

21

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

Finding Medical Libraries

97

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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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

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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

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

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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

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

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

•

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

•

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

•

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

•

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

Finding Medical Libraries

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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

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

•

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

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

•

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

•

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

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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

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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

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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/

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

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

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

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

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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/

100 Colposcopy

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

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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

101

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 colposcopy: •

Basic Guidelines for Colposcopy Colposcopy - directed biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003913.htm

•

Signs & Symptoms for Colposcopy Wasting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003188.htm

•

Diagnostics and Tests for Colposcopy Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm Cervical biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003912.htm Cold cone biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003910.htm

102 Colposcopy

Pap smear Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003911.htm •

Background Topics for Colposcopy Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Cervix Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002317.htm Invasive Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002384.htm Vagina Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002342.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

103

COLPOSCOPY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 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] ACE: Angiotensin-coverting enzyme. A drug used to decrease pressure inside blood vessels. [NIH]

Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [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 (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] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent that is used to abolish the sensation of pain. [EU] 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]

104 Colposcopy

Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anogenital: Pertaining to the anus and external genitals. [EU] Anoscopy: A test to look for fissures, fistulae, and hemorrhoids. The doctor uses a special instrument, called an anoscope, to look into the anus. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C,

Dictionary 105

functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [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]

Benzocaine: A surface anesthetic that acts by preventing transmission of impulses along nerve fibers and at nerve endings. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH]

106 Colposcopy

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

Body 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] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

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] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] 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]

Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU]

Dictionary 107

Caustic: An escharotic or corrosive agent. Called also cauterant. [EU] Cauterization: The destruction of tissue with a hot instrument, an electrical current, or a caustic substance. [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] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervical intraepithelial neoplasia: CIN. A general term for the growth of abnormal cells on the surface of the cervix. Numbers from 1 to 3 may be used to describe how much of the cervix contains abnormal cells. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [NIH] Chancroid: Acute, localized autoinoculable infectious disease usually acquired through sexual contact. Caused by Haemophilus ducreyi, it occurs endemically almost worldwide, especially in tropical and subtropical countries and more commonly in seaports and urban areas than in rural areas. [NIH] Chemokines: Class of pro-inflammatory cytokines that have the ability to attract and activate leukocytes. They can be divided into at least three structural branches: C (chemokines, C), CC (chemokines, CC), and CXC (chemokines, CXC), according to variations in a shared cysteine motif. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chlamydia: A genus of the family Chlamydiaceae whose species cause a variety of diseases in vertebrates including humans, mice, and swine. Chlamydia species are gram-negative and produce glycogen. The type species is Chlamydia trachomatis. [NIH] Chlorhexidine: Disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by

108 Colposcopy

calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colposcope: A lighted magnifying instrument used for examination of the vagina and cervix. [NIH] Colposcopy: The examination, therapy or surgery of the cervix and vagina by means of a specially designed endoscope introduced vaginally. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH]

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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] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [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] Cone biopsy: Surgery to remove a cone-shaped piece of tissue from the cervix and cervical canal. Cone biopsy may be used to diagnose or treat a cervical condition. Also called conization. [NIH] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conization: The excision of a cone of tissue, especially of the cervix uteri. [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] Consumption: Pulmonary tuberculosis. [NIH] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [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] Cost-benefit: A quantitative technique of economic analysis which, when applied to

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radiation practice, compares the health detriment from the radiation doses concerned with the cost of radiation dose reduction in that practice. [NIH] Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results. [NIH] Cryosurgery: The use of freezing as a special surgical technique to destroy or excise tissue. [NIH]

Cryotherapy: Any method that uses cold temperature to treat disease. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Curettage: Removal of tissue with a curette, a spoon-shaped instrument with a sharp edge. [NIH]

Curette: A spoon-shaped instrument with a sharp edge. [NIH] Cutaneous: Having to do with the skin. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystitis: Inflammation of the urinary bladder. [EU] Cystometrogram: A line graph that records urinary bladder pressure at various volumes. [NIH]

Cystoscope: A thin, lighted instrument used to look inside the bladder and remove tissue samples or small tumors. [NIH] Cystoscopy: Endoscopic examination, therapy or surgery of the urinary bladder. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [NIH]

Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Deoxyribonucleic: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Deoxyribonucleic acid: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH]

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Deoxyribonucleotides: A purine or pyrimidine base bonded to a deoxyribose containing a bond to a phosphate group. [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] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diathermy: The induction of local hyperthermia by either short radio waves or highfrequency sound waves. [NIH] Diethylstilbestrol: DES. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digitalis: A genus of toxic herbaceous Eurasian plants of the Scrophulaceae which yield cardiotonic glycosides. The most useful are Digitalis lanata and D. purpurea. [NIH] Digitalization: The administration of digitalis in a dosage schedule designed to produce and then maintain optimal therapeutic concentrations of its cardiotonic glycosides. [EU] Dilator: A device used to stretch or enlarge an opening. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH] 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] Dosage schedule: A scheme set up to determine and regulate size, frequency and number of doses. [EU] Dose-limiting: Describes side effects of a drug or other treatment that are serious enough to prevent an increase in dose or level of that treatment. [NIH] Dosimetry: All the methods either of measuring directly, or of measuring indirectly and computing, absorbed dose, absorbed dose rate, exposure, exposure rate, dose equivalent, and the science associated with these methods. [NIH]

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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] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dysuria: Painful or difficult urination. [EU] Ecosystem: A dynamic complex of plant, animal and micro-organism communities and their non-living environment interacting as a functional unit. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electron microscope: A microscope (device used to magnify small objects) that uses electrons (instead of light) to produce an enlarged image. An electron microscopes shows tiny details better than any other type of microscope. [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] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [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] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocervical curettage: The scraping of the mucous membrane of the cervical canal using a

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spoon-shaped instrument called a curette. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family. [NIH] Fat: Total lipids including phospholipids. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH]

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Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gadolinium: An element of the rare earth family of metals. It has the atomic symbol Gd, atomic number 64, and atomic weight 157.25. Its oxide is used in the control rods of some nuclear reactors. [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] 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]

General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information

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about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [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] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Gynecology: A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Human papillomavirus: HPV. A virus that causes abnormal tissue growth (warts) and is often associated with some types of cancer. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation

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and certain anticancer drugs. [NIH] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Image Enhancement: Improvement of the quality of a picture by various techniques, including computer processing, digital filtering, echocardiographic techniques, light and ultrastructural microscopy, fluorescence spectrometry and microscopy, scintigraphy, and in vitro image processing at the molecular level. [NIH] Immaturity: The state or quality of being unripe or not fully developed. [EU] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

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

effects

of

foreign

Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunologic Factors: Biologically active substances whose activities affect or play a role in the functioning of the immune system. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] 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

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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]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intraepithelial: Within the layer of cells that form the surface or lining of an organ. [NIH] Intravenous: IV. Into a vein. [NIH] Intravenous pyelogram: IVP. A series of x-rays of the kidneys, ureters, and bladder. The xrays are taken after a dye is injected into a blood vessel. The dye is concentrated in the urine, which outlines the kidneys, ureters, and bladder on the x-rays. [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]

Invasive cervical cancer: Cancer that has spread from the surface of the cervix to tissue deeper in the cervix or to other parts of the body. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH]

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Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactobacillus: A genus of gram-positive, microaerophilic, rod-shaped bacteria occurring widely in nature. Its species are also part of the many normal flora of the mouth, intestinal tract, and vagina of many mammals, including humans. Pathogenicity from this genus is rare. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Lavage: A cleaning of the stomach and colon. Uses a special drink and enemas. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] 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] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH]

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Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] 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] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [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] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbicide: Any substance (gels, creams, suppositories, etc.) that can reduce transmission of sexually transmitted infections. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microscopy, Fluorescence: Microscopy of specimens stained with fluorescent dye (usually fluorescein isothiocyanate) or of naturally fluorescent materials, which emit light when exposed to ultraviolet or blue light. Immunofluorescence microscopy utilizes antibodies that are labeled with fluorescent dye. [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] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of

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a single species of immunoglobulin molecules. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [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] 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] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nonoxynol: Nonionic surfactant mixtures varying in the number of repeating ethoxy (oxy-

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1,2-ethanediyl) groups. They are used as detergents, emulsifiers, wetting agents, defoaming agents, etc. Nonoxynol-9, the compound with 9 repeating ethoxy groups, is a spermatocide, formulated primarily as a component of vaginal foams and creams. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nurse Practitioners: Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [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] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH]

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Papillomavirus: A genus of Papovaviridae causing proliferation of the epithelium, which may lead to malignancy. A wide range of animals are infected including humans, chimpanzees, cattle, rabbits, dogs, and horses. [NIH] Parturition: The act or process of given birth to a child. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Perceived risk: Estimate or evaluation of risk as observed through personal experience or personal study, and personal evaluation of consequences. [NIH] 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] Peripheral blood: Blood circulating throughout the body. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Photodynamic therapy: Treatment with drugs that become active when exposed to light. These drugs kill cancer cells. [NIH] Photosensitizer: A drug used in photodynamic therapy. When absorbed by cancer cells and exposed to light, the drug becomes active and kills the cancer cells. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Pilot study: The initial study examining a new method or treatment. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid

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and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [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] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [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]

Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] 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] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo

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transfer or fertilization in vitro. [NIH] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [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] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] 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] Prostatitis: Inflammation of the prostate. [EU] 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] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Pupil: The aperture in the iris through which light passes. [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] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the

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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] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] 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] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Receptivity: The condition of the reproductive organs of a female flower that permits effective pollination. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the

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extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Resected: Surgical removal of part of an organ. [NIH] Residual disease: Cancer cells that remain after attempts have been made to remove the cancer. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] 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] Retrospective: Looking back at events that have already taken place. [NIH] Reverse Transcriptase Polymerase Chain Reaction: A variation of the PCR technique in which cDNA is made from RNA via reverse transcription. The resultant cDNA is then amplified using standard PCR protocols. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] 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]

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Screening: Checking for disease when there are no symptoms. [NIH] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sexual Abstinence: Refraining from sexual intercourse. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [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] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sperm: The fecundating fluid of the male. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Spermicide: An agent that is destructive to spermatozoa. [EU] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Squamous: Scaly, or platelike. [EU] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH]

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Squamous intraepithelial lesion: SIL. A general term for the abnormal growth of squamous cells on the surface of the cervix. The changes in the cells are described as low grade or high grade, depending on how much of the cervix is affected and how abnormal the cells appear. [NIH]

Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] 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] Supplementation: Adding nutrients to the diet. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Systemic: Affecting the entire body. [NIH] Telomerase: Essential ribonucleoprotein reverse transcriptase that adds telomeric DNA to the ends of eukaryotic chromosomes. Telomerase appears to be repressed in normal human somatic tissues but reactivated in cancer, and thus may be necessary for malignant transformation. EC 2.7.7.-. [NIH]

Dictionary 129

Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Topical: On the surface of the body. [NIH] 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] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcutaneous: Transdermal. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translating: Conversion from one language to another language. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH]

130 Colposcopy

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] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [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] Urodynamic: Measures of the bladder's ability to hold and release urine. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginal Discharge: A common gynecologic disorder characterized by an abnormal, nonbloody discharge from the genital tract. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vaginosis: A condition caused by the overgrowth of anaerobic bacteria (e. g., Gardnerella vaginalis), resulting in vaginal irritation and discharge. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH]

Dictionary 131

Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Void: To urinate, empty the bladder. [NIH] Vulva: The external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] Wetting Agents: A surfactant that renders a surface wettable by water or enhances the spreading of water over the surface; used in foods and cosmetics; important in contrast media; also with contact lenses, dentures, and some prostheses. Synonyms: humectants; hydrating agents. [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] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH]

133

INDEX A Abdominal, 103, 107, 121 ACE, 18, 103 Adenocarcinoma, 30, 103 Adverse Effect, 103, 127 Agonist, 103, 120 Algorithms, 6, 103, 105 Alkaloid, 103, 120 Alleles, 18, 103 Alternative medicine, 78, 103 Amino Acids, 103, 124, 126, 129 Amplification, 34, 103 Anaerobic, 103, 130 Anaesthesia, 103, 116 Anaesthetic, 54, 103 Anal, 10, 91, 103 Analgesic, 103, 116 Anaphylatoxins, 104, 108 Anaplasia, 104 Annealing, 104, 123 Anogenital, 10, 51, 55, 104 Anoscopy, 10, 56, 104 Antibodies, 104, 118, 119 Antibody, 104, 108, 115, 116, 117, 119, 125, 127, 131 Antigen, 104, 108, 110, 115, 116, 117, 127 Antigen-Antibody Complex, 104, 108 Antigen-presenting cell, 104, 110 Anti-infective, 104, 107 Anti-inflammatory, 104, 116 Antioxidant, 104, 105 Anus, 15, 103, 104 Anxiety, 11, 14, 23, 25, 26, 58, 67, 104 Arterial, 104, 124 Arteries, 104, 106, 109, 119 Arterioles, 104, 106 Ascorbic Acid, 18, 104 Assay, 8, 10, 18, 105, 116 Atypical, 7, 25, 35, 38, 48, 53, 54, 57, 58, 105 Autoradiography, 12, 105 B Bacteria, 104, 105, 115, 118, 119, 123, 130 Bacterial Infections, 36, 105 Bacteriuria, 105, 130 Base, 105, 110, 111, 118, 129 Benign, 72, 105, 120, 121, 125, 131 Benzocaine, 24, 42, 105

Bewilderment, 105, 109 Bioavailability, 9, 105 Biochemical, 17, 103, 105 Biological response modifier, 105, 117 Biological Transport, 105, 111 Biomarkers, 18, 65, 105 Biopsy, 11, 12, 13, 14, 17, 18, 22, 25, 27, 28, 30, 38, 48, 53, 54, 73, 90, 91, 101, 105, 109 Biotechnology, 20, 72, 78, 85, 105 Bladder, 73, 105, 110, 117, 124, 126, 130, 131 Blood vessel, 103, 106, 113, 117, 129, 130 Blot, 18, 106 Body Fluids, 105, 106, 129 Bowel, 103, 106 Brachytherapy, 106, 117, 125, 131 Branch, 99, 106, 114, 122, 127, 129 Burns, 27, 106 Burns, Electric, 106 C Calcium, 106, 108 Candidiasis, 69, 106 Candidosis, 106 Capillary, 11, 106, 130 Carbon Dioxide, 14, 106, 126 Carcinogenic, 106, 121 Carcinoma, 11, 30, 56, 106 Cardiotonic, 106, 111 Carotene, 65, 106, 126 Causal, 10, 106 Caustic, 107 Cauterization, 38, 91, 107 Cellobiose, 107 Cellulose, 5, 15, 52, 62, 107, 114, 122 Cervical intraepithelial neoplasia, 7, 10, 25, 28, 30, 34, 35, 40, 44, 47, 48, 50, 56, 65, 66, 107 Cervix, 7, 12, 14, 19, 28, 30, 32, 35, 37, 54, 62, 67, 71, 72, 90, 91, 92, 102, 107, 108, 109, 117, 128 Cesarean Section, 14, 107 Chancroid, 10, 107 Chemokines, 5, 15, 107 Chemotactic Factors, 107, 108 Chlamydia, 19, 27, 46, 107 Chlorhexidine, 19, 107 Cholinergic, 107, 120 Chromosomal, 103, 107, 123

134 Colposcopy

Chromosome, 107, 118 Chronic, 107, 111, 117, 128 CIS, 67, 107, 126 Citrus, 104, 108 Clear cell carcinoma, 108, 111 Clinical Medicine, 108, 123 Clinical trial, 4, 11, 12, 17, 85, 108, 109, 124, 125 Cloning, 105, 108 Coenzyme, 105, 108 Cofactor, 108, 124 Colposcope, 15, 92, 108 Complement, 27, 104, 108, 109 Complementary and alternative medicine, 65, 68, 108 Complementary medicine, 65, 109 Computational Biology, 85, 109 Conception, 109, 113, 123, 128 Condoms, 92, 109 Cone, 14, 91, 101, 109, 128 Cone biopsy, 91, 101, 109 Confounding, 10, 14, 109 Confusion, 9, 109, 111 Congestion, 109, 113 Conization, 14, 21, 25, 33, 38, 109 Connective Tissue, 104, 109, 118, 126 Consumption, 109, 111, 126 Contraception, 13, 22, 52, 62, 69, 109 Contraceptive, 5, 22, 109 Contraindications, ii, 109 Controlled study, 12, 17, 109 Cornea, 11, 109 Coronary, 109, 119 Coronary Thrombosis, 109, 119 Cost-benefit, 22, 109 Cost-Benefit Analysis, 22, 110 Cryosurgery, 91, 110 Cryotherapy, 25, 110 Curative, 110, 129 Curettage, 110 Curette, 110, 113 Cutaneous, 106, 110 Cysteine, 107, 110 Cystitis, 73, 110 Cystometrogram, 73, 110 Cystoscope, 3, 110 Cystoscopy, 73, 110 Cytokine, 10, 13, 110 Cytotoxic, 13, 110, 125 D Data Collection, 110, 113 Databases, Bibliographic, 85, 110

Denaturation, 110, 123 Dendrites, 110, 120 Dendritic, 5, 10, 110 Dendritic cell, 5, 10, 110 Density, 12, 110, 121, 127 Deoxyribonucleic, 41, 110 Deoxyribonucleic acid, 41, 110 Deoxyribonucleotides, 110, 111 Dermal, 11, 111 Detergents, 111, 121 Developing Countries, 12, 111 Diagnostic procedure, 78, 111 Diathermy, 21, 54, 111 Diethylstilbestrol, 51, 111 Diffusion, 14, 105, 111 Digitalis, 111 Digitalization, 41, 111 Dilator, 52, 111 Direct, iii, 3, 10, 58, 108, 111, 125 Discrimination, 19, 111 Disease Progression, 111, 130 Disorientation, 109, 111 Disparity, 8, 111 Distal, 111, 124 Dosage schedule, 111 Dose-limiting, 10, 111 Dosimetry, 12, 111 Drug Interactions, 112 Drug Tolerance, 112, 129 Dysplasia, 4, 5, 14, 17, 21, 33, 68, 112 Dysuria, 69, 112 E Ecosystem, 32, 112 Effector, 108, 112 Efficacy, 5, 11, 15, 17, 18, 52, 54, 112 Electrolyte, 112, 123 Electron microscope, 12, 112 Electrons, 104, 105, 112, 125 Embryo, 112, 116, 123, 127 Embryo Transfer, 112, 124 Emulsion, 105, 112 Endocarditis, 106, 112 Endocervical curettage, 10, 37, 58, 91, 112 Endocrinology, 113, 115 Endoscope, 108, 113 Endoscopy, 31, 72, 113 Endothelial cell, 11, 113 Endotoxins, 108, 113 Environmental Health, 84, 86, 113 Enzymatic, 106, 108, 113, 123, 126 Enzyme, 103, 108, 112, 113, 123, 124, 129, 131

Index 135

Epidemiological, 66, 113 Epidermal, 113, 131 Epithelial, 11, 13, 15, 28, 35, 51, 103, 105, 113, 121 Epithelial Cells, 113 Epithelium, 15, 113, 117, 122 Erythema, 19, 113 Exogenous, 19, 113 External-beam radiation, 113, 117, 125, 131 F Family Planning, 85, 90, 91, 113 Family Practice, 21, 22, 25, 28, 29, 33, 36, 38, 40, 42, 45, 46, 50, 51, 52, 55, 57, 59, 113 Fat, 106, 113, 118, 126, 128 Fertilization in Vitro, 113, 124 Fetus, 107, 113, 127, 128, 130 Fluorescence, 6, 11, 51, 113 Focus Groups, 16, 90, 91, 113 Folate, 8, 18, 113, 114 Fold, 10, 16, 114 Folic Acid, 113, 114 Fungus, 106, 114 G Gadolinium, 5, 114 Gas, 106, 111, 114, 130 Gels, 18, 114, 119 Gene, 72, 103, 105, 114 General practitioner, 69, 114 Genetic testing, 114, 123 Genital, 11, 15, 40, 42, 65, 66, 69, 71, 72, 73, 91, 108, 114, 115, 130, 131 Genitourinary, 21, 26, 39, 56, 69, 114, 130 Gestation, 14, 114, 127 Glucose, 104, 107, 114 Glycogen, 107, 114 Gonorrhea, 10, 46, 114 Governing Board, 114, 123 Grade, 4, 5, 7, 13, 14, 17, 18, 20, 27, 37, 38, 44, 48, 51, 54, 58, 65, 78, 114, 115, 128 Grading, 19, 46, 114 Graft, 115 Gram-negative, 107, 115 Gram-positive, 115, 118 Growth, 91, 107, 111, 115, 117, 119, 120, 121, 122, 128 H Health Education, 16, 115 Hemorrhoids, 104, 115 Heredity, 114, 115 Herpes, 27, 92, 115

Herpes Zoster, 115 Histology, 12, 13, 32, 35, 41, 47, 115 Homologous, 103, 115, 128 Hormonal, 13, 32, 115 Hormone, 111, 115 Host, 18, 106, 115, 131 Humoral, 18, 115 Humour, 115 Hybrid, 5, 20, 34, 40, 57, 115 Hyperthermia, 111, 115 Hysterotomy, 107, 116 I Ibuprofen, 24, 116 Id, 62, 67, 92, 98, 100, 116 Image Enhancement, 18, 116 Immaturity, 13, 116 Immune response, 18, 104, 116, 131 Immune system, 104, 116, 118, 120, 130, 131 Immunity, 18, 116 Immunoassay, 18, 116 Immunodeficiency, 15, 22, 35, 51, 59, 70, 75, 116 Immunodeficiency syndrome, 75, 116 Immunologic, 7, 13, 107, 116, 125 Immunologic Factors, 13, 116 Implant radiation, 116, 117, 125, 131 In situ, 30, 116 In vitro, 5, 6, 15, 112, 116, 123, 127, 129 In vivo, 5, 6, 15, 116 Incision, 116, 117 Indicative, 4, 70, 116, 122, 130 Induction, 19, 111, 116 Infarction, 109, 116, 119 Infertility, 14, 117 Interferon, 10, 67, 117 Interferon-alpha, 117 Internal radiation, 117, 125, 131 Interstitial, 73, 106, 117, 131 Intestinal, 106, 117, 118 Intoxication, 117, 131 Intracellular, 117, 123 Intraepithelial, 8, 10, 17, 31, 36, 38, 48, 117 Intravenous, 12, 73, 117 Intravenous pyelogram, 73, 117 Invasive, 5, 6, 7, 12, 30, 35, 102, 116, 117, 118 Invasive cervical cancer, 6, 7, 117 Iris, 109, 117, 124 Irradiation, 12, 117, 131 K Kb, 84, 118

136 Colposcopy

Kidney stone, 73, 118 Kinetic, 8, 118 L Labile, 108, 118 Lactobacillus, 20, 118 Laparoscopy, 73, 118 Lavage, 18, 118 Lesion, 7, 13, 38, 118, 130 Leukocytes, 107, 117, 118 Library Services, 98, 118 Linkage, 14, 107, 118 Lipid, 19, 118 Localization, 11, 118 Localized, 107, 117, 118, 122, 123, 130 Loop, 14, 21, 26, 28, 33, 35, 38, 41, 54, 118 Lymph, 107, 113, 115, 118 Lymph node, 107, 118 Lymphatic, 117, 118 Lymphocyte, 4, 7, 13, 104, 118 Lymphocyte Count, 4, 118 M Magnetic Resonance Imaging, 5, 15, 118 Maintenance therapy, 4, 119 Malignancy, 119, 122 Malignant, 75, 103, 119, 120, 125, 128 MEDLINE, 85, 119 Membrane, 108, 112, 115, 119, 120, 121 Meta-Analysis, 29, 119 Metastasis, 119 MI, 35, 37, 102, 119 Microbe, 119, 129 Microbicide, 15, 19, 119 Microbiology, 15, 36, 105, 119 Microorganism, 108, 119, 131 Micro-organism, 112, 119, 122 Microscopy, 116, 119 Microscopy, Fluorescence, 116, 119 Modeling, 6, 119 Modification, 119, 124 Molecular, 40, 85, 87, 103, 105, 109, 116, 119 Molecule, 104, 105, 108, 112, 119, 123, 125, 129 Monoclonal, 117, 119, 125, 131 Mucosa, 3, 120 Myocardium, 119, 120 N Naive, 15, 120 NCI, 1, 7, 83, 108, 120 Necrosis, 116, 119, 120 Need, 3, 4, 13, 15, 37, 38, 46, 69, 73, 78, 93, 114, 120, 129

Neoplasia, 7, 10, 16, 17, 18, 23, 27, 28, 31, 34, 38, 48, 50, 51, 53, 58, 75, 120 Neoplasm, 120, 121 Neoplastic, 3, 35, 104, 120 Nerve, 66, 105, 110, 120, 128 Nerve Endings, 105, 120 Nerve Fibers, 105, 120 Nervous System, 120, 128 Neural, 115, 120 Neurons, 110, 120, 128 Neutrons, 117, 120, 125 Nicotine, 16, 17, 120 Nonoxynol, 22, 120 Nuclear, 112, 114, 120, 121 Nuclei, 112, 118, 120, 121 Nurse Practitioners, 9, 49, 90, 91, 121 O Observational study, 24, 121 Odds Ratio, 121, 125 Oncogenic, 5, 7, 8, 17, 121 Opacity, 110, 121 Organ Culture, 121, 129 Osmosis, 121 Osmotic, 47, 121 Outpatient, 50, 54, 121 Ovum, 114, 121 P Palliative, 121, 129 Pancreas, 103, 105, 121, 129 Papilloma, 30, 38, 75, 121 Papillomavirus, 6, 8, 16, 22, 23, 24, 28, 31, 34, 35, 36, 39, 40, 41, 48, 53, 54, 57, 62, 66, 91, 115, 122 Parturition, 121, 122 Pathogenesis, 7, 9, 15, 122 Pathologic, 4, 105, 106, 109, 122 Patient Compliance, 46, 122 Patient Education, 26, 90, 96, 98, 102, 122 Patient Satisfaction, 14, 122 Pelvic, 18, 69, 73, 122, 124 Penis, 109, 122 Perceived risk, 16, 122 Perception, 109, 122, 126 Peripheral blood, 13, 117, 122 Pharmaceutical Preparations, 107, 122 Pharmacologic, 122, 129 Photodynamic therapy, 122 Photosensitizer, 11, 122 Physical Examination, 73, 122 Physiology, 113, 115, 122 Pigments, 106, 122, 126 Pilot study, 16, 34, 122

Index 137

Plants, 103, 106, 108, 111, 114, 122, 129 Plaque, 107, 123 Plasma, 8, 18, 104, 123, 130 Plasmid, 10, 123 Platinum, 118, 123 Polymerase, 18, 40, 123 Polymerase Chain Reaction, 18, 40, 123 Polysaccharide, 104, 107, 123 Posterior, 103, 117, 121, 123 Potassium, 73, 123 Practice Guidelines, 86, 123 Precancerous, 6, 14, 123, 124 Preclinical, 72, 123 Precursor, 7, 112, 113, 123 Pregnancy Outcome, 14, 123 Premalignant, 36, 123, 124 Prevalence, 28, 57, 121, 124 Progression, 7, 8, 16, 17, 124 Progressive, 112, 115, 120, 124 Prospective study, 13, 18, 22, 45, 48, 54, 59, 124 Prostate, 105, 124, 129 Prostatitis, 69, 124 Protein S, 72, 105, 124, 126 Proteins, 103, 104, 106, 108, 119, 123, 124, 127, 129 Proteolytic, 108, 124 Protocol, 6, 124 Proximal, 3, 111, 124 Public Policy, 85, 124 Publishing, 20, 26, 124 Puerperium, 121, 124 Pupil, 109, 124 Q Quality of Life, 5, 14, 124 R Race, 8, 124 Radiation, 105, 110, 113, 115, 117, 124, 125, 131 Radiation therapy, 113, 117, 125, 131 Radio Waves, 111, 125 Radioactive, 105, 116, 117, 121, 125, 131 Radiolabeled, 117, 125, 131 Radiotherapy, 106, 117, 125, 131 Randomized, 7, 11, 12, 14, 16, 24, 38, 65, 67, 112, 125 Randomized clinical trial, 7, 11, 14, 125 Rape, 15, 28, 125 Receptivity, 14, 125 Receptor, 104, 109, 125 Rectum, 104, 114, 124, 125, 128 Recurrence, 8, 125

Refer, 1, 38, 108, 115, 118, 120, 125 Regimen, 112, 122, 125 Relative risk, 51, 125 Reliability, 21, 28, 125 Remission, 119, 125, 126 Renal pelvis, 118, 126 Reproduction Techniques, 123, 126 Resected, 10, 126 Residual disease, 33, 126 Respiration, 106, 126 Retinal, 109, 111, 126 Retrospective, 6, 14, 16, 22, 50, 126 Reverse Transcriptase Polymerase Chain Reaction, 13, 126 Rheumatism, 116, 126 Ribosome, 126, 129 Risk factor, 7, 8, 10, 40, 50, 124, 125, 126 Rod, 118, 126 S Schizoid, 126, 131 Schizophrenia, 126, 131 Schizotypal Personality Disorder, 126, 131 Screening, 6, 7, 13, 16, 25, 27, 28, 31, 33, 34, 36, 39, 40, 43, 45, 49, 51, 56, 66, 91, 108, 127, 130 Sediment, 127, 130 Self Care, 73, 127 Sequencing, 8, 123, 127 Serologic, 116, 127 Serology, 18, 127 Serum, 104, 108, 127 Sexual Abstinence, 92, 127 Sexually Transmitted Diseases, 26, 27, 51, 91, 127 Side effect, 103, 111, 127, 129 Skull, 127, 129 Social Environment, 124, 127 Solvent, 121, 127 Somatic, 115, 127, 128 Sound wave, 111, 127 Specialist, 93, 127 Species, 107, 115, 118, 120, 124, 127, 131 Specificity, 6, 16, 127 Sperm, 5, 18, 107, 127 Spermatozoa, 127 Spermicide, 18, 127 Spontaneous Abortion, 123, 127 Squamous, 7, 13, 16, 17, 22, 25, 29, 32, 33, 36, 38, 48, 57, 58, 59, 127, 128 Squamous cells, 7, 25, 48, 57, 127, 128 Squamous intraepithelial lesion, 7, 17, 22, 29, 32, 36, 48, 58, 128

138 Colposcopy

Staging, 62, 128 Standard therapy, 13, 128 Sterility, 117, 128 Stillbirth, 123, 128 Stimulus, 128, 129 Stomach, 103, 115, 118, 128 Strand, 66, 123, 128 Stress, 7, 73, 128 Subacute, 117, 128 Subclinical, 117, 128 Supplementation, 9, 65, 128 Suppositories, 119, 128 Surfactant, 120, 128, 131 Synaptic, 120, 128 Synaptic Transmission, 120, 128 Systemic, 11, 13, 106, 117, 125, 128, 131 T Telomerase, 41, 128 Temporal, 19, 129 Therapeutics, 129 Thermal, 120, 123, 129 Threshold, 4, 129 Thrombosis, 124, 129 Tissue Culture, 5, 129 Tolerance, 52, 62, 129 Topical, 11, 15, 19, 42, 67, 69, 107, 129 Toxic, iv, 111, 116, 120, 129 Toxicity, 10, 112, 129 Toxicology, 86, 129 Toxins, 104, 113, 117, 129 Transcriptase, 128, 129 Transcutaneous, 66, 129 Transfection, 105, 129 Translating, 6, 129 Translation, 15, 129 Triage, 5, 7, 13, 24, 34, 38, 48, 57, 129 Tumor marker, 105, 129 U Ulcer, 130 Ulceration, 69, 130 Unconscious, 116, 130 Ureters, 117, 118, 130

Urethra, 3, 122, 124, 130 Urinalysis, 73, 130 Urinary, 31, 39, 73, 105, 110, 114, 130 Urinary tract, 73, 105, 130 Urinate, 130, 131 Urine, 73, 105, 117, 118, 126, 130 Urodynamic, 73, 130 Urogenital, 114, 130 Uterus, 107, 116, 130 V Vaccine, 10, 13, 124, 130 Vagina, 66, 71, 92, 102, 106, 107, 108, 111, 116, 118, 130, 131 Vaginal, 4, 5, 15, 18, 19, 22, 31, 32, 55, 69, 73, 75, 90, 121, 130, 131 Vaginal Discharge, 69, 130 Vaginitis, 106, 130 Vaginosis, 13, 69, 130 Vascular, 116, 117, 130 VE, 19, 130 Vein, 117, 121, 130 Venous, 115, 124, 130 Venules, 106, 130 Veterinary Medicine, 85, 130 Viral, 5, 10, 15, 36, 38, 121, 130, 131 Viral Load, 38, 130 Virulence, 129, 131 Virus, 5, 10, 15, 18, 22, 27, 30, 35, 51, 59, 70, 75, 115, 117, 123, 130, 131 Vitro, 6, 131 Vivo, 6, 15, 131 Void, 73, 131 Vulva, 6, 31, 71, 131 W Warts, 39, 51, 55, 65, 91, 115, 131 Wetting Agents, 121, 131 White blood cell, 104, 118, 131 Withdrawal, 17, 131 X X-ray, 113, 117, 121, 125, 131 X-ray therapy, 117, 131

Index 139

140 Colposcopy

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